Depression
Key Points
Assessment for depression must always include assessment of current and past suicidality. If a patient expresses suicidal thoughts, providers must take measures immediately to ensure the child’s or adolescent’s safety. Suicidality.
About 1 in 5 children have special health care needs. Of those children and youth with special healthcare needs, 17-23% are affected by depression compared to 5-9% of other children. [Parmar: 2021] Children and adolescents with developmental delays can also develop depression. The term "dual diagnosis" refers to the combination of intellectual disability and a psychiatric disorder in the same patient or a substance use disorder and another psychiatric disorder. Always consider the child's developmental level when looking for behaviors and changes in mood that might signal a depressive disorder. For more detail on how depression can present in different childhood developmental stages, see Presentations below.
SIGECAPS is a commonly used mnemonic for the symptoms of depression that can occur in addition to depression:
- S – sleep
- I – interest
- G – guilt
- E – energy
- C – concentration
- A – appetite or weight
- P – psychomotor changes
- S - suicidality
Although depressed/sad mood is the most common mood reported in youth meeting criteria for depression, irritable mood is also common. It may occur concurrently with depressed mood (35.6% of cases) or alone (5.7% of cases). [Stringaris: 2013]
Antidepressant medications may cause mood changes and therefore need to be monitored closely. Providers must counsel caregivers and youth about the increased risk of suicidal thoughts or behaviors when taking an antidepressant. In antidepressant studies, about 4% of children and adolescents had worsening suicidal thoughts or behaviors (compared to 2% with a placebo). However, in over 4000 subjects studied, there were no (0) completed suicides. [US: 2018] An independent review of available data by the American Medical Association indicated that “a causal role for antidepressants in increasing suicides in children and adolescents has not been established. Concerns that antidepressants potentiate suicidal or self-injurious behavior need to be balanced by the clear risk of suicide in children and adolescents with untreated depression.” [Jane: 2016] There is also data demonstrating a correlation between higher rates of SSRI prescriptions and reduced child and adolescent suicide rates. [Gibbons: 2006] Refer to the section below for more information about antidepressants and suicidal adverse events (SAEs).
Check for interactions with other prescriptions, over-the-counter medications, herbal medications (such as St. John’s wort), and dietary supplements (such as S -adenosylmethionine (SAMe), hydroxytryptophan (5-HTP), and saffron). When prescribing antidepressants, be aware of the prescribed agent’s side effects and risks of serotonin syndrome and antidepressant discontinuation syndrome. See the sections on Serotonin Syndrome and Antidepressant Discontinuation Syndrome below for more information.
- Four to six weeks of adherence is required to assess a dose’s full effect and determine if the dose is adequate, although some people may feel a benefit in less time.
- The general recommendation for therapy and medications is that they are continued for at least 6-12 months from symptom improvement because depressive episodes can last from months to years.
- Up to 70% of adolescents with major depression will experience some degree of recurrence within 5 years and may need to restart treatment.
While the most effective treatment for moderate to severe depression combines psychotherapy and antidepressant medication, in cases of mild to moderate depression, psychotherapy alone may be a reasonable treatment option. [March: 2007] Providers should make this decision in collaboration with the patient and family. It may take longer to realize the positive effects of psychotherapy compared to medication. Failure to improve with adequate treatment trials is a criterion for consultation with, or referral to, a qualified child and adolescent psychiatrist.
Practice Guidelines
Walter HJ, Abright AR, Bukstein OG, Diamond J, Keable H, Ripperger-Suhler J, Rockhill C.
Clinical Practice Guideline for the Assessment and Treatment of Children and Adolescents With Major and Persistent Depressive
Disorders.
J Am Acad Child Adolesc Psychiatry.
2022.
PubMed abstract
Zuckerbrot RA, Cheung A, Jensen PS, Stein REK, Laraque D.
Guidelines for Adolescent Depression in Primary Care (GLAD-PC): Part I. Practice Preparation, Identification, Assessment,
and Initial Management.
Pediatrics.
2018.
PubMed abstract
Cheung AH, Zuckerbrot RA, Jensen PS, Laraque D, Stein REK.
Guidelines for Adolescent Depression in Primary Care (GLAD-PC): Part II. Treatment and Ongoing Management.
Pediatrics.
2018.
PubMed abstract
Diagnosis
History
Family History
Presentations
Depressive symptoms in infants may include sadness, inactivity, withdrawn behavior, agitation, sleep problems, feeding problems, and failure to thrive. A major controversy is whether symptoms may occur endogenously or are always associated with environmental stress (separation from caregivers, maternal depression, neglect, abuse, severe illness). Such symptoms should prompt a search for environmental causes or physical conditions. Diagnostic criteria for depression in infancy are available in the Classification of Mental and Developmental Disorders (Zero to Three). The proper diagnosis and treatment of such cases warrant referral to a specialist. There is no data on treatment in this age group, but providers and families should consider environmental interventions as appropriate.
