Document Detail


Depression treatment during outpatient visits by U.S. children and adolescents.
MedLine Citation:
PMID:  16310120     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Depression affects approximately 2-8% of all children and adolescents, and treatment of depression in children and adolescents has been the center of recent serious debates. We examined national trends in depression visits and treatment among outpatients aged 7 to 17 years. METHODS: We analyzed visit-based data between 1995 and 2002 in two national ambulatory care surveys. RESULTS: The number of visits by children and adolescents during which depression was reported more than doubled from 1995-1996 (1.44 million) to 2001-2002 (3.22 million). The proportion of these visits during which antidepressants were prescribed rose slightly from 47% in 1995-1996 to 52% in 2001-2002, whereas the proportion during which psychotherapy or mental health counseling was provided declined from 83% to 68%. Selective serotonin reuptake inhibitors (SSRI) represented 76% of all antidepressants prescribed in 1995-1996 and 81% in 2001-2002. In absolute terms, SSRIs were reported in 1.35 million visits in 2001-2002, reflecting a 2.6-fold increase from 1995-1996. Fluoxetine was prescribed in 207,914 visits in 1995-1996 and increased 100% to 415,580 visits in 2001-2002. The use of sertraline increased by 62% to 345,576 visits and paroxetine by 269% to 279,275 visits. CONCLUSIONS: We observed a declining trend in the provision of psychotherapy/mental health counseling during outpatient visits by children and adolescents diagnosed with depression. Although the likelihood of receiving antidepressants remained essentially unchanged, the number of children and adolescents whose visits involved prescription of antidepressants, particularly SSRIs, has increased markedly through 2002. Although fluoxetine remained the most commonly prescribed, other SSRIs were increasingly prescribed through 2002. These trends raise concerns regarding the widespread off-label use of antidepressants lacking reliable evidence of safety and efficacy for use in children and adolescents.
Authors:
Jun Ma; Ky-Van Lee; Randall S Stafford
Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The Journal of adolescent health : official publication of the Society for Adolescent Medicine     Volume:  37     ISSN:  1879-1972     ISO Abbreviation:  J Adolesc Health     Publication Date:  2005 Dec 
Date Detail:
Created Date:  2005-11-28     Completed Date:  2006-03-14     Revised Date:  2009-05-21    
Medline Journal Info:
Nlm Unique ID:  9102136     Medline TA:  J Adolesc Health     Country:  United States    
Other Details:
Languages:  eng     Pagination:  434-42     Citation Subset:  IM    
Affiliation:
Program on Prevention Outcomes and Practices, Stanford Prevention Research Center, Stanford University, Palo Alto, California, USA. jun.ma@stanford.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Antidepressive Agents / adverse effects,  therapeutic use*
Child
Counseling
Depressive Disorder / drug therapy*,  epidemiology*
Female
Health Surveys
Humans
Incidence
Male
Office Visits / statistics & numerical data
Outpatients
Physician's Practice Patterns / statistics & numerical data
Product Labeling
Psychotherapy
Retrospective Studies
Serotonin Uptake Inhibitors / adverse effects,  therapeutic use*
Grant Support
ID/Acronym/Agency:
R01- HS11313/HS/AHRQ HHS
Chemical
Reg. No./Substance:
0/Antidepressive Agents; 0/Serotonin Uptake Inhibitors
Comments/Corrections
Comment In:
J Adolesc Health. 2005 Dec;37(6):431-3   [PMID:  16310119 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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