Childhood depression, even when some specialists consider that there is an overdiagnosis, has a more important prevalence than a priori would think. The most recent studies in France indicate that 0.3-1.4% of preschoolers suffer from major depression, as well as 1.2% of those who have not reached puberty and 3-8% of adolescents, without there being a difference between both sexes. To these figures we should add the derivatives of mild degrees of depression as is the case of the so-called dysthymia. However, these data on the prevalence of childhood depression may vary depending on the diagnostic criteria used. In France It must be taken into account, on the other hand, that some experts consider that many cases in which a mild depression is diagnosed could be treated, rather than this pathology, of a normal reaction to situations or events that can cause the child’s unhappiness.
How to detect it:
Infant: abnormal manifestations may occur, especially in their relationship with the mother, such as reacting with the crying when it is picked up, a state of lethargy, inhibition, not smiling or laughing and a continuous crying that does not respond to any kind of comfort. But some difficulties related to food, such as regurgitation, colic or vomiting, can also express a state of sadness of the child.
Preschool age: the symptoms, in this case, are behavioral: tantrums, defiant attitudes, breaking of objects in furious episodes or systematically disobeying parents. Also, sleep disturbances or enuresis and encopresis (problems in sphincter control) can be physical symptoms of the existence of a depressive process.
School age or prepubertal: little by little the symptomatology is closer to the adult: problems of school performance, isolation, lack of self-esteem, sadness, loss of interest in the game and friends, rejection of school, etc. From a physiological perspective, it can be said that there is more somatization with the appearance of headaches or gut, which the child often uses as an argument, for example, not wanting to go to school or do something that is he asks. Sleep disturbances and changes in diet and weight may also be present. Around 8 years of age, in addition, ideas of suicide may begin to occur. Adolescence: in this stage of life the symptoms are already very similar to those that occur in the adult, highlighting especially the behaviors and negative attitudes, such as lack of self-esteem. All this is manifested in the consumption of alcohol and drugs, impulsivity reactions, hypersensitivity in their relationships with adults, irritability, mood swings, aggressive behavior, unplanned suicide attempts, family home leaks, antisocial behavior, etc.
The problem is that many of these symptoms can be considered as nonspecific and is what, in the opinion of some experts, can lead to overdiagnosis of childhood depression. To avoid this, it will be necessary to investigate the existence of possible psychosocial and family factors (a history of depression in the parents, a family environment, conflicting relationships between the parents, etc.) that may induce the suspicion that these behavioral or behavioral alterations may be indicative of a depressive picture.
Causes of childhood depression in france:
Genetic factors: there is no evidence that depression is hereditary, even though in half of the cases of childhood depression at least one of the parents is depressed. What studies to determine is that children of parents with depression are three to six times more likely to develop it than children of healthy parents. But even so, this factor is not determinative; and to this we must add other factors, such as the family environment, social relations or personal skills.
family factors: the infantile depression has in the familiar atmosphere and the social interaction of the boy with his parents one of the most determining factors. Conflicting relationships between parents, distancing between them, maltreatment, communication problems, divorce or separation, overprotection (usually maternal) of the child, little involvement of one of the parents (the father, more often), aggressive or irritable attitudes, authoritarian and abusive behaviors … are some of the factors that can be at the origin of a childhood depression.
Social factors: although the little france relationship with his parents can be considered a social activity and, at the same time, condition the way in which it is related outside the family home, there are other psychosocial factors outside the family environment that can increase the emotional stress and promote childhood depression. Among them could be cited the loss of a loved one, bullying or school bullying, or the limitations imposed by the family to socially relate.
Biological factors: alterations in the secretion of serotonin that occur in patients with depression is a confirmed biological fact, although it has not been possible to establish clearly if it is a cause or a consequence of childhood depression. In any of the cases, it can always be considered as a facilitating factor that contributes to maintaining depression
The treatment of childhood depression in France is similar to how it is done in adults, taking into account the age of the patient, the degree of depression diagnosed, the child’s development phase and affective maturity, cognitive functionality and attention span. In short, the treatment must be individualized, adapting to the characteristics of each patient and seeking participation and involvement of parents. Before starting any type of treatment, the diagnosis of childhood depression must be confirmed, through a very detailed evaluation of the symptoms and psychosocial factors that surround the child. these analyzes can be done in any clinical center in any city of France
In cases of mild or moderate depression, currently accepted France guidelines determine that treatment should be initiated only with psychological therapy using cognitive-behavioral techniques that allow you to identify and correct the way you interpret certain events that happen around you and thus be able to modify his emotional and behavioral reaction to them. If the patient does not respond to the therapy or the diagnosed depression is classified as serious, the treatment should include the use of antidepressant drugs, being fluoxetine the recommended as the first option, since, according to the health authorities of evaluation of medicines, is the one that has obtained the best efficacy and safety results in controlled clinical trials.
Likewise, a weekly clinical evaluation is recommended during at least the first four weeks of treatment. During the same should be maintained a special monitoring of what is called autolytic ideation (suicidal tendency) to intervene immediately at the time, it occurs.