Depression as seen from the psychotherapy perspective
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Arch Psych Psych 2010;12(1):25–30
Childhood and adolescent depression have been the point of interest of child and adolescent psychiatrists since the 60's of the last century. The antidepressants have not brought the expected results in treatment. Some - because of the immaturity of the metabolic system; others - due to the risk of suicide. The earliest links between understanding and treating of childhood and adolescent depression are these of the psychoanalytical and psychodynamic tradition; although depression described in the psychodynamic psychopathology language is different from this described by descriptive psychopathology. The important publications are these of Anna Freud, Eva Frommer, Gerhardt Nissen and - later - of Antoni Kepinski. Lack of safe support during adolescence has been discussed as pathogenic for adolescent depression. The concept of adolescent depression was introduced by Antoni Kepinski. The last years' studies of family relations (e.g. Stierlin) and brain development (Fonagy, Schore) point out the importance of care continuity, adjusted to the developing child's needs, from babyhood till full individuation. The main problem - from the psychotherapeutic perspective - is not the support, which the patient can get from the therapist, but the patients' own possibility of taking advantage of it.