ABSTRACT
What quali®es for a diagnosis of depression in a child? According to the DSM-IV criteria for children, dysthymic disorder must include depressed mood for one year but no major depressive episode. In addition, two or more of the following must be present with no interval exceeding two months: (1) poor appetite or overeating, (2) insomnia or hypersomnia, (3) low energy or fatigue, (4) low self-esteem, (5) poor concentration or dif®culty making decisions, (6) feelings of hopelessness. For major depressive disorder, the criteria are (1) anhedonia, (2) ¯attened affect or at least three of the following, (3) morning onset of depressed mood not related to loss, (3) premature awakening, (4) mental and physical slowdown or agitation, (5) anorexia or weight loss, (6) acute and inappropriate guilt. It has been pointed out that when a diagnosis is based on symptom count, only implausibly high rates of depressive disorder are produced (Harrington 2002).
