Assessment and management of pediatric depression

Pediatric depression is difficult to identify and manage because of complex nature of the disorder. Psychological and cognitive developments impact the clinical presentation and often make assessment tenuous. In addition, the disorder is often associated with multiple biological, psychological, and environmental risk factors, which need thorough assessment. Clinical presentation varies from subsyndromal depression to depression with psychotic features. Although diagnostic criteria for depression remain the same for children; deciphering symptoms need specialized clinical training. This article discusses identification and assessment of depression in the pediatric population. Specialized interviewing techniques pertaining to assessment in this unique population are discussed. Evidence-based guidelines for management of pediatric depression in terms of both pharmacotherapy and psychotherapy are also enumerated. Choice of medication based on multiple parameters with available evidence base is discussed. Treatment planning and continued evaluation on long-term basis are also elaborated.