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(Ivanhoe Newswire) -- Although a growing body of data suggests major depressive disorder does exist among preschoolers, skepticism remains about whether it is clinically meaningful or increases the later risk of psychiatric conditions. And while the existence of depression in childhood has been well established, previous studies have focused primarily on children six years and older.
In a new study, Joan L. Luby, M.D., and colleagues at Washington University School of Medicine in St. Louis studied 306 preschoolers age three to six. Of these, 75 nearly one-fourth -- met criteria for major depressive disorder, 79 had anxiety or disruptive disorders but not depression, and 146 did not meet criteria for any psychiatric disorder.
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A comprehensive three- to four-hour laboratory assessment was completed at the beginning of the study. While children were completing measures of emotional, cognitive and social development, primary caregivers were interviewed separately about the preschoolers' psychiatric symptoms and developmental skills. Similar developmental and behavioral assessments were conducted 12 and 24 months later.
After controlling for demographic variables and risk factors, preschoolers with depression at the beginning of the study had a four times greater likelihood of having depression one and two years later than preschoolers without depression, according to the study authors.
Depression also showed a chronic and recurrent course among preschoolers in a subset of 119 preschoolers with depression or depressive symptoms who were screened by phone at six and 18 months. Fifty-seven percent of those with depression had an episode during at least two follow-up points during the study, and 18 percent followed a chronic course, defined as having an episode in at least four waves of the study.
"These results underscore the clinical and public health importance of identification of depression as early as preschool," the authors concluded. Early intervention during the preschool period has proved effective in other childhood disorders, they note. "Therefore, study findings that demonstrate longitudinal stability and homotypic continuity of preschool major depressive disorder suggest that earlier interventions for major depressive disorder during the preschool period may be an important area for investigation in the search for more effective treatments for childhood major depressive disorder."
SOURCE: Archives of General Psychiatry, August 2009
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