Mental health professionals are beginning to view major depressive disorder in children and adolescents as a developmental disorder. Up to 50% of adult patients with depression had symptoms during childhood.

Dr. Kovacs noted that major depressive disorder is found in school-aged children, with a large increase noted among patients around the age of fifteen years. There is a high morbidity: Childhood major depressive disorder is a long-term condition with an average episode length of 7 to 9 months; it has a high recurrence rate (30%-70%), and a high rate of co-morbid psychiatric problems. Moreover, the risk of bipolar disorder is high (up to 20 percent).

Dr. Kovacs also discussed the impact of childhood depression on the adult. If depressed adolescents are followed into adulthood, they are found to have many continuing problems related to disruptions in normal personality development. For example, depressed children often develop problems with socialization brought about by missing school or by withdrawing from peers. If these behaviors occur at an early age, depressed children may delay or even stop making new friends and learning social skills.

Dr. Kovacs believes that early identification of children at risk for major depressive disorder is critical. She notes that delaying a first episode of depression for even a few years can have a large and continuing impact on personality development. Although prevention of childhood depressive episodes would be optimal, Dr. Kovacs believes that delaying the initial presentation of major depressive disorder until the late teens or early 20s would allow more time for children to develop toward adulthood.
A first major depressive episode at twenty, she points out, will have less impact than a first major depressive episode at nine or ten years of age.

Dr. Kovacs also outlined ongoing research about prevention strategies and optimal psychological and pharmaco-therapeutic interventions in children and adolescents.