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Immune changes in childhood depression
arOL PSYCHIATRY i q~| :29:43A- ~85A
Child
149A
these parameters were also examined. Subjects were 90 i~arent-bereaved children aged 6-18 yea-s. They and their surviving parents were administered structured ,nterviews 6 weeks postparemaI death to theft social support networks (Home Environment lnter,'iew, Grief Interview, and Interventton Survey) psychiatric status (DICA). Additionally, questionnaires were administered to the c h i l ~ n , t ~ k parents, and teachers (Conners-Parent and Teacher Forms, CDRS-R, CDI and CBCL). ~ d r e n ~ talked about the death with others, including surviving parent (47%), a friend (42%), relative outside the n u c ~ family (27%), a sibling (26%), another patent-bereaved child (25%), a nom-elative adult (19%), ~ a court,(or or therapist (18%). Use of nonfamilial support was associated with greater behavioral problems (r = 0 o ~ p < 0.05). Adolescent males with living fathers had the most extensive and helpful {by s e ~ f - ~ ) suppor~ networks. Boys with living mothers utilized the most familial support and exhibited the most b e h a v i ~ difficulties Implications of these findings are discu:.sed.
231 CHILDREN WITH DEPRESSION AND
LEARNING DISABILITIES Mary Fristad, Ph.D., Shani TcI;olsky, B.A., Elizabeth Weller, M.D., Rona!d Weller, M.D. Ohio State University Hospital, Columbus, OH 43210. Both major depressive disorders (MDD) and learning disabilities (LD) can impair a child's academic functioning. As the relationship between these di~rders has not been well studied, academic functioning in hospitalized MDD children aged 6-12 with LD in = 10) and without LD in = 20) was compared. Standard tests of cognitive (WISC-R, Woodcock-Johnson, VMI), behavioral (DICA), and affective (CDRSR) functioning were administered. A sevenfold increase in LD was found in the MDD c ~ d r e n , compared with general population base rates (33% versus 4.7%). Relative risk is as follows: reading, 4.5:1; writing, 4.6:1; and arithmetic, 4:1. V!Q, PIQ, and FSIQ OVISC-R) did not differ between groups. However, MDD/LD children were more likely to have a greater than 15-point VIQ > PIQ discrepancy i30% verstts 6%; X-" = 3.14; p < 0.04). Although rates of comorbid diagnoses were similar between groups (DICA-C, DICA-P), teacher ~ti_ng scales (CBCL, Connors) indicated increased problems with conduct (t = 3.03, p < 0.004), inattentive-passive behavior it = 1.43, p < 0.09). hyperactivity it = 2.08, p = < 0.03), extema!ized behavior it = 2.10. p < 0.03), and overall behavior (t = 1.97, p < 0.03), and decreased school performance it --- 2.00, p < 0.03), and ability to learn it = 1.87, p < 0.04) in the MDD/LD group. Implications of these results are discussed.
232 IMMUNE CHANGES IN CHILDHOOD DEPRESSION
Jacqueline Bartlett, M.D., Steven Schleifer, M.D., Steven Keller, Ph.D. New Jersey Medical School, Newark. NJ 07103. Major depressive disorder (MDD) in adults has been shown to influence immunity, and specific age-related differences have been described. This study is of psychoimmunologic findings in 20 children with MDD ages 8-12 compared with healthy age-, sex-, and race-matched controls. Diagnosis was made using the DISC-R and severity of depressive symptoms was assessed with both the CDRS and CDI. Total white counts and lymphocyte counts were within normal ranges for all subjects and controls. There were no significant group differences in total numbers of iymphocytes, lymphocyte subtypes, or lymphocyte response to mitogen stimulation. Depressed subjects i'_ad significantly lower NK cell activity it = 2.3, p < 0.03). Analyses controlling for age, sex, and group reve~3ed that higher severity scores were associated with less total iymphocytes it = 2.3, p < 0.03), suppressor T cells it = 2.1, p < 0.05), and B cells (t = 2.3, p < 0.03). These data demonstrate that some parameters of immune function are altered in childhood MDD but that these changes are not identical to those seen in adult MDD.
