Hopp til hovedinnhold

Depressive lidelser hos barn og unge

Sist revidert:
Sist revidert av:
Definisjon:
Depresjon hos barn og ungdom
Forekomst:
Alvorlig depresjon forekommer hos 1-5% av barn og ungdom, mens 14-25% av ungdommer opplever minst én episode med sterk depresjon før voksenalder
Symptomer:
Senket stemningsleie med endret selvfølelse, aktivitetsnivå og oftest somatiske symptomer i tillegg
Funn:
Nedstemthet, negative tanker om seg selv, passivitet eller irritabilitet, oppmerksomhets- og konsentrasjonsvansker
Diagnostikk:
Tilleggsundersøkelser kan være ulike spørreskjema
Behandling:
Multimodal og individuelt tilpasset. Hovedbehandlingen er psykoterapi, ev. supplert med antidepressivum (fluoxetin)
  1. Ryan ND. Treatment of depression in children and adolescents. Lancet 2005; 366: 933-40. PubMed  
  2. Grøholt B, Sund AM. Depressive lidelser. Faglig veileder for barne- og ungdomspsykiatri. 21. mars 2019. www.legeforeningen.no  
  3. Costello EJ, Mustillo S, Erkanli A, Keeler G and Angold A. Prevalence and development of psychiatric disorders in childhood and adolescence. Arch Gen Psychiatry 2003; 60: 837-44. PubMed  
  4. Sørensen MJ, Thomsen PH. Depression hos børn og unge. Ugeskr Læger 2006; 168: 679-82. PubMed  
  5. Costello JE, Erkanli A, Angold A. Is there an epidemic of child or adolescent depression? Journal of child psychology and psychiatry, and allied disciplines. 2006 Dec;47(12):1263-1271.
  6. Rice F, Harold G and Thapar A. The genetic aetiology of childhood depression: a review. J Child Psychol Psychiatry 2002; 43: 65-79. PubMed  
  7. Rice F, Harold GT and Thapar A. Negative life events as an account of age-related differences in the genetic aetiology of depression in childhood and adolescence. J Child Psychol Psychiatry 2003; 44: 977-87. PubMed  
  8. Lin LY, Sidani JE, Shensa A, et al. Association betwenn soscial media use and depression among U.S. young adults. Depress Anxiety 2016; 33: 323-31. pmid:26783723 PubMed  
  9. Jaffee SR, Moffitt TE, Caspi A, Fombonne E, Poulton R and Martin J. Differences in early childhood risk factors for juvenile-onset and adult-onset depression. Arch Gen Psychiatry 2002; 59: 215-22. PubMed  
  10. Zucker N, Copeland W, Franz L, et al. Psychological and Psychosocial Impairment in Preschoolers With Selective Eating. Pediatrics 2015. doi:10.1542/peds.2014-2386 DOI  
  11. Brent DA, Maalouf FT. Pediatric depression: is there evidence to improve evidence-based treatments? Journal of child psychology and psychiatry, and allied disciplines. 2009 Jan;50(1-2):143-152.
  12. Hopkins K, Crosland P, Elliott N, et al. Diagnosis and management of depression in children and young people: summary of updated NICE guidance. BMJ 2015;350. doi:10.1136/bmj.h824 DOI  
  13. Cipriani A, Zhou X, Del Giovane C, et al. Comparative efficacy and tolerability of antidepressants for major depressive disorder in children and adolescents: A network meta-analysis. Lancet 2016. doi: 10.1016/S0140-6736(16)30385-3 DOI  
  14. Hammad TA, Laughren T, Racoosin J. Suicidality in pediatric patients treated with antidepressant drugs. Arch Gen Psychiatry 2006; 63: 332-39.
  15. Sharma T, Guski LS, Freund N, Gøtzsche PC. Suicidality and aggression during antidepressant treatment: systematic review and meta-analyses based on clinical study reports. BMJ 2016; 352: i65. doi:10.1136/bmj.i65 DOI  
  16. Cox GR, Callahan P, Churchill R, et al. Psychological therapies versus antidepressant medication, alone and in combination for depression in children and adolescents. Cochrane Database Syst Rev. 2014 ;11:CD008324. doi: 10.1002/14651858.CD008324.pub3 DOI  
  17. Dalsbø TK, Siqveland J, Dahm KT, Reinar LM. Effekter av psykologisk terapi sammenlignet med antidepressive medikamenter alene eller i kombinasjon med psykologisk terapi for barn og unge med depresjon eller depresjonssymptomer: en systematisk oversikt. Folkehelseinstituttet 2017. www.fhi.no  
  18. Larun L, Nordheim LV, Ekeland E, Hagen KB, Heian F. Exercise in prevention and treatment of anxiety and depression among children and young people. Cochrane Database of Systematic Reviews, issue 3, 2006. The Cochrane Library  
  19. Emslie GJ, Heiligenstein JH, Wagner KD et al. Fluoxetine for acute treatment of depression in children and adolescents: a placebo-controlled, randomized clinical trial. J Am Acad Child Adolesc Psychiatry 2002; 41: 1205-15. PubMed  
  20. Hetrick SE, McKenzie JE, Cox GR, et al. Newer generation antidepressants for depressive disorders in children and adolescents. Cochrane Database Syst Rev 2012 Nov 14; 11: CD004851. DOI: 10.1002/14651858.CD004851.pub3 DOI  
  21. Birmaher B, Brent D, Bernet W, Bukstein O, Walter H, Benson RS, et al. Practice parameter for the assessment and treatment of children and adolescents with depressive disorders. Journal of the American Academy of Child and Adolescent Psychiatry. 2007 Nov;46(11):1503-1526. PubMed  
