Epidemiology of psychiatric disorders in very young children in a Romanian pediatric setting

Abstract

Background A growing literature demonstrates that early clinical intervention can reduce risks of adverse psychosocial outcomes. A first step necessary for developing early intervention services is to know the prevalence of clinical disorders, especially in systems that are rebuilding, such as Romania, where the mental health system was dismantled under Ceaucescu. No epidemiologic studies have examined prevalence of psychiatric disorders in young children in Romania. Objective To determine the prevalence of psychiatric disorders in Romanian children 18-60 months in pediatric settings. Methods Parents of 1003 children 18-60 months in pediatric waiting rooms of two pediatric hospitals completed background information, the Child Behavior Checklist (CBCL). A subgroup over-sampled for high mental health problems were invited to participate in the Preschool Age Psychiatric Assessment. Results Rates of mental health problems were similar to the U.S. norms on the CBCL. The weighted prevalence of psychiatric disorders in these children was 8.8%, with 5.4% with emotional disorders and 1.4% with behavioral disorders. Co-morbidity occurred in nearly one fourth of the children with a psychiatric disorder and children who met diagnostic criteria had more functional impairment than those without. Of children who met criteria for a psychiatric disorder, 10% of parents were concerned about their child’s emotional or behavioral health. Conclusions This study provides prevalence rates of psychiatric disorders in young Romanian children, clinical characteristic of the children and families that can guide developing system of care. Cultural differences in parental report of emotional and behavioral problems warrant further examination.

Risk Factors for Internalizing and Externalizing Problems in the Preschool Years: Systematic Literature Review Based on the Child Behavior Checklist 1½–5

“…In two studies (Velders et al 2011;Liu et al 2014a) low maternal education is related to increases in IEP, and one found no significant results on IEP (Gleason et al 2011). Only one study (Gleason et al 2011) assessed the effect of paternal low education, finding significant results indicating that when the fathers have a low education level, children tend to present more IEP. In the three studies mothers have a similar education distribution, and almost …”

“…In the review, four studies examined the role of SES on IEP. One study (Gleason et al 2011) indicated that low income increases IEP and two studies (Paterson et al 2013;Ciciolla et al 2014) reported that low SES increases EP. Only one study (Utendale and Hastings 2011) stated that SES does not have an influence on IEP.…”

“…Three studies (Gleason et al 2011;Velders et al 2011;Liu et al 2014a) examined the effect of parental education on child's IEP. In two studies (Velders et al 2011;Liu et al 2014a) low maternal education is related to increases in IEP, and one found no significant results on IEP (Gleason et al 2011). Only one study (Gleason et al 2011) assessed the effect of paternal low education, finding significant results indicating that when the fathers have a low education level, children tend to present more IEP.…”

Deviations from the Expectable Environment in Early Childhood and Emerging Psychopathology

“…In preschool children, attention seeking behavior, overbright emotional displays, and violation of physical and verbal boundaries of others also may occur (Zeanah and Gleason, in press). Indiscriminate behavior is rare in epidemiological studies (Egger et al, 2006;Gleason et al, 2011b), but it is one of the most common social abnormalities described in young children living in institutions (Zeanah et al, , 2005 and in those adopted out of institutions (Bruce et al, 2009;Chisholm, 1998;Rutter et al, 2010a). In addition to children in institutions, indiscriminate behavior has been identified in maltreated children in foster care Oosterman et al, 2007;Pears et al, 2010;Zeanah et al, 2004).…”

The need of epidemiological data on child mental disorders from low-middle income countries

“…In this context, Gleason et al [2] provide us with extremely interesting data coming from Romania. The authors assessed a sample of 1,003 children aged 18-60 months from two pediatric centers using state of the art instruments in a two-stage study.…”