By Dennis P. Cantwell M.D., Gabrielle A. Carlson M.D. (auth.)
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Extra resources for Affective Disorders in Childhood and Adolescence: An Update
He remained serious, caring, and resourceful. His future goal was to join the Marines. Discussion This example underscores a number of important clinical issues in the diagnosis of childhood depression. First, the child is often more aware of his mood state and other depressive symptoms than the parents. 's misbehavior. 's depression (possibly because they felt responsible for it). This child might previously have been considered as having a "masked" depression and certainly displayed a number of symptoms sometimes called "depressive equivalents" (fighting, delinquency, occasional fecal soiling, deteriorating school performance).
However, his parents were rigid disciplinarians and threatened him by saying he would cause a heart attack (mother had coronary artery disease) or spell (described later) in the mother or by using physical punishment that bordered on abusive. Family turmoil was described by R. " History from parents and school ultimately revealed a behavior change a few months earlier. R. had begun getting into trouble in school for not completing assignments, bothering other children, and getting into more fights (though the teacher considered R.
Characteristic features were irritability, weepiness, and a tendency to recurrent explosions of temper or misery. Difficulty in sleeping, nightmares, and sleepwalking were also common. This group of depressive subjects was the only one in which a fairly large number complained spontaneously of feeling depressed. Suicidal ideation and attempt was almost exclusively limited to this group. Anxiety and lack of confidence were not prominent features of the pure depressive group. Nearly half were described as warm and outgoing and had many friends, but antisocial behavior was present in somewhat less than quarter.
Affective Disorders in Childhood and Adolescence: An Update by Dennis P. Cantwell M.D., Gabrielle A. Carlson M.D. (auth.)