A case-control study of the difficulties in daily functioning experienced by children with depressive disorder

The parent-assessed children-with-difficulties questionnaire (Questionnaire-Children with Difficulties; QCD) is designed to evaluate a child׳s difficulties in functioning during specific periods of the day. This study aimed to use the QCD to evaluate the difficulties in daily functioning experienced by children with depressive disorders.

A case-control design was used. The cases comprised 90 junior high school students with depressive disorder, whereas a community sample of 363 junior high school students was enrolled as controls. Behaviors were assessed using the QCD, Depression Self-Rating Scale (DSRS), Tokyo Autistic Behavior Scale (TABS), attention deficit hyperactivity disorder-rating scale (ADHD-RS), and Oppositional Defiant Behavior Inventory (ODBI). We then analyzed the effects of sex and diagnosis on the QCD scores as well as the correlation coefficients between the QCD and the other questionnaires.

We included 90 cases (33 boys, 57 girls) with depressive disorders and 363 controls (180 boys, 183 girls). The QCD scores for the children with depressive disorders were significantly lower compared with those from the community sample (P<0.001). The morning, school-time, and night subscores of the QCD were lower for the children with both depressive disorders and truancy problems than for those with depressive disorders alone (P<0.001). Significant correlations were observed between the following: the night QCD subscore and the DSRS scores among boys, the morning QCD subscore and ADHD-RS inattention scores for all groups, and the evening QCD subscore and the TABS score.

Parents reported that children with depressive disorders experienced greater difficulties in completing basic daily activities compared with community controls. These difficulties were dependent on sex, symptoms, and the time of day. The use of QCD to assess children with depressive disorders enables clinicians to clarify the time periods at which the children face difficulties.