Executive Functions, Psychiatric Symptoms and ADHD in Child Psychiatric Patients-Concurrent and Longitudinal Associations from Preschool to School Age.

We investigated in a child psychiatric sample whether preschool age executive functions (EFs) associate with concurrent and school age psychiatric symptoms and ADHD diagnosis. At baseline the children (n = 172) were 4-7 years old, at follow-up (n = 65) 8-13 years. EFs were measured at baseline with Attention and Executive Function Rating Inventory-Preschool Version, psychiatric symptoms were measured at both timepoints by Child Behavior Checklist. Information on diagnoses was collected from medical records. Deficits in EFs were associated with more concurrent externalizing and attention symptoms, but less internalizing symptoms. Preschool EFs predicted only school age attention symptoms. Preschool EFs were associated with both concurrent and school age ADHD diagnosis. Our results emphasize the importance of recognizing EF deficits early to arrange appropriate support to reduce later problems. More research is needed to understand the role of EFs over time in the manifestation of psychiatric symptoms in child psychiatric patients.

Sleep and psychiatric symptoms in young child psychiatric outpatients - a Follow-up study.

BACKGROUND: Knowledge of the continuity of sleep problems and the associations between sleep and psychiatric symptoms in child psychiatric patients is scarce. OBJECTIVES: To investigate the persistency of sleep problems and how sleep at preschool age predicts sleep problems and psychiatric symptoms at school age in child psychiatric patients. METHODS: Participants (n = 68) were child psychiatry outpatients at Helsinki University Hospital in 2015-2017. Caregivers evaluated sleep with the Sleep Disturbance Scale for Children (SDSC) and psychiatric symptoms with the Child Behavior Checklist (CBCL) at baseline (age 4-7 years) and again at follow-up (age 8-13 years). Family background information was collected at both time points. RESULTS: Sleep problems at preschool age predicted sleep problems at school age (R2Adjusted = .48, p < .001). Persistent sleep problems associated strongly with the intensity of psychiatric symptoms (p = .001). Internalizing symptoms were predicted by sleep problems (p = .038) even after controlling for age, sex, and psychiatric symptoms at preschool age. CONCLUSION: Sleep problems are prevalent and persistent and relate to psychiatric symptoms in children treated at child psychiatry clinics. These results emphasize the need for identification and treatment of sleep problems in these children.