Thursday, July 9, 2009
(NaturalNews) The U.S. Preventive Services Task Force has issued a new recommendation, published in the journal Pediatrics, that all children between the ages of 12 and 18 be regularly screened for the symptoms of major depressive disorder (MDD).
The new recommendations surpass those of most doctors’ groups — which advise screening high-risk youths only — and even those of the of the American Academy of Pediatrics, which recommends only that doctors ask teens about depression, rather than giving them a full screening.
“Adolescent-onset MDD is associated with an increased risk of death by suicide, suicide attempts, … recurrence of major depression by young adulthood, … early pregnancy, decreased school performance, and impaired work, social, and family functioning during young adulthood,” the report authors wrote. “Mass screening in primary care could help clinicians identify missed cases and increase the proportion of depressed children and adolescents who initiate appropriate treatment. It could also help clinicians to identify cases earlier in the course of disease.”
The Preventive Services Task Force is a panel of independent experts given responsibility for setting national primary care treatment guidelines.
According to the panel, approximately 6 percent of U.S. teens, or two million, suffer from MDD, also known as clinical depression. Symptoms include sadness, anxiety, changes in eating or sleeping habits, hopelessness, irritability, isolation, moodiness, negativity, poor grades, risk taking, substance abuse and death wishes or suicidal thoughts.
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Because depression is so common in teens, the researchers said, the majority of cases go undiagnosed.
“You will miss a lot if you only screen high-risk groups,” said task force chair Ned Calonge of the Colorado Department of Public Health and Environment.
In order to develop the recommendation, the researchers reviewed high quality studies conducted since 2002 on the effectiveness of screening in diagnosing depression in children between the ages of 7 and 18, and also on the effectiveness of various treatments. They concluded that all children between the ages of 12 and 18 should receive yearly screening, preferably in a primary care setting such as an annual physical. Patients would merely need to fill out a simple questionnaire, which could even be completed in the waiting room, the researchers said.
The panel did not recommend screening younger children, due to absence of evidence that screening was effective in that age group.
“Limited available data suggest that primary care–feasible screening tools may accurately identify depressed adolescents and treatment can improve depression outcomes,” the task force wrote.
Another report, authored by the American Academy of Pediatrics and the American Academy of Child and Adolescent Psychiatry and appearing in the same issue of Pediatrics, also calls for primary care physicians to get more involved in the treatment of mental illness, including depression. Recommendations include that pediatricians consult regularly with child psychiatrists, and try to have one working in their office if possible.
Report co-author Alan Axelson said that because parents have built up trust with pediatricians over time, these doctors may be in a better position to screen for and treat mental illness without invoking the social stigma of a visit to a therapist or psychiatrist. He noted that pediatricians are authorized to prescribe antidepressant drugs, though they may not perform psychotherapy.
Yet the Preventive Services Task Force report recommends that doctors screen for depression only in cases where psychotherapy is available as a treatment option. The selective serotonin reuptake inhibitor (SSRI) drugs commonly used to treat depression have been linked to increased risks of suicidal thoughts in teenagers, Calonge noted, and the panel does not want to encourage their use in the absence of therapy.
“Treating depressed youth with [SSRIs] may be associated with a small increased risk of suicidality and should only be considered if judicious clinical monitoring is possible,” the report reads.
The task force’s study did not show any correlation between depression screening and improved physical or mental health outcomes.
This article was posted: Thursday, July 9, 2009 at 4:30 am