Controversies Depression in childhood and adolescence

1 controversies

1.1 legitimacy diagnosis
1.2 diagnosis controversy

1.2.1 measurement reliability
1.2.2 treatment issues

controversies

throughout development , research of disorder, controversies have emerged on legitimacy of depression in childhood , adolescence diagnosis, proper measurement , validity of scales diagnose, , safety of particular treatments.

legitimacy diagnosis

in research of depression in children, there debate whether or not children clinically fit criteria major depressive disorder. however, since 1970s, has been accepted among psychological community depression in children can clinically significant. more pertinent controversy in psychology today centers around clinical significance of sub-threshold mood disorders. controversy stems debate regarding definition of specific criteria clinically significant depressed mood in relation cognitive , behavioral symptoms. psychologists argue effects of mood disorders in children , adolescents exist (but not meet criteria depression) not have severe enough risks. children in area of severity, argue, should receive sort of treatment since effects still severe. however, since there has yet enough research or scientific evidence support children fall within area shy of clinical diagnosis require treatment, other psychologists hesitant support dispensation of treatment.

diagnosis controversy

in order diagnose child depression, different screening measures , reports have been developed clinicians make proper decision. however, accuracy , effectiveness of measures psychologists diagnose children have come question. questions have surfaced safety , effectiveness of antidepressant medications.

measurement reliability

the effectiveness of dimensional child self-report checklists has been criticized. although literature has documented strong psychometric properties, other studies have shown poor specificity @ top end of scales, resulting in children high scores not meeting diagnostic criteria depression. issue reliability of measurement diagnosis occurs in parent, teacher, , child reports. 1 study, observed similarities between child self-report , parent reports on child s symptoms of depression, acknowledged on more subjective symptom reports measures, agreement not significant enough considered reliable. 2 self-report scales demonstrated erroneous classification of 25 percent of children in both depressed , controlled samples. large concern in use of self-report scales accuracy of information collected. main controversy caused uncertainty how data these multiple informants can or should combined determine whether child can diagnosed depression.

treatment issues

the controversy on use of antidepressants began in 2003 when great britain s department of health stated that, based on data collected medicines , healthcare products regulatory agency, paroxetine (an antidepressant) should not used on patients under age of 18. since then, united states food , drug administration (fda) has issued warning describing increased risk of adverse effects of antidepressants used treatment in under age of 18. main concern whether risks outweigh benefits of treatment. in order decide this, studies @ adverse effects caused medication in comparison overall symptom improvement. while multiple studies have shown improvement or efficacy rate of on 50 percent, concern of severe side effects – such suicidal ideation or suicidal attempts, worsening of symptoms, or increase in hostility – still concerns when using antidepressants. however, analysis of multiple studies argues while risk of suicidal ideation or attempt present, benefits outweigh risks. due variability of these studies, recommended if antidepressants chosen method of treatment children or adolescents, clinician monitor closely adverse symptoms, since there still no definitive answer on safety , overall efficacy.