Psychiatric services for preschoolers: an emerging need
Objective: To describe clinical presentation and service requirements for those under six years of age referred to a specialised child and adolescent psychiatry unit. Method: 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) Conclusion: 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.
Journal of child and adolescent mental health