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Clinical Updates

 
Child and Adolescent Psychiatry

UCLA clinic provides interventions for teens with mild to severe depression

12/01/2005

Teen depression is strongly associated with poor school performance, trouble with friendships, and self-destructive behavior. These problems can be cyclical in nature, leading to greater depression and even further negative outcomes, including the possibility of suicidal behavior. Because teen depression usually responds well to treatment, patients should be evaluated as early as possible to avoid unnecessary suffering.

Teen depression can be difficult to diagnose. It is often not clear if the patient is suffering from clinical depression or if his or her emotional response to the turmoil of a transitional time of life is within the normal range. Symptoms of teen depression can include:

  • Frequent sadness, tearfulness, crying
  • Hopelessness
  • Decreased interest in activities, or inability to enjoy previously favored activities
  • Persistent boredom, low energy
  • Social isolation, poor communication
  • Low self-esteem and guilt
  • Extreme sensitivity to rejection or failure
  • Increased irritability, anger, hostility
  • Difficulty with relationships
  • Frequent complaints of physical illnesses such as headaches and stomachaches
  • Frequent absences from school or poor performance in school
  • Poor concentration
  • A major change in eating and/or sleeping pattern
  • Talk of or efforts to run away from home
  • Thoughts or expressions of suicide or self-destructive behavior

Often, teens do not present with symptoms of depression as clearly as do adult patients. Candidates for referral for psychiatric evaluation teens who are not doing well in school, in social situations, or who do not meet other common measures of standard function for children.

Services offered by the UCLA Teen Depression Clinic

The UCLA Teen Depression Clinic provides diagnostic evaluation, group therapy, family education and treatment, and other interventions for teens with mild to severe depression. Limited individual therapy is also available. Diagnostic evaluations focus on evaluating symptoms and establishing recommendations for appropriate treatment, whether or not the patient meets the criteria for a diagnosis of major depression. If needed, the evaluation may involve more than a single session. The clinic emphasizes evidence-based treatments for depression and self-injury, including cognitive behavioral therapy, dialectical behavior therapy and medication.

Cognitive behavioral therapy helps teens decrease symptoms by increasing positive emotions and improving social skills and family relationships. They are taught skills for coping with stress, controlling negative emotions and thinking positively. 

Dialectical behavior therapy is a type of psychotherapy targeted to patients who have difficulties regulating their emotional reactions. This can be particularly helpful for patients who are suicidal or injure themselves. This treatment approach helps patients regulate strong negative emotions that can lead to self-injurious behaviors and to replace maladaptive coping styles with other, more positive coping strategies.

Recent research supports the value of medication and combined medication and psychotherapy for the treatment of major depression. A psychiatrist who is part of the clinic can prescribe medication for appropriate patients not already being treated with medications by a physician outside the clinic.

The clinic is also involved in ongoing research projects on the treatment of depression and self-harm behavior. Youths who may be eligible for treatment through one of these studies will be given more information about the studies following the initial evaluation.

Published findings

Asarnow, J. R., L. Jaycox, et al. (2005). Effectiveness of a quality improvement intervention for adolescent depression in primary care clinics: a randomized controlled trial. Journal of the American Medical Association 293(3): 311-319.

Faculty contacts

Joan Asarnow, Ph.D.
Director, Youth Stress and Mood Program
(310) 794-4962
Michele Berk, Ph.D.
Associate Director, Youth Stress and Mood Program
(310) 794-4962
Robert Suddath, M.D.
Medical Director, Youth Stress and Mood Program
(310) 794-4962





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