Clinical characteristics associated with the prescribing of SSRI medication in adolescents with major unipolar depression
European Journal of Child and Adolescent Psychiatry
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Cousins, L., Whitaker, K., Widmer, B., Midgley, N., Byford, S., Dubicka, B., Kelvin, R., et al. (2016). Clinical characteristics associated with the prescribing of SSRI medication in adolescents with major unipolar depression. European Journal of Child and Adolescent Psychiatry https://www.repository.cam.ac.uk/handle/1810/255149
Objective: 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. Method: 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. Results: 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. Conclusions: 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.
adolescents, depression, antidepressants, SSRIs, risk, self-harm
RCT Study supported by a grant to IMG (Chief Investigator) from the NIHR-HTA (trial number ISRCTN83033550, grant number 06/05/01).
NIHR Evaluation, Trials and Studies Coordinating Centre (NETSCC) (HTA/06/05/01)
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This record's URL: https://www.repository.cam.ac.uk/handle/1810/255149