Childhood and adolescence major depression is an under-diagnosed mental disorder, which can be traced back to several causes: 1. the DSM-IV diagnostic system is not specific enough considering the age. 2. Comorbidities frequently co-occurring with major depression, may overlap symptoms, thus they are rarely or not at all recognised. A small number of studies have examined developmental differences in rates of specific symptoms across depressed children and adolescents. These studies do not
show a uniform picture. Some researchers reported m
ore somatic complaints among depressed children. The gender has an influence on the symptoms of major depression. Anxiety comorbidities co-occurs with major depressive episode in 40%, while disruptive comorbidies 10-80%. The mental disorders have the negative effect on the quality of life of children. QoL is the combination of objectively and subjectively indicated well being in multiple domains of life. The stressful life events contribution to depression. 1. I hypothesized that there are some developmental and gender differences in depressive symptom presentation. 2. The somatic symptoms are more frequent in earlier life. 3. The frequency of depressive symptoms is increased by psychiatric comorbidities. 4. Stressful life events affect quality of life adversely, and it is worsened by depression. Methodes: We examined the above hypothesis in three samples. Participants were children (ages 7–14) with MDD, and community control kids from elementary schools. Diagnoses (via DSM-IV criteria) and onset dates of disorders were finalized “best estimate” psychiatrists, and based on multiple information sources. The depressive
symptoms and effects of comorbidities were examinedin depressive sample, and the quality of life was examined in the community sample.
Results: Six symptoms increased with age, namely: depressed mood, hypersomnia, psychomotor retardation, fatigue, thoughts of death, and suicidal ideation. Only psychomotor agitation was more frequent
in younger children. Anhedonia, insomnia, hypersomnia, and somatic complaints were more frequent among girls, and psychomotor agitation was more frequent among boys. Depressed mood, sleeping problems, psychomotor retardation, suicidal symptoms are significantly more frequent in anxiety group. Irritability and psychomotor agitation is significantly more frequent in the disruptive group. Worthlessness is the most frequent in the disruptive group, and in this group it is the third most frequent symptom. The clinical depression influences the quality of life the most strongly, and the higher depression score goes together with a lower quality of life. Stressful life events influence the quality 6 of life directly and through the depressive symptoms indirectly. Conclusionsthere are some developmental and gender differences in depressive symptom presentation. Irritability is the most frequent criterion symptom. We also observed stable and elevated rates of irritability, which were concurrent with stable and low rates of anhedonia across all age groups. Somatic complaints should be considered an associated feature of the symptom profile of MDD in pediatric populations. Depressive symptoms are reported to have more negative effects on the quality of life than do stressful life events
