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Telltale Clues That Your Child Is Depressed

“In children and adolescents who are depressed, you may notice more irritability and loss of interest rather than just sadness or a depressed mood,” said Kimberly Burkhart, a pediatric psychologist at University Hospitals Cleveland Medical Center.

Be alert for 11 telltale warning signs, she advises. They include changes in sleeping habits, such as sleeping too little, too much or taking long naps; avoiding or not enjoying activities they once liked; withdrawing from family and friends; trouble thinking or concentrating; and a decline in school performance.

Other warning signs include changes in appetite, weight loss or gain; fatigue or loss of energy; lack of self-confidence or self-esteem; feelings of worthlessness or hopelessness; self-harm; and recurring thoughts of death or suicide.

About 5 percent of U.S. children and teens suffer from depression, according to the American Academy of Child and Adolescent Psychiatry.

The causes can be external factors, such as stress, bullying or a traumatic event, or depression or anxiety may run in your family, according to Burkhart.

A number of treatment options are available, including several that don’t involve medication.

“One of the most effective treatments for dealing with depression in children and adolescents is cognitive behavioral therapy, which looks at the relationship among thoughts, feelings and behavior,” Burkhart said.

Other approaches include exercise and behavioral activation — where a patient’s involvement in positive activities is gradually increased.

If moderate or severe depression persists, a doctor may recommend an antidepressant, Burkhart said.

Features of Comorbid Autism Spectrum and Pediatric Bipolar Disorders

Children with autism spectrum disorder (ASD) and comorbid pediatric bipolar disorder (PBD) follow a highly episodic progression through manic episodes, phases of subsyndromal symptoms, and euthymic periods, according to a study published in the Journal of Autism and Developmental Disorders.

ASD usually occurs with at least 1 additional disorder. This study sought to describe the clinical features of comorbid pediatric bipolar disorder in children with ASD, with a secondary aim of comparing these clinical features with those of ASD with no affective disorder.

Forty patients age 6 to 17 with both ASD and PBD under treatment at the Ondokuz Mayıs University Medical Faculty Health Application and Research Center Child and Adolescent Mental Health and Diseases Clinic in Turkey made up the study group. The control group included 40 patients with ASD disorder who had experienced no previous affective episodes. Of these 80 children with a mean age of 12.36 ± 2.93 years, 12.5% were girls (n=10) and 87.5% were boys (n=70). The only significant sociodemographic difference between the groups was that children with ASD or PBD received a higher level of special education.

The Autism Behavior Checklist (ABC) and Aberrant Behavior Checklist (ABCL) were administered twice for the PBD+ASD group, for both euthymic and episodic periods. The ABC scores were significantly higher in the episodic periods compared with the euthymic periods, especially within the subcategories of social and adaptive skills, body and object use, and social relating.

No difference was indicated between ABC scores of the study group during euthymic periods compared with those of the control group.

The ABCL scores of the PBD+ASD group showed significantly elevated clinical impairment during episodic periods compared with euthymic periods, although no significant difference was indicated between ABCL scores of the study group during euthymic periods compared with those of the control group. Within the study group, 56.4% experienced manic episodes only.

What’s the Best Way to Treat Mental Health Problems in Kids?

No one knows for sure, but the U.S. Centers for Disease Control and Prevention estimates(link is external) that between 13 and 20 percent of youth ages 3 to 17 experience a mental health problem each year. This includes diagnoses of attention deficit hyperactivity disorder (ADHD), anxiety, depression, autism spectrum disorders and Tourette syndrome.

In fact, many mental health problems that continue into adulthood – including substance abuse and behavioral problems – actually begin during childhood and adolescence. This issue raises many questions; maybe the most pressing is, what’s the best way to treat mental health problems in children?

The U.S. does not have a broad pediatric mental health system in place, but the vast majority of young people do go to the pediatrician. A new health care field is emerging called integrative behavioral health care, where behavioral interventions are delivered in primary care settings, such as the pediatricians’ office. But what’s the evidence say on the effectiveness of this approach?

Several recent meta-analyses look at the evidence on offering mental and behavioral health interventions to children in pediatrician’s offices