Childhood depression.

The spectrum of depressive disorders found in children and adolescents presents diagnostic and treatment challenges for the physician. The increasing scientific rigor of child and adolescent mental disorder research has explicated the importance of clinical diagnoses. Distinctions have to be made between depressive symptoms that are transient and situational specific and the constellation of depressive symptoms that represent clinical disorders such as bipolar disorder, cyclothymia, major depressive disorder, or dysthymia. The clinically sensitive physician attuned to the diagnostic criteria of these disorders has the opportunity to promote effective treatment and to reduce the morbidity associated with these conditions. The established severity and persistence of these disorders over time suggests the need for definitive medical management of these conditions. The recognition of childhood depression as a medical entity of varying severity, persistence, and prognosis represents the first step in effective treatment.