Depression in children

Sadness is common in children but depression, although not as common, does occur and is characterised by feelings of helplessness, worthlessness and despair. Parents and doctors both tend to be unaware of depression in children. 5

Major depression in children and adolescents may be diagnosed using the same criteria as for adults, namely loss of interest in usual activities and the presence of a sad or irritable mood, persisting for 2 weeks or more. 6 The other constellation of depressive symptoms including somatic complaints may be present. Examples include difficulty in getting to sleep, not enjoying meals, poor concentration and low self-esteem. It can present as antisocial behaviour or as a separation anxiety, e.g. school refusal. Although suicidal thoughts are common, suicide is rare before adolescence. Depressed adolescents are a serious suicide risk. Referral of these patients to an experienced child psychiatrist is advisable.

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