Reduction in adolescent depression after contact with mental health services: a longitudinal cohort study in the UK

A recent study published in the Lancet Psychiatry 2017 seeks to build on evidence regarding service contact and subsequent mental health issues in adolescents in a new longitudinal study looking at change in depressive symptoms. Previous findings in this area have been mixed, and the implications of all available evidence are considered by the authors of this new study to provide the context for their research.

Methods

As part of a longitudinal cohort study, 1238 adolescents of 14yrs and their primary caregivers from 18 secodnary schools in Cambridgeshire, UK were recruited. They were assessed for current mental disorder using the Schedule for Affective Disorders and Schizophrenia for School-age Children Present and Lifetime version (K-SADS-PL). Caregivers and adolescents reported contact with mental health services in the year before baseline. Adolescents self-reported depressive symptoms using the Mood and Feelings Questionnaire (MFQ) at each time point (follow up assessment was at 18 and 36 months).  The authors assessed change in MFG scores from baseline contact with mental health services using multilevel mixed-effects regressions adjusted for sociodemographic, environmental, individual, and mental health confounders, with multiple imputation of missing data. Propensity score weighting was used to balance confounders between tretament and control gourps. An MFQ clinical cutoff was implemented following the results of receiver operating characteristic analysis.

Findings and interpretation

The study found that contact with mental health services for adolescents aged 14yrs with a mental health disorder reduced the likelihood of depression by 17yrs, and therefore supports the improvement of access to adolescent mental health services.

The full published study can be found here