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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Psychiatric Symptoms: Prevalence, Co-occurrence, and Functioning Among Extremely Low Gestational Age Newborns at Age
Yael Dvir1, Jean A Frazier1, Robert M Joseph2
1University of Massachusetts Medical School, Worcester, MA.
Insights
Children born extremely preterm (EP) show higher rates of psychiatric disorders and functional impairments by age 10. Early intervention is crucial for these vulnerable children.
Area of Science:
- Developmental Pediatrics
- Child Psychiatry
- Neonatal Follow-up
Background:
- Extremely preterm (EP) birth (<28 weeks' gestation) poses significant risks for neurodevelopmental and psychiatric outcomes.
- Long-term follow-up studies are essential to understand the full spectrum of challenges faced by EP survivors.
Purpose of the Study:
- To determine the prevalence of psychiatric disorders in 10-year-old children born EP.
- To examine co-occurrence, sex differences, and functional correlates of psychiatric symptoms in this cohort.
Main Methods:
- Prospective cohort follow-up of 871 children from the Extremely Low Gestational Age Newborn (ELGAN) Study at age 10.
- Parental completion of the Child Symptom Inventory-4 (CSI-4), medical history, and Pediatric Quality of Life Inventory (PedsQL).
Main Results:
- EP children were more likely to screen positive for psychiatric disorders compared to normative data.
- 15% screened positive for 1 disorder, 7% for 2, 3% for 3, and 4% for ≥4 disorders.
- Children with ≥3 disorders had increased rates of grade repetition, individualized education programs, and special remediation classes; those with any disorder were more likely to use psychotropic medication.
Conclusions:
- Psychiatric symptom rates in EP children exceed normative expectations at age 10.
- Multiple psychiatric disorders are associated with significant functional impairments, highlighting the need for early identification and support.
Objective:
To evaluate the percentage of children born extremely preterm (EP) who screen positive for ≥1 DSM-IV psychiatric disorders, the co-occurrence of and sex-related differences in these classifications, and the functional correlates of psychiatric symptoms.
Methods:
The Extremely Low Gestational Age Newborn (ELGAN) Study is a prospective cohort follow-up of children born <28 weeks' gestation. For 871 10-year-old children, parents completed the Child Symptom Inventory-4 (CSI-4), a child educational/medical history questionnaire, and the Pediatric Quality of Life Inventory (PedsQL).
Results:
At age 10 years, ELGANs were more likely to screen positive for a number of psychiatric disorders when compared with normative expectations on the CSI-4, with a few sex-related differences. Fifteen percent of participants screened positive for 1 disorder, 7% for 2, 3% for 3, and 4% for ≥4 psychiatric disorders. Compared with children who did not screen positive for psychiatric disorders, children who screened positive for ≥3 psychiatric disorders were approximately twice as likely to have repeated a grade, have an individualized educational program, have an individual school aide, and to require special remediation classes. Children who screened positive for any psychiatric disorder were 4 times more likely to use 1 or more psychotropic medication, and those who screened positive for ≥2 psychiatric disorders had lower PedsQL scores.
Conclusion:
Among 10-year-old children born EP, rates of psychiatric symptoms exceeded normative expectation, and children who screened positive for more than 1 psychiatric disorder were at increased risk of having multiple functional impairments.
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