Correct Answer B

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• Answer A is incorrect: The diagnosis and treatment of major depressive disorder are within the scope of pediatricians. Pediatricians also incorporate a developmental perspective and often have an established relationship with the family that facilitates trust and engagement in the treatment process. Referral to psychiatry may be indicated in certain situations (eg, complex presentation, multiple unsuccessful medication trials), but delaying care while awaiting referral could cause additional harm.
• Answer B is correct: SSRIs are the first-line medication treatment for depression, ideally combined with therapy. In most cases, they can safely and effectively be prescribed by pediatricians. The medication dose, in addition to the BIs discussed, resources provided, and follow-up should be documented in the management plan.
• Answer C is incorrect: Depression is a treatable condition that can be life-threatening. While fostering hope regarding treatment for depression is important, minimizing the patient’s symptoms or providing unrealistic expectations about its course could cause harm. 
• Answer D is incorrect: Being busy is not an appropriate reason to avoid addressing mental health concerns. If more time is needed, ask the office staff to arrange for a return visit in the next few days to allow for extra time. This approach is not indicated if a mental health emergency is present, so be sure to exclude this possibility before sending the patient home.