![]() ![]() The result of this initiative was the development of the Guidelines for Adolescent Depression in Primary Care (GLAD-PC). To address this gap as well as to meet the needs of PC clinicians and families who are on the front lines with few mental health resources available, in 2007, the Center for the Advancement of Children’s Mental Health at Columbia University and the Sunnybrook Health Sciences Center at the University of Toronto joined forces with the New York Forum for Child Health, the New York District II Chapter 3 of the American Academy of Pediatrics (AAP), and the Resource for Advancing Children’s Health (REACH) Institute along with leading experts across the United States and Canada to address the need for a synthesis of knowledge in this area. In view of the shortage of mental health clinicians, the barriers to children’s access to mental health professionals, the well-documented need for PC clinicians to learn how to manage this condition, the increasing evidence base that is available to guide clinical practice, the increased selective serotonin reuptake inhibitor–prescribing rates in pediatric PC, 9, 10 and new evidence that a multifaceted approach with mental health consultation may improve the management of depression in PC settings, 8, 10, – 16 guidance for the identification and management of depression in adolescents in PC were urgently needed. The practice preparation, identification, assessment, and initial management section of the guidelines include recommendations for (1) the preparation of the PC practice for improved care of adolescents with depression (2) annual universal screening of youth 12 and over at health maintenance visits (3) the identification of depression in youth who are at high risk (4) systematic assessment procedures by using reliable depression scales, patient and caregiver interviews, and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria (5) patient and family psychoeducation (6) the establishment of relevant links in the community, and (7) the establishment of a safety plan. The strength of each recommendation and its evidence base are summarized. Guidelines were updated for youth aged 10 to 21 years and correspond to initial phases of adolescent depression management in PC, including the identification of at-risk youth, assessment and diagnosis, and initial management.
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