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Predictors of Treatment Outcome in Adolescent Depression

  • Depressive Disorders (K Cullen, Section Editor)
  • Published:
Current Treatment Options in Psychiatry Aims and scope Submit manuscript

Abstract

Purpose of review

Major depressive disorder is a global public health concern that is common in adolescents. Targeting this illness at the early stages of development is critical and could lead to better long-term outcomes because the adolescent brain is highly plastic and, hence, neural systems are likely to be more malleable to interventions. Although a variety of treatments are available, there are currently no guidelines to inform clinicians which intervention might be most suitable for a given youth. Here, we discuss current knowledge of prognostic and prescriptive markers of treatment outcome in adolescent depression, highlight two major limitations of the extant literature, and suggest future directions for this important area of research.

Recent findings

Despite significant effort, none of the potential demographic (gender, age, race), environmental (parental depression, family functioning), and clinical (severity of depression, comorbid diagnoses, suicidality, hopelessness) predictors have been robustly replicated to warrant implementation in clinical care. Studies on biomarkers that truly reflect pathophysiology are scarce and difficult to draw conclusions from.

Summary

More efforts should be directed towards potential neurobiological predictors of treatment outcome. Moreover, rather than evaluating potential predictors in isolation, modern machine learning methods could be used to build models that combine information across a large array of features and predict treatment outcome for individual patients. These strategies hold promise for advancing personalized healthcare in adolescent depression, which remains a high clinical priority.

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Funding

Dr. Ang was supported by the A*STAR National Science Scholarship as well as the Kaplen Fellowship in Depression from Harvard Medical School. Dr. Pizzagalli was partially supported by R37MH068376.

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Authors and Affiliations

  1. Department of Social and Cognitive Computing, Institute of High Performance Computing, Agency for Science Technology and Research (A*STAR), 1 Fusionopolis Way, #16-16 Connexis, C16-49, Singapore, 138632, Singapore

    Yuen-Siang Ang DPhil

  2. Department of Psychiatry, Harvard Medical School, Boston, MA, USA

    Diego A. Pizzagalli PhD

  3. Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA

    Diego A. Pizzagalli PhD

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  1. Yuen-Siang Ang DPhil
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  2. Diego A. Pizzagalli PhD
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Correspondence to Yuen-Siang Ang DPhil.

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Conflict of interest

Over the past 3 years, Dr. Diego Pizzagalli has received consulting fees from BlackThorn Therapeutics, Boehringer Ingelheim, Compass Pathway, Engrail Therapeutics, Otsuka Pharmaceuticals, and Takeda Pharmaceuticals as well as one honorarium from Alkermes. In addition, he has received stock options from BlackThorn Therapeutics and research support from National Institute of Mental Health, Dana Foundation, Brain and Behavior Research Foundation, and Millennium Pharmaceuticals. No funding from these entities was used to support the current work, and all views expressed are solely those of the authors. Dr. Ang declares that he has no conflict of interest.

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Ang, YS., Pizzagalli, D.A. Predictors of Treatment Outcome in Adolescent Depression. Curr Treat Options Psych 8, 18–28 (2021). https://doi.org/10.1007/s40501-020-00237-5

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