Childhood depression is widely underrecognized in primary health care settings. This phenomenon appears to increase with younger age. Evidence has been provided for a valid depressive syndrome among preschool children. Based on the need for the earliest possible identification of depression, the development of a brief screening measure to capture young children with markers of depression from these community settings was developed and tested.

A group of 174 preschool children underwent a comprehensive psychiatric assessment. The majority of this study group was ascertained from primary care settings using a 20-item checklist designed to capture depressive symptoms in young children. The assessment included the Diagnostic Interview Schedule for Children Version modified for young children and the Child Behavior Checklist. Ratings on the checklist were subsequently compared with these independent measures of psychopathology using several analytic strategies.

The Preschool Feelings Checklist demonstrated high internal consistency, and 16 items showed strong associations with independent diagnostic measures of internalizing symptoms and major depressive disorder. The Preschool Feelings Checklist demonstrated high specificity and sensitivity for the identification of major depressive disorder at a cutoff score 3 or more.

The Preschool Feelings Checklist is a brief and valid screening measure highly feasible for use in primary care settings. It demonstrated utility for the identification of preschoolers in need of formal mental health evaluation for depression.