{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T12:28:28Z","timestamp":1791116908159,"version":"4.1.0"},"reference-count":22,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,2,1]]},"abstract":"<jats:p>Depressive disorders are common in children and adolescents, with estimates for depressive episodes as high as 18.2% for girls and 7.7% for boys by age 17 years, and are a major cause of morbidity and even mortality. The primary care pediatrician should be able to (1) diagnose depressive disorders and use standardized instruments; (2) ask about suicide, self-harm, homicide, substance use, mania, and psychosis; (3) triage the severity of illness; (4) be aware of the differential diagnosis, including normal development, other depressive disorders, bipolar disorders, and comorbid disorders, such as anxiety and substance use; (5) refer to evidenced-based psychotherapies; (6) prescribe first-line medications; and (7) provide ongoing coordination in a medical home. Pediatric bipolar disorders and the new disruptive mood dysregulation disorder (DMDD) diagnoses are controversial but not uncommon, with prevalence estimates ranging from 0.8% to 4.3% in children at various ages. Although the pediatrician is not likely to be prescribing medications for children with bipolar disorder and DMDD diagnoses, all clinicians should be familiar with common neuroleptics and other mood stabilizers, including important potential adverse effects. Basic management of depressive and bipolar disorders is an important skill for primary care pediatricians.<\/jats:p>","DOI":"10.1542\/pir.36.2.52","type":"journal-article","created":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T19:35:39Z","timestamp":1639078539000},"page":"52-61","source":"Crossref","is-referenced-by-count":14,"title":["Mood and Affect Disorders"],"prefix":"10.1542","volume":"36","author":[{"given":"Michael H.","family":"Tang","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Harvard Medical School, Department of Psychiatry, Massachusetts General Hospital and McLean Hospital, Boston, MA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth G.","family":"Pinsky","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Harvard Medical School, and Departments of Psychiatry and Pediatrics, Massachusetts General Hospital, Boston, MA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2015,2,1]]},"reference":[{"key":"2021120903475413700_B1","doi-asserted-by":"crossref","DOI":"10.1176\/appi.books.9780890425596","volume-title":"Diagnostic and Statistical Manual of Mental Disorders","author":"American Psychiatric Association","year":"2013","edition":"5th ed"},{"key":"2021120903475413700_B2","author":"Perou"},{"issue":"10","key":"2021120903475413700_B3","doi-asserted-by":"crossref","first-page":"980","DOI":"10.1016\/j.jaac.2010.05.017","article-title":"Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication\u2014Adolescent Supplement (NCS-A)","volume":"49","author":"Merikangas","year":"2010","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"key":"2021120903475413700_B4","unstructured":"Patient Health Questionnaire-9 (PHQ-9). Bright Futures Tool and Resource Kit. http:\/\/brightfutures.aap.org\/tool_and_resource_kit.html. Accessed July 13, 2014."},{"key":"2021120903475413700_B5","unstructured":"Center for Epidemiologic Studies Depression Scale for Children (CES-DC). Bright Futures Tool and Resource Kit. http:\/\/www.brightfutures.org\/mentalhealth\/pdf\/professionals\/bridges\/ces_dc.pdf. Accessed July 13, 2014"},{"issue":"13","key":"2021120903475413700_B6","doi-asserted-by":"crossref","first-page":"1635","DOI":"10.1001\/jama.293.13.1635","article-title":"Evaluating iatrogenic risk of youth suicide screening programs: a randomized controlled trial","volume":"293","author":"Gould","year":"2005","journal-title":"JAMA"},{"issue":"4","key":"2021120903475413700_B7","doi-asserted-by":"crossref","first-page":"e996","DOI":"10.1542\/peds.2013-0600","article-title":"Evidence for the management of adolescent depression","volume":"132","author":"Lewandowski","year":"2013","journal-title":"Pediatrics"},{"issue":"7","key":"2021120903475413700_B8","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1001\/jama.292.7.807","article-title":"Fluoxetine, cognitive-behavioral therapy, and their combination for adolescents with depression: Treatment for Adolescents With Depression Study (TADS) randomized controlled trial","volume":"292","author":"March","year":"2004","journal-title":"JAMA"},{"issue":"10","key":"2021120903475413700_B9","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1001\/archpsyc.64.10.1132","article-title":"The Treatment for Adolescents With Depression Study (TADS): long-term effectiveness and safety outcomes","volume":"64","author":"March","year":"2007","journal-title":"Arch Gen Psychiatry"},{"issue":"8","key":"2021120903475413700_B10","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1001\/jama.299.8.901","article-title":"Switching to another SSRI or to venlafaxine with or without cognitive behavioral therapy for adolescents with SSRI-resistant depression: the TORDIA randomized controlled