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Mental disorders in referred 0–3-year-old children: a population-based study of incidence, comorbidity and perinatal risk factors

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Abstract

The epidemiology of mental disorders in early childhood is still under-researched. We aim to explore the incidence, comorbidities and risk factors of mental disorders in 0–3-year-olds referred to hospital settings. In a national cohort of 918,280 children born in 1997–2010, we calculated incidence rates per 1,000 person-years (IR) of first-time mental and developmental disorders diagnosed in hospitals before four years of age. Data were obtained from Danish population registries. We used logistic regression to analyse co-morbidity and Cox proportional hazard models to evaluate the influence of pre- and perinatal risk factors. A total of 16,164 children (1.76%) were diagnosed with a mental (0.90%) or developmental disorder (1.05%). Pervasive developmental disorders (PDD) and disorders of hyperactivity and inattention (ADHD) were increasingly diagnosed with age. Feeding and eating disorders and disorders of social functioning were most frequent among the youngest children. Comorbidity was found in 18%, e.g., between PDD and ADHD (OR 135.8; 95% CI 112.0–164.7) or between ADHD and disorders of social functioning (OR 148.0; 95% CI 106.4–205.7). Young maternal age, old paternal age, maternal smoking in pregnancy, boy sex, premature birth and being small for gestational age were associated with highly increased risk of mental and developmental disorders. Mental and developmental disorders diagnosed within the first four years of life show increasing incidence rates and a complex pattern of comorbidities. Study findings point to the need of clinical and research attention towards the manifestations of developmental psychopathology in very young children.

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Abbreviations

SGA:

Small for gestational age

NPR:

National Patient Registry

IR:

Incidence rates

OR:

Odds ratio

HR:

Hazard ratio

CI:

Confidence interval

ICD-10:

The ICD-10 Classification of Mental and Behavioral Disorders

DSM-5:

Diagnostic and Statistical Manual of Mental Disorders DC:0-3 Diagnostic Classification DC Zero to Three

DC:0–5:

Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood

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Acknowledgements

Mrs C. Hermansens Remembrance grant, Beatrice Surovell Haskell Fund for Child Mental Health Research of Copenhagen, Mental Health Services, Capital Region, Denmark.

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Authors and Affiliations

  1. Department for Child and Adolescent Psychiatry, Zealand Region, Smedegade 16, 4000, Roskilde, Denmark

    Susanne V. Koch

  2. Institute of Health Sciences, University of Copenhagen, Copenhagen, Denmark

    Susanne V. Koch

  3. Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark

    Mikael Andersson

  4. Neonatal Intensive Care Unit, Department of Pediatrics, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark

    Carolina Hvelplund

  5. National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark

    Anne Mette Skovgaard

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  1. Susanne V. Koch
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Correspondence to Susanne V. Koch.

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Koch, S.V., Andersson, M., Hvelplund, C. et al. Mental disorders in referred 0–3-year-old children: a population-based study of incidence, comorbidity and perinatal risk factors. Eur Child Adolesc Psychiatry 30, 1251–1262 (2021). https://doi.org/10.1007/s00787-020-01616-2

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