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This excellent text is based on the most recent
conceptual, clinical, theoretical, and research data in the field
of child and adolescent depression. The editor is internationally
well known in child and adolescent psychiatry for his scholarly
book on the study of life experiences and their impact on the development
of child psychopathology. He has collaborated with several contributors
in this volume, choosing well-established and proven experts to
contribute chapters on their particular area of clinical and academic
research. This volume bears witness to the rapid advances taking
place in our understanding of depression in children and adolescents,
specifically, in the realms of psychopharmacology, psychotherapies,
and genetics. Our understanding of the interplay between the bio-psycho-sexual-social
factors is crystallizing: we are gaining better understanding of
the way in which each component impacts on the other. Gone are the
days of polarized camps of dynamic vs behaviourist vs biologic theorists.
This book comprises 13 chapters. It begins with a chapter on the
historical aspects of mood disorders in young people, taken from
the first edition as a tribute to its author, the late Professor
William Parry Jones. This is an excellent and fascinating review
of the conceptualization of mood disturbances over the centuries.
It is interesting that as early as 1621 reference was made to the
impact of extremes of child rearing and disciplinary practices on
the emotional well-being of children. Especially interesting is
the section on theories of causation, which locates the nidus for
present day thinking in early, rudimentary theories.
Chapter 2 covers the development of emotional intelligence. It
is an excellent review of social emotional norms, the ways in which
cognitive processes can affect emotions, and the contribution of
various skills to better regulation of emotions. What can interfere
with and what can enhance the acquisition of regulatory competence
are discussed, as is the therapeutic importance of understanding
that attributions can be altered by interventions such as cognitive-behavioural
therapy (CBT).
Chapter 3 deals with developmental precursors and looks at the
factors underlying the development of depression. It stresses the
importance of attachment and its effect on the development of coping
mechanisms, resilience, and also vulnerabilities. It makes clear
that the developmental process underlying good coping and, conversely,
vulnerability to depression, is complex, both within the family
and within the individual. All this is wonderfully illustrated in
diagrammatic form at the end of the chapter.
Chapter 4 is a study of physiological processes and how they may
contribute to the development and natural history of depression.
It reviews the most recent literature on the influence of hormonal
fluctuation on the etiology and history of depression. This chapter
not only addresses the limitations of the most current studies but
also proposes specific areas in the physiological aspects of depression
for further, future investigation. The need to elucidate the physiological
contribution to depressive disorders is emphasized.
Chapter 5 focuses on the phenomenology and classification of depressive
disorder. Here, the authors have critically reviewed the most recent
literature, and the chapter includes a detailed description and
discussion of some of the methodologies and conclusions from more
important studies in this field. The authors stress the importance
of refining the diagnostic criteria for depression and dysthymia.
Again, they propose areas of potential interest for further study.
The epidemiology of affective disorder is the focus of Chapter
6. This chapter examines the frequently discussed issue of comorbidity
of attention-deficit hyperactivity disorder (ADHD) and bipolar affective
disorder. It also discusses various other comorbid disorders and
exhaustively reviews the relevant literature. It would have been
interesting had the authors elaborated on the varied results of
some studies, especially had they compared the subjective and objective
rating scales.
Chapter 7 reviews the family–genetic aspects of affective
disorder in children and adolescents, focusing on a detailed review
of the current literature. It is a scholarly, yet easily read, analysis
of a few of the more pertinent studies. Although understandably
difficult, it would be valuable to be able to stratify risk factors
from the available evidence.
Chapter 8, by the editor, assimilates all the available hypotheses
to further explain the contributory effect of life events on depression.
It highlights their role in the genesis and maintenance of depression
in children and adolescents. In the era of biopsychopharmacology
and receptors, this reminds practitioners to consider the extremely
important social factors that interact to produce disorders.
Chapter 9 is rewarding for readers who enjoyed Chapter 4. This
chapter focuses on the neuroendocrine aspects of child and adolescent
depression. Apart from an overview of the current literature, the
authors have clearly stated the persistent problem of clinical studies
that have very limited inferential power. Research into the endocrinological
aspect of depression is still in its infancy, yet one hopes that
this chapter’s concise conclusion will inspire readers to invest
energy in this area.
In their attempt to formulate the etiological and psychological
aspects of suicide, the authors of Chapter 10 have covered one of
the most urgent topics of child and adolescent depression. They
have extensively reviewed the current literature in the field and
discuss topics specific to the child and adolescent population.
It should be noted, however, that this chapter seems to have a European
bias. There are few references to North American literature on suicide
prevention and intervention.
The innate difficulty of composing an interesting chapter on psychopharmacology
is understandable. Allowing for that, Chapter 11 is a useful review
that offers a very practical approach, with evidence-based suggestions
on the nature and the use of several medications. Several randomized
controlled trials of various medications are carefully reviewed,
which helps readers to understand the current state-of-the-art evidenced-based
medicine on psychopharmacology. This chapter is a good quick reference
on psychoactive medications.
Chapter 12 provides an excellent review of available evidence on
various psychotherapies. A significant portion of the chapter is
devoted to discussing the strengths and limitations of psychotherapies,
based on empirical studies. This is an indispensable and very well-written
chapter. Chapter 13, the final chapter, offers readers valuable
information on the choice of treatment for patients presenting with
first-episode depression. Relevant longitudinal research on the
mechanisms, course, continuity, and recurrence of affective disorders—especially
depression—are amply discussed. Important clinical evidence
is cited throughout.
The paperback format of this well-presented volume makes it relatively
inexpensive. We hope that Goodyer will consider a third edition
in a few years, so that we can be brought up to date on the inevitable
new developments in our understanding of mood disorder in the child
and adolescent population. We highly recommend this volume as a
research reference text for academic and clinical staff and trainees
in the field of child and adolescent psychiatry
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