Overdiagnosis in depression: there are doors better left closed

Andrés Fontalba

A young Cecilia, aged 13, in Sofia Coppola's brilliant film based on the homonymous novel, "The suicide virgins" advised:

-Obviously doctor, you were never a 13-year-old girl.

It’s obvious that depression in children and adolescents is an important cause of disability and generates great suffering for the person and his or her environment, requiring specific management adapted to the needs of that peculiar age. Based on the severity of this pathology, the availability of effective screening tools in the detection of depression, and a treatment that improves prognosis, the United States Preventive Task Force in 2009 recommended the screening for depression in all adolescents in a medical and integrated with mental health services setting, despite not having any previous trials that would justify this intervention.

Mental health: services integration is the key

A systematic review accompanied by a meta-analysis shows that the model Collaborative Chronic Care Models (CCMs), designed by Edward Wagner for chronic patients, offers a robust framework for service integration and may improve health outcomes in psychiatric patients, both mentally and physically.

Let's look in the following table at the components that the authors have used to identify projects that were based on CCMs model: