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.