Synthèse critique des recommandations internationales de traitement de la dépression chez l’adolescent

Abstract

ObjectiveAdolescent depression treatment remains a challenge. Some follow-up studies have shown 25 to 50% of relapse among adolescent treated with both pharmacotherapy and psychotherapy. Guidelines aim at helping health professional by giving them knowledge in order to reduce the gap between practice and theory. Adolescent depression guidelines seem to be heterogeneous. This heterogeneity could be a problem in guidelines’ application in practice. In this context, we propose a critical synthesis of the main international guidelines for the treatment of adolescent depression. Materials and methodsWe present a critical review of international recommendations for the management of adolescent depression. We summarize consensual treatment options and comment on options that differ across guidelines. ResultsThis synthesis shows a consensus for the type of antidepressant drug and psychotherapy. Only fluoxetine is approved for use in adolescent with depression and both cognitive behavioral therapy and interpersonal therapy are recommended. International guidelines also present with some differences, especially about the management of moderate to severe depression. Indeed, some guidelines do not recommend antidepressor drug in first line treatment. ConclusionImplement the recommendations is difficult in current practice, especially when guidelines are heterogenous. Future data from more representative samples are needed to treat adolescent depression.