Recognizing that “early onset is associated with worse outcomes”, the US Preventive Services Task Force (USPSTF) has recommended screening asymptomatic adolescents aged 12-18 years for major depressive disorder (MDD) with grade B recommendation in a draft recommendation statement stating that this has “moderate net benefit”.¹ It has not recommended screening for MDD in children aged 11 years or younger. Also, these recommendations do not apply to other depressive disorders like minor depression or dysthymia.

Marking a first, the USPSTF also recommends screening children aged 8 years and older for anxiety (Grade B) irrespective of presence of signs and symptoms. But it states that currently the evidence is insufficient to screen younger children (≤7 years) for anxiety.

Although asymptomatic for depression, some risk factors may help to identify at-risk adolescents, says the Statement, which include family history of depression, prior episode of depression/other mental health/behavioral problems, childhood abuse or neglect, exposure to traumatic events, bullying, adverse life events and an insecure parent relationship. Repeated screenings are helpful.

But evaluation to confirm the diagnosis should follow screening with effective treatment and regular follow-ups.

While acknowledging suicide as the “second-leading” cause of death in this age group, the USPSTF has stopped short of recommending screening asymptomatic children and adolescents for suicide citing lack of adequate evidence (Grade I).

The draft statement is in public domain till May 9, 2022 for comments.

Reference

1. U.S. Preventive Services Task Force "Draft recommendation statement: screening for depression and suicide risk in children and adolescents" USPSTF April 12, 2022.