The aim of the present study was to examine the current strain and impairment of children with depressive and anxiety disorders in terms of their development and family environment compared to children without mental disorders. Conclusions for dealing with clinical disorders in preschool are to be derived. Internalizing symptoms/disorders were measured dimensionally with the Strengths and Difficulties Questionnaire (SDQ; multi-informant approach) and categorially with the Preschool Age Psychiatric Assessment (PAPA). The sample consisted of n = 93 children with pure anxiety disorders, n = 20 children with depressive and anxiety disorders, n = 42 children with subclinical symptoms of depression and anxiety disorders, and n = 76 children without mental disorders. We assessed stability of symptoms, as well as agreement between mothers, fathers and kindergarten teachers regarding internalizing symptoms which was higher between mothers and fathers than between parents and kindergarten teachers. In comparison to kindergarten teachers parents reported more internalizing symptoms. Regarding the overall impairment, family adversity, family environment and maternal psychopathology children with depression and additional anxiety disorders showed the highest scores. There were no differences in overall impairment between children with pure anxiety disorders and without mental disorders. Finally, implications for practice are discussed.