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.
1. The interaction of symptoms, psychological indicators (including environmental risk factors and neuropsychology), peripheral biology (peripheral neuroimmunity, neurotrophic factors and neuroendocrine related indicators), central biological indicators (neuroimaging, near-infrared functional brain imaging) and brain-derived exosome detection in peripheral blood was constructed based on artificial intelligence technology The network of clinical diagnosis platform, and according to the high and low suicide risk classification of deep learning, the establishment of adolescent depression early identification and suicide risk warning system. 2. To develop a simplified interpersonal psychotherapy technique (IPT-A) for adolescent depression. 3. Research and development of rTMS neuroregulation technology for precise positioning of robot navigation in adolescent depression. 4. Construct comprehensive intervention models and efficacy prediction models for adolescent depression, such as drug combined with psychology and drug combined with physical therapy, and promote and demonstrate the application.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
100
The US Food and Drug Administration(FDA) has only approved fluoxetine and escitalopram for the treatment of adolescent depression
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.
The subjects received adolescent interpersonal psychotherapy for adolescent(IPT-A) while taking medication
The subjects received Robotic navigational repetitive transcranial magnetic stimulation while taking medication
The subjects received sham Robotic navigational repetitive transcranial magnetic stimulation while taking medication
The First Affiliated Hospital of Zhejiang University
Hangzhou, Zhejiang, China
RECRUITINGScore of Child Depression Rating Scale-Revised
For clinical depression symptom assessment
Time frame: Baseline, 2-week, 4-week, 8-week
Score of Beck Scale for Suicide Ideation
For the quantitative assessment of suicidal ideation
Time frame: 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
Time frame: 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
Time frame: Baseline, 2-week, 8-week
Hypocretin
Hypocretin is a neurotransmitter that regulates wakefulness and appetite
Time frame: 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
Time frame: Baseline, 2-week, 8-week
Neuroimmune-related factors
Such as IL-lβ、IL-6、TNF-α
Time frame: Baseline, 2-week, 8-week
Neurotrophic pathway related factors
Such as BDNF、VGF、TrkB、tPA
Time frame: 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.
Time frame: 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
Time frame: 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
Time frame: 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.
Time frame: 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
Time frame: Baseline, 2-week, 8-week
Score of 24-item Hamilton Depression Rating Scale
For clinical depression symptom assessment
Time frame: Baseline, 2-week, 4-week, 8-week
Ottawa Self-injury Questionnaire
To evaluate the situation of NSSI among adolescents
Time frame: Baseline, 2-week, 4-week, 8-week
Score of Childhood Trauma Questionnaire
Used to assess traumatic experiences in childhood
Time frame: Baseline
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