Chapter 7.

Abstract College age students are in the midst of important psychosocial and neurobiological changes. The developmental fluidity of this period of life compels caution in diagnosing and treating depressive episodes, especially in discriminating between bipolar and non-bipolar depression. Treating college age students with depression requires adherence to four basic principles that guide treatment. We urge you to aim for diagnostic clarity, keep the developmental context in mind when making diagnoses and conducting treatment, establish clear aims for the pharmacologic intervention, and provide adequate resources to monitor treatment outcomes and respond rapidly to any untoward events.

[1]  T. Rosenthal,et al.  Bipolar outcome in the course of depressive illness. Phenomenologic, familial, and pharmacologic predictors. , 1983, Journal of affective disorders.

[2]  L. Altshuler,et al.  Antidepressant-induced mania and cycle acceleration: a controversy revisited. , 1995, The American journal of psychiatry.

[3]  F. Goodwin,et al.  The de facto US mental and addictive disorders service system. Epidemiologic catchment area prospective 1-year prevalence rates of disorders and services. , 1993, Archives of general psychiatry.

[4]  D. Cicero,et al.  Antidepressant Exposure in Bipolar Children , 2003, Psychiatry.

[5]  B. Laursen,et al.  Reconsidering changes in parent-child conflict across adolescence: a meta-analysis. , 1998, Child development.

[6]  Peter Fonagy,et al.  Selective serotonin reuptake inhibitors in childhood depression: systematic review of published versus unpublished data , 2004, The Lancet.

[7]  R. Kessler,et al.  Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. , 1994, Archives of general psychiatry.

[8]  Mihaly Csikszentmihalyi,et al.  Mood variability and the psychosocial adjustment of adolescents , 1980, Journal of youth and adolescence.

[9]  Benedetto Vitiello,et al.  Fluoxetine, cognitive-behavioral therapy, and their combination for adolescents with depression: Treatment for Adolescents With Depression Study (TADS) randomized controlled trial. , 2004, JAMA.

[10]  A. Stoll,et al.  Antidepressant-associated mania: a controlled comparison with spontaneous mania. , 1994, The American journal of psychiatry.

[11]  B. Wampold,et al.  A meta-(re)analysis of the effects of cognitive therapy versus 'other therapies' for depression. , 2002, Journal of affective disorders.

[12]  D J Kupfer,et al.  Drug therapy in the prevention of recurrences in unipolar and bipolar affective disorders. Report of the NIMH Collaborative Study Group comparing lithium carbonate, imipramine, and a lithium carbonate-imipramine combination. , 1984, Archives of general psychiatry.

[13]  J. Lewis,et al.  The induction of mania. A natural history study with controls. , 1982, Archives of general psychiatry.

[14]  P. Gaspar,et al.  The developmental role of serotonin: news from mouse molecular genetics , 2003, Nature Reviews Neuroscience.

[15]  J. Ahlner,et al.  Selective serotonin reuptake inhibitor antidepressants and the risk of suicide: a controlled forensic database study of 14 857 suicides , 2005, Acta psychiatrica Scandinavica.

[16]  A. Nierenberg,et al.  Clinical features of bipolar depression versus major depressive disorder in large multicenter trials. , 2006, The American journal of psychiatry.

[17]  L. Altshuler.  Premenstrual Dysphonias: Myths and Realities , 1995 .

[18]  J. Rapoport,et al.  Progressive cortical change during adolescence in childhood-onset schizophrenia. A longitudinal magnetic resonance imaging study. , 1999, Archives of general psychiatry.

[19]  K. Demyttenaere.  Compliance during treatment with antidepressants. , 1997, Journal of affective disorders.

[20]  R. Neimeyer,et al.  Psychotherapy for the treatment of depression: a comprehensive review of controlled outcome research. , 1990, Psychological bulletin.

[21]  H. Chugani.  Biological basis of emotions: brain systems and brain development. , 1998, Pediatrics.

[22]  W. Nolen,et al.  Earlier onset of bipolar disorder in children by antidepressants or stimulants? An hypothesis. , 2004, Journal of affective disorders.

[23]  A. Toga,et al.  In vivo evidence for post-adolescent brain maturation in frontal and striatal regions , 1999, Nature Neuroscience.

[24]  A. M. Mann,et al.  Clinical Experience with Imipramine (G 22355) in the Treatment of Depression 2 , 1959, Canadian Psychiatric Association journal.

[25]  A. Rush,et al.  A double-blind, randomized, placebo-controlled trial of fluoxetine in children and adolescents with depression. , 1997, Archives of general psychiatry.

[26]  G. Stanley Hall,et al.  Adolescence; Its Psychology and Its Relations to Physiology, Anthropology, Sociology, Sex, Crime, Religion and Education , 2012 .

[27]  F. Goodwin,et al.  Can antidepressants cause mania and worsen the course of affective illness? , 1987, The American journal of psychiatry.

[28]  Alan C. Evans,et al.  Structural maturation of neural pathways in children and adolescents: in vivo study. , 1999, Science.

