depression

The HEADSSS assessment is an internationally recognised tool used to structure the assessment of an adolescent patient, encompassing Home, Education/Employment, Activities, Drugs, Sex and relationships, Self harm and depression, Safety and abuse. The assessment starts with simple and easy questions about life to allow a rapport to be built, before delving into more personal and embarrassing aspects.

The assessment does not necessarily have to be completed in one sitting, it may take multiple conversations to build up the trust for the young person to disclose such personal information to you. Once a HEADSSS assessment is completed, it is important to document your findings in the notes and communicate appropriate information to other members of the healthcare team. Follow through on any offers of help or support you have made.

If concerns about the young person’s safety have been raised, you must explain to them that you need to pass that information on to the relevant agency. Reassure them that the main priority is their safety and establish what they will do in the meantime to help keep themselves safe.

Author/s:

Dr Nicola Martin, Dr Louise Ingram, Adam Bonfield

Pharmacologic Treatment of Perinatal Depression

Megan George — Fri, 21 Nov 2025 19:44:10 +0000

Date Added:

November 21, 2025

Journal/Publication:

JAMA Insights

Publication Date:

November 19, 2025

URL:

Pharmacologic Treatment of Perinatal Depression

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1001/jama.2025.17250

Keywords

Pharmacology

Perinatal Depression

Major Depressive Disorder

abuse

depression

PMID (1):

41259042

A review of the treatment of patients with perinatal depression with an emphasis on pharmalogic therapy. James W. Mold, MD, MPH

View

Approximately 1 in 7 individuals are affected by perinatal depression, defined as a depressive episode occurring during pregnancy or within 12 months after delivery. Although the diagnostic criteria are similar to those of major depressive disorder, perinatal depression may also include symptoms such as difficulty forming an emotional attachment with the fetus or infant, persistent doubts about parenting abilities, and intrusive thoughts of harm to self or infant.1 Mental health conditions are leading contributors to maternal mortality in the US; among reporting states, the rate of death from perinatal suicide ranges from 4.2 to 21.4 per 100 000 pregnancies.2 Untreated or undertreated perinatal depression increases other maternal risks, including limited engagement in care, impaired relationships, substance use, preeclampsia, and suicide, as well as fetal or neonatal risks, including preterm birth, low birth weight, and disrupted attachment with long-term developmental consequences.3 Individuals from marginalized communities, such as those who are non–English speaking, uninsured, or geographically isolated, experience a higher prevalence of perinatal depression and are at increased risk of underdiagnosis and undertreatment.3

Risk factors for perinatal depression include a personal or family history of depression, abuse, stressful life events, low socioeconomic status, adolescent or single parenthood, and pregnancy complications, such as preterm birth or pregnancy loss. Each factor individually confers only a small increase in risk, making accurate prediction based on clinical factors challenging.4 Therefore, to facilitate early identification and treatment, universal screening during and after pregnancy is recommended. The American College of Obstetricians and Gynecologists (ACOG) recently issued 2 Clinical Practice Guidelines on perinatal mental health, 1 on screening and diagnosis5 and 1 on treatment and management,3 highlighting opportunities for obstetricians to address existing health gaps.

Author/s:

Emily S. Miller, S. Karlene Cunningham, Lauren M. Osborne

Uniting depression care through generalism: a primary care-informed response to the Lancet–World Psychiatric Association Commission’s call for action on depression

Megan George — Thu, 06 Nov 2025 14:44:00 +0000

Date Added:

November 6, 2025

Journal/Publication:

The Lancet

Publication Date:

October 9, 2025

URL:

Uniting depression care through generalism: a primary care-informed response to the Lancet–World Psychiatric Association Commission’s call for action on depression

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1016/j.lanprc.2025.100042

Keywords

MeSH

I thoughtful, evidence-based set of recommendations for improving the care of patients with depression in primary care settings. James W. Mold, MD, MPH

Free full text

View

In this Viewpoint, we respond to the 2022 Lancet–World Psychiatric Association Commission’s call for united action on depression. We present primary care-focused recommendations synthesised from key outcomes of 16 observational cohorts of adults with depression in primary care, representing more than 26 000 individuals from 26 countries. Identified areas for action included prediction of the depression severity trajectory, the complexity of the depressive experience, and the need for tailored yet holistic depression-care plans. Personal resilience and reductions in social burden were identified as powerful predictors of improved depression outcomes. Aimed at policy makers in primary care, researchers, and primary care providers, our recommendations emphasise a generalist model of care that is person focused and trauma informed. We advocate for increased primary care capacity for depression risk prediction, social support integration, care navigation, and continuity of care. By bridging the gap between primary care and psychiatric knowledge, our recommendations provide actionable guidance for reducing the global burden of depression.

