Children of parents with affective disorder.

Depression is a family illness. The pediatrician's involvement is as a physician for the family. Initially, his or her role is as a diagnostician for the family. The presence of depressive symptoms in either a parent or a child requires investigation and may signal distress in other members of the family as well as the individual with symptoms. Often, even for parents, depressive symptoms will be first evident to the pediatrician. This provides a significant responsibility and the opportunity to function as a physician for the family in distress. An ongoing collaborative relationship with a psychiatrist or other mental health professional will aid in the treatment of disorder in the parents. Furthermore, in the absence of acute illness, there is an opportunity to discuss and help the family to understand the illness and to encourage resiliencies within the child or children. There is also the opportunity for continued follow-up, both of the parental distress and of the children's adaptive functioning.