Pediatric Depression Workup

  • Author: Angelo P Giardino, MD, PhD, MPH; Chief Editor: Caroly Pataki, MD   more...
 
Updated: Mar 16, 2012
 

Approach Considerations

Workup includes laboratory evaluation along with additional, selected tests. Include a complete blood count (CBC) with differential in the initial laboratory evaluation to rule out infection and anemia. Assay electrolytes, blood urea nitrogen, creatinine clearance, creatinine, and urine osmolality to exclude renal disorders.

When using tricyclic antidepressants (TCAs) or lithium carbonate, monitor plasma levels to measure compliance and to avoid toxicity. Evaluate urine osmolality and creatinine clearance periodically during lithium treatment.

Other tests that may be indicated or helpful include the following:

  • Electroencephalography - For patients with a history or presentation that is suggestive of seizure disorder
  • Electrocardiography - For patients who will be treated with a TCA
  • Liver function tests and thyroid function tests (triiodothyronine [T3], thyroxine [T4], and thyroid-stimulating hormone [TSH]) to rule out thyroid disease
  • Dexamethasone suppression test - When properly performed, this can help to confirm a clinical diagnosis of depression and may be useful in monitoring treatment response during follow-up (overall sensitivity of 70% in prepubertal children and 47% in adolescents)[35]
  • Children’s Depression Inventory - A simple test that may assist in detecting the occurrence and degree of childhood depression
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Contributor Information and Disclosures
Author

Angelo P Giardino, MD, PhD, MPH  Associate Professor, Baylor College of Medicine; Chief Medical Officer, Texas Children's Health Plan; Chief Quality Officer, Medicine, Texas Children's Hospital

Angelo P Giardino, MD, PhD, MPH is a member of the following medical societies: Academic Pediatric Association, American Academy of Pediatrics, American Professional Society on the Abuse of Children, Harris County Medical Society, Helfer Society, and International Society for Prevention of Child Abuse and Neglect

Disclosure: Bayer Honoraria Review panel membership; Pfizer Grant/research funds Independent contractor; MedImmune Honoraria Review panel membership; Teva Pharmacutical travel & honoraria Managed Care Advisory Panel; CIGNA Honoraria Physician Advisory Council

Coauthor(s)

Tami D Benton, MD  Clinical Director, Child and Adolescent Psychiatry, Psychiatrist-in-Chief, Executive Director, Department of Child and Adolescent Psychiatry and Behavioral Science, Children's Hospital of Philadelphia

Tami D Benton, MD is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose.

Chief Editor

Caroly Pataki, MD  Professor of Clinical Psychiatry and Behavioral Sciences, Department of Psychiatry, Division Chair, Child and Adolescent Psychiatry, Keck School of Medicine of the University of Southern California

Caroly Pataki, MD is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, New York Academy of Sciences, and Physicians for Social Responsibility

Disclosure: Nothing to disclose.

Additional Contributors

Jacqueline Lynch, MSW, Research Assistant, Department of Child and Adolescent Psychiatry, Children's Hospital of Philadelphia

Disclosure: Nothing to disclose.

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

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