Getting a Grasp on Kids' Mental Health

Mental heath disorders in preschoolers remained at mostly steady rates through age 6

/ Author:  / Reviewed by: Robert Carlson, M.D

(RxWiki News) Do children really have mental health disorders at rates similar to teens and adults? Or are they overdiagnosed and just being kids? There may not be a simple answer to that question.

But a recent research study has shed a little light on how children meet the criteria for mental health conditions. This study found that rates of diagnoses among children at age 3 remained about the same at age 6.

The three diagnoses which were particular consistent in children, age 3 to age 6, were anxiety, attention deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD).

"Ask your pediatrician about child behavior."

The study, led by Sara J. Bufferd, PhD, a professor of clinical psychology at California State University San Marcos, aimed to find out whether preschoolers diagnosed with a psychiatric disorder still met the diagnosis by the time they began school.

The researchers interviewed the parents of 462 children when the kids were 3 and 6 years old. The researchers used a comprehensive diagnostic interview to assess the children's mental health.

Overall, the study found the rate of mental health disorders from age 3 to age 6 remained about the same.

Any 3-year-old who met the criteria for a diagnosis of a specific psychiatric condition was almost five times more likely than other children to meet that diagnostic criteria again three years later.

While 127 children at age 3 met the criteria for any psychiatric condition, the number changed only slightly, to 123, when the children were 6 years old. Similarly, 91 children met the diagnostic criteria for an emotional disorder at 3 years old, and 87 children met it at 6 years old, so there was little change over the years for these children.

For example, 89 children were diagnosed with an anxiety disorder at age 3, and 72 of the children at age 6 were diagnosed with an anxiety disorder.

With ODD, 42 children were diagnosed with it at age 3, which only dropped to 41 when the children were 6.

There was a significant increase in children with diagnoses of depression: with only 6 children diagnosed as depressed at age 3, there were 25 diagnosed with depression at age 6.

However, there were some pairs of diagnoses that switched over the three-year period.

Children diagnosed with depression were sometimes diagnosed three years later with anxiety or vice versa. A similar pattern occurred for anxiety and ODD and for ADHD and ODD.

This may partly explain the increase that occurred for ADHD: 11 children were diagnosed with it at age 3, and 25 were diagnosed with it at age 6.

The authors concluded that rates of psychiatric disorders remain mostly stable as children approach school-age years, which is similar to what has been seen in older children.

This study does not necessarily show that children are or are not being diagnosed when they should not.

It shows that, using the same criteria to identify a possible psychiatric condition in a child three years apart, there is a high likelihood the child will meet that criteria again.

Whether that criteria is appropriate or sufficient, or whether the child needs any kind of treatment was beyond the scope of this study.

The study was published in the November issue of the American Journal of Psychiatry. The research was funded by the National Institute of Mental Health and a General Clinical Research Center grant.

One author has received funding from Bristol-Myers Squibb, GlaxoSmithKline, Merck and Pfizer. The other authors disclosed no conflicts of interest.

Reviewed by: 
Review Date: 
November 9, 2012
Last Updated:
June 3, 2013