PRESCHOOLERS BEHAVIOR PROBLEMS AND HEALTH CARE USE

我们对精神病诊断和精神病学的了解， 学龄前和早期文法学龄儿童是非常有限的， 一般来说，具体来说，关于这种方式， 初级保健儿科环境中存在的问题。 我们目前正在 进行一项NIMH赞助的研究（将于1991年8月完成）， 儿科医生识别行为/情绪问题的能力， 学龄前儿童，2-5岁。 作为这项研究的一部分，一组513 学龄前儿童正在接受全面评估， 情绪和智力功能，以及一致的DSMIII-R诊断 被分配。 我们建议进行一项为期五年的纵向研究， 这组儿童（第一年通过目前的资助- （四）今后四年的经费筹措。 在513人中 符合纵向研究条件的儿童，约250名（40-45%） 将接受精神病诊断。 拟议 纵向研究，包括有和没有精神病诊断的儿童 将每年进行随访和重新评估。 的结果 这项研究将使我们能够检查：1）精神病诊断的稳定性 和行为/情绪问题的学龄前儿童， 从学前班到早期文法学校的做法; 2） 在有和没有艾滋病的儿童中， 精神病诊断，包括准确或不准确的诊断 在最初评估时由儿科医生诊断; 3） 社会人口学和家庭风险因素之间的关系，以及a） 学龄前儿童精神状态和精神病学的变化，以及B） 学龄前和小学学龄前儿童卫生保健利用 孩子 这项研究的一个重要的次级产品是 开发设计用于进行随机回归的软件 适当分析此类纵向数据所需的分析。

Our knowledge about psychiatric diagnoses and symptomatology among preschool and early grammar school-age children is very limited both generally and, specifically, with regard to the manner in which such problems present in primary care pediatric settings. We are currently conducting an NIMH-sponsored study (to be completed in 8/91) to examine the pediatrician's ability to identify behavioral/emotional problems among preschool children, ages 2-5 years. As part of this study, a group of 513 preschool children are being seen for a thorough evaluation of their emotional and intellectual functioning, and a consensus DSMIII-R diagnosis is assigned. We are proposing to conduct a five-year longitudinal study of this group of children (with the first year funded through the currently- funded grant and funding being sought for the next 4 years). Of the 513 children eligible for the longitudinal study, approximately 250 (40-45%) are expected to receive a psychiatric diagnosis. In the proposed longitudinal study, both children with and without a psychiatric diagnosis will be followed and seen annually for a reevaluation. The results of the study will allow us to examine: 1) the stability of psychiatric diagnoses and behavior/emotional problems of preschoolers followed in pediatric practices from preschool through early grammar school; 2) patterns of health care utilization prospectively, among children with and without a psychiatric diagnosis, including those either accurately or inaccurately diagnosed by their pediatricians at the time of the initial evaluation; 3) the relationship between sociodemographic and familial risk factors and a) changes in psychiatric status and symptomatology among preschoolers, and b) health care utilization among preschool-age and early grammar school-age children. An important, secondary product of the study will be the development of the software designed to conduct the random regression analyses necessary for appropriate analyses of such longitudinal data.