All U.S. teens should be screened for depression, task force says

From USA Today:

If you have teens or tweens, government-appointed experts have a message: U.S. adolescents should be routinely screened for major depression by their primary care doctors. The benefits of screening kids 12 to 18 years old outweigh any risks if doctors can assure an accurate diagnosis, treatment and follow-up care, says the independent U.S. Preventive Services Task Force.

It's a change from the group's 2002 report concluding there wasn't enough evidence to support or oppose screening for teens. The task force, though, says there's still insufficient proof about the benefits and harms of screening children 7 to 11 years old.

Depression strikes about 1 out of 20 teens, and it's been linked to lower grades, more physical illness and drug use, as well as early pregnancy.

Questionnaires can accurately identify teens prone to depression, plus there's new evidence that therapy and/or some antidepressants can benefit them, the expert panel says in a report in today's Pediatrics. But careful monitoring is vital since there's "convincing evidence" that antidepressants can increase suicidal behavior in teens, the report says.

Accompanying the task force advisory in Pediatrics is a research review saying there have been few studies on the accuracy of depression screening tests, but the tests "have performed fairly well" among adolescents. Treatment can knock down symptoms of depression, say the reviewers from Kaiser Permanente and the Oregon Evidence-Based Practice Center in Portland, Ore.

In a "show me the money" volley back, pediatricians also weigh in on the topic in today's issue of their journal. Insurance plans and managed care companies that stiff or under-pay pediatricians for mental health services throw up barriers to mental health care in doctors' offices, says the American Academy of Pediatrics. Kids' doctors should be compensated for screenings, as well as consults with mental health specialists and parents, AAP recommends.