Diagnostic Stability of Psychiatric Disorders in Preschool Children
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Abstract
Objective: To examine the stability of psychiatric disorders in preschoolers across time and to determine the factors associated with diagnostic stability.
Methods: This retrospective chart review was conducted on 256 children aged 3 to 5 years who received psychiatric evaluation at the Child and Adolescent Psychiatric Clinic and the Developmental and Behavioral Pediatric Clinic over a period of at least 2 years and had the last follow-up visit within the ages of 6 to 18 years.
Results: Only autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) showed statistical significance of good and fair diagnostic stability, respectively. Conditions unlisted in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) manual such as behavioral, child-rearing, emotional dysregulation, and writing problems, and also normal condition, had high transition rates to later ADHD. Living with parents, chief complaints, psychiatric comorbidity, medication use at the first visit, duration of follow-up and change of doctor over time were significantly associated with the stability of diagnoses.
Conclusions: Preschool ASD and ADHD seem more stable than other diagnoses and tend to co-occur with other conditions, suggesting that they are likely to continue and exhibit further problems. Clinicians should pay particular attention to early identification based on standardized diagnostic practices and consider the factors influencing dynamical changes in order to prevent future impairment.
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