Implementation of a therapeutic identification program of depression in young people in health area of Santiago de Compostela

Downloads

Published

2018-09-30

How to Cite

Varela Reboiras, L., Mazaira Castro, J. A., Brenlla González, J. B., & Atienza Merino, G. (2018). Implementation of a therapeutic identification program of depression in young people in health area of Santiago de Compostela. Revista De Psiquiatría Infanto-Juvenil, 35(3), 229–240. https://doi.org/10.31766/revpsij.v35n3a1

Issue

Vol. 35 No. 3 (2018): July-September

Section

Special Article
Crossref
Scopus
Google Scholar
Europe PMC

Authors

  • L. Varela Reboiras Complejo Hospitalario Universitario de Santiago de Compostela
  • J. A. Mazaira Castro Complejo Hospitalario Universitario de Santiago de Compostela
  • J. B. Brenlla González Complejo Hospitalario Universitario de Santiago de Compostela
  • G. Atienza Merino Complejo Hospitalario Universitario de Santiago de Compostela

DOI:

https://doi.org/10.31766/revpsij.v35n3a1

Keywords:

Depression, teenagers, TIDY, Primary Care professionals

Abstract

Objective: Implement and evaluate a therapeutic identification program for depression in adolescents developed in the United Kingdom (TIDY), among adolescents aged 13-16 who attend Primary Care (PC) centers in the Santiago de Compostela area. 

Material and methods: PC professionals (PCP) were recruited who voluntarily wanted to participate in the study, quasi-experimental, of before-after design. The changes in their knowledge and attitudes towards adolescent depression and the screening and identification rates of it in the 80 working days before and after a period of training were statistically compared. Specific details of the PC consultation were also studied.

Results: In spite of the low rate participation (23,19%), an improvement in knowledge and attitudes towards adolescent depression was observed, being only significant in one of the characteristics included in the diagnosis of depression (p <0.05). After the training, it went from not doing screening to applying it systematically. The identification fees fell from 3.39% to 0.86%. This identification was associated with being monitored for depression in the Child-Mental Health Unit (p =, 01), having a history of mental health problems (p = 0.03) and having a regular or bad subjective health status. (p = 0.04).

Conclusions: The TIDY program is a feasible approach to improve the identification of adolescent depression in PC. An additional evaluation is required in a randomized trial to assess the professional’s accuracy, clinical impact and cost benefit.

Downloads

Download data is not yet available.

Author Biography

L. Varela Reboiras, Complejo Hospitalario Universitario de Santiago de Compostela

Complejo Hospitalario Universitario de Santiago de Compostela. Población: Santiago de Compostela

Correspondencia:
Lucía Varela Reboiras. Servicio de Psiquiatría.
Complejo Hospitalario Universitario de Santiago de Compostela.
Travesía da Choupana s/n. 15706.
Santiago de Compostela.
Correo electrónico: lu-manselle@hotmail.com

References

Merry S, McDowell H, Hetrick S, Bir J, Muller N. Psychological and/or educational interventions for the prevention of depression in children and adolescents. Cochrane Database Syst Rev. 2004 (1):Cd003380. DOI: https://doi.org/10.1002/14651858.CD003380.pub2

Weissman MM, Wolk S, Goldstein RB, Moreau D, Adams P, Greenwald S, et al. Depressed adolescents grown up. JAMA. 1999;281(12):1707-13. DOI: https://doi.org/10.1001/jama.281.18.1707

Kandel DB, Davies M. Adult sequelae of adolescent depressive symptoms. Arch Gen Psychiatry. 1986;43(3):255-62. DOI: https://doi.org/10.1001/archpsyc.1986.01800030073007

Harrington R. Adult outcomes of childhood and adolescent depression. I. Psiquiatric status. Arch Gen Psychiatry. 1990;47(5):465-73. DOI: https://doi.org/10.1001/archpsyc.1990.01810170065010

Rey J, Bella-AwusahTolulope T, Liu J. IACAPAP Textbook of Child and Adolescent Mental Health. 2015. En: Joseph M. Rey. Mood disorders E1 Depression in children and adolescents [Internet]. Geneva: International Association for Child and Adolescent Psychiatry and Allied Professions 2015. [citado 12 ene 2017] [pp 1-36]. Disponible en: http://iacapap.org/wp-content/uploads/E.1-Depression-2015-update.pdf.

Birmaher B. Improving remission and preventing relapse in youths with major depression. Am J Psychiatry. 2014;171(10):1031-3. DOI: https://doi.org/10.1176/appi.ajp.2014.14060705

Marcelli D. Adolescencia y depresion: un abordaje multifocal. Barcelona: Masson; 1992.

Alonso-Fernandez F. La depresion y su diagnostico. Nuevo modelo clínico. Barcelona: Labor; 1988.

