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[Children aged 0-3 years referred to child psychiatric department. A descriptive epidemiological study]
Hanne Elberling1, Anne Mette Skovgaard
1Amtssygehuset i Glostrup, børnepsykiatrisk afdeling.
Insights
Child psychiatric referrals for 0-3 year olds increased, with pervasive developmental disorders most common in older toddlers. Many young children referred, particularly those with mentally ill parents, had attachment or adjustment disorders.
Area of Science:
- Child and Adolescent Psychiatry
- Developmental Psychology
- Pediatric Mental Health
Background:
- A significant increase in referrals to child psychiatric services for children aged 0-3 years was observed in Denmark between 1996-1998.
- This rise prompted further investigation into the characteristics of young children seeking psychiatric care.
Purpose of the Study:
- To describe children aged 0-3 years referred to child psychiatric departments.
- To analyze the distribution of diagnoses, age, sex, and parental mental illness among these young patients.
Main Methods:
- A descriptive study utilizing clinical database and hospital records.
- Inclusion criteria: Children aged 0-3 years referred to child psychiatric departments in the County of Copenhagen during 1998 and 1999.
Main Results:
- 159 children were admitted over two years, with an overall incidence of 0.4%.
- Pervasive developmental disorders were the most frequent diagnosis in children aged 2-3 years (0.25 per 1000 per year), with a 6:1 male to female ratio.
- Among the youngest children, Z-diagnoses were most common, often associated with mentally ill parents. Attachment disorders, eating disorders, and adjustment reactions were also noted in children with parental mental illness.
Conclusions:
- The incidence of pervasive developmental disorder in this study was double that reported in a previous Danish register study.
- Reactive attachment disorder, eating disorders, adjustment disorders, and Z-diagnoses were prevalent in the youngest referred children, frequently linked to parental mental illness.
Introduction:
In a Danish register study the incidence of children aged 0-3 years referred to child psychiatric services in Denmark increased by 30% during 1996-1998. The objective of this study was to further describe 0-3 year-old children referred to child psychiatric departments with a view to distribution of diagnoses, age, sex, and parental mental illness.
Material And Methods:
Children 0-3 years of age referred to child psychiatric departments in the County of Copenhagen in 1998 and 1999 were described on the basis of the clinical database and hospital records.
Results:
A total of 159 children were admitted over a two-year period corresponding to an incidence of 0.4%. The ratio boys: girls were 1.3:1. However, with regard to pervasive developmental disorders boys dominated 6:1. Among girls, eating disorders were dominating in the youngest children with ratio girls: boys 5:2. Pervasive developmental disorders were the most common diagnoses in children aged 2-3 years, and the overall incidence of this diagnosis was 0.25 per 1000 per year. The most common diagnosis of the youngest children was Z-diagnoses, and most often these children had mentally ill parents. Attachment disorders, eating disorders, and adjustment reactions were common diagnoses in children with mentally ill parents, but more than half of these children did not have any diagnosis at all.
Discussion:
The incidence of children with pervasive developmental disorder was found twice as high as observed in a register study covering referrals of children aged 0-3 years from all psychiatric departments in Denmark during 1996-1998. Reactive attachment disorder, eating and adjustment disorder, and Z-diagnosis are the most common diagnoses in the youngest children, and most often these children have mentally ill parents.