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The Context of Depression in Clinic-Referred Youth: Neglected Areas in Treatment

Doi : 10.1097/00004583-199901000-00021 

CONSTANCE HAMMEN * , KAREN RUDOLPH, JOHN WEISZ, UMA RAO, DORLI BURGE

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Abstract

Objective

To review the empirical, methodological, and conceptual limitations of psychotherapy and pharmacotherapy for childhood and adolescent depression and to present descriptive data on key characteristics of a depressed sample to illustrate gaps in treatment.

Method

Interview-based assessment of psychiatric features and psychosocial functioning, family psychopathology and marital adjustment, and child and parent stressful life events was performed in a sample of 43 depressed youngsters seeking outpatient treatment.

Results

The empirical and conceptual review indicated that treatments based on downward extensions of adult procedures are limited in number and success. Also, the treatments generally neglect the following characteristics revealed in the descriptive data: depressed youngsters have high rates of recurrent depression and comorbid conditions, impaired academic and social functioning, exposure to high rates of parental psychopathology. parental assortative mating, severe marital dysfunction, and high rates of severe stressors.

Conclusions

Treatments need to be informed by and address the actual characteristics of depressed youngsters and their environments, which are highly dysfunctional. J. Am. Acad. Child Adolesc. Psychiatry, 1999, 38(1):64–71.


Key Words : depression, treatment, children, youth



 This study was supported by the William T. Grant Foundation (C.H, K.R.) and NIMH grants R01 MH49522 (J.W.) and K08 MH01419 (U.R.). The authors are grateful for the assistance of Nangel Lindberg, Ph.D., David Herzberg, Ph.D., and Shannon Daley, Ph.D., in conducting interviews.


© 1999  The American Academy of Child and Adolescent Psychiatry. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 38 - N° 1

P. 64-71 - janvier 1999 Retour au numéro
Article précédent Article précédent
  • Natural Course of Adolescent Major Depressive Disorder: I. Continuity Into Young Adulthood
  • PETER M. LEWINSOHN, PAUL ROHDE, DANIEL N. KLEIN, JOHN R. SEELEY
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  • CHRISTINA M. MITCHELL, DOUGLAS K. NOVINS, TAMARA HOLMES

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