Objective

The long-term clinical and functional outcomes of preschool-age irritability are unknown. This study examined longitudinal associations of preschool irritability with psychiatric disorders and functional impairment assessed in adolescence in a large community sample.

Method

A total of 453 children were assessed at age 3 and again at ages 12 and/or 15. At age 3, parents were interviewed about their child’s irritability, other psychiatric symptoms, and functional impairment with the Preschool Age Psychiatric Assessment (PAPA). In adolescence, both parents and youths were interviewed with the Schedule for Affective Disorders and Schizophrenia for School-Age Children–Present and Lifetime (K-SADS-PL) to assess youth psychopathology and functional impairment; youths also completed the UCLA Life Stress Interview (LSI) to assess different domains of functioning. Lastly, youths and parents completed the Children’s Depression Inventory 2 (CDI 2) and the Screen for Child Anxiety Related Disorders (SCARED).

Results

Irritability at age 3 predicted internalizing and externalizing disorders in adolescence; parent-reported anxiety and depressive symptoms; and greater functional impairment, including poorer peer functioning, poorer physical health, and antidepressant and educational service use, even after controlling for baseline psychiatric disorders. All longitudinal associations persisted after further adjusting for well-established early life risk markers for psychopathology.

Conclusion

The findings of this study underscore the clinical significance and predictive power of preschool irritability and provide support for its use in large-scale identification and intervention efforts.

中文翻译：

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学龄前易怒预测青少年精神病理学和功能障碍：一项为期 12 年的前瞻性研究

客观的

学龄前易激惹的长期临床和功能结果尚不清楚。这项研究调查了学龄前易怒与精神障碍和功能障碍在大型社区样本中评估的纵向关联。

方法

共有 453 名儿童在 3 岁时接受了评估，并在 12 岁和/或 15 岁时再次接受了评估。在 3 岁时，父母接受了关于他们孩子的易怒、其他精神症状和学龄前精神评估 (PAPA) 功能障碍的访谈。在青春期，父母和青少年都接受了学龄儿童情感障碍和精神分裂症时间表（K-SADS-PL）的采访，以评估青少年精神病理学和功能障碍；年轻人还完成了加州大学洛杉矶分校生活压力访谈 (LSI)，以评估不同的功能领域。最后，青少年和家长完成了儿童抑郁量表 2 (CDI 2) 和儿童焦虑相关障碍筛查 (SCARED)。

结果

3 岁时的易怒预示着青春期的内化和外化障碍；父母报告的焦虑和抑郁症状；和更大的功能障碍，包括较差的同伴功能、较差的身体健康、抗抑郁药和教育服务的使用，即使在控制了基线精神障碍之后也是如此。在进一步调整心理病理学公认的早年生活风险标记后，所有纵向关联仍然存在。

结论

这项研究的结果强调了学龄前易怒的临床意义和预测能力，并为其在大规模识别和干预工作中的应用提供了支持。