对于学龄儿童的抑郁症，是否应该采用不同的诊断标准？
Should depression in young school-children be diagnosed with different criteria?
作者信息
Puura K, Tamminen T, Almqvist F, Kresanov K, Kumpulainen K, Moilanen I, Koivisto A M
机构信息
University of Tampere, Tampere School of Public Health, Finland.
出版信息
Eur Child Adolesc Psychiatry. 1997 Mar;6(1):12-9. doi: 10.1007/BF00573635.
In a two-stage epidemiological study 5686 randomly selected 8 to 9-year-old children were screened using the CDI (Children's Depression Inventory), of whom 418 were questioned with the DISC-C1 (Diagnostic Interview Schedule for Children). According to DSM-III criteria the prevalence of MDD (Major Depressive Disorders) was 0.48% and of DD (Dysthymic Disorder) 0.06%. The prevalence rates did not change when DSM-III-R and DSM-IV criteria were employed. Fifteen children reported suicidal thoughts but according to DSM-III criteria only 1 of these children was depressed. Duration and frequency of depressive symptoms are essential for making a diagnosis of depressive disorder by the DSM-III, but children's reliability in reporting them is questionable. Omitting the duration and frequency of symptoms from the DSM-III criteria raised the prevalence of MDD to 4.0% and of DD to 2.2%. Eight of the children with suicidal thoughts were depressed. By the adapted DSM-III-R and DSM-IV criteria the prevalence rate of MDD was 4.0% and of DD 9.7%.
在一项两阶段的流行病学研究中，随机选取了5686名8至9岁的儿童，使用儿童抑郁量表（CDI）进行筛查，其中418名儿童接受了儿童诊断访谈量表（DISC-C1）的询问。根据《精神疾病诊断与统计手册》第三版（DSM-III）标准，重度抑郁症（MDD）的患病率为0.48%，恶劣心境障碍（DD）的患病率为0.06%。采用《精神疾病诊断与统计手册》第三版修订版（DSM-III-R）和第四版（DSM-IV）标准时，患病率并未改变。15名儿童报告有自杀念头，但根据DSM-III标准，这些儿童中只有1名患有抑郁症。抑郁症状的持续时间和频率对于根据DSM-III诊断抑郁症至关重要，但儿童报告这些症状的可靠性值得怀疑。从DSM-III标准中省略症状的持续时间和频率后，MDD的患病率升至4.0%，DD的患病率升至2.2%。有自杀念头的儿童中有8名患有抑郁症。根据修订后的DSM-III-R和DSM-IV标准，MDD的患病率为4.0%，DD的患病率为9.7%。
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