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J Clin Outcomes Manage
2005 May;12(5):260-276
Current perspectives on the diagnosis and treatment of adolescent depression in the primary care setting
Schloredt K, Varley CK
Educational Needs Addressed Adolescent depression represents a serious mental health issue that is increasingly coming to the attention of primary care physicians. Approximately 1 in 5 adolescents experiences a major depressive episode by age 18 years, and many others experience less severe and transient depressive symptoms. Depression is often associated with functional impairment and other negative outcomes, including recurrent episodes and suicide. The high prevalence of adolescent depression and the limited availability of adolescent mental health specialists have resulted in a growing need for primary care providers to be able to recognize, diagnose, and treat depression. Educational Objectives: 1. Outline an approach to the diagnostic evaluation/workup for an adolescent presenting with depressive symptoms and highlight factors that complicate accurate diagnosis; 2. Discuss common etiologies of major depressive disorder in adolescents and describe the expected clinical course and sequelae of adolescent depressive illness; 3. Describe indicators of pharmacotherapy, psychotherapy, and/or combined therapy in the treatment of adolescent major depression and the evidence for the efficacy of each strategy; 4. Outline the controversy regarding use of selective serotonin reuptake inhibitor medications in adolescents and discuss FDA recommendations for use of these medications in adolescents; 5. Discuss how issues of diversity may impact the presentation, assessment, and clinical management of depression in adolescents
Review
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