Preschoolers with depression benefit from therapy that helps regulate emotions: Study

Yes, some preschoolers suffer from depression. A community-health based therapy that empowers parents to help children regulate negative feelings has been shown to help very young children with depression, a new study has found.

The study, conducted by researchers at the Washington University School of Medicine and published Thursday in the American Journal of Psychiatry, focuses on the effectiveness of a therapy that helps parents help their children develop and regulate their emotions. The study looked at preschoolers and young children under the age of 7.

Known as Parent-Child Interaction Therapy - Emotion Development (PCIT-ED), the program gives parents tools to coach their children through the emotions that accompany depression in order to enhance the child’s ability to control them.

The study looked at 229 randomly selected parent-child pairs with children aged 3 to 6 who met the criteria for early childhood depression. Researchers gave some of the patients PCIT-ED and compared them to a control group who were put on a waitlist. The study lasted 18 weeks.

Researchers evaluated the children’s psychiatric symptoms, including emotional self-regulation, level of functioning, and feelings of "guilt" before and after undergoing PCIT-ED, and did the same with the control group. The therapy worked: children who had undergone PCIT-ED had improved cognitive functioning, improved emotional regulation, and fewer of the signs and symptoms that accompany depression.

The emotional well-being of the child is closely tied to the parents, so they were assessed as well. Researchers looked at parents' coping mechanisms, amount of stress, and the strategies that they used to respond to their child's negative emotions.

After PCIT-ED treatment, researchers found that parents also had decreased stress levels and improved parenting techniques that could help their children better express their feelings.

"The study provides very promising evidence that an early and brief psychotherapeutic intervention that focuses on the parent-child relationship and on enhancing emotion development may be a powerful and low-risk approach to the treatment of depression," said Dr. Joan Luby, the lead author of the study.

The study was a randomized, controlled trial and claims to be the first empirically-supported, psychotherapeutic therapy dedicated to treating very early childhood depression. The prevalence of depression in children under 3 is "similar" to the rate for school-aged children, according to the study.

The researchers tout PCIT-ED as a promising way to treat childhood depression, since it can conveniently be delivered in community health settings.

"It will be very important to determine if gains made in this early treatment are sustained over time and whether early intervention can change the course of the disorder," Luby said.

Concerns about depression in young children and adolescents have been taken more seriously over the past two decades, according to the National Institute of Mental Health (NIMH).

Depression in children can be difficult to diagnose because children may exhibit a wide range of symptoms. In young children, these symptoms may include increased absences from school, excessive dependence on parents, or recurring worries that their parental figures may die. In older children, depression may manifest itself as getting in trouble more than usual, feeling misunderstood, and being easily agitated.

According to the DSM-5, a guide for psychiatric professionals, a child needs to have at least five of nine symptoms during a 2-week period to be diagnosed with a major depressive disorder. Among the symptoms: excessive fatigue, depressed or irritable mood, decreased interest or lack of enjoyment, insomnia or hypersomnia and change of appetite or weight, among others.

Researchers said studies like this one are important in identifying and treating depression as early as developmentally possible.