10-Year Research Update Review: The Epidemiology of Child and Adolescent Psychiatric Disorders: I. Methods and Public Health Burden

Center for Developmental Epidemiology, Duke University Medical School, Durham, NC, USA.
Journal of the American Academy of Child & Adolescent Psychiatry (Impact Factor: 7.26). 11/2005; 44(10):972-86. DOI: 10.1097/01.chi.0000172552.41596.6f
Source: PubMed


To review recent progress in child and adolescent psychiatric epidemiology in the area of prevalence and burden.
The literature published in the past decade was reviewed under two headings: methods and findings.
Methods for assessing the prevalence and community burden of child and adolescent psychiatric disorders have improved dramatically in the past decade. There are now available a broad range of interviews that generate DSM and ICD diagnoses with good reliability and validity. Clinicians and researchers can choose among interview styles (respondent based, interviewer based, best estimate) and methods of data collection (paper and pencil, computer assisted, interviewer or self-completion) that best meet their needs. Work is also in progress to develop brief screens to identify children in need of more detailed assessment, for use by teachers, pediatricians, and other professionals. The median prevalence estimate of functionally impairing child and adolescent psychiatric disorders is 12%, although the range of estimates is wide. Disorders that often appear first in childhood or adolescence are among those ranked highest in the World Health Organization's estimates of the global burden of disease.
There is mounting evidence that many, if not most, lifetime psychiatric disorders will first appear in childhood or adolescence. Methods are now available to monitor youths and to make early intervention feasible.

