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We examined hopelessness as a predictor of suicide ideation in depressed youth after acute medication treatment. A total of 158 depressed adolescents were administered the Children's Depression Rating Scale-Revised (CDRS-R) and Columbia Suicide Severity Rating Scale (C-SSRS) as part of a larger battery at baseline and at weekly visits across 6 weeks of acute fluoxetine treatment. The Beck Hopelessness Scale (BHS) was administered at baseline and week 6. A negative binomial regression model via a generalized estimating equation analysis of repeated measures was used to estimate suicide ideation over the 6 weeks of acute treatment from baseline measure of hopelessness. Depression severity and gender were included as covariates in the model. The negative binomial analysis was also conducted separately for the sample of males and females (in a gender-stratified analysis). Mean CDRS-R total scores were 60.30 ± 8.93 at baseline and 34.65 ± 10.41 at week 6. Mean baseline and week 6 BHS scores were 9.57 ± 5.51 and 5.59 ± 5.38, respectively. Per the C-SSRS, 43.04% and 83.54% reported having no suicide ideation at baseline and at week 6, respectively. The analyses revealed that baseline hopelessness was positively related to suicide ideation over treatment (p = .0027), independent of changes in depression severity. This significant finding persisted only for females (p = .0024). These results indicate the importance of early identification of hopelessness. [ABSTRACT FROM AUTHOR]

Adolescence, when suicidal ideation and behaviors often begin, might offer an important window to understand the causes and prevent the progression of suicide phenomena. The need for frameworks to organize the fragmented field has been noted, but few studies are theoretically driven. An important recent contribution to understanding suicidality is Joiner's (2005) Interpersonal-Psychological Theory of Suicide (IPTS). This article reviews the evidence for the applicability of the IPTS in adolescence. Seventeen studies of adolescents that specifically tested or interpreted findings in the light of Joiner's theory or the IPTS were located. In addition, several recent reviews of the literature on suicidality in adolescence covered information relevant to the IPTS. There is some support for the theory in adolescence, particularly with regard to its most novel component, the association between acquired capability and suicide attempt. In summary, we find this theory to be a promising heuristic to organize the disparate studies in suicide research. Future challenges and directions for researchers seeking to test and elaborate the applicability of the IPTS in adolescence include: adaptations of instruments to the developmental stage, capturing of imminent risk, and consideration of whether the current model is underspecified. Age might moderate adult findings that give impulsivity an indirect role in suicide attempts. [ABSTRACT FROM PUBLISHER]

While prior research has investigated trajectories of depressive symptom change throughout psychotherapy, such work has not been conducted exclusively among underserved patients receiving brief Behavioral Activation (BA) teletherapy, intervention modifications that should reduce barriers to therapy initiation and engagement. The current project used cluster analysis to determine discrete groups of symptom change among patients receiving an 8-session BA teletherapy intervention, and analyzed whether demographic and clinical characteristics were associated with group membership. Data from 105 patients referred from charity primary care clinics and receiving at least two therapy sessions were analyzed. Patients were predominantly female and Latina. The 9-item Patient Health Questionnaire (PHQ-9) was the outcome. Two categories were determined: a larger group (N = 61) demonstrating initially less severe symptoms and experiencing a gradual recovery, and a smaller group beginning with more severe symptoms, and experiencing a steeper recovery. In both groups, a majority of participants experienced at least a 5-point drop in depressive symptoms, while in the latter group, a majority of patients achieved depressive symptom remission (PHQ-9 < 5). Monolingual Spanish speakers were more likely to be in the former group, but no other demographic or clinical characteristics were associated with group membership. In both groups, a majority of the symptom reduction occurred by sessions 4-6. Therefore, two categories of depressive symptom change, slow responders and rapid responders, occur among patients receiving a brief BA teletherapy intervention. No demographic differences aside from primary language, nor any clinical characteristics, distinguish group membership, suggesting similar patterns of symptom reduction among a primarily underserved sample. [ABSTRACT FROM AUTHOR]

Objective: To evaluate psychometrically and provide crosswalks between 3 self-report measures of depressive symptomatology in youth in psychiatric care settings. Ratings included the Patient Health Questionnaire for Adolescents (PHQ-A), a widely used 9-item self-report; the 16-item Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR 16 ); and the 5-item Very Quick Inventory of Depressive Symptomatology-Self-Report (VQIDS-SR 5 ), a recent effort to create a bridge from the QIDS-SR 16 to clinical practice., Methods: Data from the Texas Youth Depression and Suicide Research Network Registry (August 26, 2020-May 11, 2022) were included in this work. At first visit, 795 depressed or suicidal adolescent (12-20 years of age) psychiatric outpatients completed the PHQ-A, QIDS-SR 16 , and VQIDS-SR 5 . Classical test theory and item-response theory (IRT) analyses were conducted. Crosswalks among total scales were created. Sensitivity to change over 1-month follow-up was assessed for all 3 scales (n = 682)., Results: Cronbach alphas were 0.86 (PHQ-A), 0.80 (QIDS-SR 16 ), and 0.76 (VQIDS-SR 5 ). Item total correlations were 0.49-0.72, 0.29-0.64, and 0.43-0.61, respectively. All 3 scales were unidimensional and sensitive to change over a 1-month period. IRT analyses revealed satisfactory item performance. Modest but significant associations were found between baseline to 1-month changes in PHQ-A and VQIDS-SR 5 total scores ( r  = 0.50, P  < .0001) and between PHQ-A and QIDS-SR 16 total scores ( r  = 0.56; P  < .0001). Categorical thresholds of severity (ie, mild, moderate, severe, and very severe) were comparable between PHQ-A and QIDS-SR 16 ., Conclusions: The PHQ-A, QIDS-SR 16 , and VQIDS-SR 5 are unidimensional, psychometrically acceptable self-reports of depressive prevalence or severity in adolescents and young adults in this sample. Total scale scores on any measure can be converted reliably to those on any other., (© Copyright 2023 Physicians Postgraduate Press, Inc.)