Treatment-resistant depression in children and adolescents

Depression is a common psychiatric diagnosis in children and adolescents, and approximately half of adult cases of depression will begin prior to age 18. Depression is associated with significant morbidity and mortality, with suicide now the second‑leading cause of death in individuals aged 10-34 years in the United States. Treatment-resistant depression affects a substantial minority of youth with depression and presents a challenge to clinicians managing these cases. It is important for clinicians to be aware of evidence-based treatments for acute depressive episodes in youth to help decrease the risk of treatment-resistant cases. This chapter will review the evidence base for treatment of youth with depression, with a focus on management of treatment-resistant depression.