Evidence-Based Treatment of Unipolar Depression in Adolescents

Untreated depression has a detrimental effect in the lives of the adolescents suffering from this disorder. Depression is a multidimensional phenomenon that has been linked to biological, psychosocial and cognitive risk factors. Adolescents may be at risk for depression because adolescence is a time of physical, hormonal, emotional and intellectual changes. Depression may lead to impaired social and school performances and to poor physical health. In addition to a reduced quality of life, depression has also been linked to suicidal ideation and attempts. Suicide is the third cause of death in adolescents in the United States.The purpose of this practice inquiry was to conduct a critical review and synthesis of the literature on evidence-based treatment of unipolar depression in adolescents and to make recommendations for health care providers. This topic was chosen because of the high prevalence of depression in adolescents and because of the devastating effects of not treating this disorder.The methods used to synthesize the literature are described in the Guide for Literature Reviews by Cooper (1998). After the problem was identified, a literature search was conducted in PubMed, Cinahl, Psych Info, Complementary and Alternative Medicine and AMED. Next, the literature yielded 93 articles. The evidence from the literature was ranked according to the Oncology Nursing Society (ONS), Putting Evidence into Practice (PEP), Levels of Evidence scale. This system is an adaptation of the Rating the Quality of Evidence for Clinical Practice Guidelines developed by Hadorn and others (1996). Lastly, the recommendations for practice were made based on the ONS PEP, Weight of Evidence Classification Schema by Mitchell & Friese. Based on the evidence found in the literature, a guideline with the recommendations for practice was developed.The need for the treatment of adolescents with depression was supported in this synthesis of the literature. Future research is needed to explore treatment modalities tailored to the developmental, biological, psychosocial and cultural needs of adolescents and their families