Depression is one of the most burdensome and leading causes of disability worldwide. In children, depression can occur in those aged as young as 3 years, but this was largely unrecognized until the 1980s, with the publication of the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III).
Depression during childhood is uncommon but is nevertheless an important clinical priority given the greater severity of long-term mental health sequelae compared with individuals with a later age of onset. This rarity could also explain why many clinicians report lacking confidence in treating depression in children, further exacerbated by receiving inadequate training. As such, compared with adolescents, there are lower rates of children receiving appropriate evidence-based care for depression, despite there being a strong evidence base for interventions such as cognitive behavioral therapy.
There have been noticeable environmental changes to childhood experiences over the last 2 decades that may have negatively affected child mental health outcomes. Family dynamics, for example, have changed in that there is greater parental involvement in children’s activities than in the past. This could potentially lead parents into adopting a more overinvolved parenting style, which has been linked to increased depressive symptoms.
Various sedentary behaviors have also become more prevalent. There has also been an increase in screen time: as many as two-thirds of children are estimated to exceed recommended limits. In turn, this affects sleep, physical activity levels, and diet, which all exist in a bidirectional relationship with depression where one exacerbates the other.
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Jennifer L. Hudson, MClinPsych, PhD, Black Dog Institute, Hospital Road, Prince of Wales Hospital, Randwick NSW 2031, Australia
