title: Psychiatric services for preschoolers: an emerging need.
abstract: OBJECTIVE
  To describe clinical presentation and service requirements for those under six years of age referred to a specialised child and adolescent psychiatry unit.
  
  
  METHODS
  This study used a retrospective review of preschoolers, six years and younger, assessed at a child, family and adolescent psychiatric unit (January 2006 to 31 December 2010). Data analysis established predominant diagnoses (prevalence percentages) and correlations and associations (diagnoses and a range of clinical variables - Fischer's exact test and chi-square test).
  
  
  RESULTS
  The sample comprised 149 subjects. Males predominated (77.2%; N = 115). Mean age of presentation was 54 months (SD=12.59). Children were referred predominantly by health professionals (36.9%; N = 55) and schools (20.8%; N = 31). Attention-deficit hyperactivity disorder (ADHD) was the most common diagnosis (52.8%; N = 70), and was not over-represented amongst boys. Girls mostly presented with anxiety disorders (44.1%; 15/34) and reactive attachment disorder (RAD) (35.3%; 12/34), and boys mostly with pervasive developmental disorders (PDD) (26%; 30/115). Psychometric testing was frequent (68.5%; N = 102). Pharmacological intervention was common (46.3%; N = 69). The defaulting rate after initial assessment was high (42.1%; 48/114).
  
  
  CONCLUSIONS
  The study demonstrates the existence of psychiatric illness in this sample, highlighting service needs. Vulnerability of this age group and limited sub-specialist resources emphasise the need for the development of community services leading to early recognition and intervention.
authors.affiliation: a Department of Psychiatry, Faculty of Health Sciences , University of the Witwatersrand, Charlotte Maxeke Johannesburg Academic Hospital , South Africa.
authors.forename: Lavinia
authors.initials: L
authors.lastname: Lumu
authors.affiliation: b Department of Psychiatry, Faculty of Health Sciences , University of the Witwatersrand, Charlotte Maxeke Johannesburg Academic Hospital, Child and Adolescent Family Unit , South Africa.
authors.forename: Lynda
authors.initials: L
authors.lastname: Albertyn
authors.affiliation: a Department of Psychiatry, Faculty of Health Sciences , University of the Witwatersrand, Charlotte Maxeke Johannesburg Academic Hospital , South Africa.
authors.forename: Christopher Paul
authors.initials: CP
authors.lastname: Szabo
mesh_terms: D001008:Anxiety Disorders / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D002648:Child; D002662:Child Health Services; D002665:Child Psychiatry; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008605:Mental Health Services; D012189:Retrospective Studies