OBJECTIVE: To assess the treatment of childhood depression in a managed care population. METHODS: All subjects contained within Pharmetric s Integrated Outcomes database possessing a diagnosis of depression (ICD-9-CM=296.2, 296.3, 300.4, 311) during 1997-98, who were between 6-18 years of age at the time of diagnosis and were continuously enrolled for more than 1 year, were eligible for study inclusion. Utilization of psychotherapy and pharmacotherapy during the 1-year period following initial diagnosis was measured, as was depression-related hospitalization. These measures were compared across age categories (6-14, 15-18) and gender, and hospitalization rates were compared across psychotherapy and pharmacotherapy cohorts. RESULTS: 461 patients met the inclusion criteria. The mean age was 15.4 years and 51.4% of the sample was female. 96.5% of patients received some type of pharmacotherapy, while only 214 (46.4%) subjects received psychotherapy. While patients in the younger group were more likely to be male (69.3%), the majority of patients in 15-18 age category were female (59.3%). Older patients were less likely to receive psychotherapy treatment (p<0.01). During the year, 99 (21.5%) patients were hospitalized for depression. Females were more likely to receive more than one class of antidepressant (24.1% vs. 13.39%). The difference was more pronounced within the 15-18 age category (26.3% vs. 11.0%). Hospitalization rates were higher among older patients (25.2%) compared to younger patients (11.8%). Hospitalization was not related to the presence of pyschotherapy, but it was associated with the multiple antidepressant treatment (p<0.01). CONCLUSION: Hospitalization was a common outcome for patients, suggesting the need for improved treatment.