Common Mental Disorders Depression - New Zealand Doctor

Chapter 3 Recognition and assessment of common mental disorders in young people/rangatahi/tamariki
Somatic complaints
Children frequently display distress by means of physical symptoms and 2% to 10%
experience functional aches and pains for which no organic cause is found. 214 Young
children with mental disorders in primary care usually present with parental reports that
they are in poor health, low in energy and physically ill when under stress. 215 Common
symptoms are dizziness, back pain, abdominal pain, headaches, or sleeping and eating
problems. 205 Adolescents are more likely to present with emotional symptoms, but fatigue
and other somatic symptoms are still common, especially in early adolescence. 188
Possible medical illness should be ruled out as a cause of symptoms. 216,217 Also, the
practitioner should be mindful of the possibility of culturally-specific syndromes and,
if concerned, seek advice from cultural support workers 151,162 or consider liaising with
local iwi groups.
Family violence
If family violence or child abuse of any form is identified or suspected, some level of
safety planning is needed. New Zealand guidelines on family violence 193 recommend
consultation with an experienced colleague, social worker, specialist child protection
team, paediatrician or family violence prevention advocate or with the duty social
worker at Child, Youth and Family or Youth Health Service. It is advisable to develop
referral relationships with local staff from agencies that provide support for actual or
suspected victims of abuse. 193
Common mental disorders
The most common mental disorders in primary school-aged children are attentiondeficit
hyperactivity disorder (ADHD), anxiety (especially separation anxiety), conduct
disorder, and depressive disorders (depression and dysthymia), in that order. The most
common mental disorders in adolescents are anxiety, conduct disorder, depressive
disorders and alcohol or substance abuse/dependence. Table 1.2 (see Chapter 1:
Background) provides further detail on prevalence rates by age group. The clinical
features of these disorders are outlined in this chapter in the section entitled:
Clinical features of common mental disorders in young people/rangatahi/tamariki.
3.5 Assessment tools: evidence review
A brief assessment tool may help the practitioner to reach a provisional diagnosis,
assess severity or evaluate response to treatment. A systematic review of the literature
was undertaken to identify evidence on brief assessment tools for common mental
disorders in young people/rangatahi/tamariki. ‘Brief’ was defined as taking 5 minutes
or less to administer.
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