Faculty Collaboration Database

The 2-week duration criterion and severity and course of early childhood depression: implications for nosology. J Affect Disord 2011 Oct;133(3):537-45

Date

05/31/2011

Pubmed ID

21621267

Pubmed Central ID

PMC3163057

DOI

10.1016/j.jad.2011.04.056

Scopus ID

2-s2.0-80955179575 (requires institutional sign-in at Scopus site)   30 Citations

Abstract

BACKGROUND: Although validity for DSM-IV MDD symptom criteria in preschoolers has been demonstrated, whether the 2-week duration criterion is an appropriate threshold of clinical significance at this age remains unclear. The current study aimed to begin addressing this question.

METHOD: Three hundred and six preschoolers were recruited from community sites and followed longitudinally for 2 years. A subsample including healthy preschoolers (N=77) and those with MDD (N=74) were examined. The MDD group was further divided based upon meeting (DSM, N=24) or failing to meet (<DSM, N=50) the DSM-IV 2-week duration criterion. Groups were compared on parent and teacher report measures of symptom severity and functional impairment at baseline and 2-year follow-up.

LIMITATIONS: A larger sample of depressed preschoolers and refined measures of duration are needed to replicate the current study.

RESULTS: Preschoolers with MDD differed significantly from controls on the majority of measures examined regardless of duration status and time of assessment. Further, the DSM group significantly differed from the<DSM group at baseline on measures of MDD symptom severity and impairment. No differences in the risk of a MDD diagnosis at follow-up were found on the basis of duration group status.

CONCLUSIONS: DSM-IV duration criterion failed to capture all clinically affected preschoolers at baseline or confer greater predictive validity for a depression diagnosis 2 years later. Findings suggest that preschoolers meeting all DSM-IV MDD criteria except for episode duration exhibit a clinically significant form of depression and experience a 2-year MDD outcome similar to those meeting full criterion.

Author List

Gaffrey MS, Belden AC, Luby JL

Author

Michael S. Gaffrey PhD Associate Professor in the Pediatrics department at Medical College of Wisconsin

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

Child, Preschool
Depression
Depressive Disorder
Depressive Disorder, Major
Diagnostic and Statistical Manual of Mental Disorders
Female
Follow-Up Studies
Humans
Male
Reproducibility of Results
Severity of Illness Index
Time Factors