Teacher and parent ratings of children with depressive disorders

The fields of child psychology and psychiatry have not yet established the clinical presentation in school of children and adolescents who have been diagnosed as having a depressive disorder. To address this issue, the authors used teacher ratings on scale oriented to the third, revised edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R). Based on DSM-III-R diagnoses generated from interviews-using the Schedule for Affective Disorders and Schizophrenia for School Age Children, Epidemiological Version (K-SADS-E)-of parents and children ages 6 to 18 years old (N = 153), the authors formed three groups of children: Depressed, Attention-Deficit/ Hyperactivity Disorder and Control. They then used the DSM-oriented scales of Achenbach's Teacher's Report Form and the Child Behavior Checklist, the latter completed by parents, to compare the children in each group. Teacherparent agreement on the scales was consistent with the results from past studies.Teacher ratings distinguished among the groups almost identically to parent ratings; in particular, the Affective Problems scales significantly differentiated the Depressed group from the other two groups. Furthermore, teachers rated substantial numbers of members of the Depressed group with serious levels of both affective and anxious symptoms. Overall, teacher accuracy in identifying children with depression was 66% on the Affective Problems scales. In addition,the ratings identified two subgroups of the Depressed group: Parent-Identified Only and Teacher/Parent-Identified. Consequently, teachers appear to make clinically relevant ratings of depression in children that may enhance the diagnosis and treatment monitoring of depressive disorders in children and adolescents.