Epidemiology of child psychiatric disorders

Prevalence of mental illness

Epidemiological research has shown that between 3% and 18% of children have a psychiatric disorder causing significant functional impairment (reasons for these widely divergent prevalence rates are discussed below) and Costello and colleagues^[1] have proposed a median prevalence estimate of 12%. Using a different statistical method, Waddell and colleagues^[2] propose a prevalence rate for all mental disorders in children of 14.2%.

Developmental epidemiology

Developmental epidemiology seeks to "disentangle how the trajectories of symptoms, environment, and individual development intertwine to produce psychopathology".^[3]

Socio-economic influences

Mental illness in childhood and adolescence is associated with parental unemployment, low family income, being on family income assistance,^[4] lower parental educational level, and single-parent, blended or stepparent families.^[5]

Methodological issues

Epidemiological research has produced widely divergent estimates, depending on the nature of the diagnostic method (e.g. structured clinical interview, unstrutured clinical interview, self-report or parent-report questionnaire), but more recent studies using DSM-IV-based structured interviews produce more reliable estimates of clinical "caseness". Past research has also been limited by inconsistent definitions of clinical disorders, and differing upper and lower age limits of the study population. Changing definitions over time have given rise to spurious evidence of changing prevalence of disorders. Furthermore, almost all epidemiological surveys have been carried out in Europe, North America and Australia, and the cross-cultural validity of DSM criteria have been questioned, so it is not clear to what extent the published data can be generalized to developing countries.^[1][4]

Footnotes

1. ^ ^{a b} Costello, Jane; Egger, Helen; Angold, Adrian (2005). "10-Year Research Update Review: The Epidemiology of Child and Adolescent Psychiatric Disorders: I. Methods and Public Health Burden". Journal of the American Academy of Child and Adolescent Psychiatry 44 (10): 972–986. doi:10.1097/01.chi.0000172552.41596.6f. PMID 16175102. 
2. ^ Waddell, Charlotte; Offord, David; Shepherd, Cody; Hua, Josephine; McEwan, Kimberley (2002). "Child Psychiatric Epidemiology and Canadian Public Policy-Making: The State of the Science and the Art of the Possible". Canadian Journal of Psychiatry 47 (9): 825–832. PMID 12500752. http://server03.cpa-apc.org:8080/Publications/archives/CJP/2002/November/waddell.pdf. Retrieved 2008-07-04. 
3. ^ Costello, Jane; Foley, Deborah; Angold, Adrian (2006). "10-year research update: The epidemiology of child and adolescent psychiatric disorders: II. Developmental epidemiology". Journal of the American Academy of Child and Adolescent Psychiatry 45 (1): 8–25. doi:10.1097/01.chi.0000184929.41423.c0. PMID 16327577. 
4. ^ ^{a b} Belfer, Myron (2008). "Child and adolescent mental disorders: the magnitude of the problem across the globe". Journal of Child Psychology and Psychiatry 49 (3): 226–236. doi:10.1111/j.1469-7610.2007.01855.x. PMID 18221350. 
5. ^ Sawyer, M.G.; Arney, F.M.; Baghurst, P.A.; Clark, J.J.; Graetz, B.W.; Kosky, R.J.; Nurcombe, B.; Patton, G.C.; Prior, M.R.; Raphael, B.; Rey, J.M.; Whaites, L.C.; Zubrick, S.R. (2001). "The mental health of young people in Australia: key findings from the child and adolescent component of the national survey of mental health and well-being". Australian and New Zealand Journal of Psychiatry 35 (6): 806–814. doi:10.1046/j.1440-1614.2001.00964.x. PMID 11990891. 

See also

• Child and adolescent psychiatry