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BACKGROUND: There have been significant challenges in understanding functional brain connectivity associated with adolescent depression, including the need for a more comprehensive approach to defining risk, the lack of representation of participants from low- and middle-income countries, and the need for network-based approaches to model connectivity. The current study aimed to address these challenges by examining resting-state functional connectivity of frontolimbic circuitry associated with the risk and presence of depression in adolescents in Brazil. METHODS: Adolescents in Brazil ages 14 to 16 years were classified into low-risk, high-risk, and depressed groups using a clinical assessment and composite risk score that integrates 11 sociodemographic risk variables. After excluding participants with excessive head movement, resting-state functional magnetic resonance imaging data of 126 adolescents were analyzed. We compared group differences in frontolimbic network connectivity using region of interest-to-region of interest, graph theory, and seed-based connectivity analyses. Associations between self-reported depressive symptoms and brain connectivity were also explored. RESULTS: Adolescents with depression showed greater dorsal anterior cingulate cortex (ACC) connectivity with the orbitofrontal cortex compared with the 2 risk groups and greater dorsal ACC global efficiency than the low-risk group. Adolescents with depression also showed reduced local efficiency and a lower clustering coefficient of the subgenual ACC compared with the 2 risk groups. The high-risk group also showed a lower subgenual ACC clustering coefficient relative to the low-risk group. CONCLUSIONS: These findings highlight altered connectivity and topology of the ACC within frontolimbic circuitry as potential neural correlates and risk factors of developing depression in adolescents in Brazil. This study broadens our understanding of the neural connectivity associated with adolescent depression in a global context.

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Ample research has shown that the link between social skills and adolescent depression is significant. However, how the changes in different domains of social skills influence the change in depression from early to middle adolescence remains largely unknown. To address this gap in knowledge, the current research used longitudinal data from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development (N = 1061) to examine the influences of the changes in cooperation, assertion, responsibility, and self-control on the change in depression from early to middle adolescence. Univariate latent growth modeling showed that, from early to middle adolescence, adolescents experience decreases in cooperation and assertion, increases in responsibility and depression, and stability in self-control. Multivariate latent growth modeling suggested that adolescents who had more increases in responsibility and self-control tended to experience a slower increase in depression from early to middle adolescence; while adolescents who had more decreases in cooperation and assertion tended to experience a faster increase in depression from early to middle adolescence. The results suggested that promoting adolescents social skills might be particularly salient for the prevention of adolescent depression.

Investigaciones han demostrado que hay un vínculo significativo entre las habilidades sociales y la depresión en adolescentes. Sin embargo no se tiene mucha claridad sobre cómo los diferentes dominios de las habilidades sociales influyen en la depresión durante la adolescencia media y temprana. Para abordar este tema se tomaron datos del Estudio de Cuidado Infantil y Desarrollo Juvenil del Early Child Care and Youth Development (N = 1061) donde se evaluó la influencia de la cooperación, aprobación, responsabilidad y autocontrol sobre la depresión en esta población. El modelo de crecimiento latente univariado mostró que, desde la adolescencia temprana a la media, los adolescentes experimentan disminución en la cooperación y la aprobación, aumento en la responsabilidad y la depresión, y estabilidad en el autocontrol. El modelo sugirió que los adolescentes que tenían más aumento en la responsabilidad y en el autocontrol, tendían a experimentar un incremento más lento de la depression, desde la adolescencia temprana hasta la media; mientras que los que tenían disminución en la cooperación y en la aprobación tendían a experimentar un aumento más rápido de la depresión en esta misma etapa de la asdolescencia. Los resultados sugirieron que la promoción de las habilidades sociales de los adolescentes podría ser particularmente importante para la prevención de la depresión adolescente.

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This is a longitudinal randomized control trial on the impact of adding a parent psychoeducation intervention (TEPSI) as part of cognitive-behavioral therapy (CBT) for adolescents with Major Depressive Disorder (MDD) in a Puerto Rican sample. We tested the efficacy of adding 8 group sessions of TEPSI to 12 sessions of individual CBT on reducing depressive symptoms, MDD diagnosis, and improving family functioning. Participants (n = 121) were randomized to individual CBT with or without TEPSI. No main group effects were found for most patient domains including depression symptoms, as well as presence of adolescent's MDD diagnosis at posttreatment. Results did show a main effect of CBT over time for depression symptoms, suicide ideation, family criticism, and the presence of MDD diagnosis decreasing from pre- to postintervention. A year post treatment, almost 70% of adolescents in both conditions (CBT and CBT + TEPSI) remained in remission. A main effect was obtained for treatment in the adolescent's perception of familism and family emotional involvement. The primary hypothesis that family psychoeducation would optimize CBT for depression in adolescents was not supported. Both conditions yielded similar clinical end points. The culturally adapted CBT was found effective with Latino/a adolescents showing clinically significant improvements from pretreatment to posttreatment and remained stable at a 1-year follow-up. Regarding family outcomes, adolescents in CBT + TEPSI remained stable from pretreatment to posttreatment on family emotional involvement, while adolescents in CBT-alone showed an increase. The implication of these findings is discussed.

