ARTICLESChild Psychiatrists’ Self-Reported Treatment and Monitoring of Children and Adolescents with Major Depressive DisorderPFALZGRAF, ANDREA R., PhD, MPH*; SCOTT, VIRGINIA, PhD, RPh, MS†; MAKELA, EUGENE, PharmD, BCPP‡; KAVOOKJIAN, JAN, PhD, MBA§; HARTSOCK, STEVEN L., PhD, LCSW-C∥; MILLER, LESLEY-ANN, PhD, MS¶Author Information *Duquesne University, Pittsburgh, PA †West Virginia University, Morgantown, WV ‡Charles George VA Medical Center, Asheville, NC §Auburn University, Auburn, AL ∥Frostburg State University, Frostburg, MD ¶Eli Lilly and Company, Indianapolis, IN. The authors declare no conflicts of interest. Please send correspondence to: Andrea R. Pfalzgraf, PhD, MPH, Mylan School of Pharmacy, Division of Clinical, Social, and Administrative Sciences, Duquesne University, 600 Forbes Avenue, Pittsburgh, PA 15282. firstname.lastname@example.org Journal of Psychiatric Practice®: July 2012 - Volume 18 - Issue 4 - p 253-261 doi: 10.1097/01.pra.0000416015.60838.a5 Buy SDC Metrics Abstract Objective. Major depressive disorder (MDD) is a serious U.S. public health problem for children and adolescents. This study examined the type and course of treatment and monitoring habits of child psychiatrists treating newly diagnosed children and adolescents with MDD. Length of treatment and monitoring frequency were compared to current recommendations. Methods. A national random sample of child psychiatrists (N = 2,250) was surveyed via a modified Dillman approach to mailed surveys. Descriptive statistics and t-tests were used to report and analyze the data. Results. Of 1,982 surveys that were delivered to child psychiatrists, 316 (15.9%) were returned, with 299 surveys (15.1%) providing usable data. The child psychiatrists who responded to the survey reported that they use a combination of antidepressant and psychotherapy treatment, although many (40.1%) treat children with psychotherapy alone as a first-line treatment. With regard to pharmacotherapy for MDD, the child psychiatrists self-reported using fluoxetine or sertraline. Many child psychiatrists also use bupropion or other drug classes as a third-line treatment strategy. The child psychiatrists reported that they treat children and adolescents with antidepressant medication for an average of 10 months. This is significantly (p < 0.05) longer than the 6 month minimum recommended by the American Academy of Child and Adolescent Psychiatry (AACAP). During the first and second months of treatment, the monitoring reported was significantly (p < 0.05) less than that recommended by the U.S. Food and Drug Administration (FDA), while the reported monitoring did not differ (p = 0.10) from FDA recommendations in the third month. Conclusions. Child psychiatrists reported using combination treatment when treating children and adolescents with MDD. When they reported using antidepressant medications, the most commonly prescribed agents were fluoxetine or sertraline. Reported length of antidepressant treatment was adequate for relapse prevention. The monitoring behavior reported by respondents was not consistent with the FDA’s recommendations for the first 2 months of treatment, but it was consistent for month 3. (Journal of Psychiatric Practice 2012;18:253–261) Copyright © 2012 Wolters Kluwer Health, Inc. All rights reserved.