Author/s:

Alison Flehr, Christopher Dowrick, Catherine Kaylor-Hughes, Jane Gunn

Diagnosis and management of depression in adolescents

Alex Haga — Wed, 06 Nov 2024 14:34:56 +0000

Date Added:

November 6, 2024

Journal/Publication:

Canadian Medical Association Journal

Publication Date:

May 29, 2023

Issue:

Volume:

195

Pages:

E739-E746

URL:

Diagnosis and management of depression in adolescents

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1503/cmaj.220966

Keywords

PMID (1):

37247881

MeSH

depression

child

A concise review of the diagnosis and treatment of adolescents who are depressed. James W. Mold, MD, MPH

Free full text

View

KEY POINTS
Depression is common among adolescents in Canada and has the potential to negatively affect long-term function and quality of life; despite this, in most affected adolescents depression remains undetected and untreated.

Management requires a multimodal approach, including risk assessment, psychoeducation, psychotherapeutic and pharmacologic treatment, and interventions to address contributing factors.

Support from child and adolescent psychiatrists may be required in the case of diagnostic uncertainty and complex presentations, as well as for patients who do not respond to first-line treatments.

Author/s:

Daphne J Korczak, Clara Westwell-Roper, Roberto Sassi

Nonpharmacologic Treatments for Maternal Mental Health Conditions

Alex Haga — Tue, 20 Aug 2024 19:53:30 +0000

Date Added:

August 20, 2024

Journal/Publication:

Agency for Healthcare Research and Quality

Publication Date:

July 31, 2024

URL:

Nonpharmacologic Treatments for Maternal Mental Health Conditions

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

Keywords

MeSH

Cognitive Behavioral Therapy

counseling

Postpartum period

An evidence-based review of non-pharmocologic treatments for maternal mental health conditions. James W. Mold, MD, MPH

Free full text

View

Objectives. This systematic review evaluates nonpharmacologic treatments for mental health conditions during the perinatal period (pregnancy and up to 12 months postpartum). We evaluated nonpharmacologic treatments for perinatal individuals with depressive disorders, anxiety disorders, bipolar disorder, post-traumatic stress disorder (PTSD), or obsessive-compulsive disorder (OCD).

Data sources and review methods. We searched MEDLINE®, PsycINFO®, Embase®, CINAHL®, the Cochrane Register of Clinical Trials, the Cochrane Database of Systematic Reviews, and ClinicalTrials.gov from January 1, 2000, to January 17, 2024, to identify relevant randomized controlled trials (RCTs). Nonpharmacologic interventions of interest included, among others, cognitive behavioral therapy (CBT), interpersonal therapy (IPT), exercise, non-directive counseling, behavioral activation, bright light therapy, eye movement desensitization and reprocessing (EMDR), and acupuncture. Outcomes of interest were improvement in scores on psychological assessment tools, cure or resolution of symptoms, suicide-related outcomes, and adherence to treatment. PROSPERO registration number: CRD42023440650.

Results. We identified 103 RCTs. Nonpharmacologic treatments were compared to control or each other in 101 RCTs and to pharmacologic treatments in 2 RCTs. The risk of bias was moderate for the majority of included studies, mostly related to lack of blinding. For perinatal individuals with depressive disorders, CBT was more effective than treatment as usual (TAU) to reduce depressive and anxiety symptoms (both moderate strength of evidence [SoE]); IPT was more effective than TAU to treat depressive symptoms (moderate SoE) and anxiety symptoms (low SoE); and both behavioral activation (a CBT technique, with low SoE) and exercise interventions (moderate SoE) were more effective than TAU to reduce depressive symptoms. Remission rates for depressive symptoms were higher with CBT and IPT compared to TAU (both low SoE) and higher with specific acupuncture than nonspecific or sham acupuncture (low SoE). There were no differences between CBT and non-directive counseling (an active patient-led intervention), between counseling and TAU, and between bright light and placebo light therapy (all low SoE). CBT was more effective than TAU to reduce anxiety and depressive symptoms for individuals with combined depressive and anxiety disorders (low SoE). Few (or no) eligible studies evaluated individuals with anxiety disorder, PTSD, OCD, or bipolar disorders, precluding conclusions for these conditions. There was also insufficient evidence for suicide-related outcomes, potential harms of treatment, and adherence to treatment, and for comparisons of nonpharmacologic with pharmacologic treatments.

