Childhood depression and its nosological approach in the pediatric population

Abstract

Introduction: Depression in children and adolescents may present differently according to age, sex, and family context; therefore, screening alone does not always provide an adequate nosological interpretation. Objective: To determine the frequency and intensity of depressive symptoms and analyze their nosological approach in a school-age pediatric population from Milagro, Ecuador. Methodology: A quantitative, observational, non-experimental, cross-sectional study was designed with 201 participants aged 8 to 17 years. A sociodemographic form, the Children's Depression Inventory 2, and a structured clinical interview were used. Descriptive statistics, chi-square tests, between-group comparisons, and Cohen's kappa were applied, with a significance level of 0.05. Results: Elevated depressive symptoms were identified in 28.9% of participants, whereas 20.9% showed a clinical assessment compatible with a relevant depressive condition. Elevated symptoms were more frequent among females, 36.1%, than males, 20.4%, and increased from 17.7% in participants aged 8 to 11 years to 39.1% in those aged 15 to 17 years. Agreement between screening and clinical assessment was substantial, κ = 0.63. Previous psychological or psychiatric care and selected family living conditions were associated with greater symptom burden. Conclusions: Pediatric depression assessment should combine screening measures with structured clinical evaluation. Age, sex, and psychosocial history should be considered when interpreting findings and identifying children and adolescents who require specialized care.