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Age and Sex Analyses of Somatic Complaints and Symptom Presentation of Childhood Depression in a Hungarian Clinical Sample

Ildikó Baji, MD; Nestor L. Lopez-Duran, PhD; Maria Kovacs, PhD; Charles J. George, MS; László Mayer, MD; Krisztina Kapornai, MD; Enikő Kiss, MD; Julia Gádoros, MD, PhD; and ígnes Vetró, MD, PhD

Published: August 25, 2009

Article Abstract

Objective: To determine whether the symptom presentation of major depressive disorder (MDD) in a large clinical sample of youngsters is influenced by age, sex, and the interaction of age and sex.

Method: The sample included 559 children (mean age‘ ‰=‘ ‰11.69 years; range, 7-14 years; 247 girls) with MDD recruited from 23 mental health facilities across Hungary. Psychiatric evaluations were conducted via the semistructured Interview Schedule for Children and Adolescents-Diagnostic Version (ISCA-D). Final DSM-IV diagnoses were rendered via the best-estimate diagnostic procedure. Evaluations were conducted between April 2000 and May 2005.

Results: Six depression symptoms increased with age: depressed mood (odds ratio [OR]‘ ‰=‘ ‰1.10, P‘ ‰<‘ ‰.05), hypersomnia (OR‘ ‰=‘ ‰1.17, P‘ ‰<‘ ‰.05), psychomotor retardation (OR‘ ‰=‘ ‰1.11 P‘ ‰<‘ ‰.05), fatigue (OR‘ ‰=‘ ‰1.13, P‘ ‰<‘ ‰.01), thoughts of death (OR‘ ‰=‘ ‰1.11, P‘ ‰<‘ ‰.05), and suicidal ideation (OR‘ ‰=‘ ‰1.18, P‘ ‰<‘ ‰.01), while psychomotor agitation decreased with age (OR‘ ‰=‘ ‰0.91, P‘ ‰<‘ ‰.05). Boys were less likely to evidence anhedonia (OR‘ ‰=‘ ‰0.67, P‘ ‰<‘ ‰.05), insomnia (OR‘ ‰=‘ ‰0.68, P‘ ‰<‘ ‰.05), and hypersomnia (OR‘ ‰=‘ ‰0.56, P‘ ‰<‘ ‰.05) but more likely to have psychomotor agitation (OR‘ ‰=‘ ‰1.59, P‘ ‰<‘ ‰.01). There were no age-by-sex interactions. Rates of somatic complaints did not decrease with age (OR‘ ‰=‘ ‰1.01, P‘ ‰>‘ ‰.05).

Conclusions: The symptom presentation of MDD becomes somewhat more neurovegetative as children get older. However, girls display more affective and atypical symptoms across all age groups. Somatic complaints were common regardless of age and should be considered an associated feature of depression in children and adolescents.

Submitted: December 2, 2008; accepted February 23, 2009.

Online ahead of print: August 25, 2009.

Corresponding author: Nestor L. Lopez-Duran, PhD, University of Michigan, Department of Psychology, 530 Church St, 2253 East Hall, Ann Arbor, MI 48109 (

Volume: 70

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