New urgency in youth depression treatment
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Major depressive episodes among adolescents are on the rise but there hasn’t been a corresponding rise in treatment levels, suggesting many teens are left untreated.

The 12-month prevalence of major depressive episodes (MDE) in adolescents aged 12-17 years rose to 11.3% in 2014, from 8.7% in 2005, according to data from the National Surveys on Drug Use and Health. This corresponded to a 37% increase in odds over the time period studied (odds ratio, 1.37; 95% confidence interval, 1.27-1.48; P less than .001).

KatarzynaBialasiewicz/Thinkstock
“These proportions translate into an increase of more than a half-a-million adolescents with 12-month MDE between 2005 (approximately 2,200,000) and 2014 (approximately 2,700,000),” Ramin Mojtabai, of the Bloomberg School of Public Health and Johns Hopkins University in Baltimore, and colleagues wrote in Pediatrics (2016 Nov 14. doi: 10.1542/peds.2016-1878).

For young adults aged 18-25 years, the change was more modest, from 8.8% in 2005 to 9.6% in 2014 (OR, 1.13; 95%, CI, 1.05-1.22; P = .001), the researchers noted.

The trend of rising depression rates was limited to those in the 12-20 year age range and was more prominent among non-Hispanic whites and adolescent girls.

The researchers found no link between the increasing trend in depression and factors typically associated with adverse mental health outcomes, such as substance abuse, single parent homes, or income.

Of particular concern was the finding that the proportion of adolescents with depression who received treatment or counseling did not significantly change over the time period studied. While the use of specialty mental health providers increased in adolescents and young adults, most of the increases were limited to the years after 2011.

“In view of the growing prevalence of MDE in these age groups, stable treatment rates translate into a growing number of untreated depressed adolescents,” the researchers wrote. “These trends suggest that little progress has been made in narrowing the mental health treatment gap for adolescent depression. This lack of progress may reflect lingering reluctance on the part of providers to diagnose and treat depression in the wake of the FDA’s black box warning regarding the use of antidepressants.”

The researchers reported having no relevant financial disclosures.

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Depression is a sizable and growing deadly threat to our U.S. adolescent population. The prioritization of youth depression treatment of our U.S. population health is imperative. In fact, the American Academy of Pediatrics recently updated its 2007 statement on recognizing suicide risks with a recommendation to routinely screen youth aged 11-21 for depression.

Sadly, even if this important update influences primary care providers to screen more youth, there will never be enough qualified mental health specialists to take care of the million or more adolescents per year, who, if screened and identified, will need treatment and monitoring for depression. The most recently updated Accreditation Council for Graduate Medical Education program requirements for graduate medical education in Pediatrics and Child and Adolescent Psychiatry are such that trainees in neither specialty are clearly required to gain specific skills to tackle the plague of youth depression at a population level.

Is it not time for educational requirements that reflect the urgent needs of our pediatric patients?
 

Anne Glowinski, MD, and Giuseppe D’Amelio are from Washington University in St. Louis. Dr. Glowinski serves on the Advisory Board of the Klingenstein Third Generation Foundation and the Accreditation Council for Graduate Medical Education Psychiatry Residency Review Committee. Mr. D’Amelio reported having no relevant financial disclosures. Their comments are adapted from an accompanying editorial (Pediatrics. 2016 Nov 14. doi: 10.1542/peds.2016-2869 ).

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Depression is a sizable and growing deadly threat to our U.S. adolescent population. The prioritization of youth depression treatment of our U.S. population health is imperative. In fact, the American Academy of Pediatrics recently updated its 2007 statement on recognizing suicide risks with a recommendation to routinely screen youth aged 11-21 for depression.

Sadly, even if this important update influences primary care providers to screen more youth, there will never be enough qualified mental health specialists to take care of the million or more adolescents per year, who, if screened and identified, will need treatment and monitoring for depression. The most recently updated Accreditation Council for Graduate Medical Education program requirements for graduate medical education in Pediatrics and Child and Adolescent Psychiatry are such that trainees in neither specialty are clearly required to gain specific skills to tackle the plague of youth depression at a population level.

Is it not time for educational requirements that reflect the urgent needs of our pediatric patients?
 

Anne Glowinski, MD, and Giuseppe D’Amelio are from Washington University in St. Louis. Dr. Glowinski serves on the Advisory Board of the Klingenstein Third Generation Foundation and the Accreditation Council for Graduate Medical Education Psychiatry Residency Review Committee. Mr. D’Amelio reported having no relevant financial disclosures. Their comments are adapted from an accompanying editorial (Pediatrics. 2016 Nov 14. doi: 10.1542/peds.2016-2869 ).

Body

 

Depression is a sizable and growing deadly threat to our U.S. adolescent population. The prioritization of youth depression treatment of our U.S. population health is imperative. In fact, the American Academy of Pediatrics recently updated its 2007 statement on recognizing suicide risks with a recommendation to routinely screen youth aged 11-21 for depression.

Sadly, even if this important update influences primary care providers to screen more youth, there will never be enough qualified mental health specialists to take care of the million or more adolescents per year, who, if screened and identified, will need treatment and monitoring for depression. The most recently updated Accreditation Council for Graduate Medical Education program requirements for graduate medical education in Pediatrics and Child and Adolescent Psychiatry are such that trainees in neither specialty are clearly required to gain specific skills to tackle the plague of youth depression at a population level.

