Teen angst may indicate depression risk to PCPs

Common expressions of teen angst may indicate the need for further evaluation for depression among adolescents, according to findings presented at the Pediatric Academic Societies Meeting.

“Much of what a teen is feeling and experiencing is easy to attribute to the ups and downs of teen angst,” Daniela DeFrino, PhD, RN, of the University of Illinois at Chicago, said in a press release. “But, sometimes, there is so much more under the surface that can lead to depression.”

To determine expressions of predepressive symptoms and coping strategies among adolescents, researchers conducted the Promoting Adolescent Health Study (PATH) among 446 adolescents. Study participants completed the Kiddie-Schedule for Affective Disorders and Schizophrenia for School-Age Children interviews. Analysis included 24 interviews.

Participants used terms such as “stressed” or “sad” to describe feelings that came and went, often in “bursts.” They rarely stated they were “depressed.”

Most participants reported increased anger and irritability toward others.

New feelings of apathy toward prior interests were mentioned, according to researchers.

Participants commonly reported significant difficulty falling and staying asleep.

School pressure related to homework and expectations to succeed were consistently reported as sources of stress and difficulty.

Family discord was a significant stressor contributing to worsening mood, including arguments with a parent or in the household, divorce, separation, neglect, sexual abuse, and moving.

Many participants visited their primary care providers for physical illnesses such as ulcers, migraines, stomach pains, difficulty sleeping, and fatigue.

Spending time and talking with friends were helpful coping mechanisms.

“Teens may be experiencing a lot of internal turmoil and difficult life stresses that we can easily overlook if we don’t probe with sensitive questioning and understanding,” DeFrino said in the release. “Reframing these feelings as outward symptoms of predepression by the primary care provider would allow for connection to and discussion about the importance of mental health with the teen and parent.” – by Amanda Oldt

Reference:

DeFrino D, et al. Understanding teen expression of sadness in primary care: A qualitative exploration. Presented at: The Pediatric Academic Societies Meeting; May 6-9, 2017; San Francisco.

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