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Screen Teens for Depression, Task Force Recommends

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Adolescents ages 12 to 18 should be screened for major depressive disorder "when adequate systems are in place for diagnosis, treatment, and monitoring," the U.S. Preventative Services Task Force recommended in an updated position paper this week.

But "the current evidence is insufficient to assess the balance of benefits and harms of screening for [major depressive disorder] in children age 11 years and younger," the independent organization said, noting that it found no studies of the use of such instruments on younger children.

The paper updates the organization's 2009 position, which recommended screening for adolescents but limited potential treatment options to therapy and counseling. The draft updated position doesn't included such limits because there is "decreased concern over the harms of pharmacotherapy in adolescents when patients are adequately monitored."

The recommendations, which apply to primary care settings, are also significant for schools, which often serve as a venue to connect students, particularly low-income students, to mental health services. Many schools with onsite health centers have introduced mental health and counseling as well as primary care services. From the paper:

"Children and adolescents with [major depressive disorder] typically have functional impairments in their performance at school or work, as well as in their interactions with their families and peers. Depression can also negatively affect the developmental trajectories of affected youth. [Major depressive disorder] in children and adolescents is strongly associated with recurrent depression in adulthood; other mental disorders; and increased risk for suicidal ideation, suicide attempts, and suicide completion.

In nationally representative U.S. surveys, about 8% of adolescents reported having major depression in the past year. Little is known about the prevalence of MDD in children. Among children and adolescents ages 8 to 15 years, 2% of males and 4% of females reported having [major depressive disorder] in the past year."

You can comment on the draft position here.

Further reading on mental health and schools:

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