Assessment of depression and diagnosis of depressive disorder among psychiatrically disturbed children

This study examined the relations between performance on alternative measures of childhood depression and diagnosis of depressive disorder. Hospitalized inpatient children (N=770, ages 7–13) with a diagnosis of depressive disorder (Research Diagnostic Criteria) were compared with a matched sample of patients whose diagnoses excluded depression. Children and parents completed four standardized depression scales plus measures designed to assess associated features including hopelessness, selfesteem, and internalizing symptoms. The results indicated that (1) alternative depression measures, whether completed by children or parents, yielded scores that were significantly higher for children with a diagnosis of depression; (2) parent ratings of severity of depression were consistently higher among the measures than the child ratings; (3) optimal cutoff scores derived for each measure correctly classified approximately 60% of depressed and nondepressed cases; (4) different cutoff scores were required for the same measure, depending on whether children or parents were the raters; and (5) using a battery of measures and combining these in a stepwise discriminant function yielded over 80% classification accuracy. The implications of the results for selection of cases for clinical research are discussed.Completion of this research was supported by a Research Scientist Development Award (MH00353) and by a Clinical Research Center Grant for the Study of Affective Disorders (MH30915) from the National Institute of Mental Health. The authors are grateful to members of the clinical research team of the Child Psychiatric Treatment Service, who greatly facilitated this research.