Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
Depress Anxiety. 2011 Feb;28(2):153-9. doi: 10.1002/da.20770. Epub 2010 Dec 13.
Psychotherapies with known efficacy in adolescent depression have been adapted for prepubertal children; however, none have been empirically validated for use with depressed very young children. Due to the centrality of the parent-child relationship to the emotional well being of the young child, with caregiver support shown to mediate the risk for depression severity, we created an Emotional Development (ED) module to address emotion development impairments identified in preschool onset depression. The new module was integrated with an established intervention for preschool disruptive disorders, Parent Child Interaction Therapy (PCIT). Preliminary findings of an open trial of this novel intervention, PCIT-ED, with depressed preschool children are reported.
PCIT was adapted for the treatment of preschool depression by incorporating a novel emotional development module, focused on teaching the parent to facilitate the child's emotional development and enhance emotion regulation. Eight parent-child dyads with depressed preschoolers participated in 14 sessions of the treatment. Depression severity, internalizing and externalizing symptoms, functional impairment, and emotion recognition/discrimination were measured pre- and posttreatment.
Depression severity scores significantly decreased with a large effect size (1.28). Internalizing and externalizing symptoms as well as functional impairment were also significantly decreased pre- to posttreatment.
PCIT-ED seems to be a promising treatment for preschoolers with depression, and the large effect sizes observed in this open trial suggest early intervention may provide a window of opportunity for more effective treatment. A randomized controlled trial of PCIT-ED in preschool depression is currently underway.
已证明对青少年抑郁症有效的心理疗法已被改编为适用于青春期前儿童；然而，对于患有严重抑郁症的非常年幼的儿童，尚无经过验证的方法。由于亲子关系对幼儿的情感健康至关重要，并且有研究表明，照顾者的支持可以缓解抑郁严重程度的风险，因此我们创建了一个情感发展（ED）模块，以解决在学龄前发病的抑郁症中发现的情感发展障碍。新模块与针对学龄前破坏性行为障碍的既定干预措施——亲子互动疗法（PCIT）相结合。报告了对这种新干预措施 PCIT-ED 进行的开放式试验的初步结果。
通过纳入一种新的情感发展模块，PCIT 被改编为治疗学龄前抑郁症，该模块专注于教导父母促进孩子的情感发展并增强情绪调节能力。8 对患有学龄前抑郁症的父母-儿童对参加了 14 次治疗。在治疗前和治疗后测量了抑郁严重程度、内化和外化症状、功能障碍以及情绪识别/区分。
抑郁严重程度评分显著降低，具有较大的效应量（1.28）。内化和外化症状以及功能障碍也在治疗前到治疗后显著降低。
PCIT-ED 似乎是治疗学龄前抑郁症的一种有前途的方法，在这项开放性试验中观察到的大效应量表明早期干预可能为更有效的治疗提供机会。目前正在进行一项 PCIT-ED 治疗学龄前抑郁症的随机对照试验。
