pediatrics
Depressive Disorders in Children and Adolescents
Introduction
Depressive disorders are characterized by sadness or irritability that is severe or persistent enough to interfere with functioning or cause considerable distress. Diagnosis is by clinical criteria. Treatment is with antidepressants, supportive and cognitive-behavioral therapy, or a combination of these modalities. (See also discussion of Depressive Disorders in adults.) Depressive disorders in children and adolescents include Disruptive mood dysregulation disorder Major depressive disorder Persistent depressive disorder (dysthymia) The term depression is often loosely used to describe the low or discouraged mood that results from disappointment (eg, serious illness) or loss (eg, death of a loved one). However, such low moods, unlike depression, occur in waves that tend to be tied to thoughts or reminders of the triggering event, resolve when circumstances or events improve, may be interspersed with periods of positive emotion and humor, and are not accompanied by pervasive feelings of worthlessness and self-loathing. The low mood usually lasts days rather than weeks or months, and suicidal thoughts and prolonged loss of function are much less likely. Such low moods are more appropriately called demoralization or grief. However, events and stressors that cause demoralization and grief can also precipitate a major depressive episode. The etiology of depression in children and adolescents is unknown but is similar to Etiology ; it is believed to result from interactions of genetically determined risk factors and environmental stress (particularly early life stress such as abuse, injury, natural disaster, domestic violence, death of family member, and deprivation [ During the COVID-19 pandemic, depression symptoms doubled in youths, especially in older adolescents ( General references ) and mental health care visits for depression increased by 43% ( 