DEXAMETHASONE SUPPRESSION AND CHILDHOOD DEPRESSION - ASSOCIATION WITHCATEGORICAL AND DIMENSIONAL MEASURES

This article examines the relationship of dexamethasone nonsuppression to both categorical (i.e., diagnostic categories) and dimensional (i. e., quantitative, multivariate) measures of depression in children. Si xty inpatients, ages 5-13 years, were administered the dexamethasone s uppression test (DST). Categorical measures were the diagnoses of majo r depression or dysthymic disorder obtained from semi-structured inter views of child and parent. Dimensional measures of depression were the Short Child Depression Inventory (which is a child's self-report inst rument) and the Child Behavior Checklist (which gave parent-rated quan titative scores for depression, aggression, hyperactivity, internalizi ng behaviors, and externalizing behaviors). Cortisol nonsuppression wa s associated with both dimensional and categorical measures of depress ion, but not with ratings of aggression or hyperactivity or with the d iagnoses of dysthymic disorder or disruptive behavior disorder. Childr en with major depression had a higher rate of nonsuppression (69%) tha n children with either dysthymic disorder (29%) or disruptive behavior disorders (36%). Abnormal DST findings and postdexamethasone cortisol levels appeared significantly associated with higher scores on both d imensional measures of depression, but not with measures of internaliz ing or externalizing behavior, aggression, or hyperactivity. The total variance in dexamethasone suppression accounted for by dimensional ra tings of depression was relatively modest (<20%). Although the potenti ally confounding roles of comorbid anxiety disorders and psychosocial stressors remain to be investigated, it appears that biological studie s of mood disorders in children may be advanced by the use of both dim ensional and categorical approaches to the assessment of depression.