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Psychiatric Symptoms

Prevalence, Co-occurrence, and Functioning Among Extremely Low Gestational Age Newborns at Age 10 Years

Dvir, Yael MD*; Frazier, Jean A. MD*; Joseph, Robert M. PhD; Mokrova, Irina PhD; Moore, Phoebe S. PhD*; O'Shea, T. Michael MD, MPH; Hooper, Stephen R. MD; Santos, Hudson P. Jr PhD, RN; Kuban, Karl MD, SM Epi for the ELGAN Study Investigators

Journal of Developmental & Behavioral Pediatrics: December 2019 - Volume 40 - Issue 9 - p 725–734
doi: 10.1097/DBP.0000000000000744
ORIGINAL ARTICLE
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Objective: To evaluate the percentage of children born extremely preterm (EP) who screen positive for ≥1 DSM-IV psychiatric disorders, the co-occurrence of and sex-related differences in these classifications, and the functional correlates of psychiatric symptoms.

Methods: The Extremely Low Gestational Age Newborn (ELGAN) Study is a prospective cohort follow-up of children born <28 weeks' gestation. For 871 10-year-old children, parents completed the Child Symptom Inventory-4 (CSI-4), a child educational/medical history questionnaire, and the Pediatric Quality of Life Inventory (PedsQL).

Results: At age 10 years, ELGANs were more likely to screen positive for a number of psychiatric disorders when compared with normative expectations on the CSI-4, with a few sex-related differences. Fifteen percent of participants screened positive for 1 disorder, 7% for 2, 3% for 3, and 4% for ≥4 psychiatric disorders. Compared with children who did not screen positive for psychiatric disorders, children who screened positive for ≥3 psychiatric disorders were approximately twice as likely to have repeated a grade, have an individualized educational program, have an individual school aide, and to require special remediation classes. Children who screened positive for any psychiatric disorder were 4 times more likely to use 1 or more psychotropic medication, and those who screened positive for ≥2 psychiatric disorders had lower PedsQL scores.

Conclusion: Among 10-year-old children born EP, rates of psychiatric symptoms exceeded normative expectation, and children who screened positive for more than 1 psychiatric disorder were at increased risk of having multiple functional impairments.

This article has supplementary material on the web site: www.jdbp.org.

*University of Massachusetts Medical School, Worcester, MA;

Boston University School of Medicine, Boston, MA;

University of North Carolina at Chapel Hill, Chapel Hill, NC.

Address for reprints: Jean A. Frazier, MD, University of Massachusetts Medical School, 55 Lake Avenue, North, Worcester, MA 01655; e-mail: jean.frazier@umassmed.edu.

This study was supported by The National Institute of Neurological Disorders and Stroke (5U01NS040069-05; 2R01NS040069-06A2), and the National Institute of Child Health and Human Development (5R01HD092374-02 and 5P30HD018655-34), and the Office of the National Institutes of Health Director (1UG3OD023348-01).

Disclosure: J. A. Frazier has the following disclosures: receiving research support from Takeda Pharmaceuticals, Fulcrum Therapeutics, Janssen Research and Development, and Roche. No funds from these entities supported this project, and none of these entities reviewed/commented on this study. The remaining authors declare no conflict of interest.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.jdbp.org).

Received April , 2019

Accepted August , 2019

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