Conclusion. Several nonpharmacologic treatments are more effective than TAU for perinatal mental health conditions, with the strongest evidence for CBT and IPT to reduce depressive symptoms among perinatal individuals with depressive disorders or combined depressive and anxiety disorders. Future research is needed to evaluate the comparative effectiveness of lesser studied nonpharmacologic interventions and lesser studied perinatal mental health conditions.

Ketamine vs Electroconvulsive Therapy for Treatment-Resistant Depression: A Secondary Analysis of a Randomized Clinical Trial

Alex Haga — Sun, 30 Jun 2024 18:18:25 +0000

Date Added:

June 30, 2024

Journal/Publication:

JAMA

Publication Date:

June 25, 2024

Issue:

Volume:

URL:

Ketamine vs Electroconvulsive Therapy for Treatment-Resistant Depression: A Secondary Analysis of a Randomized Clinical Trial

Type:

Clinical Research Results

Format:

Article

DOI (1):

10.1001/jamanetworkopen.2024.17786

Keywords

depression

ketamine

electroconvulsive therapy

PMID (1):

38916891

MeSH

Depressive Disorder

Treatment-Resistant* / therapy

Electroconvulsive Therapy* / methods

Ketamine* / administration & dosage

Ketamine* / therapeutic use

A series of ketamine infusions was more effective than ECT for treatment of adults with moderate to severe depression. James W. Mold, MD, MPH

Free full text

View

Importance: The ELEKT-D: Electroconvulsive Therapy (ECT) vs Ketamine in Patients With Treatment Resistant Depression (TRD) (ELEKT-D) trial demonstrated noninferiority of intravenous ketamine vs ECT for nonpsychotic TRD. Clinical features that can guide selection of ketamine vs ECT may inform shared decision-making for patients with TRD.

Objective: To evaluate whether selected clinical features were associated with differential improvement with ketamine vs ECT.

Design, setting, and participants: This secondary analysis of an open-label noninferiority randomized clinical trial was a multicenter study conducted at 5 US academic medical centers from April 7, 2017, to November 11, 2022. Analyses for this study, which were not prespecified in the trial protocol, were conducted from May 10 to Oct 31, 2023. The study cohort included patients with TRD, aged 21 to 75 years, who were in a current nonpsychotic depressive episode of at least moderate severity and were referred for ECT by their clinicians.

Exposures: Eligible participants were randomized 1:1 to receive either 6 infusions of ketamine or 9 treatments with ECT over 3 weeks.

Main outcomes and measures: Association between baseline factors (including 16-item Quick Inventory of Depressive Symptomatology Self-Report [QIDS-SR16], Montgomery-Asberg Depression Rating Scale [MADRS], premorbid intelligence, cognitive function, history of attempted suicide, and inpatient vs outpatient status) and treatment response were assessed with repeated measures mixed-effects model analyses.

