The Newcastle Child Depression Project: Diagnosis and Classification of Depression

Article Abstract:

The study of depression in children is a relatively new field. Although it is progressing rapidly, little is currently known. The validity of diagnostic criteria and how to classify depression in children are areas of particular concern. With regard to the former issue, some argue that childhood depression can be diagnosed with the same used in diagnosing depression in adults. Others argue that this is not possible. With regard to the latter issue, the classification of depression in children is difficult because of the developmental stages that children go through. The Newcastle Depression Project addressed several areas within the study of childhood depression. First, it explored the use of the Standard Psychiatric Interview for diagnosing depression in children. Second, it compared different formulations of depression in children. Third, it explored the extent to which depression in children might be mixed with other disorders. Fourth, it explored issues in classifying depression in children. It was hypothesized that the validity of different diagnostic criteria would vary, with the most useful being based on the clinical interview, and that the proportions of mixed depression would depend on the type of associated disorder. The Child Depression Inventory was used to assess 275 children; 95 of these children were further examined with a structured interview during which the Standard Psychiatric Interview (SPI), Kiddie-SADS (Schedule of Affective Disorders and Schizophrenia), the Newcastle Instrument, and the Weinberg criteria were used. About 35 percent of the children were diagnosed to have significant depression. It was determined that childhood depression may be missed unless an evaluation of other symptoms, such as neurosis, conduct disorder, and phobic disorder, is conducted as well. Statistical analysis of the validation of diagnoses using the various instruments is discussed as well. (Consumer Summary produced by Reliance Medical Information, Inc.)

Reports, Psychiatric research

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The context of childhood depression: the Newcastle Childhood Depression Project

Article Abstract:

The relation between life events and subsequent depression has been extensively studied in adults, but not in children. Among adults, depression has been linked to current provoking agents and vulnerability factors. In children, prospective studies have linked major life events, such as parental divorce, birth of a sibling, and hospital admission for the child, with certain psychiatric disorders, including depression. In the current paper, childhood depression was investigated with respect to life events, premorbid personality, social context, and maternal state. In this sample, some of the factors associated with depression were higher social class, better family employment, longstanding parental marriage, and better parental education. It is suggested, however, that these seemingly unusual findings highlight the tendency for the opposites of these factors to result in acting-out behaviors, such as conduct disorders, rather than depression. Surprisingly though, mothers of nondepressed children had a higher rate of depression and other affective disturbances than mothers of depressed children. Other factors associated with childhood depression included premorbid obsessive personality style, abnormal delivery, higher rates of absence from school than nondepressed peers, and less preschool exposure to bereavement. Other than illness and change in social relationships, life events were not significantly correlated with depression in this sample. (Consumer Summary produced by Reliance Medical Information, Inc.)

Social aspects, Demographic aspects, Mental illness, Mental disorders

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Diagnosing childhood depression: who should be interviewed, parent or child? the Newcastle Child Depression Project

Article Abstract:

With improvements in assessment and diagnosis of psychiatric disorders in adults has come the need for similar progress in child psychiatry. In the latter, clinicians have tended to focus on psychopathology rather than symptoms, and information is often obtained from parents and teachers rather than directly from the child. In the present study, the Kiddie-SADS (Schedule of Affective Disorders and Schizophrenia) assessment tool was modified to include independent interviews with both parent and child, and the modified version was administered to 87 children and one parent of each child. Agreement between parent and child was explored. Parents were not always aware of the intrapsychic distress that their children were experiencing and children reported more depressive symptoms than their parents described. Indeed, more than 50 percent of symptoms were reported in greater numbers by children than by their parents. Prepubertal children were in better agreement with their parents than adolescents. It is unclear whether this is due to the tendency of adolescents to hide their feelings from parents, or from parents' decreased sensitivity of teenagers' feelings. It is recommended that, in addition to indirect investigation through parents and teachers, clinicians directly ask even young children about their feelings. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Evaluation, Parent and child, Parent-child relations

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