The prevalence of depression in preschoolers is approximately 2%, based on available studies. [Whalen: 2017] Depressive symptoms may include those listed above for infants, as well as the child’s stated emotions (e.g., “I’m sad”) or observation of depressive themes in the child’s play (e.g., themes of sadness, loss, guilt, aggression, death, or suicide). Somatic symptoms (e.g., headaches, stomachaches) may be present but are less frequent than more typical depressive symptoms. [Luby: 2003] Endogenous depression is less controversial in this age group, but environmental factors are still important. As with infant depression, diagnostic criteria are available that have been modified to reflect developmental stage and include decreased number and duration of symptoms. [Luby: 2003]

The prevalence of endogenous depression in school-age children is thought to be 1-2% with a 1:1 male-to-female ratio. [Costello: 2003] Diagnosis is based on DSM-5-TR criteria. [American: 2013] The criteria for depression in children are the same as adult criteria except for the inclusion of irritable mood in addition to depressed or sad mood. School-age children are more able than younger children to report their symptoms and commonly present with temper tantrums, increased frustration and irritability, and somatic symptoms. [Walter: 2022] Often, symptoms reported by the child may be combined with those reported by caregivers to arrive at a diagnosis. School dysfunction may be a strong indicator of the need for evaluation.
The prevalence of depression in adolescence is 11.0% in the United States. [Miller: 2021] The sex ratio changes as the prevalence in girls increases relative to boys resulting in a 2:1 female-to-male ratio that persists until late middle age. Pubertal hormonal and physiologic changes undoubtedly play a role, but research has not yet defined causal factors. [Angold: 2006] Diagnosis is by DSM-5-TR criteria and often can be made by an interview with the adolescent alone. It is strongly recommended to interview the adolescent and their caregivers; school dysfunction, social withdrawal, changes in friends, and new onset of arguing or defiant behavior at home may be clues to underlying depression.
Diagnostic Criteria and Classifications
Screening & Diagnostic Testing
- Beck Depression Inventory-II - ages 13 and older (available for a fee)
-
Patient Health Questionnaire Modified for Adolescents (PHQ-A) (
228 KB) - ages 11 to 17 (free)
-
Center for Epidemiological Studies Depression Scale for Children (CES-DC) (
37 KB) - ages 12 to 18 (free)
-
Center for Epidemiologic Studies Depression Scale Revised (CESD-R-20) (
262 KB) - ages 14 and older (free)
- Pediatric Symptom Checklist - ages 4-17 (free)
- Mood and Feelings Questionnaire – ages 6-19 (free)
- Strengths and Difficulties Questionnaire (SDQ) – ages 2-17 (free) - Useful to assess problematic behaviors that can be indicative of a diagnosis such as depression. [Mieloo: 2012]

Screening Family Members


Labs
Other
Genetics & Inheritance
Prevalence
Differential Diagnosis
Co-occurring Conditions
Prognosis
Treatment & Management
Mental Health / Behavior
Interim History
- Ask if the patient has, over the past month, frequently felt depressed, hopeless, sad, or irritable or has felt less interest in or enjoyment of usual activities. Depression and diminished interest (aka anhedonia) are cardinal symptoms of depression – one or the other must be present for diagnosis.
- Positive replies should prompt further questioning.
The diagnosis of major depression in children and adolescents
outlined in the DSM-5-TR [American: 2022]
requires 5 total symptoms; one of the symptoms must be either
depressed or irritable mood, or anhedonia. Additional symptoms
include:
- Changes in sleep
- Feelings of guilt or worthlessness
- Low energy
- Poor concentration
- Appetite or weight change
- Psychomotor slowing or agitation
- Suicidal thoughts or behaviors
- See the SIGECAPS mnemonic for depressive symptoms in Key Points above. Gather information from both the child/adolescent and a guardian. Most child/adolescent mental health professionals agree that combining symptoms from these separate reports is sufficient for a clinical diagnosis of depression. Symptoms must cause significant distress or dysfunction to meet criteria – ask about the impact on school, home, and social areas/activities. Because children may not report symptoms clearly, assessment of changes in behavior or function may provide the best clues.
Treatment Approaches
- Infants - Medication and psychotherapy have not been studied in this age group. A nurturing home environment and treatment of depression in affected caregivers may help reduce rates of depression in infants at high familial risk. [American: 2020]
- Preschoolers - Psychotherapeutic and parenting/behavioral interventions are the treatment options most commonly used. Medication is not recommended as first-line treatment in this age group and should be referred to a psychiatrist if medication is considered due to the severity of the case; please see Monitoring treatment efficacy below for more information about referrals.
- School-Age Children - There are positive research findings for using medications and cognitive behavioral therapy (CBT) in this age group.
- Adolescents - There are positive research findings in this age group for the use of medications, cognitive behavioral therapy (CBT), interpersonal psychotherapy (IPT), and electroconvulsive therapy (ECT).
Monitoring treatment efficacy
- Require more than 2 psychotropic medications to control symptoms or has had only partial response to medication
- Have no improvement after 6-8 weeks of medication or therapy
- Require psychiatric hospitalization
- Have parents with significant emotional impairment or substance use issues
- Have complex psychosocial issues (e.g., history of abuse/neglect, legal problems, poor parental support/supervision, family conflict)
- Have a family history suggesting adverse reactions to therapy (e.g., planned antidepressant treatment in a patient with a family history of bipolar disorder)
- Are young (<5 years old) with emotional and behavioral disturbances that are severe or prolonged
- Have chronic medical illness with behaviors that interfere with the treatment of that illness
Medications
- Start at low doses and titrate up as tolerated. A trial at an adequate dose should last 2-4 weeks before any further dose increase because it may take that long to see any benefit. If there is no beneficial effect after 2-4 weeks, and the patient is tolerating the medication, the dose may be increased.
- Total trial time should be at least 6-8 weeks. A medication trial should not be considered a failure until the maximum tolerated dose has been used for this long without improvement.
