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Depression in children and adolescents: a few pointers for improved care

Carefully observing and listening attentively to children and those around them are vital for identifying depression and providing appropriate solutions.

The diagnosis of depression in children and adolescents is exclusively clinical. Numerous classifications show how difficult it is to come up with a definite diagnosis.

There are many signs of depressive disorders in children and adolescents. Body language (solemn expression, absent air), language ("I’m useless", "Nothing interests me") as well as behavioural changes reported by those around them are indicators which should not be neglected: loss of interest and enjoyment, loss of self-esteem, lack of self-worth or feeling of helplessness, words suggesting a feeling of guilt, shame, loss of love, attention deficit or memory difficulties, a feeling of despair, thoughts of death, and suicide, etc.

A few pointers help to gauge the severity of the depression, especially the duration, as it is important not to confuse transient gloom with depression. In evaluating the situation, it is helpful to take into consideration the family background, history and other associated disorders.

In short, the key issue is not to diagnose depression, but to relieve psychological suffering. Careful observation and listening attentively to children and to those around them help identify those who have a genuine, long-term psychological condition. A multi-disciplinary approach makes it possible to determine the most suitable care option. For most children, the risk-benefit balance of drug treatments is unfavourable.

©Prescrire May 2010

"Diagnosis of depression in children an adolescents" Prescrire Int 2010; 19 (106): pp. 81-83.

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