Parent-reported mental health in preschoolers: findings using a diagnostic interview

Previous research suggests that many preschoolers meet criteria for psychiatric diagnoses; still, relatively little is known about preschool mental health, particularly emotional problems, in the community. This study investigated the rates of parent-reported DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision) disorders in a large community sample of preschoolers using the Preschool Age Psychiatric Assessment (PAPA). Five hundred forty-one parents were interviewed with the PAPA. Of the children, 27.4% met criteria for a PAPA/DSM-IV diagnosis; 9.2% met criteria for 2 or more diagnoses. Oppositional defiant disorder (ODD) (9.4%), specific phobia (9.1%), and separation anxiety disorder (5.4%) were the most common diagnoses; depression (1.8%), selective mutism (1.5%), and panic disorder (0.2%) were the least common. In addition, there was significant comorbidity/covariation between depression, anxiety, and ODD and between ODD and attention-deficit/hyperactivity disorder (odds ratios = 1.81-18.44; P < .05), and significant associations with measures of psychosocial functioning. The stability and clinical significance of diagnoses and patterns of comorbidity must be elucidated in future research. (C) 2011 Elsevier Inc. All rights reserved.