Depression in adolescents growing pains or true morbidity?

This review discusses the prevalence and characteristics of depression in childhood and adolescence. Depression in this age group is a major public health concern, but is often under-recognised and dismissed as 'growing pains'. Interviewing the patient and their parents is essential for accurate diagnosis and structured interviews may be helpful. Prevalence increases with age. Risk of recurrence is high and is influenced by family conflict. Childhood onset depression has a 60-70% risk of continuing into adulthood and 20-40% develop bipolar disorder within 5 years. The nature of the disorder is affected by family history and symptoms vary with age. Comorbidity is common and influences treatment choice and long-term outcome. It is hoped that complications such as poor academic performance, impaired social functioning, and substance abuse may be prevented by early intervention.