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Clinical Picture of Depression in Preschool Children

NCJ Number
199331
Journal
Journal of the American Academy of Child & Adolescent Psychiatry Volume: 42 Issue: 3 Dated: March 2003 Pages: 340-348
Author(s)
John L. Luby; Amy K. Heffelfinger; Christine Mrakotsky; Kathy M. Brown; Martha J. Hessler; Jeffrey M. Wallis; Edward L. Spitznagel
Date Published
March 2003
Length
9 pages
Annotation
This study investigated the clinical characteristics of depression in a sample of 174 preschool children between the ages of 3.0 and 5.6 years.
Abstract
A comprehensive assessment of each child included an age-appropriate psychiatric interview for parents. Modifications were made to the assessment of DSM-IV major depressive disorder (MDD) criteria so that age-appropriate manifestations of symptom states could be determined. Typical and "masked" symptoms of depression were studied in three groups: depressed (met all DSM-IV MDD criteria except duration criterion); those with nonaffective psychiatric disorders (met criteria for attention-deficit/hyperactivity disorder and/or oppositional defiant disorder); and those who did not meet criteria for any psychiatric disorder. The study found that depressed preschool children displayed "typical" symptoms (e.g., sadness and/or irritability) and vegetative signs of depression more often than other nonaffective or "masked" symptoms. Depressed preschool children also displayed significantly more destructive and/or suicidal play themes compared with psychiatric and no-disorder comparison groups. Anhedonia (lack of pleasure in activities) emerged as a highly specific symptom of depression. Clinicians should thus be particularly alert to the presence of sadness and anhedonia when considering MDD in the differential diagnosis of a young child. 4 figures, 3 tables, and 19 references