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Professional interventions to improve the detection of depression among adolescents in primary care

Depression is common in adolescence – studies show that 3% – 8% of adolescents suffer from depression at any one time, and that there is a lifetime prevalence of approximately 20% by the end of adolescence, which is similar to that of adulthood. Adolescent depression is associated with considerable impairment in social, academic and physical functioning, and is a a major risk factor for suicide. According to a recent EU report, Ireland has the highest rate of female suicide (2.1/100,000) and the second highest rate of male suicide (5.1/100,000) for people under 19 years of age.
General practice is well-placed to facilitate early intervention for mental health problems among adolescents and young people. The vast majority of young people (approximately 70%) will visit their GP at least once a year and thus GPs are well-positioned to serve an important monitoring and health promotion function in terms of adolescent mental health. General practice can also act as a conduit to specialised services for those
experiencing mental disorders and provide ongoing support. However, depression in adolescents attending primary care often goes undetected.
Objective:
We aim to evaluate the effectiveness of professional interventions to improve the detection of depression among adolescents in primary care. The review aims to answer the following questions:
 Does training of primary care practitioners (PCPs) improve detection of adolescent depression?
 Do other professional interventions for PCPs (eg. audit and feedback) improve detection of adolescent depression?
 Do professional interventions for PCPs lead to a reduction in depressive symptoms of identified adolescents?
 Are professional interventions for PCPs more effective for particular groups of adolescents eg. younger/older age groups; male/female?
 Are some types of professional interventions more effective than other types for improving detection of adolescent depression and reducing depressive symptomatology?
 Are there adverse consequences of the above interventions, eg. misdiagnosis?