Research on the diagnosis and treatment of mental disorders in children and adolescents, however, has lagged behind that in adults. Diagnosing depression in these age groups is often difficult because early symptoms can be hard to detect or may be attributed to other causes. In addition, treating depression in children and adolescents remains a challenge, because few studies have established the safety and efficacy of treatments for depression in youth.
Depression in children and adolescents is associated with an increased risk of suicidal behaviors. However, early diagnosis and treatment of depression and other mental disorders, and accurate evaluation of suicidal thinking, possibly hold the greatest suicide prevention value.
Until recently, there were limited data on the safety and efficacy of antidepressant medications in children and adolescents. The use of antidepressants in this age group was based on adult standards of treatment. A recent NIMH-funded study supported fluoxetine, an SSRI, as a safe and efficacious medication for child and adolescent depression. The response rate was not as high as in adults, however, emphasizing the need for continued research on existing treatments and for development of more effective treatments, including psychotherapies designed specifically for children. Other complementary studies in the field are beginning to report similar positive findings in depressed young people treated with any of several newer antidepressants. In a number of studies, TCAs were found to be ineffective for treating depression in children and adolescents, but limitations of the study designs preclude strong conclusions.
One ongoing research study, Treatment Of Resistant Depression In Adolescents or TORDIA, hopes to 'determine how best to treat adolescents with depression that is "resistant" to the first SSRI they have tried.'
To qualify for the study, children should be between the ages of 12 and 18 and still have symptoms of depression despite being treated with one of the following SSRI antidepressants:
- switching to an alternative SSRI
- switching to a different non-SSRI antidepressant
- switching to an alternative SSRI and receiving cognitive behavioral therapy (CBT)
- switching to a different non-SSRI antidepressant and receiving CBT
If your child has resistant depression and you live near one of the study sites, the 'Treatment Of Resistant Depression In Adolescents' study may be a good option for you. There are study sites in Los Angelas, California, Portland, Oregon, Pittsburgh, Pennsylvania, Providence, Rhode Island, and in Galveston and Dallas, Texas.
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