A total of 275 successive referrals to a university child psychiatry unit out-patient department were examined using the Child Depression Inventory. Of these, 95 children were examined further by a structured clinical interview, and the relationship between different instruments for the assessment of depression in childhood was investigated. Just over one-third of the children (35%) had significant depression, and it was found that depression may be missed unless children with other psychiatric diagnoses are examined closely. Multivariate analyses of the clinical data provided factorial validation of diagnoses when employing different clinical diagnostic schemas.

The extent of the similarities and discrepancies in the reporting of depressive symptomatology by children and their mothers was examined. Child-parent agreement was not always impressive, particularly for more subjective symptoms. It is suggested that direct psychiatric assessment of children provides a more accurate picture of their mental state regardless of presenting disorder, but particularly where depression is suspected.

This paper examines the family background, premorbid personality traits and adverse life events preceding childhood depression. The non-depressed group proved more likely to have experienced pre-school bereavement and familial disturbance, and to come from the more deprived background; there was also an excess of premorbid anxiety and hysterical personality traits in this group. School phobia and premorbid obsessional traits were associated with the depressed group. Although there was an association between depression and the total number of adverse life events, this was more substantial when the perceived impact of the events was taken into account. Of the individual classes of life event, only illness and a change in social relationships were associated specifically with depression.

A comparison was made of the reliability and validity of two self-rating scales, the Children's Depression Inventory (CDI) and Depression Self-Rating Scale (DSRS), in the diagnosis of depression in 93 children (aged 8–16 years) attending a university child psychiatry department. The two scales were of comparable merit but had only moderate discrimination between depressed and non-depressed children, with each scale having a misclassification rate of 25%. Better agreement was obtained in more verbally intelligent children, irrespective of age. Girls scored higher on the instruments than boys. No significant relationship was found between teacher assessment of classroom behaviour and the two self-rating depression instruments.

The dexamethasone suppression test was carried out on 44 children to assess agreement with diagnosis of depression. No significant association was found between suppression of plasma cortisol and depression diagnosed clinically or by cluster analysis.