Early Onset of Depression During Childhood and Adolescence

  • Benjamin G. Shapero
  • Erica Mazzone
Part of the Current Clinical Psychiatry book series (CCPSY)


Identifying, preventing, and treating the early onset of depression during childhood and adolescence presents unique challenges for mental health professionals. The rates of depression are relatively low in childhood but increase dramatically in mid-to-late adolescence. Young people with depression are at an increased risk for academic and social impairment and the development of later substance abuse, suicide, and the persistence or reoccurrence of depression into adulthood. This highlights the importance of identifying and treating depression early during these ages. The presentation of depression in youth resembles that of adults; however, it can be difficult to differentiate features of the disorder from the typical patterns of sadness and irritability during these transitional years. Clinicians must also be adept at differentiating depression from other related disorders. Once identified, there are several empirically supported intervention options. These include psychotherapies (such as cognitive-behavioral therapy and interpersonal psychotherapy) that are effective at reducing symptoms and improving overall functioning. Clinicians may also consider medication-based treatments, especially in cases of severe depression, with selective serotonin reuptake inhibitors, particularly fluoxetine, demonstrating the greatest efficacy. Studies have also supported the combination of cognitive-behavioral therapy and fluoxetine as effective. Finally, there are several alternative treatment options, such as exercise, behavioral activation, family therapy, and non-approved medications. It is essential for clinicians and families to weigh the costs and benefits of each treatment approach, taking differences such as age, depression severity, and the presence of suicidal ideation into consideration.


Child Adolescent Transitional aged youth Early onset Depression Major depressive disorder 


  1. 1.
    Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the national comorbidity survey replication. Arch Gen Psychiatry. 2005;62:593–602.CrossRefGoogle Scholar
  2. 2.
    Kessler RC, Avenevoli S, Merikangas KR. Mood disorders in children and adolescents: an epidemiologic perspective. Biol Psychiatry. 2001;49:1002–14.CrossRefGoogle Scholar
  3. 3.
    Hankin BL, Abramson LY, Moffitt TE, Silva PA, McGee R, Angell KE. Development of depression from preadolescence to young adulthood: emerging gender differences in a 10-year longitudinal study. J Abnorm Psychol. 1998;107:128.CrossRefGoogle Scholar
  4. 4.
    Costello EJ, Egger H, Angold A. 10-year research update review: the epidemiology of child and adolescent psychiatric disorders: I. Methods and public health burden. J Am Acad Child Psychiatry. 2005;44:972–86.CrossRefGoogle Scholar
  5. 5.
    Kessler RC, McGonagle KA, Zhao S, Nelson CB, Hughes M, Eshleman S, et al. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: results from the national comorbidity. Surv Arch Gen Psychiatry. 1994;51:8–19.CrossRefGoogle Scholar
  6. 6.
    Birmaher B, Ryan ND, Williamson DE, Brent DA, Kaufman J, Dahl RE, et al. Childhood and adolescent depression: a review of the past 10 years. Part I. J Am Acad Child Adolesc Psychiatry. 1996;35:1427–39.CrossRefGoogle Scholar
  7. 7.
    Hammen C, Brennan PA, Keenan-Miller D, Herr NR. Early onset recurrent subtype of adolescent depression: clinical and psychosocial correlates. J Child Psychol Psychiatry. 2008;49:433–40.CrossRefGoogle Scholar
  8. 8.
    Monroe SM, Harkness KL. Life stress, the “kindling” hypothesis, and the recurrence of depression: considerations from a life stress perspective. Psychol Rev. 2005;112:417.CrossRefGoogle Scholar
  9. 9.
    Judd LL. The clinical course of unipolar major depressive disorders. Arch Gen Psychiatry. 1997;54:989–91.CrossRefGoogle Scholar
  10. 10.
    Lewinsohn PM, Rohde P, Seeley JR, Klein DN, Gotlib IH. Natural course of adolescent major depressive disorder in a community sample: predictors of recurrence in young adults. Am J Psychiatry. 2000;157:1584–91.CrossRefGoogle Scholar
  11. 11.
