Prevalence and Treatment Rates

  • Anxiety and depression are both very common in children.  A 2018 study in The Journal of Pediatrics stated that among children aged 3-17 years:
    • 3.2% have diagnosed depression (1.9 million children)
    • 7.1% have diagnosed anxiety (4.4 million children)
  • 21.9% (or more than 1 in 5) children with depression went untreated
  • 40.7% (or more than 2 in 5) children with anxiety went untreated

Program Goals

  • To identify children at well child care visits that are at risk for having anxiety and/or depression
  • To further assess those children identified as being at risk
  • To provide consultations for those who have concerns regarding these issues without waiting until their well visit
  • To educate as to treatment options available
  • To help plan and implement selected treatment option
    • Facilitate connections with therapists as needed
    • To initiate medication when appropriate
    • To monitor progress on medications, assess for side effects, and manage dosing as appropriate
    • To refer out to psychiatry when appropriate

Screening

  • Performed at all well visits by asking questions on a wide array of topics that could be concerning (as examples: recent drops in school performance or recent changes in sleep patterns)
  • Through use of standardized screening instruments.  We utilize the Pediatric Symptom Checklist in younger children and the PHQ-9 and SCARED in older children. Use of these instruments is recommended by the AAP as part of the Bright Futures guidelines.
  • Standardized screening instruments may or may not be covered by insurance.  If you choose to opt out of these recommended screens, you will be asked to sign a declination advising that you understand the risks associated with your decision.

Screening

  • Performed at all well visits by asking questions on a wide array of topics that could be concerning (as examples: recent drops in school performance or recent changes in sleep patterns)
  • Through use of standardized screening instruments.  We utilize the Pediatric Symptom Checklist in younger children and the PHQ-9 and SCARED in older children. Use of these instruments is recommended by the AAP as part of the Bright Futures guidelines.
  • Standardized screening instruments may or may not be covered by insurance.  If you choose to opt out of these recommended screens, you will be asked to sign a declination advising that you understand the risks associated with your decision.

Consultations

Consultations for anxiety and depression involve:

  • Obtaining a full history regarding the concern
  • Performing a physical examination to identify potential underlying causes (such as thyroid deficiency) and or manifestations (such as cutting)
  • Ordering of laboratory studies and referrals to specialists if indicated
  • Administration of standardized assessment tools if indicated
  • Making diagnosis and discussing treatment options or scheduling return visit if diagnosis is depending on laboratory studies or consultations with specialists.

Treatment Options

Treatment of anxiety and depression consists of:

  • Cognitive behavior therapy (CBT) alone
  • Medication alone
  • Combination of CBT and Medication

Treatment Options

Treatment of anxiety and depression consists of:

  • Cognitive behavior therapy (CBT) alone
  • Medication alone
  • Combination of CBT and Medication

Post Partum Depression

  • Postpartum depression is very common.  1 in 9 women experience symptoms of postpartum depression.
  • We screen for postpartum depression three times during the newborn period using the Edinburgh Postnatal Depression Scale
  • We ask questions at well child care visits to try to identify those that may be at risk
  • We will facilitate treatment for parents as required