20 Apr Emotional Problems in Adolescents: Very Common, Most Brief

MedicalResearch.com Interview with:
Dr. George Patton
Department of Paediatrics, University of Melbourne
Centre for Adolescent Health, Murdoch Children’s Research Institute,
Royal Children’s Hospital, Parkville, VIC, Australia

MedicalResearch.com: What are the main findings of the study?

Dr. Patton: Although there has been wide acceptance that the teens are a time when emotional problems are common, views have been polarized about their significance. Some have viewed these problems are usual for this phase of life with little significance for later life mental health; others have argued that early psychiatric intervention was essential given the risks of ongoing disorders.

In this sample almost two thirds of girls and a third of boys had an episode of emotional troubles (anxiety and depression) at a level that would concern a family physician. For those where the episode were brief lasting weeks to months, recovery without further later life episodes was common. In contrast those with persistent (longer than 6 months) or recurrent emotional problems during the teens had a high likelihood of similar problems with depression and anxiety in their twenties. In general these emotional problems persisted more in females than in males.

MedicalResearch.com: Were any of the findings unexpected?

Dr. Patton: There was a substantial tendency for emotional problems to ‘mature out’ by the late twenties, even in those with more entrenched earlier disorders. We do not know if this was related to important life changes during these years (e.g. marriage or parenthood) but it does suggest that the window for intervention to affect the course of illness may be wide.

MedicalResearch.com: What should clinicians and patients take away from your report?

Dr. Patton: For first presentation of recent onset emotional problems in teenagers, particularly in response to stressful life events, a policy of supportive watchful waiting may be the best level of intervention. Where a problem persists beyond a month or two there is good reason to be intervening with some more structured counseling probably based around a cognitive behavioural therapy framework. This might be in the form of an internet based intervention (iCBT) supported by the clinician or face to face. If the problem persists for a further couple of months, it is probably time to think about either a more intensive psychotherapy with a skilled practitioner (e.g. formal CBT) or medication.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Patton: We need a lot more work on trialing interventions for emotional problems in this adolescent age group. Currently we have very few trials at any level of persistence or severity and none that have longer term follow-ups. We also need to understand better that factors that may be associated with resolution of these emotional problems in young adulthood.

Citation:
The prognosis of common mental disorders in adolescents: a 14-year prospective cohort study
Prof George C Patton MD,Carolyn Coffey PhD,Helena Romaniuk PhD,Prof Andrew Mackinnon PhD,Prof John B Carlin PhD,Prof Louisa Degenhardt PhD,Craig A Olsson PhD,Paul Moran MD
The Lancet – 19 April 2014 ( Vol. 383, Issue 9926, Pages 1404-1411 )
DOI: 10.1016/S0140-6736(13)62116-9

Last Updated on April 20, 2014 by Marie Benz MD FAAD