Although depression was originally described as an adult
disorder, we now recognize that depression is also common
in adolescents
and even younger children. Depressive symptoms are common
throughout the lifespan with many depressed adults experiencing
early symptoms in childhood and adolescence. In addition,
depressive disorders cause considerable
and mortality - childrens' depression
affects school performance, social interactions,
family relationships, and suicide is the
number three cause of death in adolescents.
However, recent advances in understanding
of brain neurodevelopment, chronic stress,
and pharmacology offer potential for effective
treatment and prevention of future morbidity.
Primary care physicians (family physicians,
pediatricians, and others) provide care
to the majority of depressed children
and are having an increased role in identification,
evaluation, and treatment for depression.
In order to maximize effective interventions
and to operationalize new findings, research
initiatives must include pediatricians
and primary care providers.
Our work with the Depression Center involves
pediatric health services research to
describe pediatric patient utilization
of primary care services, to improve primary
care physician recognition/diagnosis,
to understand physician practice patterns/variation,
and to enhance integration of services
under different health system organizations.
Our previous studies have been published in Pediatrics,
the Journal
of the Ambulatory Pediatric Association, and the Archives
of Pediatric and Adolescent Medicine. This work described
the increasing prescription of newer serotonin selective
reuptake inhibitor (
) antidepressants, physician variation in prescription and
referral practices, and pediatric patient factors (age,
gender, race) that affect SSRI prescription prevalence.
Our studies generated significant national media interest
and attention in Newsweek, USA Today, CNN, and other venues.
As children, parents, and providers struggle with how to
consider these new therapies, we hope to provide guidance
and recommendations that will lead to rational, appropriate
diagnosis and treatment.
