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These globally-published research summaries on teen depression
mislead and misinform casual readers. Their main message is accurate - that
millions of teenagers are "depressed," and need help. This supports the main
in this nonprofit Web site.
For perspective on depression, see this brief YouTube video. It mentions eight
lessons in this self-improvement Web site: I've simplified that to seven.
See my comments after the
two summaries. The links and hilights
are mine. -
Peter Gerlach, MSW
+ + +
Panel advises depression
screening for U.S. teens
The Oregonian - OregonLive.com via The Associated Press 3-29-09
government-appointed medical panel is urging doctors to routinely screen all
American teens for depression -- a bold step that acknowledges that
million teens are affected by this debilitating condition.
Most are undiagnosed and untreated, said the panel, the
U.S. Preventive Services
Task Force, which sets guidelines for doctors on a host of health
The task force recommendations appear in April's issue of the journal
Pediatrics. And they go farther than the
American Academy of Pediatrics'
own guidance for teen depression screening.
An estimated 6 percent of U.S.
teenagers are clinically depressed. Evidence shows that detailed but
simple questionnaires can accurately diagnose depression in primary-care
settings such as a pediatrician's office.
The task force said that when followed by treatment, including
psychotherapy, screening can help improve symptoms and help kids cope.
Because depression can lead to persistent sadness, social isolation, school
problems and even suicide, screening to treat it early is crucial, the panel
The task force is an independent panel of experts convened by the federal
government to establish guidelines for treatment in primary-care. Its new
guidance goes beyond the pediatrics academy, which advises pediatricians to
ask teen patients questions about depression. Other doctor groups advise
screening only high-risk youngsters.
Because depression is so common,
"you will miss a lot if you only screen high-risk groups," said Dr. Ned
Calonge, task force chairman and chief medical officer for Colorado's
Department of Public Health and Environment.
The group recommends research-tested screening tests even for kids without
symptoms. It cited two questionnaires that focus on depression tip-offs,
such as mood, anxiety, appetite and substance abuse.
Calonge stressed that the panel does not want its advice to lead to drug
treatment alone, particularly anti-depressants that have been linked with
increased risks for suicidal thoughts.
Routine depression testing should
only occur if psychotherapy is also readily available, the panel
said. Calonge said screening once yearly likely would be enough.
The recommendations come at a pivotal time for treatment of depression and
other mental health problems in children.
Recently passed federal mental health equity legislation mandates equal
coverage for mental and physical ailments in insurance plans offering both.
The law is expected to prompt many more adults and children to seek mental
Yet at the same time psychiatrists
specializing in treating children and teens are scarce. A separate
report, also released Monday in the Pediatrics journal, says primary care
doctors including pediatricians and family physicians will need to get more
involved in mental health care.
That report is from the pediatrics academy and the
American Academy of Child and Adolescent
Psychiatry. The groups say pediatricians should routinely consult with
child psychiatrists, including working in the same office when possible. And
it says insurers should compensate pediatricians for any mental health
services they provide.
Dr. Alan Axelson, a Pittsburgh psychiatrist who co-authored the second
report, praised the task force recommendations and said pediatricians can
play a key role.
Because children's families often get to know their pediatricians, having
those doctors offer mental health screening can help make it seem less
stigmatizing, Axelson said.
Most pediatricians aren't trained to
do psychotherapy, but they can prescribe depression medication and
monitor patients they've referred to others for therapy, he said.
Dr. Ted Epperly, president of the American Academy of Family Physicians,
said his group strongly supports both Pediatrics reports.
While primary care doctors have full plates just dealing with physical
ailments, many recognize the importance of providing mental health services
-- and many already do, Epperly said.
It isn't always as time-consuming as it might seem; some screening
questionnaires can be filled out by patients in the waiting room, Epperly
said. Doctors can easily spot any red flags.
TV and video games increase
teen depression risk: study
2/2/09 AFP via Yahoo News
WASHINGTON (AFP) – Spending more
hours watching television or playing video games as a teenager may lead to
depression in young adults, according to a study published Monday.
Researchers looked at the exposure to electronic media of 4,142 adolescents
who were not depressed when the study began in 1995, before DVDs and the
Internet were widely used.
The teens reported an average of
5.68 hours of media exposure per day, including 2.3 hours of
television, 2.34 hours of radio, 0.62 hours of videocassettes and 0.41 hours
of computer games.
Seven years later, when the participants were an average of 21.8 years old,
308 of them (7.4 percent) had developed symptoms consistent with depression.
"In the fully adjusted models, participants had significantly greater odds
of developing depression by follow-up for each hour of daily television
viewed," wrote the authors of the study published in the Archives of General Psychiatry
"In addition, those reporting higher total media exposure had significantly
greater odds of developing depression for each additional hour of daily
use," said the study, led by Brian Primack of the University of Pittsburgh School of
Young women were found to be less likely to develop symptoms of depression
than young men when exposed to the same amount of electronic media.
Depression, the leading cause of
non-fatal disability worldwide, commonly begins in adolescence or young
adulthood, the article explained.
The authors noted that time spent engaging with electronic media may replace
time that could be spent on social, athletic or intellectual activities that
could guard against depression.
Messages transmitted through electronic media may encourage aggression,
inspire fear or anxiety and hamper identity development, they added.
Being exposed to media at night may also disrupt sleep important for
emotional and cognitive development.
"When high amounts of television or total exposure are present, a broader
assessment of the adolescent's psychosocial functioning may be appropriate,
including screening for current depressive symptoms and for the presence of
additional risk factors," the authors said.
"If no other immediate intervention is indicated, encouraging patients to
participate in activities that promote a sense of mastery and social
connection may promote the development of protective factors against
research summaries are available to millions of global viewers via Yahoo. As a veteran family therapist,
several things stand out to me about these reports:
Neither study defines "depression," which is
a catchall label for a spectrum of human attitudes and behaviors ranging
between mild and temporary to severe and chronic.
Neither study notes the possibility that
some (or much?) "depression" is really grief. As a whole, our
media and hi-tech culture ignores and denies the wholistic and social
importance of healthy grief.
The first study makes no attempt to assess
why two million American teens may be "depressed," but advocates
that doctors should "screen for it" when "psychiatric help" is
Neither article suggests that the primary
responsibility for preventing teen depression lies with the
child's parents and relatives, not doctors or politicians.
Both reports imply that "depression" is an
individual malady, rather than a symptom of
"Family therapy" is not mentioned in either
report. This omission is demonstrates that reputable human-behavior
researchers (and media editors) cling to the obsolete "medical model" of
personal psychological problems.
Both studies quote doctors opinions, which
implies depression is a "medical illness" rather than a
psychological condition. This reinforces the public's belief that medication is an
appropriate treatment for depression, rather than personal and family
Neither study comments on the long term
personal and societal effects of teens who get no help for significant
depression - e.g. how it may affect their ability to conceive and raise
Bottom line - these two reports
are examples of media coverage that promotes public unawareness and ignorance
about "mental health." The lack of an informed oversight body to screen the quality
and accuracy of what is published on this topic puts news-consumers at risk
of being misinformed.