An influential government-appointed medical panel is urging doctors to routinely screen all American teenagers for depression—a bold step that acknowledges that nearly 2 million teenagers are affected by the debilitating condition.
Most are undiagnosed and untreated, says the panel, the U.S. Preventive Services Task Force, which sets guidelines for doctors on a host of health issues.
The task force recommendations appear in the April issue of the journal Pediatrics. They go further than the American Academy of Pediatrics’ own guidance for teen-depression screening.
An estimated 6 percent of U.S. teenagers are clinically depressed. Evidence shows that detailed but simple questionnaires can accurately diagnose depression in primary-care settings such as a pediatrician’s office.
The task force says that when followed by treatment, including psychotherapy, screening can help improve symptoms and help young people cope. Because depression can lead to persistent sadness, social isolation, school problems, and even suicide, screening to treat it early is crucial, the panel says.
The task force is an independent panel of experts convened by the federal government to establish guidelines for treatment in primary care. Its new guidance goes beyond that of the pediatrics academy, which advises pediatricians to ask teenage patients questions about depression. Other doctor groups advise screening only high-risk youngsters.
Because depression is so common, “you will miss a lot if you only screen high-risk groups,” said Dr. Ned Calonge, the task force chairman and the chief medical officer for the Colorado Department of Public Health and Environment.
The group recommends research-tested screening tests even for young people without symptoms. It cites two questionnaires that focus on depression tip-offs, such as mood, anxiety, appetite, and substance abuse.
Dr. Calonge stressed that the panel does not want its advice to lead to drug treatment alone, particularly antidepressants that have been linked with increased risks for suicidal thoughts. Routine depression testing should only occur if psychotherapy is also readily available, the panel says.
A version of this article appeared in the April 08, 2009 edition of Education Week