Results: Among the 365 participants included in this study (mean [SD] age, 46.0 [14.5] years; 191 [52.3%] female), 195 were randomized to the ketamine group and 170 to the ECT group. In repeated measures mixed-effects models using depression levels over 3 weeks and after false discovery rate adjustment, participants with a baseline QIDS-SR16 score of 20 or less (-7.7 vs -5.6 points) and those starting treatment as outpatients (-8.4 vs -6.2 points) reported greater reduction in the QIDS-SR16 with ketamine vs ECT. Conversely, those with a baseline QIDS-SR16 score of more than 20 (ie, very severe depression) and starting treatment as inpatients reported greater reduction in the QIDS-SR16 earlier in course of treatment (-8.4 vs -6.7 points) with ECT, but scores were similar in both groups at the end-of-treatment visit (-9.0 vs -9.9 points). In the ECT group only, participants with higher scores on measures of premorbid intelligence (-14.0 vs -11.2 points) and with a comorbid posttraumatic stress disorder diagnosis (-16.6 vs -12.0 points) reported greater reduction in the MADRS score. Those with impaired memory recall had greater reduction in MADRS during the second week of treatment (-13.4 vs -9.6 points), but the levels of MADRS were similar to those with unimpaired recall at the end-of-treatment visit (-14.3 vs -12.2 points). Other results were not significant after false discovery rate adjustment.

Conclusions and relevance: In this secondary analysis of the ELEKT-D randomized clinical trial of ECT vs ketamine, greater improvement in depression was observed with intravenous ketamine among outpatients with nonpsychotic TRD who had moderately severe or severe depression, suggesting that these patients may consider ketamine over ECT for TRD.

Author/s:

Manish Kumar Jha, Samuel T Wilkinson, Kamini Krishnan, Katherine A Collins, Gerard Sanacora, James Murrough

Depression - Screening and Treating Depression in Adolescents

Alex Haga — Thu, 20 Jun 2024 21:10:05 +0000

Date Added:

June 20, 2024

Journal/Publication:

New England Journal of Medicine

Publication Date:

June 12, 2024

Issue:

Volume:

390

URL:

Depression - Screening and Treating Depression in Adolescents

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Video

DOI (1):

10.1056/NEJMp2400711

Keywords

adolescent

psychotherapy

depression

PMID (1):

38865659

MeSH

adolescent

Antidepressive Agents* / therapeutic use

Depression* / diagnosis

Depression* / therapy

Depressive Disorder / diagnosis

Depressive Disorder / therapy

Psychotherapy

A 14-minute audio-video discussion of screening and treatment of depression in adolescents. James W. Mold, MD, MPH

Free full text

View

Drs. Crawford, Fallucco, and Scott-Vernaglia take a closer look at the prevalence of depression among teenagers. Recognizing the existing gaps in pediatricians’ training and resources to address this issue, the doctors describe signs and symptoms of depression and how to screen for the diagnosis in this patient population. They review available treatments and associated adverse effects, while also underscoring the importance of follow-up after antidepressants are started.

Author/s:

Christine M Crawford, Elise Fallucco, Maurizio Fava, Julie Ingelfinger, Shannon Scott-Vernaglia

Management of Depression in Adults: A Review

Alex Haga — Sun, 16 Jun 2024 18:49:55 +0000

Date Added:

June 16, 2024

Journal/Publication:

JAMA

Publication Date:

June 10, 2024

URL:

Management of Depression in Adults: A Review

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1001/jama.2024.5756

Keywords

depression

Adults

PMID (1):

38856993

MeSH

depression

Depressive Disorder

depressive disorder, major

Bipolar Disorder

antidepressive agents

anxiety disorders

substance-related disorders

Self-Injurious Behavior

A comprehensive review of what we currently know about the treatment of depression in adults. James W. Mold, MD, MPH

Free full text

View

Importance: Approximately 9% of US adults experience major depression each year, with a lifetime prevalence of approximately 17% for men and 30% for women.

