Depression Protocols

Abstract

Depression is surprisingly common in the pediatric population, and the risk of depression increases with age into adolescence and young adulthood. Major depressive disorder (MDD) affects approximately 3% of prepubertal children and 4 percent to 8 percent of adolescents at any one time. By age 18 years, approximately 20% of youth will have experienced a MDD, very close to its lifetime prevalence. Dysthymic disorder, a chronic form of depression lasting at least one year, is found in approximately 1% of prepubertal children and between 2 percent and 8 percent of adolescents. Persistently depressed or irritable mood does not reflect “normal adolescence”.

There is growing consensus that primary care providers can and should work to identify children and adolescents under their care who are suffering from depression. This reflects the public health relevance of this disorder. Depressed children and adolescents are functionally impaired relative to their peers (i.e., interpersonally, socially, and academically, with poorer school attendance and performance on average), and are at greater risk for suicide; alcohol, drug, and tobacco use; persistence of MDD; recurrence of MDD; other “comorbid” psychiatric disorders; or future psychiatric disorders.

Download our recommended protocol for pediatric depression in primary care

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