The 2-week duration criterion and severity and course of early childhood depression: implications for nosology

Although validity for DSM-IV MDD symptom criteria in preschoolers has been demonstrated, whether the 2-week duration criterion is an appropriate threshold of clinical significance at this age remains unclear. The current study aimed to begin addressing this question.

Three hundred and six preschoolers were recruited from community sites and followed longitudinally for 2 years. A subsample including healthy preschoolers (N=77) and those with MDD (N=74) were examined. The MDD group was further divided based upon meeting (DSM, N=24) or failing to meet (

A larger sample of depressed preschoolers and refined measures of duration are needed to replicate the current study.

Preschoolers with MDD differed significantly from controls on the majority of measures examined regardless of duration status and time of assessment. Further, the DSM group significantly differed from the

DSM-IV duration criterion failed to capture all clinically affected preschoolers at baseline or confer greater predictive validity for a depression diagnosis 2 years later. Findings suggest that preschoolers meeting all DSM-IV MDD criteria except for episode duration exhibit a clinically significant form of depression and experience a 2-year MDD outcome similar to those meeting full criterion.