Pediatric Depression Symptoms, Executive Functioning Weaknesses, and Associated Neuropsychological and Psychiatric Outcomes

Despite numerous studies in adults, only a handful of studies have examined executive functioning (EF) in childhood depression. Our study examined the relationship between significant depressive symptoms and an EF weakness in a child inpatient psychiatric setting. A medical chart review was conducted for 98 ethnically diverse 6- to 12-year-old boys and girls, who received a neuropsychological evaluation during their psychiatric inpatient hospitalization. Children were classified as having depressive symptoms if they had a T-Score 1.5 SD above the mean on at least 1 subdomain of the Childhood Depression Inventory and classified as having an EF weakness if they had a T-score 1.5 SD below the mean on at least 1 test of executive functioning. Results indicated that compared to children with either depressive symptoms only or only an EF weakness, children with both depressive symptoms and an EF weakness had poorer cognitive test performance on a measure of immediate memory (F(2,72) = 4.07, p = .000; Cohen’s d = −.83 and −.90, respectively) and longer hospitalizations stay (F(2,93) = 4.04, p = .021; Cohen’s d = .54 and .62, respectively). Additionally, children with both depressive symptoms and an EF weakness had higher rates of ADHD than children with depressive symptoms only (OR = 2.11) and higher rates of EF weaknesses than children with only an EF weakness (t(60) = 2.54, p = .014; Cohen’s d = .68). Results suggest that not all children with depressive symptoms have an EF weakness; however, children who present with this comorbidity are at risk for more cognitive difficulties and significant psychiatric outcomes including prolonged hospitalizations.