Depression in childhood is relatively common, with the majority representing a normal response to distressing or adverse circumstances.

Children tend to describe themselves as ‘grouchy’, ‘empty’, or ‘unable to have fun’rather than low or depressed.

Parents often present the child saying they are sad and tearful, or haven’t been eating and sleeping well.

  • The core symptoms remain low mood, anhedonia, and fatigue; mood may also be irritable in children.
  • Symptoms must be present for at least 2 weeks and have a negative effect upon functioning. In children the level of functioning in different settings may vary; for example, they may be very low at home but able to function slightly better at school. Disorders of school-age children and teenagers Management.
  • Sleep is often disturbed, but may not show the classical pattern of early morning awakening.
  • Rather than weight loss, children may fail to gain weight or fall off of their growth centile.
  • Occasionally, physical symptoms (e.g. abdominal pain, headaches, or fatigue) may be the only presenting complaint.


The prevalence of depression in prepubertal children is 1 to 2 per cent, and in adolescents is 3 to 8 per cent.

In younger children the ratio of males to females is equal, but in adolescents it is 1:3.

Environmental and social factors in the aetiology of childhood depression

  • Abuse at an early age
  • Family discord
  • Criminality in the family Losses or bereavements
  • Attachment difficulties
  • Neglect Family
  • substance abuse
  • Traumatic life events
  • Maternal-child conflict
  • Good academic achievement
  • Bullying
  • Social isolation
  • Low-income family Unstable or unpredictable family environment


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