Prevalence of DSM-5 mental disorders in a nationally representative sample of children in Taiwan: methodology and main findings.

Yi-Lung Chen,Kuan-Chia Lin,Lih-Jong Shen,Susan Shur-Fen Gau,Wei J Chen

doi:10.1017/s2045796018000793

Abstract

There has been a lack of prevalence estimates of DSM-5 mental disorders in child populations at the national level worldwide. This study estimated the lifetime and 6-month prevalence of mental disorders according to the DSM-5 diagnostic criteria in Taiwanese children. Taiwan's National Epidemiological Study of Child Mental Disorders used the stratified cluster sampling to select 69 schools in Taiwan resulting in a nationally representative sample of 4816 children in grades 3 (n = 1352), 5 (n = 1297) and 7 (n = 2167). All the participants underwent face-to-face psychiatric interviews using the Kiddie-Schedule for Affective Disorders and Schizophrenia-Epidemiological version, modified for the DSM-5, and they and their parents completed questionnaires. The inverse probability censoring weighting (IPCW)-adjusted prevalence was reported to minimise non-response bias. The IPCW-adjusted prevalence rates of mental disorders decreased by 0.1-0.5% than raw weighted prevalence. The IPCW-adjusted weighted lifetime and 6-month prevalence rates for overall mental disorders were 31.6 and 25.0%, respectively. The most prevalent mental disorders (lifetime, 6-month) were anxiety disorders (15.2, 12.0%) and attention-deficit hyperactivity disorder (10.1, 8.7%), followed by sleep disorders, tic disorders, oppositional defiant disorder and autism spectrum disorder. The prevalence rates of new DSM-5 mental disorders, avoidant/restrictive food intake disorder and disruptive mood dysregulation disorder were low (<1%). Our findings, similar to the DSM-IV prevalence rates reported in Western countries, indicate that DSM-5 mental disorders are common in the Taiwanese child population and suggest the need for public awareness, early detection and prevention.

Highlights

Mental health issues across the lifespan have attracted tremendous attention in recent decades, mental illnesses in the child population remain a global public-health challenge (Patel et al, 2007)
According to the bias analysis, we found that parents who provided written informed consent for their children to receive the psychiatric interviews were younger, had more severe depression and anxiety symptoms based on the Adult Self-(Report Inventory-Anxiety and Depression score; Yeh et al, 2008), reported poorer self-perceived health, lower perceived family function, their children had more behavioral problems and more behavioral problems at home than their counterparts
The results suggested a possible non-response bias; we conducted inverse probability censoring weighting (IPCW) to adjust for the weighted prevalence rates

Summary

Introduction

Mental health issues across the lifespan have attracted tremendous attention in recent decades, mental illnesses in the child population remain a global public-health challenge (Patel et al, 2007). Only a few Western countries have conducted their national surveys, including Australia (Sawyer et al, 2001), Germany (Ravens-Sieberer et al, 2008), the Netherlands (Verhulst et al, 1997), Israel (Farbstein et al, 2010), Italy (Frigerio et al, 2009), the UK (Ford et al, 2003) and the USA (Merikangas et al, 2009; Kessler et al, 2012; Nock et al, 2013) (see online Supplementary Table S1) These mental disorders include attention-deficit hyperactivity disorder (ADHD; 2.2–11.2%), anxiety disorder (4.0–31.9%), major depressive disorder (MDD; 0.9–11.7%), oppositional defiant disorder (ODD; 1.8–12.6%) and conduct disorder (CD; 0.9–6.8%). Despite varied prevalence rates across these studies, they suggest that 25–30% of children and adolescents are affected by any mental disorder (Costello et al, 2005)

Methods

Results

Discussion

Conclusion