Este es un ensayo clínico longitudinal aleatorizado y controlado sobre el efecto de agregar una intervención psicoeducativa para los padres (TEPSI, en inglés) como parte de la terapia cognitivo-conductual (TCC) para adolescentes con trastorno depresivo mayor (TDM) en una muestra puertorriqueña. Evaluamos la eficacia de agregar 8 sesiones grupales de TEPSI a 12 sesiones de TCC individual en la reducción de síntomas depresivos, en el diagnóstico de TDM y en la mejora del funcionamiento familiar. Los participantes (n = 121) fueron distribuidos al azar a la TCC individual con o sin TEPSI. No se encontraron efectos grupales principales en la mayoría de las áreas de los pacientes, como en los síntomas de depresión ni en la presencia de un diagnóstico de TDM en los adolescentes después del tratamiento. Los resultados sí demostraron un efecto principal de la TCC con el tiempo para los síntomas de depresión, las ideas suicidas, la crítica familiar y la presencia de un diagnóstico de TDM que disminuye desde antes hasta después de la intervención. Un año después del final del tratamiento, casi el 70 % de los adolescentes en ambas condiciones (TCC y TCC + TEPSI) se mantuvo en remisión. Se obtuvo un efecto principal del tratamiento en la percepción de los adolescentes del familismo y la implicación emocional familiar. No se respaldó la hipótesis principal de que la psicoeducación familiar optimizaría la TCC para la depresión en los adolescentes. Ambas condiciones dieron variables clínicas similares. Se descubrió que la TCC culturalmente adaptada fue eficaz con los adolescentes latinos, ya que demostró mejoras clínicas considerables desde antes del tratamiento hasta después del tratamiento y permaneció estable un año después al momento del seguimiento. Con respecto a los resultados familiares, los adolescentes de la TCC + TEPSI se mantuvieron estables desde antes del tratamiento hasta después del tratamiento en la implicación emocional familiar, mientras que los adolescentes de la TCC sola demostraron un aumento. Se debaten las implicancias de estos resultados.

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ABSTRACT Objective: To explore the relationship between substance use and depressive symptomatology among adolescents in Colombia. Methods: Adolescents aged 13-19 years from a rural city in Colombia completed the Spanish version of the Alcohol, Smoking and Substance Involvement Screening Test and the Kutcher Adolescent Depression Scale-6 (KADS-6). Results: Regression analyses indicated that gender, having used cannabis, having used sedatives, and having a family member who used illegal drugs were predictive of higher symptom levels of depression according to KADS-6. Conclusion: The results of this study suggested that substance use was associated with depressive symptoms in this sample of Colombian adolescents.

RESUMEN Objetivo: Explorar la relación entre el uso de sustancias y la sintomatologia depresiva entre adolescentes en Colombia. Métodos: Los adolescentes de 13 a 19 años de una ciudad rural en Colombia completaron la versión en español de la Prueba de Detección de Alcohol, Tabaco y Sustancias (ASSIST, en inglés) y la Escala de Depresión pasa Adolescentes de Kutcher-6 (KADS-6, en inglés). Resultados: Los análisis de regresión indicaron que tanto el género, como el haber consumido cannabis, usado sedantes, y tener un miembro de la familia que usó drogas ilegales, fueron predictores de niveles más altos de sintomas depresivos de acuerdo con la escala KADS-6. Conclusión: Los resultados de este estudio sugirieron que el uso de sustancias estaba asociado con sintomas depresivos en esta muestra de adolescentes colombianos.

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Adolescent depression is a prevailing international mental health concern as up to 27% of adolescents experience either subsyndromal depression or a major depressive episode by the age of 18. Depression in adolescence has been found to negatively impact current and future academic achievement, functioning, mental health, and quality of life. Accordingly, the authors emphasize the importance of proactively preventing depression (and its negative outcomes) instead of waiting and having to "fix" the problems after they have already developed. The current article begins with a discussion of the various types of prevention, including their respective advantages and disadvantages. Further and more importantly, the article's primary focus is to provide a summary of the theoretical basis, development of, empirical support for, and content of a universal school-based cognitive-behavioral program to prevent adolescent depression entitled LARS&LISA (Lust An Realistischer Sicht & Leichtigkeit Im Sozialen Alltag). As the program exists within the overlapping realms of universal prevention, school-based programs, and cognitive-behavioral interventions, the content of this article is relevant to all three areas and offers insight into the development of depression prevention in general. Finally, empirical support for the positive effects of the program is presented and some ideas for further research are discussed.

