Adolescent Depression Screening and Management in Primary Care

Depression in adolescence constitutes a major public health challenge, with onset often occurring during the transition from childhood. Primary care settings are uniquely positioned to identify and manage depressive symptoms early, given their accessibility and continuity of care. Formal screening programmes employ validated self-report tools to detect symptom clusters indicative of major depressive disorder, enabling timely intervention. Management strategies in primary care follow a stepped-care approach: initial active support and monitoring for mild cases, brief psychosocial interventions or psychotherapeutic referral for moderate presentations, and combined pharmacotherapy with specialist involvement for severe or treatment-resistant depression. Parental engagement and shared decision-making are critical to adherence and therapeutic alliance, while digital decision-support tools offer opportunities to streamline assessment and guide clinicians. Global initiatives emphasise integration of mental health into routine paediatric practice, training of non-specialist providers, and linkage with school or community-based services. Ongoing evaluation of screening frequency, tool performance and potential unintended consequences informs policy decisions and ensures that screening and management frameworks remain equitable, effective and safe across diverse populations.

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Adolescent Depression Screening and Management in Primary Care publication trend

The graph below shows the total number of articles in adolescent depression screening and management in primary care across all publications each year (not limited to Nature Index journals).

Technical terms

Patient Health Questionnaire-9 (PHQ-9): A nine-item self-report instrument widely used to assess depressive symptom severity and screen for major depressive disorder in adolescents and adults.

Universal screening: The process of systematically assessing all individuals within a defined population for a specific condition, regardless of risk factors or presenting symptoms.

False positive: A screening result indicating the presence of a condition (such as depression) when it is actually not present, potentially leading to unnecessary further assessment or intervention.

Stepped-care model: A framework that delivers interventions of increasing intensity based on symptom severity and treatment response, aiming to optimise resource use and patient outcomes.

References

1. Parental Preferences for Mental Health Screening of Youths From a Multinational Survey. JAMA Network Open (2023).
2. Potential mental health-related harms associated with the universal screening of anxiety and depressive symptoms in Australian secondary schools. Child and Adolescent Psychiatry and Mental Health (2024).
3. Screening for depression in children and adolescents in primary care or non-mental health settings: a systematic review update. Systematic Reviews (2024).