Psychiatric Disorders in Preschoolers: Continuity From Ages 3 to 6

Sara J. Bufferd, Ph.D., Lea R. Dougherty, Ph.D., Gabrielle A. Carlson, M.D., Suzanne Rose, M.A., and Daniel N. Klein, Ph.D.Authors Info & Affiliations

Publication: American Journal of Psychiatry

Volume 169, Number 11

https://doi.org/10.1176/appi.ajp.2012.12020268

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Abstract

About half of 127 children meeting criteria for psychiatric diagnoses at age 3 received diagnoses again at age 6, and half of those with psychiatric diagnoses at age 6 also had disorders at age 3. Disorders most likely to remain constant were ADHD, oppositional defiant disorder, and anxiety disorders. The six cases of depression at age 3 were gone at age 6, but several of these children developed anxiety disorders or oppositional defiant disorder. Switches also occurred from anxiety or ADHD to oppositional defiant disorder and from oppositional defiant disorder to ADHD.

Abstract

Objective

Recent studies indicate that many preschoolers meet diagnostic criteria for psychiatric disorders. However, data on the continuity of these diagnoses are limited, particularly from studies examining a broad range of disorders in community samples. Such studies are necessary to elucidate the validity and clinical significance of psychiatric diagnoses in young children. The authors examined the continuity of specific psychiatric disorders in a large community sample of preschoolers from the preschool period (age 3) to the beginning of the school-age period (age 6).

Method

Eligible families with a 3-year child were recruited from the community through commercial mailing lists. For 462 children, the child’s primary caretaker was interviewed at baseline and again when the child was age 6, using the parent-report Preschool Age Psychiatric Assessment, a comprehensive diagnostic interview. The authors examined the continuity of DSM-IV diagnoses from ages 3 to 6.

Results

Three-month rates of disorders were relatively stable from age 3 to age 6. Children who met criteria for any diagnosis at age 3 were nearly five times as likely as the others to meet criteria for a diagnosis at age 6. There was significant homotypic continuity from age 3 to age 6 for anxiety, attention deficit hyperactivity disorder (ADHD), and oppositional defiant disorder, and heterotypic continuity between depression and anxiety, between anxiety and oppositional defiant disorder, and between ADHD and oppositional defiant disorder.

Conclusions

These results indicate that preschool psychiatric disorders are moderately stable, with rates of disorders and patterns of homotypic and heterotypic continuity similar to those observed in samples of older children.

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Information & Authors

Information

Published In

American Journal of Psychiatry

Volume 169 • Number 11 • November 2012

Pages: 1157 - 1164

PubMed: 23128922

History

Received: 24 February 2012

Revision received: 21 May 2012

Revision received: 9 June 2012

Revision received: 22 June 2012

Accepted: 25 June 2012

Published online: 1 November 2012

Published in print: November 2012