- Patients should have frequent follow-ups, preferably weekly, until a dose is stable and medication is tolerated.
- Antidepressants work best when taken at the same time daily, which helps adherence and minimizes the risk of discontinuation syndrome (especially agents with a shorter half-life).
- Most antidepressants with once-a-day dosing can be taken in the morning or evening based on patient preference and observed side effects. • Family history of response to a particular medication may be an approximate guide for medication selection.
- The FDA approval of fluoxetine and escitalopram may make those medications appealing choices for clinicians; however, clinical judgment may lead to the “off-label” use of other medications.
Selective Serotonin Reuptake Inhibitors (SSRIs)
- FDA approved for use in children eight years and older with MDD and those seven years and older with obsessive-compulsive disorder.
- Available as brand name (e.g., Prozac) and generic in several formulations, including 10 mg, 20 mg, 40 mg, and 60 mg tablets; 10 mg, 20 mg, and 40 mg capsules; 90 mg delayed release (weekly) capsules; 20 mg/5 ml solution
- Starting dose for adolescents: 10 to 20mg once daily, initial target dose 20mg once daily, dose range 10mg-60mg once daily
- FDA-approved treatment of depression in adolescents aged 12 to 17 years (based on the strength of the positive study and data from a study of citalopram)
- Available as brand name (e.g., Lexapro) and generic in 5 mg, 10 mg, 20 mg tablets and 5 mg/5 ml oral solution.
- Starting dose for adolescents: 5mg to 10mg once daily, initial target dose 10mg once daily, dose range 10mg to 30mg once daily.
- FDA approved for use in children 6 years and older with MDD.
- Available as brand name (e.g., Zoloft) and generic in several formulations, including 25 mg, 50 mg, 100 mg tablets, and 20 mg/ml oral concentrate.
- Starting dose for adolescents: 12.5mg to 25mg once daily, initial target dose 50mg once daily, dose range 25mg to 200mg once daily.
- Not FDA approved for use in children; other SSRIs may be better for children and adolescents who may be more prone to missing doses and therefore be at higher risk of discontinuation syndrome.
- Not FDA-approved for use in children. In August 2011, the FDA issued a Drug Safety Communication warning of the potential for QT prolongation and Torsades de Pointes in patients taking citalopram at doses higher than 40mg daily, and that citalopram should no longer be used at such doses. The FDA also discouraged citalopram in patients with cardiac conditions predisposing to arrhythmia, including congenital long QT syndrome.
- Available as brand name (e.g., Celexa) and generic in 10 mg, 20 mg, and 40 mg tablets and 10 mg/5 ml oral solution
- Starting dose for adolescents: 10mg once daily; initial target dose 10mg to 20mg once daily; dose range 10mg to 40mg once daily.
Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)
- Not FDA approved for use in children and adolescents
- Available as brand name (e.g., Effexor or Effexor XR) and generic in 25 mg, 37.5 mg, 50 mg, 75 mg, and 100 mg tablets.
- “Off label” starting dose for adolescents: 37.5-75 mg/day with maintenance dose of 150-300 mg/day
- Not FDA approved for use in children and adolescents
- Starting dose in adults: 50 mg/day
- Not FDA approved for depression in children and adolescents, but is FDA-approved for Generalized Anxiety Disorder (GAD) in ages 7-17
- Starting dose for GAD in children and adolescents : 30 mg/day
- Not FDA approved for use in children and adolescents
- Starting dose in adults: 20 mg/day
Atypical Antidepressants
- Not FDA-approved for use in children.
- Available as brand names (Wellbutrin, Wellbutrin SR, Wellbutrin XL, Zyban) and generic in 75 mg and 100 mg tablets; 100 mg, 150 mg, and 200 mg extended release (12-hour) tablets; 174 mg, 348 mg, and 522 mg extended release (24 hours) tablets (as hydrobromide); and 150 mg, 300 mg, and 450 mg extended release (24 hours) tablets (as hydrochloride)
- Starting doses in adolescents: bupropion SR 75 mg twice daily, initial target dose 100 mg twice daily, dose range 75 mg to 150 mg twice daily; bupropion XL (Wellbutrin XL) starting dose 150 mg once daily, initial target dose 150 mg to 300 mg once daily, dose range 150 mg to 450 mg once daily.
- Not FDA approved for use in children and adolescents
- “Off label” use starting dose: 7.5 mg up to 30 mg daily. Lower doses preferred when additionally targeting insomnia.
- Not FDA approved for use in children and adolescents
- Starting dose in adults: 10 mg/day
- Not FDA approved for use in children and adolescents
- Starting dose in adults: 10 mg/day with food
Tricyclic Antidepressants (TCAs)
Over-the-Counter and Herbal
Safety Considerations
Serotonin Syndrome
Antidepressants and Suicidal Adverse Events (SAEs)
Antidepressant Discontinuation Syndrome
Psychotherapy
Cognitive Behavioral Therapy (CBT)
- Identifying faulty assumptions (cognitive distortions) and correcting them gradually
- Behavioral interventions designed to minimize symptoms of depression
Interpersonal Therapy (IPT)
Sleep
Nutrition
Physical Activity
Services & Referrals
This category includes all types of counselors/counseling for children. Once on the page, the search can be narrowed by city or using the Search within this Category field.
Can be very helpful in guiding and/or managing pharmacologic therapy, particularly for patients who do not respond promptly or well to standard medications.
