Internet review

Citation

(2007), "Internet review", Health Education, Vol. 107 No. 1. https://doi.org/10.1108/he.2007.142107aag.001

Internet review

In an open letter to a national newspaper in the UK a group of 110 teachers, psychologists and other experts have claimed that children are being poisoned through a combination of junk food, sedentary entertainment and pressurised education that is overly academic and test driven. The consequences of this are an increasing incidence of children’s behavioural problems and childhood depression. A recent study by the Institute of Psychiatry in London has found that disturbed behaviour and depression in children and adolescents has almost doubled since 1976. Along with electronic toys, tamagotchis, and sophisticated robots, the Internet must take its share of the blame for these unfortunate developments. So if the Internet is contributing to the problem, can it be of any use in helping to alleviate it, or at least in helping young people and their parents understand it?

The Depressed Childwww.depressedchild.org/

The Depressed Child is a North American web site aimed at lay people, especially the parents of children with depression. Although quite simplistic in design the content is good and most of the things a person would want to know about childhood depression can be found here. The home page starts by making the point that childhood depression is dangerous but often overlooked. It was not until 1980 that childhood depression was recognised as an illness by the psychiatric profession and even today many health professionals will not have been trained in the recognition of symptoms. It was probably just assumed that children did not get depressed! Some parts of the “Symptoms” section are quite complex, including many references and quotes. However for the layperson there is also a simple checklist of nine common symptoms taken from the Diagnostic and Statistical Manual for Mental Disorders (DSM-IV). The only problem is that these appear to be the general symptoms that would be expected in an adult, there is no indication if they are different in a child. This point is actually dealt with quite well at the start of the “Treatment” section where it is acknowledged that therapeutic input is better earlier rather than later, but the problem is that parents may not always recognise the symptoms as depression and may attribute the depressed behaviour to a phase the child is going through. The remaining part of the “Treatment” section deals with a comparison of the different types of drug treatments, serotonin uptake inhibitors, lithium and the like, but the conflicting data presented does not make this section easily digestible. The “Resources” section is as would be expected a series of links to other organisations that may offer relevant information. There is also a reading list and although the books listed are not directly available it is possible to read excerpts from the book and to peruse the contents page. At the bottom of each page of this web site is the following disclaimer … “Unless identified otherwise, all information on this website was prepared by a person who is not a mental health professional”. Unfortunately there is no indication who this person might be and therefore users should be cautious when looking for advice and guidance. However the well-meaning amateurs who have put this web site together have done quite a good job and since there is a dearth of information on childhood depression on the Internet, they should be applauded for their efforts.

Understanding and Dealing with Depression (six to 12 year olds)www.oregoncounseling.org/Handouts/DepressionChildren.htm

Unlike the previous example, in this case we know exactly where the information is coming from, Michael G. Conner, a Clinical and Medical Psychologist from Oregon in the USA. If a user wanted to check out his credentials they can do so through an online link to his curriculum vitae, or resume as the Americans call it. The design of this web site is simple and is analogous to a paper leaflet, even if rather a long one. It is wholly text based and no hyperlinks are provided so the user has to scroll down through the “leaflet” to find what they are looking for. Despite this the design works well and the content is excellent. Starting with a brief introduction to depression the content rapidly moves on to detailing symptoms of depression and this time the focus is on symptoms in children. This is followed by a discussion of various theories of models of childhood depression. These include biopsychosocial, psychosocial and social models that are all well summarized through a series of bullet points. Common treatment approaches are dealt with in a similar way with great emphasis being placed on the psychological/social forms of treatment. Medications do get a mention but is rather brief. Finally there is a section on “Advice to Parents” which I thought was particularly good. It is practical common sense advice that any parent should be able to follow. There are no links to other web sites, no resources or downloadable freebies, this web site is simplicity itself, but many lay users will be glad of that.

Child and Adolescent Depression: Diagnosis and Treatment:www.baltimorepsych.com/cadepress.htm

This web site adopts a very similar design to the previous in that the entire main content is presented in a single web page that the user has to scroll down. However to facilitate the retrieval of information, the designers have added a series of links at the top of the page which link to information further down, or at least that is how it appears. Unfortunately it is not quite as simple as that. Sometimes the links take you down the page, other times the links take you to pages outside of the original web site, and sometimes they take to totally unrelated places, all rather confusing! These design, or more likely, maintenance problems, do detract from a web site that has some excellent features. There is a particularly good checklist of depressive symptoms for parents to use, a reasonable links section, though they are all to North American web sites. There appears to be a greater emphasis on suicide in this web site than in others and indeed it is pointed out that more adolescents die from suicide than AIDS, cancer, heart disease, birth defects and lung disease all put together. This may not be an altogether fair comparison since AIDS, heart disease and lung disease are more likely to afflict older people rather than adolescents anyway. Nevertheless the section on teenage suicide is excellent and while it will always be only a small minority of depressed children who actually go on to attempt suicide, it is as well that parents and teachers are aware of the warning signs and this web site provides this information very clearly. As to the quality of the information provided, the authors are medically qualified and do provide contact details which should be reassuring for potential users

Critical Psychiatry Networkwww.critpsynet.freeuk.com/childdepression.htm

This web site is distinct from the usual web sites reviewed in that it is very much aimed at the professional rather than the layperson. The National Institute for Clinical Excellence (NICE) have been reviewing the concept of childhood depression and the paper published in this web site is a response to some of their deliberations. The author of this paper is concerned with three main issues, “does the concept of ‘depression’ have cross culturally validity?”, “Is the concept of ‘childhood depression’ a valid and useful one?”, and “how useful is the concept of childhood depression when making treatment decisions?”. In answering these questions the author questions the validity of concepts like “childhood” as well as the attribution of adult medical conditions to very young children. The use of “adult” medications with children is severely criticised not least, the author suggests, because there is very little evidence that they are effective beyond placebo level. The paper is obviously written for an academic readership, but lay people may find something of interest here. If you are happy with phrases like “context-depleted paradigms … .”, then you should not have too much trouble!

Channel 4 Mind Matters:www.channel4.com/health/microsites/0-9/4health/teenlife/mma_depression.html

In previous reviews we have looked at health education information provided by the BBC web site, which has always been very good, and now it seems that Channel 4 is getting in on the act, and to quite good effect. The content is largely text based though there are a few illustrations sprinkled about. The format is the familiar one of a continuous page of information that requires the user to scroll down. One or two hyperlinks are provided to help this but not many. There is a good section on “recognising depression” and this is usefully divided in the more general symptoms of depressions followed by those symptoms more likely to be observed in children and adolescents. Since we do not know the cause of childhood depression the web site can only speculate. Physical and/or sexual abuse is mentioned as a possible cause, but social and psychological factors like family income, parental education and the influence of siblings are also discussed. The section on different forms of treatment and where it can be obtained is usefully summarised. Finally the “help and info” section provides details of other relevant organisations, books and web sites that young people and their parents may find of interest. A very professional web site as would be expected of a large media organisation.