Sir.—I read with interest the article "Childhood Depression: Developmental Considerations" by Herzog and Rathbun in the Journal (1982;136:115-120). Certainly, all of the five patients they described had ample psychiatric cause for their depressive illnesses.
However, in Table 2, which listed "Developmentally Specific Criteria" for the different age groups, the following manifestations were listed in the 3- to 5-year-olds: sad facies, woeful eyes, enuresis, asthma, eczema, excessive activity, lethargy, aggressive behavior, and sleep difficulties. And in the 6- to 8-year-olds, the manifestations listed included vague complaints, abdominal pain, eczema, seizure-like episodes, asthma, enuresis, encopresis, irritability, and prolonged unhappiness.
In my general pediatric and allergy practice during the past 25 years, I have seen many allergic children with these same symptoms who improved after offending foods were identified and removed from their diets. Moreover, a number of these children with food-induced problems also suffered from depression.1,2,3 Randolph4 and Speer