Strategies and challenges in the management of adolescent depression

Adolescent depression is a chronic, pervasive, and disabling problem that is often under-recognized and under-treated. The objective of this article is to review recent (over the past 12-18 months) literature on the management of depression in adolescents, with a particular focus on pharmacological and psychological treatments as well as community and internet-based prevention and treatment programmes.

The tendency for depression in young people to be associated with a number of other disorders and behaviours, including anxiety, suicide, conduct disorder and substance abuse, compounds the complexity of management and can contribute to a negative long-term impact on adult mental health. Results of recent randomized controlled trials have reinforced our understanding that the management of moderate-to-severe depression in adolescents should be assertive and prompt, typically including a combination of psychological and pharmacological interventions.

While the development of novel treatments is evolving, there is an urgent need to focus on defining the optimal use of available therapies and tailoring these to individual presentations, as well as upon improving identification of adolescent depressive disorders in the community.