Depression in children and adolescents - A guide to diagnosis and treatment

Mood disorders are prevalent and serious disorders in children and adolesce nts, often causing substantial difficulties in school performance and socia l relationships. Although the criteria for major depressive disorder are th e same for children and adolescents as for adults, some challenges exist in ascertaining the diagnosis. For example, children often have difficulty in expressing or recalling information regarding their disorder; therefore, m ultiple informants (usually parents) must often be used to obtain the infor mation. In addition, comorbid diagnoses are common in early onset depressio n, making diagnosis more difficult. However, depression is diagnosable in c hildren and adolescents. The treatment of depression in this population is multi-modal, including th e child, parents and school, and is aimed at shortening the episode of depr ession. Treatment, which is individualised based on need, may include psych otherapy, family therapy or education, and pharmacological treatment. Selec tive serotonin (5-hydroxytryptamine; 5-HT) reuptake inhibitors are generall y the first line of pharmacological treatment in children and adolescents, as they are well tolerated and appear to have fewer adverse effects than an tidepressants. As with adults, the majority of children and adolescents with depression do recover within 1 to 2 years; however, recurrence is common. In fact, the r ecurrence rate is somewhat higher in children and adolescents than in adult s. Unfortunately, little research has been done regarding maintenance treat ment in children and adolescents. Further research in this area is needed t o determine the most effective duration of medication treatment.