Kids and Depression
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Kids and teenagers who suffer from depression may not be receiving care in accordance with published guidelines, finds a new study in this month’s Archives of General Psychiatry.
Studies show depressive disorders occur in about 2 percent of primary school children. Four percent to 8 percent of teenagers are diagnosed with depression. Children with depression are at greater risk for suicide, substance abuse, early pregnancy, poor school performance, and impaired psychosocial functioning. About half of all kids who experience depression will suffer a relapse in young adulthood. The first line of treatment is considered psychotherapy.
Antidepressants are recommended only for children with severe depression who do not respond to psychotherapy.
Investigators from Columbia University analyzed health data from a national survey of the general population, looking at patients ages 6 to 18 who made at least one trip to the doctor for the treatment of depression over a four-year period. The primary goals of the study were to gauge the rate of treatment among the children and how they were treated.
Results showed a lower rate of treatment for both black children and children without insurance. Although nearly 80 percent of the children who were treated received psychotherapy, less than a third underwent 10 or more visits a year. However, about 57 percent were prescribed an antidepressant. Compared to children who were treated without an antidepressant, those who did receive the medications were more likely to live in a large urban area, have health insurance, and have parents who graduated from high school. Researchers found little evidence linking prescriptions for antidepressants to illness severity. Medically speaking, only children who showed signs of being unable to experience pleasure from activities that typically produce pleasurable feelings were more likely to get the medications.
The investigators conclude serious gaps exist in the treatment of children with depression, and antidepressants are being used far more often than would be expected based on published treatment guidelines.
Revision date: July 4, 2011
Last revised: by Sebastian Scheller, MD, ScD
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