National study shows 1 in 5 children meet criteria for a mental disorder across their lifetime

Washington, DC, 13 October 2010 - Mental disorders in children are often difficult to identify due to the myriad of changes that occur during the normal course of maturation. For the first time, researchers at the National Institute of Mental Health have reported on the prevalence data on a broad range of mental disorders in a nationally representative sample of U.S. adolescents, which show that approximately one in five children in the U.S. meet the criteria for a mental disorder severe enough to disrupt their daily lives.

The prevalence of the mental health disorders as well as the notable link between parental mental health issues and their teen's disorders are the subject of the article by Merikangas and colleagues in the October 2010 issue of the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP).1

In the article titled "Lifetime Prevalence of Mental Disorders in U.S. Adolescents : Results from the National Comorbidity Study–Adolescent Supplement (NCS-A).," Dr. Merikangas and colleagues examined the lifetime prevalence, severity, and comorbidity of DSM-IV mental health disorders across broad classes of disorders. The NCS-A is a nationally representative, face-to-face survey of 10,123 adolescents aged 13 to 18 years in the continental United States.2 Diagnostic assessment of DSM-IV mental disorders were measured using a modified version of the World Health Organization (WHO) Composite International Diagnostic Interview.

The researchers found that anxiety disorders were the most common condition (31.9%),followed by behavior disorders (19.1%), mood disorders (14.3%), and substance use disorders (11.4%), with approximately 40% of participants with one class of disorder also meeting criteria for another class of lifetime disorder.

Strikingly, the overall prevalence of disorders with severe impairment and/or distress, marked by interference with daily life was over one in five children, or 22.2%.

The authors note, "The prevalence of severe emotional and behavior disorders is even higher than the most frequent major physical conditions in adolescence, including asthma or diabetes, which have received widespread public health attention."

In an era when funding allocations for science are being reduced, evaluation of nationally representative samples of children and adolescents are critical in providing the necessary information for establishing priorities for prevention, treatment, and research.

In conclusion, Merikangas and colleagues state, "The present data can inform and guide the development of priorities for future research and health policy by providing previously lacking prevalence estimates in a nationally representative sample of U.S. adolescents, as well as the individual, familial, and environmental correlates of mental disorders. Prospective research is now needed to understand the risk factors for mental disorder onset in adolescence, as well as the predictors of the continuity of these disorders into adulthood."

The National Comorbidity Survey Adolescent Supplement (NCS-A) and the larger program of related NCS surveys are supported by the National Institute of Mental Health (U01-MH60220) and the National Institute of Drug Abuse (R01 DA016558) with supplemental support from Substance Abuse and Mental Health Services Administration, the Robert Wood Johnson Foundation (Grant 044708), and the John W. Alden Trust. The NCS-A was carried out in conjunction with the World Health Organization World Mental Health Survey Initiative.

This work was supported by the Intramural Research Program of the National Institute of Mental Health. The views and opinions expressed in this article are those of the authors and should not be construed to represent the views of any of the sponsoring organizations, agencies, or U.S. Government.

The study is published in the Journal of the American Academy of Child and Adolescent Psychiatry and online at www.jaacap.org.

REFERENCES
1. Merikangas K, Avenevoli S, Costello J, Koretz D, Kessler RC. National comorbidity survey replication adolescent supplement (NCS-A): I. Background and measures. Journal of the American Academy of Child and Adolescent Psychiatry.2009;48:367-369.

2. Merikangas KR, He J, Burstein M, Swanson SA, Avenevoli S, Cui L, Benjet C, Georgiades, Swendsen J. 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. 2010; 49:980-989.

You may contact the author, Dr. Kathleen Merikangas at kathleen.merikangas@nih.gov.

For further information, please contact Rebecca Jensen, Managing Editor, JAACAP, rjensen@jaacap.org or 202.966.7300 x 112.

The Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP) is the official publication of the American Academy of Child and Adolescent Psychiatry. JAACAP is the leading journal focusing exclusively on today's psychiatric research and treatment of the child and adolescent. Published twelve times per year, each issue is committed to its mission of advancing the science of pediatric mental health and promoting the care of youth and their families.

The Journal's purpose is to advance research, clinical practice, and theory in child and adolescent psychiatry. It is interested in manuscripts from diverse viewpoints, including genetic, epidemiological, neurobiological, cognitive, behavioral, psychodynamic, social, cultural, and economic. Studies of diagnostic reliability and validity, psychotherapeutic and psychopharmacological treatment efficacy, and mental health services effectiveness are encouraged. The Journal also seeks to promote the well-being of children and families by publishing scholarly papers on such subjects as health policy, legislation, advocacy, culture and society, and service provision as they pertain to the mental health of children and families.

Elsevier is a world-leading publisher of scientific, technical and medical information products and services. The company works in partnership with the global science and health communities to publish more than 2,000 journals, including the Lancet (www.thelancet.com) and Cell (www.cell.com), and close to 20,000 book titles, including major reference works from Mosby and Saunders. Elsevier's online solutions include ScienceDirect (www.sciencedirect.com), Scopus (www.scopus.com), Reaxys (www.reaxys.com), MD Consult (www.mdconsult.com) and Nursing Consult (www.nursingconsult.com), which enhance the productivity of science and health professionals, and the SciVal suite (www.scival.com) and MEDai's Pinpoint Review (www.medai.com), which help research and health care institutions deliver better outcomes more cost-effectively.

A global business headquartered in Amsterdam, Elsevier (www.elsevier.com) employs 7,000 people worldwide. The company is part of Reed Elsevier Group PLC (www.reedelsevier.com), a world-leading publisher and information provider. The ticker symbols are REN (Euronext Amsterdam), REL (London Stock Exchange), RUK and ENL (New York Stock Exchange).