Concluding Comments

Mood symptoms are common among those individuals with acute and chronic physical illnesses. The challenge for the mental health clinician is to differentiate the multiple factors that may contribute to the presentation: direct effects of a physical illness, treatment effects of the illness, adjustment to the illness, and/or primary mood disorder may all underlie the clinical presentation of a youngster with a physical illness presenting with disabling mood symptoms. Thorough medical and psychiatric evaluations of the child and family are required to understand the presenting symptoms. Strong evidence is emerging that supports the effectiveness of psy-chotherapies for mood disorders in physically ill children and adolescents; less data support the use of psychopharmacology in this population. When present, troubling mood symptoms and/or the presence of a mood disorder can significantly complicate the course of medical treatment for affected children and their families. Mood difficulties should be identified early and treated aggressively.

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