Clinical Summary
Depression in Children and Adolescents: Screening
February 08, 2016
Recommendations made by the USPSTF are independent of the U.S. government. They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.
| Population | Adolescents aged 12 to 18 y | Children aged ≤11 y |
|---|---|---|
| Recommendation | Screen for major depressive disorder (MDD). Adequate systems should be in place to ensure accurate diagnosis, effective treatment, and appropriate follow-up. Grade: B |
No recommendation: Grade: I (Insufficient Evidence) |
| Risk Assessment | Risk factors for MDD include female sex; older age; family (especially maternal) history of depression; prior episode of depression; other mental health or behavioral problems; chronic medical illness; overweight and obesity; and, in some studies, Hispanic race/ethnicity. Other psychosocial risk factors include childhood abuse or neglect, exposure to traumatic events (including natural disasters), loss of a loved one or romantic relationship, family conflict, uncertainty about sexual orientation, low socioeconomic status, and poor academic performance. | |
| Screening Tests | Two instruments which have been most often studied are the Patient Health Questionnaire for Adolescents and the primary care version of the Beck Depression Inventory. | |
| Screening Interval | The optimal interval for screening for MDD is not known. Opportunistic screening may be appropriate for adolescents, who may have infrequent health care visits. | |
| Treatment and Interventions | Treatment options for MDD include pharmacotherapy, psychotherapy, collaborative care, psychosocial support interventions, and complementary and alternative medicine approaches. | |
| Balance of Benefits and Harms | Screening for MDD in adolescents aged 12 to 18 y has a moderate net benefit. | The evidence on screening for MDD in children aged ≤11 y is insufficient, and the balance of benefits and harms cannot be determined. |
| Other Relevant USPSTF Recommendations | The USPSTF has made recommendations on screening for suicide risk in adolescents, adults, and older adults. Other USPSTF recommendations on mental health topics pertaining to children and adolescents, including illicit drug and alcohol use, can be found on the USPSTF Web site (www.uspreventiveservicestaskforce.org). | |
For a summary of the evidence systematically reviewed in making this recommendation, the full recommendation statement, and supporting documents, please go to: http://www.uspreventiveservicestaskforce.org.