Tired all the time: Fatigue in adolescents with depression

疲劳是一种极度疲劳或疲惫的状态，可以在身体和精神上感受到。疲劳是青春期相对常见的经历，青春期是儿童和成年（通常为10至19岁）之间的时期。然而，当疲劳的感觉挥之不去，并持续很长一段时间，它可以成为高度禁用，可以在生活的方式得到充分。抑郁症通常在青春期开始，疲劳是九个主要症状之一。先前的研究发现，许多患有抑郁症的青少年也报告有问题的疲劳。虽然从事青少年工作的心理健康专业人员认识到疲劳对心理健康的重要性，但往往没有得到解决或治疗。到目前为止，很少有研究集中在患有抑郁症的青少年的疲劳上，这意味着有很多未回答的问题。因此，本研究的主要目的是进一步了解疲劳作为青少年抑郁症的常见症状。为此，我们将回答以下研究问题：1。青少年抑郁症患者如何感受疲劳？2.我们如何衡量青少年抑郁症患者的疲劳程度？3.目前治疗青少年抑郁症的方法是否能解决疲劳问题？4.哪些干预措施和技术有助于解决青少年疲劳问题？为了回答这些问题，我计划做4项研究：研究一将通过探索患有抑郁症的青少年如何经历疲劳以及可以做些什么来帮助解决第一个研究问题。这将是一项定性研究，通过半结构化访谈收集数据，并使用主题分析或解释性现象学分析进行分析。参与者将是11-18岁的青少年，他们将通过儿童和青少年心理健康服务和专门从事青少年心理健康的慈善机构招募。研究二将研究如何最好地测量青少年抑郁症中的疲劳。我们将为青少年开发一个新的量表，或者尝试验证目前用于测量成人疲劳的现有量表。然后，将对该大学的青少年和年轻人进行抽样测试。将使用心理测量分析来评估测量的可靠性和有效性。第三项研究将探讨目前用于青少年抑郁症的治疗方法是否也能治疗疲劳。这将与IMPACT研究的研究人员合作完成（Goodyer等人，2017），这是一项针对青少年抑郁症的心理社会治疗的大规模随机对照试验。我将对这项研究的数据进行二次分析，并将观察疲劳水平在整个治疗过程中是否会发生变化，以及这种变化是否会因接受的治疗（包括认知行为治疗[CBT]，心理动力学心理治疗和简短的心理干预）而有所不同。第四项研究将是一项系统性综述，将汇集所有关于青少年疲劳干预措施有效性的现有证据，重点是确定所使用的行为改变技术。这将解决最后的研究问题。青少年抑郁症中的疲劳是一个研究不足的领域，因此这项研究产生的工作将解决当前知识中的一个重要空白。预计这些研究的结果将用于为未来的研究和临床实践提供信息，并为患有抑郁症和有问题的疲劳的青少年提供更好的治疗。

Fatigue is an extreme state of tiredness or exhaustion and can be felt both physically and mentally. Fatigue is a relatively common experience in adolescence, which is the period between childhood and adulthood (usually 10 to 19 years old). However, when feelings of fatigue linger and continue for a long period of time, it can become highly disabling and can get in the way of living life to the fullest. Depression frequently starts during adolescence, and fatigue is one of the nine main symptoms. Previous research has found that many adolescents with depression also report problematic fatigue. Whilst mental health professionals working with adolescents recognise the importance of fatigue on mental health, it is often not addressed or treated. To-date, minimal research has focused on fatigue in adolescents with depression, meaning that there are lots of unanswered questions. Therefore, the main aim of this research is to further our understanding of fatigue as a common symptom of adolescent depression. To do this, we will be answering the following research questions: 1. How is fatigue experienced by adolescents with depression? 2. How do we measure fatigue in adolescents with depression? 3. Do current treatment for depression in adolescents address fatigue? 4. What interventions and techniques are helpful for addressing adolescent fatigue? To answer these questions, I plan to do 4 studies: Study One will address the first research question by exploring how adolescents with depression experience fatigue and what can be done to help. This will be a qualitative study, with data collected through semi-structured interviews and analysed using either Thematic Analysis or Interpretative Phenomenological Analysis. Participants will be adolescents aged 11-18 years old, who will be recruited through Child and Adolescent Mental Health Services and charities specialising in adolescent mental health. Study Two will look at how fatigue in adolescent depression can best be measured. We will either develop a new scale for adolescents or will attempt to validate an existing scale that is currently used to measure fatigue in adults. This revised measure will then be tested with a sample of adolescents and young adults at the university. A psychometric analysis will be used to assess the reliability and validity of the measure. Study Three will address whether current treatments used for adolescent depression also treat fatigue. This will be done in collaboration with researchers from the IMPACT study (Goodyer et al., 2017), which is a large-scale randomised controlled trial of psychosocial treatments for adolescent depression. I will conduct a secondary analysis of the data from this study, and will see if levels of fatigue change throughout treatment, and if this change is different depending on what treatment is received (including Cognitive Behavioural Therapy [CBT], psychodynamic psychotherapy, and a brief psychological intervention). Study Four will be a systematic review, which will pool all the existing evidence about how effective interventions for adolescent fatigue are, with a focus on identifying the behaviour change techniques used. This will address the final research question. Fatigue in adolescent depression is an under-researched area, so the work produced from this research will address an important gap in current knowledge. It is anticipated that the findings from these studies will be used to inform future research and clinical practice, and lead to better treatment for those adolescents who have depression and problematic fatigue.