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Child and Adolescent Depression

Large-scale research studies have reported that up to 2.5 percent of children and up to 8.3 percent of adolescents in the United States suffer from depression. In addition, research has discovered that depression onset is occurring earlier in individuals born in more recent decades.There is evidence that depression emerging early in life often persists, recurs, and continues into adulthood, and that early onset depression may predict more severe illness in adult life.

Diagnosing and treating children and adolescents with depression is critical to prevent impairment in academic, social, emotional, and behavioral functioning and to allow children to live up to their full potential.

Research on the diagnosis and treatment of mental disorders in children and adolescents, however, has lagged behind that in adults. Diagnosing depression in these age groups is often difficult because early symptoms can be hard to detect or may be attributed to other causes.

In addition, treating depression in children and adolescents remains a challenge, because few studies have established the safety and efficacy of treatments for depression in youth. Children and adolescents are going through rapid, age-related changes in their physiological states, and there remains much to be learned about brain development during the early years of life before treatments for depression in young people will be as successful as they are in older people.

Suicidal Behaviors

NIMH is pursuing brain-imaging research in children and adolescents to gather information about normal brain development and what goes wrong in mental illness.

Depression in children and adolescents is associated with an increased risk of suicidal behaviors. Over the last several decades, the suicide rate in young people has increased dramatically.

In 1996, the most recent year for which statistics are available, suicide was the third leading cause of death in 15-24 year olds and the fourth leading cause among 10-14 year olds.

NIMH researchers are developing and testing various interventions to prevent suicide in children and adolescents. However, early diagnosis and treatment of depression and other mental disorders, and accurate evaluation of suicidal thinking, possibly hold the greatest suicide prevention value.

Until recently, there were limited data on the safety and efficacy of antidepressant medications in children and adolescents. The use of antidepressants in this age group was based on adult standards of treatment.

A recent NIMH-funded study supported fluoxetine, an SSRI, as a safe and efficacious medication for child and adolescent depression. The response rate was not as high as in adults, however, emphasizing the need for continued research on existing treatments and for development of more effective treatments, including psychotherapies designed specifically for children.


Other complementary studies in the field are beginning to report similar positive findings in depressed young people treated with any of several newer antidepressants. In a number of studies, TCAs were found to be ineffective for treating depression in children and adolescents, but limitations of the study designs preclude strong conclusions.

NIMH is committed to developing an infrastructure of skilled researchers in the areas of child and adolescent mental health. In 1995, NIMH co-sponsored a conference that brought together more than 100 research experts, family and patient advocates, and representatives of mental health professional organizations to discuss and reach consensus on various recommendations for psychiatric medication research in children and adolescents.

Outcomes of this conference included awarding additional funds to existing research grants to study psychotropic medications in children and adolescents and establishing a network of Research Units of Pediatric Psychopharmacology (RUPPs). Recently, a large, multi-site, NIMH-funded study was initiated to investigate both medication and psychotherapeutic treatments for adolescent depression.

Continuing to address and resolve the ethical challenges involved with clinical research on children and adolescents is an NIMH priority.

Source: National Institute of Mental Health

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