Abstract
Major depressive disorder (MDD) is common in children and adolescents,
affecting up to 2 percent of children and 4 percent to 7 percent of adolescents
in a given year (Costello et al., 2002). Pediatric depression negatively impacts
mood, self-esteem, and daily functioning. For example, children may experience
persistent sad mood, irritability, increased feelings of hopelessness, or disturbances
in sleep and appetite (American Psychiatric Association, Association, 2013). The
onset of MDD increases during adolescence, as compared to lower prevalence
rates observed among younger children (Kessler, Avenevoli, & Ries Merikangas,
2001; Lewinsohn, Clarke, Seeley, & Rohde, 1994). Before reaching adulthood,
approximately 20 percent of adolescents will have been diagnosed with MDD
(Birmaher, Ryan, Williamson, Brent, & Kaufman, 1996; Birmaher, Ryan,
Williamson, Brent, Kaufman, et al., 1996).