Seifer R, Nurcombe B, Scioli A, Grapentine W L
J Am Acad Child Adolesc Psychiatry. 1989 Nov;28(6):935-41. doi: 10.1097/00004583-198911000-00020.
One approach to validation of the construct of major depressive disorder in childhood was examined. Multivariate analyses of parents' responses on the Child Behavior Checklist (CBCL) were undertaken to determine whether a depressive symptom component would emerge and whether a group of children with pure depressive disorder could be isolated. The study involved 284 children (91 inpatients and 193 outpatients) aged 6 to 11 years. Principal components analyses identified a weak depression component among the CBCL items. Other components were aggressive, anxious, withdrawn, and immature. Cluster analyses designed to isolate a group of children with pure depressive disorder did not accomplish that goal. The results suggest that current enthusiasm for the diagnosis of major depressive disorder in children may be misplaced, and that a dimensional dysthymic syndrome that accompanies many other problems may better explain patterns of symptoms in children. The importance of the use of multiple methods to validate important psychiatric diagnoses is discussed.
对儿童期重度抑郁症结构的一种验证方法进行了研究。对父母在儿童行为清单（CBCL）上的回答进行了多变量分析，以确定是否会出现抑郁症状成分，以及是否可以分离出一组患有单纯抑郁症的儿童。该研究涉及284名6至11岁的儿童（91名住院患者和193名门诊患者）。主成分分析在CBCL项目中确定了一个微弱的抑郁成分。其他成分包括攻击性、焦虑、退缩和不成熟。旨在分离出一组患有单纯抑郁症儿童的聚类分析并未实现这一目标。结果表明，目前对儿童重度抑郁症诊断的热情可能放错了地方，并且一种伴随着许多其他问题的维度性心境恶劣综合征可能能更好地解释儿童的症状模式。讨论了使用多种方法验证重要精神疾病诊断的重要性。
