Depression in Children Introduction 1970 Depression in children

Depression in Children- Introduction 1970: Depression in children as entity • Shpitz, Bolby: anaclytic depression • Difficult to diagnose before 7 y • body language, posture, face • Age and developmental stage =>clinical picture

Depression in Children –Clinical Picture Early Childhood < 10 y: Late childhood: • • • • looks sad tearful slow movements monotone voice Irritability hopeless self in negative terms school problems somatization!! low self esteem apathy irritability anxiety Poor concentration suicide attempts

Mood Disorders are Genetic Higher concordance for depression among MONOZYGOTIC twins compared with DIZYGOTIC

Amygdala in Child Behavior • The gate for the assignment of emotional significance to memories. • Fear • Anxiety • Depression (Hariri A. et al, AGP 2004 -5; Charney DS, BP 2004)

Neuroendocrine Disregulation of Serotonin and not Epinenephrineprimary event. Other indolamine disregulations later in life are secondary to the damage in adolescence (Sokolov & Kutcher 2001; Cambridge Child Depression Studies (19881997)

2 Learning Disorders (Academic Skills Disorders)

Learning Disorders (Academic Skills Disorders) DSM IV (1994): • Reading disorder • Disorders of written expression • Mathematics disorder (“dyscalculia”) • Learning disorders NOS

: לקות למידה ספציפית ( קריאה )דיסלקציה Reading Disorder (=Dyslexia) • Visual-spatial type verbal association to visual stimuli (dog=god; p=q) R/L confusion, mixed laterality. May have good visual skills for holistic perceptions • Audio-phonological type Phonemic substitutions (evaporate=evacuate) • Language disorder Dysnomia, low comprehension, poor sound discrimination Mattis 1978, King & Noshpitz , 1991

: לקות למידה ספציפית ( כתיבה )דיסגרפיה Writing Disorder (=Dysgraphia) • Specific reading disability is rare • Usually with dyslexia • Poor spelling Mattis 1978, King & Noshpitz , 1991

: לקות למידה ספציפית ( כתיבה )דיסקלקוליה Arithmetic Disorder (=Dyscalculia) • Chain of processes • Problem in each part of the chain • Organization skills • With dyslexia Mattis 1978, King & Noshpitz , 1991

: לקות למידה ספציפית. 3 =comorbidity תחלואה נלוות • • NVLD MR ADHD ADD ODD CD Depression (Erikson 1950, Gallicio, 1987, Simpson 1997) Erikson: • School as crucial for identity and industry. • Personal inferiority

: לקות למידה ספציפית =תחלואה נלוות comorbidity The literature supports considerable comorbidity of attention deficit hyperactivity disorder with conduct disorder, oppositional defiant disorder, mood disorders, anxiety disorders, learning disabilities, and other disorders, such as mental retardation, Tourette's syndrome, and borderline personality disorder. Biederman J et al Am J Psychiatry. 1991

: לקות למידה ספציפית תסמיני דיכאון כחלק מלקות למידה The researchers have found that students with learning disabilities (LD) obtain statistically higher scores on measures of depression than their peers without LD. However, what is not known is whether students with LD display greater levels of clinical depression than their peers without LD. (Maag JW, Reid R. (meta-anlysis)J Learn Disabil. 2006)