An audit of medical records for 150 young people, aged 15 to 25, diagnosed with depressive disorder examined the gaps between theory and practice of treating youth depression.
It found that antidepressants were prescribed to 75% of patients before undertaking an adequate trial of psychotherapy.
The researchers noted that medication may have been prescribed earlier for young people who declined to engage in psychological therapy.
They also acknowledged barriers to implementing recommendations such as clinicians’ beliefs that medication was warranted earlier than recommended owing to the severity and complexity of cases, and the difficulty in delivering psychotherapy.
It was also difficult for doctors to monitor young people prescribed medication.
Doctors monitored less than half of young patients for depression symptom improvement or suicide-related behaviours, but “encouragingly” prescribed the recommended drug fluoxetine first line to 92% of patients 18 and under – and 53% for those over 18.
“Youth specific psychotherapy that incorporates the most effective components for this age group, delivered in a youth friendly way would likely aid effective implementation of guideline recommendations … before medication is initiated,” the study authors concluded in BMC Health Services Research.
As first appeared in Psychiatry Update, 5 July 2012.