Table 1.

The left column lists characteristics of depression seen in both children and adults. The asterisks (*) indicate qualities that are unique to or more commonly observed in childhood depression. The presentation of depression in children with autism spectrum disorders can be more challenging to characterize and recognize. The right column lists additional characteristics that have been described in ASD-affected children presumed to be affected by depression or depressive symptomatology (ASD-affected children have been observed to exhibit signs or symptoms from both the left and right columns).

Traditional signs and symptoms of depression including characteristics that may be seen in childhood depression include:

Additional signs and symptoms that may be present in ASD-affected children who are experiencing depression

Depressed mood, sadness, tearfulness Irritability* Anhedonia Insomnia or hypersomnia Psychomotor agitation or retardation (behavioral problems*) Fatigue or loss of energy Social withdrawal Weight loss not associated with dieting / change in appetite Increased guilt or worthlessness Somatic complaints* Lack of brightening* Diminished ability to concentrate; indecisiveness Recurrent thoughts of death or suicidal ideation Play characterized by themes of suicide or death*

Aggression Mood lability Hyperactivity Decreased adaptive functioning or self-care Regression of previously learned skills Increased compulsiveness Fluctuations in autistic symptoms including both increased stereotypic behavior and decreased interest in preoccupations/restricted interests Self-injurious behavior Catatonia Overall marked change in behavior from baseline not otherwise specified by above characteristics