Clinical features of depressive disorder among patients below 18 years of age.

OBJECTIVE: To determine clinical manifestations of depressive disorder among cases below 18 years.

DESIGN: Cross-sectional study.

PLACE AND DURATION OF STUDY: Carried out at NMI (Neurospinal Medical Institute), Karachi, over a period of 3 years (October 2001 to 2004).

PATIENTS AND METHODS: Four hundred consecutive cases, below the age of 18 years, were evaluated. One hundred cases were inducted in this study based on detailed history and interview by psychiatrists. The diagnostic criteria of ICD-10 (International classification of diseases in its tenth revision) of WHO was used. Results based on clinical features were tabulated and analysed with SPSS-10. Fisher s exact test/Chi-square test were used for comparison between male and female cases.

RESULTS: A total number of 400 consecutive cases, below the age of 18, who approached for psychiatric consultation, were evaluated. After applying the ICD-10 diagnostic criteria, a 100 (25%) of them were found to be suffering from depressive disorder. Among them, 54 were girls and 46 boys, giving a male to female ratio of 1:1.32 and statistically insignificant gender difference. Instead of mood disturbance, the most frequent presenting complaints included pain (55%), insomnia (33%), fear (16%), weakness (14%) and aggression (13%).

CONCLUSION: Depression is a common psychiatric disorder among the pediatrics and adolescents. The clinical presentation was usually found to be atypical.