Clinical Profile of Childhood Onset Depression Presenting to Child Adolescent and Family Services in Northampton

Abstract

Background: The clinical profile of depressive disorder in children and young people in Child Adolescent and Family Services (CAFS), Northampton was studied. Methods: Twenty-five patients who had attended the CAFS over a period of 2 years were analysed retrospectively. Results: The age range of subjects was 8 to 19 years. Majority of patients were in their GCSE (secondary) or A level (higher secondary) courses. In 44% of cases the biological parents of the patients were not living together. Family conflict could be detected in more than half of the subjects. Alcohol related problems were present in one fourth of subjects. Bullying was the most common pattern of child abuse. Physical and sexual abuse was more common in the females than in the males. Almost half of the patients had history of one or more episodes of self-harm. Family history of mental illness, mostly depression, was present in 48% of patients. Most commonly used non-pharmacological interventions were individual psychotherapy and counselling. However in one fourth of patients no psychological intervention was used. Fluoxetine was the most commonly used medication. Frequency of follow-ups ranged from once weekly to once every three monthly. Conclusions: This study suggests that cumulative adverse experiences like high stress level of the GCSE and A level examinations, marital disharmony between parents, stressful family environment etc. singly or together increase the risk of depression in children and young people. It also suggests that parental depression is one of the risk factors associated with depression in this age group. This study also indicates that prescribing antidepressants without any psychological intervention is still a common practice and also that the patients on medication should be followed up more frequently than what is commonly done.