Effect of Narrative Therapy on the Psychological Status and Life Quality of Family Caregivers of Adolescents with First-episode Depression

[Objectives]The research aimed to explore the effect of narrative therapy on the negative emotion,quality of life,care burden and nursing satisfaction of family caregivers of adolescents with first-episode depression.[Methods]Using convenient sampling method,the family caregivers of the adolescents with first-episode depression hospitalized in the Children and Adolescents Psychology Department of a GradeⅢLevel A hospital in Shiyan City,Hubei Province from July 2021 to April 2022 were selected as the research objects.The coin toss method was used to determine the test group and the control group,with 60 cases in each group.The control group received routine nursing care,and the experimental group implemented narrative therapy on this basis.Self-rating anxiety scale,self-rating depression scale,health status questionnaire(SF-36),and caregiver burden inventory were used to evaluate the anxiety and depression level,quality of life,and care burden level of the caregivers before and after the intervention.The nursing satisfaction questionnaire was used to evaluate the nursing satisfaction to the caregivers after the intervention.[Results]After 8 weeks of intervention,4 cases fell off in the control group and 3 cases fell off in the intervention group.The scores of anxiety and depression in the two groups were lower than those before intervention,and the scores in the test group were significantly lower than those in the control group(P<0.05).The life quality scores of life vitality,emotional function and mental health dimensions were higher than before the intervention,and the scores in the test group were significantly higher than those in the control group(P<0.05).The total score of care burden and the scores in time dependence,development limitation and physiological dimension of the two groups were lower than those before intervention,but the difference was not statistically significant(P>0.05).[Conclusions]Narrative therapy can effectively alleviate the negative emotions of family caregivers of adolescents with first-episode depression,and improve their quality of life and nursing satisfaction,but not their care burden.

Acupuncture for treating adolescent depression:Study protocol for a randomized controlled trial

The prevalence of depression among adolescents has been significantly increasing in recent years.However,current antidepressants for adolescents have limited safety and efficacy.Acupuncture has been shown to be effective in treating depression in adults,but there is a lack of high-quality evidence for its effect on the treatment of adolescent depression,and the underlying mechanism is still unclear.Therefore,we designed a randomized controlled trial to explore the effectiveness and the therapeutic mechanisms of acupuncture on adolescent depression.This study will be designed as a multi-center,sham and randomized controlled clinical trial.For this purpose,a total of 96 adolescent depression patients diagnosed with moderate and severe depression will be randomly divided into the manual acupuncture group and the sham one,respectively.The two groups received acupuncture treatment 3 times a week for a total course lasting 4 weeks.All patients will be assessed according to the primary outcomes including Beck Depression Inventory-II(BDI-II),Hamilton Depression Rating Scale(HAMD-24)and Zung self-rating depression scale(SDS)at baseline,week 2,4 and 8.Additionally,the secondary outcomes will be assessed at baseline and week 4,which includes intestinal flora structure,fecal short chain fatty acids(SCFAs)content and serum serotonin(5-HT)level.This study is the first randomized trial of acupuncture treatment of adolescent depression.

Aberrant single-subject morphological brain networks in first-episode,treatment-naive adolescents with major depressive disorder

Background:Neuroimaging-based connectome studies have indicated that major depressive disorder(MDD)is associated with dis-rupted topological organization of large-scale brain networks.However,the disruptions and their clinical and cognitive relevance are not well established for morphological brain networks in adolescent MDD.Objective:To investigate the topological alterations of single-subject morphological brain networks in adolescent MDD.Methods:Twenty-five first-episode,treatment-naive adolescents with MDD and 19 healthy controls(HCs)underwent T1-weighted magnetic resonance imaging and a battery of neuropsychological tests.Single-subject morphological brain networks were constructed separately based on cortical thickness,fractal dimension,gyrification index,and sulcus depth,and topologically characterized by graph-based approaches.Between-group differences were inferred by permutation testing.For significant alterations,partial correla-tions were used to examine their associations with clinical and neuropsychological variables in the patients.Finally,a support vector machine was used to classify the patients from controls.Results:Compared with the HCs,the patients exhibited topological alterations only in cortical thickness-based networks character-ized by higher nodal centralities in parietal(left primary sensory cortex)but lower nodal centralities in temporal(left parabelt complex,right perirhinal ectorhinal cortex,right area PHT and right ventral visual complex)regions.Moreover,decreased nodal centralities of some temporal regions were correlated with cognitive dysfunction and clinical characteristics of the patients.These results were largely reproducible for binary and weighted network analyses.Finally,topological properties of the cortical thickness-based net-works were able to distinguish the MDD adolescents from HCs with 87.6%accuracy.Conclusion:Adolescent MDD is associated with disrupted topological organization of morphological brain networks,and the disrup-tions provide potential biomarkers for diagnosing and monitoring the disease.