Depression in children

Abstract

Purpose of review: This summary of literature published during the past year focuses on research into factors that may contribute to development of childhood-onset depression and on appropriate assessment and treatment.

Recent findings: The recent literature suggests that investigating risk factors and gene-environment interactions could be fruitful in elucidating the aetiology of childhood-onset depression and could have implications for developing preventive (selective or targeted programmes) and therapeutic strategies. These strategies clearly should involve interventions to improve parent-child relationships and parenting style, especially in children at high risk early in their lives. Cognitive-behavioural therapy, interpersonal therapy and (in the case of severe depression) selective serotonin reuptake inhibitor medications (fluoxetine as the first-line option, with close monitoring for adverse effects during treatment) appear to be effective in the management of depression in children. However, recent reports on psychotherapies yield a less clear picture about their effectiveness in childhood depression than was previously indicated.

Summary: Controlled trial data and evidence-based guidelines for management of depressed children are limited with respect to pharmacological and psychotherapeutic options, especially in prepubertal and preschool children. Further research in this area is therefore warranted.