Screen All Teens For Depression?
I understand that some pediatricians are advocating screening all teenagers for depression. Is this really necessary? Are kids this age really at risk?
Andrew Weil, M.D. |April 24, 2018
Teens are at much greater risk for depression than adults may think. Research suggests that during the teenage years, kids have a 20 percent chance of developing depression or anxiety, and that only about half of these cases are diagnosed and treated before adulthood. Causes of the upsurge in teen depression may include social media, cyberbullying and trauma related to social violence, gun violence and community violence.
New guidelines adopted by the American Academy of Pediatrics (AAP) in February 2018 call for screening everyone between the ages of 12 and 21 for depression once a year. In announcing the recommendations, the AAP noted that parents might not detect depression in their kids or may confuse it with something else. Dr. Rachel Zuckerbrot, an adolescent psychiatrist and lead author of the guidelines has said that sometimes teens who act out or misbehave are seen as being hostile when, in fact, they’re suffering from depression. What’s more, if kids themselves recognize that they have a problem, they may not ask for help because they are ashamed. The guidelines urge pediatricians to be especially vigilant in monitoring teens who have a family history of depression, trauma or substance abuse.
Screening can be performed by questionnaire during a doctor’s visit or sports physical. Dr. Zuckerbrot said teens are “often more honest when they’re not looking somebody in the face who’s asking questions” about their emotional health.
The questionnaires ask whether teens have been feeling down, depressed or hopeless over the past two weeks or if they have less interest and pleasure in doing things than in the past. They’re also asked if they’re getting enough sleep – or sleeping too much – and if they have any problems with eating.
Depression in kids can be very serious – so much so that suicide is a leading cause of death for those aged 10 to 17. To prevent that, the AAP recommendations call for families with a depressed teen to develop a safety plan that restricts his or her access to guns or any other means by which they could harm themselves.” The authors noted, “Adolescent suicide risk is strongly associated with firearm availability.”
We all know that teenage years aren’t always happy and carefree. Screening kids for depression makes sense.
Andrew Weil, M.D.
Rachel A. Zukerbrot et al, “Guidelines for Adolescent Depression in Primary Care (GLAD-PC): I. Identification, Assessment, and Initial Management.” American Academy of Pediatrics, guidelines, Pediatrics, February 26, 2018,