DEVELOPMENTAL PATHWAYS IN DEPRESSION - MULTIPLE MEANINGS, ANTECEDENTS, AND END-POINTS

This article presents an overview of work conducted at the Institute o f Psychiatry over the past 30 years on childhood depression. The work began with the basic question of definition and measurement. Epidemiol ogical studies showed that depressive symptoms were quite common in ch ildren and were a good, if nonspecific, indicator of psychological dis turbance. Further work in both epidemiological and clinical samples pr ovided some evidence for the validity of a depressive syndrome. Howeve r, this work also showed that these depressive syndromes represented a heterogeneous group of phenomena. The validity of major depressive di sorder in children was therefore tested further in longitudinal and fa mily-genetic studies. These studies supported the validity of the conc ept but confirmed that there was heterogeneity in respect to both deve lopmental stage at the time of onset and comorbidity with conduct diso rder. We concluded that there are probably several different kinds of depressive syndromes in children, Some are strongly linked with depres sive disorders in adulthood, but others are probably better conceptual ized as part of another psychopathological problem altogether.