Adolescent depression: a review.
OBJECTIVE
To review the characteristic clinical, illness course and risk factors to adolescent depression.


METHODS
A literature review is provided with interpretive comments.


RESULTS
The clinical feature profile is likely to reflect the rarity of melancholic depression, while the non-melancholic "irritable hostile" pattern appears distinctly increased. A "reactive depressive disorder" is rare in those who get to psychiatric assessment, while comorbidity (e.g. anxiety and personality disorders, illicit drug use) is the rule. Aetiological determinants and the prognosis generally more relate to comorbid factors than to depression per se. Predisposing and precipitating psychological and social determinants are considered, while the efficacies of varying antidepressant strategies remain unclear apart from those with an "anxious" or "irritable" depression where selective serotonin re-uptake inhibitor medication has shown utility and where cognitive-behavioural therapy may be relevant.


CONCLUSIONS
For the majority who develop adolescent depression, its expression and outcome appear more a reflection of the propagating determinants, most commonly anxiety and personality style. The clinician should determine a treatment plan that not only addresses the depression but which identifies and addresses the contributing features.
Parker
G
G
Mood Disorders Unit, School of Psychiatry, Prince of Wales Hospital, Randwick, New South Wales 2031, Australia. g.parker@unsw.edu.au
Roy
K
K
D000293:Adolescent; D001007:Anxiety / Q000453:epidemiology; D001315:Australia / Q000453:epidemiology; D015897:Comorbidity; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D003937:Diagnosis, Differential; D020022:Genetic Predisposition to Disease; D006801:Humans; D010554:Personality Disorders / Q000453:epidemiology; D000297:Psychology, Adolescent; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000453:epidemiology