207885 Physicians' Self-reported Treatment and Monitoring for Children and Adolescents with Major Depressive Disorder

Monday, November 9, 2009: 11:35 AM

Andrea Pfalzgraf, MPH, PhD , Department of Clinical, Social, and Administrative Sciences, Duquesne University, Pittsburgh, PA
Virginia Scott, MS PhD , Deparment of Pharmaceutical Systems and Policy, West Virginia Univeristy, Morgantown, WV
Gene Makela, PharmD, BCCP , West Virginia University, Morgantown, WV
Steven L. Hartsock, PhD, LCSW-C , Department of Social Work, Frostburg State University, Frostburg, MD
Jan Kavookjian, MBA, PhD , Harrison School of Pharmacy, Auburn University, Auburn, AL
Lesley-Ann Miller, MS, PhD , Department of Drug Use Policy and Pharmacoeconomics, University of Texas M.D. Anderson Cancer Center, Houston, TX
Maria Mori Brooks, PhD , Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA
S. Suresh Madhavan, PhD, MBA , Department of Pharmaceutical Systems and Policy, West Virginia University, Morgantown, WV
Major Depressive Disorder (MDD) is a serious U.S. public health problem and impacts 2% of children and 4-8% of the adolescents. In the absence of empirical research to guide treatment, the purpose of this study is to determine child psychiatrists': preferred treatment; course of treatment; and monitoring habits when treating these patients. Length of treatment and monitoring is compared to the American Academy of Child and Adolescent Psychiatry (AACAP) and FDA recommendations.

A survey was mailed to a national random sample of child psychiatrists (n=2,250). Descriptive statistics and t-tests were utilized to analyze the data.

Child psychiatrists report a preference for antidepressant and psychotherapy to treat children (52.2%) and adolescents (77.0%), although some treat children (40.1%) with counseling only, as a first-line treatment. The preference is to first attempt treatment with Prozac® or Zoloft®. Many child psychiatrists utilize Wellbutrin® or “other” class of medication as third-line treatment strategy.

Child psychiatrists indicated continuation of antidepressant treatment for children and adolescents significantly (p=0.00) longer than current AACAP recommendations.

During the first and second months of treatment, child psychiatrists monitor significantly (p=0.00) less than FDA recommendations. In contrast, monitoring does not differ from the recommendations for children (p=0.10) or adolescents (p=0.10) in the third month.

Child psychiatrists report a preference for combination treatment and the use of Prozac® or Zoloft®. Reported length of antidepressant treatment is adequate to prevent relapse. Monitoring behavior is not consistent with FDA's recommendations for months one and two, but is consistent for month three of treatment.

Learning Objectives:
1. Identify child psychiatrists' preferred treatment strategies for children and adolescents with major depressive disorder. 2. Compare child psychiatrists’ treatment strategies to the current U.S. FDA and American Academy of Child and Adolescent Psychiatry recommendations.

Keywords: Child and Adolescent Mental Health, Outcomes Research

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Recently completed PhD and currently employed as a faculty member at Duquesne Univerity. I am the principal investigator on the research project being submitted.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.