When meeting with all patients, please consider the following:
Many children have times when they are sad or down. Occasional sadness is a normal part of growing up. However, if children are sad, irritable, or no longer enjoy things, and this occurs day after day, it may be a sign that they are suffering from major depressive disorder, commonly known as depression.
However, not all children/adolescents show depression in the same way. They may not look depressed in a typical fashion but still may be depressed. Depressed mood may be attributable to other causes such as bullying, gender dysphoria, abuse or neglect.
Some people believe that only adults become depressed. In fact, children can experience depression, and studies show that it is on the rise. More than 1 in 7 teens experience depression each year.
Common symptoms of depression in children include:
- Feeling or appearing depressed, sad, tearful, or irritable
- Not enjoying things as much as they used to
- Spending less time with friends or in after school activities
- Changes in appetite and/or weight
- Sleeping more or less than usual
- Feeling tired or having less energy
- Feeling like everything is their fault or they are not good at anything
- Having more trouble concentrating
- Caring less about school or not doing as well in school
- Having thoughts of suicide or wanting to die
- Children also may have more physical complaints, such as frequent headaches or stomach aches.
- Depressed adolescents may use alcohol or other drugs as a way of trying to feel better.
Guidelines
- AAP Guidelines for Adolescent Depression in Primary Care (GLAD-PC): Identification, Assessment, and Initial Management
- AAP Guidelines for Adolescent Depression in Primary Care (GLAD-PC): Treatment and Ongoing Management
- GLAD-PC Toolkit for Screening, Diagnosing, Treating, and Monitoring Adolescent Depression in the Primary Care Setting AACAP Practice Parameter for the Assessment and Treatment of Children and Adolescents with Depressive Disorders Florida Best Practice Medication Guidelines 07: Depression Under 6 Years - Treatment Flowchart
Screening
Pediatric Symptom Checklist and Pediatric Symptom Checklist Youth Report (PSC and Y-PSC)
- Screens for cognitive, emotional, and behavioral problems
- 4-16 years
- 35 items
- Parent and youth complete questionnaires
- 5-10 minutes for parent/youth to complete, brief time for staff to score
- Free
Strengths and Difficulties Questionnaire (SDQ)
- Assesses positive and negative attributes on five scales (emotional, conduct, hyperactivity, peer problems, and social behavior)
- Emotional symptoms scale addresses depressive and anxiety symptoms
- Self-report for adolescents, ages 11-17 years; teacher and parent versions, ages 4-10 years and 11-17 years
- Available in 46 languages
- 5-15 minutes to complete
- Free
Rating Scales
Patient Health Questionnaire-9 (PHQ-9)
- Tool specific to depression; scores each of the nine DSM-IV criteria
- 18+ years
- Available in 16 languages
- 5 minutes for youth to complete; brief time for staff to score
- Useful for diagnosis and tracking response to treatment
- Free
Columbia DISC Depression Scale (Teen and Parent Version)
- Covers all major mental health diagnoses; teen scale covers suicide ideation
- Ages 11 years and over
- Parent report: 22 yes/no questions; teen report: 22 yes/no questions
- About 5 minutes for teen to complete; about 5 minutes for parent to complete; brief time for staff to score
- Free
Parent Information and Handouts
- Medication Guide for Treating Depression
- AACAP Facts for Families: The Depressed Child
- AAP Depression and Suicide Web Page - This site contains brochures, fact sheets, and quick facts regarding depression and suicide
- National Alliance for the Mentally Ill (NAMI): 'About Mental Illness: Major Depression'
- American Family Physician: What to Do If You Think Your Child Is Depressed
The Depression and Bipolar Support Alliance has printable materials that may be downloaded and printed. These include pediatric bipolar fact sheets and information.
For extensive family information including parent guides visit the Families for Depression Awareness at www.familyaware.org