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Many Depressed Teens Don't Get Follow-Up Care

Some receive initial treatment after diagnosis, but longer-term therapy often lacking, study finds

MONDAY, Feb. 1, 2016 (HealthDay News) -- Depression can strike during the teen years, but too many U.S. teenagers with the illness are not getting proper follow-up care, a new study finds.

"These results raise concerns about the quality of care for adolescent depression," concluded a team led by Briannon O'Connor, who conducted the study while at New York University School of Medicine.

One expert wasn't surprised by the findings.

"Most adolescents who are depressed do not receive any treatment whatsoever for their impairments for many reasons, including lack of access to care, stigma, and a workplace shortage of trained child and adolescent psychiatrists," said Dr. Aaron Krasner, chief of the Adolescent Transitional Living Service at Silver Hill Hospital in New Canaan, Conn.

As the study authors explained, major depression affects 12 percent of teens, and as many as 26 percent of young people experience at least mild depression. Prompt treatment is crucial because failure to relieve depression increases the risk of recurrent depression and more impaired functioning in the long term, the researchers said.

In the new study, O'Connor's team tracked the care of more than 4,600 teens with depression symptoms. The teens averaged 16 years of age, and two-thirds of them were girls. All were patients in one of three large health care systems.

Treatment was started for more than 2,900 of the teens -- most received talk therapy alone or in combination with antidepressants.

However, 36 percent of the teens received no treatment at all within three months of their diagnosis, and more than two-thirds (68 percent) did not have any follow-up assessment. About a fifth (19 percent) did not receive any follow-up care, and 40 percent of those teens who were prescribed antidepressants did not undergo documented follow-up care, the researchers reported.

Dr. Jane Swedler is chief of adolescent medicine at Winthrop-University Hospital in Mineola, N.Y. She called the new findings "very disturbing."

"It appears that the initial recommendations for treatment --- therapy referral, medications or both -- are being offered to most patients," she said. "However, a significant portion of those patients did not have follow-up scheduled in the following three months.

"It is clear from this study that the guidelines for follow-up of adolescent depression fall significantly below the mark," Swedler said, "and that we must improve monitoring and follow-up of those adolescents identified with depression."

Another child psychiatrist agreed, noting that there are ways to expand depression treatment for at-risk teens.

"With the increased use of technology by youth, treatment opportunities that include smartphone reminders, apps, online counseling, tele-psychotherapy, may all increase treatment adherence for depressed youth," said Dr. Victor Fornari, director of child and adolescent psychiatry at Zucker Hillside Hospital in Glen Oaks, N.Y.

The study was published online Feb. 1 in the journal JAMA Pediatrics.

More information

There's more on spotting depression in teens at Mental Health America.


SOURCES: Aaron Krasner, M.D., chief, Adolescent Transitional Living Service, Silver Hill Hospital, New Canaan, Conn.; Jane Swedler, M.D., chief, adolescent medicine, Winthrop-University Hospital, Mineola, N.Y.; Victor Fornari, M.D., director, division of child and adolescent psychiatry, Zucker Hillside Hospital, Glen Oaks, N.Y., and Cohen Children's Medical Center, New Hyde Park, N.Y.; JAMA Pediatrics, news release, Feb. 1, 2016

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