Psychology Department, Stony Brook University, Stony Brook, NY, USA.
Temple University, Philadelphia, PA, USA.
J Child Psychol Psychiatry. 2022 Sep;63(9):984-991. doi: 10.1111/jcpp.13553. Epub 2021 Dec 2.
In recent years, epidemiological and clinical studies have revealed that depressive disorders can present in early childhood. To clarify the validity and prognostic significance of early childhood-onset depression, we investigated diagnostic and functional outcomes in later childhood and adolescence.
A community sample (N = 516) was assessed for psychopathology at ages 3 and 6 using the Preschool Age Psychiatric Assessment. When participants were 9, 12, and 15 years old, children and parents completed the Kiddie Schedule for Affective Disorders and Schizophrenia and measures of symptoms and functioning.
In models adjusting for covariates, depressed 3/6-year-old children were more likely to experience subsequent episodes of depressive disorders and exhibited significantly higher rates of later anxiety disorder, attention deficit hyperactivity disorder, and suicidality compared to children without depressive disorders at age 3/6. Early childhood depression was also associated with higher levels of mother, but not child, reported depressive symptoms at age 15 compared to children without depressive disorders at age 3/6. Finally, depression at age 3/6 predicted lower levels of global and interpersonal functioning and higher rates of treatment at age 15 compared to children without depressive disorders at age 3/6.
Results support the clinical significance of depression in 3/6-year-old children, although further studies with larger samples are needed.
近年来，流行病学和临床研究表明，抑郁障碍可在儿童早期出现。为了阐明儿童早期发病的抑郁障碍的有效性和预后意义，我们研究了后期儿童期和青春期的诊断和功能结局。
使用学前心理评估对 516 名社区样本在 3 岁和 6 岁时进行精神病理学评估。当参与者 9、12 和 15 岁时，儿童和家长完成了儿童心境障碍和精神分裂症谱系检查表以及症状和功能测量。
在调整协变量的模型中，3/6 岁时患有抑郁的儿童更有可能经历随后的抑郁障碍发作，并且与 3/6 岁时没有抑郁障碍的儿童相比，他们在后期出现焦虑障碍、注意缺陷多动障碍和自杀的比率显著更高。与 3/6 岁时没有抑郁障碍的儿童相比，在 15 岁时，母亲报告的抑郁症状水平更高，但儿童报告的抑郁症状水平没有差异。最后，与 3/6 岁时没有抑郁障碍的儿童相比，3/6 岁时的抑郁预测了较低的总体和人际功能水平，以及在 15 岁时更高的治疗率。
结果支持 3/6 岁儿童抑郁的临床意义，尽管需要更大样本的进一步研究。
