Researchers Probe Depression in Children

Abstract

FOR MORE THAN TWO DECADES, childhood depression has presented researchers and clinicians with some of the most fascinating and anxiety-provoking questions in the fields of psychiatric and psychological research. Some, like whether prepubertal youth are even capable of being depressed and successfully treated, have been answered with a resounding “yes.” Others, like the impact of long-term antidepressant use on the developing brain, remain for the future frontiers of research. According to epidemiological studies, about 2.5% of prepubertal children and up to 8.3% of adolescents in the United States have depression (J Am Acad Child Adolesc Psychiatry. 1996; 35:1427-1439). But surprisingly, it wasn’t until the late 1970s, through pioneering studies of researchers such as the late Joachim Puig-Antich, MD, of the Western Psychiatric Institute and Clinic in Pittsburgh, Pa, that groundbreaking findings demonstrated that children do, indeed, possess a strong enough concept of “self” to experience such feelings as guilt, which is a central component of depression. Puig-Antich developed a medical model for assessing depression in children that involved direct interviews with the children themselves rather than observing how they play. “Children were asked about symptoms, whether they feel sad, if they cry, and if they feel guilty—it was revolutionary when the kids were interviewed directly,” explains Barbara Geller, MD, professor of psychiatry at Washington University in St Louis, Mo. “With that came the recognition that children, even the very young, can have serious, major depression the same as adults.” Since then, researchers have attempted to determine whether depression in children really is the same disorder as in adolescents and adults, or if there are important differences. What they are finding is a mixed picture. Although the basic underpinnings—the fact that both environmental and biological factors play a role—are the same, some notable differences (including dif-