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January 2005

Preschoolers Can be Diagnosed with Depression

 

   








 
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New diagnostic tools now allow researchers to identify clinical depression in children as young as three years of age. Child mental health care professionals previously believed that young children were too developmentally immature to experience many of the core emotions of depression, such as guilt and shame, without having experienced severe trauma or neglect. However, new empirical data demonstrate children’s capacities for these emotional states. New diagnostic techniques have revealed that young children are, in fact, subject to major depressive disorder (MDD).

One clear, highly specific symptom of depression among young children is the inability to enjoy activities and play, or anhedonia. Anhedonia was found in almost 60% of preschoolers with depression. Young children with a depressive syndrome were also sad or irritable, and more likely to exhibit changes in sleep and activity levels.

An age-appropriate mental health evaluation is critical to the detection of depression, or any psychiatric disorder, in this very young age group. One essential element of an appropriate evaluation is the use of play as the medium of observation.

Researchers also stressed the importance of multiple diagnostic visits, conducted within the family context. Children should be observed with different caregivers whenever possible, as at that young stage of life they are inextricably linked to the care-giving system. Also, symptoms of depression may manifest in some contexts and not others.

The observations of parents and caregivers are crucial to the assessment of depression in preschoolers. Caregivers have the opportunity to observe the child over time, potentially detecting alterations in mood or play that may be missed during a clinical assessment. The Preschool Feelings Checklist is a brief report that can be used as a screening measure in community or family settings as well as clinical ones. Although further study in this area is still required, clinicians and parents should be cognizant of the possibility of depressive syndrome in children as young as three years old.


This article is a summary of an article that appeared in the Psychiatric Times; 12/1/2004



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