title: Modification of DSM-IV criteria for depressed preschool children.
abstract: OBJECTIVE
  This study compared the severity of depression in preschoolers diagnosed by standard versus modified DSM-IV criteria for major depression.
  
  
  METHODS
  A group of 145 preschoolers and their caregivers underwent a diagnostic assessment for preschool children. A factor analysis of depressive symptoms from the group was performed to derive a depression severity score. Scores were compared among four groups: standard DSM-IV major depression, modified DSM-IV major depression, DSM-IV attention deficit hyperactivity disorder and/or oppositional defiant disorder, and no disorder.
  
  
  RESULTS
  A hierarchy in severity emerged, with significant differences among all four groups. Preschoolers meeting standard criteria displayed the highest severity, followed by those who met modified criteria. Both depressed groups had significantly higher severity than the two comparison groups.
  
  
  CONCLUSIONS
  Standard DSM-IV criteria captured the most severely affected preschoolers, missing a substantial proportion of children with potentially clinically significant but less severe symptoms who were captured by modified DSM-IV criteria.
authors.affiliation: Department of Psychiatry, Washington university School of Medicine, AMO 63110, USA. lubyj@msnotes.wustl.edu
authors.forename: Joan L
authors.initials: JL
authors.lastname: Luby
authors.forename: Christine
authors.initials: C
authors.lastname: Mrakotsky
authors.forename: Amy
authors.initials: A
authors.lastname: Heffelfinger
authors.forename: Kathy
authors.initials: K
authors.lastname: Brown
authors.forename: Martha
authors.initials: M
authors.lastname: Hessler
authors.forename: Edward
authors.initials: E
authors.lastname: Spitznagel
mesh_terms: D000367:Age Factors; D001289:Attention Deficit Disorder with Hyperactivity / Q000145:classification / Q000175:diagnosis; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000145:classification / Q000175:diagnosis; D002675:Child, Preschool; D003866:Depressive Disorder / Q000145:classification / Q000175:diagnosis* / Q000523:psychology; D003937:Diagnosis, Differential; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005163:Factor Analysis, Statistical; D006801:Humans; D025341:Principal Component Analysis; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data*; D011594:Psychometrics; D012720:Severity of Illness Index