Childhood depression

Depression in children and adolescents is associated with more lifetime episodes, more suicide attempts, greater comorbidities and poorer quality of life. The tenth edition of the International Statistical Classification of Diseases and Related Health Problems (ICD 10) assumes that the psychopathology of depression in childhood and adulthood is similar. The symptoms must cause impairment in functioning or cause clinically significant distress. Suicide is the third leading cause of death for 15 to 24 year olds and the sixth leading cause of death for five to 15 year olds. Genetics is most predictive factor. Neuroimaging have shown the amygdala functioning to be affected in depressed subjects. Adoption studies have supported the role of environmental factors. Cognitive theories include the idea of learned helplessness and the idea of cognitive distortion. The persons have certain distortions like personalisation, selective abstraction, arbitrary inferences and overgeneralisation. Alcohol or drug abuse, involvement in gangs and cults, attempted suicide are common consequences. About one third develop bipolar disorder. There is increased recognition of the continuity between childhood major depression and depression in adulthood. Fluoxetine alone or in combination with cognitive behaviour therapy (CBT) is superior to placebo in various studies. The benefits of antidepressants in youth outweigh the potential risk from suicidal ideation or attempts. The two most studied treatment modalities for depression are CBT and interpersonal psychotherapy. Depression is a strong predictor of suicide attempts or completion. It is dangerous but highly treatable condition.