Depression in Children and Adolescents

267 Pages·2015·10.71 MB·English

by  Harold S. Koplewicz

ROUTLEDGE LIBRARY EDITIONS:
ADOLESCENCE
Volume 4
DEPRESSION IN CHILDREN
AND ADOLESCENTS
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DEPRESSION IN CHILDREN
AND ADOLESCENTS
Edited by
HAROLD S. KOPLEWICZ AND EMILY KLASS
Firstpublishedin1993byHarwoodAcademicPublishers
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Depression in Children
and Adolescents
edited by
Harold S. Koplewicz and Emily Klass
Schneider Children’s Hospital
Long Island Jewish Medical Center
New York, USA
harwood academic publishers
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Library of Congress Cataloging-in-Publication Data
Depression in children and adolescents / edited by Harold S. Koplewicz
and Emily Klass.
p. cm. ~ (Monographs in clinical pediatrics ; 6)
Includes bibliographical references and index.
ISBN 3-7186-5317-6. - ISBN 3-7186-5318-4 (pbk.)
1. Depression in children. 2. Depression in adolescence.
I. Koplewicz, Harold S. II. Klass, Emily. III. Series.
RJ506.D4D46 1993
618.92,8527~dc20 93-28562
CIP
No part of this book may be reproduced or utilized in any form or by any means, electronic
or mechanical, including photocopying and recording, or by any information storage or retrieval
system, without permission in writing from the publisher. Printed in Singapore.
CONTENTS
INTRODUCTION vii
THEORIES OF DEVELOPMENT AND ETIOLOGY
1. Developmental Issues in Childhood and Adolescent Depression
Jayne E. Schächter and Barbara A. Romano 1
2. Cognitive and Behavioral Theories of Depression
Anita Gurian 15
3. Family Studies of Affective Disorders
Carl E. Anderson and Myrna M. Weissman 33
4. Depression within the Family: A Systems Perspective
Fiona True and Laurie Kaplan 45
5. Child Abuse, Neglect and Depression
Arthur H. Green 55
MEDICAL ILLNESS AND DEPRESSION
6. Pediatric Illness as a Risk Factor in Depression
Candace J. Erickson 63
7. Depression in Acutely 111 Children and Adolescents
Lois Lyon Neumann and David G. Inwood 89
8. The Dying Child
Avron Kriechman 97
DEPRESSION AND OTHER PSYCHIATRIC CONDITIONS
9. Depression and Anxiety
Greta Francis 109
10. Conduct Disorder and Depression
James T. McCracken, Dennis P. Cantwell and Gregory L. Hanna 121
11. Substance Abuse in Depressed Adolescents
John Piacentini and Caroly Pataki 133
12. Depression and Eating Disorders
Lynne Hoffman and Katherine A. Halmi 149
TREATMENT APPROACHES
13. Psychotherapy of Depression in Childhood and Adolescence
Clarice J. Kestenbaum and Ian A. Canino 175
v
vi CONTENTS
14. Pragmatic Approaches to the Treatment of Prepubescent Depression
Emily Klass and Richard Gallagher 199
1 5. Pragmatic Approaches to the Treatment of Depressed Adolescents
G. Randolph Schrodt Jr, Cyrus E. Adams and Anthony J. Siegel 219
16. The Psychopharmacology of Childhood and Adolescent Depression
Harold S. Koplewicz, Emily Klass and Vivian Kafantaris 235
INDEX 253
Introduction
Harold S. Koplewicz
The origin of this volume arose from our work at the Schneider Children’s Hospital
of Long Island Jewish Medical Center. In 1986, we began a study funded by the
Leon Lowenstein Foundation of the efficacy of desipramine in the treatment of
adolescents with Major Depressive Disorder. At the same time, we established the
first Adolescent Depression Service in the New York metropolitan area. This research
study and clinical service brought us into contact with hundreds of families whose
children had depressive symptoms.
Our interaction with our pediatric colleagues clarified for us the need for early
identification of depression in children and adolescents. This goal could only be
reached by increasing the pediatrician’s awareness of the presence, identification
and nature of depressive disorders of children and adolescents. He must possess
the clinical skills to differentiate transient moodiness from a depressed mood that
is a harbinger of a disorder which can result in dysfunction and possibly suicidal
behavior. He must broach the often sensitive matter of explaining to parents the
necessity and sometimes the urgency of seeking a psychiatric consultation in the
face of lingering prejudice about the stigma of “seeing the shrink”. He must answer
questions and reassure parents that their depressed child is not “crazy”, but has a
serious disorder.
Long believed “masked” or absent from childhood, recent research has delineated
clear syndromes of depression in all age groups. Depression in children and adoles-
cents can be a chronic, debilitating condition with major impact on family, social
and intrapsychic life. Early detection facilitates early treatment, a key to preserving
a child’s continued growth and development. The presentation of depression can
be complicated by co-morbid diagnoses, psychosocial stressors within the family,
developmental differences and medical illnesses. This volume seeks to disentangle
some threads, weave others together and to generally span the current research in
etiology, biology, phenomenology and treatment of depression in children and
adolescents.
To do so, we have asked investigators to report on the state-of-the-art in the
research of depression in their area of expertise. Beginning with Part One, “Theories
of Development and Etiology”, Drs. Romano and Schachter of our institution
present the essence of the developmental approach to understanding childhood
psychopathology in their chapter concerning the varying presentations of depression
throughout childhood. Dr. Gurian writes of the “Learned Helplessness” model,
vii