Differing views on treatment for childhood depression.

* A global review of the evidence for childhood depression treatments reveals no firm guidelines for treatment. A report of the research by Dr Neal Ryan, University of Pittsburgh, published in The Lancet (September 2005), says that between 1% and 2% of primary school-age children, and 2% to 5% of adolescents suffer depression. Treatments include cognitive behavioural therapy, interpersonal therapy and antidepressant medication--the latter treatment has been controversial but the decrease in youth suicide rates overall, parallels a rise in prescription of the drugs over the past 20 years. Research comparing the therapies remains inconclusive. Dr Louise Newman, director of the NSW Institute of Psychiatry, says there are no guidelines for treatment of youth depression and that Australian policy-makers needed to commission more research and clinical trials into effective measures (Sydney Morning Herald, 10/9/05, p.5).

* Britain's National Institute for Health and Clinical Excellence (NICE) has found that about half of the 40,000 children and adolescents in the UK on some form of antidepressants do not receive additional back-up counselling and a large proportion should not be on the drugs at all. NICE chief executive, Andrew Dillon, says the Institute's new guidelines (released in September) state that doctors should first offer counselling and consider giving children advice on nutrition, exercise and sleep, before prescribing antidepressant drugs. 'It is clear that psychological treatments are the most effective way to treat depression in children and young people' (West Australian, 4/10/05, p.1).

* The NICE guidelines (above) refer to other research on things that can make you feel good without taking pills, including: sleeping in a clark room at about 18.3 degrees; foods containing omega-3 fatty acids, such as walnuts and oily fish; foods high in tryptophan such as turkey (the body converts tryptophan into serotonin); bananas and avocados (they have readymade serotonin; poetry and relaxing music; and exercise--a 20-minute walk at a pace that leaves you puffing, but not exhausted, is the best way to boost mental health according to a study at Indiana University. 'The benefits, they discovered, were comparable to the improvement a depressed patient could expect as a result of a course of psychotherapy' (Sydney Morning Herald, 6/10/05, p.8).