Can subsyndromal manifestations of major depression be identified in children at risk?
OBJECTIVE
Children of parents with major depression are at significantly increased risk for developing major depression themselves; however, not all children at genetic risk will develop major depressive disorder (MDD). We investigated the utility of subsyndromal scores on the Child Behavior Checklist (CBCL) Anxiety/Depression scale in identifying children at the highest risk for pediatric MDD from among the pool of children of parents with MDD or bipolar disorder.


METHODS
The sample was derived from two previously conducted longitudinal case-control family studies of psychiatrically and pediatrically referred youth and their families. For this study, probands were stratified based on the presence or absence of a parental mood disorder.


RESULTS
Subsyndromal scores on the CBCL Anxiety/Depression scale significantly separated the children at high risk for pediatric MDD from those at low risk in a variety of functional areas, including social and academic functioning. Additionally, children at genetic risk without elevated CBCL Anxiety/Depression scale scores were largely indistinguishable from controls.


CONCLUSIONS
These results suggest that the CBCL Anxiety/Depression scale can help identify children at highest risk for pediatric MDD. If implemented clinically, this scale would cost-effectively screen children and identify those most in need of early intervention resources to impede the progression of depression.
Pediatric Psychopharmacology and Adult ADHD Program, Division of Child Psychiatry, Massachusetts General Hospital, Boston, MA, USA.|Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
M
M
Uchida
Pediatric Psychopharmacology and Adult ADHD Program, Division of Child Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
M
M
Fitzgerald
Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
K
K
Lin
Pediatric Psychopharmacology and Adult ADHD Program, Division of Child Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
N
N
Carrellas
Pediatric Psychopharmacology and Adult ADHD Program, Division of Child Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
H
H
Woodworth
Pediatric Psychopharmacology and Adult ADHD Program, Division of Child Psychiatry, Massachusetts General Hospital, Boston, MA, USA.|Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
J
J
Biederman
D000293:Adolescent; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis* / Q000209:etiology; D016241:Child of Impaired Parents / Q000523:psychology*; D003865:Major Depressive Disorder / Q000150:complications*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors
children; depression; pediatric; subsyndromal