Depression in children and adolescents in primary care

Abstract

Depression is a commonly occurring illness in children and adolescents. Appropriate and timely care of these patients is essential in the primary care setting. A narrative review was undertaken for pediatric depression based on the AAP-approved guidelines, GLAD-PC, for the management of depression in the primary care setting. Emerging research regarding suicidality and social media was also reviewed. There are many tools to assist primary care in the assessment and management of adolescents and children with depression. The key components include: Assessment and Diagnosis, Initial Management (including safety planning), Treatment, and Ongoing Management. Comprehensive interviews with patients individually and with caregivers along with the use of tools are critical to the assessment process. Initial management after confirming the diagnosis of depression includes safety planning, psychoeducation and referral to peer support. Evidenced-based treatments for depression in children and adolescents include psychotherapy, antidepressants (SSRIs), and the combination of the two. Brief psychosocial interventions (BPI) have also been demonstrated to be efficacious when compared to CBT. Ongoing management is essential to reach or to maintain remission. Depression is common in the pediatric population and it is critical that primary care provide accessible and timely care to this population and their families.