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

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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.
Original languageEnglish
Pages (from-to)1287–1295
JournalEuropean Child & Adolescent Psychiatry
Volume25
Issue number12
Early online date28 Apr 2016
DOIs
Publication statusPublished - Dec 2016

Keywords

  • Adolescents
  • Depression
  • Antidepressants
  • SSRIs
  • Risk
  • Self-harm

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