    Fergusson DM, Horwood LJ, Ridder EM, Beautrais AL. Subthreshold depression in adolescence and mental health outcomes in adulthood. Arch Gen Psychiatry. 2005;62:66–72.CrossRefGoogle Scholar
  12. 12.
    Klein DN, Shankman SA, Lewinsohn PM, Seeley JR. Subthreshold depressive disorder in adolescents: predictors of escalation to full-syndrome depressive disorders. J Am Acad Child Adolesc Psychiatry. 2009;48:703–10.CrossRefGoogle Scholar
  13. 13.
    Pine DS, Cohen E, Cohen P, Brook J. Adolescent depressive symptoms as predictors of adult depression: moodiness or mood disorder? Am J Psychiatry. 1999;156:133–5.CrossRefGoogle Scholar
  14. 14.
    Heron M. Deaths: leading causes for 2014. Natl Vital Stat Rep. 2016;65:1–96.PubMedGoogle Scholar
  15. 15.
    American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5®). Arlington: American Psychiatric Pub; 2013.CrossRefGoogle Scholar
  16. 16.
    Birmaher B, Williamson DE, Dahl RE, Axelson DA, Kaufman J, et al. Clinical presentation and course of depression in youth: does onset in childhood differ from onset in adolescence? J Am Acad Child Psychiatry. 2004;43:63–70.CrossRefGoogle Scholar
  17. 17.
    Copeland WE, Angold A, Costello EJ, Egger H. Prevalence, comorbidity, and correlates of DSM-5 proposed disruptive mood dysregulation disorder. Am J Psychiatry. 2013;170:173–9.CrossRefGoogle Scholar
  18. 18.
    Copeland WE, Shanahan L, Egger H, Angold A, Costello EG. Adult diagnostic and functional outcomes of DSM-5 disruptive mood dysregulation disorder. Am J Psychiatry. 2014;171:668–74.CrossRefGoogle Scholar
  19. 19.
    Brady EU, Kendall PC. Comorbidity of anxiety and depression in children and adolescents. Psychol Bull. 1992;111:244–55.CrossRefGoogle Scholar
  20. 20.
    Stein MB, Fuetsch M, Müller N, Höfler M, Lieb R, Wittchen HU. Social anxiety disorder and the risk of depression: a prospective community study of adolescents and young adults. Arch Gen Psychiatry. 2001;58:251–6.CrossRefGoogle Scholar
  21. 21.
    Woodward LJ, Fergusson DM. Life course outcomes of young people with anxiety disorders in adolescence. J Am Acad Child Adolesc Psychiatry. 2001;40:1086–93.CrossRefGoogle Scholar
  22. 22.
    Centers for Disease Control. Attention-deficit/hyperactivity disorder: data and statistics from. 2010.
  23. 23.
    Kessler RC, Adler L, Barkley R, Biederman J, Conners CK, Demler O, et al. The prevalence and correlates of adult ADHD in the United States: results from the national comorbidity survey replication. Am J Psychiatry. 2006;163:716–23.CrossRefGoogle Scholar
  24. 24.
    Polanczyk G, de Lima MS, Horta BL, Biederman J, Rohde LA. The worldwide prevalence of ADHD: a systematic review and meta-regression analysis. Am J Psychiatry. 2007;164:942–8.CrossRefGoogle Scholar
  25. 25.
    Meinzer MC, Pettit JW, Viswesvaran C. The co-occurrence of attention-deficit/hyperactivity disorder and unipolar depression in children and adolescents: a meta-analytic review. Clin Psychol Rev. 2014;34:595–607.CrossRefGoogle Scholar
  26. 26.
    Meinzer MC, Lewinsohn PM, Pettit JW, et al. Attention-deficit/hyperactivity disorder in adolescence predicts onset of major depressive disorder through early adulthood. Depress Anxiety. 2013;30:546–53.CrossRefGoogle Scholar
  27. 27.
