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In order to realize the early identification, risk warning and comprehensive intervention of adolescent depression, this project carried out research on the diagnosis platform of adolescent depression, the construction of suicide risk warning and evaluation system, the development of interpersonal psychotherapy technology (IPT-A), and the rapid intervention technology of robotic navigation repetitive transcranial magnetic stimulation (rTMS). Through the extraction of psychological, peripheral and central biological characteristics of adolescent depression and the establishment of a diagnostic platform, combined with artificial neural network to achieve efficient and accurate identification of high risk of suicide population. Antidepressant drugs combined with psychotherapy and antidepressant drugs combined with rTMS physical therapy were used to improve the clinical effective rate and recovery rate. Finally, a comprehensive prevention and control technology suitable for hospitals, schools and families to participate in.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Simple Medication | Active Comparator | Escitalopram alone treatment |
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| Simple Psychotherapy | Active Comparator | Simple interpersonal psychotherapy group |
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| Medication combined with psychotherapy | Experimental | Medication combined with interpersonal psychotherapy |
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| Medication combined with physical therapy group | Experimental | Medication combined with robotic navigational repetitive transcranial magnetic stimulation |
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| Medication combined with sham physical therapy group | Sham Comparator | Medication combined with sham robotic navigational repetitive transcranial magnetic stimulation |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Escitalopram | Drug | The US Food and Drug Administration(FDA) has only approved fluoxetine and escitalopram for the treatment of adolescent depression |
|
| Measure | Description | Time Frame |
|---|---|---|
| Score of Child Depression Rating Scale-Revised | For clinical depression symptom assessment | Baseline, 2-week, 4-week, 8-week |
| Score of Beck Scale for Suicide Ideation | For the quantitative assessment of suicidal ideation | Baseline, 2-week, 4-week, 8-week |
| Score of Iowa Gambling Task | The simulation of the real decision situation is a kind of decision making task in the fuzzy situation accompanied by corresponding rewards and punishments | Baseline, 2-week, 8-week |
| Score of THINC-it test | The test includes Spotter, Symbol check, Codebreaker, Trails, and the 5-item Depression Cognitive Deficit Questionnaire (PDQ-5-D). It is used to assess working memory, executive function and attention | Baseline, 2-week, 8-week |
| Hypocretin | Hypocretin is a neurotransmitter that regulates wakefulness and appetite | Baseline, 2-week, 8-week |
| Endocannabinoid | Endocannabinoid play an important role in regulating many functions in the body, including the inflammatory system, immune function, sleep, appetite, digestion, pain receptors, hormones, reproductive function and memory | Baseline, 2-week, 8-week |
| Neuroimmune-related factors | Such as IL-lβ、IL-6、TNF-α |
| Measure | Description | Time Frame |
|---|---|---|
| Score of 24-item Hamilton Depression Rating Scale | For clinical depression symptom assessment | Baseline, 2-week, 4-week, 8-week |
| Ottawa Self-injury Questionnaire | To evaluate the situation of NSSI among adolescents |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Huang, Manli, M.D | Contact | 13957162975 | 86 | huangmanli@zju.edu.cn |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The First Affiliated Hospital of Zhejiang University | Recruiting | Hangzhou | Zhejiang | 310009 | China |
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| Interpersonal Psychotherapy for Adolescent | Other | Interpersonal Psychotherapy for Adolescent(IPT-A), A modified version of interpersonal psychotherapy, is shorter than the standard therapy duration (12-16 sessions), with a total of eight sessions, retaining the structure of the standard IPT but employing a series of strategies to extract the most important components to speed up the time process. |
|
| Escitalopram combined with psychotherapy | Other | The subjects received adolescent interpersonal psychotherapy for adolescent(IPT-A) while taking medication |
|
| Escitalopram combined with rTMS | Other | The subjects received Robotic navigational repetitive transcranial magnetic stimulation while taking medication |
|
| Escitalopram combined with sham rTMS | Drug | The subjects received sham Robotic navigational repetitive transcranial magnetic stimulation while taking medication |
|
| Baseline, 2-week, 8-week |
| Neurotrophic pathway related factors | Such as BDNF、VGF、TrkB、tPA | Baseline, 2-week, 8-week |
| Near infrared functional imaging of the brain | Near infrared functional brain imaging can reflect the activation degree of brain function and functional connectivity of brain by detecting the concentration changes of oxygenated hemoglobin and deoxygenated hemoglobin in the target brain area. | Baseline, 2-week, 8-week |
| Change in working memory test scores after intervention | The working memory test consists of two parts, which measure the breadth and accuracy of working memory respectively. The breadth of working memory will be tested using the operating span experiment, as the accuracy of working memory will be tested using the Memory Orientation experiment | Baseline, 2-week, 8-week, 24-week |
| Change in three component test of executive function scores after intervention | The three component tests of executive function were one-backward test, anti-saccade and shifting test respectively.In the one-backward test, subjects need to memorize letters while counting numbers, scoring them according to the accuracy of the alphabetic memory order; The anti-saccade test asks subjects to react to a flash of arrows (0.5 seconds) by selecting the direction they see on a keyboard;The shifting test asked subjects to select a forward or reverse feedback key depending on where the icon appeared | Baseline, 2-week, 8-week, 24-week |
| TMS-Evoked potential | The integration of transcranial magnetic stimulation (TMS) and electroencephalography (EEG) is a valuable method for directly probing excitability, connectivity and oscillatory dynamics of regions throughout the brain. Offering in depth measurement of cortical reactivity, TMS-EEG allows the evaluation of TMS-evoked components that may act as a marker for cortical excitation and inhibition. | Baseline, 2-week, 8-week |
| Magnetic Resonance Imaging | Functional magnetic resonance brain imaging can reflect the functional and metabolic information of neurons before morphological changes | Baseline, 2-week, 8-week |
| Baseline, 2-week, 4-week, 8-week |
| Score of Childhood Trauma Questionnaire | Used to assess traumatic experiences in childhood | Baseline |
| ID | Term |
|---|---|
| D003866 | Depressive Disorder |
| ID | Term |
|---|---|
| D019964 | Mood Disorders |
| D001523 | Mental Disorders |
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| ID | Term |
|---|---|
| D000089983 | Escitalopram |
| D000079062 | Interpersonal Psychotherapy |
| D011613 | Psychotherapy |
| D050781 | Transcranial Magnetic Stimulation |
| ID | Term |
|---|---|
| D011437 | Propylamines |
| D000588 | Amines |
| D009930 | Organic Chemicals |
| D009570 | Nitriles |
| D001572 | Benzofurans |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D006571 | Heterocyclic Compounds |
| D004191 | Behavioral Disciplines and Activities |
| D055909 | Magnetic Field Therapy |
| D013812 | Therapeutics |
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