Featured in the Course

• American Academy of Child and Adolescent Psychiatry. (2019). Recommendations for Pediatricians, Family Practitioners, Psychiatrists, and Non-physician Mental Health Practitioners.
• American Academy of Child and Adolescent Psychiatry (2018). Suicide in Children and Teens. Facts for Families, No. 10, updated June 2018.
• American Academy of Pediatrics, Cheung, A. H., Zuckerbrot, R. A., Jensen, P. S. Laraque, D., & Stein, R. E. K. (2018). Guidelines for Adolescent Depression in Primary Care (GLAD-PC): Part II. Practice Preparation, Identification, Assessment, and Initial Management. Pediatrics, 141(3): e20174082.
• American Academy of Pediatrics, healthychildren.org. (2018). AAP Policy Statement: How Pediatricians Can Advocate for Children’s Health by Collaborating with Public Health Professionals. (News release).
• American Academy of Pediatrics. (2017). Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, 4th edition.
• American Academy of Pediatrics. (2016). Clinical Report: Suicide and Suicide Attempts in Adolescents. Pediatrics, 138(1): e20161420.
• American Academy of Pediatrics. (2016). Policy Statement: Firearm-Related Injuries Affecting the Pediatric Population. Pediatrics,130(5).
• American Academy of Pediatrics. (2008). Policy Statement: The Medical Home. Pediatrics, 110:184–186.
• American College of Obstetricians and Gynecologists, Committee on Obstetric Practice. (2018). ACOG Committee Opinion: Screening for Perinatal Depression.
• American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders–5th Edition (DSM-5). (Payment required).
• American Psychiatric Association. (2013). Disruptive Mood Dysregulation Disorders.
• Anxiety and Depression Association of America. (2021) Diverse Communities.
• Birmaher, B., & Brent, D. (2007). Practice parameter for the assessment and treatment of children and adolescents with depressive disorders. Journal of American Academy of Child & Adolescent Psychiatry, 46, 1503-1526.
• Centers for Disease Control and Prevention. (2021). Deaths: Leading Causes for 2018. National Vital Statistics Reports, 70(4).
• Chentsova-Dutton, Y., Ryder, A., & Tsai, J. L. (2015). Understanding depression across cultural contexts. In I. Gotlib & C. Hammen (Eds.). Handbook of Depression, 3rd edition (pp. 337-352). New York, NY: Guilford Press.
• Cheung, A. H., Zuckerbrot, R. A., Jensen, P. S., Laraque, D., Stein, R. E. K., & GLAD-PC Steering Group. (2018). Guidelines for Adolescent Depression in Primary Care (GLAD-PC): Part II. Treatment and Ongoing Management. Pediatrics, 141(3): e20174082.
• Constantino, J. N., Strom, S., Bunis, M., Nadler, C., Rodgers, T., LePage, J., . . . Wilson, A. (2020). Toward Actionable Practice Parameters for “Dual Diagnosis”: Principles of Assessment and Management for Co-Occurring Psychiatric and Intellectual/Developmental Disability. Current Psychiatry Reports, 22, Article 9.
• Cooper, W. O., Callahan, S. T., Shintani, A., Fuchs, D. C., Shelton, R. C., Dudley, J. A., … Ray, W. A., (2014). Antidepressants and Suicide Attempts in Children. Pediatrics, 133:204–210.
• Cuijpers, P., Stringaris, A., & Wolpert, M. (2020). Treatment outcomes for depression: challenges and opportunities. The Lancet Psychiatry, 7(11), p925-927.
