The Cundill Centre collaborates with researchers around the world to develop best practices, including screening tools, early interventions and treatments for children and youth who are experiencing depression.
Our innovative projects:
In partnership with Indigenous, First Nations and Métis youth, the Cundill Centre — along with Dr. Nancy Young and her team at Children’s Hospital of Eastern Ontario — supported the creation of Aaniish Naa Gegii: the Children's Health and Well-Being Measure. This measure offers insight into young people's spiritual, emotional, physical and mental wellness. For more information on this measure or to access culturally relevant wellness resources, visit ACHWM.ca.
The prevalence of depression and anxiety, and their association with physical health in low- and middle-income countries, is an area that has not been well studied. Nash-wo-Numa will begin to close this gap by examining levels of depression and anxiety in young people from ages 9-15 in a rural area of Pakistan. Researchers will also explore the relationship between mood disorders and gender, school attendance, and physical health measures, including body mass index, anemia, undernutrition and puberty.
Our researchers recently completed the first comprehensive review of predictors, mediators and moderators of depression treatment outcomes for youth. Through our learnings from this review, we can develop more effective treatments for depression and understand the most important components to target in depression interventions.
The Cundill Centre also collaborated with the World Health Organization to review research approaches and trends on ways to scale up child and youth mental health interventions. Recommendations include the need for community input, facilitators who are trained and skilled at managing complexity, and systematic reporting of outcomes to better facilitate comparisons among different interventions.
Care for Adolescents who Receive Information ‘Bout OUtcomes (CARIBOU), which was co-developed with youth and their caregivers, is a care pathway based on the National Institute for Health Care and Excellence (NICE) guidelines for depression that incorporates stepped care, shared decision-making principles and measurement-based care. For more information, visit CARIBOU: Care for Adolescents who Receive Information ‘Bout OUtcomes.
Relationship challenges between youth and their caregivers are common when youth experience mental health difficulties. The Cundill Centre is investigating ways to successfully improve those relationships.
A new project is also underway to measure how caregivers and youth discuss feelings by analyzing their communications via text messages.
For more information on current projects and to learn about the Communication, Relationships and Feelings Team (CRAFT) research lab, visit www.craft-lab.ca.
Researchers at the Cundill Centre have created, and are now testing, a group program called Communication & Relationship Enhancement (CARE) to reduce caregiver-youth relationship challenges when youth are experiencing depression. Initial findings suggest that the intervention shows promise in engaging families and reducing conflict. A more rigorous study is now in progress.
First-line treatments for child and youth depression typically only show mild to moderate effectiveness, and 40 to 70 per cent of youth who receive treatment relapse within two years. Investigators at the Cundill Centre are examining the effects of lifestyle strategies on youth experiencing depression in an attempt to increase treatment effectiveness and reduce relapse.
One Cundill project has been looking at the effectiveness of omega-3 supplements for reducing depression in children and youth. While there is not enough evidence to conclusively say that the supplements are effective, the available information in the scientific literature suggests they may have a moderate benefit on depressive symptoms in young people.
Our researchers have also been exploring disturbed sleep as a risk factor for depression, and found a small but important relationship between sleep disturbance in children and youth, and later depression.
The Depression Early Warning study (DEW) is a multi-year study using mobile wearable devices to predict depression relapse. The researchers are collecting information on movement, sleep, mood, energy, speech, and facial expressions to produce a software program that predicts depression relapse. We will use this program to gain new insights and a better understanding of the course of depression over time, and to intervene early before depression re-occurs.
Scholars at the Cundill Centre examined pediatric depression clinical practice guidelines (CPGs) on nutrition, sleep and exercise. Unfortunately, most recommendations in the existing CPGs were general statements based on opinion rather than on clinical trials. Therefore, more work is needed to understand when, for who and what lifestyle interventions are likely to be most effective for youth. Whether lifestyle recommendations should be provided as adjunctive treatments alongside psychotherapy or medication or as interventions in their own right also remains to be answered.
