Dysthymia | Symptoms & Causes
What causes persistent depressive disorder?
The exact cause for persistent depressive disorder is not known, but experts point to several risk factors for developing depressive disorders:
- Family history of depressive disorder
- Temperamental factors: negative affectivity
- Environmental stressors such as:
- Death of a parent, relative, or friend
- Abuse or neglect
- Other mental health problems such as anxiety
- Divorce or illness in the family
- Dealing with a chronic medical illness
- Chronic social or academic difficulties
What are the symptoms of persistent depressive disorder?
A child or adolescent with persistent depressive disorder will experience a depressed or irritable mood on most days for at least a year. In addition, the child will exhibit appetite changes, sleep disturbances, fatigue, low self-esteem, poor concentration, difficulty making decisions, or feelings of hopelessness.
Dysthymia | Diagnosis & Treatments
How is persistent depressive disorder diagnosed?
A child psychiatrist or other mental health professional typically diagnoses persistent depressive disorder after conducting a thorough psychiatric evaluation. Such an evaluation will involve an interview with the child and with the family. Many times the child’s school will be consulted to provide additional information.
If my child is diagnosed with persistent depressive disorder, what happens next?
If your child’s healthcare provider diagnoses your child with persistent depressive disorder, treatment options will be presented to you, including the potential risks and benefits of possible treatments. Taking into consideration your opinions and preferences, your healthcare provider will work with you and your child to create the most appropriate treatment plan.
How is persistent depressive disorder treated?
Treatment for persistent depressive disorder consists of psychotherapy and medication. Evidence-based psychotherapeutic interventions for depression include cognitive behavioral therapy and interpersonal therapy. Combination treatment using psychotherapy and antidepressant medication has shown to be the most effective intervention. The antidepressant medications most commonly used are the selective serotonin reuptake inhibitors (SSRIs). Children and adolescents need to be monitored very closely by their healthcare team when antidepressant medications are being initiated or doses are being increased. The Outpatient Psychiatry Service at Boston Children’s Hospital is experienced in the assessment and treatment of depressive disorders in children and adolescents. For more information please call 617-355-6680.
(How) can I prevent persistent depressive disorder?
There is some evidence that treating depression in parents can help prevent the development of depression in their children. Intervention strategies targeting families of children at risk for depression have demonstrated some efficacy for preventing depressive symptoms in these children.
What is the long-term outlook for a child with persistent depressive disorder?
Those with persistent depressive disorder are at high risk of going on to develop a major depressive episode. People that develop persistent depressive disorder earlier in life (<21 years of age) tend to have a poorer prognosis than those that develop the disorder later in life. Children with persistent depressive disorder who do not receive treatment are more likely to develop personality disorders and substance use disorders in adulthood. Early identification and treatment of the disorder is important to minimize the long-term impact on the child or adolescent.