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

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 Ceausescu. No epidemiologic studies
have examined prevalence of psychiatric disorders in young children in Romania. The objective of this study was to determine
the prevalence of psychiatric disorders in Romanian children 18–60 months in pediatric settings. Parents of 1,003 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. Rates of mental health problems were similar to the US 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. Comorbidity 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. 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.