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Adolescent depression: Could school screening help?

Adolescent depression: Could school screening help?

  • In the United States, depression among adolescents has been increasing.
  • As most adolescents attend schools, they can be useful places to identify students with depressive symptoms.
  • In a new study, universally screening students for depression was more effective in identifying students and getting them to start treatment than teachers flagging changes in behavior that might suggest depression.

A new study investigates the effects of universally screening students for depression in schools.

The researchers conclude that this screening is a more successful approach than simply relying on teachers to report behavior that might indicate depression.

The study, which appears in the journal JAMA Network OpenTrusted Source, offers a new way to respond to the significant rise in depression in U.S. adolescents since 2008.

Depression

According to the National Institute of Mental Health (NIMH)Trusted Source, depression is a common but serious

mood disorder that can have profound negative effects on quality of life.

The symptoms vary among individuals but can include:

  • feeling sad, anxious, emotionally empty, irritable, restless, or hopeless
  • speaking slowly
  • having low energy
  • having disrupted sleep
  • finding it difficult to concentrate
  • having suicidal thoughts

Depression is a condition that can affect people of different ages, including adolescents.

According to the NIMHTrusted Source, in 2019 — the most recent year for which data are available — 1

5.7% of adolescents in the U.S. had at least one major depressive episode.

This number has almost doubled from the 2008 figure of 8.3%.

Screening for depression

In 2009, the Preventive Services Task Force suggested that primary care services should screen all adolescents for depression. However, this has not been achieved in practice.

There are also inequalities based on region and inequities due to race and ethnicity.

Schools can be a good place to identify adolescents who may be experiencing depression, as most adolescents attend school.

Schools in the U.S. currently universally screen for some physical health problems. However, mental health issues such as depression depend on the staff at schools flagging behavior that may suggest depression to the relevant services.

A global trial, led by the pharmaceutical company Merck — known as MSD outside the United States and Canada — and Ridgeback Therapeutics, has found that the companies’ experimental antiviral drug molnupiravir reduces the risk of hospital admission or death from COVID-19 by approximately 50%.

Although this was a small-scale trial, these positive results have led to countries rushing to sign up for supplies of the drug.

In the randomized, phase 3 trial, scientists gave molnupiravir or a placebo to 775 people. All the participants had

tested positive for SARS-CoV-2 infections and experienced mild to moderate COVID-19 symptoms that had begun no more than 5 days earlier.

Every participant had at least one risk factor for severe COVID-19 but had not been admitted to a hospital.

Risk factors included obesity, an age of over 60 years, diabetes, and heart disease.

The scientists allocated each of the 775 participants randomly to one of two groups.

One group received molnupiravir and the other a placebo. The participants took the capsules twice a day for 5 days.

Of the 385 patients taking molnupiravir, 28 were admitted to a hospital, compared with 53 of those in the placebo

group. Eight of the placebo group participants died, while all those receiving the antiviral were alive at the end of the 29-day study period.

Recruitment into the study has now been halted because of these overwhelmingly positive results.

The manufacturer, Merck, is applying for emergency use authorization from the Food and Drug Administration (FDA).

The Singapore health ministry has signed a purchase agreement for molnupiravir,

and the European Medicines Agency is considering a rolling review of the drug.

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