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Box 4

 

 

 

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Depression

Symptoms

  • Persistent depressed mood, unhappiness and irritability
  • Loss of interest in play and friends
  • Loss of energy and concentration
  • Deterioration in schoolwork
  • Loss of appetite and no weight gain
  • Disturbed sleep
  • Thoughts of worthlessness and suicide (suicide attempts are rare before age 10, then increasing)
  • Somatic complaints (headache, abdominal pain)
  • Comorbid anxiety, conduct disorder, attention deficit hyperactivity disorder, eating disorders or substance abuse
Family factors
  • Family stress (ill or deceased parent, family conflict, parental separation)
  • Repeated experience of failure or criticism
  • Family history of depression
Management
  • Cognitive-behavioural therapy
  • Family therapy for grief and conflict
  • Psychotherapy (interpersonal therapy)
  • Success achievement school programs
  • Antidepressant drugs: role still to be established in children; more useful in adolescents

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