W HEN ONE examines most textbooks on child psychiatry, he finds little or no mention of depressions in childhood. As an example, in the third edition of Child Psychiatry (1957) by Leo Kanner, the word "depression" is neither listed in the table of contents nor in the index of this otherwise excellent text. This is surprising since all psychiatrists have seen depressed children. As a matter of fact, with growing experience and awareness of this condition, such a diagnosis is being made more often. In this paper, I will explore the concepts of depression in childhood and adolescence and, through the use of clinical examples, develop means for a more effective diagnosis of this condition with the hope that early identification can lead to the prevention of some of the disabling depressions of adults. Let us first recall what the classical clinical picture of depression in adults is. Dr. Hans Lehmann 1 describes it very well: "Fortunately there has always been agreement about the phenomena that characterize the psychiatric condition which we call depression or melancholia. The characteristic symptoms are a sad or despairing mood, decrease of mental productivity and a reduction of drive, retardation or agitation in the field of expressive motor responses. These might be called the primary symptoms of depression. The group of secondary symptoms comprises feelings of hopelessness, hypochondriacal preoccupation, feelings of depersonalization, obsessive and compulsive behavior, ideas of self-accusation, nihilistic delusions, paranoid delusions, hallucinations, suicidal rumination and tendencies. Insomnia, anorexia and weight loss are usually associated with depressive states. . . The sad, despairing emotional state and depressive mood seem to constitute the real core of all depressions..." The foregoing excellent clinical description of depression is rarely seen in childhood; if we were to diagnose depressive illness in children using Dr. Lehmann's definition, we would be talking about very few children. Perhaps this accounts for the paucity of interest in depression shown by the writers of texts on child psychiatry. Yet, there is a growing awareness that depression in children does exist much more commonly than heretofore expressed. In 1959, at Cambridge, England, a symposium on depression 2 was held. I have selected a few quotations concerning children and adolescents. Dr. Glennie z said: "I think depressions in children occur quite frequently in the illnesses of children though it is hard to find straightforward evidence of the single symptom of depression. The picture in children is usually less clear-cut; anxiety seems to play a more obvious part." Later in this symposium Dr. Glennie state#: "I think I see depressive states in children though I cannot at present correlate them with what is seen in adults or understand them in isolation, that is, without considering the attitudes of the children towards their parents or vice versa." Dr. Burns, in the same conference, statesS: "Depressions in small children are more common than previously thought because they can present themselves in many different ways. An intelligent boy of ten, for example, began to fail in school, but I had no doubt he was depressed... In looking back I can think of many other cases in which children