Lisa Feldmann

Zusammenfassung: „ich bin alles“ ist ein digitales Informationsportal, das über eine Website und zugehörige Social-Media-Kanäle evidenzbasiert über Depressionen und psychische Gesundheit bei Kindern und Jugendlichen aufklärt sowie Tipps und Hilfen vermittelt. Das Angebot richtet sich an Kinder und Jugendliche im Alter von 12–18 Jahren mit und ohne Depression sowie an deren Eltern. Ziele sind 1) die Aufklärung über Depression und Präventions- sowie Behandlungsmöglichkeiten, 2) die Gesundheit zu stärken und das Hilfesuchverhalten zu erhöhen und 3) die Erkrankung zu entstigmatisieren. Zielgruppengerecht werden dazu evidenzbasierte Informationen über Symptome, Diagnostik, Ursachen und Verlauf sowie die leitliniengerechte Behandlung der Erkrankung bereitgestellt. Dabei wird spezifisches Wissen vermittelt und Hilfe zum Einholen frühzeitiger Diagnostik und Behandlung gegeben. Zudem werden die Nutzer_innen über Präventionsmöglichkeiten aufgeklärt. Das Projekt wird fortlaufend wissenschaftlich evaluiert. Ein zentraler Aspekt aller Projektphasen ist die aktive Beteiligung der Zielgruppen, die ihre Perspektiven kontinuierlich in die Entwicklung, Gestaltung und Evaluation einbringen. Über „ich bin alles“ wird gezielt auf diversen Veranstaltungen, Fachkongressen, in sozialen Medien und der Presse informiert. Im Folgenden stellen wir das Gesamtprojekt erstmalig detailliert in einer Fachzeitschrift vor, um über die wissenschaftlich basierte Entwicklung digitaler Informationsangebote zu informieren sowie die Dissemination von „ich bin alles“ unter Fachpersonal und in den Zielgruppen zu fördern.

Background: Although there is a high co‐occurrence of psychopathological symptoms and asthma, longitudinal studies considering asthma endotypes in childhood and adolescence are scarce. Therefore, this study examined the prospective association between psychopathology in childhood and current atopic and non‐atopic asthma in adolescents, considering sex and puberty‐related characteristics. Methods: The study includes 3584 participants (1790 females, 1794 males) from two German birth cohort studies, GINIplus and LISA. Psychopathological symptoms at age 10 ( M = 10.06, SD = .22) were assessed by parent‐reported Strengths and Difficulties Questionnaire (SDQ) and current asthma at age 15 ( M = 15.07, SD = .30) was defined as a positive parent‐reported medical diagnosis, wheezing, and/or medical treatment against asthma (at least two criteria). Atopic asthma was characterized as current asthma and a positive specific immunoglobulin E (IgE) test (≥0.35 kU/L), non‐atopic asthma as current asthma without sensitization. Data were analyzed by logistic regression and multinomial regression models, controlling for potential covariates and confounders. Results: Psychopathological symptoms at age 10 were associated with asthma at age 15 (odds ratio (OR) = 1.69, 95% confidence interval (CI) = 1.04–2.92, p = .035). When examining the endotypes, this effect was replicated only for non‐atopic asthma at age 15 (relative risk ratio (RRR) = 2.92, 95% CI = 1.13–7.60, p = .028), but not for atopic asthma ( p = .381). Regarding the SDQ subscales, an association between peer problems at age 10 and atopic asthma at age 15 was revealed (RRR = 2.00, 95% CI 1.01–3.97, p = .048). Furthermore, significant interaction effects of puberty onset with psychopathological symptoms ( p = .020), and particularly with peer problems ( p = .029), were found on atopic asthma. Conclusion: The findings highlight the importance of early recognition and treatment of psychopathological symptoms to prevent and reduce development, persistence and exacerbation of asthma endotypes, and point to the necessity for further research into hormonal mechanisms linking psychopathology with atopy.

Intermittent theta burst stimulation (iTBS), a variant of repetitive transcranial magnetic stimulation (rTMS), is an established treatment for adults with major depressive disorder (MDD). Due to its favorable safety profile, iTBS is also a promising early intervention in the transition phase from adolescence to early adulthood, but this has not been systematically investigated to date. Thus, the EARLY-BURST trial investigates the efficacy and safety of iTBS over the left dorsolateral prefrontal cortex (lDLPFC) in treatment-seeking young patients (age 16–26 years) with depressive disorders (i.e. major depressive disorder, persistent depressive disorder, bipolar depression), allowing for relevant co-morbidities. Participants have not received antidepressant or antipsychotic medication during the last 12 months except for short-term (< 2 weeks) on-demand medication. The trial will employ a novel sequential Bayesian, randomized, double-blind, parallel-group, sham-controlled design. Up to 90 patients at two clinical sites (Munich, Augsburg) will be randomized 1:1 to the treatment groups, with sequential analyses starting after 26 patients in each group completed the treatment. The primary outcome will be the difference in depression severity at week 6 (post-treatment visit) between active iTBS and sham iTBS, assessed with the Montgomery-Åsberg Depression Rating Scale (MADRS). The trial is planned to be expanded towards a three-arm leapfrog design, contingent on securing additional funding. Thus, in addition to potentially providing evidence of iTBS’s efficacy in adolescents and young adults with depressive disorders, the EARLY-BURST trial aims at setting the stage for subsequent platform trials in this dynamic research field, where novel adaptive study designs are required to meet the need for rapidly testing promising new vs established rTMS protocols. Trial registration: DRKS00033313.