    Biederman J, Ball SW, Monuteaux MC, et al. New insights into the comorbidity between ADHD and major depression in adolescent and young adult females. J Am Acad Child Adolesc Psychiatry. 2008;47:426–34.CrossRefGoogle Scholar
  28. 28.
    Chronis-Tuscano A, Molina BSG, Pehlahm WE, et al. Very early predictors of adolescent depression and suicide attempts in children with attention-deficit/hyperactivity disorder. Arch Gen Psychiatry. 2010;10:1044–51.CrossRefGoogle Scholar
  29. 29.
    Jane Costello E, Erkanli A, Angold A. Is there an epidemic of child or adolescent depression? J Child Psychol Psychiatry. 2006;47:1263–71.PubMedGoogle Scholar
  30. 30.
    Kessler RC, Birnbaum H, Bromet E, Hwang I, Sampson N, Shahly V. Age differences in major depression: results from the national comorbidity survey replication (ncs-r). Psychol Med. 2010;40:225–37.CrossRefGoogle Scholar
  31. 31.
    Center for Disease Control. Trends in the prevalence of suicide-related behavior national YRBS: 1991–2015. 2015.
  32. 32.
    Nock MK, Green JG, Hwang I, McLaughlin KA, Sampson NA, et al. Prevalence, correlates, and treatment of lifetime suicidal behavior among adolescents: results from the National Comorbidity Survey Replication Adolescent Supplement. JAMA Psychiatry. 2013;70:300–10.CrossRefGoogle Scholar
  33. 33.
    Nock MK, Borges G, Bromet EJ, Alonso J, Angermeyer M, Beautrais A, et al. Cross-national prevalence and risk factors for suicidal ideation, plans and attempts. Brit J Psychiatry. 2008;192:98–105.CrossRefGoogle Scholar
  34. 34.
    Beck AT, Steer RA, Kovacs M, Garrison B. Hopelessness and eventual suicide: a 10-year prospective study of patients hospitalized with suicidal ideation. Am J Psychiatry. 1985;142:559–63.CrossRefGoogle Scholar
  35. 35.
    May AM, Klonsky ED. What distinguishes suicide attempters from suicide ideators? A meta-analysis of potential factors. Clin Psychol-Sci Pr. 2016;23:5–20.CrossRefGoogle Scholar
  36. 36.
    Baldessarini RJ, Tondo L, Visioli C. First-episode types in bipolar disorder: predictive associations with later illness. Acta Psychiat Scand. 2014;129:383–92.CrossRefGoogle Scholar
  37. 37.
    Lish JD, Dime-Meenan S, Whybrow PC, Price RA, Hirschfeld RM. The National Depressive and Manic-depressive Association (DMDA) survey of bipolar members. J Affect Disord. 1994;31:281–94.CrossRefGoogle Scholar
  38. 38.
    Brent DA. Antidepressants and pediatric depression-the risk of doing nothing. N Engl J Med. 2004;251:1598–9.Google Scholar
  39. 39.
    Brent DA. Antidepressants and suicidal behavior: cause or cure? Am J Psychiatry. 2007;164:989–91.CrossRefGoogle Scholar
  40. 40.
    Newman TB. A black-box warning for antidepressants in children. N Engl J Med. 2004;351:1595–7.CrossRefGoogle Scholar
  41. 41.
    Simon GE. How can we know whether antidepressants increase suicide risk? Am J Psychiatry. 2006;163:1861–2.CrossRefGoogle Scholar
  42. 42.
    Olfson M, Marcus SC, Shaffer D. Antidepressant drug therapy and suicide in severely depressed children and adults: a case-control study. Arch Gen Psychiatry. 2006;63:865–72.CrossRefGoogle Scholar
  43. 43.
