New Tool May Help Identify Young Children At Risk of Developing Depression as Teens

The Childhood Behavior Checklist (CBCL) may help primary care physicians determine if young children are at risk for developing major depressive disorder or anxiety disorders in their teenage and young adult years, according to a study published in The Journal of Pediatrics.

Mai Uchida, MD, assistant professor of psychiatry at Harvard Medical School, and lead author of the study, explained that there is a shortage of pediatric psychiatrists in the United States, and so she and her team set out to develop a tool to identify at-risk children that could be used by someone without the training of a psychiatrist.

“We wanted to know if we could gather clues to who may eventually develop depression in their lives,” she explained to MD Magazine^®, “[And,] we wanted to find a tool that could be used without the expertise of a child psychiatrist that could identify children at risk for developing depression.”

Uchida and her team studied children between the age of 6 and 17 who had originally been recruited for a 10-year study on Attention Deficit Hyperactivity Disorder and their families. Children who had already been diagnosed with depression at the start of the study were excluded. The children were screened using the Child Behavioral Checklist (CBCL) anxiety/depression scale and the team followed up with the children 10 years later.

For the analysis, the children were split into groups. At the start of the study, 22 children showed symptoms of depression that did not meet the criteria for a diagnosis, and also had parents who had mood disorders. These children had the highest risk of developing major depressive disorder or anxiety disorder 10 years later. A total of 22 children showed subthreshold symptoms of depression but did not have parents with mood disorders, and 172 did not show symptoms of depression but did have parents with mood disorders. Those 2 groups showed higher rates of major depressive disorders and anxiety disorders at the 10-year follow up but not as high as the group that had both the subthreshold symptoms and parental history of mood disorders.

Uchida has previously suggested that symptoms of depression can be problematic even if they don’t reach the threshold for a diagnosis of depression. Her team’s next goal is to determine if there are specific brain characteristics that might predict a child’s risk for future depression.

“I hope that doctors will take away from this study that they should not dismiss subthreshold symptoms of anxiety and depression in young children, as they could develop into a diagnosable level of anxiety or depression. Even if they feel the symptoms are not functionally impairing enough to call for specific treatments, observing the symptoms with a keen eye throughout the years could help them connect to treatment when they need it,” she said.