Depression

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Overview of Mental Disorders in Children
A consideration of developmental principles enhances understanding of mental illness in children and adolescents by reconciling the concept of mental disorder as a stable state or condition with the ongoing development of the child. According to these principles, a mental disorder results from the interaction of a child and his or her environment. Thus, mental illness often does not lie within the child alone. Within the conceptual framework and language of integrative neuroscience, the mental disorder is an“emergent property” of the transaction with the environment. Proper assessment of a child’s mood, thought, and behaviors demands a simultaneous consideration of nature and nurture, genes and environment, and biology and psychosocial influences. These relationships are reciprocal. The brain shapes behavior, and learning shapes the brain.

Mental disorders must be considered within the context of the family and peers, school, home, and community. Taking the social-cultural environment into consideration is essential to understanding mental disorders in children and adolescents, as it is in adults. However, the changing nature of these environments, coupled with the progressively unfolding processes of brain development, makes the emphasis on context, as well as development, more complex and more central in child mental health (Jensen & Hoagwood, 1997).

Thus, developmental psychopathology encourages consideration of the transactions between the individual and the social and physical environment at the same time that signs and symptoms of mental disorder are considered. Moreover, focusing on diagnostic labels alone provides too limited a view of mental disorders in children and adolescents.

General Categories of Mental Disorders of Children
Mental disorders with onset in childhood and adolescence are listed in Table 3-2 as they appear in DSM-IV. These disorders fall into a number o...