WILLIAM H. SACK, MORTON BEISER, NORMAN PHILLIPS, AND GLORIA BAKER-BROWN CO-MORBID SYMPTOMS OF DEPRESSION AND CONDUCT DISORDER IN FIRST NATIONS CHILDREN: SOME FINDINGS FROM THE FLOWER OF TWO SOILS PROJECT ABSTRACT. The prominence of co-morbidity in children and adolescents has increased over the past decade as new empirical research data has accumulated. Yet little epidemiological data of any kind exists for First Nations Children. Following a brief literature review on co-morbidity in children and adolescents, the authors analyzed data from the Flower of Two Soils Project (M. Beiser, principal investigator) to examine more closely the relationship between self-reported depressive symptoms and parent/teacher reported conduct symptoms. Such a relationship has been consistently found in a number of studies. Children aged 7 to 10 were found to show more academic and social problems when rated as having high conduct symptoms. Children in the co-morbid group were found to have the highest rates of family stress and help-seeking behavior. Suicidal ideation was as high in the conduct and co-morbid groups as it was in the high depression group. More First Nations children were found in the high conduct-low depression group. The significance of these findings is discussed. INTRODUCTION While definitive prevalence rates for psychopathology in both First Nations children and non-native children have yet to be determined, the existing evidence strongly suggests that they are not parallel. Compared to non-native children, Beiser and Attneave (1982) showed that First Nation children appear to come under an increasing risk of emotional disorder as they move from childhood to adolescence. First Nation children's academic achievement appears to deteriorate at about the same stage of development (Bryde 1966). More recently, Dinges (1991) and Ackerson et al. (1990) have shown very high rates of affective disorder in boarding school groups of First Nations adolescents. Manson (1990), who reviewed the existing literature, found First Nations adolescents to have overall suicide rates two to three times higher than their non-native counterparts. Despite our lack of overall basic epidemiological knowledge in this area, the current empirical evidence does suggest that co-morbidity is frequently found in clinical samples of children and adolescents (Woolsten et al. 1987) and com- munity samples as well (McGee 1984, Lewinsohn et al. 1991). As DSM-III-R is now being extensively used to make clinical diagnoses, one finds it much less difficult to distinguish psychopathology from normality in children and adolescents, but much more difficult to distinguish various categories within DSM-III-R (McClellan et al. 1990). As studies proceed, questions of whether co-morbid conditions are more stable than single diagnoses, whether they lead to Culture, Medicine and Psychiatry 16: 471-486, 1993. © 1993 KluwerAcademic Publishers. Printed in the Netherlands.