Preadolescent Benefits of Parent–Child Interaction Therapy Emotion Development for Preschool Depression: 4-Year Follow-up

Objective: Childhood depression can arise as early as age 3 years and is a chronic and relapsing disorder, with high rates of comorbidity and functional impairment. Previous research demonstrated a high rate of sustained gains in remission from preschool depression 18 weeks after completion of a novel intervention for depression, Parent–Child Interaction Therapy—Emotion Development (PCIT-ED). However, there have been no data regarding longer-term outcomes. We investigated whether response to PCIT-ED was evident 4 years after treatment completion and whether individuals who were remitted had decreases in mental health service use and psychotropic prescriptions compared to nonresponders. Method: We followed participants into preadolescence 4 years after participation in a randomized controlled trial of PCIT-ED delivered during the preschool period. Potential predictors of depression remission, obtained from pre-therapy and post-therapy assessments, were investigated using logistic regression models. Characteristics of participants in remission at preadolescence were compared to those not in remission. We also tracked psychiatric care. Results: There was a high rate of remission at preadolescence (57.1%). Post-therapy externalizing symptoms predicted relapse. Participants with remission at preadolescence had significantly lower rates of lifetime use of α-agonist, antidepressant, and atypical antipsychotic medication as well as decreased use of intensive mental health interventions. Conclusion: PCIT-ED for preschool depression had effects at long-term follow-up in a majority of young children. Early intervention, when effective, was associated with reduced psychotropic and intensive mental health service use. PCIT-ED, as a brief early intervention, may be a cost-effective way to minimize relapse and to decrease subsequent mental health interventions.