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PSYCHIATRIKI 21 (4), 2010 CHILDREN WITH PERVASIVE DEVELOPMENTAL DISORDERS 301In our study we focused on stress-inducing eventsor adverse family functioning as a possible compoundingfactor in these disorders. However, ourresults showed a remarkable lack of stressful factorsin our sample’s children and their families. Mostof the families live harmoniously together, with noblatant socio-economic problems and no other reportedstress-inducing factors. Although there are arelatively large number of immigrant families in oursample, this seems to reflect the evolutions in greeksociety.Our fifth hypothesis concerned our Service itselfand its contribution to this increase in frequency,for instance, whether there are new members inthe professional team, more specialized diagnostictools or indeed any differences in the diagnosticprocedure. 23 However, yet again the results ofour study did not confirm this: the clinicians arethe same people they were 10 years ago, althoughinevitably more experienced. No new diagnostictools are being used. The diagnostic procedure hasnot changed and is strictly multidisciplinary. Eventhe mean number of diagnostic sessions has remainedstable over the years (4.3 sessions) despitethe increased demand. In fact, our study highlightsthe fact that even though our clinical team hasbeen working in the community for over twentyyears and the number of patients is on a constantincrease, service delivery has not changed duringthese years. In a study examining service deliveryfor these disorders in the USA, it was observed thatthere was a 40% decrease in mean service days forthese disorders over the past few years. 24Most of the patients (70%) were examined by achild psychiatrist, psychologist and speech therapistonly. More than 20% of the total sample was offeredtherapy intervention at our Service. These were usuallycases who presented other coexistent factors,such as inadequate parental care, stressful life eventsor other compounding medical factors, which neededfurther investigation.In conclusion, this study offers some preliminarydata on the observed rise in frequency of patientswith pervasive developmental disorders applying toour community-based service. Although the numberof cases in our study is relatively small, it is representativeof the frequency in our catchments area, whichconsists of approximately 600,000 inhabitants in theinner Athens urban area.Our data does not indicate any reasons for thisincrease, however the only plausible explanation,which may only be described as a tendency, is thatof increased public awareness. On the other hand,our study shows that, despite the increase in patientintake without the complementary increase in staffat our Service, services are still delivered accordingto our original multidisciplinary model of conductand according to individual patient needs. Neithermore sensitive diagnostic tools, nor more inclusivediagnostic criteria seemed to play a part in this increaseddiagnosis.LimitationsOur study reports data from a specific communitymental health service and therefore a considerablelimitation is that our sample consists of few cases.More research is necessary to generalize these findingswith larger samples and in other areas and inother services throughout Greece. Epidemiologicalstudies are necessary tools for service providers, butlongitudinal research is also necessary since it allowsthe evaluation of service delivery and provisionwith respect to individual patient needs, somethingwhich is urgently needed by the clinician in the firstline.