Abstract
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Chang et al. describe their study of 10–17 treatment-naive youth with bipolar depression who receive quetiapine treatment. Researchers obtained functional magnetic resonance imaging scans at baseline and after 8 weeks of treatment with study drug or placebo. “Our results are consistent with functional neuroimaging studies in adults with bipolar depression that suggest core impairments in brain regions critical for emotional regulation,” they write.
Chang et al. also find promising candidates for biomarkers of treatment response in the dorsal and ventral prefrontal subregions. “Youth with bipolar depression who have higher severity of depressive symptoms have lower prefrontal activation that may be more predisposed to neurofunctionally respond to quetiapine,” the authors write.
Maalouf et al. follow different neural signatures in their study of neurocognitive predictors of selective serotonin reuptake inhibitor (SSRI) response in youth with major depressive disorder (MDD). In short, the authors write, “cognitive deficits known to represent a core component in MDD emerge now as important predictors of poor clinical improvement in depressed adolescents treated with SSRIs.”
Maalouf et al. found that when behavioral tasks indicated higher attentional ability and lower impulsivity, they could expect greater improvement. Furthermore, they write, “lower impulsivity at baseline remained a significant predictor of clinical improvement” at follow-up. It is a strong argument that “the use of cognitive measures to predict treatment outcomes may prove to be a cost-efficient and rapid approach to differentiate responders from nonresponders early on.”
In the realm of psychosocial preventative interventions, Wolff et al. have done welcome work on the feasibility and efficacy of a cognitive behavioral therapy (CBT)-based treatment for use in adolescent psychiatric inpatient units. Their article describing a pilot study of the Coping, Problem-solving, Enhancing life, and Safety planning (COPES) treatment protocol provides evidence that argues for further, more rigorous research into this approach. The study's large sample size, practical clinical setting and clinical-research integration should make it of interest to a broad audience.
Most encouraging, Wolff et al. write, is that the “greater number of {COPES protocol} modules completed predicted a longer time to subsequent intensive service,” after controlling for age, gender, length of hospital stay, and number of diagnoses.
Also notable in this issue are articles from Londono Tobon et al., who review the literature on pharmacologic treatments for school refusal, and Scholle et al., who investigate the effects of combination antipsychotic and methylphenidate treatment on attention-deficit/hyperactivity disorder symptoms.