Preschoolers Can Suffer Chronic Depression: Study

A new study reaches the at once fascinating and troubling result that preschoolers as young as three can suffer one of the most debilitating mental illnesses we know of: chronic depression.

An Associated Press story reports some of the study's main details:

The study is billed as the first to show major depression can be chronic even in very young children, contrary to the stereotype of the happy-go-lucky preschooler.

Until fairly recently, "people really haven't paid much attention to depressive disorders in children under the age of 6," said lead author Dr. Joan Luby, a psychiatrist at Washington University in St. Louis. "They didn't think it could happen ... because children under 6 were too emotionally immature to experience it."

Previous research suggested that depression affects about 2 percent of U.S. preschoolers, or roughly 160,000 youngsters, at one time or another. But it was unclear whether depression in preschoolers could be chronic, as it can be in older children and adults.

Luby's research team followed more than 200 preschoolers, ages 3 to 6, for up to two years, including 75 diagnosed with major depression. The children had up to four mental health exams during the study.

Among initially depressed children, 64 percent were still depressed or had a recurrent episode of depression six months later, and 40 percent still had problems after two years. Overall, nearly 20 percent had persistent or recurrent depression at all four exams.

Depression was most common in children whose mothers were also depressed or had other mood disorders, and among those who had experienced a traumatic event, such as the death of a parent or physical or sexual abuse.

Here's the abstract of the study. The study's conclusions, according to the abstract:

Preschool depression, similar to childhood depression, is not a developmentally transient syndrome but rather shows chronicity and/or recurrence... These results underscore the clinical and public health importance of identification of depression as early as preschool. Further follow-up of preschoolers with depression is warranted to inform the longitudinal course throughout childhood.

What makes this study so interesting is, if it's borne out by further research that some preschoolers do indeed have chronic depression, then it raises a huge challenge. How will mental health professionals effectively treat these children?

Not nearly enough is known about how antidepressant drugs, a major treatment for people with depression affect such young minds, including their long-term brain development. Presumably, cognitive behavior play therapy which is often used in children this age, would be part of the therapy. But, again, the potential use of powerful antidepressants in such young patients is enough to give many people pause.

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