Clinical guidelines for depressive disorders in childhood and adolescence

Major depressive and dysthymic disorders are recurrent and sometimes persis tent unipolar mood disorders, which often present in childhood and adolesce nce. Depressive episodes may increase in severity and duration with recurre nce and are associated with substantial morbidity and risk of suicide. The role of child and adolescent mental health services in early intervention a nd management is thus of major importance. This paper draws together curren t research evidence and common clinical practice, in guidelines for the spe cialist management of depressive disorders in childhood and adolescence. Bo th psychotherapy and pharmacotherapy have been found to be beneficial for t he acute treatment of children and adolescents with depressive disorders. B ased on current evidence, psychotherapy may be the first treatment for most depressed youngsters, but antidepressants should be considered for those w ith severe depression. All patients need continuation therapy, and some wil l need maintenance treatment. Evidence supporting the efficacy of psycholog ical and psychopharmacological treatments are reviewed. An integration of a pproaches is suggested as a guideline for treatment planning.