The clinical significance of preschool depression: impairment in functioning and clinical markers of the disorder.

Objective: While much is now known about depression during school age and adolescence, whether clinical depression can onset even earlier in development during the preschool period remains under explored. The earliest possible identification of depression may be important for the design of preventio...

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Published in:Journal of Affective Disorders Vol. 112; no. 1-3; pp. 111 - 120
Main Authors: Luby JL, Belden AC, Pautsch J, Si X, Spitznagel E, Luby, Joan L, Belden, Andy C, Pautsch, Jennifer, Si, Xuemei, Spitznagel, Edward
Format: research Journal Article
Published: Elsevier B.V. Jan2009
Online Access:View this record in EBSCOhost
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      dt: Jan2009
      vid: 112
      iid: 1-3
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      pub: Elsevier B.V.
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        atl: The clinical significance of preschool depression: impairment in functioning and clinical markers of the disorder.
      aug:
        au:
          Luby JL
          Belden AC
          Pautsch J
          Si X
          Spitznagel E
          Luby, Joan L
          Belden, Andy C
          Pautsch, Jennifer
          Si, Xuemei
          Spitznagel, Edward
        affil: Washington University School of Medicine, Department of Psychiatry, Box 8134, 660 S. Euclid, St. Louis, MO 63110, United States
      sug:
        subj:
          Depression Diagnosis
          Age Factors
          Age of Onset
          Caregivers Psychosocial Factors
          Caregivers Statistics and Numerical Data
          Child
          Child, Preschool
          Comorbidity
          Cross Sectional Studies
          Data Collection
          Depression Epidemiology
          Depression Psychosocial Factors
          Developmental Disabilities Diagnosis
          Developmental Disabilities Epidemiology
          Developmental Disabilities Psychosocial Factors
          Fatigue Diagnosis
          Fatigue Epidemiology
          Female
          Guilt
          Male
          Multivariate Analysis
          Myers-Briggs Type Indicator Statistics and Numerical Data
          Prevalence
          Psychological Tests Statistics and Numerical Data
          Questionnaires
          Reproducibility of Results
          Severity of Illness Indices
          Human
          Child: 6-12 years
          Child, Preschool: 2-5 years
          Female
          Male
      ab: Objective: While much is now known about depression during school age and adolescence, whether clinical depression can onset even earlier in development during the preschool period remains under explored. The earliest possible identification of depression may be important for the design of prevention and early developmental intervention programs. This study investigated functional impairment associated with depression, symptoms that served as the best markers of depression vs. other disorders, as well as depression severity between two depressed sub-groups and other diagnostic comparison groups.Method: Three hundred and five preschoolers between the ages of 3.0 and 6.0 and their primary caregivers were recruited using a depression screening checklist distributed at community sites. The Preschool Age Psychiatric Assessment (PAPA) was used to derive psychiatric diagnoses in the study sample. Multivariate analyses of covariance were used to investigate the effects of depression on independent measures of functional impairment while controlling for the effects of co-morbidities.Results: Functional impairment specifically associated with depression was found in multiple domains and contexts, however depressed preschoolers were not developmentally delayed. The symptoms of guilt and extreme fatigue were found to be highly specific for preschool depression. A statistically significant hierarchy of depression severity was found between diagnostic comparison groups, in the expected direction with the highest in a melancholic subgroup.Conclusions: Validation for preschool depression with associated functional impairment across contexts was found in preschool children. These findings replicate and extend earlier evidence for validity of MDD diagnosed in the preschool period and highlight the need for clinical attention. The finding that these depressed and impaired preschoolers were not yet developmentally delayed may have important public health significant significance as it suggests a possible window of opportunity for early intervention. Study findings were limited by reliance on parent and teacher informants and a cross-sectional view.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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