July/August 2017Vol. 18, No. 5Evidence-Based Treatments for Depression in Children and Youth

The webinar "Evidence-Based Treatments for Depression in Children and Youth," presented by Christopher Bellonci, M.D., medical director of the National Technical Assistance Network for Children's Behavioral Health, is the first of the Clinical Distance Learning Series webinars. This webinar focuses on evidence-based treatment for behavioral disorders in children and youth, specifically for the two most common depressive disorders in children—major depressive disorder and disruptive mood dysregulation disorder.

Depression is characterized as the presentation of five or more depression symptoms over the same two-week period that can cause significant distress or functional impairment. These symptoms must include depressed mood and loss of pleasure in almost all activities, which in children may manifest as irritability rather than sadness. Other symptoms may include significant changes in weight and appetite, sleep issues, fatigue, feelings of worthlessness, difficulty in processing thoughts and decision-making, and suicidal ideation. In children, depression can manifest as a lack of interest in play-based or sports activities, a gloomy outlook, low self-esteem, and mood swings.

Research has shown that depression can appear in preschool age children as young as 3 years old, with about a 2 percent rate of occurrence in children ages 2–5. In school-age children between ages 7 and 15, 2 percent of boys and 4 percent of girls were diagnosed with depression in 2016. In adolescents, however, the rate rises to approximately 11 percent among those ages 12–17 (in 2014), with onset most likely at puberty and the incidence peaking in their 20s.

The webinar suggests using diagnostic interviews as well as screening tools such as the Patient Health Questionnaire for Adolescents (which is available for free from the U.S. Preventive Services Task Force), the Beck Depression Inventory, and the Children's Depression Inventory to diagnose depression in children and adolescents. These screening tools allow clinicians to determine treatment options and next steps.

Treating depression in children and adolescents can be difficult and requires cooperation between the child, his or her family members, and the clinician. Treatment approaches recommended in the webinar differ depending on age and development. For preschool age children, Dr. Bellonci suggests a dyadic developmental approach that focuses on working with the child and his or her parents together. For school-age children and adolescents, cognitive-behavioral therapy has proven to be rather effective.

To learn more and to view the webinar, go to https://www.youtube.com/watch?v=65qasq15S8w&feature=youtu.be.