Depressive symptomatology and dexamethasone suppression test in preschool age children

The association between depressive symptomatology and failure of cortisol suppression following dexamethasone administration is explored in a preschool age tertiary care psychiatric population. Clinical research investigation of 16 preschoolers, including 13 inpatients and three outpatients, indicates that a broad range of DSM-III depressive symptomatology can be identified in this population. Seven patients had a serum cortisol value greater than 5 micrograms/dl following 1 mg dexamethasone and six of these had diagnoses within the depressive spectrum. The appropriateness of DSM-III criteria in this age group is discussed and the usefulness of the Preschool Depression Scale as an interview guide is reviewed. Difficulties in interpreting the biological findings are also reviewed, in addition to possible genetic or environmental influences from the family psychiatric history.