Depressive disorder in children and adolescents: dysthymic disorder and the use of self-rating scales in assessment.

The authors describe a pilot study on depressed children and adolescents, where the DSM-III diagnosis on clinical interviews is compared to the results from ~wo self-rating scales on 35 children and adolescents referred to the researchers. These 35 subjects were seen as depressed by their primary helpers. The value of the self-rating scales is mentioned and the usefulness of the category "dysthymic disorder" is commented upon. The diagnosis of depression in children and adolescents is well accepted and the criteria used are well delineated. 1 The more controversial diagnosis of dysthymic disorder is more all-encompassing and includes dysphoria and anhedonia, and twelve other criteria including: poor performance in school, lack of ability to concentrate, and irritability and excessive anger towards parents and caretakers. 2 These last three criteria are present in the separation anxiety disorders, attention deficit disorders, and conduct disorders. Some dysthymics respond to antidepressants and for this, if for no other reason, careful diagnosis is important. We are interested to see what proportion of 8to 17-year-olds referred to us as having depressive symptoms would be diagnosed as having dysthymic disorder. Also, we wanted to see whether rating scales distinguished between affective and non-affective disorders and between major affective and dysthymic disorders. Stuart Fine and Keith Marriage are with the Division of Child Psychiatry, Department of Psychiatry, University of British Columbia and Vancouver General Hospital, Vancouver, B.C., Canada. Marlene Moretti and Glenn Haley are with the Department of Psychology, Simon Fraser University, Burnaby, B.C., Canada. Correspondences may be addressed to: Dr. S. Fine, 717 West 10th Avenue, Vancouver, B.C., Canada, V5Z 1L6. This work was partially supported by a grant from the UBC/VGH Academic Fund. Child Psychiatry and Human Development, Vo114(4), Summer 1984 9 1984 Human Sciences Press 223 224 Child Psychiatry and Human Development The i m p o r t a n c e of d i f ferent sources of i n fo rma t ion in m a k i n g d iagnoses in child and adolescen t p s y c h i a t r y is only r ecen t ly be ing s t ressed . We w a n t e d to c o m p a r e severa l sel f report scales and p a r e n t scales and to see how t h e y cor re la ted wi th the d iagnos i s on psych ia t r i c in terv iew. Chi ldren are o f ten seen as no t capab le of, or rel iable in, r e p o r t i n g dep re s sed feelings, and recen t f inding show t h a t child and p a r e n t r e p o r t s of depress ion are d i sc repan t . 3 These i n t e r e s t s led to the pi lot s t u d y we r epor t here.