Depression and Social Functioning in Preschool Children with Chronic Medical Conditions

Objective

To investigate the relations among depressive symptoms, social behavior, and chronic medical illness in preschool children.

Study design

Caregivers of 273 preschool children (3.0-5.2 years of age) completed questionnaires about preschoolers' physical health, depressive symptoms, and social behavior. Interviewers determined ratings for preschoolers' impairment in social and behavioral functioning. Analyses examined the relationships among chronic medical conditions, depressive symptoms, peer acceptance/rejection, and social behavior.

Results

Chronic illness was significantly associated with early-onset depressive symptoms and impairment in several social functioning domains, even after accounting for socioeconomic status. Regression analyses demonstrated that the number of health conditions predicted higher depression scores, frequency of asocial behaviors, and impairment in daycare role cooperation and behavior toward others. Preschoolers with at least 1 medical condition experienced a greater frequency of peer rejection and bullying compared with healthy peers. Depressive symptoms mediated the relationship between illness and asocial behavior.

Conclusions

There is a need for greater attention to depression and difficulties in social functioning in preschool children with chronic illness. Because of the potential impact on later developmental and mental health outcomes, primary care physicians should be attentive now to depressive symptoms in chronically ill preschoolers.

Abbreviations: ANCOVA, Analysis of covariance, HBQ, MacArthur Health and Behavior Questionnaire, PECFAS, Preschool and Early Childhood Functional Assessment Scale