Feature Article

Childhood depression and anxiety disorders: don’t miss the telltale signs

Philip Hazell



The recognition and management of most anxiety disorders in children is straightforward, whereas the detection and management of depression can be challenging. Cognitive behavioural therapy and pharmacotherapy options are available to treat children with anxiety or depressive disorders.

Key Points

  • Anxiety is the second most common mental disorder affecting children.
  • Depression is less common than anxiety and typically will present in association with anxiety.
  • Acute anxiety is instantly recognisable. In the general practice setting, chronic anxiety is likely to present with physical complaints.
  • Depression is more difficult to detect than anxiety and can therefore be overlooked.
  • The symptom criteria to diagnose depression are the same for children as they are for adults, but there are some small modifications.
  • First-line management of children with anxiety is general support and psychological treatment; pharmacological treatment is only considered when other measures have failed.
  • First-line management of children with depression is general support and monitoring. Children with mild depression that has not improved with monitoring should be treated with specific psychotherapy, whereas those with moderate-to-severe depression are likely to require antidepressant medication.

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    Model used for illustrative purposes only.