Decreasing psychotherapy, increasing antidepressant prescriptions in U.S. children and adolescents: A Disturbing Trend
> 12/3/2005 9:12:31 AM

by William E. Hapworth M.D.

The authors in an article published in The Journal of Adolescent Health titled Depression treatment during outpatient visits by children and adolescents by Jun Ma M.D., R.D., Ph.D,Ky-Van Lee Ph.D. and Randall S. Stafford M.D., Ph.D. found a disturbing 15% decrease in psychotherapy being used as a treatment for both children and adolescents in the United States from 1995-2002. Their specific findings follow:

“The number of visits by children and adolescents during which depression was reported more than doubled from 1995–1996 (1.44 million) to 2001–2002 (3.22 million). The proportion of these visits during which antidepressants were prescribed rose slightly from 47% in 1995–1996 to 52% in 2001–2002, whereas the proportion during which psychotherapy or mental health counseling was provided declined from 83% to 68%. Selective serotonin reuptake inhibitors (SSRI) represented 76% of all antidepressants prescribed in 1995–1996 and 81% in 2001–2002. In absolute terms, SSRIs were reported in 1.35 million visits in 2001–2002, reflecting a 2.6-fold increase from 1995–1996. Fluoxetine was prescribed in 207,914 visits in 1995–1996 and increased 100% to 415,580 visits in 2001–2002. The use of sertraline increased by 62% to 345,576 visits and paroxetine by 269% to 279,275 visits.”

The disturbing part of these findings is that medication alone is being relied on more frequently for treatment of child and adolescent depression than simply having a trained mental health professional talk to the patient and explore the sources of their depression. The lack of providing psychotherapy is often a function of a lack of resources and the fact that physicians other than psychiatrists are writing the prescriptions to these patients. This trend prevents a full understanding of the complexities that are involved in a child/adolescent’s depression and makes the emergence of suicide a more likely occurrence. If a patient is ill enough to be placed on antidepressants they are certainly ill enough to require psychotherapy.

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