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Early detection and prevention of psychiatric disorders among preschoolers in the community: Mechanisms of change and long term follow up

Tildelt: kr 5,5 mill.





2008 - 2011

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Young children have psychiatric disorders to a comparable extent with that of any other age group, and they endure. If undetected, problems may escalate and become more resistant to change. However, far fewer young children with psychiatric disorders rece ive treatment than do school age children, adolescents, and adults - most likely because they go undetected. These facts provide a strong rationale for community-wide screening programs in combination with effective early intervention. Existing screens p roduce high rates of false positives when used at the community level, which is unfortunate if prevention is to be based on screen results. Our aim is therefore to develop a screen with higher predictive power. Existing evidence based prevention programs for young children commonly target a specific set of disorders, most often behaviour problems. Most communities do not have the resources to keep a series of programs targeting a variety of problems. Generic prevention programs strengthening the parent-ch ild relationship would therefore be the prevention program of choice, if proven effective. All children meeting at the health checkup for 4-year olds in the city of Trondheim during 2007 and 2008 will be screened with the SDQ (N=4,000). At present the co nsent rate is XX%. 1000 families will be invited to participate in a more intensive study. Children high on SDQ are oversampled. One of the parents completes a structured diagnostic interview (ePAPA). The parent and the child meet on a later occasion fo r observation and testing, which include parent-child interaction; children?s attachment representations, children?s reporting on their interaction with peers, teachers, and parents, language skills, emotional competence; parents report on the child?s tem perament, social skills, and the parent?s own symptoms. Reports are taken from day care personnel/teachers, health nurses, medical records and from official registers. Retesting take place after 2 and 4 years.