Young Children's Depression (Medicine to Treat Premenstrual) | Article on Child depression | psychology article

 

Quite Young Children's Depression

    Young children diagnosed with depression may benefit from a treatment that includes a parent, according to a clinical trial reported June 20 in the American Journal of Psychiatry.

 

The case, led by Joan L. Luby, MD, won the 2004 Klerman Prize for Exceptional Clinical Research, 2008 and 2004 Independent Investigator and 1999 Young Investigator at Washington University School of Medicine in St. Petersburg. parent and child treatment for children between the ages of 3 and 7 diagnosed with depression. The new treatment model was imitated after a widely used parent-child treatment program in which the therapist trained the parent as he or she interacted with his or her child, but also placed additional emphasis on emotional development.

 

The randomized trial includes 229 pairs of parent and child. Those in the treatment group participated in 20 treatment sessions over 18 weeks, during which the therapists led the parents to better help their children to see and control their emotions.

 

At the end of the study, children who participated in the treatment had significantly lower levels of depression and more severe symptoms than those in the study group who did not receive treatment. Parents who participated in the study with their children also experienced a decrease in their symptoms of depression and also reported a decrease in parental pressure.

 

"Findings from this study of parent and child psychotherapy on early childhood depression suggest that previous diagnosis and intervention in this chronic and relapsing disease represent an important new approach to effective treatment," the group concluded.

 

Clinical depression in 3-year-olds has been confirmed, and growth rates are similar to those in school-age children, the researchers noted, adding that there is a continuum between early depression and childbirth, "with changes in brain function and structure similar to those reported in depressed adults."

 

Drs. participants in a study to determine whether the benefits of concomitant treatment are long-lasting.

 

Medicine to Treat Premenstrual Mood Disorder is Tested:

 

    In a clinical trial, researchers found the effects of the drug to treat premenstrual dysphoric disorder (PMDD) - an emotional disorder that affects 3% to 5% of women of childbearing age.

 

Early behavioral symptoms of PMDD include mood swings, irritability, depression, and anxiety in addition to the physical symptoms associated with the disorder (constipation, breast tenderness, stomach problems).

 

PMDD may be caused by a change in sex hormones, especially progesterone. Symptoms often appear during the "late luteal" phase of the menstrual cycle, between ovulation and menstruation. When a new egg is not fertilized, the levels of progesterone and other hormones rise in preparation for a pregnancy that may begin to decline rapidly. These changes in ovarian hormone are accompanied by the onset of symptoms of PMDD, which affect quality of life and in some cases can be disabling.

 

A team of researchers based in Sweden and led by Inger Sundström-Poromaa, MD, Ph.D., of Uppsala University, conducted a randomized, double-blind clinical trial of a drug called ulipristal acetate in a group of 95 women diagnosed with PMDD. Cynthia Neill Epperson, MD, an independent BBRF investigator for 2005 and 1997 and 1995 Young Investigator, who played a key role in formulating brexanolone, a fast-acting antidepressant approved for 2019 for use in postpartum depression, was part of the team. Their results were published in the American Journal of Psychiatry.

 

Ulipristal acetate, or UPA, was given in doses (5mg / day) and drugs already approved for use in the treatment of uterine fibroids by regulators in the European Union in 2009 and by the FDA in the U.S. The following year.

 

48 women received a UPA case and 47 received a placebo pill. The women were between the ages of 18 and 46 and had not been treated for psychiatric treatment for 3 months prior to their participation in the trial. The trial began with each participant on the first day of the menstrual cycle, and continued for more than three consecutive menstrual cycles.

 

UPA binds and modulates the activation of two progesterone cellular receptors. Among other areas of the body, these are abundant in the amygdala and other parts of the brain involved in the functioning of the nerves: the hippocampus, hypothalamus, thalamus, and frontal cortex. Drug fluctuations of receptors have the effect of inhibiting the synthesis and production of progesterone itself.

 

Each participant in the trial used a smartphone app to keep a daily log of PMDD emotions and physical symptoms, measuring each scale from "none" to "extreme." These self-report reports produced the statistical data used to assess the comparative effects of UPA and placebo over three menstrual cycles.

 

While the UPA showed no difference compared with placebo in measuring PMDD physical symptoms, women in the UPA group registered the improvement in PMDD emotional symptoms that researchers found statistically significant. 85% of women in the UPA group experienced complete remission (50%) or partial remission (35%) of emotional symptoms at the end of the three menstrual cycles. This compared with 52% of participants who received a full (21%) or partial (31%) exemption from the placebo group.

 

The impact of UPA was significant in measuring symptoms of depression, anger / irritability, social conflicts, and lack of energy, the researchers noted.

 

Side effects were uncommon, they said, the most common being headache and nausea (each accounting for about 8% of those who received UPA) and fatigue (about 6%). Investigators were careful to note that in both the EU and the U.S., the UPA was under investigation after approval from 2018 on the role it could play in under-reported cases of liver damage. While these studies were ongoing, continuous monitoring of liver function in the first three months of drug administration was now performed on patients as a precaution.

 

The team also noted that although the mechanism of action of the drug is not yet fully understood, up to 80% of those who have developed uterine fibroids suffer from ovarian failure. No ovulation or progesterone levels were measured in the current trial; however, amenorrhea, or menopause, was diagnosed by 27.5% of those in the current trial receiving UPA.

 

Researchers say that the UPA is a “promising drug” for the treatment of PMDD's emotional symptoms, and has urged large trials to confirm its effects and to examine more closely the potential drug effects on the liver and menopause. They also noted that UPA mutation of progesterone receptors provides insight into the cellular processes under PMDD, and opened the way for the formation of other chemicals with similar effects.

     ZARIA NOREEN