Social workers can help families identify family issues and improve communication skills and relationships. Social workers can help with crisis intervention and utilizing resources.
ICD-10 Coding
- F32.x, Major depressive disorder, single episode
- F33.xx, Major depressive disorder, recurrent episode
- F32.89, Other specified depressive disorder
- F32.9, Unspecified depressive disorder
- F34.1, Persistent depressive disorder (formerly dysthymia)
- F34.81, Disruptive mood dysregulation disorder
- F43.21, Adjustment disorder with depressed mood
- F43.23, Adjustment disorder with mixed anxious and depressed mood
- F32.81, Premenstrual dysphoric disorder
Resources
Information & Support
- Suicidality
- Anxiety Disorders
- Attention-Deficit/Hyperactivity Disorder (ADHD) & Mood Disorders
- Mental Health Screening for Children & Teens
- Postpartum Depression Screening
- Screening for Eating Disorders
- Depression (FAQ)
- Anxiety Disorders (FAQ)
Medical information in one place with fillable templates to help both families and providers. Choose only the pages needed to keep track of the current health care summary, care team, care plan, and health coverage.
For Professionals
Depression Resource Center (AACAP)
Information for clinicians and families, including FAQs, “Facts for Families,” books, videos, practice parameters, research,
and getting help for depression; American Academy of Child & Adolescent Psychiatry.
Resources for Primary Care (AACAP)
A resource center for clinicians treating substance use disorders and mental health issues. Includes practice parameters,
a guide for integrating mental health care into the medical home, and information about policy and advocacy; American Academy
of Child & Adolescent Psychiatry.
Zero to Three
A national nonprofit organization that aims to promote the health and development of infants and toddlers, with information
and resources for parents and professionals. Information about parenting, development, learning, behavior, and well-being
of infants and toddlers. Includes video real-life examples, articles, and FAQs.
Resources for Clinicians for the Treatment of Depression (APA)
Treatment manuals, continuing education and other courses, training and professional organizations, case examples, and more;
American Psychological Association.
For Parents and Patients
Support
Children's Mental Health (MHA)
Policy, advocacy, information, and referral to maximize mental health for people of all ages; Mental Health America.
Depression (NAMI)
Explanations of treatment for various mental disorders, including depression, and suggestions for how to help yourself or
others who are struggling with mental health issues ; National Alliance on Mental Illness.
Teens & Young Adults (NAMI)
Focused information about adolescent depression, how to find help, and links to a teen mental health forum called Ok2Talk;
National Alliance on Mental Illness.
Depression in Children and Teens (AACAP)
Common symptoms of depression in children and teenagers; American Academy of Child and Adolescent Psychiatry.
Child and Adolescent Mental Health (NIMH)
Information about mental health conditions in children and adolescents, including a list of warning signs, featured videos,
and health hotlines; National Institute of Mental Health.
Childhood Depression: What Parents Need to Know (KidsHealth)
How to recognize depression in children, give support, and seek help.
National Alliance of Mental Illness (NAMI)
A national organization provides information and resources for families and professionals, including a helpline, local chapter
resources, and advocacy, links to state chapters, information about conferences, and links to additional resources.
When to Seek Help for Your Child with Depression (AACAP)
Warning signs by age; American Academy of Child and Adolescent Psychiatry.
Patient Education
Family Resources (AACAP)
Family education for disorders that include anxiety, autism, depression, conduct disorder, oppositional defiant disorder,
and more, Includes facts, videos, and a psychiatrist finder tool; American Academy of Child & Adolescent Psychiatry.
Tools
Beck Depression Inventory-II
A self-administered, 21-item, 10-minute screen for depression for ages 13 years and older; available in Spanish or English
for purchase.
Center for Epidemiologic Studies - Depression Scale (CES-D) ( 171 KB)
A free, self-administered, 20-item, 10-minute screen for depression for ages 14 years and older.
Center for Epidemiologic Studies Depression Scale Revised (CESD-R-20) ( 262 KB)
Self-report measure of depression with 8 different subscales.
Patient Health Questionnaire (PHQ) Screeners
Free screening tools in many languages with scoring instructions to be used by clinicians to help detect mental health disorders.
Select from right menu: PHQ, PHQ-9, GAD-7, PHQ-15, PHQ-SADS, Brief PHQ, PHQ-4, PHQ-8.
Preschool Feelings Checklist (PFC) ( 22 KB)
A 16-item parent report measure of depressive symptoms in young children.
Depression: Parents' Medication Guide (AACAP and APA) ( 1.2 MB)
Causes and symptoms of depression, suicide prevention, medications, psychosocial treatment, unproven treatments, and helping
the depressed child; American Academy of Child and Adolescent Psychiatry and the American Psychiatric Association.
Bright Futures in Practice: Mental Health—Volume II, Tool Kit
Comprehensive set of tools for clinicians and families; addresses mental health in various pediatric age groups; includes
a variety of resources, checklists, intake and assessment forms, and patient education materials.
Services for Patients & Families in New Mexico (NM)
Service Categories | # of providers* in: | NM | NW | Other states (4) (show) | | NV | OH | RI | UT |
---|---|---|---|---|---|---|---|---|---|
General Counseling Services | 3 | 1 | 209 | 1 | 30 | 371 | |||
Psychiatry/Medication Management | 2 | 49 | 79 | 56 | |||||
Social Workers | 8 | 12 |
For services not listed above, browse our Services categories or search our database.
