Clinical guidelines for adolescent depression: An integrated traditional Chinese and Western medicine approach

Table 2 Traditional Chinese medicine syndrome differentiation and treatment of adolescent depressive disorder

Syndrome diagnosis	Core symptoms	Tongue and pulse	Medication
Liver qi stagnation	Main symptoms: Depressed mood, restlessness. Secondary symptoms: Slowed thinking, self-blame and low self-esteem, aversion to learning, or reticence, delayed response, distending pain in the hypochondrium, epigastric stuffiness with belching, poor appetite, dull complexion	Pale tongue with thin white coating; wiry and thready pulse	Modified Chaihu shugan powder
Stagnation of qi transforming into fire	Main symptoms: Depressed mood, irritability, distending pain in the chest and hypochondrium. Secondary symptoms: Aggressive behavior, social withdrawal, restlessness and agitation, poor concentration, bitter taste in the mouth, dry mouth, loss of appetite, or headache, red eyes, tinnitus, constipation	Red tongue with thin white or yellow coating; wiry and rapid pulse	Modified Danzhi xiaoyao san
Syndrome of phlegm-qi stagnation	Main symptoms: Low mood, sensation of a foreign body in the throat that cannot be swallowed or expected. Secondary symptoms: Chest tightness, distending pain in the hypochondrium, cough with sputum, or sputum production without cough, or accompanied by stabbing pain in the chest and hypochondrium	Pale red tongue with white greasy coating; wiry and slippery pulse	Modified Banxia houpu decoction
Liver stagnation and spleen deficiency	Main symptoms: Low mood, distension and fullness in the hypochondria, frequent sighing. Secondary symptoms: Sentimentality, excessive rumination, reticence, insomnia, forgetfulness, social withdrawal, fatigue, decreased appetite, weight loss, or accompanied by dizziness, abdominal distension, diarrhea, or constipation	Pale tongue with thin white coating; wiry and thready pulse	Modified Xiaoyao powder
Deficiency of heart and spleen	Main symptoms: Excessive contemplation and worry, poor appetite, fatigue. Secondary symptoms: Palpitations, dream-disturbed sleep, sallow complexion, numbness in the limbs, dizziness, spontaneous sweating, abdominal distension, loose stools, irregular menstruation	Pale tongue and tender with white coating; thready and weak pulse	Modified Guipi decoction