Recognition of adolescent depression in primary care by nurse- practitioners: a descriptive study

Primary care providers, such as nurse-practitioners (NPs) often are the first to encounter depressed adolescents, particularly those with somatic complaints. NPs provide early recognition and referral for treatment of adolescent depression, interventions that can greatly decrease life-time morbidity and mortality of the disorder. Research documents that under-recognition of depressive disorders in primary care is, however, the reality. The purpose of this study was to examine the current practices of NPs regarding adolescent depression. This was considered an initial step toward explaining under-recognition and making recommendations for change. A questionnaire was distributed to all licensed NPs practicing in the state of Utah. The results demonstrated significant relationships between the use of screening tools and increased number of adolescents referred, as well as increased frequency of prescribing antidepressants for adolescents in rural settings. Though NPs recognized characteristics of adolescent depression, they may have overestimated the prevalence in the general population. Further research is needed to improve primary care recognition and management of adolescent depression. Emphasis on education, research and utilization of on-site mental health professionals is recommended.