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Sleep problems in preschool-onset major depressive disorder: the effect of treatment with parent–child interaction therapy-emotion development

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Abstract

In school-aged children, adolescents, and adults, more than 72% of individuals diagnosed with major depression report co-occurring sleep problems, but little is known about sleep problems in the context of preschool-onset major depressive disorder (PO-MDD). The current study examined the prevalence of various sleep problems in a sample of young children diagnosed with PO-MDD and explored how the treatment of depression, using a modification of parent–child interaction therapy focused on emotional development (PCIT-ED), affects sleep problems. Participants included 229 preschoolers (ages 3–6 years) who met criteria for PO-MDD and participated a single-blind, randomized control trial comparing PCIT-ED to a waitlist control condition. Children were randomly assigned to either PCIT-ED (n = 114) or the waitlist condition (n = 115). Children were assessed at baseline, immediately after PCIT-ED, and 3 months after treatment completion for parent-reported sleep problems across the domains of insomnia, hypersomnia, daytime fatigue, and a total sleep problem index. In our sample, 45% of children had at least one subthreshold sleep problem, 38.4% had at least one threshold sleep problem, and 72.5% had at least one sleep problem (either threshold or subthreshold). Treatment with PCIT-ED significantly reduced sleep problems, including insomnia, daytime fatigue, and total sleep problems, compared to a waitlist condition, even when controlling for child depression. This reduction was maintained at a 3-month follow-up. Sleep problems are a prevalent co-occurring condition with PO-MDD. Interventions such as PCIT-ED that also effectively reduce sleep problems may be particularly beneficial for recovery from PO-MDD.

Clinical trial registration information: a randomized control trial of PCIT-ED for preschool depression; https://clinicaltrials.gov/NCT02076425.

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Acknowledgements

This work was supported by the National Institute of Mental Health, Grant #s 5R01MH098454-04 (PI: Luby), K23MH22325028202-01 (PI: Whalen); L30 MH108015 (PI: Whalen); T32 MH0100019-06.

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Hoyniak, C.P., Whalen, D.J., Barch, D. et al. Sleep problems in preschool-onset major depressive disorder: the effect of treatment with parent–child interaction therapy-emotion development. Eur Child Adolesc Psychiatry 30, 1463–1474 (2021). https://doi.org/10.1007/s00787-020-01641-1

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