Adolescent Collaborative Care Treatment for Depression

描述(申请人提供)：重度抑郁症是青春期最常见的精神健康障碍之一，与发育和功能的严重障碍有关。该项目将通过一项随机对照试验，将干预措施与常规护理进行比较，严格测试青少年合作护理治疗干预措施，这是一种旨在改善青少年抑郁障碍管理的卫生服务干预措施。试验的关键部分包括加强对青年和父母的教育，青年参与选择循证治疗，由专职保健专业人员在精神健康专家和儿科医生的定期监督下进行护理管理，以及在青年病情没有改善时进行阶段性护理以推进治疗。还增加了吸引青少年和家长参与的其他功能，包括一个供青少年相互分享和学习的温和留言板，父母的正式参与，以及在放学后提供护理经理。我们的发现将为发展敏感的适应性护理干预治疗青春期抑郁症的有效性提供关键信息。 公共卫生相关性：当前青少年抑郁症干预的目标是显着提高青少年抑郁症得到准确诊断和有效治疗的比例。只有不到50%的患有抑郁症的年轻人接受了治疗。大多数青少年每年至少去看一次初级保健医生：在这种情况下，改进抑郁症的检测和治疗可以显着改善青少年的抑郁症结果，降低自杀风险。

DESCRIPTION (provided by applicant): Major Depression is one of the most common mental health disorders in adolescence and is associated with significant impairments in development and functioning. This project will rigorously test the Adolescent Collaborative Care Treatment intervention, a health services intervention designed to improve management for depressive disorders among adolescents, via a randomized controlled trial comparing the intervention to usual care. Key components of the trial include enhanced education for youth and parents, youth involvement in choice of evidence-based treatments, care management by an allied health professional with regular supervision by a mental health specialist and pediatrician, and stepped care to advance treatment when youth are not improving. Additional features have been added to engage adolescents and parents including a moderated message board for youth to share with and learn from one another, formalized involvement of the parent, and availability of the care manager during after school hours. Our findings will provide key information on the effectiveness of a developmentally-sensitive adapted collaborative care intervention for the treatment of adolescent depression. PUBLIC HEALTH RELEVANCE: The goal of the current adolescent depression intervention is to markedly improve the percentage of adolescents who are accurately diagnosed and effectively treated for depression. Fewer than 50% of youth with depression receive treatment. Most adolescents visit a primary care doctor at least once a year: improving the detection and treatment of depression in this setting could markedly improve depression outcomes in teenagers and decrease risk of suicide.