A 3-Year Panel Study of Mental Disorders Among Adolescents in Taiwan

Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan.
American Journal of Psychiatry (Impact Factor: 12.3). 08/2005; 162(7):1344-50. DOI: 10.1176/appi.ajp.162.7.1344
Source: PubMed


This study investigated the prevalence and changing trends of mental disorders and the effects of gender and urbanization among adolescents in Taiwan.
A random sample of seventh-grade students (N=1,070) was recruited from one urban and one rural junior high school in which 1,051 (98.2%) and 1,035 (96.7%) were reassessed in the second and third years, respectively. A two-stage case identification was conducted by mental health professionals with the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Epidemiologic Version, supplemented by information from the Child Behavior Checklist.
The weighted 3-month prevalence rates across the 3 consecutive years for overall psychiatric disorders were 20.3%, 22.7%, and 14.8%, respectively. The most prevalent psychiatric condition was attention deficit hyperactivity disorder (ADHD) in the first 2 years and substance use disorders in the third. During the 3 years, the rates for ADHD, specific phobia, and social phobia decreased, and the rates for major depression and substance use disorders, conversely, increased. Although conduct disorder, ADHD, and substance use disorders were more prevalent among boys, the rates for major depression, social phobia, specific phobia, and adjustment disorder were higher among girls. Rural adolescents had higher rates of conduct disorder, oppositional defiant disorder, and substance use disorders than their urban counterparts.
Our findings are similar to those of previous studies among adolescents in prevalence rates, changing trends of most mental disorders, and gender effects. The differential changing trends in various diagnostic groups may imply the importance of specific measures for prevention during adolescence.

