Joan L. Luby
Interactive therapy that involves parents and children helped youth as young as 3 years of age reduce rates of depression and lower their severity of depressive symptoms, findings published in American Journal of Psychiatry showed.
“Clinical depression can arise in early childhood and has phenotypic and biological characteristics similar to those of the adult form,” Joan L. Luby, MD, Samuel and Mae S. Ludwig professor of child psychiatry and director of the Early Emotional Development Program at Washington University in St. Louis, and colleagues wrote. “Such findings underscore the importance of identifying and treating this disorder at these early developmental stages. However, to date there are no empirically tested treatments for early childhood depression.”
In this randomized controlled trial, Luby and colleagues examined a dyadic parent-child psychotherapy for early childhood depression that focused on developing and regulating the child’s emotions. Researchers modified an effective parent-child interaction therapy (PCIT) to include an “emotion development” module (PCIT-ED), then compared it with a waiting list control condition. In total, 229 parent-child dyads that included children aged 3 to 6 years with depression received 20 sessions of PCIT-ED or the control condition for 18 weeks.
The researchers found that children who received PCIT-ED were significantly less likely than children in the control group to meet major depression criteria in the past month, were more likely to experience remission and had lower major depression severity. In addition, the PCIT-ED group was less impaired than those in the control group.
The results showed that PCIT-ED recipients had significantly lower rates of comorbid disorders at the end of the trial as well, including anxiety disorders and oppositional defiant disorder. In measures of emotional development and regulation, children in the PCIT-ED group were rated by their caregivers on the Emotion Regulation Checklist as showing less emotional lability (P < .001) and more emotion regulation (P < .001) at the end of the trial.
Furthermore, PCIT-ED helped ease parents’ own symptoms of depression. Parents who completed PCIT-ED also had lower parenting stress scores and employed more parenting techniques that focused on emotion reflection and processing than those in the waiting list groups.
“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,” Luby said in a press release. “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.” – by Savannah Demko
: Luby reports research support from NIMH and royalties from Guilford Press. Please see the study for all other authors’ relevant financial disclosures.