Psychotropic prescriptions in a sample including both healthy and mood and disruptive disordered preschoolers: relationships to diagnosis, impairment, prescriber type, and assessment methods.

OBJECTIVE Epidemiological data has shown that psychotropic medications are being prescribed to preschoolers at increasing rates. The diagnostic context and functional impairment of these preschoolers remains unknown. This investigation aimed to address these questions in a sample of preschoolers who were either without symptoms (healthy) or with mood and disruptive disorders by assessing them using a structured diagnostic interview and measure of impairment. METHOD Preschoolers aged 3.0 to 5.11 without symptoms and those with symptoms of mood and disruptive disorders were recruited from primary care and daycare sites in the St. Louis area to participate in a psychiatric evaluation that included information about psychotropic prescriptions from community practitioners. RESULTS Seven percent of preschoolers (n = 19) out of a total sample of n = 267 were prescribed psychotropic medications. Fifty-two percent of preschoolers in the total sample met criteria for an Axis I psychiatric disorder. Presence of an Axis I disorder was significantly related to psychotropic prescription (p < 0.01). Among preschoolers who met criteria for an Axis I disorder 12% received psychotropics (Dx/Rx group). The Dx/Rx group was more impaired than those with a diagnosis who were not prescribed psychotropics (p < 0.001). Among preschoolers taking psychotropic medications, two failed to meet criteria for any Axis I disorder. CONCLUSION In this sample, most psychotropic medications were prescribed for impaired preschoolers with an Axis I diagnosis. These findings shed some light on the prescribing trends among mood and disruptive disordered preschoolers.