University of Texas Southwestern Medical Center Dallas.
University of Texas Southwestern Medical Center Dallas.
J Am Acad Child Adolesc Psychiatry. 2019 Jun;58(6):632-635. doi: 10.1016/j.jaac.2019.01.019. Epub 2019 Apr 4.
Depression in youth is a critical public health concern. Nearly 13% of adolescents have experienced a depressive episode within the last year, and suicide is the second leading cause of death among 15- to 24-year-olds. Depression's negative impact spans several domains of functioning, leading to long-term effects on development. Recognizing the magnitude of the crisis, renewed guidelines by the US Preventive Services Taskforce and the American Academy of Pediatrics suggest that pediatric primary care providers become more active in the screening, diagnosis, and treatment of depression. Primary care settings provide optimal opportunities to identify and treat depression, while reducing stigma and barriers surrounding mental health, particularly given the limited availability and cost of psychiatric specialists. Although providers cite difficulties, including insufficient appointment time, inadequate training, discomfort addressing mental health disorders, and stigma, the management of depressed patients is feasible and efficacious in primary care. Several cost-efficient and easy-to-use depression screening tools are readily available and can be used alongside clinical interviews to diagnose and initiate treatment. In the following letter, we examine the feasibility of implementing a program focused on supporting pediatric providers in screening, diagnosing, and initiating depression treatment in youth.
青少年抑郁症是一个严重的公共卫生问题。近 13%的青少年在过去一年中经历过一次抑郁发作，而自杀是 15 至 24 岁人群的第二大死因。抑郁症的负面影响涉及多个功能领域，对发展造成长期影响。鉴于危机的严重性，美国预防服务工作组和美国儿科学会的新指南建议儿科初级保健提供者在抑郁症的筛查、诊断和治疗方面更加积极主动。初级保健机构提供了最佳机会来识别和治疗抑郁症，同时减少了心理健康方面的污名和障碍，特别是考虑到精神科专家的可用性和成本有限。尽管提供者指出存在困难，包括预约时间不足、培训不足、不愿处理精神健康障碍以及污名化，但在初级保健中管理抑郁患者是可行且有效的。有几种经济高效且易于使用的抑郁症筛查工具，可与临床访谈一起用于诊断和启动治疗。在以下信函中，我们探讨了实施一项专注于支持儿科提供者对青少年进行抑郁症筛查、诊断和启动治疗的计划的可行性。
