- General term that includes major depressive disorder (MDD), persistent depressive disorder (dysthymic disorder), depression associated with bipolar disorder, disruptive mood dysregulation disorder and adjustment disorder with depressed mood
- Syndrome of persistent sadness or irritability associated with a variety of symptoms, resulting in functional impairment in the following:
- Interpersonal (family, friends) relationships
- Health (somatic complaints, unhealthy habits)
- Work or school (task completion, grades)
- Safety (high-risk behaviors including suicide)
- 12-month prevalence of MDD: 7.5% of adolescents (age 13 to 18 years), 3–4% in younger children
- Lifetime prevalence: 11% will have diagnosable depression by adolescence.
- Ratio of females to males: 1:1 in school-aged children, 2:1 in adolescents
- Often chronic with high rate of recurrence and comorbidity with other psychiatric disorders
- <45% of affected individuals receive disorder-specific care.
- Family history of depression, bipolar disorder, suicidal behavior in 1st-degree relative
- Personal history of anxiety disorders, ADHD, learning disabilities, and conduct problems
- Prior depressive episodes
- Family dysfunction or caregiver–child conflict
- Negative style of interpreting events and coping with stress
- Substance abuse
- Exposure to adversity (e.g., victim of abuse, bullying)
- Chronic illness (including obesity)
- Not everyone with exposure to adversity or chronic illness will go on to have MDD (some moderators are resilience and response to treatment).
Commonly Associated Conditions
40–70% of children and adolescents with depression have comorbid psychiatric disorders:
- Anxiety disorders
- Somatization disorders
- Disruptive behavioral disorders (e.g., oppositional defiant and conduct disorders)
- Eating disorders
- Substance abuse
- Physical or sexual abuse
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