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fast breaking papers - 2010

February 2010 Download this article
David A. Brent talks with and answers a few questions about this month's Fast Breaking Paper Paper in the field of Psychiatry/Psychology.
David A. Brent Article Title: Predictors of Spontaneous and Systematically Assessed Suicidal Adverse Events in the Treatment of SSRI-Resistant Depression in Adolescents (TORDIA) Study
Authors: Brent, DA;Emslie, GJ;Clarke, GN;Asarnow, J;Spirito, A;Ritz, L;Vitiello, B;Iyengar, S;Birmaher, B;Ryan, ND;Zelazny, J;Onorato, M;Kennard, B;Mayes, TL;Debar, LL;McCracken, JT;Strober, M;Suddath, R;Leonard, H;Porta, G;Keller, MB
Journal: AMER J PSYCHIAT, Volume: 166, Issue: 4, Page: 418-426, Year: APR 2009
* Univ Pittsburgh, Sch Med, Western Univ Sch Med, Western Psychiat Inst & Clin, 3811 O'Hara St, Suite 112, Pittsburgh, PA 15213 USA.
* Univ Pittsburgh, Sch Med, Western Univ Sch Med, Western Psychiat Inst & Clin, Pittsburgh, PA 15213 USA.

  Why do you think your paper is highly cited?

I did not know that it was! It is one of the few to look at suicidal events in adolescent depression, and describes predictors of the occurrence of these events.

  Does it describe a new discovery, methodology, or synthesis of knowledge?

"I would be interested in using these indicators to see if we can prevent the onset of suicidal events..."

Most studies look at suicidal events using spontaneous reports. Some assess suicidal events systematically. Due to a change in requirements from our Institutional Review and Data Safety Monitoring Boards, this study used the first method for the first half of the study, and the second for the second half, allowing for a comparison of the findings using these two different methods.

  Would you summarize the significance of your paper in layman's terms?

Suicidal events in the treatment of adolescent depression occur early in treatment, are more common in those who are severely depressed and are not responding to treatment, and are predicted by high suicidal ideation at entry, drug and alcohol use, and family conflict. The use of trazodone (a psychoactive compound with sedative and anti-depressant properties) and of benzodiazepines, which are widely prescribed for a variety of conditions, particularly anxiety and insomnia, were also associated with suicidal events.

  How did you become involved in this research, and were there any problems along the way?

We were doing the treatment study anyway, and the reports of the relationship between antidepressants and suicidal events in adolescents left us wanting to know more, so we tried to learn what we could from this study.

  Where do you see your research leading in the future?

I would be interested in using these indicators to see if we can prevent the onset of suicidal events; I would also like to look at biological predictors of suicidal events, using pharmacogenetics and functional Magnetic Resonance Imaging (fMRI).

  Do you foresee any social or political implications for your research?

I think it supports systematic, rather than spontaneous, assessment of suicidal occurrences in future clinical trials.

David A. Brent, M.D.
Director, Services for Teens at Risk (STAR)
Academic Chief, Child and Adolescent Psychiatry
Western Psychiatric Institute & Clinic
Western University School of Medicine
Professor of Psychiatry, Epidemiology, and Pediatrics
UPMC Endowed Chair, Suicide Studies
University of Pittsburgh School of Medicine
Pittsburgh, PA, USA



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2010 : February 2010 - Fast Breaking Papers : David A. Brent on His Work With Adolescent Depression