Collaborative Care Intervention Helps Teens with Depression

By Amy Orciari Herman

Edited by David G. Fairchild, MD, MPH, and Lorenzo Di Francesco, MD, FACP, FHM

A collaborative care intervention involving depression care managers can lead to significant improvements in depression symptoms among teens, a JAMA study finds.

Some 100 teens from Washington State primary care practices who screened positive for depression were randomized to receive collaborative care or usual care for 12 months. Collaborative care included an education and engagement session, during which depression care managers helped teens and their parents choose among treatment with medication, cognitive behavioral therapy, or both. Care managers also followed up regularly with teens and their parents to check progress and make any treatment adjustments. With usual care, teens and their parents received letters with the depression screening results and encouragement to begin treatment.

At 12 months, depression scores had improved significantly more with collaborative care than with usual care. In addition, more collaborative-care than usual-care patients had achieved a "clinically important depression response" (68% vs. 39%) or remission (50% vs. 21%).

The collaborative care intervention cost roughly $1400 per patient.