Purpose: BioMD-Y is a comprehensive biobank study of children and adolescents with major depression (MD) and their healthy peers in Germany, collecting a host of both biological and psychosocial information from the participants and their parents with the aim of exploring genetic and environmental risk and protective factors for MD in children and adolescents.Participants: Children and adolescents aged 8–18 years are recruited to either the clinical case group (MD, diagnosis of MD disorder) or the typically developing control group (absence of any psychiatric condition).Findings to date: To date, four publications on both genetic and environmental risk and resilience factors (includingFKBP5, glucocorticoid receptor activation, polygenic risk scores, psychosocial and sociodemographic risk and resilience factors) have been published based on the BioMD-Y sample.Future plans: Data collection is currently scheduled to continue into 2026. Research questions will be further addressed using available measures.

Theoretical Background: Youth with major depressive disorder often do not receive appropriate treatment. Furthermore, evidence-based, highly acceptable, and easily accessible information about depression and its treatment along with services as a complementary strategy to professional treatment is needed for young people seeking help for depression. In autumn 2021, we launched the website www.ich-bin-alles.de. Besides evidence-based information about depression, the website provides self-help exercises based on principles of positive psychology, which might attract young people and can be easily implemented in daily life as a hands-on support. Objective: This randomized controlled trial (preregistered at ClinicalTrials.gov: NCT04994470) examined the efficacy of this positive psychology intervention (PPI) to improve affect- and stress-related outcomes in adolescents with a history of major depressive disorder and assessed its acceptability and adherence aspects. Methods: Data from 77 youth with current or remitted major depressive disorder (who were undergoing or had undergone psychiatric and/or psychotherapeutic treatment) aged 12 – 18 years were analyzed. Participants were randomized to receive either 14 daily web-based self-help exercises based on positive psychology in the experimental group or a web-based sham intervention in the control group. Self-report inventories were applied to assess changes in affect- and stress-related outcome measures as well as the acceptability of and adherence to the intervention. Results: No differential effects of the experimental intervention on affect- and stress-related outcomes were revealed. More than 78 % of the participants in the experimental group reported that they would recommend the self-help exercises of the PPI to other youth and the overall acceptance of the PPI exercises was good. Moreover, 75 % of the participants in the experimental group reported that they carried out the PPI self-help exercises. Discussion and Conclusion: The results have important implications for future approaches that aim to implement web-based self-help exercises based on positive psychology for adolescents with depression, for which we found good adherence and acceptance. In future studies, it would be important to investigate whether a more intensive PPI might also specifically improve affect- and stress-related outcomes and be a promising way to augment the efficacy of traditional therapy approaches in adolescents affected by major depressive disorder.

Substantial sex differences have been reported in the physiological response to stress at multiple levels, including the release of the stress hormone, cortisol. Here, we explore the genomic variants in 93 females and 196 males regulating the initial transcriptional response to cortisol via glucocorticoid receptor (GR) activation. Gene expression levels in peripheral blood were obtained before and after GR-stimulation with the selective GR agonist dexamethasone to identify differential expression following GR-activation. Sex stratified analyses revealed that while the transcripts responsive to GR-stimulation were mostly overlapping between males and females, the quantitative trait loci (eQTLs) regulation differential transcription to GR-stimulation were distinct. Sex-stratified eQTL SNPs (eSNPs) were located in different functional genomic elements and sex-stratified transcripts were enriched within postmortem brain transcriptional profiles associated with Major Depressive Disorder (MDD) specifically in males and females in the cingulate cortex. Female eSNPs were enriched among SNPs linked to MDD in genome wide association studies. Finally, transcriptional sensitive genetic profile scores derived from sex-stratified eSNPS regulating differential transcription to GR-stimulation were predictive of depression status and depressive symptoms in a sex-concordant manner in a child and adolescent cohort ( n = 584). These results suggest potential of eQTLs regulating differential transcription to GR-stimulation as biomarkers of sex-specific biological risk for stress-related psychiatric disorders.