* number of provider listings may vary by how states categorize services, whether providers are listed by organization or individual, how services are organized in the state, and other factors; Nationwide (NW) providers are generally limited to web-based services, provider locator services, and organizations that serve children from across the nation.
Studies
Depression in Children and Adolescents (ClinicalTrials.gov)
Studies looking at better understanding, diagnosing, and treating this condition; from the National Library of Medicine.
Helpful Articles
PubMed search for depression in children and adolescents, last two years
Cheung AH, Kozloff N, Sacks D.
Pediatric depression: an evidence-based update on treatment interventions.
Curr Psychiatry Rep.
2013;15(8):381.
PubMed abstract / Full Text
Maalouf FT, Brent DA.
Child and adolescent depression intervention overview: what works, for whom and how well?.
Child Adolesc Psychiatr Clin N Am.
2012;21(2):299-312, viii.
PubMed abstract
LeMoult J, Humphreys KL, Tracy A, Hoffmeister JA, Ip E, Gotlib IH.
Meta-analysis: Exposure to Early Life Stress and Risk for Depression in Childhood and Adolescence.
J Am Acad Child Adolesc Psychiatry.
2020;59(7):842-855.
PubMed abstract
Mendelson T, Tandon SD.
Prevention of Depression in Childhood and Adolescence.
Child Adolesc Psychiatr Clin N Am.
2016;25(2):201-18.
PubMed abstract
Wren FJ, Foy JM, Ibeziako PI.
Primary care management of child & adolescent depressive disorders.
Child Adolesc Psychiatr Clin N Am.
2012;21(2):401-19, ix-x.
PubMed abstract
Page Bibliography
American Academy of Child and Adolescent Psychiatry.
Practice parameter on the use of psychotropic medication in children and adolescents.
J Am Acad Child Adolesc Psychiatry.
2009;48(9):961-73.
PubMed abstract / Full Text
Evidence-based information about the appropriate and safe use of psychotropic medications in children and adolescents with
psychiatric disorders; emphasizes the best practice principles that underlie medication prescribing.
American Psychiatric Association.
Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR).
Fifth ed. Arlington, VA: American Psychiatric Association Publishing;
2022.
978-0-89042-579-4 https://psychiatry.org/psychiatrists/practice/dsm
American Psychiatric Association.
Diagnostic and Statistical Manual of Mental Disorders, DSM-5.
Fifth ed. Arlington, VA: American Psychiatric Association;
2013.
978-0-89042-554-1
American Psychiatric Association.
A Child’s Home Environment Can Impact the Risk of Developing Depression.
(2020)
https://www.psychiatry.org/newsroom/news-releases/a-child-s-home-envir.... Accessed on 3/20/2023.
Angold A, Costello EJ.
Puberty and depression.
Child Adolesc Psychiatr Clin N Am.
2006;15(4):919-37, ix.
PubMed abstract
Atkinson SD, Prakash A, Zhang Q, Pangallo BA, Bangs ME, Emslie GJ, March JS.
A double-blind efficacy and safety study of duloxetine flexible dosing in children and adolescents with major depressive disorder.
J Child Adolesc Psychopharmacol.
2014;24(4):180-9.
PubMed abstract
Avenevoli S, Swendsen J, He JP, Burstein M, Merikangas KR.
Major depression in the national comorbidity survey-adolescent supplement: prevalence, correlates, and treatment.
J Am Acad Child Adolesc Psychiatry.
2015;54(1):37-44.e2.
PubMed abstract / Full Text
Birmaher B, Brent D, Bernet W, Bukstein O, Walter H, Benson RS, Chrisman A, Farchione T, Greenhill L, Hamilton J, Keable H,
Kinlan J, Schoettle U, Stock S, Ptakowski KK, Medicus J.
Practice parameter for the assessment and treatment of children and adolescents with depressive disorders.
J Am Acad Child Adolesc Psychiatry.
2007;46(11):1503-26.
PubMed abstract
The most recent practice parameter on the diagnosis and treatment of depressive disorders in children and adolescents. Our
prevalence calculation roughly adjusts the cited age-specific prevalences for the age distribution in typical primary care
pediatric practice.
Bitsko RH, Holbrook JR, Ghandour RM, Blumberg SJ, Visser SN, Perou R, Walkup JT.
Epidemiology and Impact of Health Care Provider-Diagnosed Anxiety and Depression Among US Children.
J Dev Behav Pediatr.
2018;39(5):395-403.
PubMed abstract / Full Text
Boylan K, Romero S, Birmaher B.
Psychopharmacologic treatment of pediatric major depressive disorder.
Psychopharmacology (Berl).
2007;191(1):27-38.
PubMed abstract
Brent D, Emslie G, Clarke G, Wagner KD, Asarnow JR, Keller M, Vitiello B, Ritz L, Iyengar S, Abebe K, Birmaher B, Ryan N,
Kennard B, Hughes C, DeBar L, McCracken J, Strober M, Suddath R, Spirito A, Leonard H, Melhem N, Porta G, Onorato M, Zelazny
J.
Switching to another SSRI or to venlafaxine with or without cognitive behavioral therapy for adolescents with SSRI-resistant
depression: the TORDIA randomized controlled trial.
JAMA.
2008;299(8):901-13.
PubMed abstract / Full Text
Bridge JA, Iyengar S, Salary CB, Barbe RP, Birmaher B, Pincus HA, Ren L, Brent DA.
