Discriminating depression and anxiety in youth: A role for diagnostic criteria

Objective: To test the hypothesis that anxiety and depression in youth, as in adults, become increasingly discriminable when youth meet criteria for an emotional disorder. Method. The study uses cross-sectional data at two points in time from a large (n = 776) community sample of youths, aged eight to twenty. Associations between major depression and five anxiety disorders (overanxious, obsessive compulsive and separation anxiety disorders, and social and simple phobias) are examined by symptom scale and diagnosis. Results: Anxiety and depression are moderately correlated, and substantially comorbid by diagnostic category. Symptoms are more discriminable among youths with diagnoses of at least one emotional disorder than among those without. A single factor accounts for symptoms among the non-diagnosed but multiple factors are required for the diagnosed group. Conclusions: Anxiety and depression are discriminable among youth who meet criteria for a specific emotional disorder but more highly associated among youths without such a diagnosis. This suggests that in youth, as has been shown in adults, depression and anxiety become increasingly discriminable as emotional psychopathology becomes more severe.