Intended for healthcare professionals

Education And Debate

abandoning the diagnosis will endanger severely depressed children

BMJ 2004; 329 doi: (Published 09 December 2004) Cite this as: BMJ 2004;329:1396
  1. Quentin Spender (, consultant1
  1. 1 Chichester Child and Adolescent Mental Health Services, Chichester PO19 6PQ

As a family therapist, I applaud Timimi's broadly systemic approach to childhood unhappiness.1 In my experience, young people aged 14-16 are most likely to present to clinicians with depression, and he is right to emphasise the sociocultural roots of their unhappiness. However, I am concerned at the underemphasis on possible consequences of depression, such as school failure, social withdrawal, antisocial behaviour, substance misuse, family disharmony, and suicide, which are more than just potential …

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