Clinical response and risk for reported suicidal ideation and suicide attempts in pediatric antidepressant treatment: a meta-analysis
of randomized controlled trials.
JAMA.
2007;297(15):1683-96.
PubMed abstract
Campbell PD, Miller AM, Woesner ME.
Bright Light Therapy: Seasonal Affective Disorder and Beyond.
Einstein J Biol Med.
2017;32:E13-E25.
PubMed abstract / Full Text
Carter T, Morres ID, Meade O, Callaghan P.
The Effect of Exercise on Depressive Symptoms in Adolescents: A Systematic Review and Meta-Analysis.
J Am Acad Child Adolesc Psychiatry.
2016;55(7):580-90.
PubMed abstract
Cheung AH, Zuckerbrot RA, Jensen PS, Laraque D, Stein REK.
Guidelines for Adolescent Depression in Primary Care (GLAD-PC): Part II. Treatment and Ongoing Management.
Pediatrics.
2018.
PubMed abstract
Connolly MD, Zervos MJ, Barone CJ 2nd, Johnson CC, Joseph CL.
The Mental Health of Transgender Youth: Advances in Understanding.
J Adolesc Health.
2016;59(5):489-495.
PubMed abstract
Costello EJ, Mustillo S, Erkanli A, Keeler G, Angold A.
Prevalence and development of psychiatric disorders in childhood and adolescence.
Arch Gen Psychiatry.
2003;60(8):837-44.
PubMed abstract / Full Text
Coutinho D, Farias AC, Felden EPG, Cordeiro ML.
ADHD Comorbid With Major Depression on Parents and Teachers Perceptions.
J Atten Disord.
2021;25(4):508-518.
PubMed abstract
Daviss WB, Bentivoglio P, Racusin R, Brown KM, Bostic JQ, Wiley L.
Bupropion sustained release in adolescents with comorbid attention-deficit/hyperactivity disorder and depression.
J Am Acad Child Adolesc Psychiatry.
2001;40(3):307-14.
PubMed abstract
Elmore AL, Crouch E.
The Association of Adverse Childhood Experiences With Anxiety and Depression for Children and Youth, 8 to 17 Years of Age.
Acad Pediatr.
2020;20(5):600-608.
PubMed abstract / Full Text
Emslie GJ, Heiligenstein JH, Wagner KD, Hoog SL, Ernest DE, Brown E, Nilsson M, Jacobson JG.
Fluoxetine for acute treatment of depression in children and adolescents: a placebo-controlled, randomized clinical trial.
J Am Acad Child Adolesc Psychiatry.
2002;41(10):1205-15.
PubMed abstract
Emslie GJ, Prakash A, Zhang Q, Pangallo BA, Bangs ME, March JS.
A double-blind efficacy and safety study of duloxetine fixed doses in children and adolescents with major depressive disorder.
J Child Adolesc Psychopharmacol.
2014;24(4):170-9.
PubMed abstract / Full Text
Emslie GJ, Ventura D, Korotzer A, Tourkodimitris S.
Escitalopram in the treatment of adolescent depression: a randomized placebo-controlled multisite trial.
J Am Acad Child Adolesc Psychiatry.
2009;48(7):721-729.
PubMed abstract
Emslie GJ, Wagner KD, Kutcher S, Krulewicz S, Fong R, Carpenter DJ, Lipschitz A, Machin A, Wilkinson C.
Paroxetine treatment in children and adolescents with major depressive disorder: a randomized, multicenter, double-blind,
placebo-controlled trial.
J Am Acad Child Adolesc Psychiatry.
2006;45(6):709-719.
PubMed abstract
Fergusson DM, Horwood LJ, Ridder EM, Beautrais AL.
Subthreshold depression in adolescence and mental health outcomes in adulthood.
Arch Gen Psychiatry.
2005;62(1):66-72.
PubMed abstract
Findling RL, DelBello MP, Zuddas A, Emslie GJ, Ettrup A, Petersen ML, Schmidt SN, Rosen M.
Vortioxetine for Major Depressive Disorder in Adolescents: 12-Week Randomized, Placebo-Controlled, Fluoxetine-Referenced,
Fixed-Dose Study.
J Am Acad Child Adolesc Psychiatry.
2022;61(9):1106-1118.e2.
PubMed abstract
Flint J, Kendler KS.
The genetics of major depression.
Neuron.
2014;81(3):484-503.
PubMed abstract / Full Text
Freeman J, Benito K, Herren J, Kemp J, Sung J, Georgiadis C, Arora A, Walther M, Garcia A.
Evidence Base Update of Psychosocial Treatments for Pediatric Obsessive-Compulsive Disorder: Evaluating, Improving, and Transporting
What Works.
J Clin Child Adolesc Psychol.
2018;47(5):669-698.
PubMed abstract
Gibbons RD, Hur K, Bhaumik DK, Mann JJ.
The relationship between antidepressant prescription rates and rate of early adolescent suicide.
Am J Psychiatry.
2006;163(11):1898-904.
PubMed abstract
Hammad TA, Laughren T, Racoosin J.
Suicidality in pediatric patients treated with antidepressant drugs.
Arch Gen Psychiatry.
2006;63(3):332-9.
PubMed abstract
Hazell P, Mirzaie M.
Tricyclic drugs for depression in children and adolescents.
Cochrane Database Syst Rev.
2013(6):CD002317.
PubMed abstract / Full Text
Hinckley JD, Riggs P.
