Dermatitis

Four out of five teens who attempt suicide have given clear warnings. Warning signs that should always be taken seriously include:

• suicide threats (direct and indirect)

• obsession with death

• poems, essays, and drawings that refer to death

• dramatic change in personality or appearance

• irrational, bizarre behavior

• overwhelming sense of guilt, shame, or rejection

• different eating or sleeping patterns

• severe drop in school performance

• giving away belongings

Cause

Experts believe there are many causes of depression. It is likely that a combination of biological, environmental, and psychological factors contribute to the onset of the disorder. Moreover, children who develop depression are likely to have a family history of the disorder. At even greater risk are those children who have a chronic illness or who experience abuse, neglect, or other trauma.

Depression in children often occurs together with other mental disorders such as anxiety disorders or disruptive behavior disorders. Adolescents who are depressed are also at risk for substance abuse.

Treatment

It is extremely important that depressed children and teens receive prompt, professional treatment. Depression is serious and, if left untreated, can worsen to the point of becoming life-threatening. If depressed children and teens refuse treatment, it may be necessary for family members or other concerned adults to seek professional advice.

Clinical depression is a serious disorder that responds well to a combination of medication and therapy. Some of the most common and effective ways to treat depression in children and adolescents are:

Psychotherapy This provides children and teens an opportunity to explore events and feelings that are painful or troubling to them. Psychotherapy also teaches coping skills.

Cognitive-behavioral therapy This type of counseling helps children and teens change negative patterns of thinking and behaving.

Interpersonal therapy This type of treatment helps children and teens focus on how to develop healthier relationships at home and at school.

Medication Antidepressants can be very effective in easing symptoms of depression and is often prescribed along with therapy. Currently only Prozac is officially approved for use in children and adolescents, but doctors can still legally prescribe other antidepressants to children on an "off-label" basis. Even very young children are taking many of the newest antidepressants.

So far, studies of citalopram (Celexa), Prozac, and Zoloft suggest that these newer antidepres-sants may help to relieve the suffering of children with depression. While only Prozac has been specifically approved for use in children, doctors can still prescribe antidepressants for children. It may be necessary to try several antidepressants before finding one that is effective.

dermatitis The general term used to refer to a group of inflammatory conditions of the skin. While people often use the terms eczema and dermatitis interchangeably, eczema is actually dermatitis in its advanced stages, with blisters, fissures, oozing, crusting, scabbing, thickening, peeling, and discoloration. While there are a wide variety of dermatitis conditions, there are three main categories: atopic dermatitis, contact dermatitis, and seborrheic dermatitis. (See also dermatitis, atopic; dermatitis, contact; dermatitis,

SEBORRHEIC.)

dermatitis, atopic Also known as atopic eczema, this is a common condition in infants, often appearing between two and 18 months of age. It tends to occur in those with an inherited tendency to develop allergy and is found in 10 percent of the population. The condition is usually associated with ASTHMA, HAY FEVER, or ALLERGIC RHINITIS, and it may affect as many as seven to 24 of every 1,000 people. It is most common in children.

Typically, the condition begins in the first year of life, fading away about 40 percent of the time by age 15. However, children with very severe disease

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