If your pre-teen or teenager has an examination by his pediatrician, you may notice a different addition to questions. This year, the Amercian Academy of Pediatrics updated its standards of care to include screening for depression between 11 and 21 years of age.
The change is screening is a result of the prevalence of depression in teens. Reports indicate as many as 20% of teens have an episode of depression sometime during adolescence and approximately 9% meet the criteria for chronic depression.
Depression impacts self-esteem, social relationships with family and peers and school performance. Depressed adolescents often do poorly in school, are at risk for the development of eating disorders, tend to become involved in high risk behaviors (drug abuse, violence, school truancy, promiscuity), and have a high risk for suicide.
The new guidelines were put in place because there is a fear that many depressed children are not being identified. Historically, many physicians were often unaware of the depression unless the family or patient discusses their concerns. Estimates suggest that 50% of adolescents are not identified until they become adults. For these reasons the American Academy of Pediatrics has recommended physicians who care for adolescents routinely screen them all for depression.
Several screening tools for adolescent depression are available and the best rely on the observations of both the adolescent and their parent(s). While none are perfect, their relative high sensitivity (70-90%) makes them good "red flags" for identifying kids who need to be looked at in greater detail by their physician.
The more severe (the higher the score) the initial screening result is, and if the symptoms persist (present for 6 weeks or longer), this is the strongest predictor of significant depression.
I discuss more about the 6 major changes in screening in the Ask an Expert section.