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Depression can create a huge cost burden on patients and institutions, and for teenagers that includes issues like missed school and the costs of healthcare for families. A new study in  JAMA Pediatrics , led by Seattle Children's Research Institute and Group Health Cooperative, identifies a cost-effective treatment that yields promising results for depressed teens. "We used a collaborative care approach to treat teen depression, which included having a depression care manager who worked with the patient, family and doctors to develop a plan and support the teen in implementing that plan," said Dr. Laura Richardson, an adolescent medicine physician and researcher at Seattle Children's. "We were pleased to find that this collaborative approach was significantly more effective in treating depression than standard care with only a small increase in costs." Collaborative care led to better results Richardson and her co-investigators worked with nine Grou...

Up to a third of patients who receive drug treat for depression do not respond to treatment. Knowing which groups don't respond could help clinicians understand which treatments are appropriate to which person. In the case of workers, it may also enable employers to take steps to ease stressful conditions. Although there is a wealth of research showing that low social and economic status is associated with a greater risk of depression, there has been little work focusing on how occupational levels respond to treatment. A group of international researchers from Belgium, Italy, Israel and Austria enlisted 654 working adults attending clinics for depression, and classified their work according to occupational level. 336 (51.4%) held high occupational level jobs, 161 (24.6%) middle-level, and 157 (24%) low level. Around two-thirds of the patients were female (65.6%), which reflects the normal gender difference in reported depression. Most patients were treated with SRIs (Serotonin ...

The paper, an extensive review of current research, offers a much deeper understanding of why nicotine withdrawal symptoms for people with depression make it much more difficult to quit smoking. The paper was published in the international journal Addiction . "We've used this new theory of withdrawal in depressed smokers to develop the first targeted approach for smoking cessation in this underserved population," said senior author Brian Hitsman, associate professor of preventive medicine and of psychiatry and behavioral sciences at Northwestern University Feinberg School of Medicine. Depressed smokers experience adverse withdrawal states that contribute to resumption of smoking, including low mood, difficulty engaging in rewarding activities and impaired thinking/memory, the paper reports. These symptoms are more severe for people with depression than for those without depression. In addition, depressed smokers tend to have fewer ways to cope with the symptoms and ...

Part of the reason lies in concern that due to stigma, others may doubt their ability to keep up with a demanding profession. But there's another factor: Many states require physicians to report any mental diagnosis -- no matter how mild or treatable, or how far in the past -- to their state medical licensing board. This leads physicians to fear that seeking help for depression or anxiety could lead to restrictions on their medical license. In a survey answered by more than 2,100 female physicians who are also mothers, nearly half believed they had met the definition for a mental illness at least some time during their career, but had not sought treatment. Two-thirds reported that fear of stigma drove them to keep their worries quiet. One in three of the women who answered the survey said they'd been given a formal mental health diagnosis since medical school. Many thought they could manage their situation on their own, including writing their own prescriptions or payin...