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Program effective at reducing depression in teens

An intervention for adolescents aimed at improving the quality of treatment for depression is effective at reducing depression, according to a study in the January 19 issue of JAMA.

Lifetime prevalence for major depression in adolescence is estimated at 15 percent to 20 percent, current prevalence is estimated as high as 6 percent, and 28.3 percent of adolescents report periods during the past year of depressive symptoms leading to impairment, according to background information in the article. Untreated depression is associated with suicide, a leading cause of death for youth aged 15 to 24 years, and with other negative outcomes including school dropout, pregnancy, substance abuse, and adult depression. Few depressed adolescents receive effective treatment for depression in primary care settings.

Joan Rosenbaum Asarnow, Ph.D., of the David Geffen School of Medicine at UCLA, Los Angeles, and colleagues conducted a study (Youth Partners-in-Care [YPIC]) to determine if a quality improvement intervention for adolescents would improve use of evidence-based treatments, depression outcomes, mental healthrelated quality of life, and satisfaction with mental health care after a 6-month intervention period. The randomized controlled trial was conducted between 1999 and 2003 and included 418 primary care patients, aged 13 through 21 years, with current depressive symptoms. The participants were from 5 health care organizations purposively selected to include managed care, public sector, and academic medical center clinics in the United States, and were assigned at random to receive either usual care at their primary care clinic or a quality improvement intervention.

The quality improvement intervention included expert leader teams at each site, care managers who supported primary care clinicians in evaluating and managing patients' depression, training for care managers in cognitive-behavior therapy for depression, with patient and clinician choice
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Contact: Dan Page
310-794-2265
JAMA and Archives Journals
18-Jan-2005


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