Diagnosis of Depression
Carol E. Watkins, M.D.
Characteristics of Childhood Depression
In psychotic depression, children are more likely to report hallucinations.
Older adolescents, adults with psychotic depression more likely to have delusions
Young children are more likely to show phobias, separation anxiety, physical complaints and behavior problems.
Preschool to young
Child may look serious or vaguely sick.
Less bouncy or spontaneous.
May become irritable or tearful without provocation.
May say negative things about himself
May be self-destructive.
Older elementary through adolescence
Problems with friends.
Parent may say that the adolescent hates himself and everything else.
Why might it look different in children?
More limited vocabulary
More concrete, stimulus-bound
More dependent on, influenced by family
Physically different from adults
Shorter attention span
Less psychologically sophisticated
Diagnosis in the Clinical Office
Children take more time than adults
Include child and both parents in the process
Child more aware on inward signs—Ask!
Adults more aware of outward signs
School, other reports
Discuss Treatment Choices
Different families want or need different approaches
Don’t overwhelm family with too many directives
Write out recommendations
Be available for later questions
Testing and Checklists
To look for L.D.
Checklists for children and adolescents