• Cummings, C., Caporino, N., & Kendall, P. (2014). Comorbidity of Anxiety and Depression in Children and Adolescents: 20 Years After. Psychology Bulletin, 140(3): 816–845.
• Curry, J., Silva, S., Rohde, P., Ginsburg, G., Kratochvil, C., Simons, A., … March, J. (2010). Recovery and recurrence following treatment for adolescent major depression. Archives of General Psychiatry, 68(3): e1-e8.
• Del Vecchio, P. (2018). The Good News about Preventing Adolescent Depression. Prevention Science, 19(Supplement 1): 112.
• Emslie, G. J., Mayes, T., Porta, G., Vitiello, B., Clarke, G., Wagner, K. D., … Brent, D. (2010). Treatment of Resistant Depression in Adolescents (TORDIA): Week 24 Outcomes. American Journal of Psychiatry, 167(7): 782-791.
• Emslie, G. J., Kennard, B. D., Mayes, T. L., Nightingale-Teresi, J., Carmody, T., Hughes, C. W., … Rintelmann, J. W. (2008). Fluoxetine versus placebo in preventing relapse of major depression in children and adolescents. American Journal of Psychiatry, 165, 459-467.
• Hawes, M. T., Szenczy, A. K., Klein, D. N., Hajcak, G., & Nelson, B. D. (2021). Increases in depression and anxiety symptoms in adolescents and young adults during the COVID-19 pandemic. Psychological Medicine, 1-9.
• Hertz, M. F., Donato, I., & Wright, J. (2013). Bullying and Suicide: A Public Health Approach. Journal of Adolescent Health (Editorial), 53: S1eS3.
• Hoge, E., Bickham, D., & Cantor, J. (2017). Digital Media, Anxiety, and Depression in Children. Pediatrics, 140: Supplement 2.
• Hunt, M. G., Young, J., Marx, R., & Lipson, C. (2018). No More FOMO: Limiting Social Media Decreases Loneliness and Depression. Journal of Social and Clinical Psychology, 37(10):751-768. [Abstract].
• Kim, J., Chan, Y., McCauley, E. & Vander Stoep, A. (2016). Parent-Child Discrepancies in Reporting of Child Depression in Ethnic Groups. The Journal for Nurse Practitioners, 12(6): 374–380.
• Konac, D., Young, K. S., Lau, J., & Barker, E. D. (2021). Comorbidity Between Depression and Anxiety in Adolescents: Bridge Symptoms and Relevance of Risk and Protective Factors. Journal of Psychopathology and Behavioral Assessment, 43(3): 583–596.
• Leeb, R. T., Bitsko, R., Radhakrishnan, L., Martinez, P. Njai, R., & Holland, K. M. (2020). Mental Health–Related Emergency Department Visits Among Children Aged <18 Years During the COVID-19 Pandemic — United States, January 1–October 17, 2020. Morbidity and Mortality Weekly Report, 69(45). 
• Liu, C. H., Zhang, E., Wong, G. T. F., Hyun., S.,& Hahm, H. (2020). Factors associated with depression, anxiety, and PTSD symptomatology during the COVID-19 pandemic: Clinical implications for U.S. young adult mental health. Psychiatry Research, 290: 113172.
• Loades, M. E., Chatburn, E., Higson-Sweeney, N., Reynolds, S., Shafran, R., Brigden, A., . . . Crawley, E. (2020). Rapid Systematic Review: The Impact of Social Isolation and Loneliness on the Mental Health of Children and Adolescents in the Context of COVID-19. Journal of the American Academy of Child and Adolescent Psychiatry, 59(11), 1218–1239.e3.
• Lu, W., Muñoz-Laboy, M., & Sohler, N. (2021). Trends and Disparities in Treatment for Co-occurring Major Depression and Substance Use Disorders Among US Adolescents From 2011 to 2019. JAMA Network Open, 4(10): e2130280.
