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Infants react to  caregivers�� anxiety and depressive affects with marked behavioral and affective dysregulation (crying, protest, affective withdrawal) (30). Children of mothers with post-partum depression often have cognitive and emotional deficits at an early age (e43). They often show a [https://en.wikipedia.org/wiki/Reelin Reelin] depressive affect in interactions with their mothers, and with other persons as well, which implies internalization of the depressive affect (31). Disturbed early relationships and a genetic predisposition to depression (e44) are causative factors for depression in later life. In a longitudinal study, Murray et al. showed that children of mothers with post-partum depression are more than three times as likely to suffer from depression themselves, with a 41.5% prevalence by age 16 (32). Skovgaard et al. (2007) found some type of affective disorder (depressive mood, anxiety, or rage lasting at least two weeks) in 2.8% of a representative sample of 18-month-old Danish children (1). In an American epidemiological study, 10.5% of a sample of preschool children were found to be suffering from emotional disorders (anxiety and depression), and 2.1% met the diagnostic criteria for a depressive disorder (2). Klein et al. (2014) studied 1034 German preschool children whose manifestations were rated by their mothers: 5.8% were found to have signs of internalization beyond the pathological threshold, which remained  moderately stable into school age. The prevalence of diagnosable depressive disorders rises with age; unlike the externalization disorders, these are roughly equally common in boys and girls (33). Irritability and inhibition while at play Irritability and inhibited behavior during play are typical signs of depression in preschool children. Depression in preschool children is characterized by an irritable affect lasting more than two weeks. At this early age, affect disorders are only rarely persistent and uninterrupted, as they often are in adolescence and adulthood (Box 4). Special attention must be paid to play behavior: lack of desire to play, decision-making difficulties, and self-abasement can be  early signs of depression (34). Subclinical depressive signs can also be significant even though they do not reach the threshold of a diagnosable depressive disorder, e.g., frequent tearfulness or irritability. Anxiety disorders in preschool children (prevalence, 7.7% [2]) are harder to distinguish from normal developmental anxiety; common varieties are separation anxiety, generalized anxiety disorder, and phobic disorders. The combination of anxiety that impairs the child in everyday life together with clinically diagnosable or subclinical depression has been found to be a particularly worrisome constellation in preschool children (35).