Study shows increase in Canadian adolescents with depression

A study published in the Canadian Medical Association Journal said more research is needed for the detection and treatment of depression in young people.

The study, called “Diagnosis and Management of Depression in Adolescents”, examined the role of depression as a "leading cause of disability and a major contributor to the global burden of disease."

The study was authored by Drs. Daphne J. Korczak, Clara Westwell-Roper and Roberto Sassi, all MDs. 

The prevalence of depression among adolescents increases with age, said the study.

Before COVID-19, the prevalence of Major Depressive Disorder (MDD) among adolescents was estimated at 13 to 15 per cent, said the study. 

"A recent meta-analysis found that around one in four youth had clinically significant depressive symptoms during the COVID-19 pandemic with higher rates associated with older age and female sex," said the study.  

The study also reported "depression is common among adolescents in Canada and has the potential to negatively affect long-term function and quality of life; despite this, in most affected adolescents depression remains undetected and untreated."

The authors said a good part of their research came from searching medical online databases such PubMed, PsychINFO and MEDLINE to gather information on children and adolescents, up to May of 2022. Along with gathering data from Canadian sources, the study reviewed data from the United States, the United Kingdom, Australia and New Zealand. 

It was further revealed there are numerous factors involved that will increase the risk of, or resilience to, depression among children and adolescents. Family history is one of those, with a three- to five-fold increase in the risk of depression among older children, said the study.

It also reported there are genetic traits that were associated with psychological traits that may increase the risk of depression. This would include such things as exposure to parental depression during the postnatal period, adverse childhood experiences and family conflict. The study also said that stigma and experiences of bullying have links to increased rates of depression among LGBTQ2+ adolescents.

When it comes to detection and treatment of young people who might be suffering MDD, the study said that symptoms for young people are more likely to present as being irritable, constant fatigue and social withdrawal. 

"Risk assessment is a critical component of the assessment of depression and includes a review of current suicidal ideation. intent and plan; recent hopelessness, perceived burdensomeness and impulsivity; previous suicide attempts and non-suicidal self injury; situation stressors and protective factors including supports and future orientation," said the study.

The study asked the question of whether clinicians should be screening more often for depression. The answer was that although there is no direct evidence that screening for MDD leads to improved outcomes, there was "indirect evidence" that screening was associated with moderate benefit.

The study concluded that "depression is an increasingly common, but treatable condition among adolescents." It also said that primary care physicians and pediatricians are well-positioned to support assessment and treatment of adolescent depression.

"Future research that supports important clinical questions in the detection and treatment of adolescent depression is needed," said the report.