Age and gender differences in depressive symptomatology and comorbidity: an incident sample of psychiatrically admitted children

Background: Studies indicate that major depressive disorder (MDD) is frequent in children but that it may be missed. This study determines the incidence of hospital-treated MDD based on the frequency of MDD in child psychiatric patients, and analyses effects of age and gender on depressive symptoms and psychiatric comorbidity. Methods: One hundred ninety-nine consecutive child psychiatric patients were interviewed using a semi-structured diagnostic interview (K-SADS-PL). Comorbidity and symptoms were compared across age and gender. Results: Current or partly remitted MDD was found in 42 children (21%). Thirty-eight (90%) had comorbid psychiatric disorder(s). Onset of the comorbid disorder was prior to onset of depression in 74% of cases. No significant gender-differences, were found, but anhedonia, hypersomnia and decreased ability to concentrate were more frequent in the older age group. In contrast, feelings of worthlessness were more frequent in the younger age group. The number of melancholic symptoms was significantly associated with older age. Conclusion: MDD is frequent in child psychiatric patients aged 8-13 years. Age-but not gender-had significant effects on melancholy score and the prevalence of specific symptoms. Results suggest that MDD may be underdiagnosed in clinical samples unless careful examined with diagnostic interview. (C) 2004 Elsevier B.V. All rights reserved.