Prevalence and comorbidity of psychiatric disorders among 6-year-old children: 2004 Pelotas Birth Cohort

Sandra Petresco,Luciana Anselmi,Aluísio J D Barros,Fernando C Barros,Alicia Matijasevich,Bacy Fleitlich-Bilyk,Iná S Santos

doi:10.1007/s00127-014-0826-z

Abstract

PurposeMost studies published on the prevalence of psychiatric disorders in children were conducted in high-income countries despite the fact that nearly 90 % of the world’s population aged under 18 live in low- and middle-income countries. The study aimed to assess the prevalence of psychiatric disorders among children of 6 years of age, to examine the distribution of psychiatric disorders by gender and socioeconomic status and to evaluate the occurrence of psychiatric comorbidities.MethodsThe 2004 Pelotas Birth Cohort originally comprised 4,231 live births from Pelotas, southern Brazil. A total of 3,585 (84.7 % of 4,231 births) children aged 6 years were assessed using the Development and Well-Being Assessment (DAWBA).ResultsNearly 13 % of the children presented a psychiatric diagnosis according to DSM-IV, being more prevalent among males than females (14.7 and 11.7 %, respectively, p = 0.009). Anxiety disorders were the most prevalent of all disorders (8.8 %) and specific phobias (5.4 %) and separation anxiety disorder (3.2 %) were the most common subtypes. Attention deficit hyperactivity disorder (2.6 %), oppositional defiant disorder/conduct disorder (2.6 %), and depression (1.3 %) were also diagnosed. More than one psychiatric disorder was presented by 17 % of children. Socioeconomically disadvantaged children had a higher prevalence of psychiatric disorders.ConclusionOur findings underline the early onset of psychiatric disorders among children and the frequent occurrence of psychiatric comorbidity. Early prevention is needed in the field of mental health in Brazil and should start during infancy.

Highlights

Mental disorders and conditions account for as much as 30 % of the leading causes of loss of economic productivity and independence among adults worldwide [1]
Nearly 13 % of the children presented a psychiatric diagnosis according to DSM-IV, being more prevalent among males than females (14.7 and 11.7 %, respectively, p = 0.009)
It was found that 13.2 % (N = 475) and 12.8 % (N = 458) of the children fulfilled criteria for at least one diagnosis of psychiatric disorder according to DSM-IV and

Summary

Introduction

Mental disorders and conditions account for as much as 30 % of the leading causes of loss of economic productivity and independence among adults worldwide [1]. Mental disorders have been associated with increased mortality in adult life [4]. Longitudinal studies have shown that mental disorders with onset occurring in childhood and adolescence are perpetuated throughout life greatly compromising normal development and having significant direct and indirect costs on society [3, 5,6,7]. There is a scarcity of epidemiological studies on mental disorders in children in low- and middle-income countries [6, 8,9,10]. A systematic review of populationbased samples from low- and middle-income countries found that the prevalence of mental disorders varied between 10 and 20 % among children and adolescents [6]. Previous studies on the prevalence of mental disorders in childhood and adolescence conducted in Brazil using the Development and Well-Being Assessment (DAWBA) reported prevalence ranging from 7 to 13 % in different Brazilian regions [11,12,13], but none of them provided data on 6-year-old children

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Discussion

Conclusion