The NICE guidelines for treatment of depression in children and adolescents are reviewed. Depression is not an uncommon presentation in children and adolescents. Treatment is a balance between risk and benefits, in particular with reference to use of medication. Treatment depends on very accurate diagnosis, as well as assessment of the possible psychosocial causes of depression. It is necessary to distinguish which causes can be altered by social intervention, which by psychological treatments and which require medication. If medication is necessary, choice of medication must be determined by the balance of evidence regarding its efficacy and adverse effects. Before committing to using medication, the possibility of bipolar disorder must be considered and eliminated. There is limited evidence for the efficacy of antidepressants in this age group and most antidepressants do not have a licence for use in children. Despite these problems, careful assessment and treatment can improve outcomes.
Keywords: depression, children, adolescents, SSRIs, risk profiling, CBT, interpersonal psychotherapy, family therapy