    Wohlfarth TD, van Zwieten BJ, Lekkerkerker FJ, Gispen-de Wied CC, Ruis JR, et al. Antidepressants use in children and adolescents and the risk of suicide. Eur Neuropsychopharmacol. 2006;16:79–83.CrossRefGoogle Scholar
  44. 44.
    Hammad TA, Laughren T, Racoosin J. Suicidality in pediatric patients treated with antidepressant drugs. Arch Gen Psychiatry. 2006;63:332–9.CrossRefGoogle Scholar
  45. 45.
    Bridge JA, Iyengar S, Salary CB, Barbe RP, Birmaher B, Pincus HA, et al. Clinical response and risk for reported suicidal ideation and suicide attempts in pediatric antidepressant treatment: a meta-analysis of randomized controlled trials. J Am Med Assoc. 2007;297:1683–96.CrossRefGoogle Scholar
  46. 46.
    Beardslee WR, Gladstone TR. Prevention of childhood depression: recent findings and future prospects. Biol Psychiatry. 2001;49:1101–10.CrossRefGoogle Scholar
  47. 47.
    Beardslee WR, Gladstone TR, O'Connor EE. Transmission and prevention of mood disorders among children of affectively ill parents: a review. J Am Acad Child Psychiatry. 2011;50:1098–109.CrossRefGoogle Scholar
  48. 48.
    Weissman MM, Wickramaratne P, Nomura Y, Warner V, Pilowsky D, Verdeli H. Offspring of depressed parents: 20 years later. Am J Psychiatry. 2006;163:1001–8.CrossRefGoogle Scholar
  49. 49.
    Lewinsohn PM, Rohde P, Klein DN, Seeley JR. Natural course of adolescent major depressive disorder: I. Continuity into young adulthood. J Am Acad Child Psychiatry. 1999;38:56–63.CrossRefGoogle Scholar
  50. 50.
    Clarke GN, Hawkins W, Murphy M, Sheeber LB, Lewinsohn PM, Seeley JR. Targeted prevention of unipolar depressive disorder in an at-risk sample of high school adolescents: a randomized trial of a group cognitive intervention. J Am Acad Child Psychiatry. 1995;34:312–21.CrossRefGoogle Scholar
  51. 51.
    Clarke GN, Hornbrook M, Lynch F, Polen M, Gale J, Beardslee W, et al. A randomized trial of a group cognitive intervention for preventing depression in adolescent offspring of depressed parents. Arch Gen Psychiatry. 2001;58:1127–34.CrossRefGoogle Scholar
  52. 52.
    Garber J, Clarke GN, Weersing VR, Beardslee WR, Brent DA, Gladstone TR, et al. Prevention of depression in at-risk adolescents: a randomized controlled trial. J Am Med Assoc. 2009;301:2215–24.CrossRefGoogle Scholar
  53. 53.
    Beardslee WR, Brent DA, Weersing VR, Clarke GN, Porta G, Hollon SD, et al. Prevention of depression in at-risk adolescents: longer-term effects. JAMA Psychiat. 2013;70:1161–70.CrossRefGoogle Scholar
  54. 54.
    Brent DA, Brunwasser SM, Hollon SD, Weersing VR, Clarke GN, Dickerson JF, et al. Effect of a cognitive-behavioral prevention program on depression 6 years after implementation among at-risk adolescents: a randomized clinical trial. JAMA Psychiat. 2015;72:1110–8.CrossRefGoogle Scholar
  55. 55.
    Gillham JE, Reivich KJ, Jaycox LH. The Penn Resiliency Program. Unpublished manuscript, University of Pennsylvania. 2008.Google Scholar
  56. 56.
    Gillham JE, Reivich KJ, Jaycox LH, Seligman ME. Prevention of depressive symptoms in schoolchildren: two-year follow-up. Psychol Sci. 1995;6:343–51.CrossRefGoogle Scholar
  57. 57.
    Brunwasser SM, Gillham JE, Kim ES. A meta-analytic review of the Penn Resiliency Program’s effect on depressive symptoms. J Consult Clin Psych. 2009;77:1042.CrossRefGoogle Scholar
  58. 58.
