Notes

Outline

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  elementary age 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 Academic decline Disruptive behavior Problems with friends. Aggressive behavior, Irritability Suicidal talk. 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 Recent physical

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. Projectives Checklists for children and adolescents