18 Feb Depressive Disorders Youth: Prevalence and Contributing Variables
Treating mood disorders in children and adolescents requires a specialized approach for successful outcomes. Merely altering the treatment modality used for an adult population will not yield the support needed for the unique needs of children and adolescents. First mental health professionals require a complex understanding of the types of depressive disorders most prevalent in youth and the contributing variables to such disorders.
The Centers for Disease Control and Prevention (CDC) reports that depressive disorders are common in youth, estimating that 4.4% or 2.7 million youths aged 3-17 years are diagnosed with depression. The most common diagnoses include Disruptive Mood Dysregulation Disorder, Persistent Depressive Disorder, and Major Depressive Disorder. Research published in the Journal of the American Academy of Child & Adolescent Psychiatry in 2019 reports that the etiology of childhood depressive disorders is not known; however, assumed to be similar to the etiology in adults. The findings concluded that stressors experienced early in life were positively correlated with an increased risk of being diagnosed with depression prior to the age of 18. These early life stressors were categorized into eight specific forms, which included sexual abuse, physical abuse, poverty, physical illness/injury, death of a family member, domestic violence, natural disaster, and emotional abuse. Among these life events, some had a stronger correlation with symptoms of depression; for example, emotional abuse had an increased risk of depression than poverty.
The Association of American Family Physicians (AAFP) estimates that persistent depressive disorder (PDD) or dysthymic disorder has a prevalence of 0.6 to 1.7 percent in young children and 1.6 to 8 percent in adolescents. Early intervention for persistent depressive disorder is crucial because of its relatively early onset and the elevated risk of developing subsequent affective disorders.
Disruptive Mood Dysregulation Disorder (DMDD) can present a different symptom profile than depressive symptoms may look in adulthood. Children with DMDD display extreme irritability, and anger, with frequent, intense outbursts. Children with this disorder experience symptoms before age ten and have significant difficulty functioning in more than one life area, such as home or school. Introduced into the DSM-V in 2013, there is limited research into this DMDD’s etiology and risk factors. Similarly, there is limited incidence data. Research published in 2018 in the Journal for Nurse Practitioners identifies inconsistency in data on prevalence, with 5% diagnosed when using relaxed criteria and 0.12% identified when using strict criteria.
Researchers also cite the unclear patterns in the etiology of the psychopathology of DMDD. While recent research in the Journal of Child and Adolescent Psychopharmacology identifies that the possible association between abnormalities of neural pattern activation are likely a contributing factor to the development of DMDD. Other research has implied that only 29% of children with DMDD displayed symptoms at an eight-year follow-up. Researchers in this study published in the Journal of Abnormal Child Psychology tout DMDD as controversial and question the validity of DMDD as an independent diagnosis.
Major Depressive Disorder (MDD) is prevalent in young people in alarming statistics, with the National Institute of Mental Health reporting that in 2020 an estimated 17% of youth aged 12 to 17, or 4.1 million adolescents had at least one major depressive episode. Countless studies have identified the variables related to the development of MDD in young people, both biological and environmental. A family history of mood disorders places a child or teen at a higher risk of developing depression. Environmental factors, often referred to as Adverse Childhood Experiences or ACES, such as abuse, neglect, stress, loss of a parent, or bullying, also place young people at greater risk of developing depression.
Understanding the variables that influence the development of common depressive disorders in children and adolescents needs to be a primary focus for parents, school administrators, and mental health professionals. Offering early intervention in response to a young person experiencing a life event that may pose the risk of developing a mood disorder will arm that youth with the tools to respond successfully to those stressors.