Integrated Treatment of Adolescents with Co-occurring Depression and Substance Use Disorder.
Child Adolesc Psychiatr Clin N Am.
2019;28(3):461-472.
PubMed abstract
Jane Garland E, Kutcher S, Virani A, Elbe D.
Update on the Use of SSRIs and SNRIs with Children and Adolescents in Clinical Practice.
J Can Acad Child Adolesc Psychiatry.
2016;25(1):4-10.
PubMed abstract / Full Text
Keller MB, Ryan ND, Strober M, Klein RG, Kutcher SP, Birmaher B, Hagino OR, Koplewicz H, Carlson GA, Clarke GN, Emslie GJ,
Feinberg D, Geller B, Kusumakar V, Papatheodorou G, Sack WH, Sweeney M, Wagner KD, Weller EB, Winters NC, Oakes R, McCafferty
JP.
Efficacy of paroxetine in the treatment of adolescent major depression: a randomized, controlled trial.
J Am Acad Child Adolesc Psychiatry.
2001;40(7):762-72.
PubMed abstract
Kim P, Swain JE.
Sad dads: paternal postpartum depression.
Psychiatry (Edgmont).
2007;4(2):35-47.
PubMed abstract / Full Text
Korczak DJ, Madigan S, Colasanto M.
Children's Physical Activity and Depression: A Meta-analysis.
Pediatrics.
2017;139(4).
PubMed abstract
Kupfer DJ, Frank E, Phillips ML.
Major depressive disorder: new clinical, neurobiological, and treatment perspectives.
Lancet.
2012;379(9820):1045-55.
PubMed abstract / Full Text
Lohoff FW.
Overview of the genetics of major depressive disorder.
Curr Psychiatry Rep.
2010;12(6):539-46.
PubMed abstract / Full Text
Luby JL, Belden AC, Jackson JJ, Lessov-Schlaggar CN, Harms MP, Tillman R, Botteron K, Whalen D, Barch DM.
Early Childhood Depression and Alterations in the Trajectory of Gray Matter Maturation in Middle Childhood and Early Adolescence.
JAMA Psychiatry.
2016;73(1):31-8.
PubMed abstract / Full Text
Luby JL, Heffelfinger AK, Mrakotsky C, Brown KM, Hessler MJ, Wallis JM, Spitznagel EL.
The clinical picture of depression in preschool children.
J Am Acad Child Adolesc Psychiatry.
2003;42(3):340-8.
PubMed abstract
March J, Silva S, Petrycki S, Curry J, Wells K, Fairbank J, Burns B, Domino M, McNulty S, Vitiello B, Severe J.
Fluoxetine, cognitive-behavioral therapy, and their combination for adolescents with depression: Treatment for Adolescents
With Depression Study (TADS) randomized controlled trial.
JAMA.
2004;292(7):807-20.
PubMed abstract
March JS, Silva S, Petrycki S, Curry J, Wells K, Fairbank J, Burns B, Domino M, McNulty S, Vitiello B, Severe J.
The Treatment for Adolescents With Depression Study (TADS): long-term effectiveness and safety outcomes.
Arch Gen Psychiatry.
2007;64(10):1132-43.
PubMed abstract
Merikangas KR, Avenevoli S, Costello EJ, Koretz D, Kessler RC.
National comorbidity survey replication adolescent supplement (NCS-A): I. Background and measures.
J Am Acad Child Adolesc Psychiatry.
2009;48(4):367-379.
PubMed abstract / Full Text
Mieloo C, Raat H, van Oort F, Bevaart F, Vogel I, Donker M, Jansen W.
Validity and reliability of the strengths and difficulties questionnaire in 5-6 year olds: differences by gender or by parental
education?.
PLoS One.
2012;7(5):e36805.
PubMed abstract / Full Text
Miller L, Campo JV.
Depression in Adolescents.
N Engl J Med.
2021;385(5):445-449.
PubMed abstract
Mitchison GM, Njardvik U.
Prevalence and Gender Differences of ODD, Anxiety, and Depression in a Sample of Children With ADHD.
J Atten Disord.
2019;23(11):1339-1345.
PubMed abstract
Molendijk M, Molero P, Ortuño Sánchez-Pedreño F, Van der Does W, Angel Martínez-González M.
Diet quality and depression risk: A systematic review and dose-response meta-analysis of prospective studies.
J Affect Disord.
2018;226:346-354.
PubMed abstract
Moraczewski J, Aedma KK.
Tricyclic Antidepressants.
StatPearls [Internet].
2022.
PubMed abstract
Mullen S.
Major depressive disorder in children and adolescents.
Ment Health Clin.
2018;8(6):275-283.
PubMed abstract / Full Text
Nussbaumer-Streit B, Forneris CA, Morgan LC, Van Noord MG, Gaynes BN, Greenblatt A, Wipplinger J, Lux LJ, Winkler D, Gartlehner
G.
Light therapy for preventing seasonal affective disorder.
Cochrane Database Syst Rev.
2019;3(3):CD011269.
PubMed abstract / Full Text
Parker GB, Brotchie H, Graham RK.
Vitamin D and depression.
J Affect Disord.
2017;208:56-61.
PubMed abstract
Parmar A, Esser K, Barreira L, Miller D, Morinis L, Chong YY, Smith W, Major N, Church P, Cohen E, Orkin J.
Acceptance and Commitment Therapy for Children with Special Health Care Needs and Their Parents: A Systematic Review and Meta-Analysis.
