Department of Psychiatry (966), Nijmegen Centre for Evidence-Based Practice, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Eur Child Adolesc Psychiatry. 2013 Feb;22(2):103-15. doi: 10.1007/s00787-012-0332-3. Epub 2012 Oct 18.
Precursors of child psychiatric disorders are often present in infancy, but little is known about the prevalence and course of general psychopathology in population-based samples of children 0-3 years. We examined whether homogeneous behavioural and developmental profiles could be identified in children aged 14-15 months (M = 14.84; SD = 2.19), and we explored whether or not these profiles corresponded with existing classifications of DSM-IV-TR, ICD-10, and DC 0-3R. Parents of 6,330 children answered 74 items about externalizing, internalizing, and social-communicative behaviour. Exploratory factor analysis revealed nine factors: deviant communication, negative emotionality, deviant reactive behaviour, deviant play behaviour, demanding behaviour, social anxiety/inhibition, advanced social interaction problems, basic social interaction problems, and sleep problems. Latent class analysis yielded five profiles, of which three were associated with increased behavioural and developmental problems. Some infants (5.7 %) had communication and social interaction problems corresponding to multisystem developmental disorders (DC 0-3R) and suggestive of anxiety, mood, or pervasive developmental disorders (DSM-IV-TR, ICD-10). Other infants (16.4 %) had communication problems, possibly precursors of communication, language, or speech disorders (DSM-IV-TR, ICD-10). Yet other infants (10.8 %) showed negative and demanding behaviour suggestive of regulation disorders (DC 0-3R), attention-deficit and disruptive behaviour disorders (DSM-IV-TR), or hyperkinetic and conduct disorders (ICD-10). Thus, even in infancy certain distinct behavioural and developmental profiles can be recognized. This combined approach will enable follow-up research into the stability of factors, classes, and profiles over time, and will facilitate early detection, diagnosis, and treatment of behavioural and developmental problems.
儿童精神障碍的前兆通常在婴儿期就存在,但人们对基于人群的 0-3 岁儿童一般精神病理学的患病率和病程知之甚少。我们研究了在 14-15 个月大的儿童(M=14.84;SD=2.19)中是否可以识别出同质的行为和发育特征,我们还探讨了这些特征是否与 DSM-IV-TR、ICD-10 和 DC 0-3R 的现有分类相对应。6330 名儿童的父母回答了 74 个关于外在、内在和社交沟通行为的项目。探索性因素分析显示有九个因素:异常沟通、负性情绪、异常反应性行为、异常游戏行为、要求行为、社交焦虑/抑制、高级社交互动问题、基本社交互动问题和睡眠问题。潜在类别分析产生了五个特征,其中三个与行为和发育问题增加有关。一些婴儿(5.7%)存在沟通和社交互动问题,与多系统发育障碍(DC 0-3R)相对应,并提示存在焦虑、情绪或广泛发育障碍(DSM-IV-TR、ICD-10)。其他婴儿(16.4%)存在沟通问题,可能是沟通、语言或言语障碍(DSM-IV-TR、ICD-10)的前兆。还有其他婴儿(10.8%)表现出消极和要求行为,提示存在调节障碍(DC 0-3R)、注意力缺陷和破坏性行为障碍(DSM-IV-TR)或多动和品行障碍(ICD-10)。因此,即使在婴儿期,也可以识别出某些特定的行为和发育特征。这种综合方法将使后续研究能够跟踪因素、类别和特征随时间的稳定性,并有助于早期发现、诊断和治疗行为和发育问题。