[29]  R. Milev,et al.  Switch to Mania upon Discontinuation of Antidepressants in Patients with Mood Disorders: A Review of the Literature , 2003, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[30]  R. DeRubeis,et al.  Medications versus cognitive behavior therapy for severely depressed outpatients: mega-analysis of four randomized comparisons. , 1999, The American journal of psychiatry.

[31]  L. Judd,et al.  The long-term course of rapid-cycling bipolar disorder. , 2003, Archives of general psychiatry.

[32]  M. Peet.  Induction of Mania with Selective Serotonin Re-uptake Inhibitors and Tricyclic Antidepressants , 1994, British Journal of Psychiatry.

[33]  Michael J. Constantino,et al.  Effectiveness of psychotherapy and combination treatment for chronic depression. , 2003, Journal of clinical psychology.

[34]  M. Stemmler,et al.  Depression in adolescence. , 1993, The American psychologist.

[35]  J. Angst.  Switch from depression to mania--a record study over decades between 1920 and 1982. , 1985, Psychopathology.

[36]  F. Goodwin,et al.  Is bipolar disorder still underdiagnosed? Are antidepressants overutilized? , 1999, Journal of affective disorders.

[37]  L. Judd,et al.  The prevalence and disability of bipolar spectrum disorders in the US population: re-analysis of the ECA database taking into account subthreshold cases. , 2003, Journal of affective disorders.

[38]  J. Arnett.  Adolescent storm and stress, reconsidered. , 1999, The American psychologist.

[39]  D. Safer,et al.  Increased methylphenidate usage for attention deficit disorder in the 1990s. , 1996, Pediatrics.

[40]  J. Smetana.  Adolescents' and parents' reasoning about actual family conflict. , 1989, Child development.

[41]  D J Kupfer,et al.  Treatment of major depression with psychotherapy or psychotherapy-pharmacotherapy combinations. , 1997, Archives of general psychiatry.

[42]  R. Hirschfeld,et al.  Perceptions and impact of bipolar disorder: how far have we really come? Results of the national depressive and manic-depressive association 2000 survey of individuals with bipolar disorder. , 2003, The Journal of clinical psychiatry.

[43]  J. R. Koch,et al.  The prevalence and correlates of untreated serious mental illness. , 2001, Health services research.

[44]  M. Frye,et al.  Antidepressant discontinuation-related mania: critical prospective observation and theoretical implications in bipolar disorder. , 1999, The Journal of clinical psychiatry.

[45]  H. Reinherz,et al.  General and specific childhood risk factors for depression and drug disorders by early adulthood. , 2000, Journal of the American Academy of Child and Adolescent Psychiatry.

[46]  D. Murphy,et al.  The "switch process" in manic-depressive illness. I. A systematic study of sequential behavioral changes. , 1972, Archives of general psychiatry.

[47]  F. Goodwin,et al.  Antidepressants in bipolar disorder: the case for caution. , 2003, Bipolar disorders.

[48]  J. Eccles,et al.  Are adolescents the victims of raging hormones: evidence for activational effects of hormones on moods and behavior at adolescence. , 1992 .

[49]  A. Erkanli,et al.  The Great Smoky Mountains Study of Youth. Goals, design, methods, and the prevalence of DSM-III-R disorders. , 1996, Archives of general psychiatry.

[50]  G. Klerman,et al.  The Current Age of Youthful Melancholia , 1988, British Journal of Psychiatry.

[51]  Alan C. Evans,et al.  Brain development during childhood and adolescence: a longitudinal MRI study , 1999, Nature Neuroscience.

[52]  M. Frye,et al.  The relationship between antimanic agent for treatment of classic or dysphoric mania and length of hospital stay. , 1996, The Journal of clinical psychiatry.

[53]  A. Young,et al.  Possible biological mechanisms of the serotonin reuptake inhibitor discontinuation syndrome. Discontinuation Consensus Panel. , 1997, The Journal of clinical psychiatry.

[54]  L. Kiloh,et al.  A Controlled Trial of Imipramine in Treatment of Depressive States , 1959, British medical journal.

[55]  C. Bowden,et al.  Strategies to reduce misdiagnosis of bipolar depression. , 2001, Psychiatric services.

[56]  F. Verhulst,et al.  The prevalence of DSM-III-R diagnoses in a national sample of Dutch adolescents. , 1997, Archives of general psychiatry.

[57]  L. Magliano,et al.  The prognostic significance of "switching" in patients with bipolar disorder: a 10-year prospective follow-up study. , 2002, The American journal of psychiatry.

[58]  G. Emslie,et al.  Review of the efficacy and safety of antidepressants in youth depression. , 2005, Journal of child psychology and psychiatry, and allied disciplines.

[59]  D. Ford,et al.  Beliefs and Attitudes Associated With the Intention to Not Accept the Diagnosis of Depression Among Young Adults , 2005, The Annals of Family Medicine.

[60]  M. Olfson,et al.  Relationship between antidepressant medication treatment and suicide in adolescents. , 2003, Archives of general psychiatry.