This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in this journal  Topic Collections  • Child Psychiatry  • Depression  • Alert me on articles by topic  Social Bookmarking   What's this?

Homotypic Continuity and Course Over 24 Months

Joan L. Luby, MD; Xuemei Si, MS, MPH; Andy C. Belden, PhD; Mini Tandon, DO; Ed Spitznagel, PhD

Arch Gen Psychiatry. 2009;66(8):897-905.

Context  Childhood depression is a serious and relapsing psychiatric disorder. However, to date studies have focused mostly on children aged 6 years and older. Validation for depression in preschool children has been provided by 2 independent study samples. While several studies have demonstrated stability and poor outcomes of internalizing symptoms in preschoolers, there has not yet been longitudinal data available to inform the course of preschool depression and whether it shows homotypic continuity into early childhood.

Objective  To examine the 24-month course of preschool depression and whether it showed homotypic vs heterotypic continuity or was a developmentally transient phenomenon.

Design  Blindly rated, prospective, 24-month, longitudinal follow-up study.

Setting  Community sites.

Patients  Three hundred six preschoolers aged 3 to 6 years recruited from community sites and oversampled for symptoms of depression.

Main Outcome Measure  Recurrence/stability of depression and predictors of course.

Results  Preschoolers with depression at baseline had the highest likelihood of subsequent depression 12 and/or 24 months later compared with preschoolers with no baseline disorder and with those who had other psychiatric disorders. Preschoolers with depression at baseline were more likely to have later depression rather than other psychiatric disorders. Findings from a logistic regression analysis indicated that when controlling for demographic variables, risk factors, and comorbid disorders, depression during the preschool period and family history of affective disorders were the most robust and significant predictors of later depression.

Conclusions  Preschool depression, similar to childhood depression, is not a developmentally transient syndrome but rather shows chronicity and/or recurrence. Homotypic continuity of preschool MDD during a 24-month period was found. These results underscore the clinical and public health importance of identification of depression as early as preschool. Further follow-up of preschoolers with depression is warranted to inform the longitudinal course throughout childhood.

Author Affiliations: Washington University School of Medicine in St Louis, St Louis, Missouri.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLE

This Month in Archives of General Psychiatry
Arch Gen Psychiatry. 2009;66(8):808.
FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Early Childhood Depression
Luby
Am. J. Psychiatry 2009;166:974-979.
ABSTRACT | FULL TEXT