Symptoms of DSM-III-R Major Depression in Adolescence: Evidence from an Epidemiological Survey

Objective: To examine the phenomenology of DSM-III-R major depression among adolescents diagnosed as "cases" in a community-based epidemiology study.

Method: A representative sample (N = 1,710) of older adolescents from several Oregon communities were interviewed using structured diagnostic schedules and DSM-III-R criteria in two annual assessments. Although the focus was depression, diagnoses were made for most child and adolescent psychiatric disorders.

Results: Nearly 30% of the sample at baseline had at least one current symptom of DSM-III-R major depression, but only 2.6% received a diagnosis. The most prevalent symptoms at baseline were depressed mood, sleep, and thinking problems. For new, or incident cases, the most frequent symptoms involved depressed mood, anhedonia, and thinking problems. Among those adolescents who had experienced two episodes of major depression, there was low concordance across episodes for both diagnostic criteria and specific symptoms. Comparisons with six studies of adolescent patients indicate our community "cases" are phenomenologically very similar to clinical cases of major depression in treatment settings.

Conclusions: The results presented, along with those from other studies of adults and children, provide strong evidence that DSM criteria for major depression are appropriate for adolescents. That is, DSM-III-R symptom criteria are manifested by both youths and adults, although the relative frequency of these criterion symptoms appear to be age-related.