• Luby, J. L., Gaffrey, M. S., Tillman, R., April, L. M., & Belden, A. C. (2014). Trajectories of Preschool Disorders to Full DSM Depression at School Age and Early Adolescence: Continuity of Preschool Depression. American Journal of Psychiatry, 171:7, 768–776.
• Luxton, D. D., June, J. D., & Fairall, J. M. (2012). Social media and suicide: a public health perspective. American Journal of Public Health, 102(Supplement 2): S195-200.
• Mayne, S. L., Hannan, C.; Davis, M.; Young, J. F., Kelly, M. K., Powell, M., . . . Fiks, A. G. (2021) COVID-19 and Adolescent Depression and Suicide Risk Screening Outcomes. Pediatrics, 148 (3): e2021051507.
• Mayo Clinic. (2019). Self-injury/Cutting.
• MDWise. (2014). Clinical Care Guidelines for: Major Depression in Children and Adolescents.
• Mojtabai, R., & Olfson, M. (2020). National Trends in Mental Health Care for US Adolescents. JAMA Psychiatry, 77(7):703-714.
• Munir, K. (2016). The co-occurrence of mental disorders in children and adolescents with intellectual disability/intellectual developmental disorder. Current Opinion in Psychiatry, 29(2), p 95-102.
• National Alliance on Mental Illness. (2021). Mental Health in Texas.
• National Alliance on Mental Illness (NAMI). (2019). LBGTQ: How Do Mental Health Conditions Affect The LGBTQ Community?
• National Institute of Mental Health. (2018). Depression.
• National Institute on Drug Abuse. (2020). Why is there comorbidity between substance use disorders and mental illnesses?
• National Institute for Mental Health. (2021). Prevalence of Major Depressive Episode Among Adolescents.
• Richardson, L. P., McCauley, E., Grossman, D. C., McCarty, C. A., Richards, J., Russo, J. E., Rockhill, C., & Katon, W. (2010). Evaluation of the Patient Health Questionnaire-9 Item for detecting major depression among adolescents. Pediatrics, 126, 1117-1123.
• Smith, V. C., Wilson, C. R., & AAP Committee on Substance Use and Prevention. (2016). Families Affected by Parental Substance Use. Pediatrics, 138(2): e20161575.
• Stanley, B. & Brown, G. K. (2016). Safety Planning Intervention. Suicidesafetyplan.com.
• Stewart, S. L., Vasudeva, A. S., Van Dyke, J. N., & Poss, J. W. (2021). Child and youth mental health needs and service utilization during COVID-19. Traumatology. Advance online publication of the American Psychological Association.
• Sutton, M. (2000). Improving patient care: cultural competence. Family Practice Management, 7(9):58-60.
• Texas Department of Family and Protective Services. (2019). Report Abuse, Neglect, or Exploitation.
• Texas Department of State Health Services. (2014). The Mental Health Workforce Shortage in Texas.
• Texas Department of State Health Services. (2018). Texas Health Steps Periodicity Schedule for Infants, Children, and Adolescents.
• Texas Occupations Code: Title 3, Health Professions, Subtitle B, Physicians, Chapter 159, Physician-Patient Communication.
• U.S. Surgeon General’s Advisory (2021). Protecting Youth Mental Health.
• Zuckerbrot, R. A., Cheung, A., Jensen, P. S., Stein, R. E. K., Laraque, D., & GLAD-PC Steering Group. (2018). Guidelines for Adolescent Depression in Primary Care (GLAD-PC). Pediatrics, 141(3): e20174081.
• Zuckerbrot, R., & Cheung, A. (2018). Treating depression in youths: AAP endorses updated GLAD-PC guidelines. AAP News.

