Children diagnosed with depression as preschoolers are likely to suffer from depression as school-age children and young adolescents, new research shows.
Depressed preschoolers were 2.5 times more likely to suffer from the condition in elementary and middle school than kids who were not depressed at very young ages, according to researchers at Washington University School of Medicine in St. Louis.
Their study is published in the July issue of The American Journal of Psychiatry.
“It’s the same old bad news about depression; it is a chronic and recurrent disorder,” said child psychiatrist Joan L. Luby, MD, who directs Washington University’s Early Emotional Development Program. “But the good news is that if we can identify depression early, perhaps we have a window of opportunity to treat it more effectively and potentially change the trajectory of the illness so that it is less likely to be chronic and recurring.”
The investigators followed 246 children, now ages 9 to 12, who were enrolled in the study as preschoolers when they were 3 to 5 years old. The children and their primary caregivers participated in up to six annual and four semiannual assessments. They were screened using a tool called the Preschool Feelings Checklist, developed by Luby and her colleagues, and evaluated using an age-appropriate diagnostic interview.
As part of the evaluation, caregivers were interviewed about their children’s expressions of sadness, irritability, guilt, sleep, appetite and decreased pleasure in activity and play. In addition, researchers used two-way mirrors to evaluate child-caregiver interactions because the team’s earlier research had shown that a lack of parental nurturing is an important risk factor for recurrence of depression.
The study was designed to follow children as they grew and to evaluate them for depression and other psychiatric conditions. However, if children were found to be seriously depressed or in danger of self harm, or if their caregivers requested treatment, they were referred to mental health providers. Currently, there are no proven treatments for depression that arises in the preschool years. Even in depressed adults, available treatments and medications are effective only about half the time.
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