Philadelphia—It's hard to get a fix on depression in children and adolescents. Even mentally healthy children occasionally act cranky, refuse food, and disdain hobbies, sports, and other activities that once proved engaging. "Normal" teenagers sometimes slam doors, agonize over rejections, and withdraw from family and friends. Families and teachers typically put up with a troubled child or adolescent for weeks or months before seeking help.
Physicians, too, often hesitate to diagnose potentially stigmatizing psychiatric disorders in the young. Early diagnosis and treatment, however, can help restore a youngster to health, reduce the lifetime burden of depression, and possibly prevent suicide, now the third leading cause of death in the United States among 15- to 19-year-olds, exceeded only by unintentional injury and homicide. About 1% to 3% of prepubertal children and 3% to 9% of adolescents have depression. By age 18 years, about one in four has experienced a depressive episode. Episodes often last several months and recur within 5 years (The Many Faces of Depression in Children and Adolescents, Shaffer D, Waslick B, eds. Washington, DC: American Psychiatric Publishing Inc; 2002).
Lamberg L. Multifaceted Treatment Aids Depressed Young. JAMA. 2002;288(11):1338–1341. doi:10.1001/jama.288.11.1338-JMN0918-2-1
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