Medical Definitions

The medical definitions provided in this module were adapted or obtained from the American Psychiatric Association, the federal Centers for Medicare & Medicaid Services, the Diagnostic and Statistical Manual of Mental Disorders–5th Edition (DSM-5), Columbia University Medical Center, Mayo Clinic, Merriam-Webster, the National Institute of Mental Health, PsychCentral, the Suicide Prevention Resource Center, U.S. Department of Health and Human Services and WebMD.

Continuing Medical Education

The Texas Department of State Health Services, Continuing Education Service is accredited by the Texas Medical Association to provide continuing medical education for physicians. 

The Texas Department of State Health Services, Continuing Education Service designates this enduring material for a maximum of 1.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Continuing Nursing Education

The Texas Department of State Health Services, Continuing Education Service is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. The Texas Department of State Health Services, Continuing Education Service has awarded 1.25 contact hour(s) of Continuing Nursing Education.

Certified Health Education Specialists

Sponsored by The Texas Department of State Health Services, Continuing Education Service, a designated provider of continuing education contact hours (CECH) in health education by the National Commission for Health Education Credentialing, Inc. This program is designated for Certified Health Education Specialists (CHES®) and/or Master Certified Health Education Specialists (MCHES®) to receive up to 1.25 total Category I contact education contact hours. Maximum advanced-level continuing education contact hours available are 1.25.

Licensed Marriage and Family Therapists

The Texas Department of State Health Services, Continuing Education Service, the continuing education provider, ensures that the education provided is related to the practice of marriage and family therapy; and that the individuals presenting the information have the necessary experience and knowledge in the topics presented. The Texas Department of State Health Services, Continuing Education Service has awarded 1.25 hours of credit.

Licensed Professional Counselors

Up to 1.25 LPC hours may be earned at this event.

Licensed Psychologists

The Texas Department of State Health Services, Continuing Education Service is approved as a provider of professional development hours for licensed psychologists, per the Texas Administrative Code Rule §463.35 (f)(1). The Texas Department of State Health Services, Continuing Education Service has awarded  1.25 professional development hours.

Social Workers

The Texas Department of State Health Services, Continuing Education Service, the continuing education provider, ensures that the education provided is directly related to the practice of social work; and that the individuals presenting the information have the necessary experience and knowledge in the topics presented. The Texas Department of State Health Services, Continuing Education Service has awarded 1.25 hours of credit.

Certificate of Attendance

The Texas Department of State Health Services, Continuing Education Service has designated 1.25 hour(s) for attendance.

General Disclosure

One of the requirements of continuing education is disclosure of the following information to the learner:

1. Notice of requirements for successful completion of continuing education activity. To receive continuing education credit the learner must successfully complete the following activities:
   • Create a Texas Health Steps account.
   • Complete on-line registration process.
   • Thoroughly read the content of the module.
   • Complete the on-line examination.
   • Complete the evaluation.
2. Commercial Support.
   The THSTEPS Web-based Continuing Education Series has received no commercial support.
3. Disclosure of Relevant Financial Relationships.
   The THSTEPS Continuing Education Planning Committee and the authors of these modules have no relevant financial relationships to disclose.
4. Non-Endorsement Statement.
   Accredited status does not imply endorsement of any commercial products or services by the Department of State Health Services, Continuing Education Service; Texas Medical Association; or American Nurse Credentialing Center.
5. Off-Label Use.
   Using a disclosure review process, the THSTEPS Continuing Education Planning Committee has examined documents and has concluded that the authors of these modules have not included content that discusses off-label use (use of products for a purpose other than that for which they were approved by the Food and Drug Administration).

The following are policies and definitions of terms related to continuing education disclosure:

The intent of disclosure is to allow Department of State Health Services (DSHS) Continuing Education Service the opportunity to resolve any potential conflicts of interest to assure balance, independence, objectivity and scientific rigor in all of its Continuing Education activities.

All faculty, planners, speakers and authors of Department of State Health Services (DSHS) Continuing Education Service sponsored activities are expected to disclose to the Department of State Health Services (DSHS) Continuing Education Service any relevant financial, relationships with any commercial or personal interest that produces health care goods or services concerned with the content of an educational presentation. Faculty, planners, speakers and authors must also disclose where there are any other potentially biasing relationships of a professional or personal nature.

Glossary of Terms

Conflict of Interest: Circumstances create a conflict of interest when an individual has an opportunity to affect Continuing Education content about products or services of a commercial interest with which she/he has a financial relationship or where there are any other potentially biasing relationships of a professional or personal nature.

Commercial Interest: Any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients.

Financial Relationships: Those relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefit. Financial benefits are usually associated with roles such as employment, management position, independent contractor (including contracted research), consulting, teaching, membership on advisory committees or review panels, board membership, and other activities for which remuneration is received or expected. Relevant financial relationships would include those within the past 12 months of the person involved in the activity and a spouse or partner. Relevant financial relationships of your spouse or partner are those of which you are aware at the time of this disclosure.

Off Label: Using products for a purpose other that that for which it was approved by the Food and Drug Administration (FDA).

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