Monday’s BRIEFS: Quick musings in child related research.
Psychiatric disorders in children and adolescents I: Prevalence and sex differences
Today is the first of a series of Brief posts about the results of the latest National Comorbidity Survey (NCS).
The NCS is a large nationally representative study of over 10,000 adolescents aged 13 to 18. The study aims to examine the prevalence of psychiatric disorders in youth across the United States by conducting a comprehensive face-to-face structured diagnostic assessment of every participant. Such diagnostic interview is currently the gold standard in diagnostic assessment, which arguably provides us with the most accurate picture of the true prevalence of these disorders in the population. The study included 4,945 boys and 5,170 girls. The racial/ethnicity breakdown was 65% non-Hispanic whites, 15.1% non-Hispanic black, 14.4% Hispanic, and 5% other.
During the next few days I will break down a series of results from this study. Today, I’ll start by summarizing the findings related to the overall frequency of psychiatric diagnosis and the sex differences in such frequencies.
The table below presents the “life time prevalence” by age 18 of each disorder for females, males, and the entire sample. The life time prevalence means the percentage of adolescents that meet the diagnostic criteria for each disorder sometime during their lives by the age of 18.
Life time prevalence of psychiatric disorder by age 18.
|Any 1 Disorder||51||48.1||49.5|
A few notable numbers. Close to 50% of all teens by the age of 18 would experienced enough symptoms to qualify for at least one psychiatric diagnosis sometime during their lives. At first this sounds like an alarming number that could not possibly be true. However, remember that this refers to “life time prevalence.” The number does not suggest that 50% of 18 year olds have or even received a psychiatric diagnosis, but that 50% experienced enough symptoms sometime in the past to meet the diagnostic criteria for at least 1 psychiatric diagnosis. Also, the number made me wonder how this compares to other medical conditions. For example, what percentage of 18 year olds have experienced a diagnosis of any non-psychiatric medical condition sometime during their lives?
I was surprised at the high rates of some disorders and the low rates of others. For example, 11% of females and 7% of males met diagnostic criteria for social phobia sometime during their lives. This appears high especially since this is not a condition we often see in non-specialized clinical settings. In contrast, only 3.8% of girls and 1.5% of boys met criteria for an eating disorder. This sounds surprisingly low given how often we see cases of eating disorders in clinical practice.
The largest sex differences were noted in depression, PTSD, and ADHD. By age 18, a larger percentage of females experienced depression and PTSD than males. In contrast, males were more likely to experience ADHD. Overall, being male reduced the risk of a mood disorder by 50% and the risk of an anxiety disorder by 40%. However, being male increased the risk of having a behavior disorder by 70% and the risk of having a substance use/abuse disorder by 30%.
Also in this series:
- A close look at impairment: What percentage of affected kids are severely impaired?
- A close look at race: Are there race biases in diagnostic practices?
- Storm and Stress: Psychiatric disorders in adolescence.
The reference:Merikangas KR, He JP, Burstein M, Swanson SA, Avenevoli S, Cui L, Benjet C, Georgiades K, & Swendsen J (2010). Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry, 49 (10), 980-9 PMID: 20855043
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