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Abstract Adolescent depression is a prevailing international mental health concern as up to 27% of adolescents experience either subsyndromal depression or a major depressive episode by the age of 18. Depression in adolescence has been found to negatively impact current and future academic achievement, functioning, mental health, and quality of life. Accordingly, the authors emphasize the importance of proactively preventing depression (and its negative outcomes) instead of waiting and having to "fix" the problems after they have already developed. The current article begins with a discussion of the various types of prevention, including their respective advantages and disadvantages. Further and more importantly, the article's primary focus is to provide a summary of the theoretical basis, development of, empirical support for, and content of a universal school-based cognitive-behavioral program to prevent adolescent depression entitled LARS&LISA (Lust An Realistischer Sicht & Leichtigkeit Im Sozialen Alltag). As the program exists within the overlapping realms of universal prevention, school-based programs, and cognitive-behavioral interventions, the content of this article is relevant to all three areas and offers insight into the development of depression prevention in general. Finally, empirical support for the positive effects of the program is presented and some ideas for further research are discussed.

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INTRODUCTION: Adolescent depression is associated with serious consequences. School staff is in a unique position to screen and refer adolescents with depression in a timely manner, and can collaborate with healthcare teams to assist in the proper management of the disease. The objective of this paper is to describe the results of a workshop that aims to improve the knowledge of adolescent depression among school staff. MATERIALS AND METHODS: This was a single-arm trial with a pre-post design. Six workshops were conducted in four cities in Chile. Each workshop lasted 4 h. Participatory methodology was used. A 26-item knowledge questionnaire about adolescent depression, with the alternatives "I agree," "I disagree," and "I don't know," was administered to the participants, before and after the workshop. RESULTS: A total of 152 people participated in the trial. Of these, 74.3% were female, and 44.7% were school psychologists, 25.0%, teachers, 17.8%, school counselors, and 5.3%, social workers. On average, there were 69.6% (SD 21.3) correct responses on the initial test, and 91.8% (SD 8.0) on the final test. All items had an increase of correct answers and a decrease of "don't know" answers. There were notable increases of correct responses on statements dealing with myths: "Antidepressants for the treatment of depression in adolescents must be avoided because they produce dependence" (59-96%), and "Depression in adolescence is better defined as a weakness of character than as a disease" (75-95%). School psychologists scored higher than the other participants on the questionnaire both before and after the workshop. CONCLUSION: The workshop: "Adolescent depression: What can schools do?" can improve school staff knowledge of this topic, especially aiding to dispel myths regarding the disease and its treatment. This can help bring about timely case detection and improved collaboration with health team for proper handling of adolescent depression.

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Determinar la asociación entre la depresión y el consumo de sustancias psicoactivas en adolescentes. El estudio: Descriptivo, Transversal. Lugar: Chiclayo, Perú 2010. Muestra: trescientos setenta adolescentes, de ellos 110 mujeres y 260 varones. Intervenciones: Se encuestó a adolescentes, usando test auto aplicado de Zung y ENA. Para el análisis se utilizaron los programas: EPIDAT y SPSS. Hallazgos: El 99,73% de nuestra población presenta depresión. Manifestándose depresión leve en un 30,27 %, depresión modera 65,95 % y depresión grave 3,51%. Dentro del principal motivo para iniciar el consumo de drogas ilícitas es la curiosidad y del consumo de drogas lícitas es el placer. La principal droga consumida por adolescentes es el alcohol arrojando un porcentaje de 69,19%, el tabaco con un 33,24% y drogas ilícitas con un 8%. Conclusiones: No se encontró asociación entre los niveles de depresión y el consumo de sustancias psicoactivas. La principal droga consumida por adolescentes es el alcohol. El 8% de nuestra población está en riesgo de consumir drogas.(AU)

Objective: Establish the situation between the depression and the psychoactive substances consume as well known as drugs. The study: Transverse. City/Place: Chiclayo, Peru. 2010 Sample: Three hundred seventy teenagers, 110 female and 260 male. Interventions: We make a poll for the teenagers using the applied auto test from Zung and Zena. For the analysis we used programs: EPIDAT and SPSS. Findings: The 99.73% of our sample presents depression. Showing low grade of depression in a 30.27 %, mid grade of depression in a 65.95 % and high grade of depression in a 3.51%.The most common reason for consuming drugs is the pleasure and the curiosity of the nowaday's teenagers. The principal drug taken by teenagers is the alcohol with a 69.19%, the tobacco with a 33.24% and other kinds of illegal drugs with an 8%. Conclusions: We couldn't get an association between the depression levels and the psychoactive substances consuming. The most consumed drug for the teenagers is the alcohol. The 8% of our simple is in a consuming drug risk.(AU)

