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

ObjectiveChildhood 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.MethodWe 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.ResultsThere 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.ConclusionPCIT-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.Plain language summaryThis longitudinal study followed children (N = 105) who participated in a randomized controlled trial for a novel parent-child therapy for preschool depression, Parent–Child Interaction Therapy—Emotion Development (PCIT-ED). Four years later, in preadolescence, over half (57.1%) of the children were in remission. Those in remission had lower lifetime use of alpha agonist, antidepressant, and atypical antipsychotic medication, as well as decreased utilization of intensive mental health interventions. These findings suggest that early intervention for childhood depression can have lasting benefits and may reduce the need for future mental health care.Clinical trial registration informationA Randomized Controlled Trial of PCIT-ED for Preschool Depression; https://clinicaltrials.gov/study/NCT02076425.