Depression Fact Sheet for Physicians
-Reckless behavior
-Difficulty with relationships
Screening
There are several tools that are useful for screening children and adolescents for depression. They include the Children's Depression Inventory (CDI)(9) for ages 7 to 17; and, for adolescents, the Beck Depression Inventory(10) and the Center for Epidemiologic Studies Depression (CES-D) Scale.(11) When these are positive, further evaluation, which may include interviews with the child, parents, and collateral informants, such as teachers and social services personnel, is warranted.
Risk Factors Among children, boys and girls appear to be at equal risk for developing depression. Adolescent girls, however, may be more at risk than their male counterparts.(13) Children who develop major depression are likely to have a family history of the disorder, often a parent who experienced depression at an early age.(14) Adolescents with depression are also likely to have a family history of depression, though the correlation is not as high as it is for children. In addition, teen cigarette smoking is associated with depression.(15)
Other risk factors include:(16)
-Stress
-A loss of a parent or loved one
-Attentional, conduct or learning disorders
-Chronic illnesses, such as diabetes
-Abuse or neglect
-Other trauma, including natural disasters
Treatment
The last decade has spawned advances in treatment options for young people with depression. Treatment often combines short-term psychotherapy, medication, and targeted interventions involving the home or school environment. There remains, however, a pressing need for additional research on treatments for depression in children and adolescents, including medications as well as psychotherapies.
In general, to prevent the recurrence of depression, it is recommended that treatment be continued for all patients for at least 6 months after the remission of symptoms.
Psychotherapy
Recent research shows that certain types of short-term psychotherapy, particularly cognitive-behavioral therapy (CBT), can help relieve depression in children and adolescents.(12,18,19) CBT is based on the premise that depressed patients have cognitive distortions in their views of themselves, the world, and the future. CBT, designed to be a time-limited therapy, focuses on changing these distortions. An NIMH-supported study on treating major depression in adolescents, for example, found that CBT resulted in a rate of remission of nearly 65 percent, a higher rate than either supportive therapy or family therapy. CBT also resulted in a more rapid treatment response.(20)
Related forms of focused, problem-solving psychotherapy that target interpersonal features of depression also appear to be effective.(21)
Continuing psychotherapy after remission of symptoms helps patients and families consolidate the skills learned during the acute phase of
Latest Articles