Adolescent primary care patients' preferences for depression treatment.
ABSTRACT Despite efficacious treatments for depression in youth, current data indicate low rates of care. To better understand reasons for these low rates of care, we examined treatment preferences for depression treatment. Adolescents (N=444) who screened positive for depression at a primary care visit completed measures of predisposing, enabling, and need characteristics thought to be related to help seeking. Results indicated a strong tendency for adolescents to prefer active treatment (72%) versus watchful waiting (28%), and for youth to prefer counseling (50%) versus medication (22%). Female gender, prior treatment experience, and current depression and anxiety were related to preference for active treatment over watchful waiting. In multivariable analyses, female gender and current anxiety symptoms remained significant predictors of preference for active treatment. Ethnicity, attitudes about depression care, prior treatment experience, and anxiety symptoms were related to preference for medication over counseling. In multivariable analyses, those with negative attitudes about depression treatment generally, with positive attitudes about treatment via medication, or with current anxiety symptoms were more likely to prefer medication. Youth preference for counseling over medication may contribute to low adherence to medication treatment and underscores the importance of patient education aimed at promoting positive expectations for treatments.
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ABSTRACT: Recent estimates indicate that 6.5 million adolescents and young adults in the United States are neither in school nor working. These youth have significant mental health concerns that require intervention.JAMA Psychiatry 11/2014; 72(1). DOI:10.1001/jamapsychiatry.2014.2022 · 12.01 Impact Factor
European Child & Adolescent Psychiatry 05/2014; 23(6). DOI:10.1007/s00787-014-0554-7 · 3.55 Impact Factor
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ABSTRACT: During the young adult years (ages 18 to 25 years), many young people participate in postsecondary education. Mental health problems such as anxiety, depression, and substance misuse are especially common in this age range. The purpose of this study was to survey the extended health insurance plans available to undergraduate students at colleges and universities across Canada to evaluate the extent of coverage for prescription medication and for psychotherapy and counselling services. Information from 210 postsecondary institutions was collected. Sixty-eight percent of universities and 41% of colleges provided private extended health insurance. For those institutions with these plans, the amount of coverage for prescription medication would adequately cover the yearly average cost of most medication treatments for problems such as anxiety or depressive disorders. Seventy-one percent of plans had maximum coverage of at least $3,000 a year and 28% had no maximums. Sixty-nine percent of universities and 28% of colleges have plans that provide coverage for psychotherapy. For institutions with this coverage, the modal level of total coverage was in the range of $300 to $500 per year. Very few plans provide sufficient coverage for the psychological treatment of common mental health problems. Recommendations are made for improving the support available for students with mental health problems through extended health insurance plans and the development of campus-wide plans for mental health promotion. (PsycINFO Database Record (c) 2014 APA, all rights reserved)05/2014; 55(2):101. DOI:10.1037/a0036476