Cited by 137Child and Adolescent Psychosocial and Emotional DevelopmentTreatment of Major DepressionAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

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Characteristics of Depressed Preschoolers With and Without Anhedonia: Evidence for a Melancholic Depressive Subtype in Young Children

Luby, Joan L., Mrakotsky, Christine, Heffelfinger, Amy, Brown, Kathy, Spitznagel, Edward·2004·American Journal of Psychiatry

DOI 10.1176/appi.ajp.161.11.1998

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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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Authors: Luby, J. L., Mrakotsky, C., Heffelfinger, A., Brown, K., & Spitznagel, E.
Affiliations: Washington University in St. Louis (US)
ORCID: Luby, Joan L.
Mrakotsky, Christine
Heffelfinger, Amy
Venue: American Journal of Psychiatry
Publisher: American Psychiatric Association Publishing
Published: 2004-11-01
Volume: 161
Issue: 11
Pages: 1998-2004
ISSN: 0002-953X (ISSN-L)
1535-7228
DOI: 10.1176/appi.ajp.161.11.1998
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 (medical) › 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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Characteristics of Depressed Preschoolers With and Without Anhedonia: Evidence for a Melancholic Depressive Subtype in Young Children

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