Clinical significance of type of mood disturbance (depressed mood, irritable mood, or anhedonia) in children and adolescents with major depressive disorder

Date of Award




Degree Name

Doctor of Philosophy (Ph.D.)



First Committee Member

Donald K. Routh - Committee Chair

Second Committee Member

Benjamin B. Lahey - Committee Member


This study examined the various types of mood disturbances (depressed mood, irritable mood, or anhedonia) exhibited by 60 children and adolescents receiving diagnoses for Major Depressive Disorder (MDD) in the DSM-IV field trials. There were two main goals of this study: (1) to determine the extent of the heterogeneity in the types of mood disturbances expressed in children and adolescents receiving diagnoses of MDD, and (2) to determine the clinical significance of the presence or absence of the various types of mood disturbances. This second goal was accomplished by examining the relationship between the various types of mood disturbances and numerous other variables, such as age, suicidal ideation, suicidal behavior, and degree of psychiatric disturbance as measured by the Children's Global Assessment Scale (CGAS). Further analyses were conducted examining gender and comorbidity. In addition, all analyses were conducted using the whole field trials sample (N = 440) as well in order to determine if the findings could be replicated in a general psychiatric sample.Contrary to what was expected, subjects receiving diagnoses of MDD were found to be fairly homogeneous with respect to mood disturbance in that the most typical presentation involved all three types of disturbances of mood. Other major findings were as follows: (1) subjects who presented with anhedonia received interviewer-generated CGAS scores indicating greater levels of functional impairment than others within the MDD category, and (2) subjects who presented with irritability were found to be significantly older than others with MDD. Both of these findings were replicated in the whole field trials sample as well.


Psychology, Developmental; Psychology, Clinical

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