Clinical characteristics associated with the prescribing of SSRI medication in adolescents with major unipolar depression

Lesley Cousins; Kirstie J. Whitaker; Barry Widmer; Nick Midgley; Sarah Byford; Bernadka Dubicka; Raphael Kelvin; Shirley Reynolds; Christopher Roberts; Fiona Holland; Barbara Barrett; Robert Senior; Paul Wilkinson; Mary Target; Peter Fonagy; Ian M Goodyer

doi:10.1007/s00787-016-0849-y

Clinical characteristics associated with the prescribing of SSRI medication in adolescents with major unipolar depression

Lesley Cousins, Kirstie J. Whitaker, Barry Widmer, Nick Midgley, Sarah Byford, Bernadka Dubicka, Raphael Kelvin, Shirley Reynolds, Christopher Roberts, Fiona Holland, Barbara Barrett, Robert Senior, Paul Wilkinson, Mary Target, Peter Fonagy, Ian M Goodyer

Norwich Medical School

Research output: Contribution to journal › Article › peer-review

9 Citations (Scopus)

11 Downloads (Pure)

Abstract

Unipolar major depressions (MD) emerge markedly during adolescence. National Institute for Health and Care Excellence (NICE) UK recommends psychological therapies, with accompanying selective serotonin reuptake inhibitors (SSRIs) prescribed in severe cases only. Here, we seek to determine the extent and rationale of SSRI prescribing in adolescent MD before entering a randomised clinical trial. SSRI prescribing, together with their clinical characteristics was determined in 465 adolescent patients with MD prior to receiving a standardised psychological therapy as part of the Improving mood with psychoanalytic and cognitive therapies (IMPACT) clinical trial. Overall, 88 (19 %) had been prescribed antidepressants prior to psychological treatment. The clinical correlates varied by gender: respectively, depression severity in boys and self-harming behaviours in girls. Prescribing also differed between clinical research centres. Medical practitioners consider severity of depression in boys as an indicator for antidepressant prescribing. Self-injury in girls appears to be utilised as a prescribing aid which is inconsistent with past and current revised UK NICE guidelines.

Original language	English
Pages (from-to)	1287–1295
Journal	European Child & Adolescent Psychiatry
Volume	25
Issue number	12
Early online date	28 Apr 2016
DOIs	https://doi.org/10.1007/s00787-016-0849-y
Publication status	Published - Dec 2016

Keywords

Adolescents
Depression
Antidepressants
SSRIs
Risk
Self-harm

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10.1007/s00787-016-0849-yLicence: CC BY

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Cite this

Cousins, L., Whitaker, K. J., Widmer, B., Midgley, N., Byford, S., Dubicka, B., Kelvin, R., Reynolds, S., Roberts, C., Holland, F., Barrett, B., Senior, R., Wilkinson, P., Target, M., Fonagy, P., & Goodyer, I. M. (2016). Clinical characteristics associated with the prescribing of SSRI medication in adolescents with major unipolar depression. European Child & Adolescent Psychiatry, 25(12), 1287–1295. https://doi.org/10.1007/s00787-016-0849-y

Cousins, Lesley ; Whitaker, Kirstie J. ; Widmer, Barry ; Midgley, Nick ; Byford, Sarah ; Dubicka, Bernadka ; Kelvin, Raphael ; Reynolds, Shirley ; Roberts, Christopher ; Holland, Fiona ; Barrett, Barbara ; Senior, Robert ; Wilkinson, Paul ; Target, Mary ; Fonagy, Peter ; Goodyer, Ian M. / Clinical characteristics associated with the prescribing of SSRI medication in adolescents with major unipolar depression. In: European Child & Adolescent Psychiatry. 2016 ; Vol. 25, No. 12. pp. 1287–1295.

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abstract = "Unipolar major depressions (MD) emerge markedly during adolescence. National Institute for Health and Care Excellence (NICE) UK recommends psychological therapies, with accompanying selective serotonin reuptake inhibitors (SSRIs) prescribed in severe cases only. Here, we seek to determine the extent and rationale of SSRI prescribing in adolescent MD before entering a randomised clinical trial. SSRI prescribing, together with their clinical characteristics was determined in 465 adolescent patients with MD prior to receiving a standardised psychological therapy as part of the Improving mood with psychoanalytic and cognitive therapies (IMPACT) clinical trial. Overall, 88 (19 %) had been prescribed antidepressants prior to psychological treatment. The clinical correlates varied by gender: respectively, depression severity in boys and self-harming behaviours in girls. Prescribing also differed between clinical research centres. Medical practitioners consider severity of depression in boys as an indicator for antidepressant prescribing. Self-injury in girls appears to be utilised as a prescribing aid which is inconsistent with past and current revised UK NICE guidelines.",

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note = "Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. ",

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Cousins, L, Whitaker, KJ, Widmer, B, Midgley, N, Byford, S, Dubicka, B, Kelvin, R, Reynolds, S, Roberts, C, Holland, F, Barrett, B, Senior, R, Wilkinson, P, Target, M, Fonagy, P & Goodyer, IM 2016, 'Clinical characteristics associated with the prescribing of SSRI medication in adolescents with major unipolar depression', European Child & Adolescent Psychiatry, vol. 25, no. 12, pp. 1287–1295. https://doi.org/10.1007/s00787-016-0849-y

Clinical characteristics associated with the prescribing of SSRI medication in adolescents with major unipolar depression. / Cousins, Lesley; Whitaker, Kirstie J.; Widmer, Barry; Midgley, Nick; Byford, Sarah; Dubicka, Bernadka; Kelvin, Raphael; Reynolds, Shirley; Roberts, Christopher; Holland, Fiona; Barrett, Barbara; Senior, Robert; Wilkinson, Paul; Target, Mary; Fonagy, Peter; Goodyer, Ian M.

In: European Child & Adolescent Psychiatry, Vol. 25, No. 12, 12.2016, p. 1287–1295.

Research output: Contribution to journal › Article › peer-review

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AU - Cousins, Lesley

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AU - Dubicka, Bernadka

AU - Kelvin, Raphael

AU - Reynolds, Shirley

AU - Roberts, Christopher

AU - Holland, Fiona

AU - Barrett, Barbara

AU - Senior, Robert

AU - Wilkinson, Paul

AU - Target, Mary

AU - Fonagy, Peter

AU - Goodyer, Ian M

N1 - Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

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