    Werner-Seidler A, Perry Y, Calear AL, Newby JM, Christensen H. School-based depression and anxiety prevention programs for young people: a systematic review and meta-analysis. Clin Psychol Rev. 2017;51:30–47.CrossRefGoogle Scholar
  59. 59.
    Compas BE, Forehand R, Keller G, Champion JE, Rakow A, Reeslund KL, et al. Randomized controlled trial of a family cognitive-behavioral preventive intervention for children of depressed parents. J Consult Clin Psych. 2009;77:1007–20.CrossRefGoogle Scholar
  60. 60.
    Compas BE, Forehand R, Thigpen JC, Keller G, Hardcastle EJ, Cole DA, et al. Family group cognitive–behavioral preventive intervention for families of depressed parents: 18-and 24-month outcomes. J Consult Clin Psych. 2011;79:488.CrossRefGoogle Scholar
  61. 61.
    Beardslee WR, Gladstone TR, Wright EJ, Cooper AB. A family-based approach to the prevention of depressive symptoms in children at risk: evidence of parental and child change. Pediatrics. 2003;112:99–111.CrossRefGoogle Scholar
  62. 62.
    Beardslee WR, Wright EJ, Gladstone TR, Forbes P. Long-term effects from a randomized trial of two public health preventive interventions for parental depression. J Fam Psychol. 2007;21:703–13.CrossRefGoogle Scholar
  63. 63.
    Horowitz JL, Garber J. The prevention of depressive symptoms in children and adolescents: a meta-analytic review. J Consult Clin Psych. 2006;74:401–15.CrossRefGoogle Scholar
  64. 64.
    Stice E, Shaw H, Bohon C, Marti CN, Rohde P. A meta-analytic review of depression prevention programs for children and adolescents: factors that predict magnitude of intervention effects. J Consult Clin Psych. 2009;77:486–503.CrossRefGoogle Scholar
  65. 65.
    Brunwasser SM, Garber J. Programs for the prevention of youth depression: evaluation of efficacy, effectiveness, and readiness for dissemination. J Clin Child Adolesc Psychol. 2016;45:763–83.CrossRefGoogle Scholar
  66. 66.
    Weersing VR, Jeffreys M, Do MC, Schwartz KT, Bolano C. Evidence base update of psychosocial treatments for child and adolescent depression. J Clin Child Adolesc Psychol. 2017;46:11–43.CrossRefGoogle Scholar
  67. 67.
    Lewinsohn PM, Clarke GN. Psychosocial treatments for adolescent depression. Clin Psychol Rev. 1999;19:329–42.CrossRefGoogle Scholar
  68. 68.
    Klein JB, Jacobs RH, Reinecke MA. Cognitive-behavioral therapy for adolescent depression: a meta-analytic investigation of changes in effect-size estimates. J Am Acad Child Psychiatry. 2007;46:1403–13.CrossRefGoogle Scholar
  69. 69.
    Weisz JR, Kuppens S, Eckshtain D, Ugueto AM, Hawley KM, Jensen-Doss A. Performance of evidence-based youth psychotherapies compared with usual clinical care: a multilevel meta-analysis. JAMA Psychiat. 2013;70:750–61.CrossRefGoogle Scholar
  70. 70.
    David-Ferdon C, Kaslow NJ. Evidence-based psychosocial treatments for child and adolescent depression. J Clin Child Adolesc Psychol. 2008;37:62–104.CrossRefGoogle Scholar
  71. 71.
    Mufson L, Weissman MM, Moreau D, Garfinkel R. Efficacy of interpersonal psychotherapy for depressed adolescents. Arch Gen Psychiatry. 1999;56:573–9.CrossRefGoogle Scholar
  72. 72.
    Rudolph KD, Hammen C, Burge D, Lindberg N, Herzberg D, Daley SE. Toward an interpersonal life-stress model of depression: the developmental context of stress generation. Dev Psychopathol. 2000;12:215–34.CrossRefGoogle Scholar
  73. 73.
