Childhood and adolescent depression: a review of the past 10 years. Part II.
OBJECTIVE
To review the literature of the past decade covering the assessment, treatment, and prevention of early-onset major depressive disorder (MDD) and dysthymic disorder (DD).


METHODS
A computerized search for articles published during the past decade was made, and selected studies are presented.


RESULTS
Diagnostic systems and standardized interviews have been developed to reliably assess and diagnose early-onset MDD and DD. To data, few controlled psychotherapeutic trials, in particular cognitive-behavioral therapy (CBT), and one study using fluoxetine have been shown to be efficacious in the acute management of early-onset MDD. While studies of tricyclic antidepressants have shown no difference between medication and placebo, these studies are inconclusive because of the inclusion of small samples and other methodological issues. CBT may also be useful for the prevention of MDD. No studies have been published on maintenance treatment of MDD or the treatment of early-onset DD.


CONCLUSIONS
It appears that both pharmacological and psychotherapeutic interventions have a role in the acute treatment of MDD. However, further research on the separate and combined efficacy of these treatments for the acute treatment, maintenance, and prevention of early-onset MDD and DD is needed. The impact of comorbidity and psychosocial consequences of early-onset depression also emphasize the importance of utilizing a multimodal approach to treatment.
Birmaher
B
B
Department of Psychiatry, Western Psychiatric Institute and Clinic, School of Medicine, University of Pittsburgh, PA 15213, USA.
Ryan
N D
ND
Williamson
D E
DE
Brent
D A
DA
Kaufman
J
J
D000293:Adolescent; D017668:Age of Onset; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D002648:Child; D003866:Depressive Disorder / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy; D019263:Dysthymic Disorder / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy; D006801:Humans; D011613:Psychotherapy / Q000379:methods; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use
D000929:Antidepressive Agents, Tricyclic; D017367:Selective Serotonin Reuptake Inhibitors