ArticleJournal of developmental and behavioral pediatrics : JDBP2014
Primary care providers' initial treatment decisions and antidepressant prescribing for adolescent depression.
Article in Journal of developmental and behavioral pediatrics : JDBP, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
18 citing papers in PubMed.
- Effects of Primary Care Provider Characteristics on Changes in Behavioral Health Delivery During a Collaborative Care Trial.Academic pediatrics · 2020Trial
- Community Mental Health Workers: Their Workplaces, Roles, and Impact.Community mental health journal · 2024Review
- Attitudes and psychotropic preferences of primary care providers in the management of mental disorders: a web-based survey.Frontiers in medicine · 2024Article
- Systematic Review: Child Psychiatry Access Program Outcomes.JAACAP open · 2023Article
- Light Therapy for Adolescent Depression: A Scoping Review.Current psychiatry reports · 2023Article
- Anxiety and Depression Treatment in Primary Care Pediatrics.Pediatrics · 2023Review
- Medication Management of Anxiety and Depression by Primary Care Pediatrics Providers: A Retrospective Electronic Health Record Study.Frontiers in pediatrics · 2022Article
- Perceived Facilitators of and Barriers to Implementation of a Decision Support Tool for Adolescent Depression and Suicidality Screening: Focus Group and Interview Study.JMIR mental health · 2021Article
- Prescribing Technology to Increase Uptake of Depression Treatment in Primary Care: A Pre-implementation Focus Group Study of SOVA (Supporting Our Valued Adolescents).Journal of clinical psychology in medical settings · 2020Article
- When Behavioral Health Concerns Present in Pediatric Primary Care: Factors Influencing Provider Decision-Making.The journal of behavioral health services & research · 2018Article
- Collaborative Care: a Pilot Study of a Child Psychiatry Outpatient Consultation Model for Primary Care Providers.The journal of behavioral health services & research · 2017Article
- Which Pediatricians Comanage Mental Health Conditions?Academic pediatrics · 2017Article
- Outpatient Visits and Medication Prescribing for US Children With Mental Health Conditions.Pediatrics · 2015Article
- Parents' Role in Adolescent Depression Care: Primary Care Provider Perspectives.The Journal of pediatrics · 2015Article
- Primary care providers' beliefs about teen and parent barriers to depression care.Journal of developmental and behavioral pediatrics : JDBP · 2014Article
- Why are pediatric primary care providers reluctant to prescribe antidepressants to teens?Clinical practice (London, England) · 2014Article
- Patterns of Antidepressant and Antianxiety Medication Prescriptions in Pediatric Primary Care in the U.S.Journal of primary care & community healthArticle
- Achieving Quality Integrated Care for Adolescent Depression: A Scoping Review.Journal of primary care & community healthArticle
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
objectiveAdolescent depression is a serious and undertreated public health problem. Nonetheless, pediatric primary care providers (PCPs) may have low rates of antidepressant prescribing due to structural and training barriers. This study examined the impact of symptom severity and provider characteristics on initial depression treatment decisions in a setting with fewer structural barriers, an integrated behavioral health network.
methodsA cross-sectional survey was administered to 58 PCPs within a large pediatric practice network. PCP reports of initial treatment decisions were compared in response to 2 vignettes describing depressed adolescents with either moderate or severe symptoms. PCP depression knowledge, attitudes toward addressing psychosocial concerns, demographics, and practice characteristics were measured.
resultsFew PCPs (25% for moderate, 32% for severe) recommended an antidepressant. Compared with treatment recommendations for moderate depression, severe depression was associated with a greater likelihood of child psychiatry referral (odds ratio [OR], 5.50; 95% confidence interval [CI], 2.47-12.2] p < .001). Depression severity did not affect the likelihood of antidepressant recommendation (OR, 1.58 [95% CI, 0.80-3.11] p = .19). Antidepressants were more likely to be recommended by PCPs with greater depression knowledge (OR, 1.72 [95% CI, 1.14-2.59] p = .009) and access to an on-site mental health provider (OR, 5.13 [95% CI, 1.24-21.2] p = .02) and less likely to be recommended by PCPs who reported higher provider burden when addressing psychosocial concerns (OR, 0.85 [95% CI, 0.75-0.98] p = .02).
conclusionPCPs infrequently recommended antidepressants for adolescents, regardless of depression severity. Continued PCP support through experiential training, accounting for provider burden when addressing psychosocial concerns, and co-management with mental health providers may increase PCPs' antidepressant prescribing.
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