Child
149A
these parameters were also examined. Subjects were 90 i~arent-bereaved children aged 6-18 yea-s. They and their surviving parents were administered structured ,nterviews 6 weeks postparemaI death to theft social support networks (Home Environment lnter,'iew, Grief Interview, and Interventton Survey) psychiatric status (DICA). Additionally, questionnaires were administered to the c h i l ~ n , t ~ k parents, and teachers (Conners-Parent and Teacher Forms, CDRS-R, CDI and CBCL). ~ d r e n ~ talked about the death with others, including surviving parent (47%), a friend (42%), relative outside the n u c ~ family (27%), a sibling (26%), another patent-bereaved child (25%), a nom-elative adult (19%), ~ a court,(or or therapist (18%). Use of nonfamilial support was associated with greater behavioral problems (r = 0 o ~ p < 0.05). Adolescent males with living fathers had the most extensive and helpful {by s e ~ f - ~ ) suppor~ networks. Boys with living mothers utilized the most familial support and exhibited the most b e h a v i ~ difficulties Implications of these findings are discu:.sed.
231 CHILDREN WITH DEPRESSION AND
LEARNING DISABILITIES Mary Fristad, Ph.D., Shani TcI;olsky, B.A., Elizabeth Weller, M.D., Rona!d Weller, M.D. Ohio State University Hospital, Columbus, OH 43210. Both major depressive disorders (MDD) and learning disabilities (LD) can impair a child's academic functioning. As the relationship between these di~rders has not been well studied, academic functioning in hospitalized MDD children aged 6-12 with LD in = 10) and without LD in = 20) was compared. Standard tests of cognitive (WISC-R, Woodcock-Johnson, VMI), behavioral (DICA), and affective (CDRSR) functioning were administered. A sevenfold increase in LD was found in the MDD c ~ d r e n , compared with general population base rates (33% versus 4.7%). Relative risk is as follows: reading, 4.5:1; writing, 4.6:1; and arithmetic, 4:1. V!Q, PIQ, and FSIQ OVISC-R) did not differ between groups. However, MDD/LD children were more likely to have a greater than 15-point VIQ > PIQ discrepancy i30% verstts 6%; X-" = 3.14; p < 0.04). Although rates of comorbid diagnoses were similar between groups (DICA-C, DICA-P), teacher ~ti_ng scales (CBCL, Connors) indicated increased problems with conduct (t = 3.03, p < 0.004), inattentive-passive behavior it = 1.43, p < 0.09). hyperactivity it = 2.08, p = < 0.03), extema!ized behavior it = 2.10. p < 0.03), and overall behavior (t = 1.97, p < 0.03), and decreased school performance it --- 2.00, p < 0.03), and ability to learn it = 1.87, p < 0.04) in the MDD/LD group. Implications of these results are discussed.
232 IMMUNE CHANGES IN CHILDHOOD DEPRESSION
Jacqueline Bartlett, M.D., Steven Schleifer, M.D., Steven Keller, Ph.D. New Jersey Medical School, Newark. NJ 07103. Major depressive disorder (MDD) in adults has been shown to influence immunity, and specific age-related differences have been described. This study is of psychoimmunologic findings in 20 children with MDD ages 8-12 compared with healthy age-, sex-, and race-matched controls. Diagnosis was made using the DISC-R and severity of depressive symptoms was assessed with both the CDRS and CDI. Total white counts and lymphocyte counts were within normal ranges for all subjects and controls. There were no significant group differences in total numbers of iymphocytes, lymphocyte subtypes, or lymphocyte response to mitogen stimulation. Depressed subjects i'_ad significantly lower NK cell activity it = 2.3, p < 0.03). Analyses controlling for age, sex, and group reve~3ed that higher severity scores were associated with less total iymphocytes it = 2.3, p < 0.03), suppressor T cells it = 2.1, p < 0.05), and B cells (t = 2.3, p < 0.03). These data demonstrate that some parameters of immune function are altered in childhood MDD but that these changes are not identical to those seen in adult MDD.