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The Pediatric Forum
Octomber 6, 2008

Adult Mental Health Effects of Early Childhood Intervention

Arch Pediatr Adolesc Med. 2008;162(10):995. doi:10.1001/archpedi.162.10.995-a

The findings of Reynolds et al1 of the longitudinal effects of preschool intervention provide compelling evidence that preschool programs have a positive long-term impact on educational outcomes, health insurance status, and incarceration. These findings are diluted, however, in the large number of other assessed and reported outcomes. The findings related to mental health, in particular, raise more questions than they answer. While the study purports to look at adult mental health as an outcome, the only measure is a 5-item self-report of depressive symptoms, which was administered in conjunction with a larger survey. Respondents were considered positive for depression if they reported feeling sad, lonely, depressed, helpless, or that life was not worth living at levels ranging from a few times a month to almost every day. A respondent who reported feeling lonely a few times a month would be classified as positive for depression according to this scale. The authors identify the narrow scope of this assessment as a limitation of their study, suggesting that the intervention's effects on mental health may have been underestimated. Studies of brief screening measures of depression, however, have found that these measures likely overestimate depression compared with longer measures with higher specificity.2,3

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