Author: Jules R. Bemporad M.D.
The treatment of depression in the pediatric age group must consider the psychopathological symptoms against a framework of the developmental process. The clinical manifestations, causes, and therapeutic options vary greatly with age and one has to be flexible both in terms of understanding the disorder and in the therapeutic course of action. As outlined in chapters 4 and 8, true depression is not seen before late childhood, and even then it is quite
rare. In over a dozen years of private practice of child psychiatry as well as of directing a psychiatric division in a large pediatric hospital, I have seen only a handful of prepubertal children who were truly depressed. Many children
appeared sad or unhappy, but each was reacting to a readily discernible stress in the environment and had not as yet crystallized modes of interaction or ideas of the self which would perpetuate this sense of unhappiness. In every case, the unpleasant affect responded proportionally to ameliorating the environmental situation.