Association Between Irritability and Depressive Symptoms in Children and Adolescents

Introduction Irritability is the most frequently reported symptom in child and adolescent depression. The association of both has been linked with high rates of chronicity, comorbility and impairment. Objectives To study the association between irritability and depressive symptoms in children and adolescents. Methods We have studied 857 participants recruited from the only child and adolescent mental health clinic in a catchment area of 122,968 people under 18 (2004–2010). A sample of 857 participants (112 controls and 745 patients) was included to carry out a cross-sectional study. Irritability was measured by a Visual Analog Scale (VAS irritability)–scored from 0 to 10–, and depressive symptoms by the Children's Depression Inventory (CDI). The participants were categorized into controls and patients, and according to their irritability (≤ 4 [I], 5 [II] and ≥ 6 [III]). The mean of CDI score was calculated for each of the groups, adjusted by sex and age, and analyzed by ANCOVA. Results The following means were obtained from the controls: 13,71 (group I), 9,82 (group II) and 17,45 (group III). Regarding to the patients: 13,92 (group I), 11,54 (group II) and 15,64 (group III). A quadratic association ( P < 0.0015) was found between VAS irritability score and CDI score. Conclusions There is not a linear association between irritability and depressive symptoms in children and adolescent. High rates of depressive symptoms were associated both with high and low rates of irritability. Several questions remain unexplained about the status of irritability in psychiatry, as Stringaris group has been pointed out. Disclosure of interest The authors have not supplied their declaration of competing interest.