[Clinical aspects of depressive states]

During the last 4 years (1979-1982), 4117 patients have been examined in our out-patient department. Since the most important dates of each patient are electronically registered, it was easy to ascertain the frequency of the depressive conditions with the computer. This amounts to 819 and corresponds to 19.9% of the patients examined during that period. The depressive states were divided in 4 categories: 1. depressive reactions, 2. depressive developments, 3. neurotic depressions, and 4. endogenous depressions. Of all depressive patients, only 27 were treated with drugs. The others were treated with the classical methods of the child- and youthpsychiatry, that is psychotherapy including family-therapy, educational measures and interventions in the social field. Patients with a depressive reaction never received any drugs. The few patients who suffered from an endogenous depression all received thymoleptica in combination with a Lithium salt. However, one dozen patients with a neurotic depression respectively with a depressive personality development received various drugs, whereby the antidepressants were leading, but not prescribed alone. Neuroleptica as well as psychotonica were prescribed, especially for children suffering from an infantile psychoorganic syndrome (MBD, ADD) with a depression. Psychotrope substances have their place in the treatment of depressive conditions in childhood. Their scarce and critical use is in the interest of the children.