Psychiatric illness in a clinical sample of children with
prenatal alcohol exposure.
O'Connor MJ, Shah B, Whaley S, Cronin P, Gunderson B, Graham J.
Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine,
Los Angeles, California 90024, USA. moconnor@mednet.ucla.edu
The purpose of this study was to describe psychiatric disorders exhibited by
children with prenatal alcohol exposure. Twenty-three children between the ages
of 5 and 13 years who were referred to the UCLA Fetal Alcohol and Related
Disorders Clinic because of heavy exposure to alcohol in utero were evaluated.
Children with intelligence quotients of 70 and above and their families were
interviewed by the study child psychiatrist and psychologist and psychiatric
diagnoses were based upon DSM-IV diagnostic criteria. Inter-observer reliability
of diagnosis was established comparing clinical diagnoses with diagnoses made
using the "best-estimate" procedure. For the best estimate method, items from
the Child Behavior Checklist, the Fetal Alcohol Behavior Scale, the Child
Symptom Inventory-4, the Conners' Rating Scale, as well as information from
historical records were reviewed by two experienced clinicians who were blind to
the diagnostic and alcohol exposure status of the children. Approximately 87% of
the sample met criteria for a psychiatric disorder. The majority of the children
(61%) were assigned a mood disorder diagnosis. Twenty-six percent were diagnosed
with major depressive disorder or adjustment disorder with depressed mood and
35% met criteria for bipolar disorder. Psychiatric disorders are common in
children with prenatal alcohol exposure. In particular, these children seem to
be highly vulnerable to mood disorders. There is a need for training in how to
recognize the physical and behavioral phenotypes of children with prenatal
alcohol exposure so that appropriate treatment can be initiated early.
Am J Drug Alcohol Abuse. 2002 Nov;28(4):743-54