Author Interviews, Depression, JAMA, NYU, Pediatrics / 01.02.2016
Most Adolescents With Depression Do Not Receive Follow Up Care
MedicalResearch.com Interview with:
Briannon O'Connor PhD
New York University Child Study Center
Department of Child and Adolescent Psychiatry
New York University School of Medicine
New York
Medical Research: What is the background for this study? What are the main findings?
Dr. O'Connor: a. As the health care system continues to emphasize accountability for providing high quality care, the development of meaningful quality standards is critical. This study came from NCQA’s work to develop these quality measures for adolescent depression care. Prior to this study, little was known about what routine care looked like for adolescents who showed up at their primary care visits with significant symptoms of depression.
This study looked at follow up care documented in an electronic health record in the three months after an adolescent was first identified with significant symptoms of depression.
Medical Research: What is the background for this study? What are the main findings?
Dr. O'Connor: Key findings from this study include:
- Most adolescents (nearly two-thirds) with newly prescribed depression symptoms received some treatment, usually including psychotherapy, within the first 3 months after depression symptoms were first identified.
- Among those adolescents who were prescribed antidepressant medications, 40% had no other follow up care in three months, which is quite concerning since current black box warnings highlight the risk for increased suicidality for youth prescribed antidepressants and clearly recommend close monitoring in the few months following initial prescription.
- There were low rates of other follow up care events in the three month follow up period: 19% of adolescents did not receive any follow up care at all, 36% did not receive any treatment, and the majority (68%) lacked documentation that symptoms were monitored or re-assessed using a valid questionnaire
- The sites that participated in the study are highly regarded health care institutions, often looked to as leaders in cutting-edge care. Thus, results from this study, discouraging as they are, may overstate the quality of care in other settings.