‘Pre-school Depression’ Can Last for a Decade, Study Finds
Even kids get depressed. And experiencing depression early in life increases the risk that a child will be depressed throughout their formative school years – new research found.
Researchers from Washington University found that children who had depression as pre-schoolers 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.
In the study, the use of two-way mirrors was used to observe 246 children from preschool age through middle school. At the time they were enrolled in the study, the kids were just three to 9 years old. Now, they are 12 years old.
The children and their primary caregivers participated in up to six annual and four semi-annual 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. Researchers also 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.
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.
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.
“It’s the same old bad news about depression; it is a chronic and recurrent disorder,” said child psychiatrist Joan L. Luby, MD.
“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.”
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. At the start of the study, 74 of the children were diagnosed with depression. When the researchers evaluated the same group six years later, they found that 79 children met the full criteria for clinical depression based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V).
More than 51 per cent of the 74 children who originally were diagnosed as pre-schoolers also were depressed as school-age kids. Only 24 per cent of the 172 children who were not depressed as pre-schoolers went on to develop depression during their elementary and middle school years.
They also found that school-age children had a high risk of depression if their mothers were depressed. Researchers noted that children diagnosed with a conduct disorder as pre-schoolers had an elevated risk of depression by school age and early adolescence, but this risk declined if the children were found to have significant maternal support.
“Preschool depression predicted school-age depression over and above any of the other well-established risk factors,” Luby explained.
“Those children appear to be on a trajectory for depression that’s independent of other psychosocial variables.”
Luby said her findings continue to contradict doctors and scientists who have maintained that children as young as three or four could not be clinically depressed. She advocates including depression screenings in regular medical check-ups for pre-schoolers, but she said such monitoring is unlikely to begin anytime soon.
“The reason it hasn’t yet become a huge call to action is because we don’t yet have any proven, effective treatments for depressed pre-schoolers,” she explained.
“Paediatricians don’t usually want to screen for a condition if they can’t then refer patients to someone who can help.”
The team is now studying the potential of parent-child psychotherapies that may help pre-schoolers overcome depression. However, they say it’s too early to determine whether they work.
The new study was published in The American Journal of Psychiatry journal.
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Preschool Depression May Continue For A Decade
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