Collaborative care intervention may be the best strategy for improving depression among teens in the United States, according to a recent study.

Researchers found that a collaborative care intervention that included patient and parent engagement and education resulted in greater improvement in depressive symptoms at 12 months than usual care.

Depressed youth are at greater risk of suicide, substance abuse, early pregnancy, low educational attainment, recurrent depression and poor long-term health. Fourteen percent of adolescents between the ages of 13-18 years have major depression yet few receive evidence-based treatments for their depression.

Researchers said the failure to accurately diagnose and treat adolescents and an inadequate supply of child mental health specialists have led to increasing focus on improving the quality of depression treatment in pediatric primary care, according to background information in the article.

For the study, the research team randomly assigned 101 adolescents at Group Health Cooperative who had screened positive for depression to a 12-month collaborative care intervention or usual care.

The intervention included an education and engagement session, during which perspectives on symptoms were elicited, depression education was provided, and active treatment participation of adolescents and parents was encouraged. During the session, a depression care manager helped the youth and parent choose and initiate treatment with antidepressant medication, brief cognitive behavioral therapy, or both. The intervention youth then received ongoing follow-up with care provided in the primary care clinic. In the usual care group, youth received depression screening results and could access mental health services through Group Health.

Intervention youth, compared with those who received usual care, had greater decreases in depressive symptoms by 12 months. Sixty-eight percent of intervention youth had a 50 percent or greater reduction in depressive symptoms compared to 39 percent among control youth. The overall rate of depression remission at 12 months was 50.4 percent for intervention youth and 20.7 percent for control youth.

Researchers said the results suggest that mental health services for adolescents with depression can be effectively integrated into primary care.

The findings were recently published in JAMA.