    Shih JH, Eberhart NK, Hammen CL, Brennan PA. Differential exposure and reactivity to interpersonal stress predict sex differences in adolescent depression. J Clin Child Adolesc Psychol. 2006;35:103–15.CrossRefGoogle Scholar
  74. 74.
    Vrshek-Schallhorn S, Stroud CB, Mineka S, Hammen C, Zinbarg RE, et al. Chronic and episodic interpersonal stress as statistically unique predictors of depression in two samples of emerging adults. J Abnorm Psychol. 2015;124:918.CrossRefGoogle Scholar
  75. 75.
    Zhou X, Hetrick SE, Cuijpers P, Qin B, Barth J, Whittington CJ, et al. Comparative efficacy and acceptability of psychotherapies for depression in children and adolescents: a systematic review and network meta-analysis. World Psychiatry. 2015;14:207–22.CrossRefGoogle Scholar
  76. 76.
    Wallace AE, Neily J, Weeks WB, Friedman MJ. A cumulative meta-analysis of selective serotonin reuptake inhibitors in pediatric depression: did unpublished studies influence the efficacy/safety debate? J Child Adol Psychopharmacol. 2006;16:37–58.CrossRefGoogle Scholar
  77. 77.
    Whittington CJ, Kendall T, Fonagy P, Cottrell D, Cotgrove A, Boddington E. Selective serotonin reuptake inhibitors in childhood depression: systematic review of published versus unpublished data. Lancet. 2004;363:1341–5.CrossRefGoogle Scholar
  78. 78.
    Cipriani A, Zhou X, Del Giovane C, Hetrick SE, Qin B, Whittington 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.CrossRefGoogle Scholar
  79. 79.
    Qin B, Zhang Y, Zhou X, Cheng P, Liu Y, Chen J, et al. Selective serotonin reuptake inhibitors versus tricyclic antidepressants in young patients: a meta-analysis of efficacy and acceptability. Clin Ther. 2014;36:1087–95.CrossRefGoogle Scholar
  80. 80.
    March J, Silva S, Petrycki S, Curry J, Wells K, Fairbank J, et al. Fluoxetine, cognitive-behavioral therapy, and their combination for adolescents with depression: Treatment for Adolescents With Depression Study (TADS) randomized controlled trial. J Am Med Assoc. 2004;292:807–20.CrossRefGoogle Scholar
  81. 81.
    March JS, Silva S, Petrycki S, Curry J, Wells K, Fairbank J, et al. The Treatment for Adolescents With Depression Study (TADS): long-term effectiveness and safety outcomes. Arch Gen Psychiatry. 2007;64:1132–43.CrossRefGoogle Scholar
  82. 82.
    Zhou X, Michael KD, Liu Y, Del Giovane C, Qin B, Cohen D, et al. Systematic review of management for treatment-resistant depression in adolescents. BMC Psychiatry. 2014;14:340.CrossRefGoogle Scholar
  83. 83.
    Dubicka B, Elvins R, Roberts C, Chick G, Wilkinson P, Goodyer IM. Combined treatment with cognitive–behavioural therapy in adolescent depression: meta-analysis. Brit J Psychiatry. 2010;197:433–40.CrossRefGoogle Scholar
  84. 84.
    Brent D, Emslie G, Clarke G, Wagner KD, Asarnow JR, Keller M, et al. Switching to another SSRI or to venlafaxine with or without cognitive behavioral therapy for adolescents with SSRI-resistant depression: the TORDIA randomized controlled trial. J Am Med Assoc. 2008;299:901–13.CrossRefGoogle Scholar
  85. 85.
    Mazzucchelli T, Kane R, Rees C. Behavioral activation treatments for depression in adults: a meta-analysis and review. Clin Psychol-Sci Pr. 2009;16:383–411.CrossRefGoogle Scholar
  86. 86.
