A child who experiences depression is a tragic diagnosis, but now research reveals the younger in age at diagnosis, the higher the risk of depression throughout the rest of childhood. Washington University researchers published their study, which appears in The American Journal of Psychiatry, and also revealed a mother’s role in her child’s diagnosis.

“It’s the same old bad news about depression; it is a chronic and recurrent disorder,” said child psychiatrist Dr. Joan L. Luby. Researchers analyzed 246 children from the time they were 3 to 5 years old up until they were 9 to 12 years old. They evaluated each child through a “Preschool Feelings Checklist” designed for each age group, which interviewed them about their expressions of sadness, irritability, guilt, sleep, appetite, and if there was decreased pleasure in activity and play.

More than 51 percent of the 74 children originally diagnosed with depression as preschoolers were also depressed throughout their elementary and middle school years. Of the 172 children who were not diagnosed with depression at high school age, 24 percent went on to develop depression as they aged. “But the good news is that if we can identify depression early, perhaps we have a window of opportunity to treat it more effectively and potentially change the trajectory of the illness so that it is less likely to be chronic and recurring,” Luby said.

Researchers also placed the children in a two-way mirror room in order to watch how they interacted with their caregiver, since a lack of parental nurturing is a key risk factor for depression. If their mothers were depressed, there was a much higher risk found. However, having a depressed mother didn’t put the child at as high of a risk as depression diagnosis during preschool years.

According to the National Institutes of Health, roughly 11 percent of adolescents are diagnosed with depression by the age 18. Girls are more likely to experience depression than boys. Depressed teens are more worrisome because they’re more likely to have substance abuse problems, which is why early diagnosis and treatment is important to try to curb the problem before it worsens into adulthood.

“Preschool depression predicted school-age depression over and above any of the other well-established risk factors,” Luby explained. “Those children appear to be on a trajectory for depression that’s independent of other psychosocial variables.”

Luby and her colleagues hope their findings will help provide support for requiring preschoolers to undergo depression screenings in their regular medical checkups. Researchers will continue to study the group of children throughout puberty in order to determine if preschool depression remains as a high risk factor during adolescence and young adulthood.

“The reason it hasn’t yet become a huge call to action is because we don’t yet have any proven, effective treatments for depressed preschoolers,” Luby said. “Pediatricians don’t usually want to screen for a condition if they can’t then refer patients to someone who can help,” Luby said.

Source: Luby JL, Gaffrey MS, Tillman R, April, LM, and Belden AC.  Trajectories of Preschool Disorders to Full DSM Depression at School Age and Early Adolescence: Continuity of Preschool Depression. The American Journal of Psychiatry. 2014.