Kessler RC, Avenevoli S, Costello EJ, Georgiades K, Green JG, Gruber MJ et al. Prevalence, persistence, and sociodemographic correlates of DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Supplement. Arch Gen Psychiatry 69: 372-380

Department of Health Care Policy, Harvard Medical School, Boston, MA 02115, USA.
Archives of general psychiatry (Impact Factor: 14.48). 12/2011; 69(4):372-80. DOI: 10.1001/archgenpsychiatry.2011.160
Source: PubMed


Community epidemiological data on the prevalence and correlates of adolescent mental disorders are needed for policy planning purposes. Only limited data of this sort are available.
To present estimates of 12-month and 30-day prevalence, persistence (12-month prevalence among lifetime cases and 30-day prevalence among 12-month cases), and sociodemographic correlates of commonly occurring DSM-IV disorders among adolescents in the National Comorbidity Survey Replication Adolescent Supplement.
The National Comorbidity Survey Replication Adolescent Supplement is a US national survey of DSM-IV anxiety, mood, behavior, and substance disorders among US adolescents based on face-to-face interviews in the homes of respondents with supplemental parent questionnaires.
Dual-frame household and school samples of US adolescents.
A total of 10,148 adolescents aged 13 to 17 years (interviews) and 1 parent of each adolescent (questionnaires).
The DSM-IV disorders assessed with the World Health Organization Composite International Diagnostic Interview and validated with blinded clinical interviews based on the Schedule for Affective Disorders and Schizophrenia for School-Age Children. Good concordance (area under the receiver operating characteristic curve ≥0.80) was found between Composite International Diagnostic Interview and Schedule for Affective Disorders and Schizophrenia for School-Age Children diagnoses.
The prevalence estimates of any DSM-IV disorder are 40.3% at 12 months (79.5% of lifetime cases) and 23.4% at 30 days (57.9% of 12-month cases). Anxiety disorders are the most common class of disorders, followed by behavior, mood, and substance disorders. Although relative disorder prevalence is quite stable over time, 30-day to 12-month prevalence ratios are higher for anxiety and behavior disorders than mood or substance disorders, suggesting that the former are more chronic than the latter. The 30-day to 12-month prevalence ratios are generally lower than the 12-month to lifetime ratios, suggesting that disorder persistence is due more to episode recurrence than to chronicity. Sociodemographic correlates are largely consistent with previous studies.
Among US adolescents, DSM-IV disorders are highly prevalent and persistent. Persistence is higher for adolescents than among adults and appears to be due more to recurrence than chronicity of child-adolescent onset disorders.

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    • "ORIGINAL ARTICLE Maughan et al. 2008; Merikangas et al. 2010; Moffitt et al. 2010; Kessler et al. 2012a, b). However, some important aspects remain unaddressed or need replication . "
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    ABSTRACT: Background. With psychopathology rising during adolescence and evidence suggesting that adult mental health burden is often due to disorders beginning in youth, it is important to investigate the epidemiology of adolescent mental disorders. Method. We analysed data gathered at ages 11 (baseline) and 19 years from the population-based Dutch TRacking Adolescents’ Individual Lives Survey (TRAILS) study. At baseline we administered the Achenbach measures (Child Behavior Checklist, Youth Self-Report) and at age 19 years the World Health Organization’s Composite International Diagnostic Interview version 3.0 (CIDI 3.0) to 1584 youths. Results. Lifetime, 12-month and 30-day prevalences of any CIDI-DSM-IV disorder were 45, 31 and 15%, respectively. Half were severe. Anxiety disorders were the most common but the least severe whereas mood and behaviour disorders were less prevalent but more severe. Disorders persisted, mostly by recurrence in mood disorders and chronicity in anxiety disorders. Median onset age varied substantially across disorders. Having one disorder increased subjects’ risk of developing another disorder. We found substantial homotypic and heterotypic continuity. Baseline problems predicted the development of diagnosable disorders in adolescence. Non-intact families and low maternal education predicted externalizing disorders. Most morbidity concentrated in 5–10% of the sample, experiencing 34–55% of all severe lifetime disorders. Conclusions. At late adolescence, 22% of youths have experienced a severe episode and 23% only mild episodes. This psychopathology is rather persistent, mostly due to recurrence, showing both monotypic and heterotypic continuity, with family context affecting particularly externalizing disorders. High problem levels at age 11 years are modest precursors of incident adolescent disorders. The burden of mental illness concentrates in 5–10% of the adolescent population.
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    • "Contrary to our expectations, neither binge drinking nor MJ use was independently related to depressed mood after accounting for abuse history, and behavior problem and anxiety symptoms. This finding adds to the literature as prior studies reporting a relationship between binge drinking or marijuana use and depression did not take into account these relevant factors (Needham 2007), yet the clinical reality is that these tend to co-occur (Kessler et al. 2012; Mangerud et al. 2014) especially among those with a trauma history (Hodgins et al. 2014). "
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    • "To this end, we estimated the reliability of the SDQ scores, examined the internal structure, and tested the measurement invariance by gender and age. Knowledge of the SDQ psychometric properties is relevant for use it as a screening tool in an age group at particular risk of developing emotional and behavioural symptoms and disorders (Carli et al., 2014; Erol et al., 2005; Kessler et al., 2012; Merikangas et al., 2010). The SDQ scores showed discrete reliability levels in Conduct and Peer problems subscales. "
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