- Describe your topic.
- Topic: Identification, Assessment, Treatment, and Prevention of Depressive Disorders in Children and Adolescents Population: Children and adolescents through 17 years of age with a DSM-5 depression diagnosis or with elevated risk of developing depression. Questions: 1. What is the comparative accuracy of instruments/techniques that can be used to screen for, monitor response to treatment of, and/or diagnose depressive disorders? 2. What are the comparative benefits and harms of nonpharmacologic and pharmacologic treatments for depression, alone and in combination, against active and inactive treatments, in improving patient, clinician, family, and payer-reported outcomes (e.g., symptom reduction, disorder remission, global severity/improvement, global symptoms/function improvement, specific function improvement [school, family/peer relationships], family/parent stress/functioning, health care utilization, total medical expenditures)? 3. Do benefits and harms of nonpharmacologic and pharmacologic treatments for depression vary by: a. patient characteristics (e.g., age, gender, race/ethnicity, socioeconomic status, exposure to trauma/adverse childhood events, adherence to treatment); b. disorder characteristics (e.g., type, severity, chronicity, sub-type, recurrence); c. treatment characteristics (type [e.g., specific therapy, individual/group/family-focused modality, therapy components] and duration of nonpharmacologic treatment; type, dose, and duration of medication, discipline of provider, setting of treatment); d. history of previous treatment (e.g., type and duration of nonpharmacologic treatment; type, dose, and duration of medication); e. comorbid conditions (e.g., anxiety, disruptive behavior, ADHD, bipolar, schizophrenia, obsessive compulsive-related, somatic symptom, eating, substance-related, trauma-related, and autism spectrum disorders); f. family characteristics (e.g., disrupted, dysfunctional, parental psychopathology, parenting style). 4. What factors convey excess risk for the development of depressive disorders? 5. What are the comparative benefits and harms of nonpharmacologic approaches to the prevention of depressive disorders?
- Describe why this topic is important.
- Topic: Identification, Assessment, Treatment, and Prevention of Depressive Disorders in Children and Adolescents Population: Children and adolescents through 17 years of age with a DSM-5 depression diagnosis or with elevated risk of developing depression. Questions: 1. What is the comparative accuracy of instruments/techniques that can be used to screen for, monitor response to treatment of, and/or diagnose depressive disorders? 2. What are the comparative benefits and harms of nonpharmacologic and pharmacologic treatments for depression, alone and in combination, against active and inactive treatments, in improving patient, clinician, family, and payer-reported outcomes (e.g., symptom reduction, disorder remission, global severity/improvement, global symptoms/function improvement, specific function improvement [school, family/peer relationships], family/parent stress/functioning, health care utilization, total medical expenditures)? 3. Do benefits and harms of nonpharmacologic and pharmacologic treatments for depression vary by: a. patient characteristics (e.g., age, gender, race/ethnicity, socioeconomic status, exposure to trauma/adverse childhood events, adherence to treatment); b. disorder characteristics (e.g., type, severity, chronicity, sub-type, recurrence); c. treatment characteristics (type [e.g., specific therapy, individual/group/family-focused modality, therapy components] and duration of nonpharmacologic treatment; type, dose, and duration of medication, discipline of provider, setting of treatment); d. history of previous treatment (e.g., type and duration of nonpharmacologic treatment; type, dose, and duration of medication); e. comorbid conditions (e.g., anxiety, disruptive behavior, ADHD, bipolar, schizophrenia, obsessive compulsive-related, somatic symptom, eating, substance-related, trauma-related, and autism spectrum disorders); f. family characteristics (e.g., disrupted, dysfunctional, parental psychopathology, parenting style). 4. What factors convey excess risk for the development of depressive disorders? 5. What are the comparative benefits and harms of nonpharmacologic approaches to the prevention of depressive disorders?
- Tell us why you are suggesting this topic.