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    • "Many studies have shown the differences in depression prevalence rates among different age groups. For example, adolescents have a higher rate than the preadolescents (Fleitlich-Bilyk and Goodman, 2004; Gau et al., 2005). Consistent with previous studies, the present report shows differences in the prevalence rates among age groups; in addition, it also shows a U-shaped age-specific prevalence curve: 10–12 years age group has the lowest rate, and the younger (middle childhood: 7–9 years group) or older (adolescent: 13–15 years group, 16–17 years group) age groups have a higher rate. "
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    ABSTRACT: To assess the prevalence rate of depressive symptoms in left-behind participants aged 7-17 years and to explore the associated socio-demographic and communication factors. Participants were 4857 left-behind children and adolescents in Chongqing. They were screened for depressive symptoms using a 27-item Children׳s Depression Inventory (CDI) and social-demographic variables were evaluated with a structured scale. Uncorrected Pearson chi-square test and logistic regression were applied to analyzing the data. The total prevalence rate of depressive symptoms was 24.8%. Significant difference was found in the prevalence rate of depressive symptoms among groups of different income, grade, age, left-behind subtypes, and different frequency, ways and topics of parent-child communication. We found that the risk factors for depression were absence of parents, low frequency of parent-child communication, and communication by letter or about sensitive topics. The grade group 2-3 and age group 16-17 were at a higher risk of depression than all other grade and age subgroups. The protective factors for depression were high-income, high frequency of parent-child communication, communication by telephone or about such topic as learning experience, school life, and feelings. Self-report bias and cross-sectional nature of the sampling are major limitations of this study. The prevalence rate of depressive symptoms among left-behind children and adolescents in Chongqing is much higher than previously reported prevalence in other regions of China. The risk and protective factors for depression among left-behind children and adolescents are worthy of public attention. Copyright © 2015. Published by Elsevier B.V.
    Full-text · Article · Jan 2015 · Journal of Affective Disorders
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    • "All participants were right-handed as assessed with the Edinburgh Inventory (Oldfield, 1971), and the two groups did not differ in full-scale IQ (mean±S.D. = 109 ± 12.2 for ADHD, 112.4 ± 10.0 for TD, p = 0.082). All the participants and their parents were interviewed using the Chinese Kiddie epidemiologic version of the Schedule for Affective Disorders and Schizophrenia (K-SADS-E) for the diagnosis of ADHD and other psychiatric disorders (Gau et al. 2005) by S.S.-F.G. Participants with a lifetime clinical diagnosis of psychosis, mood disorders, learning disability, substance use, or autism spectrum disorders , current diagnosis of anxiety disorders, or IQ < 80 were excluded. "
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    ABSTRACT: Background: Deficits in executive function (EF), impaired school functioning and altered white matter integrity in frontostriatal networks have been associated with attention-deficit/hyperactivity disorder (ADHD). However, relationships between impairments in these areas are unclear. Using a sample of youths with and without ADHD, this study examined the association between microstructural integrity of frontostriatal tracts and school dysfunction and the mediating roles of EF and ADHD symptoms in this association. Method: The sample included 32 Taiwanese youths with ADHD and 32 age-, sex-, handedness- and IQ-matched typically-developing (TD) youths. Participants were assessed using psychiatric interviews, parent reports on ADHD symptoms and school functioning, and EF measures from the Cambridge Neuropsychological Test Automated Battery (CANTAB). The frontostriatal tracts were reconstructed by diffusion spectrum imaging (DSI) tractography and were subdivided into four functionally distinct segments: caudate-dorsolateral, caudate-medial prefrontal, caudate-orbitofrontal and caudate-ventrolateral tracts. Results: Youths with ADHD, relative to TD youths, showed altered white matter integrity in all four bilateral pairs of frontostriatal tracts (decreased general fractional anisotropy, GFA), had poor attention, vigilance and response inhibition, and showed impaired school functioning. Altered microstructural integrity in frontostriatal tracts was significantly associated with school dysfunction, which was mediated by EF measures of attention/vigilance and response inhibition in addition to inattention and hyperactivity symptoms. Conclusions: Our findings demonstrate an association between white matter integrity in the frontostriatal networks and school functioning and suggest that EF deficits and ADHD symptoms may be the mediating mechanisms for this association. Future research is needed to test the directionality and specificity of this finding.
    Full-text · Article · Jul 2014 · Psychological Medicine
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    • "For the present sample, Cronbach's alphas (αs) were 0.89 to 0.91 for Inattention and 0.89 to 0.90 for Hyperactivity/Impulsivity across three time points, showing good internal consistency of this measure. Using a symptom-count approach (i.e., a score of 2 or 3 counted as a symptomatic presence of the behavior), 6.4 % of the sample showed inattention, 2.4 % showed hyperactivity, and 7.6 % met DSM-IVADHD criteria (regardless of subtypes), which is comparable to the ADHD prevalence reported in Taiwan (7.5 %; Gau et al. 2005). The mean score of each subscale was used in the analyses as a dimensional measure of ADHD symptoms. "
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    ABSTRACT: The goals of this short-term longitudinal study were to investigate differential, independent effects of inattention and hyperactivity/impulsivity on children's peer relationships and the dynamic, transactional interplay between ADHD symptoms and indices of peer functioning over time. This study used a community sample that included 739 preadolescents (239 fourth graders and 500 fifth graders; 52.23 % boys) from northern Taiwan, who were assessed every six months at three time points. Children's ADHD symptoms were measured using the parent report on the Swanson, Nolan, and Pelham, version IV scale. Positive and negative facets of peer functioning, including peer rejection, peer acceptance, and the number of friendships, were assessed via peer nomination. Results of cross-lagged models indicated that inattention, but not hyperactivity/impulsivity, predicted subsequent peer impairment (i.e., lower peer acceptance and fewer dyadic friendships). Findings also showed a vicious cycle in which inattentive symptoms predicted later peer impairment, which in turn led to increases in both inattention and hyperactivity/impulsivity. These findings did not differ across gender, and the majority of the findings remained significant even after controlling for age and physical aggression. Taken together, this study demonstrated the detrimental effect of inattention on children's peer functioning and the transactional and dynamic interplay between inattention and peer impairment in a Chinese culture.
    Full-text · Article · May 2014 · Journal of Abnormal Child Psychology
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