Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2013 Aug;52(8):831-40.
doi: 10.1016/j.jaac.2013.05.017. Epub 2013 Jul 3.

Irritable mood as a symptom of depression in youth: prevalence, developmental, and clinical correlates in the Great Smoky Mountains Study

Argyris Stringaris  1 , Barbara Maughan, William S Copeland, E Jane Costello, Adrian Angold
Affiliations
Comparative Study

Irritable mood as a symptom of depression in youth: prevalence, developmental, and clinical correlates in the Great Smoky Mountains Study

Argyris Stringaris et al. J Am Acad Child Adolesc Psychiatry. 2013 Aug.

Abstract

Objective: DSM-IV grants episodic irritability an equal status to low mood as a cardinal criterion for the diagnosis of depression in youth, yet not in adults; however, evidence for irritability as a major criterion of depression in youth is lacking. This article examines the prevalence, developmental characteristics, associations with psychopathology, and longitudinal stability of irritable mood in childhood and adolescent depression.

Method: Data from the prospective population-based Great Smoky Mountains Study (N = 1,420) were used. We divided observations on 9- to 16-year-olds who met criteria for a diagnosis of depression into 3 groups: those with depressed mood and no irritability, those with irritability and no depressed mood, and those with both depressed and irritable mood. We compared these groups using robust regression models on adolescent characteristics and early adult (ages 19-21 years) depression outcomes.

Results: Depressed mood was the most common cardinal mood in youth meeting criteria for depression (58.7%), followed by the co-occurrence of depressed and irritable mood (35.6%); irritable mood alone was rare (5.7%). Youth with depressed and irritable mood were similar in age and developmental stage to those with depression, but had significantly higher rates of disruptive disorders. The co-occurrence of depressed and irritable mood was associated with higher risk for comorbid conduct disorder in girls (gender-by-group interaction, F1,132 = 4.66, p = .03).

Conclusions: Our study findings do not support the use of irritability as a cardinal mood criterion for depression. However, the occurrence of irritability in youth depression is associated with increased risk of disruptive behaviors, especially in girls.

Keywords: conduct disorder; depression; development; irritability; oppositional defiant disorder.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Depression group by gender.
Figure 2
Figure 2
Symptom counts for oppositional defiant disorder (ODD) and conduct disorder (CD) by gender and depression type.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Burton R. In: The Anatomy of Melancholy. Jackson H., editor. J.M. Dent and Sons; Totowa, NJ: 1932. Symptoms or signs in the mind; p. 391.
    1. APA. Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR. American Psychiatric Press; Washington, DC: 2000.
    1. Kessler R.C., Avenevoli S., Ries Merikangas K. Mood disorders in children and adolescents: an epidemiologic perspective. Biol Psychiatry. 2001;49:1002–1014. - PubMed
    1. Fava M., Hwang I., Rush A.J., Sampson N., Walters E.E., Kessler R.C. The importance of irritability as a symptom of major depressive disorder: results from the National Comorbidity Survey Replication. Mol Psychiatry. 2009;15:856–867. - PMC - PubMed
    1. Verhoeven F.E., Booij L., Van der Wee N.J., Penninx B.W., Van der Does A.J. Clinical and physiological correlates of irritability in depression: results from the Netherlands Study of Depression and Anxiety. Depress Res Treat. 2011 - PMC - PubMed

Publication types