Diagnostic Subgroups of Depression in Adolescents with Emotional and Behavioral Disorders

One hundred and eighty-five adolescent inpatients with emotional and behavioral disorders completed two self-report measures of depression, the Children's Depression Inventory and the Mood and Feelings Questionnaire, and a structured diagnostic interview of depression, the Diagnostic Interview Schedule for Children (Module C). Measures of depression were entered into a cluster analysis to determine subgroups of depressive symptom patterns. A five-cluster solution was obtained, with clusters characterized as (a) Nondepressed, (b) Endogenous Depression, (c) Depressed Mood with Subclinical Features, (d) Depressed Mood with Clinical Features, and (e) Negative Cognitions. The consistency of these findings with clusters previously obtained in child, adolescent, and adult samples suggested a continuity of depressive presentations in childhood, adolescence, and adulthood. Endogenous depression appears to be a robust subgroup of depression that is evident across the lifespan. A second subgroup of depression, characterized by negative cognitions and suicidal ideation in children and adolescents, may present in adulthood as a personality disorder with depressive features. Finally, two depressive subgroups characterized primarily by dysphoric mood may be distinguished by symptom severity. Depressed mood with subclinical features may occur as an isolated depressive syndrome in adolescents and adults. In contrast, depressed mood with clinical features in adolescence may represent the early stage of a clinical depression emerging in adulthood.