Estudos de Psicologia I Campinas I 32(4) I 641-652 I outubro -dezembro 2015 http://dx.doi.org/10.1590/0103-166X2015000400007 AbstractThe goal of this study was to evaluate family functioning in two groups of adolescents: adolescents with major depressive disorder (cases) and adolescents with no psychiatric disorders (controls). A total of 18 adolescents (13-18 years) and their first-degree relatives (N = 70) were evaluated. Cases and controls were matched for the adolescent's age, gender, level of education, number and age of siblings, parental marital status, and economic condition. A family therapist conducted the Structured Family Interview with each family to evaluate nine family functioning dimensions (communication, rules, roles, leadership, conflict, aggressiveness, affect, individuation, and integration). The interview transcripts were independently rated by two different family therapists blinded to case-control status, i.e., without knowing whether they were evaluating cases or controls. The raters scored all interview items using a standardized coding system (overall agreement = 83.5%), and when compared to the controls, the cases showed lower mean scores in seven dimensions, particularly affect (p = 0.0078). There was no difference between cases and controls regarding the dimensions rules and leadership. Difficulty in expressing affect in parent-child relationship was the main disturbance in the families of depressive adolescents evaluated. (comunicação, normas, papéis, liderança, conflito, agressividade, afeto, individualização, integração Family functioning is closely related to the physical and psychological well-being of family members and its impairment affects the family as a whole. High levels of parent-child conflict and disagreement have a negative impact on adolescents' mental health (Birmaher et al., 2004;Sheeber, Hops, & Davis, 2001). Moreover, psychopathology such as depression can appear whenever the basic needs for individual development are not provided for by the social and physical environment (Puissant, Gauthier, & Oirbeek;. The recognition that depressive disorders occur in an interpersonal context calls greater attention to the role of the family environment and its interaction processes as relevant factors to the development of depressive disorders during adolescence. Indeed, according to Sheeber et al. (2001;, family relations are important predictors of depression in adolescents. KeywordsWeich, Patterson, Shaw, and Stewart-Brown (2009) conducted a systematic review of large longitudinal studies of 10 or more years' duration with prospective data on relationships in the home during childhood (parent-parent or parent-child) and measures of common psychiatric disorders in adulthood. This review included 23 papers reporting data from 16 cohorts. The authors found that abusive relationships predicted depression, while maternal emotional unavailability in early life predicted suicide attempts in adolescence. These studies highlight the need to minimize harm associated with dysfun...

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BackgroundMood disorders have a multifactorial etiology comprising genetics and environmental aspects in a complex interplay between them. Depression and bipolar disorder have been increasingly diagnosed in children and adolescents in the recent years. A meta-analysis about the epidemiology of bipolar disorder in youth showed that the overall rate was 1.8%. Concerning depression in youth the lifetime prevalence varies from 3% in children to almost 20% in adolescents.ObjectiveTo describe a treatment and research program (PROACTH) for children and adolescents with mood disorders (depressive and bipolar disorder).MethodThe program operates from Monday through Friday. Patients are referred to the program from primary care health services. On admission, patients were screened with standardized instruments. After that, the patients were submitted to pharmacological and psychosocial interventions. Finally, the follow-up period depends on each patient illness evolution. Also, the team encompasses child psychiatrists, systemic family therapists, psychologists and social workers.ResultsThe combination of pharmacotherapy and psychosocial interventions (individual psychotherapy and family therapy) led to a decrease of symptoms and a better psychosocial functioning.ConclusionIn spite of the complex interplay between genetic and environmental factors usually found in children with mood disorders, timely and appropriate interventions are efficacious to achieve a favourable outcome.

BackgroundThe diagnosis of bipolar disorder in children and adolescents has increased in clinical settings throughout the last two decades. Its prevalence is around 1.8% being similar in different countries. However, how it is diagnosed is still a challenge due to its variability of clinical presentations, overlapping with other more commonly psychiatric disorders and high rates of comorbidities. Therefore, it is still important to report cases in order to enhance our knowledge about this complex field of the mental health in childhood and adolescence.ObjectiveTo present clinical characteristics and follow-up of a 12 year-old adolescent who met DSM-IV criteria for bipolar disorder NOS.MethodTo describe the clinical trajectory from the diagnosis to the outcomes of the mentioned case, focusing on the main symptoms and family functioning.ResultsThe combination of mood stabilizers, family interventions and individual psychodynamic therapy resulted in an improvement of the global functioning.ConclusionEven in a complex case of child bipolar disorder with early onset the treatment based on pharmacotherapy, individual psychodynamic therapy and systemic family therapy was able to provide satisfactory results.