A Clinical Study of the Relationship between School Refusal and Depression

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The subject of this study were cases exhibiting school inattendance directly examined by one of the authors between 1989 and 1997, on whom the CDI,a self-rating scale on depression could be employed. From among these cases, subjects fulfillling the criteria of school refusa or depressive disorders were selected. The number of school refusal cases is 44 (29boys, 15girls), and the number of depressive disorder cases is 12(5boys, 7girls), total 56(34boys, 22girls). Mean CDI scores for school refusal cases was 20.9(]SY.+-。[) 7.07, that for depressive disorder cases was 27.3(]SY.+-。[)6.92, and that for normal controls was 19.9(]SY.+-。[)7.50, showing significantly higher CDI scores for depressive disorder cases in comparison to school refusal cases and normal controls. According to a study by Tsujii, the CDI is constructed of the 3 subordinate scales of "feelings of interpersonal maladaptation", "core depression", and "self revulsion". The difference between school refusal cases and normaol controls in terms of the three subordinate scales was not significant. There were significant differences in terms of "feeling of interpersonal maladaptation"and"core depression"between depressive disorder cases and two other groups. We conclude these results support our belief that school refusal cases and depressive disorder cases that both complain of school inattendance should be differenciated clinically, though both cases appear same clinically.