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

UMMS Affiliation

Department of Psychiatry; Eunice Kennedy Shriver Center

Publication Date


Document Type



Mental and Social Health | Pediatrics | Psychiatry | Psychiatry and Psychology


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.


Preterm, School-Age, Psychiatric Disorders, Comorbidity, Impairment

DOI of Published Version



Dvir Y, Frazier JA, Joseph RM, Mokrova I, Moore PS, OʼShea TM, Hooper SR, Santos HP Jr, Kuban K; ELGAN Study Investigators. Psychiatric Symptoms: Prevalence, Co-occurrence, and Functioning Among Extremely Low Gestational Age Newborns at Age 10 Years. J Dev Behav Pediatr. 2019 Dec;40(9):725-734. doi: 10.1097/DBP.0000000000000744. PMID: 31764608; PMCID: PMC6884073. Link to article on publisher's site

Journal/Book/Conference Title

Journal of developmental and behavioral pediatrics : JDBP

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Link to Article in PubMed

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