title: Patterns of psychopathology and dysfunction in clinically referred preschoolers.
abstract: Despite the growing interest in the use of psychotropic medications in preschoolers, little is known about the clinical presentation of young children referred for psychiatric services. We describe the clinical characteristics, psychiatric disorders, and functioning of preschoolers referred for pediatric psychiatry evaluation. Structured psychiatric interviews assessing lifetime psychopathology by DSM-III-R criteria were completed on clinically referred youth. Family, social, and overall functioning were assessed at intake. From the pool of 1658 consecutive referrals, we identified 200 children less than or equal to (<or=) 6 years of age (12%). The most common psychopathology identified was attention deficit hyperactivity disorder (ADHD) (86%), followed by other disruptive behavioral (61%), mood (43%), and anxiety disorders (28%). Co-occurring psychiatric disorders were common with preschoolers manifesting a mean of two major psychiatric disorders per child. Despite their young age, the onset of psychopathology preceded evaluation by a mean (+/-SD) of 2.2 +/- 1.3 years. Preschoolers referred for psychiatric services had high rates of psychopathology with prominent comorbidity and associated dysfunction. These preschoolers are likely to require aggressive interventions including psychopharmacology.
authors.affiliation: Clinical Research Program in Pediatric Psychopharmacology, Massachusetts General Hospital, Harvard Medical School, Boston 02114, USA. wilens@helix.mgh.harvard.edu
authors.forename: Timothy E
authors.initials: TE
authors.lastname: Wilens
authors.forename: Joseph
authors.initials: J
authors.lastname: Biederman
authors.forename: Sarah
authors.initials: S
authors.lastname: Brown
authors.forename: Michael
authors.initials: M
authors.lastname: Monuteaux
authors.forename: Jefferson
authors.initials: J
authors.lastname: Prince
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Spencer
mesh_terms: D001008:Anxiety Disorders / Q000453:epidemiology / Q000523:psychology*; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology / Q000523:psychology*; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000453:epidemiology / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000453:epidemiology / Q000523:psychology*; D012017:Referral and Consultation