Screening for Major Depressive Disorder in Children and Adolescents: A Systematic Review for the U.S. Preventive Services Task Force

Abstract

Agency for Healthcare Research and Quality.

Screening for Depression in Children and Adolescents: US Preventive Services Task Force Recommendation Statement

“…Only 36% to 44% of children and adolescents with depression receive treatment, suggesting that the majority of depressed youth are undiagnosed and untreated. 3 …”

“…3,4 To focus on the population most likely to benefit from screening and intervention, the scope of the review was narrowed to focus on screening for and treatment of MDD. In addition, studies of paroxetine were excluded because of the 2003 FDA recommendation that this agent not be used to treat MDD in children and adolescents because of reports of possible suicidal ideation and suicide attempts in children and adolescents taking paroxetine for depression.…”

Training General Practitioners to Detect Probable Mental Disorders in Young People During Health Risk Screening

“…However, they correctly ruled out a probable mental disorder in four out of five (specificity 84% and 87% in intervention and comparison arms), suggesting that they were more accurate at excluding than recognizing probable mental disorder. Sensitivity of GP probable mental disorder assessments is clearly lower than the results of standardized screening tests (Patient Health Questionnaire, Beck Depression Inventory) [28]. The background prevalence of mental disorders suggests that there may be an added value of using standardized psychosocial screening instruments in primary care for all young people.…”

“…There is little evidence that screening improves mental health outcomes, and concerns exist about stigma and increased strain on health care resources potentially arising from incorrectly pathologizing normal adolescent developmental changes [34]. However, the 2016 U.S. preventive taskforce systematic review on the efficacy of adolescent depression screening in primary care recommended screening because effective interventions are available [28]. They found no evidence of harm from screening.…”

Primary care management of depression in children and adolescents

“…11 ■ Major studies The U.S. Preventive Services Task Force (USPSTF) revaluated the evidence on screening and treating children and adolescents for MDD. 12 The current recommendation of the USPSTF reaffi rms the previous recommendation of 2009: to screen for MDD in adolescents, ages 12 to 18, when it is possible to provide an accurate diagnosis, psychotherapy, and adequate follow-up. 2,12 The current recommendation does not recommend any specifi ed therapies.…”