Practice parameter for the assessment and treatment of children and adolescents with depressive disorders
Open accessAbstract
This practice parameter describes the epidemiology, clinical picture, differential diagnosis, course, risk factors, and pharmacological and psychotherapy treatments of children and adolescents with major depressive or dysthymic disorders. Side effects of the antidepressants, particularly the risk of suicidal ideation and behaviors are discussed. Recommendations regarding the assessment and the acute, continuation, and maintenance treatment of these disorders are based on the existent scientific evidence as well as the current clinical practice.
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Some adolescents with depression may have difficulty verbalizing feelings or may deny being depressed or suicidal.
“Notably, some adolescents with depression may have difficulty in verbalizing their feelings or may deny that they are depressed or suicidal.”
From Adolescent Suicide—Understanding Unique Risks and Opportunities for Trauma Centers to Recognize, Intervene, and Prevent a Leading Cause of Death (2022) · cites this paper as [54]
Evaluation Recommendation 3 says children may have difficulty verbalizing their feelings or may deny being depressed, in the context of assessing children and adolescents. The paper recommends assessing suicidality in Recommendation 4, but the passages do not say that adolescents may deny being suicidal; that part of the claim is unsupported. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThese adolescents may instead present with mood lability, irritability, low frustration tolerance, temper tantrums or agitation, somatic complaints, and/or social withdrawal.
“They may instead present with mood lability, irritability, low frustration tolerance, temper tantrums or agitation, somatic complaints, and/or social withdrawal instead of verbalizing feelings of depression [54].”
From Adolescent Suicide—Understanding Unique Risks and Opportunities for Trauma Centers to Recognize, Intervene, and Prevent a Leading Cause of Death (2022) · cites this paper as [54]
The Clinical Presentation passage lists mood lability, irritability, low frustration tolerance, temper tantrums, somatic complaints, and social withdrawal instead of verbalizing depression. It describes this presentation in children, not specifically adolescents, and does not include agitation in that list. No page number is supplied for the passage. (LLM, conf=0.88)
Experimental — accuracy not yet measuredOf these, 4 (19%) included a specific statement on the risk of misinterpreting withdrawal symptoms as depressive relapse.
“and of these, 4 (19%) included a specific statement on the risk of misinterpreting withdrawal symptoms as depressive relapse, stating that withdrawal symptoms may ‘mimic’, 48 ‘be misdiagnosed as’, 2 ‘mistaken for’ 28 or ‘be hard to distinguish from’ 36 relapse of depressive symptoms.”
From Clinical practice guideline recommendations on tapering and discontinuing antidepressants for depression: a systematic review (2022) · cites this paper as [48]
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BackgroundExamining minor and major depression in adolescents
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- Authors
- Birmaher, B., & Brent, D.
- Affiliations
- American Academy of Child and Adolescent Psychiatry (US)
- Venue
- Journal of the American Academy of Child & Adolescent Psychiatry
- Publisher
- Elsevier BV
- Published
- 2007-11
- Volume
- 46
- Issue
- 11
- Pages
- 1503-1526
- ISSN
- 0890-8567 (ISSN-L)
- OpenAlex
- W2183950985
- Semantic Scholar
- 42b220335baa2b314a2a3a142582b8f46bc2c17b
- Cited by
- 1,056
- References
- 190
- Citations by year
- 2026: 19 · 2025: 44 · 2024: 55 · 2023: 46 · 2022: 48 · 2021: 113 · 2020: 69 · 2019: 44 · 2018: 68 · 2017: 54 · 2016: 69 · 2015: 50 · 2014: 59 · 2013: 59 · 2012: 54
- FWCI
- 29.39
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Disorders
- Keywords
- childhood depression, adolescent depression, major depressive disorder, dysthymia, antidepressant side effects, suicidal ideation, suicidal behavior, differential diagnosis, risk factors, course of depression, psychotherapy, pharmacotherapy, maintenance therapy, continuation treatment, acute treatment, clinical evaluation
- MeSH terms
- Adolescent, Child, Child, Preschool, Depressive Disorder, Major, Major Depressive Disorder, Female, Humans, Male, Practice Patterns, Physicians', Psychotic Disorders, Prevalence
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