Depressive disorder in adolescents

Abstract

(from the chapter) Depression is widely prevalent in adolescence, with 1 in 5 youth experiencing a depressive episode before reaching the age of 18 (Lewinsohn, Hops, Roberts, Seeley, & Andrews, 1993). Depressive episodes are impairing at any age, with depression being a leading cause of disability worldwide (World Health Organization, 2012); however, this disorder may be particularly consequential with adolescent onset. Youth who first experience a depressive episode in adolescence are at substantially greater risk of experiencing recurrent depressive episodes in adulthood (Weissman et al, 1999). Adolescent depression also predicts impaired educational attainment, deficits in social support, and increased risk of suicide attempt (Gould et al, 1998; Weissman et al, 1999). Even once recovered from a depressive episode, youth continue to experience impaired functioning. Compared to healthy controls, youth with a prior depressive episode experience higher levels of anxiety, elevated depressive symptoms, impaired social functioning, and higher levels of substance abuse (Rohde, Lewinsohn, & Seeley, 1994). By far, cognitive behavioral therapy (CBT) is the most well researched intervention for adolescent depression, with the vast majority of published clinical trials investigating CBT effects. In this chapter, we attempt to bring clarity to the pattern of results in CBT studies for adolescent depression while reviewing the burgeoning evidence base for interpersonal psychotherapy for adolescents (IPT), an alternate evidence-based treatment (EBT) for this population. In addition, we discuss expectations for parental involvement in treatment and evidence supporting need for parent inclusion across these interventions, and we further emphasize findings, as available, on effects of treatment for adolescent depression in diverse samples and outside of traditional, lab-based settings. Finally, we conclude with a clinically relevant discussion of the use of standardized assessment in the provision of evidence-based care for adolescent depression and provide a case example of how evidence-based approaches could be used to treat depression in adolescence. (PsycINFO Database Record (c) 2015 APA, all rights reserved)