Cross-sectional and longitudinal associations between psychotic and depressive symptoms in depressed adolescents.

Adults with major depressive disorder (MDD) with psychotic features (delusions and/or hallucinations) have more severe symptoms and a worse prognosis. Subclinical psychotic symptoms are more common in adolescents than adults. However, the effects of psychotic symptoms on outcome of depressive symptoms have not been well studied in adolescents. Depressed adolescents aged 11-17 with and without psychotic symptoms were compared on depression severity scores at baseline and at 28- or 42-week follow-up in two large UK cohorts. Psychotic symptoms were weakly associated with more severe depression at baseline in both cohorts. At follow-up, baseline psychotic symptoms were only associated with depressive symptoms in one sample; in the other, the effect size was close to zero. This supports the DSM5 system of psychotic symptoms being a separate code to severity rather than the ICD10 system which only allows the diagnosis of psychotic depression with severe depression. There was no clear support for psychotic symptoms being a baseline marker of treatment response.

Narrative Matters: 'Who decides what a meaningful life is?' Life, Animated - a refreshing insight into an autistic person's life.

Life, Animated (2016), directed by Roger Ross Williams is a documentary that centres around the life of Owen Suskind; an autistic person. In recent decades, the media has become a powerful tool that has been used to typify and inform public opinion surrounding autism. This article analyses the portrayal of autism in Life, Animated and draws out important learning points for clinicians, families, service users and the public.

Could the link between drug addiction in adulthood and substance use in adolescence result from a blurring of the boundaries between incentive and hedonic processes?

There is a broad consensus that the development of drug addiction in adulthood is closely linked to the onset of drug use in adolescence. However, the relationship between drug exposure during adolescence and subsequent vulnerability to addiction is yet to be fully understood. This review will first use evidence from adult studies on reward and addiction to give an up-to-date reference point of normal reward-circuitry and the maladaptive changes that later occur in addiction. This will then be compared with current evidence from adolescent studies on reward-circuitry. Similarities between the reward processes governing characteristic behavioral traits in adolescence and the reward profile in adult addiction could help to explain why the risk of later developing addiction is increased when substance use is initiated in adolescence. We argue that the age of onset is a major risk factor in the development of substance use disorder due to a blurring of the boundaries between incentive and hedonic processes, which occurs during adolescence. A deeper understanding of the processes that mediate this blurring could open new avenues for the prevention and treatment of adult drug addiction.