    Cuijpers P, Van Straten A, Warmerdam L. Behavioral activation treatments of depression: a meta-analysis. Clin Psychol Rev. 2007;27:318–26.CrossRefGoogle Scholar
  87. 87.
    Dimidjian S, Hollon SD, Dobson KS, Schmaling KB, Kohlenberg RJ, Addis ME, et al. Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression. J Consult Clin Psych. 2006;74:658–70.CrossRefGoogle Scholar
  88. 88.
    Tindall L, Mikocka-Walus A, McMillan D, Wright B, Hewitt C, Gascoyne S. Is behavioural activation effective in the treatment of depression in young people? A systematic review and meta-analysis. Psychol Psychother. 2017;90(4):770–96.CrossRefGoogle Scholar
  89. 89.
    McCauley E, Gudmundsen G, Schloredt K, Martell C, Rhew I, et al. The adolescent behavioral activation program: adapting behavioral activation as a treatment for depression in adolescence. J Clin Child Adolesc Psychol. 2016;45:291–304.CrossRefGoogle Scholar
  90. 90.
    Ritschel LA, Ramirez CL, Cooley JL, Craighead EW. Behavioral activation for major depression in adolescents: results from a pilot study. Clin Psychol-Sci Pr. 2016;23:39–57.CrossRefGoogle Scholar
  91. 91.
    Kvam S, Kleppe CL, Nordhus IH, Hovland A. Exercise as a treatment for depression: a meta-analysis. J Affect Disord. 2016;202:67–86.CrossRefGoogle Scholar
  92. 92.
    Carter T, Morres ID, Meade O, Callaghan P. The effect of exercise on depressive symptoms in adolescents: a systematic review and meta-analysis. J Am Acad Child Psychiatry. 2016;55:580–90.CrossRefGoogle Scholar
  93. 93.
    Korczak DJ, Madigan S, Colasanto M. Children’s physical activity and depression: a meta-analysis. Pediatrics. 2017;139:2016–266.CrossRefGoogle Scholar
  94. 94.
    Mangerud WL, Bjerkeset O, Lydersen S, Indredavik MS. Physical activity in adolescents with psychiatric disorders and in the general population. Child Adol Psych Men. 2014;8:2.Google Scholar
  95. 95.
    Puetz TW, O’connor PJ, Dishman RK. Effects of chronic exercise on feelings of energy and fatigue: a quantitative synthesis. Psychol Bull. 2006;132:866.CrossRefGoogle Scholar
  96. 96.
    Dunn AL, Trivedi MH, Kampert JB, Clark CG, Chambliss HO. Exercise treatment for depression: efficacy and dose response. Am J Prev Med. 2005;28:1–8.CrossRefGoogle Scholar
  97. 97.
    Asarnow JR, Miranda J. Improving care for depression and suicide risk in adolescents: innovative strategies for bringing treatments to community settings. Ann Rev Clin Psychol. 2014;10:275–303.CrossRefGoogle Scholar
  98. 98.
    Curry JF. Specific psychotherapies for childhood and adolescent depression. Biol Psychiatry. 2001;49:1091–100.CrossRefGoogle Scholar
  99. 99.
    Curry JF. Future directions in research on psychotherapy for adolescent depression. J Clin Child Adolesc Psychol. 2014;43:510–26.CrossRefGoogle Scholar
  100. 100.
    Sakolsky D, Birmaher B. Developmentally informed pharmacotherapy for child and adolescent depressive disorders. Child Adol Psych Cl. 2012;21:313–25.CrossRefGoogle Scholar
  101. 101.
    Maalouf FT, Brent DA. Child and adolescent depression intervention overview: what works, for whom and how well? Child Adol Psychiatr Clin. 2012;21:299–312.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Benjamin G. Shapero
    • 1
  • Erica Mazzone
    • 1
  1. 1.Depression Clinical and Research Program, Department of PsychiatryMassachusetts General Hospital, Harvard Medical SchoolBostonUSA

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