Epidemiology of childhood depressive disorders: a critical review.

The methodology of 14 recent epidemiological studies of childhood and adolescent depressive disorders was critically reviewed and findings summarized for prevalence, comorbidity, correlates, risk factors, and outcome. Shortcomings in sampling and considerable inconsistency in the measurement of depression in the studies made it difficult to draw firm conclusions about the prevalence and correlates of depression in young people. Nonetheless, it is likely that major depressive disorder is relatively uncommon in prepubertal children, increases in frequency in adolescents, and is significantly associated with such variables as family dysfunction and low self-esteem. Comorbidity of depression with other psychiatric disorders was also high in these nonpatient samples and it will be important in future work to assess the implications of this for the etiology, treatment, and prognosis of depressive disorders in children and adolescents.