[The depressive child (author's transl)].

Depressive states in childhood often remain unrecognized and so are either handled wrongly or not at all. Some 2--3% of all children with abnormal behaviour are moderately to severely depressed, and a further 6--8% mildly so. The diagnosis of neurotic, constitutional, endogenous and exogenous depression is more difficult in children than in adults, because the depressive symptomes alter with its development. In small children the condition usually presents with psychosomatic complaints, whereas in schoolchildren it produces mixed psychological and psychosomatic manifestations, and in adolescents predominantly psychological depressive symptoms. From the point of view of the child psychiatrist, childhood depression is regarded as "primary" depression, characterized by atypical symptoms; typical adult depressions are "secondary", and masked depression in these age-groups a "regressive" form. Treatment of depressive conditions in children is directed both at the causative factors and the symptoms. Environmentally induced and constitutional depressions mainly need psychotherapy and remedial training, sometimes in conjunction with antidepressant medication. Management of exogenous depression is directed towards the underlying organic disorder. The endogenous phasic depressive illnesses, very rare in children, are a matter for treatment with psychotropic drugs.