Abstract

This is a nationwide epidemiological study using DSM-5 criteria to assess the prevalence of mental disorders in a large sample of Austrian adolescents between 10 and 18 years including hard-to-reach samples. A sample of 3615 adolescents from four cohorts (school grades 5, 7, 9, 11; age range 10–18 years) was recruited from 261 schools, samples of unemployed adolescents (n = 39) and adolescents from mental health institutions (n = 137) were added. The Youth Self-Report and SCOFF were used to screen for mental health problems. In a second phase, the Childrens’ Diagnostic Interview for Mental Disorders was used to make point and lifetime psychiatric diagnoses. Mental health service use was also assessed. Point prevalence and lifetime prevalence rates for at least one psychiatric disorder were 23.9% and 35.8%. The highest lifetime prevalence rates were found for anxiety disorders (15.6%), neurodevelopmental disorders (9.3%; ADHD 5.2%) and depressive disorders (6.2%). Forty-seven percent of adolescents with a lifetime psychiatric disorder had a second diagnosis. Internalising disorders were more prevalent in girls, while neurodevelopmental disorders and disruptive, impulse control and conduct disorders were more prevalent in boys. Of those with a lifetime psychiatric disorder, 47.5% had contacted mental health services. Of the residual 52.5% who had not contacted mental health services, 18.1% expressed an interest in treatment. DSM-5 mental health disorders are highly prevalent among Austrian adolescents. Over 50% had or were interested in accessing treatment. Early access to effective interventions for these problems is needed to reduce burden due to mental health disorders.

Highlights

  • Epidemiological studies are essential to provide data on children and adolescents who are affected by mental health problems, and to provide information on the need, availability and access to mental health services

  • The point and lifetime prevalence rates of any psychiatric disorder in the school sample were 21.89% (±4.5) and 34.09% (±5.2). When correcting these estimates with participants from the departments of child and adolescent psychiatry, the point and lifetime prevalence rates increased to 23.93% (±4.2) and 35.82% (±4.8), respectively

  • We found large discrepancies in the lifetime prevalence rates between the sample currently in psychiatric inpatient treatment and the school sample for depressive disorders, eating disorders, anxiety disorders, non-suicidal self-injury and trauma- and stress-related disorders

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Summary

Introduction

Epidemiological studies are essential to provide data on children and adolescents who are affected by mental health problems, and to provide information on the need, availability and access to mental health services. A meta-analysis of population studies assessing the prevalence of mental disorders in children and adolescents found a worldwide pooled prevalence rate of 13.4% for any mental disorder, surveys including epidemiological studies from 1970 to 2000 found median prevalence rates of 18%, and a US sample in 2010 revealed 20% of adolescents between 13 and 18 years with mental health problems who need treatment [2,3,4,5,6,7]. Mental health problems in general are more frequent in boys than in girls (2:1), but from the age of 13 years onward, the prevalence rates are higher for girls. Adolescent boys suffer more often from externalising and substance use disorders, while female adolescents are more often affected by internalising disorders, such as eating disorders and depressive disorders [3]

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