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Children’s Physicals Should Include Depression and Cholesterol Tests

By Cheri Cheng | Update Date: Feb 25, 2014 10:18 AM EST

Depression screening and cholesterol test should start as early as 11-years-old, according to the latest guidelines drafted by a leading group of pediatricians in the United States. The report, co-edited by Dr. Joseph Hagan with the American Academy of Pediatrics (AAP), recommended doctors to perform these tests during a child's standard physical check up in order to better diagnose and treat cases.

The revisions to these guidelines state that depression screenings should start at age 12 and last through to age 21. Doctors should refer at-risk patients and follow-up on their care. In order to assess suicide risk, doctors should ask key questions, such as the presence of firearms in the household. Children with untreated depression have a higher risk of suicide or murder.

"One in five kids will, at some point in time, meet the criteria for depression," said Hagan, a professor in pediatrics at the University of Vermont College of Medicine, reported by WebMD.

For cholesterol, the AAP reported that screening for high cholesterol is vital in children between nine and 11-years-old. During this time, the body has not gone through hormonal changes caused by puberty that could affect the accuracy of cholesterol readings. By keeping an eye on children's cholesterol before the onset of puberty, doctors can have a general idea about the child's health risks. Furthermore, early cholesterol screenings could identify patients who have a genetic risk for the health condition. Children who have high cholesterol and leave it untreated are more likely to suffer from heart disease later on in life. If doctors were to screen for both health conditions and monitor them continuously, deaths could be prevented.

The report also included many other changes. First, the report stated that all newborns should be screened for critical congenital heart disease. Second, doctors should consistently test older teens between the ages of 16 and 18 for HIV (human immunodeficiency virus), the sexually transmitted infection that leads to AIDS. Third, doctors should avoid pap smears and screening for precancerous cervical changes before the age of 21. Oftentimes, early screenings can lead to unnecessary tests, which increase costs and anxiety.

"Many of these changes were ones we anticipated," said Dr. Kristin Hannibal, clinic director of the Primary Care Center at Children's Hospital of Pittsburgh. "The major stumbling block is always how do we take these recommendations and implement them across the board."

The report was published in Pediatrics.

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