Psychiatric disorders in children and adolescents II: What percentage of affected kids are severely impaired?
Today is the second 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.
Yesterday I reviewed the overall prevalence rates of psychiatric disorders in children and adolescents and sex differences in such prevalence rates. In my review, I mentioned that by age 18, 50% of adolescents experienced enough symptoms sometime during their lives to meet diagnostic criteria for a psychiatric disorder. Today I tackle a related question: how many are severely impaired by such psychiatric disorders?
The table below presents the overall life time prevalence of psychiatric disorders by age 18 in the first column on the left (see here for a more detailed discussion of these numbers). The second column from the left includes the percentage of all kids in the population that experience severe impairment from each psychiatric condition by age 18. For example, 9% of kids experience severe impairment due to depression by age 18. The third column includes the percentage of diagnosed kids that experience severe impairment due to the disorder. For example, 74% of kids with depression experience severe impairment.
Prevalence and frequency of severe impairment from psychiatric disorders by age 18.
Diagnosis Categories Overall Prevalence Total % with severe impairment % of diagnosed with severe impairment
Any 1 Disorder 49.5 22.2 45%
Bi-Polar 2.9 2.6 89%
Anxiety (GAD) 2.2 0.9 30%
Social Phobia 9.1
Specific Phobia 19.3 0.6 3%
Panic Disorder 2.3 0.2 9%
PTSD 5 1.5 30%
ADHD 8.7 4.2 48%
ODD 12.6 6.5 52%
Conduct Disorder 6.8 2.2 32%
Alcohol Abuse/Dep 6.4 -- --
Drug Abuse/Dep 8.9 -- --
Eating Disorders 2.7 -- --
What was most surprising about this table is that mood disorders appear to cause the most impairment as a percentage of those affected. That is, most kids with a diagnosis of depression or bipolar disorder will experience severe impairment. In contrast, only a small percentage of kids with anxiety disorders experience severe impairment.
Also in this series:
- Prevalence and sex differences
- SOON! A close look at race: Are there race biases in diagnostic practices?
- SOON! A close look at age: Are specific diagnosis more common in early or late 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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