Panel recommends screening all teens for depression

A government-appointed medical panel is urging doctors to screen all teen patients for depression.

The U.S. Preventive Services Task Force has recommended children ages 12-18 be screened by pediatricians or primary care physicians for major depression disorder, which the panel says can lead to debilitating circumstances or suicide later in life.

The board — which encompasses primary care clinicians that, in part, have interest in preventing high-risk adolescent behavior - says about 6 percent of American teens live with depression (according to the last U.S. Census, there are about 28 million teenagers in the U.S.).

The task force says when systems for accurate diagnosis and treatment are in place, screening may prevent teen suicide, which is the third leading cause of death in people ages 15 to 24. The panel said in its recommendation - which appears in the current Pediatrics journal - that, too often, depression in teens and adolescents goes undiagnosed and untreated.

A local psychiatrist and a local social worker agreed.

“So often [depression] goes undiagnosed, and teens attempt or commit suicide because it is never recognized; it’s never treated, and it’s exceptionally treatable - that’s the tragedy,” said Dr. Stephen Sobel, an adult and adolescent psychiatrist with offices in Kearny Mesa and Carlsbad.

Michael Jones, a local licensed clinical social worker, said the early screenings have the potential to be very effective.

Dr. Ned Calonge, chair of the task force, told the Associated Press the panel does not want its new recommendation to lead to more drug treatment for children living with depression, particularly because some antidepressants have been linked to increased risk for suicidal thoughts. Calonge told the AP routine depression screening - about once a year - should only occur if therapy is readily available.

Primary care physicians and parents are the first line of defense in combating depression and teen suicide, Sobel and Jones said.

Sobel said parents must look for early warning signs of depression in teens. Among the indicators are changes in personality, sleep patterns and energy level, social withdrawal, a decreased interest in activity, irritable or anxious behavior, use of alcohol and drugs and a decline in academic performance.

The social stigma associated with depression may mislead parents to avoid asking teens whether they feel sad or anxious, or whether they’ve considered suicide, and parents may mistake a change in behavior for adolescent hormones; but Sobel and Jones said it’s a parent’s responsibility to act.

“The primary responsibility lies with the parents,” Sobel said. “Parents are in a crucial position to recognize warning signs.”

Once early warning signs are indicated, “it is incumbent on the physician” to provide support and screening, Sobel said.

“We ask primary care physicians to do so much in such a short period of time,” Sobel said. “I don’t operate under the delusion every teen will be screened by every primary care physician, but my hope is the [task force's recommendation] creates more awareness for the possibility of depression, and it is prominent in the doctor’s mind and something he’ll consider asking teen patients about.”

Jones said early screening would allow psychiatrists and social workers to take extra care with adolescent or teen clients who are depressed or considering suicide.

“If screening shows a moderate to high risk for depression, then we can act,” he said.

Jones said early detection and diagnosis of depression would allow him to help families develop safety plans. For example, he might suggest parents monitor the child more closely, remove weapons from the house and engage the child in outdoor or family activities.

More Lifestyle

According to the AP, the task force’s recommendations come at a pivotal time for treatment of depression and other mental health problems in children. A new law requires equal coverage for mental and physical ailments in insurance plans that offer both. Legislators and health care providers hope the law will allow and encourage more adults and children to seek mental health care, despite the fact psychiatrists who treat children and teens are few and far between.

The AP noted a separate report, also released in the new Pediatrics journal, says primary care doctors including pediatricians and family physicians will need to get more involved in mental health care. That report is from the pediatrics academy and the American Academy of Child and Adolescent Psychiatry. The groups say pediatricians should routinely consult with child psychiatrists, including working in the same office when possible. And it says insurers should compensate pediatricians for any mental health services they provide.

With mental health providers scarce for adolescents and teens, Sobel said TherapistFinder.com is one resource families can use to locate local psychotherapists who can help. The Web site allows users to locate therapists in surrounding zip codes who specialize in different fields of study.

The Associated Press contributed to this story.

Tags: clincis, preventive services task force, SDNN, social work, teenagers

This entry was posted on Wednesday, July 1st, 2009 at 4:10 pm and is filed under Health, Lifestyle, Local News, Politics & Government. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.