Prevalence and Development of Psychiatric Disorders in Childhood and Adolescence

TLDR

The study longitudinally assessed the prevalence and development of psychiatric disorders from age 9 to 16 years and examined homotypic and heterotypic continuity. The study followed a representative sample of 1,420 children aged 9–13 at intake, assessing DSM‑IV psychiatric disorders annually through age 16. During the study, 36.7 % of participants experienced at least one psychiatric disorder, with increased prevalence for social anxiety, panic, depression, and substance abuse, decreased prevalence for separation anxiety and ADHD, and strong homotypic and heterotypic continuity—especially in girls—making the risk of any disorder by age 16 much higher than point estimates suggest.

Abstract

This longitudinal community study assessed the prevalence and development of psychiatric disorders from age 9 through 16 years and examined homotypic and heterotypic continuity.A representative population sample of 1420 children aged 9 to 13 years at intake were assessed annually for DSM-IV disorders until age 16 years.Although 3-month prevalence of any disorder averaged 13.3% (95% confidence interval [CI], 11.7%-15.0%), during the study period 36.7% of participants (31% of girls and 42% of boys) had at least 1 psychiatric disorder. Some disorders (social anxiety, panic, depression, and substance abuse) increased in prevalence, whereas others, including separation anxiety disorder and attention-deficit/hyperactivity disorder (ADHD), decreased. Lagged analyses showed that children with a history of psychiatric disorder were 3 times more likely than those with no previous disorder to have a diagnosis at any subsequent wave (odds ratio, 3.7; 95% CI, 2.9-4.9; P<.001). Risk from a previous diagnosis was high among both girls and boys, but it was significantly higher among girls. Continuity of the same disorder (homotypic) was significant for all disorders except specific phobias. Continuity from one diagnosis to another (heterotypic) was significant from depression to anxiety and anxiety to depression, from ADHD to oppositional defiant disorder, and from anxiety and conduct disorder to substance abuse. Almost all the heterotypic continuity was seen in girls.The risk of having at least 1 psychiatric disorder by age 16 years is much higher than point estimates would suggest. Concurrent comorbidity and homotypic and heterotypic continuity are more marked in girls than in boys.