Treatment Options for Psychotic Depression in Adolescents: A Comprehensive Review
Violeta Perez-Rodriguez,1 Claudia Aymerich,2,3 Ana Catalan,1,3 Sameer Jauhar,4 Gonzalo Salazar de Pablo2,5,6 1Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK; 2Department of Child and Adolescent Psychiatry, Institute of Psych...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2025-01-01
|
| Series: | Psychology Research and Behavior Management |
| Subjects: | |
| Online Access: | https://www.dovepress.com/treatment-options-for-psychotic-depression-in-adolescents-a-comprehens-peer-reviewed-fulltext-article-PRBM |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832584045761921024 |
|---|---|
| author | Perez-Rodriguez V Aymerich C Catalan A Jauhar S Salazar de Pablo G |
| author_facet | Perez-Rodriguez V Aymerich C Catalan A Jauhar S Salazar de Pablo G |
| author_sort | Perez-Rodriguez V |
| collection | DOAJ |
| description | Violeta Perez-Rodriguez,1 Claudia Aymerich,2,3 Ana Catalan,1,3 Sameer Jauhar,4 Gonzalo Salazar de Pablo2,5,6 1Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK; 2Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK; 3Biobizkaia Health Research Institute. Basque Country University. Basurto University Hospital, OSI Bilbao-Basurto. Centro de Investigación En Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Barakaldo, Bizkaia, Spain; 4Centre for Affective Disorders, Psychological Medicine, Ioppn, King’s College, London, UK; 5Child and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London, UK; 6Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Iisgm, CIBERSAM, Madrid, SpainCorrespondence: Dr Gonzalo Salazar de Pablo, Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience (IoPPN) King’s College London, Room D1.14, Child Psychiatry Building 16 De Crespigny Park, London, SE5 8AB, United Kingdom, Tel +44 0207 848 0002, Email gonzalo.salazar_de_pablo@kcl.ac.ukAbstract: Despite being associated with increased illness severity and suicidality compared to non-psychotic depression, psychotic depression remains under-researched, particularly in adolescents. With this article, we aim to review treatment options for psychotic depression in adolescents. We performed a multi-step narrative review, first identifying studies on adolescents with psychotic depression evaluating any intervention and with any methodological design. We subsequently complemented our search with systematic reviews and meta-analysis evaluating treatment interventions in adults with psychotic depression and adolescents with bipolar depression. Finally, we reviewed clinical guidelines to complement the evidence found and provided recommendations for clinical practice. Based on the findings, we recommend a stepped approach to the treatment of psychotic depression in adolescents. For mild cases with predominance of depressive symptoms, antidepressant monotherapy with a serotonin selective reuptake inhibitor (eg fluoxetine, sertraline or citalopram) could be trialed first. In severe presentations, antidepressant-antipsychotic combination would be the treatment of choice. The antidepressant-antipsychotic combination has been recommended by several clinical guidelines, systematic reviews and meta-analysis in this population, adolescents with bipolar depression and adults with psychotic depression. Another combination of antidepressant-antipsychotic with evidence from a case report is the fluoxetine-quetiapine combination. For those adolescents not responding to the antidepressant-antipsychotic combination, or those requiring a rapid response or unable to take medication, electroconvulsive therapy could be considered. Psychological interventions (eg cognitive behavioral therapy, family therapy or interpersonal psychotherapy training for adolescents) are recommended by clinical guidelines but require further research. Overall, literature on the field is scarce and limited, with most evidence coming from adults and other populations. Further research into effective and safe treatment of psychotic depression in adolescent population is needed.Keywords: treatment, psychosis, mood, teenager |
| format | Article |
| id | doaj-art-0bb643c816904660bc300553fb8eb0ae |
| institution | Kabale University |
| issn | 1179-1578 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Psychology Research and Behavior Management |
