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Licensed Unlicensed Requires Authentication Published by De Gruyter September 4, 2013

Educating health care trainees and professionals about suicide prevention in depressed adolescents

  • Timothy R. Rice EMAIL logo and Leo Sher

Abstract

Adolescent depression is a highly prevalent disorder with significant morbidity and suicide mortality. It is simultaneously highly responsive to treatment. Adolescents wish to discuss depression with their providers, and providers routinely receive opportunities to do so. These characteristics of prevalence, morbidity, mortality, responsiveness, and accessibility make adolescent depression an excellent target of care. However, most health care trainees and professionals report low confidence in caring for adolescent depression. As a caregiver community, we fare poorly in routine matters of assessment and management of adolescent depression. All health care professionals are trained within a medical model. In this light, the conceptualization of adolescent depression and suicidality within the medical model may increase provider confidence and performance. Epidemiology and neurobiology are presented with emphasis in this review. Legal concerns also affect health care professionals. For example, providers may deviate from evidence-based medicine owing to anxieties that the identification and treatment of depression may induce suicide and consequent legal culpability. A review of the historical context and relevant outcome trials concerning the increased risk of suicidality in depressed adolescents treated with selective-serotonin reuptake inhibitors may increase provider comfort. Furthermore, increased didactic and experiential training improve provider performance. In this work, proven models were discussed, and the testable hypothesis that education incorporating the views of this article can produce the best care for depressed adolescents.


Corresponding author: Timothy R. Rice, MD, Department of Psychiatry, Mount Sinai School of Medicine, Box 1230, One Gustave L. Levy Place, New York, NY 10029, USA

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Received: 2012-8-15
Accepted: 2012-9-20
Published Online: 2013-09-04
Published in Print: 2013-09-01

©2013 by Walter de Gruyter Berlin Boston

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