PRESCHOOLER'S BEHAVIOR PROBLEMS AND HEALTH CARE USE

我们对精神病学诊断和症状学的了解 学龄前儿童和早期文法学龄儿童都非常有限 一般而言，具体地说，关于这种 初级保健儿科环境中存在的问题。我们目前正在 进行一项由NIMH赞助的研究(将于1991年8月完成)，以研究 儿科医生在以下人群中识别行为/情绪问题的能力 学龄前儿童，年龄2-5岁。作为这项研究的一部分，一组513人 学龄前儿童正在接受彻底的评估 情绪和智力功能，以及普遍的DSMIII-R诊断 是分配的。我们建议进行一项为期五年的纵向研究 这群孩子(第一年的资金来自目前- 已资助的赠款和未来4年正在寻求的资金)。在513人中 符合纵向研究条件的儿童，约250人(40%-45%) 预计会被诊断为精神疾病。在建议的 纵向研究，既有精神疾病诊断的儿童，也有无精神疾病诊断的儿童 将每年跟踪和查看以进行重新评估。评选结果 研究将使我们能够检查：1)精神病诊断的稳定性 学龄前儿童的行为/情绪问题 从学龄前到早期文法学校的练习；2)模式 在患有和不患有老年痴呆症的儿童中前瞻性地利用卫生保健 精神病学诊断，包括准确或不准确的诊断 在最初评估时由其儿科医生诊断；3) 社会人口学和家庭危险因素与a)的关系 学龄前儿童精神状态和症状的变化，以及b) 学龄前儿童和早期文法学龄儿童的卫生保健利用情况 孩子们。这项研究的一个重要的次要产品将是 随机回归软件的开发 对此类纵向数据进行适当分析所需的分析。

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.