Classification and diagnosis of depression in school phobia

Fifty-one school phobic children, aged nine to fourteen years, were assessed for psychiatric diagnosis; this revealed the presence of two clinically meaningful sub-groups--depressed and residual school phobic. A wide range of symptoms were studied to identify those which might prove useful in diagnosing adult-type depression in childhood and early adolescence, both in terms of frequency of symptoms in the depressed group and the extent of the distinction between the two groups. Eleven such key symptoms were identified and based on these, a formula for diagnosing adult-type depression was evolved. The validity of several different ways of classifying the above cases were explored; these covered: kind of disorder; type of onset; adolescence versus pre-adolescence; and sex of the child. However, on only one dichotomy--depression versus absence of depression--were there many significant discriminants. Affective symptomatology of more recent onset was contrasted with pre-morbid personality traits, usually associated with school phobia. There was no evidence to support the concept of 'masked depression' in childhood.