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Depression in Maltreated Children and Adolescents
Michael D De Bellis1, Kate B Nooner2, Jeanette M Scheid3
1Healthy Childhood Brain Development and Developmental Traumatology Research Program, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Box 104360, Durham, NC 27710, USA.
Summary
Child maltreatment significantly increases depression risk in youth. Combination therapy, including selective serotonin reuptake inhibitors and trauma-informed cognitive behavior therapy (CBT), is recommended for treatment-resistant depression in maltreated children.
Area of Science:
- Child Psychology
- Clinical Psychiatry
- Trauma Studies
Background:
- Child maltreatment impacts 9.1-17.1 per 1000 US children and adolescents.
- Maltreated youth exhibit a heightened vulnerability to developing depression.
- Depression in maltreated youth often presents with treatment resistance.
Purpose of the Study:
- To highlight the prevalence of maltreatment in children and adolescents.
- To emphasize the increased risk of depression among maltreated youth.
- To recommend effective treatment strategies for depressed maltreated youth.
Main Methods:
- Literature review on child maltreatment and depression.
- Analysis of treatment outcomes for depressed maltreated youth.
- Synthesis of evidence-based therapeutic approaches.
Main Results:
- Maltreated children and adolescents face a high risk for depression.
- Depressed maltreated youth are prone to treatment-resistant depression.
- Combination therapy is effective for this population.
Conclusions:
- Clinicians must screen for maltreatment history in young patients.
- Trauma-informed selective serotonin reuptake inhibitors (SSRIs) and cognitive behavior therapy (CBT) combination treatment is advised.
- Behavioral management integrated with trauma-focused CBT can address externalizing disorders; alternative evidence-based interventions should be considered if initial treatments fail.
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