Preschool Depression

Abstract

Context Childhood depression is a serious and relapsing psychiatric disorder. However, to date studies have focused mostly on children aged 6 years and older. Validation for depression in preschool children has been provided by 2 independent study samples. While several studies have demonstrated stability and poor outcomes of internalizing symptoms in preschoolers, there has not yet been longitudinal data available to inform the course of preschool depression and whether it shows homotypic continuity into early childhood. Objective To examine the 24-month course of preschool depression and whether it showed homotypic vs heterotypic continuity or was a developmentally transient phenomenon. Design Blindly rated, prospective, 24-month, longitudinal follow-up study. Setting Community sites. Patients Three hundred six preschoolers aged 3 to 6 years recruited from community sites and oversampled for symptoms of depression. Main Outcome Measure Recurrence/stability of depression and predictors of course. Results Preschoolers with depression at baseline had the highest likelihood of subsequent depression 12 and/or 24 months later compared with preschoolers with no baseline disorder and with those who had other psychiatric disorders. Preschoolers with depression at baseline were more likely to have later depression rather than other psychiatric disorders. Findings from a logistic regression analysis indicated that when controlling for demographic variables, risk factors, and comorbid disorders, depression during the preschool period and family history of affective disorders were the most robust and significant predictors of later depression. Conclusions Preschool depression, similar to childhood depression, is not a developmentally transient syndrome but rather shows chronicity and/or recurrence. Homotypic continuity of preschool MDD during a 24-month period was found. These results underscore the clinical and public health importance of identification of depression as early as preschool. Further follow-up of preschoolers with depression is warranted to inform the longitudinal course throughout childhood.

HPA axis genetic variation, pubertal status, and sex interact to predict amygdala and hippocampus responses to negative emotional faces in school-age children

“…The PDS is being conducted by the Washington University in St. Louis School of Medicine Early Emotional Development Program (WUSM EEDP) and its broad goal is to explore clinical and neural outcomes relating to preschool-onset depression. The details of the study have been published previously (see, Luby et al, 2009). Briefly, 3- to 5-year old children and their primary caregivers were recruited from the St. Louis metropolitan area.…”

Extending Parent–Child Interaction Therapy for Early Childhood Internalizing Problems: New Advances for an Overlooked Population

“…Rates of these disorders increase across time with roughly 25 % of adolescents suffering from an anxiety disorder and 10 % suffering from a mood disorder in the past year (Kessler et al 2012), and early onset is associated with more intractable course and poorer outcomes over time (Hammen et al 2008; Luby et al 2009; Ramsawh et al 2011), underscoring the critical need for effective early intervention. When left untreated, anxiety and depressive symptoms in youth are typically associated with disruptions in family functioning, school attendance, academic performance, and social relationships (Grills and Ollendick 2002; Hopkins et al 2013; Hughes et al 2008; Katz et al 2011).…”

Bidirectional Influences of Anxiety and Depression in Young Children

“…There is also growing evidence for the long-term stability and clinical significance of preschool depression. Studies by Luby and colleagues indicate that depression occurs in preschool children (Luby et al 2002, 2003), impairs the child’s functioning (Luby et al 2009a) and is relatively stable for at least 24 months (Luby et al 2009b); thus, it is not a developmentally transient phenomenon. Examining the temporal relationships between anxiety and depression as they first begin to develop in preschool children will help to clarify the developmental progression of these disorders.…”