Observations: Major depression is defined by depressed mood, loss of interest in activities, and associated psychological and somatic symptoms lasting at least 2 weeks. Evaluation should include structured assessment of severity as well as risk of self-harm, suspected bipolar disorder, psychotic symptoms, substance use, and co-occurring anxiety disorder. First-line treatments include specific psychotherapies and antidepressant medications. A network meta-analysis of randomized clinical trials reported cognitive therapy, behavioral activation, problem-solving therapy, interpersonal therapy, brief psychodynamic therapy, and mindfulness-based psychotherapy all had at least medium-sized effects in symptom improvement over usual care without psychotherapy (standardized mean difference [SMD] ranging from 0.50 [95% CI, 0.20-0.81] to 0.73 [95% CI, 0.52-0.95]). A network meta-analysis of randomized clinical trials reported 21 antidepressant medications all had small- to medium-sized effects in symptom improvement over placebo (SMD ranging from 0.23 [95% CI, 0.19-0.28] for fluoxetine to 0.48 [95% CI, 0.41-0.55] for amitriptyline). Psychotherapy combined with antidepressant medication may be preferred, especially for more severe or chronic depression. A network meta-analysis of randomized clinical trials reported greater symptom improvement with combined treatment than with psychotherapy alone (SMD, 0.30 [95% CI, 0.14-0.45]) or medication alone (SMD, 0.33 [95% CI, 0.20-0.47]). When initial antidepressant medication is not effective, second-line medication treatment includes changing antidepressant medication, adding a second antidepressant, or augmenting with a nonantidepressant medication, which have approximately equal likelihood of success based on a network meta-analysis. Collaborative care programs, including systematic follow-up and outcome assessment, improve treatment effectiveness, with 1 meta-analysis reporting significantly greater symptom improvement compared with usual care (SMD, 0.42 [95% CI, 0.23-0.61]).

Conclusions and relevance: Effective first-line depression treatments include specific forms of psychotherapy and more than 20 antidepressant medications. Close monitoring significantly improves the likelihood of treatment success.

Author/s:

Gregory E Simon, Nathalie Moise, David C Mohr

Exercise as a treatment for depression

Erin Blanchette — Tue, 14 May 2024 16:30:32 +0000

Date Added:

May 14, 2024

Journal/Publication:

Canadian Medical Association Journal

Publisher:

Canadian Medical Association

Publication Date:

May 5, 2024

Issue:

Volume:

196

Pages:

E596-E96

URL:

Exercise as a treatment for depression

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1503/cmaj.231288

Keywords

PMID (1):

38719220

MeSH

depression

Depressive Disorder

Depressive Disorder / therapy

Depression / therapy

exercise

exercise therapy

Exercise Therapy / methods

Supervised exercise works as well as and more consistently (NNT=2) then antidepressants in adults with depression. James W. Mold, MD, MPH

Free full text

View

Exercise effectively treats depression and may decrease suicide attempts

A 2023 meta-analysis of randomized controlled trials (RCTs) found that supervised, group or non-group, moderate- or vigorous-intensity, aerobic or resistance exercises (excluding mind–body activities such as yoga) decreased depressive symptoms among participants with depression, with a number needed to treat of 2 and an effectiveness comparable to first-line treatments such as psychotherapy and medication. Another 2023 meta-analysis of RCTs found that exercise decreased suicide attempts among people with mental or physical illness.

Author/s:

Carl Zhou, Nicholas Fabiano

Improving behavioral health outcomes in primary care

Alex Haga — Mon, 13 May 2024 21:14:31 +0000

Date Added:

May 13, 2024

Journal/Publication:

Oklahoma Primary Healthcare Improvement Cooperative

Type:

Best Local Practices

Format:

Article

Keywords

MeSH

referral and consultation

An overview of the Screening, Brief Intervention, and Referral to Treatment (SBIRT) initiative being implemented in primary care practices in Oklahoma. James W. Mold, MD, MPH

Free full text

Screening, Brief Intervention, and Referral to Treatment in Oklahoma (SBIRT-OK)
is an evidence-based, integrated approach to identify and intervene with patients whose
patterns of tobacco, alcohol, and/or drug use, or depression, put their health at risk.

New in Spanish! Seasonal Affective Disorder Fact Sheet

Erin Blanchette — Tue, 12 Mar 2024 16:07:36 +0000

Date Added:

March 12, 2024

Journal/Publication:

National Institute of Mental Health

Publisher:

National Institute of Health

Publication Date:

February 26, 2024

URL:

New in Spanish! Seasonal Affective Disorder Fact Sheet

Type:

Patient Education Materials

Format:

Web Page

Keywords

spanish

Seasonal Affective Disorder

depression

light therapy

MeSH

Seasonal Affective Disorder

Information for patients about seasonal affective disorder. James W. Mold, MD, MPH

Free full text

View

This fact sheet provides information about seasonal affective disorder (SAD), a type of depression. It includes a description of SAD, signs and symptoms, how SAD is diagnosed, causes, and treatment options.

