how do adolescents define depression? - cIRcle - University of ...

Chapter II: Literature Review
agreed-upon set of guidelines clarifying adolescent symptoms of depression (Compas &
Oppedisano, 2000). Currently, two major diagnostic systems exist, the International
Classification of Diseases and Related Health Problems -- 10 th revision (ICD-10) (WHO, 1992)
and the DSM-IV-TR (APA, 2000). The DSM-IV-TR (APA, 2000) is used predominantly in
North America and has similarities with ICD-10 (WHO, 1992), which is most commonly used
outside North America. Since the introduction of the third edition of the DSM (DSM-III) (APA,
1980),' the criteria for making a diagnosis of depressive disorders, in terms of symptomatology
and their duration in adolescents, have been more explicitly and clearly described (Essau,
Conradt, & Petermann, 1999). Although not systematically tested in research studies, the formal
and informal classification systems implemented by counsellors, social workers, psychiatrists,
psychologists, and educators have played a central role in defining the field (US Department of
Health and Human Services, 1999). In the last three decades, definitional problems with the
diagnostic criteria have been addressed to develop a reliable and meaningful classification
system (US Department of Health and Human Services, 1999).
Prevailing practices relating to intervention, professional training and certification, and
funding decisions are shaped by the ways in which individuals are described and studied
(AACAP, 1998). One concern with the current classification and diagnostic systems is that there
is still a large unexplored territory in the developmental, contextual, and relational parameters
that characterize depression in adolescents (Cicchetti & Toth, 1998). Another concern related to
the contemporary nature of the DSM-IV-TR (APA, 2000) criteria for depression is that
subthreshold presentations may go unrecognized and therefore be denied access to support
services.
Depression in Adolescence
Introduction
In a paper on adolescent research priorities, Zaslow and Takanishi (1993) emphasize two
research needs: "(a) the need to collect data that permit adolescents to describe their own
perceptions of their own experiences and (b) the need for interdisciplinary research" (p. 190).
' The ICD included a separate category for mood disorders since 1980, and before then, depression and
manic states were included under neurotic or psychotic conditions (Klerman & Weissman, 1988).
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