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《兒童和青少年抑郁障礙的評價和治療指南》內(nèi)容預覽

    Depressive disorders are often familial recurrentillnesses associated with increased psychosocialmorbidity and mortality. Early dentification andeffective treatment may reduce the impact of depressionon the amily, social, and academic functioningin youths and may reduce the risk of suicide,substance abuse, and persistence of depressivedisorders into adulthood. Evidence-supportedtreatment interventions have emerged in psychotherapyand medication treatment of childhood depressivedisorders that can guide clinicians to improveoutcomes in this population.

    The list of references for this parameter was developedby searching PsycINFO, Medline, and PsychologicalAbstracts; by reviewing the liographiesof book chapters and review articles; by asking colleagues for suggested source materials; and from theprevious version of this parameter (American Academyof Child and Adolescent Psychiatry, 1998), therecent American Psychiatric Association/AACAPguidelines “The Use of Medication in TreatingChildhood and Adolescent Depression: Information for Physicians” published by Parents-MedGuide.org, the American sychiatric Associationguidelines for the treatment of adults with MDD (American Psychiatric Association, 2000a;Fochtmann and Gelenberg, 2005), the Texas algorithmsfor the treatment of children and dolescents with MDD (Hughes et al., 2007), and theNational Institute of Health and Clinical Excellence(NICE; 2004) guidelines for the treatment ofdepressed youths.

    The searches, conducted in2005, used the following text words: “major depressivedisorder,” “dysthymia,” antidepressants,”and “psychotherapy” (e.g., interpersonal,sychodynamic,cognitive) combined with the word“child.” The searches covered the period 1990 toJanuary 2007 and only articles that included depressivedisorders were included. Given space limitations,we mainly cited review articles publishedin refereed journals and added new elevant articlesnot included in the reviews.

    The terminology in this practice parameter isconsistent with the DSM-IV-TR (American PsychiatricAssociation, 2000b). Unless specified, the term “depression” encompasses both major depressivedisorder (MDD) and dysthmic disorder (DD).Impairment means reduced functioning in one ormore major areas of life (academic performance,family relationships, and peer interactions).

    The information included in this parameter pertainsmainly to MDD. There are few clinical studiesand no controlled trials for the treatment of DDin youths. However, based on the limited literature (American Psychiatric Association,2000a), efficacious treatments for MDD may also be useful for the management of DD.In this parameter, unless otherwise specified, the terms “child” and “youths,” respectively, refer to children and adolescents. “Parent” refers to parentor legal guardian.

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