Preschoolers' Psychopathology Likely to Persist to Ages 6-9

By Bates, Betsy | Clinical Psychiatry News, March 2011 | Go to article overview

Preschoolers' Psychopathology Likely to Persist to Ages 6-9


Bates, Betsy, Clinical Psychiatry News


LOS ANGELES -- Preschool-aged children diagnosed with a psychiatric disorder have an increased likelihood of fulfilling criteria for a psychiatric disorder at ages 6-9, even after statistical adjustment for preschool pathology, according to 4-year follow-up data from a longitudinal study at Duke University.

About 3.3% of preschoolers were diagnosed with attention-deficit/hyperactivity disorder, 2.1% with depression, and 9.4% with anxiety disorders in studies at Duke that began in 2001.

At a 4-year follow-up of 307 children, those with a diagnosable psychiatric disorder in preschool had a 3.5-fold increased likelihood of being diagnosed with the same disorder and/or another during the early school years, when they were 6-9 years old.

Neither serious illnesses nor hospitalizations at ages 2-5 years were associated with subsequent development of a psychiatric disorder, but injuries to young children were associated with a later diagnosis of op-positional-defiant disorder (odds ratio, 3.3) and/or ADHD (OR, 3.8), Dr. Helen Link Egger reported.

The associations with traumatic medical events present a chicken-or-egg dilemma, since symptoms of op-positional-defiant disorder or ADHD may have been responsible for injury-prone behavior rather than triggering a traumatic response.

In some cases, "the symptoms were brewing and will emerge at a later age," Dr. Egger said.

When tracing the development of psychiatric disorders in young children, many factors come into play, including risk factors, illnesses and injuries that may have neurocognitive sequelae, and the role of parental functioning, said Dr. Egger, a psychiatrist who serves as clinical director of the Duke Preschool Psychiatric Clinic, Durham, N.C.

The Duke studies found that medical trauma is common in early childhood but that "the majority of the kids do OK," she said.

In the Duke Preschool Anxiety Study of 666 children aged 2-5 years, almost 14% had low birth weight, 12% spent time in the neonatal ICU, and 3% were diagnosed with a serious illness with a risk of death or chronic disability. …

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