Usual Care for Adolescent Depression From Symptom Identification Through Treatment Initiation

Pediatricians as Psychiatrists

“…5 Regardless of the treatment used, patient follow-up is critical to the treatment and management of depression in children and adolescents. In a study by O'Connor et al, 6 19% of adolescents with MDD did not receive any follow-up within 3 months of diagnosis, and 40% of those on medication were also not seen at 3 months after starting medicinal treatment. Better outcomes were found in adolescents with adequate follow-up no matter what treatment plan was initiated.…”

“…5,6 There is a high cost for treatment of depression, and unfortunately only about 20% of affected adolescents receive care. 6 Like other chronic diseases, early diagnosis, treatment, and education improve outcomes. For this reason, it is recommended that pediatricians screen for depression in children age 12 to 18 years during routine care health visits.…”

“…For this reason, it is recommended that pediatricians screen for depression in children age 12 to 18 years during routine care health visits. 6 The tools most commonly used are the Patient Health Questionnaire for Adolescents (PHQ-A) and the Beck Depression Inventory (BDI). 5 The PHQ-A has a higher predictive value for depression.…”

“…For younger adolescents with mild symptoms, therapy alone was beneficial. 6 The use of psychotherapy in combination with medication (fluoxetine) showed improvement in symptoms in 71% of children and teenagers compared to 35% in those who received CBT and placebo. 5 Regardless of the treatment used, patient follow-up is critical to the treatment and management of depression in children and adolescents.…”

“…Better outcomes were found in adolescents with adequate follow-up no matter what treatment plan was initiated. 6 …”