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The Informed Parent

The Depressed Youth, Part 2

by Peter W. Welty, M.D., F.A.A.P.
Published on Jan. 26, 2004

In a previous article, we discussed the issue of the diagnosis and treatment of depression in children and adolescents. Let us review the symptoms many children and adolescents may have when there is a concern that a child may be depressed.

Many doctors and clinicians use the term “major depression” to describe a certain collection of symptoms. There may be a depressed or irritable mood most of the time, for the past two weeks. This depressed mood, along with many other of the following symptoms, adversely affects a child’s home, school and community functioning. There may be difficulty or a change in a child‘s sleep pattern. There may be a decrease in a child’s usual interest in outside activities. There may be feelings of guilt. There may be decreased energy, and the child may feel “tired” all of the time. There may be poor concentration at school, leading to a decline in grades. A child’s appetite may go up or down. There may be a decrease or increase in a child’s level of activity. There may be thoughts of suicide, or even an actual attempt. If you, as a parent, are concerned about a change in your child‘s behavior, you need to discuss the concerns with your pediatrician. The child may benefit from a referral to a mental health professional for further evaluation and treatment.

Treatment of depression may involve therapy services for the child, and many times also for the family. The goal of therapy is to help the family and child identify the trigger and stressors in their lives, and develop other more effective coping strategies.

Some children may benefit from a prescription medication to aid in the treatment of depression. Sometimes antidepressants are prescribed. Recently, the August 27, 2003 issue of JAMA published a study which tested one of the available antidepressants, sertraline (Zoloft), on its efficacy against major depression in children and adolescents. The study revealed that children with major depression as young as age six can be treated safely and effectively with sertraline.

In this study, 376 children ages 6 - 17 years were diagnosed with major depression, of at least moderate severity. The doses of sertraline were increased incrementally until a clinical response was noted. The study concluded that between 63 percent and 69 percent of the children treated with sertraline responded positively to the medication. As with any medication, it is imperative that it be followed and prescribed by a physician who is expert in managing depression in children and adolescents. He or she will be able to evaluate if it is effective. Also, the physician will know how to manage the patient if there are side effects or adverse events.

Depression in children and adolescents is a serious concern. Be sure to discuss your concerns with your child’s pediatrician, so that appropriate diagnosis, referral and treatment services can begin.

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