PsychEd Episode 58: Depression in Children and Adolescents with Dr. Darren Courtney

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers depression in children and adolescents with Dr. Darren Courtney, a scientist with the Cundill Centre for Child and Youth Depression and the Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health and a staff psychiatrist in the Youth Addictions and Concurrent Disorders Service at the Centre for Addiction and Mental Health (CAMH) in Toronto. He is also an associate professor in the Department of Psychiatry at the University of Toronto.

Dr. Courtney earned his MD in 2004 at Queen’s University and completed psychiatry residency in 2009 at the University of Ottawa. He was the clinical director of the Youth Inpatient Unit at the Royal Ottawa Mental Health Centre from 2009 to 2014 and moved to Toronto in 2014, where he worked on the Concurrent Youth Inpatient Unit at the Centre for Addiction and Mental Health until 2017 and where his clinical work with concurrent disorders continues now with outpatient youth.

Dr. Courtney's research focus is on the treatment of adolescent depression through the use of an integrated care pathway — a collaboratively developed treatment algorithm based on high-quality clinical practice guidelines. Through his research, he works on identifying quality practice guidelines and corresponding multi-disciplinary care pathways to facilitate evidence-based and measurement-based care for adolescents with depression. He has also participated in a systematic review and quality appraisal of clinical practice guidelines for psychiatric disorders in children and adolescents. Additionally, he has an interest in the management of concurrent disorders, where young people are affected by both primary psychiatric disorders and substance use disorders.

The learning objectives for this episode are as follows:

By the end of this episode, you should be able to…

1. Outline the prevalence and risk factors for depression in children and adolescents

2. Explain how children and adolescents with depression present in clinical practice

3. Discuss the use of screening tools for depression in this population

4. Describe an approach to the management of depression in children and adolescents

5. Outline the management of an adolescent with suicidal thoughts or behaviours

Guest: Dr. Darren Courtney

Hosts: Kate Braithwaite (MD) and Nikhita Singhal (PGY5)

Audio editing by: Nikhita Singhal

Show notes by: Kate Braithwaite and Nikhita Singhal

Interview Content:

• Introduction - 0:00

• Learning objectives - 02:11

• Prevalence of depression in youth - 03:11

• Risk factors for depression in youth - 06:25

• Diagnosing depression in youth - 08:30

• Screening tools - 14:24

• Approach to taking a history from youth - 19:45

• Management of depression in youth - 30:12

• Psychotherapies - 33:20

• Medications - 37:37

• Assessing and managing suicidality in youth - 44:00

• Measurement based care - 51:00

• Final thoughts - 55:10

Resources:

• Previous PsychEd episodes:

• PsychEd Episode 1: Diagnosis of Depression with Dr. Ilana Shawn

• PsychEd Episode 2: Treatment of Depression with Dr. Sidney Kennedy

• PsychEd Episode 18: Assessing Suicide Risk with Dr. Juveria Zaheer