Psychiatric disorders in pre-schoolers

The psychiatric disorders seen in preschoolers are reviewed. Behaviour problems are the most commonly seen. These may be due to reaction to stress, developmental problems of attachment and temperamental characteristics such as shyness and aggressiveness. Related to behavioural problems are the developmental disorders of enuresis, encopresis and constipation. The rate of behaviour problems in Singapore was found to be 7% which compares favourably with studies overseas. Disorders that have their onset in the preschool period include Attention Deficit Hyperactivity Disorder (ADHD) and Pervasive Developmental Disorders. ADHD is increasingly important because of the response to Ritalin and pervasive disorders because of the recognition that autistic states probably cover a spectrum of disorders. Aetiological factors of preschool psychiatric disorders include biological and psychosocial contribution. The latter is associated with the quality of the home environment and quality of care experienced by the child. Assessment methods include the gathering of developmental data such as the IQ and appropriate behavioural checklists. Direct observation is increasingly practised. Management methods range from drug therapy (mainly in ADHD), to traditional psychodynamic, family and behavioural therapy.