trial","volume":"299","author":"Brent","year":"2008","journal-title":"JAMA"},{"issue":"15","key":"2021120903475413700_B11","doi-asserted-by":"crossref","first-page":"1683","DOI":"10.1001\/jama.297.15.1683","article-title":"Clinical response and risk for reported suicidal ideation and suicide attempts in pediatric antidepressant treatment: a meta-analysis of randomized controlled trials","volume":"297","author":"Bridge","year":"2007","journal-title":"JAMA"},{"issue":"2","key":"2021120903475413700_B12","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1007\/s40272-013-0061-1","article-title":"Antidepressant drugs and the risk of suicide in children and adolescents","volume":"16","author":"Isacsson","year":"2014","journal-title":"Paediatr Drugs"},{"issue":"4","key":"2021120903475413700_B13","doi-asserted-by":"crossref","first-page":"225","DOI":"10.2165\/11591660-000000000-00000","article-title":"Antidepressants and psychostimulants in pediatric populations: is there an association with mania?","volume":"13","author":"Goldsmith","year":"2011","journal-title":"Paediatr Drugs"},{"issue":"11","key":"2021120903475413700_B14","doi-asserted-by":"crossref","first-page":"1503","DOI":"10.1097\/chi.0b013e318145ae1c","article-title":"Practice parameter for the assessment and treatment of children and adolescents with depressive disorders","volume":"46","author":"Birmaher","year":"2007","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"issue":"4","key":"2021120903475413700_B15","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1176\/appi.ajp.2007.07091453","article-title":"Fluoxetine versus placebo in preventing relapse of major depression in children and adolescents","volume":"165","author":"Emslie","year":"2008","journal-title":"Am J Psychiatry"},{"issue":"1","key":"2021120903475413700_B16","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1097\/01.chi.0000242240.69678.c4","article-title":"Practice parameter for the assessment and treatment of children and adolescents with bipolar disorder","volume":"46","author":"McClellan","year":"2007","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"issue":"2","key":"2021120903475413700_B17","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1176\/appi.ajp.2012.12010132","article-title":"Prevalence, comorbidity, and correlates of DSM-5 proposed disruptive mood dysregulation disorder","volume":"170","author":"Copeland","year":"2013","journal-title":"Am J Psychiatry"},{"issue":"2","key":"2021120903475413700_B18","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1016\/j.chc.2008.11.009","article-title":"Psychosocial treatments for childhood and adolescent bipolar disorder","volume":"18","author":"West","year":"2009","journal-title":"Child Adolesc Psychiatr Clin N Am"},{"issue":"5","key":"2021120903475413700_B19","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1001\/archgenpsychiatry.2011.1508","article-title":"A randomized controlled trial of risperidone, lithium, or divalproex sodium for initial treatment of bipolar I disorder, manic or mixed phase, in children and adolescents","volume":"69","author":"Geller","year":"2012","journal-title":"Arch Gen Psychiatry"},{"issue":"7","key":"2021120903475413700_B20","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1176\/appi.ajp.2009.08101569","article-title":"Four-year longitudinal course of children and adolescents with bipolar spectrum disorders: the Course and Outcome of Bipolar Youth (COBY) study","volume":"166","author":"Birmaher","year":"2009","journal-title":"Am J Psychiatry"},{"issue":"6","key":"2021120903475413700_B21","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1176\/appi.ajp.2014.13091213","article-title":"Adult diagnostic and functional outcomes of DSM-5 disruptive mood dysregulation disorder","volume":"171","author":"Copeland","year":"2014","journal-title":"Am J Psychiatry"},{"issue":"10","key":"2021120903475413700_B22","doi-asserted-by":"crossref","first-page":"1342","DOI":"10.4088\/JCP.12m07674","article-title":"Examining the proposed disruptive mood dysregulation disorder diagnosis in children in the Longitudinal Assessment of Manic Symptoms study","volume":"73","author":"Axelson","year":"2012","journal-title":"J Clin Psychiatry"}],"container-title":["Pediatrics In Review"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatricsinreview\/article-pdf\/36\/2\/52\/838371\/pedsinreview_20140058.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatricsinreview\/article-pdf\/36\/2\/52\/838371\/pedsinreview_20140058.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,21]],"date-time":"2021-12-21T14:38:29Z","timestamp":1640097509000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatricsinreview\/article\/36\/2\/52\/32210\/Mood-and-Affect-Disorders"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,2,1]]},"references-count":22,"aliases":["10.1542\/pir.36-2-52"],"journal-issue":{"issue":"2","published-online":{"date-parts":[[2015,2,1]]},"published-print":{"date-parts":[[2015,2,1]]}},"URL":"https:\/\/doi.org\/10.1542\/pir.36.2.52","relation":{},"ISSN":["0191-9601","1526-3347"],"issn-type":[{"value":"0191-9601","type":"print"},{"value":"1526-3347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,2,1]]}}}