Pediatric Depression Symptoms, Executive Functioning Weaknesses, and Associated Neuropsychological and Psychiatric Outcomes
Despite numerous studies in adults, only a handful of studies have examined executive functioning (EF) in childhood depression. Our study examined the relationship between significant depressive symptoms and an EF weakness in a child inpatient psychiatric setting. A medical chart review was conducted for 98 ethnically diverse 6- to 12-year-old boys and girls, who received a neuropsychological evaluation during their psychiatric inpatient hospitalization. Children were classified as having depressive symptoms if they had a T-Score 1.5 SD above the mean on at least 1 subdomain of the Childhood Depression Inventory and classified as having an EF weakness if they had a T-score 1.5 SD below the mean on at least 1 test of executive functioning. Results indicated that compared to children with either depressive symptoms only or only an EF weakness, children with both depressive symptoms and an EF weakness had poorer cognitive test performance on a measure of immediate memory (F(2,72) = 4.07, p = .000; Cohen’s d = −.83 and −.90, respectively) and longer hospitalizations stay (F(2,93) = 4.04, p = .021; Cohen’s d = .54 and .62, respectively). Additionally, children with both depressive symptoms and an EF weakness had higher rates of ADHD than children with depressive symptoms only (OR = 2.11) and higher rates of EF weaknesses than children with only an EF weakness (t(60) = 2.54, p = .014; Cohen’s d = .68). Results suggest that not all children with depressive symptoms have an EF weakness; however, children who present with this comorbidity are at risk for more cognitive difficulties and significant psychiatric outcomes including prolonged hospitalizations.
KeywordsChildren, Depression Executive dysfunction Inpatient Length of stay
E.B.W.: conceptualized and designed the study, executed statistical analyses, and drafted the initial manuscript. B.C.K.: conceptualized and designed the study, executed statistical analyses, drafted several parts of the manuscript, critically reviewed the manuscript, and approved the final version. J.S., N.E.C., and G.C.: consulted about the study, helped draft and revise the manuscript, critically reviewed the manuscript, and approved the final version. K.M.: critically reviewed the manuscript and approved the final version. K.A.H.: conceptualized and designed the study, critically reviewed the manuscript, and approved the final version.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required. Please see the methods section for further details of informed consent procedures.
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