Research: Coping with Anxiety, Depression, Schizophrenia

Research is shedding new light on what happens in the brains of children and adults affected by clinical depression, anxiety disorders and schizophrenia, according to Washington University in St. Louis studies presented at a recent mental health symposium sponsored by NARSAD, the world's leading charity dedicated to mental health research.

The findings, which come as America celebrates Mental Health Awareness Month, point to new options for treating preschool-aged children with significant clinical depression, as well as those severely depressed adults who don't respond to standard treatments, such as antidepressants and psychotherapy. The studies have immediate relevance in terms of new treatment options and more targeted therapies for the estimated 57 million Americans who suffer from a diagnosable mental disorder.

Highlights of research discussed at the symposium include:

Depression in preschoolers

Joan L. Luby, MD, associate professor of child psychiatry and founder and director of Washington University School of Medicine's Early Emotional Development Program, is currently investigating the efficacy of a new treatment program for clinically depressed children as young as age 3 — a time of significant neurobiological change when there is the potential to alter the course of depression later in life.

"Clinicians used to think that very young children were not developed enough to experience depression, but studies going back to the 1980s changed this viewpoint," said Luby. "Now, we know that depression is a major childhood illness with potentially debilitating consequences."

A number of epidemiological studies have reported that up to 2.5 percent of children and up to 8.3 percent of adolescents in the U.S. suffer from depression. But until recently, very little was known about the impact of depression on very young children, which is why Luby and her colleagues are studying children between the ages of 3 years and 6 years old to identify what clinical depression looks like in preschool children.

Starting with a large-scale study funded by NARSAD and the National Institute of Mental Health, Luby and her team identified anhedonia — the inability to experience pleasure from activities and play — as a key symptom of depression in very young children. Another common symptom is that depressed children often use play to explore themes about death and sometimes even suicide.

"We learned that depressed children don't derive pleasure from the same things as a typical 3- to 5-year-old child," said Luby. "They're less joyful when they encounter the pleasures of daily life."

Now, Luby and her colleagues are testing a new treatment program for depressed preschoolers in their laboratory that applies these findings. Using a model similar to speech or other developmental therapies, this new program utilizes the interaction between parents and their children to teach depressed children how to experience positive emotions, manage negative emotions and more generally, how to enhance emotional development on a sustained basis. After pre-testing the new program in eight preschoolers, Luby's team is now recruiting 30 more young children from the St. Louis area for the new treatment study.