Int J Environ Res Public Health.
2021;18(15).
PubMed abstract / Full Text
Riley M, Ahmed S, Locke A.
Common Questions About Oppositional Defiant Disorder.
Am Fam Physician.
2016;93(7):586-91.
PubMed abstract
Roberts RE, Duong HT.
The prospective association between sleep deprivation and depression among adolescents.
Sleep.
2014;37(2):239-44.
PubMed abstract / Full Text
Rodriguez-Ayllon M, Cadenas-Sánchez C, Estévez-López F, Muñoz NE, Mora-Gonzalez J, Migueles JH, Molina-García P, Henriksson
H, Mena-Molina A, Martínez-Vizcaíno V, Catena A, Löf M, Erickson KI, Lubans DR, Ortega FB, Esteban-Cornejo I.
Role of Physical Activity and Sedentary Behavior in the Mental Health of Preschoolers, Children and Adolescents: A Systematic
Review and Meta-Analysis.
Sports Med.
2019;49(9):1383-1410.
PubMed abstract
Roohafza H, Pourmoghaddas Z, Saneian H, Gholamrezaei A.
Citalopram for pediatric functional abdominal pain: a randomized, placebo-controlled trial.
Neurogastroenterol Motil.
2014;26(11):1642-50.
PubMed abstract
Sabri MA, Saber-Ayad MM.
MAO Inhibitors.
StatPearls [Internet].
2022.
PubMed abstract
Sarris J, Byrne GJ, Stough C, Bousman C, Mischoulon D, Murphy J, Macdonald P, Adams L, Nazareth S, Oliver G, Cribb L, Savage
K, Menon R, Chamoli S, Berk M, Ng CH.
Nutraceuticals for major depressive disorder- more is not merrier: An 8-week double-blind, randomised, controlled trial.
J Affect Disord.
2019;245:1007-1015.
PubMed abstract
Siu AL.
Screening for Depression in Children and Adolescents: US Preventive Services Task Force Recommendation Statement.
Pediatrics.
2016;137(3):e20154467.
PubMed abstract
Stringaris A, Maughan B, Copeland WS, Costello EJ, Angold A.
Irritable mood as a symptom of depression in youth: prevalence, developmental, and clinical correlates in the Great Smoky
Mountains Study.
J Am Acad Child Adolesc Psychiatry.
2013;52(8):831-40.
PubMed abstract / Full Text
Tordoff DM, Wanta JW, Collin A, Stepney C, Inwards-Breland DJ, Ahrens K.
Mental Health Outcomes in Transgender and Nonbinary Youths Receiving Gender-Affirming Care.
JAMA Netw Open.
2022;5(2):e220978.
PubMed abstract / Full Text
US Food and Drug Administration.
Suicidality in Children and Adolescents Being Treated With Antidepressant Medications.
Drug Safety and Availability.
2018.
/ Full Text
Wagner KD, Ambrosini P, Rynn M, Wohlberg C, Yang R, Greenbaum MS, Childress A, Donnelly C, Deas D.
Efficacy of sertraline in the treatment of children and adolescents with major depressive disorder: two randomized controlled
trials.
JAMA.
2003;290(8):1033-41.
PubMed abstract
Wagner KD, Jonas J, Findling RL, Ventura D, Saikali K.
A double-blind, randomized, placebo-controlled trial of escitalopram in the treatment of pediatric depression.
J Am Acad Child Adolesc Psychiatry.
2006;45(3):280-8.
PubMed abstract
Walkup JT.
Antidepressant Efficacy for Depression in Children and Adolescents: Industry- and NIMH-Funded Studies.
Am J Psychiatry.
2017;174(5):430-437.
PubMed abstract
Walsh TB, Davis RN, Garfield C.
A Call to Action: Screening Fathers for Perinatal Depression.
Pediatrics.
2020;145(1).
PubMed abstract
Walter HJ, Abright AR, Bukstein OG, Diamond J, Keable H, Ripperger-Suhler J, Rockhill C.
Clinical Practice Guideline for the Assessment and Treatment of Children and Adolescents With Major and Persistent Depressive
Disorders.
J Am Acad Child Adolesc Psychiatry.
2022.
PubMed abstract
Weihs KL, Murphy W, Abbas R, Chiles D, England RD, Ramaker S, Wajsbrot DB.
Desvenlafaxine Versus Placebo in a Fluoxetine-Referenced Study of Children and Adolescents with Major Depressive Disorder.
J Child Adolesc Psychopharmacol.
2018;28(1):36-46.
PubMed abstract / Full Text
Whalen DJ, Sylvester CM, Luby JL.
Depression and Anxiety in Preschoolers: A Review of the Past 7 Years.
Child Adolesc Psychiatr Clin N Am.
2017;26(3):503-522.
PubMed abstract / Full Text
Zuckerbrot RA, Cheung A, Jensen PS, Stein REK, Laraque D.
Guidelines for Adolescent Depression in Primary Care (GLAD-PC): Part I. Practice Preparation, Identification, Assessment,
and Initial Management.
Pediatrics.
2018.
PubMed abstract
Zwank MD, Rupp PE, Salzman JG, Gudjonsson HP, LeFevere RC, Isenberger KM.
Elimination of Routine Screening Laboratory Tests for Psychiatric Admission: A Quality Improvement Initiative.
Psychiatr Serv.
2020;71(12):1252-1259.
PubMed abstract