LAUSR

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 453 children were assessed at age three and again at ages 12 and/or 15. At age three, 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 youth were interviewed with the Kiddie-Schedule of Affective Disorders and Schizophrenia (K-SADS) to assess youth psychopathology and functional impairment; youth also completed the UCLA Life Stress Interview (LSI) to assess different domains of functioning. Lastly, youth and parents completed the Child Depression Inventory (CDI) and the Screen for Anxiety Related Disorders (SCARED). RESULTS Irritability at age three predicted internalizing and externalizing disorders in adolescence, parent-reported anxiety and depressive symptoms, and greater functional impairment, including poorer peer functioning and 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 Findings underscore the clinical significance and predictive power of preschool irritability and provide support for its use in large-scale identification and intervention efforts.