Moreau D L
Department of Child Psychiatry, Columbia University College of Physicians and Surgeons, New York State Psychiatric Institute, New York.
Psychiatr Clin North Am. 1990 Jun;13(2):355-68.
Major depression in children and adolescents is diagnosed by the same criteria used in the adult disorder. There is a depth of knowledge regarding the childhood disorder in the areas of natural history, comorbidity, prognosis, epidemiology, and treatment. There are no controlled studies on the efficacy of psychotherapy for the treatment of childhood depression and only a few controlled studies on the efficacy of pharmacologic therapy. Current clinical practice combines individual psychotherapy, family intervention and education, and tricyclic antidepressant therapy in doses of 2 to 5 mg/kg to yield serum levels greater than 200 ng/ml for the treatment of major depression in children. Electrocardiograms should be performed prior to each increase in dose. Mood and cognitive functioning rapidly return to baseline levels following appropriate treatment but interpersonal difficulties tend to remain after resolution of the depression.
儿童和青少年的重度抑郁症是根据用于成人该疾病的相同标准来诊断的。在自然史、共病、预后、流行病学和治疗等领域，对儿童期疾病有一定深度的了解。关于心理治疗对儿童抑郁症治疗效果的对照研究较少，药物治疗效果的对照研究也仅有几项。目前的临床实践将个体心理治疗、家庭干预与教育以及剂量为2至5毫克/千克的三环类抗抑郁药治疗相结合，以使血清水平高于200纳克/毫升，用于治疗儿童重度抑郁症。每次增加剂量前都应进行心电图检查。经过适当治疗后，情绪和认知功能会迅速恢复到基线水平，但抑郁症缓解后人际困难往往依然存在。
