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Eight weeks after the death of a parent, children from stable families (N = 38) were compared to depressed inpatients (N = 38) and normal children (N = 19). School behavior, interest in school, peer involvement, peer enjoyment, and self-esteem were similar for bereaved and normal children. Bereaved children functioned significantly better than depressed inpatients. As a group, the bereaved children from stable families did not experience significant, acute psychosocial dysfunction.

Cortisol levels of 21 hospitalized prepubertal depressed children given the dexamethasone suppression test (DST) were measured by radioimmunoassay and by fluorescent polarization immunoassay, a new assay method. Correlation analyses demonstrated a highly significant linear relationship between the two methods of measuring cortisol. Thus, it may be possible to use fluorescent polarization immunoassay to measure cortisol levels in children undergoing the DST.

Objective: The purpose of this study was to ascertain depressive symptoms in recently bereaved prepubertal children and compare these symptoms with those of depressed prepubertal children., Method: The subjects were 38 children who had recently experienced the death of one but not both of their parents. They had to meet strict inclusion criteria so that the effects of bereavement per se, rather than other significant stressors, could be assessed. The comparison group consisted of 38 hospitalized, depressed children individually matched to each bereaved subject for age, sex, and socioeconomic status. All of the children underwent systematic and comprehensive evaluation. They and their parents were independently evaluated by trained interviewers using the parent and child versions of the Diagnostic Interview for Children and Adolescents. Family histories and basic demographic information were also obtained., Results: The recently bereaved children endorsed many depressive symptoms. Thirty-seven percent of them met the DSM-III-R criteria for a major depressive episode. The depressed children, however, had more depressive symptoms on average than the bereaved children. The factors associated with increased depressive symptoms in the bereaved children were 1) the mother as the surviving parent, 2) preexisting untreated psychiatric disorder in the child, 3) family history of depression, and 4) high socioeconomic status., Conclusions: A considerable number of the bereaved children developed the clinical symptoms of a major depressive episode immediately after the death of a parent. The relation of these symptoms to the subsequent course of grief and to major depressive disorder remains unknown and should be studied further.

Hospitalized prepubertal depressed children with abnormal dexamethasone suppression test (DST) results were treated and given repeat DSTs at 6 weeks (N = 21) and 5 months (N = 14). DST results were significantly correlated with clinical status at 5 months but not at 6 weeks.

The authors describe the manic symptoms, family psychiatric histories, and psychotic symptoms of 10 prepubertal children 6-12 years old who had a DSM-III diagnosis of manic episode with psychotic features. All of the children improved when treated with lithium alone. Improvement in both manic and psychotic symptoms was noted an average of 11 days after lithium administration was started.

The dexamethasone suppression test was performed on 20 hospitalized prepubertal children who met DSM-III criteria for major depressive disorder. Fourteen children (70%) did not suppress cortisol secretion at either 8:00 a.m. or 4:00 p.m. The 4:00 p.m. value alone predicted 93% of the nonsuppressors.

Results of the dexamethasone suppression test (DST) and the cortisol suppression index (CSI) were compared in 50 depressed prepubertal children and 36 control subjects. The 4:00 p.m. DST, the two-point DST, and the 8:00 a.m. revised criterion CSI yielded the best results and had similar clinical utility and diagnostic confidence values.