Roundup: Teens and Depression; Smoking and Pregnancy; DASH Diet Benefits

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March 2, 2018

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All Teens Should Be Screened for Depression, Pediatricians Urge in New Guidelines

Adolescents who are suffering from depression point out various health complaints to their pediatrician, but that often fails to result in a diagnosis of depression, according to the American Academy of Pediatrics (AAP). This means that major depressive disorder (MDD) is not always picked up in primary care.

For these reasons, the AAP has issued an update to its guidelines this week calling for universal screening for depression in adolescents at a time when a shortage of mental health specialists is delaying treatment for troubled youngsters, researcher said.

It has been over 10 years since the initial guidelines were published, “yet many primary care pediatricians still are not practicing evidence-based management of adolescent depression,” the group says.

The recommendations for the Guidelines for Adolescent Depression in Primary Care (or GLAD-PC), are the first to help primary care clinicians fill that void and better manage depression in youth. They will be published in the March edition of the journal Pediatrics. A major update includes a “universal adolescent depression screening” for those ages 12 and older.

“Even when a diagnosis is made, many (pediatricians) feel at a loss, given the barriers to accessing the mental health system and lack of training on treatment of MDD,” stated researchers Rachel A. Zuckerbrot, M.D., and Amy H. Cheung, M.D., in a statement issued this week. They said that one pediatrician told them: “I sought training in mental health because I got sick of hearing the families’ stories and feeling the only thing I could do was provide tissues.”

Among the AAP’s updated guidelines are these key points for pediatricians:

  • Prepare your practice by attending mental health trainings
  • Learn what statewide and/or local psychiatric consultation for primary care programs are available.
  • Implement universal depression screening at annual health maintenance visits with a formal self-report tool for those 12 years and older.
  • Implement targeted screening with a formal self-report tool of all adolescents with depression risk factors.
  • Interview adolescents alone.
  • Involve families in the depression assessment.

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About 7% of Women Still Smoke While Pregnant, CDC Says

Smoking tobacco products during during pregnancy has been linked to a several serious health issues including low birth-weight, preterm birth, and various birth defects.

Nonetheless, about 7 percent of pregnant women in the U.S. in 2016 smoked cigarettes, according to a new report released this week by the U.S. Centers for Disease Control and Prevention (CDC).

The percentage of pregnant smokers varied significantly from state to state. The smoking prevalence during pregnancy was highest in West Virginia, at 25 percent, and lowest in California, where 2 percent expectant moms reported smoking. The smoking rate in Florida was 5 percent.

Smoking during pregnancy was most common among women aged 20–24 (11 percent), followed by women aged 15–19 (9 percent) and 25–29 (8 percent). Smoking while pregnant was more common among lesser-educated women, the CDC found. Prevalence of smoking during pregnancy was highest for women with a high school diploma or GED (12 percent), followed by women with less than a high school diploma (11 percent) and women with some college or an associate’s degree (8 percent).

Concluded the CDC: “Identifying maternal characteristics linked with smoking during pregnancy can help inform the development of strategies to reduce the prevalence of maternal smoking and increase smoking cessation during pregnancy in the United States.”

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DASH Diet Can Help With Depression, in Addition to Reducing Blood Pressure

A new study says the diet known as DASH (Dietary Approaches to Stop Hypertension) does more than help lower blood pressure and the bad cholesterol. It also helps alleviate depression, researchers found.

Launched by the National Heart, Lung, and Blood Institute as a diet to help reduce blood pressure, DASH focuses on foods most everyone knows are healthy, such as fruits, vegetables, whole grains, lean protein and low-fat dairy. DASH also restricts calorie- and fat-laden sweets and red meat.

“Depression is common in older adults and more frequent in people with memory problems, vascular risk factors such as high blood pressure or high cholesterol, or people who have had a stroke,” said study author Laurel Cherian, M.D., of Rush University Medical Center in Chicago and a member of the American Academy of Neurology, in a press release. “Making a lifestyle change such as changing your diet is often preferred over taking medications, so we wanted to see if diet could be an effective way to reduce the risk of depression.”

For the new study, 964 participants with an average age of 81 were evaluated yearly for an average of six-and-a-half years. They were monitored for symptoms of depression, such as “being bothered by things that usually didn’t affect them and feeling hopeless about the future,” researcher said. They also filled out questionnaires about how often they ate various foods, and the researchers looked at how closely the participants’ diets followed diets such as the DASH diet, Mediterranean diet and the traditional Western diet.

People in the groups that followed the DASH diet most closely were less likely to develop depression than those who did not follow the diet closely, the study’s authors concluded. The study is to be formally presented at the American Academy of Neurology’s 70th Annual Meeting in April.

In previous studies, the DASH diet has reduced systolic blood pressure (the top number in a BP reading) by 6 mm Hg, and diastolic blood pressure (the bottom number) by 3 mm Hg in patients with elevated blood pressure. Those with hypertension, or high blood pressure, the numbers dropped by 11 and 6 mm Hg, respectively. These changes in blood pressure occurred with no changes in body weight.

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