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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    • "Mental health problems have increased among Swedish adolescents since the 1980s according to assessments using both self-rated and objective measurements [1] [2]. Moreover, mental health problems have become one of the greatest causes of disability, illness, and disease in the adult population, and this type of ill health can often be traced back to early life circumstances [3] [4]. This is not surprising, as early life experiences create a lifelong foundation for learning and behavior [4]. "
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    ABSTRACT: Background: Screening instruments are often used for detecting mental health problems in children and adolescents. The Strengths and Difficulties Questionnaire (SDQ) is one instrument for screening children's mental health. The SDQ can be used for assessment by different informants, i.e. parents, teachers and by 11-16 year olds for self-reporting. Aims: The aim was to compare the precision and validity of parental and teacher SDQ assessments in elementary school children, and to analyze whether assessments were affected by the child's sex and by socio-demographic factors. Methods: A total of 512 primary school students were included in a cross-sectional study. Exploratory factor analysis, sensitivity/specificity analysis, Cronbach's alphas, and logistic regression were applied. Results: Parents rated 10.9% and teachers 8.8% of the children as high-risk individuals, but the overlap was low (32.1%). Cronbach's alphas were 0.73 and 0.71 for parents and teachers, respectively. However, factor analysis showed that the five-factor solution could be confirmed only for teacher ratings. Moreover, only the parents' ratings were affected by maternal educational level and parental country of birth when rating the same children as the teachers. Conclusions: Construct validity was only confirmed for teacher assessments. However, parental assessments might capture a dimension of a child's mental health that seems to be sensitive to socioeconomic factors, which could be important when addressing equity issues, and for the dialogue between parents and school.
    Scandinavian Journal of Public Health 10/2015; DOI:10.1177/1403494815610929 · 1.83 Impact Factor
    • "Third, empirical studies have shown that the prevalence of mental health problems in two to five year-olds (Egger et al., 2006) and school-age children is high (Ford, Goodman & Meltzer, 2003), which suggests that it is important to be aware of problems prior to those ages to offer early intervention. Finally, a number of studies have emphasized the complexity of identifiable psychopathology in infancy (Burnham, Goodlin-Jones, Gaylor & Anders, 2002; Chatoor, 2002) but prevalence rates have been similar to those for older children, ranging from 6% -12% (Briggs-Gowan, Carter, Moye Skuban & McCue Horwitz, 2001; Costello et al., 2005; Lavigne et al., 1996). "
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    ABSTRACT: Background Emotional and behavioural problems emerging in very young children can represent a challenge to the child and family and warrant early identification and appropriate support or intervention. Diagnostic systems are being developed that allow for specific difficulties to be identified and this review summarizes them.ScopeThis evidenced based review describes the psychometric properties and potential for use in clinical practice of a range of instruments and methods that are available to identify infant mental health difficulties, and which may be suitable for use in primary care settings, including observations, questionnaires and checklists.FindingsWhile debate continues about whether infant mental health problems can or should be identified, the use of standardized tools may help clinicians to compare observations of infants so that those emerging as atypical can receive additional attention, reflecting a more targeted approach to primary care services (DH 2009; DH 2010.
    Child and Adolescent Mental Health 04/2015; DOI:10.1111/camh.12105 · 1.44 Impact Factor
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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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