NCJ Number
197920
Journal
JAMA Volume: 288 Issue: 11 Dated: September 18, 2002 Pages: 1338-1341
Date Published
September 2002
Length
4 pages
Annotation
After reviewing the characteristics and prevalence of depression in children and adolescents, this paper reviews the findings of psychotherapy research and pharmacotherapy studies regarding effective treatment for such depression.
Abstract
Diagnostic criteria for major depression in children and adolescents listed in the Diagnostic and Statistical Manual of Mental Disorders are essentially the same as those for adults. These include increasing unhappiness, tearfulness, anger reactions or rages ignited by small provocations, social withdrawal, and lack of motivation. Irritability may be the primary mood symptom in children and adolescents; whereas, sadness usually predominates in adults. Academic underachievement and physical complaints typically accompany depression in children and adolescents. The peak incidence of depression occurs in the later teenage years. By age 18, approximately one in four youth have experienced a depressive episode. Most recent clinical trials of psyhcotherapeutic interventions for depressed and suicidal youth have investigated cognitive behavior therapy or interpersonal psychotherapy. Cognitive behavior therapy teaches patients to monitor and modify negative thoughts presumed to elicit and prolong depressive symptoms. The behavioral component aims to reinforce pleasurable activities as well as problem-solving and social skills, while promoting interpersonal relationships that may buffer against depressed moods. Interpersonal psychotherapy targets interpersonal conflicts that often precipitate depression. Pharmacological treatment of major depressive disorder aims to achieve remission and prevent relapses and recurrences. Selective serotonin reuptake inhibitors are the first-line pharmacological treatments of depression at all ages, because of their efficacy and benign adverse effects. 5 notes