Diagnosis and Treatment

Diagnosis. The Diagnostic Statistical Manual of Mental Disorders IV (2000) now recognizes childhood depressive disorder as a distinct diagnostic entity. The main criteria for childhood depression diagnosis is often remembered by using the acronym DUMPS (See Figure 1) (Carr & Boyd, 2003). According to Carr and Boyd, (2003), These criteria direct the clinician to examine the duration of the symptoms, the academic performance of the child, any physical ailments, and thoughts of pessimism and morbidity before making a diagnosis of depression (p.

103). The severity and manifestation of depression can vary by age (Carr & Boyd, 2003). Physical ailments may be present with depression, such as stomachaches or headaches. Interestingly, Carr and Boyd (2003) reported that one hundred percent of preschool children report physical ailments associated with depression. A high rate of comorbidity has been reported with childhood depression; such as anxiety and behavioral disorders (2003). Figure 1. “Manifestation of depression in children and adolescents” (Carr & Boyd, p. 103, 2003). Treatment.

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There is much concern about appropriate treatments for child depression. The researcher will briefly discuss the treatments available after children are diagnosed. There are two categories of depression treatment; pharmacological and psychotherapeutic (Carr & Boyd, 2003). The most commonly used according to Carr and Boyd (2003) is pharmacological treatment. According to Weisz (et. al. , 1997), the most common depression intervention involves twelve or more sessions. Empirical evidence supports the need for twelve to twenty-seven treatment sessions for children diagnosed with depression (1997).

Weisz (et. al. , 1997) conducted a study with children diagnosed with depression and performed eight treatment sessions. The researchers purposely chose under the suggested twelve sessions to determine if a smaller amount of sessions would raise concern as to the effectiveness of treatment. Weisz (et. al. , 1997) concluded that while childhood depressive symptoms could be reduced with the use of eight treatment sessions; the children that were treated were only moderately depressed according to their CDI results and there post-treatment CDI showed moderate improvement.

The children were also in a school setting; more research is needed to determine whether short-term treatment would be appropriate in other settings and with children diagnosed with more severe depression. Critical Review Bhatia and Bhatia (2007) state that the Children’s Depression Inventory (CDI), is a reliable and valid self-rating scale for boys and girls seven to 17 years of age”. This is a consistent opinion with many other research reports. CDI: Parent Version.

The CDI:P is another version of CDI, a seventeen item scale created for parents in order to gain more information on the t the child for a more thorough assessment and accurate diagnosis (Kovacs, 2004). Depending on the results, numerous actions could be taken including intervention, referral or further assessment. Kovacs (2004) considers the CDI:P a valuable and effective tool in understanding whether a child has depressive symptoms. According to Kovacs (2004); CDI results must be incorporated with other information before drawing any conclusions.

It is recommended that a comprehensive evaluation include direct clinical observation of the youth, information from other relevant assessments, and information about the youth’s background, family history, and school adjustment (4). Kovacs (2004) also reviewed the Children’s Depression Inventory: Teachers Version; a twelve-question inventory that assesses students age seven to seventeen. This inventory is useful in understanding a child’s experience and potential depressive symptoms from a teacher’s point of view.

Some of the characteristics investigated are (2004): o Lack of interpersonal skills o Uncooperativeness o The need to push the student to do schoolwork o Does not enjoy school o Worse than usual school performance o Cranky and/or irritability o Having disagreements or conflict with others CDI versus BDI. Another instrument used for determining symptoms of depression is the Beck Depression Inventory. The BDI is a twenty-one item assessment for clinical and regular clients (Pearson, 2009).

The BDI however is not specifically designed for children. Rivera (et al. , 2005) conducted a study comparing CDI and BDI among the Puerto Rican adolescent population. According to the researcher, there was a need for the study. The researcher wrote, “the development and validation of measures to evaluate depression in adolescents has lagged behind the theoretical and clinical developments for these populations”; meaning the adolescent and Latin populations.

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