General psychiatrists and their patients' children: assessment and prevention.

General psychiatrists frequently treat adult patients with Major Depressive Disorder. Ordinarily, these psychiatrists focus solely on the treatment of their adult patients. However, new data suggest that treatment efforts might be doubly rewarded if psychiatrists tended to the children of these patients as well. This article reviews the literature on children whose parents have Major Depressive Disorder, and on preventive interventions for their children. We also review challenges to funding interventions of this sort based on systematic interviews of public and private insurance providers. We suggest a new standard of care for depressed patients: reliable screening of the patients' children for both risk of disorder and resilience as well as referral of these children, where indicated, for prevention services. We review obstacles to this standard of care: the professional reluctance of general psychiatrists to work with children and the lack of screening and preventive services for these children in most practice settings.