Detection of Depression in Young Children

 

Abstract: this literature review is devoted to investigation of the differences indetection and diagnosis of depression in young children. This study aims to investigate the existing peer-reviewed journal articles that have considered either diagnosis or de-tection of depression in young children.

 

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Keywords: depression, diagnosis, detection, young children.

 

As each professional through reading the academic papers have each suggested their own detections through their own type of research, which indi-cates that detection of depression in young children is challenging, although some authors suggest that such conditions could be diagnosed in children us-ing virtually the same criteria as for adults (Hammen, 1997, 12).

 

The difference between detection and diagnosis can be revealed through definitions. Detection is the action of identifying the presence of something concealed. We have learnt through the years of medical history that detection for medical purposes such as detection for cancer and screening can have a huge impact. Such changes can lead to substantial improvements in life expec-tancy and quality of life. (Michie et al, 2014, 17). Unfortunately, investment in preventive and behavioral science has been very small relative to the scale of the opportunity for improving population health (e.g. Marteau, et al, 2006, cit-ed in Michie, 2014, 18,19). Interventions have been successfully applied to a wide variety of health behaviors. (Michie, 2008) as cited by (Michie, 2014, 19)

 

Closing the gap on detection of depression in young children and engag-ing in treatment can be enhanced by educating the child, parents, general prac-titioners, teachers and all that are involved with young children. There was a time when the average person was not aware of the link between washing your hands and prevention of infection (Richer, 2014).This link has now been de-tected and has become part of common sense. Hopefully the detection of de-pression in young children will also become common knowledge but the fear and stigma of this mental illness in our children can dampen the cause and possibly mark the plight of the detection.

 

Everyone recognizes that children and young people of any age can be sad and miserable. Disappointments and frustrations, some big and some small, are common in all young lives (Graham and Hughes, 2005, 5), however it is important to distinguish between a young child being sad and a child suf-fering with depression.

 

The origins of depression are complex and varied. Authors offer psycho-logical and biological explanations (Rathus, 2011, 230). Some social cognitive theorists explain depression in terms of relationships between competencies (knowledge and skills) and feelings of self-esteem (Rathus, 2011, 230).There is also evidence of genetic factors in depression (Kendler et al, 2007) as cited by (Rathus, 2011, 230). A Norwegian study of two thousand seven hundred and ninety-four twins estimated that the heritability of depression was forty

 

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nine percent in females and twenty five percent in males (Orstavik et al, 2007, cited in Rathus, 2011, 231).

 

Rathus (2011) suggests that psychotherapy for depression currently tends to be cognitive-behavioral. Children (and adolescents) are encouraged to do enjoyable things and build social skills, because the brains of depressed children may underutilize serotonin; drugs that increase the action of the neu-rotransmitter in the brain (Rathus, 2011, 231). The attachment theory has made an important contribution to current thinking about social causes of depres-sion. (Holmes, 1993, 185)John Bowlby’s studies strongly supported the view that deprived children of maternal care, especially children under the age of seven may be seriously affected in their emotion development. Bowlby sug-gests that from as young as naught to six months a new born baby is highly re-sponsive to human contact. (Holmes, 1993).

 

From the age of seven months a baby can begin to show signs of anxie-ty, becoming silent and clingy, which can continue if the symptoms are not acknowledged. Six months to three years can show social referencing (Holmes, 1993). An over anxious parent may present a young child with their issues. Bowlby also suggest that from the age of three the attachment system is fully fledged and will remain with the child throughout its life (Holmes, 1993). From three years’ affectional bonds merge and to avoid any mental, physical or emotional issues with a child this bond should remain strong.

 

The study used the Critical Appraisal Skills Programme (CASP) The advantage of using this particular research design is that there are specific tools for most studies (Aveyard, 2014) Through this research the design of the CASP helped to recognize certain criteria from each journal. Certain questions that were considered when the CASP tool was used were, author and year, title of the journal, study and aims, methodology, results or findings and conclu-sion. These questions enabled me to become more familiar with the literature I was studying, before going ahead and beginning the evaluation.

 

Once the journals were critically analyzed as to the strength and rele-vance to match the chosen topic. They were presented in a table format using the appropriate questions as headers and using the CASP format to identify the relevant information that would be used in the research. Use of the appraisal tool will help to question the literature in a more structured and in depth way (Aveyard, 2014, 110) Without a CASP the literature could become unstruc-tured and key questions missed.

 

 

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Some of the literature that did not identify with the key words were also put into the CASP format but only as a reference to showing the reasons as to why the research did not match with the question. To study the literature, it needs to be considered carefully. The research methods used in each paper are collated, to decide if the research type literature is what you are seeking (Ave-yard, 2014).

 

The results from the journals researched were very different in their findings. The titles of the journals varied but once read through and researched the articles. It was clear that they all had a connection in trying to detect de-pression in early childhood.

 

Lavigne et al. (2009) also investigated the prevalence of mental health disorders in young children. Sanner et al. (2015) indicted at the start of the de-pression can begin in a child as early as twelve months, suggesting that alt-hough infant behavior is limited it can be communicated by play or linked through their parents. Luby (2010) linked depression with other symptoms; for example sleep patterns and a change in appetite. A psychotherapeutic treat-ment for pre-school children was developed after an emotional model of de-pression was proposed by Luby and Belden (2006, cited in Luby, 2010).

 

Urinary and facial incontinence and the link with depression had not been mentioned in the previous studies, but were supported in the findings from (Equit et al., 2013). Boys were effected by nocturnal enuresis (NE) and faecal incontinence (FI) than girls in the study. Children with FI had higher symptoms of sadness/depression. (Equit et al., 2013). Sanner et al. (2015) and Luby et al. (2004) discuss the findings in relation to depression, but Johnson et al. (2000) and Chorney et al., (2007) go further and discuss the possible link between sleep disturbance, anxiety and depression in childhood.

 

Making a case for early intervention and preventative Mental Health Services was a study by Lyons-Ruth el al., (2000) as they commented that de-velopment and clinical studies over the past twenty-five years have document-ed that parental depression is related to a wide range of impaired developmen-tal outcomes in children, making the suggestion that children of depressed mothers experience more negative emotions. A child with a depressive mother also showed a negative facial affect when interacting with their parents (Ly-ons-Ruth et al, 2000, 149). It was also present from the study that the child’s mother rather than the father’s depression was explored, raising concerns that there is little data available to explore the risks of a father’s depression and the influence of this on a young child. Cote et al., (2009) also discussed in their

 

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study that preventative interventions should be experimented with infants and toddlers of mothers with a lifetime history of depression.

 

Blair and Hall (2005) focused the facilities and services that are or need to be available to support a family experiencing difficulties. A parent’s mental health state can also reflect on a child and as Ruth-Lyons et al. (2000) also commented, the whole family needs to be included rather than isolated. Blair and Hall (2005, 732) suggested that England’s Sure Start was intended to im-plement these findings. It was hoped that by making facilities more readily available in the local community, it would benefit families who would be the ones most likely to access the services of Sure Start.

 

Through the research it has been suggested that little has been done on the detection of depression in young children and only through recent research has the matter arisen. However Blumberg (1977) investigated depression in children over thirty years ago and discovered that there was little attention be-ing paid to young children and that it was possible infant children and toddlers could experience depressive symptoms. Similar findings are noted in present literature; just as Luby (2010) also wrote that similar issues and the subject is still under discussion.

 

Literature

 

Aveyard, H. Doing a Literature Review. Berkshire: Open UniversityPress, 2014.

 

Ebony Carlton

 

University of Lincoln, School of Health and Social Care, UK Supervisor: David Nelson, University of Lincoln