Adolescent Depression Associated With Parental Depression (AdoDesP)

Regional University Hospital Center (CHRU)

Status: Terminated

Conditions: Depression

Treatments: Other: Parental depression; Other: Routine Cares; Other: MDA

Study type: Interventional

Funder types: Other

Identifiers

NCT03811041

29BRC18.0221

Details and patient eligibility

About

Depression is difficult to identify, prevent and treat in adolescents because of complex and stigmatized multiform symptoms and pathways of care.

In children the existence of a parental depression is a significant and recognized risk factor for the development of a depression. It is regularly reported that 30% of adolescents of depressed parents have depression themselves. General Practitioners (GP) have significant access to the depression of adults, potentially parents of teenagers. In fact, 20% of patients in the regular active file of one GP have depression. The primary health care system could provide indirect but voluminous and unprecedented access to the identification of adolescent depression at an early stage from the encounter of depressed parents.

The difficulties of articulation between primary care (PC) and mental health devices are demonstrated. They disrupt the care pathways of adolescents detected in PC, prevention, and may even disturb early detection of depression. An organized joint between the PC and a specialized mental health service for adolescents ("Maison Des Adolescents" MDA) could promote the process of screening and preventing depression of adolescents of depressed parents encountered in PC.

In addition, if the effects of parental depression on adolescents are established, they remain complex and interactive. They vary by age and sex of the child but also the sex of the parent. A concomitant study of adolescent and parent depression will provide data to analyze the prevalence of depressed parent adolescent depression and to define risk or protection factors.

AdoDesP study is a cluster randomised trial (randomisation of the GPs) which compare a group of adolescent with PC articulated with mental health service (MDA) and an other group without articulation (routine cares).

A third group of depressed adolescents will be constituted to analyse parental depression of depressed adolescents.

Enrollment: 80 patients

Sex: All

Ages: 11+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Parents of groups 1 and 2 :

  • Major patient consulting his GP
  • Depressed patient
  • Parent of adolescent aged between 11 and 18 years old

• Adolescents of groups 1 and 2 :

  • Aged more than 11 and less than 18 years old
  • Parent included in the study

• Parents of group 3 :

  • Parent of depressed adolescent under care at the MDA of Marseille, included in the study and whose depression is confirmed by HSCL25 scale

• Adolescents of group 3 :

  • Aged more than 11 and less than 18 years old
  • Depressed patient
  • Under care at the MDA of Marseille since less than 1 month

Exclusion criteria

• Parents of groups 1, 2 and 3 :

  • Minor patient
  • Enable to give his consent
  • Patient with guardianship or curatorship
  • Non consenting patient
  • Pregnant or nursing mother

• Adolescents of groups 1 and 2 :

  • Aged < 11 or ≥18
  • Parent whose depression isn't confirmed by HSCL25 scale
  • Non consenting adolescent
  • Pregnant or nursing mother

• Adolescent of group 3 :

  • Aged < 11 or ≥18
  • Non depressed adolescent
  • Non consenting patient
  • Pregnant or nursing mother

Trial design

Primary purpose: Diagnostic

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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80 participants in 3 patient groups

PC articulated with MDA

Experimental group

Description:

Depressed parent encountered in PC for confirmation of depression with Hopkins Symptom Checklist-25 (HSCL25) scale. If confirmed, the adolescent will also be encountered by the GP for a screening test of depression (Adolescent Depression Rating Scale - ADRS). If negative, the patient will go out of the study. If positive, 2 others tests will be performed to study the intensity of the depression (Child depressionInventory - CDI) and the quality of life (Pediatric Quality of Life InventoryTM).Finally, the patient will be oriented to the MDA of Brest and will meet again the GP at 6 and 12 month to answers the same tests.

Treatment:

Other: MDA

Routine cares

Active Comparator group

Description:

Depressed parent encountered in PC for confirmation of depression with Hopkins Symptom Checklist-25 (HSCL25) scale. If confirmed, the adolescent will also be encountered by the GP for a screening test of depression (Adolescent Depression Rating Scale - ADRS). If negative, the patient will go out of the study. If positive, 2 others tests will be performed to study the intensity of the depression (Child depressionInventory - CDI) and the quality of life (Pediatric Quality of Life InventoryTM). Finally, the patient will be oriented to the routine cares and will meet again the GP at 6 and 12 month to answers the same tests.

Treatment:

Other: Routine Cares

Parental depression

Experimental group

Description:

Parental depression will be studied. Depressed adolescent encountered in MDA of Marseille for confirmation of depression with 3 tests : ADRS, CDI and PedsQL. If positive, the parent will come to the MDA for a screening test of depression (HSCL25). Parents and adolescent are seen only once.

Treatment:

Other: Parental depression