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Adolescent Depression Time Tool for Clinicians Launch Page
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A Resource from the American College of Preventive Medicine


Adolescents aged 10-19 years make up approximately 14% of the US population.[1]  Two million adolescents suffer from an episode of depression annually, with estimates indicating 1 in 5 adolescents experience depression before they reach adulthood.  Depression during adolescence often leads to poorer academic achievement, greater absenteeism, strained relationships with family and friends, and risk-taking behaviors like substance abuse or increased number of sexual partners.  In addition to functional impairment at home and school, depression increases the risk for suicide, the third leading cause of death in this age group.

Adolescent depression is defined by the Diagnostic and Statistical Manual of Mental Disorders 4th edition-Text Revision™ (DSM-IV-TR™).  DSM-IV-TR™ outlines 9 depression symptoms with four specific criteria excluding other potential causes of depression.  Depression is very likely when five or more of the symptoms occur during the same two-week period, represent a change from previous functioning, and at least one of the symptoms is depressed mood or loss of interest or pleasure.  Severity of depression is indicated by the number of symptoms present, severity of each symptom, and degree of functional impairment. To address depression, early recognition of risk factors for depression and depression symptoms will aide in instituting effective treatment.  Effective treatment involves education and active participation of both patient and parents/caregivers when deciding upon a treatment option.  Treatment options are determined by the severity of depression, can include psychotherapy or medications alone, or a combination of both.  The primary goals of treatment are education, prevention of future episodes, and removing the risk of suicide ideation, suicide attempts, or completed suicide.

The Adolescent Depression Time Tool developed by the American College of Preventive Medicine is an innovative educational tool designed to assist the provider in recognizing and diagnosing adolescent depression.  It will increase awareness, provide education, and offer the guidance from the best current evidence and guidelines in the delivery of adolescent health services on depression.  The tool includes an executive summary of the evidence and a practical approach to delivering the needed services to patients in the context of a clinical visit.  It is complemented by a robust clinical reference document delineating the epidemiology, clinical evidence, guidelines and recommendations from professional societies and governmental agencies, and additional resources for recommended tools.

[1] United States Census Bureau. Population Estimates: National Characteristics: Annual Estimates of the White Alone or in Combination Resident Population by Sex and Age for the United States: April 1, 2000 to July 1, 2008 (NC-EST2008-04-WAC). Available: http://www.census.gov/popest/national/asrh/NC-EST2008-asrh.html. Accessed: May 12, 2011.

This educational activity is intended for primary care providers. It is intended to improve physician performance, competence and patient outcomes.

After completing this program, participants should be able to:
  1. Describe the prevalence of adolescent major depressive disorder and its significance for adolescent suicide.
  2. Describe behavioral changes suggestive of functional impairment from depression and symptoms of depression, list risk factors for adolescent depression, and diagnose adolescent major depressive disorder.
  3. Apply in practice two screening tools recommended by the USPSTF for screening of adolescents for major depressive disorder.
  4. Describe options for treatment based on severity of depression.  Identify that among selective serotonin reuptake inhibitors (SSRI’s), fluoxetine and escitalopram are the only SSRI’s approved for treating adolescents with depression.
  5. Apply major Guidelines for Adolescent Depression – Primary Care (GLAD-PC) guidelines for management of Adolescent depression (i.e., identification, assessment/diagnosis, referral to mental health specialist, etc.).
  6. Learn how to access the tools and resources needed to assess, identify, prevent and manage depression in adolescents.

This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME). The American College of Preventive Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The American College of Preventive Medicine designates this Enduring Material for a maximum of 1.0 AMA PRA Category 1 Credit(s) ™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The estimated time to complete this activity is 1.0 hour. 

To earn CME credit for this educational activity:

  1. Read the CME information on this page.
  2. Read the Time Tool and Clinical Reference.
  3. Complete the CME post-test exam with a score of at least 70%.
  4. Complete the CME evaluation survey.
  5. Your CME certificate will be sent to you via e-mail.


August 2011 through August 2013. Original release date: August 2011.


These materials have been reviewed by the members of the American College of Preventive Medicine and partners to ensure the continued scientific accuracy and medical relevance of information presented and its independence from commercial bias.
  • Kenneth J. Hoffman, MD, MPH
    Clinical Director, Mental health Services
    US Department of State
    Washington, DC
  • Jacqueline Sedgwick, MD, MPH
    Department of Family and Community Medicine
    University of California
    San Francisco, CA


In the interest of providing an educational experience free of commercial bias, and as the accredited provider of CME for this activity, the American College of Preventive Medicine was responsible for decisions regarding educational content and allocation of funds.  All individuals involved in the planning, development, and delivery of educational activities are required to sign a conflict of interest statement in which they disclose any financial interests or other affiliations with industry or other associations which may have direct and substantial interest in the subject matter of the CME activity. Such disclosure allows program participants to better evaluate the objectivity of the information presented in the program.

  • Kenneth J. Hoffman, MD, MPH has disclosed no financial relationships.
  • Jacqueline Sedgwick, MD, MPH has disclosed no financial relationships.
  • Larry Matson, Medical Writer has disclosed no financial relationships.




This program is supported by a cooperative agreement from the Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau (Title V, Social Security Act), Office of Adolescent Health.

These pages may be viewed using standard Internet browser applications (e.g., Internet Explorer). They may also be downloaded as PDFs and read using standard PDF reader applications (e.g., Adobe Acrobat Reader).


The American College of Preventive Medicine collects personal information from participants in this online activity for purposes of assigning CME credit only.  We will not share or sell your contact information, and your answers to quizzes and feedback forms will be kept confidential.


This material is copyright of the American College of Preventive Medicine.


If you have questions regarding this CME activity, please contact cme@acpm.org.




   Copyright 2011. American College of Preventive Medicine. All Rights Reserved.

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