Child and adolescent depression.

For much of the 20th century, major depression was viewed as a malady to which children were not susceptible. In recent years, this view has given way to an understanding that child and adolescent depression not only exist, but constitute an insidious and major public health problem. Depressive symptoms in children can be subtle and varied. The diagnosis in adolescents often is complicated by behavioral manifestations associated with hormonal changes. Both the etiology and the treatment of child and adolescent depression remain controversial. However, recent developments in pharmacotherapy appear promising. Primary prevention may not always be efficacious, but evidence suggests secondary prevention can reduce significantly future psychosocial problems.