Gabrielle A. Carlson

Suicidal behavior and depression in children and adolescents

The Childrens Depression Inventory (CDI) and semistructured interview were used to study suicidal ideation, suicide attempt, depression as a syndrome, and diagnosis in 102 psychiatrically referred children and adolescents. We found that severe suicidal ideation increased around puberty and correlated with increasingly severe depression. Suicide attempts were more variable and did not reflect a continuum of suicidal ideation. While most youngsters who felt suicidal felt depressed, those that did not had nonaffective diagnoses. Similarly, youngsters whose suicide attempt did not lead to psychiatric hospitalization felt less depressed and met criteria for nondepressive diagnoses. Hopelessness, chronicity of psychiatric disorders, and family history of psychopathology are also explored.

A Survey of Depressive Symptoms in a Child and Adolescent Psychiatric Population: Interview Data

Abstract One hundred and two of 210 children referred to UCLA-Neuropsychiatric Institute Child Division who completed the Short Childrens Depression Inventory (SCDI) were, in addition to their parents, systematically interviewed by one of us (GAC) who was blind to CDI results. Children were diagnosed according to the Research Diagnostic Criteria (RDC) and DSM III diagnostic categories. From their SCDI scores 50% of children were considered moderately depressed; almost 25% were rated at least moderately depressed at interview; and 28 had an affective disorder diagnosis. The SCDI score of these affective disorder children (14.1 ± 7.7) was almost twice that of nonaffective disorder children (8.0 ± 6.3). The greater number of children who appeared depressed on the basis of SCDI scores compared to those with diagnosed affective disorder is accounted for by children who are miserable secondary to other psychosocial difficulties but who do not meet rigid criteria for affective disorder.

Phenomenology and subtypes of major depressive disorder in adolescence

The authors systematically evaluated the prevalence and reliabilities of a large set of depressive symptoms and subtypes of major depressive disorder in 40 hospitalized adolescents, aged 12-17. Results indicated that the phenomenology of depressive illness in this age group is distinguished by descriptive features akin to traditional clinical formulations. Psychotic, retarded and endogenous subtypes were documented, although they are less prevalent than in adult depressives. Overall, the reliabilities of symptom and subtype ratings were found to be very satisfactory. Results were discussed with respect to current theoretical conceptions of juvenile affective illness and directions for further research.

Diagnosis of Childhood Depression: A Comparison of the Weinberg and DSM-III Criteria

Systematically interviewed children ( N = 102) aged 7 to 17 years were diagnosed by DSM-III criteria. Subgroups of children who met DSM-III depression criteria were compared to those who met the childhood depression criteria of Weinberg et al. (1973). Of the children meeting DSM-III criteria for depression, 78% also met Weinberg criteria; conversely, 58% of Weinberg depressed children met DSM-III depression criteria. Remaining children had other DSM-III diagnoses, predominantly behavior disorders and anxiety disorders. Children who met both the DSM-III and Weinberg criteria for depression were significantly more depressed on the Childrens Depression Inventory than those who only met the Weinberg criteria. A substantial number of children had depressive symptoms according to parents, but these did not represent a change in their usual behavior and most did not meet DSM-III criteria. Independent validating measures of depression are necessary before final conclusions can be drawn regarding whose criteria are most accurate in describing childhood depression.

Bipolar Disorder in Youth: An Update

The authors highlight some of the important findings regarding juvenile-onset bipolar disorder that have been published in recent years. Topics covered include the impact of definition on understanding epidemiologic studies of early-onset bipolar disorder, comorbidity, developmental risk factors, switching and medication response, family studies, and treatment. Some of the controversy surrounding bipolar disorder in youth diminishes if bipolar disorder is viewed as a spectrum, and children may fit along the spectrum without meeting full criteria for classic bipolar I disorder.