Original articleDepression treatment during outpatient visits by U.S. children and adolescents
Section snippets
Data sources
Annual data from1995 through 2002 were obtained from the National Ambulatory Medical Care Survey (NAMCS) and the Outpatient Department (OPD) component of the National Hospital Ambulatory Medical Care Survey (NHAMCS). At the time of the study, 2002 data were the latest release from NAMCS and NHAMCS. The National Center for Health Statistics (NCHS) provides complete descriptions of both surveys and yearly data at http://www.cdc.gov/nchs/about/major/ahcd/ahcd1.htm. These surveys, particularly
Volume and composition of depression visits
The number of annual visits by children and adolescents aged 7 to 17 years who were diagnosed with a depressive disorder increased markedly from 1.44 million (M) (99% CI: 1.08–1.80 M) in 1995–1996 to 3.22 M (2.50 M–3.94 M) in 2001–2002 (Figure 1). During this period, there were fewer diagnoses of major depressive disorder compared with other depression diagnoses. The number of visits with a diagnosis of depression not otherwise specified (suggesting moderate severity) increased by 138% from
Discussion
Our study supports other research that finds children and adolescents to be increasingly seen and diagnosed with depressive disorders [3], [7], [17], [18]. In concordance with the underlying epidemiology [19], depression visits were most common among 15–17-year-olds, girls, and non-Hispanic Caucasians. The absolute increase in depression visits was much greater than expected when compared with the moderate increase in the population of children and adolescents during these years. The greater
Acknowledgment
This study was supported by a research grant from Agency for Healthcare Research and Quality (AHRQ) (R01- HS11313).
References (25)
- et al.
Mood disorders in children and adolescentsan epidemiological perspective
Biol Psychiatry
(2001) - et al.
Practice parameters for the assessment and treatment of children and adolescents with depressive disorders
J Am Acad Child Adolesc Psychiatry
(1998) - et al.
National trends in the use of psychotropic medications by children
J Am Acad Child Adolesc Psychiatry
(2002) - et al.
SSRIs associated with behavioral activation and suicidal ideation
J Am Acad Child Adolesc Psychiatry
(2001) - et al.
Antidepressant medications in children
N Engl J Med
(2004) - et al.
Outpatient treatment of child and adolescent depression in the United States
Arch Gen Psychiatry
(2003) Antidepressants and pediatric depression–the risk of doing nothing
N Engl J Med
(2004)- et al.
Fluoxetine, cognitive-behavioral therapy, and their combination for adolescents with depressionTreatment for Adolescents With Depression Study (TADS) randomized controlled trial
JAMA
(2004) - et al.
Psychotropic practice patterns for youtha 10-year perspective
Arch Pediatr Adolesc Med
(2003) - et al.
A risk-benefit assessment of pharmacotherapies for clinical depression in children and adolescents
Drug Safety
(1999)