Abstract

Clinical Depression plays a key role in the suicide of young people. In 1996, the Australian National Health & Medical Research Council published guidelines for the management of Depression in young people aged 15–24 years. These have been disseminated widely to professionals in Australia; as well, comic style booklets are available for young people. The guidelines were based on a commissioned review of published work from 1985 to 1994. Consensus suggested the case for medication use in young people was at best unproven; available evidence for the use of tricyclics suggested they were little better than placebo and few studies dedicated to the use of Selective Serotonin Reuptake Inhibitors and other drugs had been completed on young people. Overall the greatest evidence seemed to point to the use of Cognitive Behavioural Therapy as the treatment of choice, though this in part related to the quantity of careful research completed on CBT. This paper briefly reviews the international literature from 1994 to date regarding treatment of depression in young people, including studies completed on adults which include young people. It seeks to discover whether the conclusions on ‘good’ or ‘best’ practice are any more clear since the 1994 reviews and, in particular how they apply to atypical presentations — for instance those often seen in young men. These conclusions are then set against a discussion of the clinical project Mood Disorders Unit funded under the Australian National Suicide Prevention Strategy.

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