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Psychiatric disorders in preschoolers: the structure of DSM-IV symptoms and profiles of comorbidity

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Abstract

Psychiatric disorders have been increasingly recognized in preschool children; at present, however, we know comparatively less about how well current diagnostic manuals capture the symptoms described in this age group and how comorbidity is patterned. Therefore, this study aimed to investigate whether the symptoms defined by the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) load on their respective disorders, examine whether individual symptoms exist that load particularly high or low on the disorder they allegedly define, and analyze how comorbidity clusters in individual children. Parents of a community sample of Norwegian 4-year-olds (N = 995) were interviewed using the Preschool Age Psychiatric Assessment. A confirmatory factor analysis (CFA) and a latent profile analysis (LPA) were performed on the symptoms of seven DSM disorders: attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder, conduct disorder, major depressive disorder (MDD), generalized anxiety disorder (GAD), social phobia, and separation anxiety disorder. The results showed that the CFA solution that closely resembled the disorders delineated in the DSM-IV fitted the data best. However, vegetative symptoms did not define preschool depression. The LPA identified nine symptom profiles among preschoolers, of which four showed evidence of psychopathology: comorbid MDD/GAD + ADHD combined type, comorbid MDD/GAD + ADHD hyperactive/impulsive type, separation anxiety only, and social phobia only. In conclusion, the symptoms observed in preschoolers fit the DSM-IV well, and comorbidity followed specific patterns.

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Acknowledgments

Grants 170449/V50, 190622/V50, 185760/V50, and 175309/V50 from the Research Council of Norway and Grant 4396 from the Liaison Committee between the Central Norway RHA and NTNU funded this research.

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On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Authors and Affiliations

  1. Department of Psychology, Norwegian University of Science and Technology (NTNU), 7491, Trondheim, Norway

    Lars Wichstrøm

  2. NTNU Social Science, Trondheim, Norway

    Lars Wichstrøm

  3. Department of Child and Adolescent Psychiatry, St. Olav’s Hospital, Trondheim, Norway

    Lars Wichstrøm

  4. Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway

    Turid Suzanne Berg-Nielsen

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Correspondence to Lars Wichstrøm.

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Wichstrøm, L., Berg-Nielsen, T.S. Psychiatric disorders in preschoolers: the structure of DSM-IV symptoms and profiles of comorbidity. Eur Child Adolesc Psychiatry 23, 551–562 (2014). https://doi.org/10.1007/s00787-013-0486-7

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