Childhood And Teen Depression In Primary Care Setting

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Childhood or teenage depression is often difficult to diagnose, partly because younger people have more difficulty expressing how they feel, or the symptoms are attributed to just being young, or being a difficult teenager, but the fact is, childhood and teen depression that is unrecognised and undiagnosed can have a devastating effect on the young person’s life and may even end in suicide.

Recently, Medscape interviewed Dr Bernadette Melynk from Arizona State University College of Nursing and Health Innovation who is an expert in childhood depression and here we will summarise some of her responses to the questions posed by Medscape.

According to Dr Melynk, mental health problems in children are as common as childhood fractures. Around 1 in 4 or 5 children have a mental health disorder but less than a quarter of these children get any treatment, partly because of inadequate screening and identification by primary care providers.

She says the best way of detecting childhood and adolescent depression in the primary care setting is to routinely screen for it. However, she recognised that many primary care practices do not have the services or access to them in order to be able to do this.

The worrying thing is she says that untreated depression “raises the risk of suicidal behaviour and completed suicide, which is the third leading cause of death in adolescents”.

“Recent annual prevalence data from the national surveillance of high school students (9th to 12th graders) indicate that depressive symptoms severe enough to impair daily functioning are reported by 37% of girls and 20% of boys. It also is estimated to affect approximately 5% of children, and the rate is higher in minority children and teens” said Dr Melnyk

According to Dr Melynk the most effective of way of managing moderate to severe child and adolescent depression is cognitive behaviour therapy (CBT) in combination with selective serotonin reuptake inhibitor drugs (SSRIs) if CBT isn’t proving effective by itself. For mild to moderate depression she recommends CBT and again if that isn’t effective, SSRIs.

The problem is that not every primary care practice has access to CBT providers but Dr Melnyk has developed a 7 session cognitive behaviour skills-building intervention programme for depressed teens called COPE (Creating Opportunities for Personal Empowerment) which after a training session, different health practitioners will be able to deliver in their own settings in only 20 to 25 minutes and even in school based health settings.

“This session is part of a 15-session COPE/Healthy Lifestyles TEEN (Thinking, Emotions, Exercise and Nutrition) program that my research team is now testing with 800 adolescents in Phoenix area high schools. From pilot work using the COPE TEEN program, we have seen substantial drops in depression and anxiety in adolescents” Dr Melnyk told Medscape.

If you think your child may be suffering from depression seek advice from your doctor.

Learn how I beat Depression

1 Comment

  1. Tori
    Posted May 14, 2010 at 3:16 pm | Permalink

    I can’t agree more with your post. Millions of Americans suffer from a misdiagnosed or undiagnosed mental illness. I’ve found Silver Hill Hospital’s website to be a useful source of information about treatments for Adolescent depression They provide hope for people who may not have been getting the right care.

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