SAN DIEGO – Between 1990 and 2001, the number of children and adolescents diagnosed with depression increased 2.4-fold, and the use of antidepressants increased from 44% to 59%, according to a nationwide study of physician office visits.
Specifically, use of selective serotonin reuptake inhibitors increased from 21% to 40% over the same time period, while use of tricyclic antidepressants fell from 21% to 3%, Linda M. Robison reported during a poster session at the annual meeting of the American Academy of Child and Adolescent Psychiatry.
“Physicians are doing a good job as far as not prescribing the tricyclics anymore,” Ms. Robison of the Washington State University College of Pharmacy in Pullman, Wash., said in an interview. “That's what you would hope to see. Children are also being diagnosed [with depression] more than they have [been] in the past, which is probably appropriate.”
In a study led by her associate, David A. Sclar, B.Pharm, the researchers used data from the U.S. National Ambulatory Medical Care Survey to determine the population-adjusted rates of office-based physician visits that resulted in a diagnosis of depression in patients aged 5–18 years between 1990 and 2001. The diagnosis was based on International Statistical Classification of Diseases, 9th Revision.
The researchers also documented the type of antidepressant prescribed and broke the analysis into three time frames: 1990–1993; 1994–1997, and 1998–2001.
Ms. Robison and her associates found that over the 12-year time period, the population-adjusted rate of physician office visits documenting a diagnosis of depression increased 2.4-fold, from 12.9 per 1,000 patients to 31.1 per 1,000 patients.
At the same time, the number of patients who were prescribed an antidepressant increased from 44% in 1990–1993 to 59% in 1998–2001. The use of SSRIs increased from 21% in 1990–1993 to 40% in 1998–2001, while the use of tricyclic antidepressants fell from 21% to 3%.
Most office visits were made by 13− to 18-year-olds who were seen by a psychiatrist.
The study was supported by the National Alliance for Research on Schizophrenia and Depression.