The Guidelines for Adolescent Depression in Primary Care cannot replace clinical judgment, and they should not be the sole source of guidance for adolescent depression management. Nonetheless, the guidelines may assist PC clinicians in the management of depressed adolescents in an era of great clinical need and a shortage of mental health specialists. Additional research concerning the management of depressed youth in PC is needed, including the usability, feasibility, and sustainability of guidelines, and determination of the extent to which the guidelines actually improve outcomes of depressed youth.

This is the first national study to examine individual pediatrician practice changes in antidepressant use subsequent to the FDA warning. Further research is needed to better understand the reasons for these changes to aid in the development of strategies that could help clinicians to optimally integrate these warnings into clinical practice.

Depression is a common condition among children and adolescents, with lasting detrimental effects on health, and social and occupational functioning. Despite being well-positioned to treat depression, primary care providers (PCPs) cite significant barriers. This review aims to summarize recent evidence to provide practical guidance to PCPs on the management of pediatric depression in their practices. Following identification and assessment, PCPs should provide general initial management. Children and adolescents with mild depression can be managed with active support and symptom monitoring, while those with moderate-to-severe depression can be treated with psychotherapy and/or antidepressants, which may involve referral to mental health specialty care. Less is known about the treatment of depression in children under the age of 12 years, who may be candidates for earlier referral to mental health specialty care. PCPs have the potential to improve the recognition and management of depression in young people, having lasting individual and societal benefits.

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Observership programs provide a unique opportunity to integrate IMGs into the U.S. medical system. This article provides a framework for establishing such programs in a way that will optimize their benefits and avoid potential pitfalls.