Characteristics of children with emotional problems and depressed mood : an examination of associations with behaviour, sleep, and inhibitory control

Emotional symptoms are symptoms of anxiety and depression that are included in the broad dimension of internalising symptoms encompassing feelings and behaviours such as fearfulness, worry, sadness, and withdrawal. Elevated levels of emotional symptoms are prevalent in children and often a precursor of adolescent and adulthood mental health disorders, such as major depression, one of the leading causes of disability in Finland and worldwide. The prevention of depression is a global challenge. Although major depression is a relatively rare condition in childhood, the more common emotional symptoms and subthreshold conditions of depression in childhood have been identified as possible targets for preventive action in the battle against depression. Results of studies involving adolescent participants suggest that examining the precursors of depression at the symptom level could aid in recognising individuals at risk for escalation to more severe disorders. Depressed mood, an emotional symptom that is one of the core symptoms of depression, has been associated with a future risk of psychopathology and may also cause current impairment, increasing the importance of early detection. However, there has not been much research on depressed mood in children. The present study examined the associations between emotional problems and depressed mood and three suggested risk factors for emerging, prolonging, and escalating emotional symptoms: inhibitory control, sleep problems, and co-occurring behaviour problems. The aim of the study was to provide data that would aid in the early recognition and prevention of emotional problems. Cross-sectional questionnaire data from the Strengths and Diffculties Questionnaire (SDQ) and the Quality of Life Questionnaire 17D were used in studies I–III, and the go/no-go task was used to assess children’s inhibitory control in the longitudinal study IV. The first study examined the prevalence of emotional problems and depressed mood in a population-based sample of 1,714 children aged 4–12. The associations of emotional problems and depressed mood with conduct problems and hyperactivity, as well as with child and family factors were also examined. In the population-based sample, 5.8% of the children had emotional problems and 16.0% had depressed mood. Both emotional problems and depressed mood were associated with sleep problems, illness or disability in children, and not living with both parents. Emotional problems and depressed mood were both significantly associated with conduct problems and hyperactivity. Of the emotional symptoms, depressed mood had the strongest association with both conduct problems and hyperactivity. The second study examined the prevalence of emotional problems and depressed mood in a child psychiatric outpatient sample of 862 children aged 6–12 and the associations of emotional problems and depressed mood with conduct problems and hyperactivity. The impact of depressed mood on children’s global functioning was also assessed. In the clinical sample, 13.1% of the children had emotional problems, and 59.4% had depressed mood. Emotional problems and depressed mood were signi