Faculty Collaboration Database

Characteristics of depressed preschoolers with and without anhedonia: evidence for a melancholic depressive subtype in young children. Am J Psychiatry 2004 Nov;161(11):1998-2004

Date

10/30/2004

Pubmed ID

15514399

DOI

10.1176/appi.ajp.161.11.1998

Scopus ID

2-s2.0-7444248914 (requires institutional sign-in at Scopus site)   119 Citations

Abstract

OBJECTIVE: This study investigated whether a melancholic subtype similar to that established in depressed adults can be identified in depressed preschool children.

METHOD: A final group total of 156 preschool children between the ages of 3.0 and 5.6 years and their caregivers underwent a comprehensive psychiatric assessment that included a structured psychiatric interview modified for young children. The clinical characteristics of four study groups (N=156) were compared: depressed preschoolers with anhedonia, depressed preschoolers without anhedonia ("hedonic"), a psychiatric comparison group with DSM-IV attention deficit hyperactivity disorder and/or oppositional defiant disorder, and a healthy comparison group.

RESULTS: Fifty-four depressed preschoolers were identified, and 57% of this depressed group was anhedonic, a symptom deemed to be highly developmentally and clinically significant when arising in the preschool period. The anhedonic depressed subgroup identified was characterized by greater depression severity, alterations in stress cortisol reactivity, increased family history of major depressive disorder, and increased frequency of psychomotor retardation as well as other melancholic symptoms, such as a lack of brightening in response to joyful events.

CONCLUSIONS: The clinical characteristics of this depressed subgroup are consistent with those described in melancholic depressed adults and suggest that a melancholic depressed subtype can be manifest in children as young as age 3.

Author List

Luby JL, Mrakotsky C, Heffelfinger A, Brown K, Spitznagel E

Author

Amy Heffelfinger PhD Professor in the Neurology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Affective Symptoms
Age Factors
Child, Preschool
Comorbidity
Depressive Disorder
Depressive Disorder, Major
Diagnostic and Statistical Manual of Mental Disorders
Family
Humans
Hydrocortisone
Income
Life Change Events
Psychiatric Status Rating Scales
Saliva
Severity of Illness Index
Sex Factors