Park R J, Goodyer I M
Department of Psychiatry, University of Cambridge, UK.
Eur Child Adolesc Psychiatry. 2000 Sep;9(3):147-61. doi: 10.1007/s007870070038.
Major depressive and dysthymic disorders are recurrent and sometimes persistent unipolar mood disorders, which often present in childhood and adolescence. Depressive episodes may increase in severity and duration with recurrence and are associated with substantial morbidity and risk of suicide. The role of child and adolescent mental health services in early intervention and management is thus of major importance. This paper draws together current research evidence and common clinical practice, in guidelines for the specialist management of depressive disorders in childhood and adolescence. Both psychotherapy and pharmacotherapy have been found to be beneficial for the acute treatment of children and adolescents with depressive disorders. Based on current evidence, psychotherapy may be the first treatment for most depressed youngsters, but antidepressants should be considered for those with severe depression. All patients need continuation therapy, and some will need maintenance treatment. Evidence supporting the efficacy of psychological and psychopharmacological treatments are reviewed. An integration of approaches is suggested as a guideline for treatment planning.
重度抑郁障碍和恶劣心境障碍是复发性的，有时是持续性的单相心境障碍，常在儿童期和青少年期出现。抑郁发作可能会随着复发而加重和延长，并伴有较高的发病率和自杀风险。因此，儿童和青少年心理健康服务在早期干预和管理中的作用至关重要。本文汇集了当前的研究证据和常见临床实践，形成了儿童和青少年抑郁障碍专科管理指南。心理治疗和药物治疗均已被证明对患有抑郁障碍的儿童和青少年的急性治疗有益。根据目前的证据，心理治疗可能是大多数抑郁青少年的首选治疗方法，但对于重度抑郁患者应考虑使用抗抑郁药。所有患者都需要持续治疗，部分患者还需要维持治疗。本文对支持心理治疗和心理药物治疗疗效的证据进行了综述。建议采用综合方法作为治疗规划的指南。
