title: Major Depressive Disorder Among Preadolescent Canadian Children: Rare Disorder or Rarely Detected?
abstract: Despite agreement that preadult onset of depression is associated with greater illness severity, and that children can meet the diagnostic criteria for major depressive disorder (MDD), few studies have examined the presentation of MDD among young children. This is the first nationwide study of MDD among preadolescent children in Canada.
  
  
  
  Pediatrician members (2500) of a Canadian pediatric surveillance network were surveyed monthly over 3 years to report new cases of MDD among 5- to 12-year-olds. Survey response and questionnaire completion rates were 80% and 85%, respectively. Symptom presentation and duration, impairment, medical and psychiatric history, and management were reported.
  
  
  
  Twenty-nine new cases of MDD were identified by pediatricians. Of these, 23 (79%) experienced symptoms for >6 months before presentation with global functional impairment. Parental depression or anxiety, commonly maternal, was present in 21 cases (72%). Twenty-two children (76%) reported suicidal ideation; 6 (21%) had attempted suicide. Twenty-three children (79%) were treated with medication. Thirteen children (45%) were treated with 2 or more medications.
  
  
  
  Children with MDD frequently had a parental history of mood disorders, experienced long-standing symptom presence, high symptom burden and functional impairment prior to presentation; and commonly treatment with polypharmacy.
authors.affiliation: Department of Psychiatry, University of Toronto, Toronto, Ontario; The Hospital for Sick Children, Toronto, Ontario. Electronic address: daphne.korczak@sickkids.ca.
authors.forename: Daphne J
authors.initials: DJ
authors.lastname: Korczak
authors.affiliation: Dalla Lana School of Public Health, Toronto, Ontario; Bloomberg Faculty of Nursing, Toronto, Ontario.
authors.forename: Marianna
authors.initials: M
authors.lastname: Ofner
authors.affiliation: Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia.
authors.forename: John
authors.initials: J
authors.lastname: LeBlanc
authors.affiliation: Stanton Hospital, Yellowknife, Northwest Territories; Department of Pediatrics, University of Alberta, Edmonton, Alberta.
authors.forename: Sam
authors.initials: S
authors.lastname: Wong
authors.affiliation: Department of Pediatrics, University of Toronto, Toronto, Ontario; The Hospital for Sick Children, Toronto, Ontario.
authors.forename: Mark
authors.initials: M
authors.lastname: Feldman
authors.affiliation: Department of Pediatrics, University of Toronto, Toronto, Ontario; The Hospital for Sick Children, Toronto, Ontario; Dalla Lana School of Public Health, Toronto, Ontario.
authors.forename: Patricia C
authors.initials: PC
authors.lastname: Parkin
mesh_terms: D000928:Antidepressive Agents / Q000627:therapeutic use; D001007:Anxiety / Q000523:psychology; D002170:Canada / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003863:Depression / Q000523:psychology; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D010290:Parents / Q000523:psychology; D015995:Prevalence; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires
chemical_list: D000928:Antidepressive Agents
keywords: children; community practice; early-onset depression; pediatrics; treatment