Esta hoja informativa ofrece una descripción del trastorno afectivo estacional, un tipo de depresión, e incluye información general sobre el trastorno, sus signos y síntomas, cómo se diagnostica, cuáles son las causas y las opciones de tratamiento disponibles.

Seasonal Affective Disorder

Erin Blanchette — Wed, 03 Jan 2024 21:04:47 +0000

Date Added:

January 3, 2024

Journal/Publication:

National Institutes of Health

Publisher:

U.S. Department of Health & Human Services

Issue:

NIH Publication No. 23-MH-8138

URL:

Seasonal Affective Disorder

Type:

Patient Education Materials

Format:

Web Page

Keywords

Seasonal Affective Disorder

MeSH

Seasonal Affective Disorder

depression

sleep initiation and maintenance disorders

Social Isolation

Appetite

sleep

A summary of information on seasonal affective disorder for patients from the US Dept. of Mental Health and Substance Abuse Disorders. James W. Mold, MD, MPH

Free full text

View

What is seasonal affective disorder?

Many people go through short periods when they feel sad or unlike their usual selves. Sometimes, these mood changes begin and end when the seasons change. Many people feel "down" or have the "winter blues" when the days get shorter in the fall and winter and feel better in the spring when longer daylight hours return.

Sometimes, these mood changes are more serious and can affect how a person feels, thinks, and behaves. If you have noticed significant changes in your mood and behavior when the seasons change, you may be experiencing seasonal affective disorder (SAD).

In most cases, SAD symptoms start in the late fall or early winter and go away during the spring and summer, known as winter-pattern SAD or winter depression. Other people experience depressive symptoms during the spring and summer months, known as summer-pattern SAD or summer depression. Summer-pattern SAD is less common.

Screening for Depression and Suicide Risk in Adults US Preventive Services Task Force Recommendation Statement

Aubrey Delammermore — Sat, 24 Jun 2023 05:00:00 +0000

Date Added:

June 24, 2023

Journal/Publication:

JAMA

Publisher:

American Medical Association

Publication Date:

June 20, 2023

Issue:

Volume:

329

Pages:

2057-2067

URL:

Screening for Depression and Suicide Risk in Adults US Preventive Services Task Force Recommendation Statement

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1001/jama.2023.9297

Keywords

PMID (1):

37338872

MeSH

Depression / diagnosis

Depressive Disorder, Major* / diagnosis

Mass Screening / adverse effects

Suicide*

pregnancy

Final recommendations from the USPSTF regarding screening adults for depression (just do it). However, there is still insufficient evidence to screen for suicide risk apparently. James W. Mold, MD, MPH

Free full text

View

IMPORTANCE Major depressive disorder (MDD), a common mental disorder in the US, may
have substantial impact on the lives of affected individuals. If left untreated, MDD can
interfere with daily functioning and can also be associated with an increased risk of
cardiovascular events, exacerbation of comorbid conditions, or increased mortality.

OBJECTIVE The US Preventive Services Task Force (USPSTF) commissioned a systematic
review to evaluate benefits and harms of screening, accuracy of screening, and benefits and
harms of treatment of MDD and suicide risk in asymptomatic adults that would be applicable
to primary care settings.

POPULATION Asymptomatic adults 19 years or older, including pregnant and postpartum
persons. Older adults are defined as those 65 years or older.

EVIDENCE ASSESSMENT The USPSTF concludes with moderate certainty that screening for
MDD in adults, including pregnant and postpartum persons and older adults, has a moderate
net benefit. The USPSTF concludes that the evidence is insufficient on the benefit and harms
of screening for suicide risk in adults, including pregnant and postpartum persons and older
adults.

RECOMMENDATION The USPSTF recommends screening for depression in the adult
population, including pregnant and postpartum persons and older adults. (B
recommendation) The USPSTF concludes that the current evidence is insufficient to assess
the balance of benefits and harms of screening for suicide risk in the adult population,
including pregnant and postpartum persons and older adults. (I statement)

Author/s:

US Preventive Services Task Force, Barry, M. J., Nicholson, W. K., Silverstein, M., Chelmow, D., Coker, T. R., Davidson, K. W., Davis, E. M., Donahue, K. E., Jaén, C. R., Li, L., Ogedegbe, G., Pbert, L., Rao, G., Ruiz, J. M., Stevermer, J. J., Tsevat, J., Underwood, S. M., Wong, J. B.

