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Depression screens needed for teens

All teens should be screened for depression, even if they don’t necessarily show signs of the blues, an influential government panel is recommending, noting that the majority of afflicted teens aren’t diagnosed or treated even though there are effective therapies.

Kids ages 12 to 18 should be routinely screened for the mood disorder with standardized depression tests by their pediatrician or family doctor, the U.S. Preventative Task Force said today. The panel's new recommendation—an update of its 2002 assessment, when it said there wasn't enough evidence to advise such screening—is set to be published in next month's Pediatrics.

The task force, which tends to run conservative in its screening guidance, modified its advice after concluding that antidepressants and psychotherapy reduce depression symptoms in teens, and that most teens who are suffering aren’t diagnosed or treated. It said it still doesn’t recommend routine screens for younger children because there isn’t enough evidence to show that those same tests and treatments help them.

Another study in April's Pediatrics echoes the task force's findings, concluding that screening tests can accurately identify depressed teenagers. An estimated 5.9 percent of teen girls and 4.6 percent of teenage boys are depressed. An estimated 2.8 percent of children younger than 13 also are depressed, according to the task force. Depression increases the risk of suicide in people of all ages, and is the third-leading cause of death (after car accidents and homicides) in youth ages 15 to 24. One in every 100 to 200 suicide attempts in that age group is successful, according to the U.S. Centers for Disease Control and Prevention (CDC).

The American Academy of Pediatrics recommends that pediatricians ask teens about their mood, suicidal thoughts and sexual orientation (some gay teens have increased risk of depression and suicide) during routine physicals; the American Medical Association recommends screening of teens considered at risk of depression because of family or substance-abuse problems.

The task force isn’t trying to encourage more use of antidepressant medications, some of which have been linked to an increased risk of suicide, Ned Calonge, the task force chairman and chief medical officer of the Colorado Department of Public Health and Environment, tells ScientificAmerican.com. "It would be a disservice if all we saw was screening followed by medication therapy," Calonge said this afternoon, adding that because they're associated with increased suicide risks, the meds should only be prescribed when teens can be monitored for suicidal behavior and also treated with psychotherapy.

Image © iStockphoto/Carlos Martinez

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