| spelling | doaj-art-0bb643c816904660bc300553fb8eb0ae2025-01-27T18:05:33ZengDove Medical PressPsychology Research and Behavior Management1179-15782025-01-01Volume 1819720899588Treatment Options for Psychotic Depression in Adolescents: A Comprehensive ReviewPerez-Rodriguez VAymerich CCatalan AJauhar SSalazar de Pablo GVioleta Perez-Rodriguez,1 Claudia Aymerich,2,3 Ana Catalan,1,3 Sameer Jauhar,4 Gonzalo Salazar de Pablo2,5,6 1Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK; 2Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK; 3Biobizkaia Health Research Institute. Basque Country University. Basurto University Hospital, OSI Bilbao-Basurto. Centro de Investigación En Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Barakaldo, Bizkaia, Spain; 4Centre for Affective Disorders, Psychological Medicine, Ioppn, King’s College, London, UK; 5Child and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London, UK; 6Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Iisgm, CIBERSAM, Madrid, SpainCorrespondence: Dr Gonzalo Salazar de Pablo, Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience (IoPPN) King’s College London, Room D1.14, Child Psychiatry Building 16 De Crespigny Park, London, SE5 8AB, United Kingdom, Tel +44 0207 848 0002, Email gonzalo.salazar_de_pablo@kcl.ac.ukAbstract: Despite being associated with increased illness severity and suicidality compared to non-psychotic depression, psychotic depression remains under-researched, particularly in adolescents. With this article, we aim to review treatment options for psychotic depression in adolescents. We performed a multi-step narrative review, first identifying studies on adolescents with psychotic depression evaluating any intervention and with any methodological design. We subsequently complemented our search with systematic reviews and meta-analysis evaluating treatment interventions in adults with psychotic depression and adolescents with bipolar depression. Finally, we reviewed clinical guidelines to complement the evidence found and provided recommendations for clinical practice. Based on the findings, we recommend a stepped approach to the treatment of psychotic depression in adolescents. For mild cases with predominance of depressive symptoms, antidepressant monotherapy with a serotonin selective reuptake inhibitor (eg fluoxetine, sertraline or citalopram) could be trialed first. In severe presentations, antidepressant-antipsychotic combination would be the treatment of choice. The antidepressant-antipsychotic combination has been recommended by several clinical guidelines, systematic reviews and meta-analysis in this population, adolescents with bipolar depression and adults with psychotic depression. Another combination of antidepressant-antipsychotic with evidence from a case report is the fluoxetine-quetiapine combination. For those adolescents not responding to the antidepressant-antipsychotic combination, or those requiring a rapid response or unable to take medication, electroconvulsive therapy could be considered. Psychological interventions (eg cognitive behavioral therapy, family therapy or interpersonal psychotherapy training for adolescents) are recommended by clinical guidelines but require further research. Overall, literature on the field is scarce and limited, with most evidence coming from adults and other populations. Further research into effective and safe treatment of psychotic depression in adolescent population is needed.Keywords: treatment, psychosis, mood, teenagerhttps://www.dovepress.com/treatment-options-for-psychotic-depression-in-adolescents-a-comprehens-peer-reviewed-fulltext-article-PRBMtreatmentpsychosismoodteenager |
| spellingShingle | Perez-Rodriguez V Aymerich C Catalan A Jauhar S Salazar de Pablo G Treatment Options for Psychotic Depression in Adolescents: A Comprehensive Review Psychology Research and Behavior Management treatment psychosis mood teenager |
| title | Treatment Options for Psychotic Depression in Adolescents: A Comprehensive Review |
| title_full | Treatment Options for Psychotic Depression in Adolescents: A Comprehensive Review |
| title_fullStr | Treatment Options for Psychotic Depression in Adolescents: A Comprehensive Review |
| title_full_unstemmed | Treatment Options for Psychotic Depression in Adolescents: A Comprehensive Review |
| title_short | Treatment Options for Psychotic Depression in Adolescents: A Comprehensive Review |
| title_sort | treatment options for psychotic depression in adolescents a comprehensive review |
| topic | treatment psychosis mood teenager |
| url | https://www.dovepress.com/treatment-options-for-psychotic-depression-in-adolescents-a-comprehens-peer-reviewed-fulltext-article-PRBM |
| work_keys_str_mv | AT perezrodriguezv treatmentoptionsforpsychoticdepressioninadolescentsacomprehensivereview AT aymerichc treatmentoptionsforpsychoticdepressioninadolescentsacomprehensivereview AT catalana treatmentoptionsforpsychoticdepressioninadolescentsacomprehensivereview AT jauhars treatmentoptionsforpsychoticdepressioninadolescentsacomprehensivereview AT salazardepablog treatmentoptionsforpsychoticdepressioninadolescentsacomprehensivereview |