Screening is not equal to treatment in teen depression
A new study takes a look at the screening and treatment of teen depression. What can parents learn from this?
Adolescent depression is a problem in the United States, but the good news is that effective treatment is readily available. An estimated 2.8 million American adolescents age 12 to 17 had at least one major depressive episode in the previous year, the National Institute of Mental Health reported in 2014. This number represented 11.4 percent of the U.S. population in that age group.
New research recently released in JAMA Pediatrics takes a closer look at the treatment of adolescent depression in the U.S. In the review of all adolescent patients in three large health systems, researchers concluded that their primary care physicians were routinely screening and identifying depression symptoms.
The majority of the 4,300 newly diagnosed adolescents during the study period began psychotherapy with or without anti-depressants medications, while a smaller number received medication alone. This is generally good news, but over a third of patients did not receive treatment in the medical setting. What isn't clear is if they had received psychotherapy offsite, such as at school or other facility, or simply went untreated.
A decade ago, routine screening for depression was not as common. Adolescents identified as having depression were often referred out and placed on a waiting list for treatment. Primary care providers for adolescents are now routinely screening, allowing for proper diagnosis and treatment initiation. This is important because research shows that adolescents who have depression do not simply "grow out of it."
If depression is not identified early, these youngsters are more likely to relapse, with depressive episodes negatively impacting family life, relationships with friends, and school performance – right at a time when students are considering their post high school education and transition to adult life. Thus, it is critical that primary care providers and other health professionals routinely screen for depression, diagnose, initiate treatment, and provide ongoing monitoring to ensure the healthy development of adolescents who have depression.
While this study shows improved screening, diagnosis, and initiation of treatment, and encouragingly also shows that the majority of patients received psychotherapy consistent with the guidelines of the American Academy of Child and Adolescent Psychiatry, it is still concerning that there is a disconnect between early identification of depression symptoms and follow-through of treatment protocols in current medical models. After three months, 40 percent of adolescents on a prescription for depression did not have a documented follow up within three months of initial prescription. So while this indicates improvement in care, there is still more to be done.
For parents and families, the message is clear:
Your adolescent should be screened for depression at his or her annual physical or other office visits, if needed. Don't attribute moodiness, poor sleep, a drop off in school performance, or a loss of interest in other activities as part of normal adolescence. Have it evaluated – and you can start in your primary care provider's office.
If your teen is diagnosed with depression, you need to know that it is very treatable.
You will see improvement with psychotherapy, and sometimes with medication. Early identification and treatment usually results in a better long-term course. But parents also need to be aware to continue to monitor symptoms and watch for relapse, which is common, and understand that treatment of a relapse is easily done and usually involves a quicker response.
As parents, you need to be vigilant and monitor your teen's progress and involve your teen by speaking openly about his or her symptoms and treatment. Depression can have a negative impact on family relationships, school performance, sports, art and music performance, and helping your teen reach his or her long-term goals should include screening and, if needed, effective treatment.
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