Paeds Cases · mental-behavioural-and-psychosomatic
Explain adolescent depression and the fluoxetine decision to parents — OSCE
OSCE communication and shared-planning station: explaining a criteria-based diagnosis of adolescent depression, suicide-risk assessment and safety planning, the role of CBT and fluoxetine, and the black-box warning framed as careful treatment rather than avoidance.
On this page
Study tools
Target exams
Candidate instructions
You are the paediatric registrar. The parents of a 15-year-old girl with a moderate depressive episode and recent superficial self-harm have ten minutes with you. They have read online that antidepressants cause suicide and are frightened. Explain, in plain language: (1) what depression in a teenager is and that it is treatable; (2) how you assessed suicide risk and the safety plan you will make together; (3) the role of talking therapy and when a medicine such as fluoxetine is added; and (4) an honest, balanced account of the suicide warning and how you will monitor. Invite their questions and agree a shared plan. Do not lecture; check understanding throughout. [1]
References4ShowHide
- [1]Cipriani A, Zhou X, Del Giovane C, et al. Comparative efficacy and tolerability of antidepressants for major depressive disorder in children and adolescents: a network meta-analysis. Lancet, 2016.PMID 27289172
- [2]March J, Silva S, Petrycki S, et al. Fluoxetine, cognitive-behavioral therapy, and their combination for adolescents with depression: Treatment for Adolescents With Depression Study (TADS) randomized controlled trial. JAMA, 2004.PMID 15315995
- [3]Bridge JA, Iyengar S, Salary CB, et al. Clinical response and risk for reported suicidal ideation and suicide attempts in pediatric antidepressant treatment: a meta-analysis of randomized controlled trials. JAMA, 2007.PMID 17440145
- [4]Cheung AH, Zuckerbrot RA, Jensen PS, et al. Guidelines for Adolescent Depression in Primary Care (GLAD-PC): Part II. Treatment and Ongoing Management. Pediatrics, 2018.PMID 29483201