Should depression in young school-children be diagnosed with different criteria?

Abstract

In a two-stage epidemiological study 5686 randomly selected 8 to 9-year-old children were screened using the CDI (Children's Depression Inventory), of whom 418 were questioned with the DISC-C1 (Diagnostic Interview Schedule for Children). According to DSM-III criteria the prevalence of MDD (Major Depressive Disorders) was 0.48% and of DD (Dysthymic Disorder) 0.06%. The prevalence rates did not change when DSM-III-R and DSM-IV criteria were employed. Fifteen children reported suicidal thoughts but according to DSM-III criteria only 1 of these children was depressed. Duration and frequency of depressive symptoms are essential for making a diagnosis of depressive disorder by the DSM-III, but children's reliability in reporting them is questionable. Omitting the duration and frequency of symptoms from the DSM-III criteria raised the prevalence of MDD to 4.0% and of DD to 2.2%. Eight of the children with suicidal thoughts were depressed. By the adapted DSM-III-R and DSM-IV criteria the prevalence rate of MDD was 4.0% and of DD 9.7%.