Children who do not stop having tantrums between the ages of three and seven are at increased risk of depression and self-harm as teenagers, a study revealed on Tuesday.
Researchers at University College London examined data from more than 7,000 children, whose parents were asked questions about their child’s irritability at three, five, and seven years of age.
This was analysed alongside responses from teenagers about their symptoms of depression and self-harm.
Irritability and tantrums are normal during the "terrible twos" and toddler years but usually improve as children get older. It peaks again briefly in adolescence but then declines as teenagers mature.
The UCL study found that children with irritability that did not decrease between the ages of three and seven years experienced higher levels of depression and self-harm in adolescence, whereas irritability at three years only was not associated with later depression.
"Persistent irritability might increase the risk of emotion dysregulation, parenting problems, avoidance, threat perception, social exclusion and negative coping strategies," the authors wrote.
Irritability was found to be higher in boys than girls, the study found, but the authors cautioned that further studies would be needed to explore how gender impacts behaviour.
Findings suggest that interventions to help parents and caregivers to support children with high irritability could help to reduce the future risk of mental illness, researchers said.
Identifying a marker for increased risk at an earlier stage in a child’s life would help parents to plan for potential mental health problems later on, they argued.
The study is the first to link irritability in early childhood to a future risk of depression.
The researchers recommended that parent management training should be offered universally to all parents of pre-school intervention.
"Such interventions could be incorporated into broader support for early childhood development and may play an important preventive role in reducing the prevalence of depression," they added.
Lead author Dr Ramya Srinivasan, of UCL Psychiatry, said: "This study suggests that while some degree of irritability is part of normal child development, we can identify children who struggle with persistent irritability from as young as five years, thus providing an opportunity for prevention and early intervention.
"The findings emphasise the importance of early childhood for emotional development. Support for parents of young children has been reduced in many countries in recent years and was substantially disrupted by the Covid pandemic. This is concerning and a possible missed opportunity."
