title: Depression in childhood and adolescence.
abstract: OBJECTIVE
  To review recent evidence on child and adolescent depression.
  
  
  METHODS
  Narrative review.
  
  
  RESULTS
  Rates of unipolar depression are low before puberty, but rise from the early teens, especially among girls. Concurrent comorbidity with both disruptive and emotional disorders is common, especially among younger children; across age, youth depression may be preceded by both anxiety and disruptive behaviour disorders, and increase risk for alcohol problems. Adolescent depression is associated with a range of adverse later outcomes including suicidality, problems in social functioning and poor physical and mental health. Across development, a family history of depression and exposure to stressful life events are the most robust risk factors for depression. Familial transmission involves both psychosocial and heritable processes; genetic and environmental influences also combine to influence risk. Neurocognitive and neuroendocrine pathways have been established, but contributors to the adolescent rise in risk, and the female preponderance later in development, remain to be clarified. Depressed youth benefit from psychological therapy or antidepressant medication or their combination; however, treatment effects are moderate.
  
  
  CONCLUSIONS
  Despite considerable progress in understanding developmental trajectories to depression, more needs to be done to identify disease mechanisms that may serve as intervention targets early in the life course.
authors: MRC Social, Genetic and Developmental Psychiatry Centre, King's College London Institute of Psychiatry, London, United Kingdom.
authors: Barbara
authors: B
authors: Maughan
authors: Stephan
authors: S
authors: Collishaw
authors: Argyris
authors: A
authors: Stringaris
keywords: adolescence; aetiology; anti-depressant; depression; epidemiology
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