Objective
Anxiety and depression are common among youth and are associated with significant
morbidity. Few youth with depression are diagnosed and receive treatment for these
disorders. The purpose of this study was to examine the rate of recognition and management
among an insured population and the factors associated with evidence of detection
among youth.
Methods
Structured mental health interviews assessing depression and anxiety diagnoses were
completed with a random sample of 581 youth (age range 11–17 years) from an integrated
health care system. Administrative data on medical and pharmacy services were used
to examine any evidence of detection by the medical system in the prior 12 months.
Results
Fifty-one youth met criteria for an anxiety or depressive disorder. Twenty-two percent
of these youth with an anxiety or depressive disorder as defined in Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition had evidence of detection or treatment. Factors associated with detection and treatment
included having diagnosis of a depressive disorder (with or without an anxiety disorder),
more depressive symptoms, greater functional impairment, a higher number of primary
care visits in the prior year, and higher parent-reported externalizing symptoms.
On multivariate analysis, having more depressive symptoms and a higher number of primary
care visits were significant predictors of detection and receipt of treatment.
Conclusions
The rate of detection and treatment of anxiety and depressive disorders is very low
in this age group and suggests a need for increased focus on detection, particularly
in light of recent evidence suggesting decreases in diagnosis and treatment among
youth following the black box warning regarding antidepressant medications.
Key Words
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Article Info
Publication History
Accepted:
September 15,
2009
Received:
February 27,
2009
Identification
Copyright
© 2010 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