- A new evidence report would serve as the basis for updated clinical practice guidelines pertaining to the assessment, treatment, and prevention of depression in children and adolescents that will be published as an Official Action of the American Academy of Child and Adolescent Psychiatry (AACAP) in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP). Previous guidelines published in JAACAP have been widely utilized by AACAP members – in a recent survey, 77% of surveyed AACAP members reported that they regularly used the AACAP guidelines to guide their clinical practice. AACAP guidelines have also been widely cited in the leading textbook (Nelson) in pediatrics, extending best practices for depression treatment to thousands of additional practitioners. Because guidelines based upon AHRQ reviews are likely to be accepted for posting on the National Guideline Clearinghouse website, the new AACAP guideline on depression potentially would have worldwide dissemination. Understanding depression treatment benefits and harms and instituting safe and effective treatment can reduce morbidity and mortality associated with this potentially debilitating and life-threatening condition. In this context, the incoming President of the American Academy of Child and Adolescent Psychiatry, Karen Dineen Wagner, MD, PhD, has selected Depression Awareness as the focus of her Presidential Initiative. She has written: “The American Academy of Child and Adolescent Psychiatry will lead efforts with national organizations dealing with children's mental health such as the American Academy of Pediatrics, Association of Directors of Child and Adolescent Psychiatry, American Academy of Family Physicians, American Psychological Association, American Suicide Foundation, and national advocacy associations to increase knowledge about depression and its impact on children and adolescents. The information obtained from the AHRQ review on treatment of depression in youth will be widely disseminated as part of this depression awareness initiative.”
- Target date.
- Describe what you are doing currently and what you are hoping will change because of a new evidence report.
- Previous guidelines published in JAACAP have been widely utilized by AACAP members – in a recent survey, 77% of surveyed AACAP members reported that they regularly used the AACAP guidelines to guide their clinical practice. AACAP guidelines have also been widely cited in the leading textbook (Nelson) in pediatrics, extending best practices for depression treatment to thousands of additional practitioners. Because guidelines based upon AHRQ reviews are likely to be accepted for posting on the National Guideline Clearinghouse website, the new AACAP guideline on depression potentially would have worldwide dissemination. Understanding depression treatment benefits and harms and instituting safe and effective treatment can reduce morbidity and mortality associated with this potentially debilitating and life-threatening condition. In this context, the incoming President of the American Academy of Child and Adolescent Psychiatry, Karen Dineen Wagner, MD, PhD, has selected Depression Awareness as the focus of her Presidential Initiative. She has written: “The American Academy of Child and Adolescent Psychiatry will lead efforts with national organizations dealing with children's mental health such as the American Academy of Pediatrics, Association of Directors of Child and Adolescent Psychiatry, American Academy of Family Physicians, American Psychological Association, American Suicide Foundation, and national advocacy associations to increase knowledge about depression and its impact on children and adolescents. The information obtained from the AHRQ review on treatment of depression in youth will be widely disseminated as part of this depression awareness initiative.”
- How will you or your group use the information from a new evidence report?
- A new evidence report would serve as the basis for updated clinical practice guidelines pertaining to the assessment, treatment, and prevention of depression in children and adolescents that will be published as an Official Action of the American Academy of Child and Adolescent Psychiatry (AACAP) in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP).
- How would you or your group plan to disseminate information from the report? Who would you plan to disseminate it to?
- A new evidence report would serve as the basis for updated clinical practice guidelines pertaining to the assessment, treatment, and prevention of depression in children and adolescents that will be published as an Official Action of the American Academy of Child and Adolescent Psychiatry (AACAP) in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP).
- Do you know of organizations that could use an evidence report to change clinical practice? Are you a part of, or have you been in contact with, any organizations that might implement the research findings of an evidence report?
- American Academy of Pediatrics, Association of Directors of Child and Adolescent Psychiatry, American Academy of Family Physicians, American Psychological Association, American Suicide Foundation
- Information About You:
-
- Provide a description of your role or perspective
- Physician, child and adolescent psychiatrist, co-chair of the AACAP Committee on Quality Issues, which is charged with developing clinical practice guidelines to inform the practice of child and adolescent psychiatrists worldwide.
- If you are you making a suggestion on behalf of an organization, please state the name of the organization
- American Academy of Child and Adolescent Psychiatry
- Please tell us how you heard about the Effective Health Care Program