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Es de gran relevancia la investigación en prevención de depresión adolescente debido a su alta prevalencia y a las graves consecuencias asociadas. Los programas de prevención en depresión en adolescentes han sido diseñados principalmente en países desarrollados. En Chile la investigación en este tema está recién iniciándose. Las intervenciones preventivas se denominan universales cuando se aplican a toda la población, y específicas cuando se aplican a un grupo considerado de riesgo. El objetivo de este artículo es revisar las características que se han asociado a mayor eficacia de estos programas en otros países, discutiendo algunos elementos a considerar para su implementación en Chile. Los programas específicos producen tamaños de efecto mayores que los universales. Sin embargo, las intervenciones universales no deben desestimarse prematuramente, ya que tienen algunas ventajas teóricas y prácticas. Existe mayor eficacia en muestras con mayor proporción de mujeres y en adolescentes de mayor edad. Los programas implementados por profesionales de salud mental son más eficaces que los implementados por profesores, especialmente en el caso de los específicos. Se debe invertir esfuerzos en la investigación en: la necesidad de intervenir de manera diferencial de acuerdo a la edad y al género, los componentes activos que hacen que un programa sea efectivo, el costo-efectividad de estos programas, el uso de nuevas metodologías que incentiven a la participación, favorezcan la incorporación de conocimientos y la mantención de resultados.

Research in prevention of adolescent depression is highly relevant due to its high prevalence and seriously related consequences. Prevention programs in adolescent depression have been designed mainly in developed countries. In Chile, research on this topic is just beginning. Preventive interventions are called universal when they are applied to the entire population and targeted when they are applied to a group considered to be at risk. The aim of this paper is to review the features that have been associated with increased effectiveness of these programs in other countries and discussing some elements that have to be considered for their implementation in Chile. Specific programs produce larger effect sizes than universal. However, universal interventions should not be dismissed prematurely because they have some theoretical and practical advantages. There is greater efficacy in samples with higher proportion of women and older teens. The programs implemented by mental health professionals are more effective than those implemented by teachers, especially in the targeted prevention programs. It is necessary to invest research efforts in: the need to intervene differentially according to age and gender, the active components that make a program effective, cost-effectiveness of these programs, the use of new methodologies that encourage participation, promoting the incorporation of knowledge and the maintenance of long-term positive.

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El estudio consistió en una evaluación cualitativa de la versión piloto del taller “Yo Pienso, Yo Siento, Yo Actúo”. Este taller está destinado a prevenir la depresión en adolescentes y está basado en el enfoque cognitivo-conductual. La versión piloto fue realizada el 2008 en cuatro cursos de Primero Medio, correspondientes a dos colegios de la Comuna de San Bernardo. El objetivo del estudio fue conocer las percepciones de los estudiantes que participaron en el taller piloto sobre la experiencia vivida y sus sugerencias sobre posibles modificaciones al diseño, con la finalidad de generar insumos para elaborar la versión definitiva del taller. La metodología consistió en la realización de grupos focales en cada curso intervenido, centrados en la evaluación de los componentes fundamentales del taller. Los principales resultados fueron que los participantes realizaron una evaluación general positiva del taller, que les pareció acertada la metodología de trabajo grupal y que le asignaron una gran importancia al control disciplinario en las sesiones y al vínculo que establecieron con los monitores. Los aprendizajes más significativos fueron en relación a la técnica de resolución de problemas. El espacio del taller fue valorado también como instancia de comunicación y mejoría de las relaciones interpersonales en los cursos. Las principales conclusiones fueron que el taller muestra una buena aceptación por parte de los participantes, que es importante reforzar el manejo de la disciplina durante las sesiones y que se debe garantizar la calidad del vínculo con los monitores.

The study consisted of a qualitative assessment of the pilot version of the workshop “Yo Pienso, Yo Siento, Yo Actúo” (“I think, I feel, I do”). This workshop is intended to prevent depression in adolescents and is based on the cognitive-behavioral approach. The pilot version was carried out in 2008 in four classes of Primero Medio (ninth grade) in two schools of the San Bernardo borough. The objective of the study was to understand the perceptions of students who participated in the pilot workshop on their experience and their suggestions for changes to the design with the objective of generating inputs to produce the final version of the workshop. The methodology included conducting focus groups in each class involved, focusing on the evaluation of the main components of the workshop. The main results were that participants held an overall positive assessment of the workshop; they found group work methodology successful; they attributed great importance to disciplinary control during sessions and to the relationship established with the monitors. The most significant learning was related with the technique of solving problems. The workshop environment was also related as an instance of communication and improvement of interpersonal relationships within the classes. The main findings were that the workshop showed good acceptance by the participants; it is important to strengthen the management of discipline during the sessions and to ensure the quality of the relationship with the monitors.

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