Characteristics of depressed preschoolers with and without anhedonia: evidence for a melancholic depressive subtype in young children
Abstract
OBJECTIVE: This study investigated whether a melancholic subtype similar to that established in depressed adults can be identified in depressed preschool children. METHOD: A final group total of 156 preschool children between the ages of 3.0 and 5.6 years and their caregivers underwent a comprehensive psychiatric assessment that included a structured psychiatric interview modified for young children. The clinical characteristics of four study groups (N=156) were compared: depressed preschoolers with anhedonia, depressed preschoolers without anhedonia ("hedonic"), a psychiatric comparison group with DSM-IV attention deficit hyperactivity disorder and/or oppositional defiant disorder, and a healthy comparison group. RESULTS: Fifty-four depressed preschoolers were identified, and 57% of this depressed group was anhedonic, a symptom deemed to be highly developmentally and clinically significant when arising in the preschool period. The anhedonic depressed subgroup identified was characterized by greater depression severity, alterations in stress cortisol reactivity, increased family history of major depressive disorder, and increased frequency of psychomotor retardation as well as other melancholic symptoms, such as a lack of brightening in response to joyful events. CONCLUSIONS: The clinical characteristics of this depressed subgroup are consistent with those described in melancholic depressed adults and suggest that a melancholic depressed subtype can be manifest in children as young as age 3.
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Luby et al. (2004) found reduced percentage change in cortisol response to a laboratory stressor in young depressed children compared with healthy controls.
“Luby et al. (2004) also compared cortisol responses to a laboratory stressor in young children and found reduced percentage change in the MDD group when compared to healthy controls.”
From Hypothalamic–pituitary–adrenal axis dysregulation in depressed children and adolescents: A meta-analysis (2009) · cites this paper as Luby et al. (2004)
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Psychopharmacology and Preschoolers: A Critical Review of Current Conditions
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Explicating the “Developmental” in Preschool Psychopathology
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Courtroom modifications for child witnesses: Law and science in forensic evaluations.
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Origins of Anhedonia in Childhood and Adolescence
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- Authors
- Luby, J. L., Mrakotsky, C., Heffelfinger, A., Brown, K., & Spitznagel, E.
- Affiliations
- Washington University in St. Louis (US)
- Venue
- American Journal of Psychiatry
- Published
- 2004-11-01
- Volume
- 161
- Issue
- 11
- Pages
- 1998-2004
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- OpenAlex
- W2097879830
- Cited by
- 137
- References
- 28
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 4 · 2023: 5 · 2022: 3 · 2021: 6 · 2020: 2 · 2019: 5 · 2018: 3 · 2017: 3 · 2016: 7 · 2015: 8 · 2014: 8 · 2013: 3 · 2012: 7
- FWCI
- 10.06
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (K08MH001462, K08 MH 01462-01)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- endogenous depression, anhedonia, depression subtypes, young children, cortisol response, psychomotor retardation, attention deficit hyperactivity disorder, oppositional defiant disorder, depression severity
- MeSH terms
- Affective Symptoms, Age Factors, Child, Preschool, Major Depressive Disorder, Depressive Disorder, Major, Depressive Disorder, Ethnicity, Family, Humans, Hydrocortisone, Income, Life Change Events, Psychiatric Status Rating Scales, Saliva, Severity of Illness Index, Sex Factors, Comorbidity, Diagnostic and Statistical Manual of Mental Disorders
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