Masked Depression in Children and Adolescents

Patterns of Psychopathology in the Families of Children with Conduct Problems, Depression, and both Psychiatric Conditions

“…This hypothesis has been offered in both directions (i.e., with both depression and CD considered to be the primary diagnosis), and is usually accompanied by the supposition that proper identification of the primary disorder has important implications for treatment. Glaser (1967) theorized that CD may represent "masked depression", with externalizing symptoms of anger and aggression marking a behavioral expression of depressed mood. According to this formulation, depression is often mistaken for CD, inflating apparent rates of comorbidity.…”

Depressão e doença bipolar na infância e adolescência

“…13 Glaser included the following symptoms in the definition of masked depression: phobias, delinquency, somatic symptoms and others such as: social withdrawal, aggressiveness, fear of death and enuresis. 14 symptoms; loss of energy and appetite, and weight loss; these symptoms represent a change in childrens general behavior; these symptoms should occur for at least one month. 18 Pearce in 1978, in a study with depressive children, shows the most common symptoms based on statistical data; determines the diagnostic criteria for childhood depression, among which he includes that depressive disorder is defined by depressive mood and two of the following symptoms: morbid or suicidal thoughts, sleep disorders, eating disorders, obsessions, irritability, hypochondriasis, eating symptoms, refusal to go to school, impaired perception such as delusions or excessive guilt and low self-esteem.…”

“…Children aged between 16 years, referred to treatment, showed low rates (1%) of major depression than those aged between 9 and 12 years (13%). Depressive disorder was rare in children, both in those aged 10-11 years (0.14%) and in those aged 14-15 years (1.5%), but depressive mood occurred in 13% of children aged less than 10-11 years and in 40% of adolescents aged [14][15] years, among which 7-8% showed suicidal thoughts.…”

Bipolar disorder and depression in childhood and adolescence

“…Rochlin considerava que a ocorrência de depressão no meio da infância era impossível, porque a criança não tinha ainda um superego suficientemente estruturado para dirigir sua agressão ao próprio ego; assim, no meio da infância (6 a 10 anos), quando a depressão ocorria, era na forma mascarada 13 . Glaser faz a hipótese de inclusão, na depressão mascarada, de sintomas como fobias, delinqüência, sintomas somáti-cos e outros, como retraimento social, agressão, medo da morte e enurese 14 . Frommer sugere três tipos de depressão: a) não-complicada ou pura grupo em que as queixas comuns de depressão eram irritabilidade, choramingo, dificuldade para dormir e ideação ou tentativa suicida (as queixas de depressão eram espontâneas e comuns); b) depressão enurética a criança com freqüência apresentava sérios problemas de aprendizado na escola, e eram comuns comportamento anti-social, conflito familiar e rejeição dos pais (a criança sofria de retardo de maturação, que levava a enurese); c) depressão fóbica este grupo apresentava uma acentuada ansiedade, queixas somáticas e alguns sintomas depressivos 15 .…”