25,26 A developmental trend has been observed for sex differences in the prevalence of depression. Prior to adolescence, the rate of depressive disorders is about equal in boys and girls, or even higher among boys.8,27 During early to middle adolescence, the rate of depressive symptoms and disorders in girls rises by two to three times that of boys, a trend that continues through adult life.11-13,28 Explanations for this gender difference have included hormonal #see more keyword# changes, increased stress, tendencies toward rumination and other maladaptive responses to

stress, and differences in interpersonal orientation and socialization experiences.7,29,30 Effect of social status The effect Inhibitors,research,lifescience,medical of social class on depression has been welldocumented in adults.31 Studies in children and adolescents, using both symptom levels and diagnostic criteria, have linked depression to lower income and socioeconomic status.32-34 Lower socioeconomic status may be a marker of specific risk factors associated with depression, rather than exerting a direct influence. For example, low

socioeconomic status is associated with high levels of Inhibitors,research,lifescience,medical chronic stress due to economic difficulties, adverse environmental conditions, and family disruption. Ethnic and cultural differences Among adults, ethnic/racial differences have been reported with regard to prevalence rates of depression, with ethnic minority groups having lower rates compared with non-Hispanic whites.35,36 Among child and adolescent samples, either no ethnic

differences were detected in depression, or ethnic minority groups, Hispanics, in particular, Inhibitors,research,lifescience,medical had higher symptom levels.33,37-39 However, analysis of data from more nationally representative samples in the United States revealed complex relationships between ethnicity and depression. For example, one study found that African-American girls did not manifest the puberty-related increase in depressive symptoms that is commonly observed in non-Hispanic white girls.40 It appears that Inhibitors,research,lifescience,medical both individual – and context-level characteristics exert effects on depressive symptomatology. For instance, African-American teens living Endonuclease within predominantly non-Hispanic white neighborhoods were at especially high risk for depressive symptoms.41 Similarly, adolescents of Mexican descent living in the United States, but not Mexican adolescents, had higher rates of depression compared with non-Hispanic white youth.37 Future investigations should attempt to disentangle the effects of adverse conditions that might be associated with ethnic status as well as cultural expressions of depressive symptoms among different ethnic groups.41,42 Functional consequences and socioeconomic burden Depressive disorders in children and adolescents are associated with significant economic and social burden on individuals, families, and societies.