Prevalence of child and adolescent psychiatric disorders in Santiago, Chile: A community epidemiological study

Department of Psychiatry and Mental Health, University of Concepción, Casilla 160-C, Concepción, Chile.
Social Psychiatry (Impact Factor: 2.54). 07/2012; 47(7):1099-1109. DOI: 10.1007/s00127-011-0415-3
Source: PubMed


To determine the prevalence of DSM-IV psychiatric disorders in a representative sample of children and adolescents living in Santiago, Chile, as part of a national sample.
Subjects aged 4-18 were selected using a stratified multistage design. First, ten municipalities/comunas of Santiago were selected; then the blocks, homes, and child or adolescent to be interviewed were chosen. Psychology graduate students administered the Spanish-language, computer-assisted version of DISC-IV that estimated DSM-IV 12-month prevalence.
A total of 792 children and adolescents were evaluated, with a participation rate of 76.7%. The most stringent impairment DSM-IV DISC algorithm for psychiatric disorders revealed a prevalence of 25.4% (20.7% for boys and 30.3% for girls). The majority of the diagnoses corresponded to anxiety and affective disorders. Prevalence was higher in children aged 4-11 (31.9%) than in adolescents aged 12-18 (18.2%). This difference was mainly accounted for by disruptive disorders in the younger age group. Anxiety disorders had the highest prevalence, although impairment was low. In contrast, most children and adolescents with affective disorders were impaired.
In Santiago, the prevalence of psychiatric disorders in children and adolescents was high. This study helps raise awareness of child and adolescent mental health issues in Spanish-speaking Latin America and serves as a basis for improving mental health services.

Download full-text


Available from: Sandra Saldivia
  • [Show abstract] [Hide abstract]
    ABSTRACT: The World Health Organization (WHO) estimates place Chile among the countries with the highest burden of disease from neuropsychiatric illnesses (23.2 percent) in the world. Major depression and alcohol use disorders rank first and second in attributed disability among adults. Nearly one-third of the population over 15 years of age has had a psychiatric disorder in their lifetime and 22.2 percent have had one in the past year. Anxiety disorders are the most prevalent, followed by major depression and alcohol use disorders. Only 38.5 percent of those with a diagnosis receive any kind of mental health service, whether from a specialist or primary care physician. In children and adolescents, the prevalence of any psychiatric disorder is 22.5 percent (19.3 percent for boys and 25.8 percent for girls). These are mainly anxiety and disruptive disorders. Their prevalence is higher among 4 to 11 year olds (27.8 percent) than 12 to 18 year olds (16.5 percent). This difference is mainly a result of disruptive disorders. The prevalence of anxiety disorders is the second highest cause but is less associated with impairment, whereas most children and adolescents with affective disorders are impaired. Only around one-fifth of the subjects in need of services seek some form of assistance. Nearly one-quarter of those using services do not present a psychiatric diagnosis in the past year. Comorbidity occurs in 27 percent of those with a disorder, but only 7 percent have three or more diagnoses. Not addressing the treatment gap in mental health has serious public health implications.
    No preview · Article · Apr 2012 · International Journal of Mental Health
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Mental health and addiction care have traditionally been conceived as specialized services. This long-standing perception has been changing globally as recognition grows that sound mental health, which includes being free from substance abuse and concurrent disorders, is a fundamental component of people's overall health and well-being. A more central role for primary health care has also emerged in large part because it provides an opportunity to improve people's mental health by offering comprehensive care from health promotion to early recognition, diagnosis, treatment, and rehabilitation. Integrating mental health into primary health care has many advantages for improving care and reaching better outcomes, such as reduction of stigma and discrimination, better access to integrated and continuing care, and improvement of social integration.Chile has been a country at the forefront of the process of integrating mental health into primary health care. Reciprocal collaboration and knowledge exchange have been critical to its change process. Canada's Centre for Addiction and Mental Health (CAMH) has been collaborating with Chile since 2003 to build capacity in primary health care from a system's approach. This article reviews the process and results of the collaboration between CAMH, through its Office of International Health, and different institutions in Chile aimed at strengthening mental health and addiction services in primary health care. Some key lessons learned and implications for the future are identified and discussed.
    Full-text · Article · Apr 2012 · International Journal of Mental Health
  • Source

    Preview · Article · Nov 2012 · Revista medica de Chile
Show more