A study from the School of Public Health at the University of Minnesota in collaboration with researchers at Dartmouth College and Yale University concludes that 2003-2004 U.S. Food and Drug Administration (FDA) warnings that reduced antidepressant treatment among adolescents with depression problems had negative effects on grade point average, substance use, and delinquent behaviors.
The findings were published this month in the Journal of Human Resources.
Depression and other mental health problems will affect 15 percent of U.S. children by the time they reach 18. Depression in adolescents is associated with poor academic outcomes, along with higher rates of substance abuse and delinquent behaviors. These consequences of depression during adolescence may help explain why depression is associated with lower rates of employment and earnings among adults.
“Most evidence on depression treatment focuses on depression symptoms, but not the broader consequences of depression for academic performance and behavioral outcomes like substance use or delinquency,” said Dr. Ezra Golberstein, an author of the study and assistant professor of health policy and management in the University of Minnesota School of Public Health.
To understand the broader effects of treating adolescents with antidepressants, the authors analyzed the reported grades, substance use and delinquency of over 100,000 adolescents in national surveys conducted before and after FDA warnings regarding suicidality and antidepressant use in children led to sudden steep declines in antidepressant use.
Following the FDA warnings, treatments like psychotherapy remained relatively similar to previous levels, rather than offsetting declines in pharmaceutical treatment; in other words, after FDA warnings total treatment of depression fell. Many children and adolescents with depression problems now receive no treatment. This study suggests that efforts to improve access to mental health care for these youth may yield large social benefits that go well beyond the clinical outcomes captured in most assessments of treatment benefits.
“We found adolescents who sought treatment for depression after the FDA warnings had poorer grades, more use of tobacco and illicit drugs, and more delinquency after a clinic visit, compared to adolescents seeking treatment for depression prior to the warnings,” said Dr. Ellen Meara, an author of the study and associate professor of health policy and clinical practice at the Geisel School of Medicine at Dartmouth.