Diagnosis and management of depression in adolescents

Aubrey Delammermore — Wed, 31 May 2023 05:00:00 +0000

Date Added:

May 31, 2023

Journal/Publication:

CMAJ

Publisher:

CMA Impact Inc

Publication Date:

May 29, 2023

Issue:

Volume:

195

Pages:

E739-E746

URL:

Diagnosis and management of depression in adolescents

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1503/cmaj.220966

Keywords

depression

diagnosis and management

adolescents

adolescent psychiatry

quality of life

PMID (1):

37247881

MeSH

Humans

adolescent

Depression* / diagnosis

Depression* / therapy

Psychotropic Drugs

A concise review of what we know about screening and treatment of adolescents suffering with depression. James W. Mold, MD, MPH

Free full text

View

Depression is common among adolescents in Canada and has the potential to negatively affect long-term function and quality of life; despite this, in most affected adolescents depression remains undetected and untreated.

Management requires a multimodal approach, including risk assessment, psychoeducation, psychotherapeutic and pharmacologic treatment, and interventions to address contributing factors.

Support from child and adolescent psychiatrists may be required in the case of diagnostic uncertainty and complex presentations, as well as for patients who do not respond to first-line treatments.

Author/s:

Korczak, D. J., Westwell-Roper, C., Sassi, R.

Post COVID-19 Syndrome (Long Haul Syndrome): Description of a Multidisciplinary Clinic at the Mayo Clinic and Characteristics of the Initial Patient Cohort

Saige Blanchard — Tue, 18 May 2021 05:00:00 +0000

Date Added:

May 18, 2021

Journal/Publication:

Mayo Clinic Proceedings

Publisher:

Mayo Foundation for Medical Education and Research

Publication Date:

April 30, 2021

URL:

Post COVID-19 Syndrome (Long Haul Syndrome): Description of a Multidisciplinary Clinic at the Mayo Clinic and Characteristics of the Initial Patient Cohort

Type:

Clinical Research Results

Format:

Article

DOI (1):

https://doi.org/10.1016/j.mayocp.2021.04.024

Keywords

MeSH

preexisting condition coverage

A description of adult patients with COVID-19 “long-haul syndrome” being seen at the Mayo Clinic.

James W. Mold, MD, MPH

Free full text

View

Objective

To describe characteristics of a series of patients reporting prolonged symptoms after an infection with COVID-19.

Methods

This study describes the multidisciplinary COVID-19 Activity Rehabilitation Program (CARP), established at Mayo Clinic to evaluate and treat post-COVID-19 syndrome (PCS) patients, and reports the clinical characteristics of the first 100 patients receiving evaluation and management during the timeframe of June 1, 2020 and December 31, 2020.

Results

The cohort consisted of 100 patients (mean age 45 years, 68% women, BMI 30.2, presenting a mean of 93 days after infection). Common pre-existing conditions were respiratory (23%) and mental health, including depression and/or anxiety (34%.) The majority (75%) had not been hospitalized for COVID-19. Common presenting symptoms ware fatigue (80%), respiratory complaints (59%), and neurologic complaints (59%) followed by subjective cognitive impairment, sleep disturbance, and mental health symptoms. More than one-third of the patients (34%) reported difficulties with performing basic activities of daily living. Only 1 in 3 patients had returned to unrestricted work duty at the time of the analysis. For most patients, laboratory and imaging studies were normal or non-diagnostic despite debilitating symptoms. Most patients required physical therapy, occupational therapy, or brain rehabilitation. Face-to-face and virtual care delivery modalities were feasible.

Conclusion

Many of the patients did not experience COVID-19-related symptoms that were severe enough to require hospitalization, were younger than 65 years of age, more likely to be female, and most had no pre-existing comorbidities prior to SARS-CoV-2 infection. Symptoms including mood disorders, fatigue, and perceived cognitive impairment resulted in severe negative impacts on resumption of functional and occupational activities in patients experiencing prolonged effects.

Author/s:

Vanichkachorn, G., Newcomb, R., Cowl, C. T., Trenary, M., Higgins, S., Neveau, D., Murad, M. H., Breeher, L., Miller, S.