New generation antidepressants for depression in children and adolescents: a network meta-analysis

CONCLUSIONS: Overall, methodological shortcomings of the randomised trials make it difficult to interpret the findings with regard to the efficacy and safety of newer antidepressant medications. Findings suggest that most newer antidepressants may reduce depression symptoms in a small and unimportant way compared with placebo. Furthermore, there are likely to be small and unimportant differences in the reduction of depression symptoms between the majority of antidepressants. However, our findings reflect the average effects of the antidepressants, and given depression is a heterogeneous condition, some individuals may experience a greater response. Guideline developers and others making recommendations might therefore consider whether a recommendation for the use of newer generation antidepressants is warranted for some individuals in some circumstances. Our findings suggest sertraline, escitalopram, duloxetine, as well as fluoxetine (which is currently the only treatment recommended for first-line prescribing) could be considered as a first option. Children and adolescents considered at risk of suicide were frequently excluded from trials, so that we cannot be confident about the effects of these medications for these individuals. If an antidepressant is being considered for an individual, this should be done in consultation with the child/adolescent and their family/caregivers and it remains critical to ensure close monitoring of treatment effects and suicide-related outcom...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Source Type: research

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CONCLUSIONS: Overall, there were significant methodological limitations across the trials included in this review. Given the moderate or very low quality of the available evidence, there is only uncertain evidence regarding a number of psychosocial interventions for adults who engage in SH. Psychosocial therapy based on CBT approaches may result in fewer individuals repeating SH at longer follow-up time points, although no such effect was found at the post-intervention assessment and the quality of evidence, according to the GRADE criteria, was low. Given findings in single trials, or trials by the same author group, both ...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Source Type: research
CONCLUSIONS: Given the moderate or very low quality of the available evidence, and the small number of trials identified, there is only uncertain evidence regarding a number of psychosocial interventions in children and adolescents who engage in SH. Further evaluation of DBT-A is warranted. Given the evidence for its benefit in adults who engage in SH, individual CBT-based psychotherapy should also be further developed and evaluated in children and adolescents.PMID:33677832 | DOI:10.1002/14651858.CD013667.pub2
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Source Type: research
DiscussionTo our knowledge, this is the first RCT of its kind to be conducted in France, and so far, there are no studies in the literature on group psychotherapy for the treatment of individuals who have attempted suicide. The outcomes will provide clear guidance for professionals to apply psychological intervention with suicide attempts. The protocol respects ethical principles, and ethical approval was obtained from the local ethics committee. The results will be disseminated through an original research published as original research in peer-reviewed manuscript, through a therapist manual for cognitive therapy, and pre...
Source: Trials - Category: Research Source Type: clinical trials
Authors: Campbell K, Lakeman R Abstract There is now compelling evidence that a range of psychotherapeutic treatments are effective in the treatment of borderline personality disorder (BPD). Such treatments are often lengthy, expensive, subject to high rates of incompletion and are rarely available to people with sub-threshold symptoms. There is broad agreement that some combination of vulnerability, invalidating environment, childhood adversity, disrupted attachment in childhood or trauma play a role in the aetiology of the syndrome of BPD. These factors also contribute to problems with the capacity to mentalise, ...
Source: Issues in Mental Health Nursing - Category: Nursing Tags: Issues Ment Health Nurs Source Type: research
ConclusionIntegrated CBT has promise for adolescents, DBT may be helpful for alcohol patients with borderline personality disorder and iDBT may be useful for the wider community with heavy alcohol use. However, given the paucity of studies and the exploratory nature of these trials, there is currently no strong evidence for an effective psychosocial intervention to reduce alcohol consumption and suicidal behaviour in adults with problematic alcohol use.
Source: Alcohol and Alcoholism - Category: Addiction Source Type: research
This study is the first of its kind to use a novel longitudinal qualitative methodology to directly compare family/carers earlier experiences supporting ARMS individuals to 12-months later. This provides a more ecologically valid insight into how perceptions change over time and how family/carers adapt. Semi-structured interviews were conducted with ten family/carers at two points within a 12-month period. This study was embedded within a randomised control trial, the Individual and Family Cognitive Behavioural Therapy (IFCBT) trial. Interview transcripts were analysed using thematic analysis, with a focus on how experienc...
Source: Clinical Psychology and Psychotherapy - Category: Psychiatry Tags: Clin Psychol Psychother Source Type: research
Conclusion: This is the first implementation of SocialMind, which is the first mindfulness-based social cognition training. It is well tolerated by participants with schizophrenia spectrum disorders, and a further randomized controlled trial is proposed for people who have suffered their first episode of psychosis within the past 5 years.Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT03434405.IntroductionPeople suffering from psychosis frequently find it difficult to establish or maintain relationships with others or to engage in community activities (1, 2). These deficits are present even in high-risk ...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
Conclusions: CBT, psychosocial intervention, supportive counseling, psychodynamic psychotherapy, and other psychological interventions can be recommended for clinical practice. More studies are needed, especially for non-CBT interventions and for all psychotherapies on negative symptoms.IntroductionSchizophrenia affects approximately 1% of the population, usually starting in adolescence or young adulthood, frequently leading to persistent disability, with a high risk of suicide (8%). Despite the advance in antipsychotics treatment, approximately 30% of patients with schizophrenia show a poor response or no response to anti...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
Conclusions: The findings from this exploratory study are consistent with the possibility that dialogue therapy may lead to improvements in symptoms and functioning compared to standard treatment in psychosis. Introduction Standard treatment (ST) for psychosis consists primarily of antipsychotics, hospitalization, social rehabilitation, and different types of supportive therapy (1–3). Antipsychotic drugs have only moderate effects on positive symptoms and no demonstrable effects on negative symptoms (4–6). Side effects are often prominent and might include a reduction in emotional expression, menstrual ...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
DiscussionThe expected results will be a major step forward in establishing empirically supported psychological treatments for survivors of CA suffering from Complex PTSD.Trial registrationGerman Clinical Trials Register: registration numberDRKS00005578, date of registration 19 December 2013.
Source: Borderline Personality Disorder and Emotion Dysregulation - Category: Psychiatry Source Type: research
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