The clinical picture of depression in preschool children. J Am Acad Child Adolesc Psychiatry 2003 Mar;42(3):340-8
Date
02/22/2003Pubmed ID
12595788DOI
10.1097/00004583-200303000-00015Scopus ID
2-s2.0-0037362660 (requires institutional sign-in at Scopus site) 175 CitationsAbstract
OBJECTIVE: To investigate the clinical characteristics of depression in preschool children.
METHOD: One hundred seventy-four subjects between the ages of 3.0 and 5.6 years were ascertained from community and clinical sites for a comprehensive assessment that included an age-appropriate psychiatric interview for parents. Modifications were made to the assessment of major depressive disorder (MDD) criteria so that age-appropriate manifestations of symptom states could be captured. Typical and "masked" symptoms of depression were investigated in three groups: depressed (who met all MDD criteria except duration criterion), those with nonaffective psychiatric disorders (who met criteria for attention-deficit/hyperactivity disorder and/or oppositional defiant disorder), and those who did not meet criteria for any psychiatric disorder.
RESULTS: Depressed preschool children displayed "typical" symptoms and vegetative signs of depression more frequently than other nonaffective or "masked" symptoms. Anhedonia appeared to be a specific symptom and sadness/irritability appeared to be a sensitive symptom of preschool MDD.
CONCLUSIONS: Clinicians should be alert to age-appropriate manifestations of typical MDD symptoms and vegetative signs when assessing preschool children for depression. "Masked" symptoms of depression occur in preschool children but do not predominate the clinical picture. Future studies specifically designed to investigate the specificity and sensitivity of the symptoms of preschool depression are now warranted.
Author List
Luby JL, Heffelfinger AK, Mrakotsky C, Brown KM, Hessler MJ, Wallis JM, Spitznagel ELAuthor
Amy Heffelfinger PhD Professor in the Neurology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Attention Deficit and Disruptive Behavior DisordersChild, Preschool
Comorbidity
Depressive Disorder, Major
Diagnostic and Statistical Manual of Mental Disorders
Female
Humans
Male
Obsessive-Compulsive Disorder
Sensitivity and Specificity
Severity of Illness Index