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Available from: Helen Egger, Aug 12, 2014
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    • "On the other hand, a number of children do not met symptomatic criteria, but have functional impairment that justifies access to services (Angold, Costello, Farmer, Burns, & Erkanli, 1999). The presence of both symptomatic and impairment criteria is the most robust approach for case definition (Costello et al., 2005). Different definitions of functional impairment may be adopted, such as measures of impairment specifically related to the disorder or global measures of impairment (such as the Child Global Assessment Scale, CGAS). "
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    ABSTRACT: Background The literature on the prevalence of mental disorders affecting children and adolescents has expanded significantly over the last three decades around the world. Despite the field having matured significantly, there has been no meta-analysis to calculate a worldwide-pooled prevalence and to empirically assess the sources of heterogeneity of estimates.Methods We conducted a systematic review of the literature searching in PubMed, PsycINFO, and EMBASE for prevalence studies of mental disorders investigating probabilistic community samples of children and adolescents with standardized assessments methods that derive diagnoses according to the DSM or ICD. Meta-analytical techniques were used to estimate the prevalence rates of any mental disorder and individual diagnostic groups. A meta-regression analysis was performed to estimate the effect of population and sample characteristics, study methods, assessment procedures, and case definition in determining the heterogeneity of estimates.ResultsWe included 41 studies conducted in 27 countries from every world region. The worldwide-pooled prevalence of mental disorders was 13.4% (CI 95% 11.3–15.9). The worldwide prevalence of any anxiety disorder was 6.5% (CI 95% 4.7–9.1), any depressive disorder was 2.6% (CI 95% 1.7–3.9), attention-deficit hyperactivity disorder was 3.4% (CI 95% 2.6–4.5), and any disruptive disorder was 5.7% (CI 95% 4.0–8.1). Significant heterogeneity was detected for all pooled estimates. The multivariate metaregression analyses indicated that sample representativeness, sample frame, and diagnostic interview were significant moderators of prevalence estimates. Estimates did not vary as a function of geographic location of studies and year of data collection. The multivariate model explained 88.89% of prevalence heterogeneity, but residual heterogeneity was still significant. Additional meta-analysis detected significant pooled difference in prevalence rates according to requirement of funcional impairment for the diagnosis of mental disorders.Conclusions Our findings suggest that mental disorders affect a significant number of children and adolescents worldwide. The pooled prevalence estimates and the identification of sources of heterogeneity have important implications to service, training, and research planning around the world.
    Journal of Child Psychology and Psychiatry 02/2015; 56(3). DOI:10.1111/jcpp.12381 · 6.46 Impact Factor
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    • "Given the evidence that depressive episodes first appear in adolescence (Costello et al., 2005) and that early age at onset predicts longer duration (Kovacs et al., 1984), adolescence and young adulthood is a critical period for identification, prevention, and intervention. While there is strong evidence supporting the increase in risk of depression during the transition from childhood to adolescence (Costello et al., 2005, 2002), epidemiological studies examining symptoms of depression during the transition to young adulthood have produced more heterogeneous findings with respect to trajectories of change over time. Early research suggested that rates of clinical depression were low from early to middle adolescence , then increased dramatically in late adolescence, and remained high into young adulthood (Hankin et al., 1998). "
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    ABSTRACT: Little is known about the natural course of depressive symptoms among youth with chronic illness during their transition from adolescence to young adulthood. A representative epidemiological sample of 2825 youth aged 10-11 years from the National Longitudinal Survey of Children and Youth were followed until 24-25 years of age. Presence of chronic illness was measured using self-report and symptoms of depression were assessed using the Center for Epidemiological Studies Depression Scale. Multilevel modeling was used to investigate trajectories of depressive symptoms, adjusting for family environment and sociodemographic characteristics during the transition to young adulthood. Trajectories showed cubic change over time - increasing from early to mid-adolescence, decreasing to early young adulthood, increasing again to late young adulthood. Youth with chronic illness (n=753) had significantly less favorable trajectories and significantly higher proportions of clinically relevant depressive symptoms over time compared to their peers without chronic illness (n=2072). This study is limited by selective attrition, self-reported chronic illness and no assessment of illness severity, and mediating effects of family environment factors could not be examined. Findings support the diathesis-stress model; chronic illness negatively influenced depressive symptoms trajectories, such that youth with chronic illness had higher depression scores and less favorable trajectories over time. The health and school system are uniquely positioned to support youth with chronic illness navigate this developmental period in an effort to prevent declines in mental health. Copyright © 2014 Elsevier B.V. All rights reserved.
    Journal of Affective Disorders 12/2014; 174C:594-601. DOI:10.1016/j.jad.2014.12.014 · 3.38 Impact Factor
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    • "Current research indicates a clear need to improve the psychological well-being and mental health among young and school-aged children, and to strengthen early support provided by services (Currie et al. 2012; OECD 2013). International reports implicate that at least one in ten children have obvious symptoms of mental health problems (Costello et al. 2005; Ford et al. 2003), and that even as young children as aged 2–3 years show early signs of mental ill-health (Skovgaard et al. 2007; Sourander 2001). Since rates of adult mental health problems also seem to be high (Kessler et al. 2005a, b), with the first onset often reported to appear during childhood or adolescence (Kessler et al. 2005a), the society and commonwealth need to find new ways to improve general well-being. "
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    ABSTRACT: The aim of the present pilot study was to provide an initial evaluation of a brief, 4-session, universal health promoting parenting group program, the “ABC”. We examined the effects of the program on improving parental strategies, parental self-efficacy, and child well-being. We also hypothesized that in a health promoting intervention implemented in the general population, increased parental self-efficacy and parental strategies would be associated with improvements in child well-being after 4 months. Parents living in 11 municipalities and local community agencies in Sweden enrolled in the project were invited to participate in the study. A repeated measurement within group design was used to assess the effects. In total, parents of 104 children aged 2-12 years participated in the ABC-study. Parental and child outcomes were evaluated before, after the intervention, and at a 4-month follow-up with parental self-report questionnaires. Paired t tests and ANOVA repeated measures showed statistically significant improvements of parental strategies (showing guidance, empathy/understanding, having rules/boundaries), parental self-efficacy (self-competence, knowledge/experience), and child well-being (emotional well-being, independence) from pre- to post measurement, with small to moderate effect sizes. Improvements were maintained at the 4-month follow-up, apart from changes in parental knowledge. University education and increased pre- to post improvements in self-efficacy predicted child emotional well-being at the 4-month follow-up. The findings suggest that the ABC-group intervention was effective in terms of improving child well-being, parental strategies and self-efficacy. This pilot study provides promising evidence for the ABC as a universal parenting program but further more rigorous evaluations are needed.
    Journal of Child and Family Studies 07/2014; 24(7):1-15. DOI:10.1007/s10826-014-9992-6 · 1.42 Impact Factor
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