Although suicide is the second-leading cause of death among Canadian youth, youth who go to the emergency department with suicide-related thoughts and behaviours often do not receive adequate care. To help prevent youth suicide and support youth with suicidal ideation, we created I AM SAFE, a short, family-focused program for youth ages 12–17 who are experiencing suicidal thoughts. This study is the first clinical trial of a youth suicide intervention in Canada. For more information, visit www.korczaklab.com/suicide-prevention-rct.
Researchers at The Cundill Centre are also conducting several other projects on youth self-harm. Ongoing analyses from a clinical trial, Self-Harm Intervention: Family Therapy (SHIFT) suggest that monitoring parent criticism while youth are being treated for self-harm could identify youth at risk of poor treatment outcomes. A systematic review is also planned to explore the relationship between parenting behaviours and suicidal ideation or attempts in young people.
Although roughly 20 per cent of youth experience depression, comparing the effectiveness of treatments is challenging because researchers often measure different outcomes. The International Network for Research Outcomes in Adolescent Depression Studies (IN-ROADS), a collaboration with SickKids, is developing a set of core outcomes to be used for studies of depression treatments for youth ages 12-18. For more information on the IN-ROADS initiative, you can get updates on Twitter at https://twitter.com/inroadscos or on the IN-ROADS website at www.in-roads.org.
The International Consortium for Health Outcomes Measurement (ICHOM) developed a standard set of outcome measures that can be used for clinical outcome monitoring among children and young people with depression and anxiety. ICHOM consists of leading global experts, including Cundill Centre members, psychiatrists, psychologists, mental health experts, measurement experts, and lived experience experts. For more information on ICHOM, visit Depression & Anxiety for Children & Young People – ICHOM Connect.
Autistic adults with depression are at higher risk for disability, poor educational and occupation outcomes, and suicide. However, there are no approved treatments for this population. Health Canada approved Repetitive Transcranial Magnetic Stimulation (rTMS for the treatment of depression in neurotypical adults, but no study has examined this treatment in people diagnosed with both autism and depression. We recently completed an initial study on rTMS for treating depression in autistic patients and found reductions in depression symptoms in a sub-group. We are now conducting a more intensive study with 40 autistic young adults, in which we will also use brain imaging before and after treatment to track changes. For more information, you can watch this video.
The Toronto Adolescent and Youth (TAY) Cohort Study is a five-year study following youth with a variety of mental health challenges that aims to better understand risk factors for recovery. This longitudinal study will follow 3,000 youth, ages 11-,24 who are currently accessing mental health services. Throughout the study, each participant will choose different activities that examine biological, clinical, cognitive, social and family-based information. The team will use the results to build a holistic picture of the whole individual, from genes to brain, behaviour and community. For more information on the TAY study, , visit www.taycohort.ca.
Researchers at the Cundill Centre are identifying how children’s and youth’s well-being has been affected by the COVID-19 pandemic, and are advocating for systems-level changes to support their mental health moving forward. One of these initiatives is POPCORN (Pediatric Outcome imProvement through COordination of Research Networks), a research network that brings together pediatric health researchers across Canada. POPCORN’s primary goal is to establish a unified and collaborative group of researchers to answer important child health questions. The Cundill Centre’s role is to provide support for examining the impact of COVID-19 on young people’s mental health. For more information on POPCORN, visit https://popcornpediatrics.ca/.
An additional initiative is using longitudinal data from the Canadian Health Survey on Children and Youth to understand the risk and protective factors for parents and children during the COVID-19 pandemic. The results will provide new information on how best to support children’s mental health during and beyond the pandemic. This study is run out of the Offord Centre for Child Studies at McMaster University. The Cundill Centre is part of the primary investigator team.
The Ontario Child Health Study (OCHS) was a large-scale, provincial research study run out of the Offord Centre for Child Studies at McMaster University that examined the physical and mental health of Ontario children and youth ages 4-17. Several Cundill Centre researchers are now using the OCHS database to examine such topics as parenting within families, the prevalence of depression in children and youth, associations between body mass index (BMI) and depression, and the co-occurrence of physical and mental health disorders. For more information on OCHS, visit https://ontariochildhealthstudy.ca/.
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