Is it not time for educational requirements that reflect the urgent needs of our pediatric patients?
 

Anne Glowinski, MD, and Giuseppe D’Amelio are from Washington University in St. Louis. Dr. Glowinski serves on the Advisory Board of the Klingenstein Third Generation Foundation and the Accreditation Council for Graduate Medical Education Psychiatry Residency Review Committee. Mr. D’Amelio reported having no relevant financial disclosures. Their comments are adapted from an accompanying editorial (Pediatrics. 2016 Nov 14. doi: 10.1542/peds.2016-2869 ).

Title
New urgency in youth depression treatment
New urgency in youth depression treatment

 

Major depressive episodes among adolescents are on the rise but there hasn’t been a corresponding rise in treatment levels, suggesting many teens are left untreated.

The 12-month prevalence of major depressive episodes (MDE) in adolescents aged 12-17 years rose to 11.3% in 2014, from 8.7% in 2005, according to data from the National Surveys on Drug Use and Health. This corresponded to a 37% increase in odds over the time period studied (odds ratio, 1.37; 95% confidence interval, 1.27-1.48; P less than .001).

KatarzynaBialasiewicz/Thinkstock
“These proportions translate into an increase of more than a half-a-million adolescents with 12-month MDE between 2005 (approximately 2,200,000) and 2014 (approximately 2,700,000),” Ramin Mojtabai, of the Bloomberg School of Public Health and Johns Hopkins University in Baltimore, and colleagues wrote in Pediatrics (2016 Nov 14. doi: 10.1542/peds.2016-1878).

For young adults aged 18-25 years, the change was more modest, from 8.8% in 2005 to 9.6% in 2014 (OR, 1.13; 95%, CI, 1.05-1.22; P = .001), the researchers noted.

The trend of rising depression rates was limited to those in the 12-20 year age range and was more prominent among non-Hispanic whites and adolescent girls.

The researchers found no link between the increasing trend in depression and factors typically associated with adverse mental health outcomes, such as substance abuse, single parent homes, or income.

Of particular concern was the finding that the proportion of adolescents with depression who received treatment or counseling did not significantly change over the time period studied. While the use of specialty mental health providers increased in adolescents and young adults, most of the increases were limited to the years after 2011.

“In view of the growing prevalence of MDE in these age groups, stable treatment rates translate into a growing number of untreated depressed adolescents,” the researchers wrote. “These trends suggest that little progress has been made in narrowing the mental health treatment gap for adolescent depression. This lack of progress may reflect lingering reluctance on the part of providers to diagnose and treat depression in the wake of the FDA’s black box warning regarding the use of antidepressants.”

The researchers reported having no relevant financial disclosures.

 

Major depressive episodes among adolescents are on the rise but there hasn’t been a corresponding rise in treatment levels, suggesting many teens are left untreated.

The 12-month prevalence of major depressive episodes (MDE) in adolescents aged 12-17 years rose to 11.3% in 2014, from 8.7% in 2005, according to data from the National Surveys on Drug Use and Health. This corresponded to a 37% increase in odds over the time period studied (odds ratio, 1.37; 95% confidence interval, 1.27-1.48; P less than .001).

KatarzynaBialasiewicz/Thinkstock
“These proportions translate into an increase of more than a half-a-million adolescents with 12-month MDE between 2005 (approximately 2,200,000) and 2014 (approximately 2,700,000),” Ramin Mojtabai, of the Bloomberg School of Public Health and Johns Hopkins University in Baltimore, and colleagues wrote in Pediatrics (2016 Nov 14. doi: 10.1542/peds.2016-1878).

For young adults aged 18-25 years, the change was more modest, from 8.8% in 2005 to 9.6% in 2014 (OR, 1.13; 95%, CI, 1.05-1.22; P = .001), the researchers noted.

The trend of rising depression rates was limited to those in the 12-20 year age range and was more prominent among non-Hispanic whites and adolescent girls.

The researchers found no link between the increasing trend in depression and factors typically associated with adverse mental health outcomes, such as substance abuse, single parent homes, or income.

Of particular concern was the finding that the proportion of adolescents with depression who received treatment or counseling did not significantly change over the time period studied. While the use of specialty mental health providers increased in adolescents and young adults, most of the increases were limited to the years after 2011.

“In view of the growing prevalence of MDE in these age groups, stable treatment rates translate into a growing number of untreated depressed adolescents,” the researchers wrote. “These trends suggest that little progress has been made in narrowing the mental health treatment gap for adolescent depression. This lack of progress may reflect lingering reluctance on the part of providers to diagnose and treat depression in the wake of the FDA’s black box warning regarding the use of antidepressants.”

The researchers reported having no relevant financial disclosures.

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Key clinical finding: Adolescent depression is on the rise, but treatment rates have stayed the same indicating undertreatment in this population.

Main finding: The 12-month prevalence of major depressive episodes in adolescents (aged 12-17 years) was 11.3% in 2014, compared with 8.7% in 2005.

Source: Analysis of data from the National Surveys on Drug Use and Health from 2005 to 2014 involving 172,495 adolescents aged 12-17 years and 178,755 adults aged 18-25 years.

Disclosures: The researchers reported having no relevant financial disclosures.