Kann L, Kinchen SA, Williams BI, Ross JG, Lowry R, Grunbaum JA, et al. Youth Risk Behavior Surveillance—United States, 1999. State and local YRBSS Coordinators. J Sch Health. 2000;70:271-85. DOI: https://doi.org/10.1111/j.1746-1561.2000.tb07252.x

Brent DA. Assessment and treatment of the youthful suicidal patient. Ann N Y Acad Sci. 2001;932:106-28. DOI: https://doi.org/10.1111/j.1749-6632.2001.tb05801.x

Estadística de defunciones según la causa de muerte [Base de datos en internet]. Madrid: INE; [citado 09 jun 2017]. Disponible en: http://www.ine.es/dyngs/INEbase/es/operacion.htm?c=Estadistica_C&cid=1254736176780&menu=resultados&idp=1254735573175.

Jacobson LD, Wilkinson C, Owen PA. Is the potential of teenage consultations being missed?: A study of consultation times in primary care. Fam Pract 1994; 11:296-299. DOI: https://doi.org/10.1093/fampra/11.3.296

Kramer T, Garralda ME. Psychiatric disorders in adolescents in primary care. Br J Psychiatry 1998; 173:508-513. DOI: https://doi.org/10.1192/bjp.173.6.508

Illiffe S, Williams G, Fernandez V, Vila M, Kramer T, Gledhill J, et al. General practitioners’ understanding of depression in young people: qualitative study. Prim Health Care Res Dev 2008; 9(4):269-279. DOI: https://doi.org/10.1017/S1463423608000868

Illiffe S, Gledhill J, da Cunha F, Kramer T, Garralda, ME. The recognition of adolescent depression in general practice: issues in the acquisition of new skills. Primary Care Psychiatry 2004; 9:51-56. DOI: https://doi.org/10.1185/135525704125004655

MacFarlane A, McPherson A. Primary health care and adolescence. BMJ 1995;311:825-826. DOI: https://doi.org/10.1136/bmj.311.7009.825

Martinez R. Factors that influence the detection of psychological problems in adolescents attending general practices. Br J Gen Pract 2006; 56:594-599.

Olson AL, Kelleher KJ, Kemper KJ, Zuckerman BS, Hammond CS, Dietrich AJ. Primary care paediatricians’ role and perceived responsibilities in the identification and management of depression in children and adolescents. Ambulatory Paediatrics 2001; 1: 91-98. DOI: https://doi.org/10.1367/1539-4409(2001)001<0091:PCPRAP>2.0.CO;2

Kramer T, Iliffe S, Gledhill J, Garralda ME. Recognising and responding to adolescent depression in general practice: Developing and implementing the Therapeutic Identification of Depression in Young people (TIDY) programme. Clin Child Psychol Psychiatry 2012;17(4) 482–494. DOI: https://doi.org/10.1177/1359104512442639

Westman A, Garralda ME. Mental health promotion for young adolescents in primary care: a feasibility study. Br J Gen Pract 1996; 46:317.

Iliffe S, Gallant C, Kramer T, Gledhill J, Bye A, Fernandez V, Vila M, Miller L, Garralda ME. Therapeutic identification of depression in young people: lessons from the introduction of a new technique in general practice. Br J Gen Pract 2012; 174-82. DOI: https://doi.org/10.3399/bjgp12X630061

Gledhill J, Kramer T, Illiffe S, Garralda ME. Training general practitioners in the identification and management of adolescent depression within the consultation: a feasibility study. J Adolesc 2003; 26:245-250. DOI: https://doi.org/10.1016/S0140-1971(02)00128-8

Kramer T, Iliffe S, Bye A, Miller L, Gledhill J, Garralda ME. Testing the Feasibility of Therapeutic Identification of Depression in Young People in British General Practice. J Adolesc Health 2013; 52: 539-45. DOI: https://doi.org/10.1016/j.jadohealth.2012.12.017

World Health Organization. The ICD-10 classification of mental and behavioral disorders: Clinical descriptions and diagnostic guidelines. Geneva: World Health Organization; 1992.

American Psychiatric Association. Diagnostic and statistical manual of mental disorders. text rev. 4th ed. Washington, DC: APA; 2000.

National Institute for Health and Care Excellence. Depression in children and Young people: Identification and management in primary, community and secondary care. London: National Institute for Health and Care Excellence; 2015. [citado 12 ene 2017]. Disponible en: https://www.nice.org.uk/guidance/cg28#.

Consultar en: http://www.agapap.org/druagapap/programa_neno_sano

Grupo de trabajo de la actualización de la Guía de Práctica Clínica sobre la Depresión Mayor en la Infancia y la Adolescencia. Guía de Práctica Clínica sobre la Depresión Mayor en la Infancia y la Adolescencia. Actualización. Ministerio de Sanidad, Servicios Sociales e Igualdad. Unidad de Asesoramiento Científico-técnico (Avalia-t); 2018. Guías de Práctica Clínica en el SNS.

Consultar: http://www.sergas.es/Docs/Conselleria/Estrategia_Sergas_2014.pdf

Triñanes Pego Y, Rial Boubeta A, Varela Reboiras L, Mazaira Castro JA, Atienza Merino G. Viabilidad y aplicabilidad del Programa TIDY (Therapeutic Identification of Depression in Young People) en el Sistema Nacional de Salud. Red Española de Agencias de Evaluación de Tecnologías Sanitarias y Prestaciones del SNS. Agencia Gallega para la Gestión del Conocimiento en Salud (ACIS), Unidad de Asesoramiento Científico-técnico, avalia-t; 2018.