Prevalence of childhood and adolescent depression in the community: Ontario child health study

Article Abstract:

A study of 2,852 children aged 6 through 16 years who participated in a community survey in Ontario, Canada was carried out to estimate the prevalence of major depression syndrome. Depression was assessed by self, parent, and teacher ratings and diagnosed by the presence of depressive mood plus four or more additional symptoms, such as eating or sleep disorders, low self-esteem, guilt, poor attention span, self-harmful or suicidal thoughts, and under- or overactivity. Diagnostic certainty (DC) was measured by a symptom severity scale, and then validated by five measures: use of mental health services, comorbidity (existence of other problems simultaneously), poor school performance, need for professional help, and problems in getting along with others. Adolescents demonstrated significantly higher rates than pre-adolescents on low, medium and high DC levels. Adolescent girls had a higher rate of depression than boys. Rates were more evenly distributed between the sexes among pre-adolescents. Parents' and teachers' ratings were similar for the high-DC group, although parents identified more low-DC children than teachers did. On all DC levels, adolescents identified themselves as being more depressed than either teachers or parents did. Divisions of high-, medium- and low-DC groups were supported by the finding that validation criteria increased with increases in DC levels. Overall estimates of prevalence rates for pre-adolescents in the high (0.6 percent) and medium (2.7 percent) DC levels were similar to estimates found in previous studies. The prevalence rate among pre-adolescents in the low-DC level was 17.5 percent. In adolescence, the prevalence estimates of low DC (43.9 percent), medium DC (7.8 percent) and high DC (1.8 percent) were also equivalent to estimates of other studies. (Consumer Summary produced by Reliance Medical Information, Inc.)

Statistics, Ontario, Depression in children, Childhood depression, Adolescent psychology

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Firesetting in an adolescent boy with Asperger's syndrome

Article Abstract:

Asperger's syndrome is a developmental disorder characterized by social isolation, lack of empathy, abnormal interactions with peers, impaired verbal and non-verbal communications, odd speech patterns, and restricted, repetitive play patterns and activity. Cases in the literature linking Asperger's syndrome with antisocial acts such as firesetting have been rare. The case report of a 17-year-old boy with a one-year history of firesetting is presented. The patient set fires during high school, and was expelled at age 16; he admitted to setting at least nine fires. Although his early developmental history appeared to be normal, by age two he began to show slightly odd speaking patterns. He always tended to be remote, to have few friends and to have odd play habits. His parents and teachers became aware of his developmental difficulties when he was five years old. At that time he was noisy and disruptive, which caused him to be suspended from one primary school and to fail in several others. After being sent to a special educational center, his learning and social skills improved somewhat. He began setting fires at a time when there was uncertainty about his future placement. After being expelled for firesetting, he seemed to understand the meaning of right and wrong, but lacked understanding of the consequences of his behavior and had little empathy for any distress he may have caused others. Although firesetting represents a disorder of conduct, his history of antisocial behavior did not fulfill criteria which would allow for a secondary diagnosis of conduct disorder. The relationship between Asperger's syndrome and conduct disorder remains unclear, and requires further evaluation. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Behavior disorders in children, Childhood mental disorders, Pyromania

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The similarities and dissimilarities between community and clinic cases of depression

Article Abstract:

In order to examine the differences between depression in community populations and clinic populations, comparative studies employing standardized psychiatric interviews and diagnostic procedures were reviewed. The majority of studies investigating depression in the community have focused on accumulating clinical support for the idea that, as compared with clinic patients, community depressives tend to demonstrate fewer, milder, and less incapacitating symptoms which are of shorter duration, are more environmentally than biologically caused, and respond better to psychological (rather than pharmacological) interventions. Although experimental data partially support the hypothesis that clinic cases demonstrate more symptoms than community cases, evidence also indicates that clinic patients may tend to have more than one psychiatric condition, so that some of the symptoms being counted may not be related to depression. No studies were found which compared either severity of symptoms or illness duration in community versus clinic depression. There were no studies found which directly compared hereditary factors between populations, or which compared responses to psychological and pharmacological interventions. Overall, no studies definitively differentiated community depressives from clinic depressives. It is suggested that future research should attempt to: (1) use well established and standardized interviewing and diagnostic criteria; (2) use carefully matched groups of patients; (3) isolate depressive symptoms from symptoms of other conditions and, (4) look at symptoms which occur in the peak of the depressive disorder to obtain more comparable data. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Analysis, Environmental aspects, Research, Depression, Mental, Depression (Mood disorder)

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