Preschool Depression

Significant strides have been made in the past 5 years in the characterization and validation of the nosology of preschool depression, perhaps related, in part, to greater developmental sensitivity of the measures used to assess depressive symptoms. Evidence is available to support the validity of this disorder, including a stable and specific symptom constellation, associated impairment, biologic markers, and greater family history of similar disorders. Because the area of study is relatively new, prevalence is uncertain but is likely to be approximately 1%. Patterns of comorbidity of depression among this young group differ from that known in older children, but it is not clear if this is related to the greater ease with which associated externalizing, compared with internalizing disorders, can be identified. Preschool children are capable of providing relevant report of some, but not all, depressive symptoms, and specific aspects of preschoolers' play have been associated with depression. Despite the greater attention to preschool psychopathology in recent years, several questions remain. Perhaps the biggest issue in need of clarification is the duration of symptoms in an episode of clinical depression. An ongoing study by Luby and colleagues aim to address this and other relevant issues, with the end goal of the appropriate identification of preschoolers with depression so that earlier and potentially more effective intervention can be applied.