title: Therapeutic identification of depression in young people: lessons from the introduction of a new technique in general practice.
abstract: BACKGROUND
  Mild-to-moderate depression in young people is associated with impaired social functioning and high rates of affective disorder in adult life. Earlier recognition of depression in young people has the potential to reduce the burden of depression in adulthood. However,  depression in teenagers is underdiagnosed and undertreated.
  
  
  OBJECTIVE
  To assess the usability and usefulness of a cognitive-behavioural-therapy-based technique for Therapeutic Identification of Depression in Young people (TIDY).
  
  
  METHODS
  A qualitative  study of four group practices in northwest London.
  
  
  METHODS
  Face-to-face semi-structured interviews were conducted with practitioners who had been trained in the use of the TIDY technique.
  
  
  RESULTS
  Twenty-five GPs and six nurses were interviewed. The key  themes that emerged from the interviews were: practitioners were 'making sense of teenage depression' when interpreting signs and symptoms; the training in the technique was variable in its impact on practitioners' attitudes and practice; and time factors constrained practitioners  in the application of the technique.
  
  
  CONCLUSIONS
  The TIDY technique is usable in routine practice, but only if practitioners are allowed to use it selectively. This need for selectivity arises partly from concerns about time management, and partly to avoid medicalisation  of psychological distress in young people. The perceived usefulness of the TIDY technique depends on the practitioner's prior knowledge, experience, and awareness.
authors.affiliation: Department of Primary Care and Population Health, University College London, UK. s.iliffe@ucl.ac.uk
authors.forename: Steve
authors.initials: S
authors.lastname: Iliffe
authors.forename: Ceri
authors.initials: C
authors.lastname: Gallant
authors.forename: Tami
authors.initials: T
authors.lastname: Kramer
authors.forename: Julia
authors.initials: J
authors.lastname: Gledhill
authors.forename: Amanda
authors.initials: A
authors.lastname: Bye
authors.forename: Victoria
authors.initials: V
authors.lastname: Fernandez
authors.forename: Mar
authors.initials: M
authors.lastname: Vila
authors.forename: Lisa
authors.initials: L
authors.lastname: Miller
authors.forename: M Elena
authors.initials: ME
authors.lastname: Garralda
mesh_terms: D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D003463:Cues; D003866:Depressive Disorder / Q000175:diagnosis* / Q000628:therapy; D005240:Feasibility Studies; D005260:Female; D058006:General Practice / Q000379:methods*; D006801:Humans; D008131:London; D008297:Male; D008875:Middle Aged; D009722:Nurse Practitioners; D011364:Professional Practice / Q000592:standards; D011369:Professional-Patient Relations