Based on the available evidence, the GLAD coalition made the following recommendations regarding identifying youth at risk: “Patients with depression risk factors (such as a history of previous episodes, family history, other psychiatric disorders, substance abuse, trauma, psychosocial adversity, etc.) should be identified and systematically monitored over time for the development of a depressive disorder (strength of recommendation: very strong).”3
With regard to diagnosis, the task force’s recommendation is: “PC (primary care) clinicians should evaluate for depression in adolescents at high risk as well as those who present with emotional problems as the chief complaint. Clinicians should assess for depressive symptoms on the basis of diagnostic criteria established in the DSM-IV… and should use standardized depression tools to aid in the assessment (grade of evidence A; strength of recommendation: very strong).”3
It’s important to assess for suicidal thoughts or intentions and the fourth recommendation of the task force suggests establishing a safety plan should the teenager deteriorate; this includes a ‘911’-type line for emergencies for the adolescent/family. The task force also recommends interviewing parents or teachers to help formulate the diagnosis.