Journal of the American Academy of Child & Adolescent Psychiatry
An Observational Analysis of Behavior in Depressed Preschoolers: Further Validation of Early-Onset Depression
Section snippets
Sample
Preschool subjects (ages 3.0-5.6) were recruited from primary care and specialty mental heath settings for participation in a study of the nosology of depression. One hundred seventy-four preschoolers and their primary caregivers participated in this study and completed a comprehensive emotional and developmental assessment that included parent, child, and dyadic assessments. One hundred fifty-two subjects fell into one of three primary diagnostic groups of interest (and had complete data) for
RESULTS
There were no significant demographic differences found between categorical diagnostic groups and subgroups (Table 1).
DISCUSSION
Findings indicated that both depressed and disruptive (ADHD and/or ODD) preschoolers were significantly less enthusiastic and had a less positive experience with their caregiver as compared with healthy children. However, only the disruptive, and not the depressed, preschoolers were significantly more noncompliant and avoidant when compared with healthy children, suggesting that these two relational impairments are more pronounced in disruptive as opposed to depressive disorders. Consistent
REFERENCES (23)
- et al.
Preschoolers' depression severity and behaviors during dyadic interactions: The mediating role of parental support
J Am Acad Child Adolesc Psychiatry
(2006) - et al.
The clinical picture of depression in preschool children
J Am Acad Child Adolesc Psychiatry
(2003) - et al.
Preschool major depressive disorder: preliminary validation for developmentally modified DSM-IV criteria
J Am Acad Child Adolesc Psychiatry
(2002) - et al.
Does anxiety mitigate the behavioral expression of severe conduct disorder in delinquent youths?
J Anxiety Disord
(1999) - et al.
Predictors of instability in children's mental test performance at 24, 48 and 96 months
Intelligence
(1994) Depression in childhood: a survey of some pertinent contributions
J Am Acad Child Psychiatry
(1966)- et al.
Can emotions and themes in children's play predict behavior problems?
J Am Acad Child Adolesc Psychiatry
(1996) Practice parameters for the psychiatric assessment of infants and toddlers (0-36 months)
J Am Acad Child Adolesc Psychiatry
(1997)- et al.
Assessment of mother-child interaction in preschoolers with behavior problems
J Am Acad Child Adolesc Psychiatry
(1998) - et al.
Assessment of developmental status and parent-infant relationships: the therapeutic process of evaluation
Maternal reports of child behavior problems and personal distress as predictors of dysfunctional parenting
Dev Psychol
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Funding for the study of preschool depression was provided by National Institute of Mental Health grants K08-MH01462 and R01 MH64769-01 ; Dr. Luby.
Disclosure: Dr. Luby has received grant/research support from Janssen, has given occasional talks sponsored by AstraZeneca, and has served as a consultant for Shire Pharmaceutical. The other authors have no financial relationships to disclose.