CHILDHOOD AND ADOLESCENT DEPRESSION - A REVIEW OF THE PAST 10 YEARS .2.

Objective: To review the literature of the past decade covering the as sessment, treatment, and prevention of early-onset major depressive di sorder (MDD) and dysthymic disorder (DD). Method: A computerized searc h for articles published during the past decade was made, and selected studies are presented. Results: Diagnostic systems and standardized i nterviews have been developed to reliably assess and diagnose early-on set MDD and DD. To date, few controlled psychotherapeutic trials, in p articular cognitive-behavioral therapy (CBT), and one study using fluo xetine have been shown to be efficacious in the acute management of ea rly-onset MDD. While studies of tricyclic antidepressants have shown n o difference between medication and placebo, these studies are inconcl usive because of the inclusion of small samples and other methodologic al issues. CBT may also be useful for the prevention of MDD. No studie s have been published on maintenance treatment of MDD or the treatment of early-onset DD. Conclusions: It appears that both pharmacological and psychotherapeutic interventions have a role in the acute treatment of MDD. However, further research on the separate and combined effica cy of these treatments for the acute treatment, maintenance, and preve ntion of early-onset MDD and DD is needed. The impact of comorbidity a nd psychosocial consequences of early-onset depression also emphasize the importance of utilizing a multimodal approach to treatment.