A novel early intervention for preschool depression: findings from a pilot randomized controlled trial

Abstract

Background Validation for depression in preschool children has been established; however, to date no empirical investigations of interventions for the early onset disorder have been conducted. Based on this and the modest efficacy of available treatments for childhood depression, the need for novel early interventions has been emphasized. Large effect sizes for preschool psychotherapies for several Axis I disorders suggest that earlier intervention in depression may also be promising. Therefore, a novel form of treatment for preschool depression, Parent Child Interaction Therapy Emotion Development (PCIT-ED) was developed and tested. Methods A preliminary randomized controlled trial (RCT) was conducted comparing PCIT-ED to psycho-education in depressed 3-7 year olds and their caregivers. N=54 subjects met symptom criteria for DSM-IV MDD and were randomized, N=19 subjects completed the active treatment (N=8 drop-outs) and N=10 completed psycho-education (N=17 drop-outs). Results Both groups showed significant improvement in several domains, with PCIT-ED showing significance in a greater number of domains. An Intent-to-Treat analysis suggested that PCIT-ED was significantly more effective than psycho-education on executive functioning (p=0.011, ES=0.12) and emotion recognition skills (p=0.002, ES=0.83). Conclusions The RCT proved feasible and suggests an individual control condition should be used in future trials to minimize differential drop-out. These pilot data, although limited by power, suggest that PCIT-ED may be a promising early intervention for depression. Larger scale randomized controlled trials of PCIT-ED for depressed preschoolers are now warranted.

Preschool is a sensitive period for the influence of maternal support on the trajectory of hippocampal development

“…Therefore, the identification of modifiable environmental exposures that can impact the development of the hippocampus and in turn later emotion functioning is a finding of key public health importance. These findings should inform prevention and early intervention strategies, a number of which have been designed and shown to effectively enhance maternal support (25)(26)(27).…”

Psychological treatments for depression in pre-adolescent children (12 years and younger): systematic review and meta-analysis of randomised controlled trials

“…One trial [18] did not assess CBT, instead comparing two other forms of therapy (psychodynamic and family therapy). The other [13] assessed a different form of psychological intervention with a much younger age group (aged 3-7 years). The results of these two studies are described separately.…”

“…Three studies [12,13,14] reported results specifically and only for the age group of interest, but in most other studies it was not possible to identify the results specifically for the population of interest (aged 12 and under) from the publications. In these cases we contacted the lead author and/or funder (in the case of the NIH-funded…”

“…One study included younger preschool children [13]. Two studies [12,14] only included participants of preadolescent age (7-11 and 9 to 12), and the four remaining studies had a wider age range from which we included data on those aged 12 or below.…”

Comparison of the Effectiveness of Two Cognitive-Behavioral and Mother-Child Interactive Therapies on Anxiety of Children With Under-Methadone Treatment Mother

“…Of course, there are results regarding the effectiveness of this treatment in treating depression disorder. For example, Luby et al [31] used an interactive approach in the treatment of depression in a sample of 54 children aged 3-6 years who lacked metacognitive abilities to use cognitive-behavioral therapy, which had been reported as successful. Also, Lenze et al [32] used interactive therapy successfully with the goal of reducing the symptoms of depression in preschoolers.…”