  22. Hetrick SE, McKenzie JE, Cox GR, Simmons MB, Merry SN. Newer generation antidepressants for depressive disorders in children and adolescents. Cochrane Database of Systematic Reviews 2012, Issue 11. Art. No.: CD004851. Cochrane (DOI)  
  23. Cipriani A, Zhou X, Del Giovane C et al.. Comparative efficacy and tolerability of antidepressants for major depressive disorder in children and adolescents: a network meta-analysis. Lancet 2016; 388: 881-90. pmid:27289172 PubMed  
  24. Dubicka B, Hadley S, Roberts C. Suicidal behavior in youths with depression treated with new-generation antidepressants. Br J Psychiatry 2006; 189: 393-8. British Journal of Psychiatry  
  25. Schneeweiss S, Patrick AR, Solomon DH, et al. Comparative safety of antidepressant agents for children and adolescents regarding suicidal acts. Pediatrics 2010; 125: 876-88. Pediatrics  
  26. Hazell P, Mirzaie M. Tricyclic drugs for depression in children and adolescents. Cochrane Database of Systematic Reviews 2013, Issue 6. Art. No.: CD002317. DOI: 10.1002/14651858.CD002317.pub2. DOI  
  27. March J, Silva S, Petrycki S, et al. Fluoxetine, cognitive-behavioral therapy, and their combination for adolescents with depression: Treatment for Adolescents with Depression Study (TADS) randomized controlled trial. JAMA 2004; 292: 807-20. Journal of the American Medical Association  
  28. Goodyer I, Dubicka B, Wilkinson P, et al. Selective serotonin reuptake inhibitors (SSRIs) and routine specialist care with and without cognitive behaviour therapy in adolescents with major depression: randomised controlled trial. BMJ 2007; 335: 142. British Medical Journal  
  29. Sund AM, Larsson B, Wichstrøm L. Depressive symptoms among young Norwegian adolescents as measured by the Mood and Feelings Questionnaire. J European Child Adolesc Psychiatry 2001; 10: 222-9. PubMed  
  30. Hammad T. Review and evaluation of clinical data, FDA, Washington DC, USA (2004). (http://www.fda.gov/ohrms/dockets/ac/04/briefing/2004-4065b1-10-TAB08-Hammads-Review.pdf) (accessed Aug 4, 2005).
  31. Clarke G, DeBar LL, Pearson JA, et al. Cognitive Behavioral Therapy in Primary Care for Youth Declining Antidepressants: A Randomized Trial. Pediatrics. 2016. PMID: 27244782 PubMed  
  32. Thapar A, Collishaw S, Potter R, Thapar AK. Managing and preventing depression in adolescents. BMJ 2010; 340: c209. BMJ (DOI)  
  33. Mufson L, Dorta KP, Wickramaratne P, Nomura Y, Olfson M and Weissman MM. A randomized effectiveness trial of interpersonal psychotherapy for depressed adolescents. Arch Gen Psychiatry 2004; 61: 577-84. PubMed  
  34. Goodyer IM, Reynolds S, Barrett B, et al. Cognitive behavioural therapy and short-term psychoanalytical psychotherapy versus a brief psychosocial intervention in adolescents with unipolar major depressive disorder (IMPACT): a multicentre, pragmatic, observer-blind, randomised controlled superiority trial. Lancet Psychiatry 2016. pmid:27914903 PubMed  
  35. Weissman MM, Pilowsky DJ, Wickramaratne PJ et al. Remissions in maternal depression and child psychopathology: a STAR*D-child report. JAMA 2006; 295: 1389-98. Journal of the American Medical Association  
  36. Beardslee WR, Brent DA, Weersing VR, et al. Prevention of depression in at-risk adolescents: Longer-term effects. JAMA Psychiatry 2013. doi:10.1001/jamapsychiatry.2013.295 DOI  
  37. Siu AL, et al. Screening for depression in children and adolescents: U.S. Preventive Services Task Force Recommendation Statement. Ann Intern Med 2016. doi:10.7326/M15-2957 DOI  
  38. Weissman MM. Juvenile-onset major depression includes childhood- and adolescent-onset depression and may be heterogeneous. Arch Gen Psychiatry 2002; 59: 223-4. PubMed  
  39. Birmaher B, Williamson DE, Dahl RE et al.. Clinical presentation and course of depression in youth: does onset in childhood differ from onset in adolescence?. J Am Acad Child Adolesc Psychiatry 2004; 43: 63-70. PubMed  
  40. Kessler RC, Avenevoli S and Ries Merikangas K. Mood disorders in children and adolescents: an epidemiologic perspective. Biol Psychiatry 2001; 49: 1002-14. PubMed  
  41. Gould MS, Greenberg T, Velting DM, Shaffer D. Youth suicide risk and preventative interventions: a review of the past 10 years. J Am Acad Child Adolesc Psychiatry 2003; 42: 386-405. PubMed  
  42. Birmaher B, Williamson DE, Dahl RE et al. Clinical presentation and course of depression in youth: does onset in childhood differ from onset in adol-escence? J Am Acad Child Adolesc Psychiatry 2004; 43: 63-70. PubMed  
  43. Lewinsohn PM, Rohde P, Seeley JR. Major depressive disorder in older adolescents: prevalence, risk factors, and clinical implications. Clin Psychol Rev 1998; 18: 765-94. PubMed  
  • Terje Johannessen, professor i allmennmedisin, Trondheim

Tidligere fagmedarbeidere

  • Marit S. Indredavik, spesialist i barnepsykiatri, overlege, Barne- og ungdomspsykiatrisk klinikk, St.Olavs hospital, Universitetssykehuset i Trondheim, Helse Midt-Norge