Prevalence Of DSM-IV Disorders Research Articles

Prevalence and Co-Occurrence of Developmental and Emotional-Behavioral Problems in Young Children.

A limited number of studies have estimated the prevalence of emotional-behavioral disorders among young children. None have assessed their co-occurrence with developmental delays using standardized assessment tools. Our objective was to estimate the prevalence of emotional-behavioral disorders and their co-occurrence with developmental delays among young children (2-5.5 years). Parents of young children (N=987) enrolled from pediatric waiting rooms completed developmental-behavioral screening questionnaires. Based on results, 585 families were invited to and 439 completed evaluations that included structured diagnostic interviews with parents to assess child psychopathology (Preschool Age Psychiatric Assessment (PAPA)), developmental testing with children (including the Bayley Scales of Infant and Toddler Development, third Edition for children ≤ 42 months; Differential Ability Scales, second Edition for older children), and videotaped observation to establish whether autism risk was sufficient to warrant further evaluation. According to PAPA algorithms, 23.0% of children met criteria for a DSM-IV disorder, while 9% qualified for a developmental delay. Presence of delay doubled the odds of having a DSM-IV disorder (OR=2.1; CI: 1.02-4.3), and presence of disorder doubled the odds of having a moderate-to-severe developmental delay (OR=2.0; CI: 1.10-3.50). Prevalence of DSM-IV disorders (48.8% (95% CI: 33.5-64.5%)) and developmental delays (57.5% (95% CI: 41.7-71.9%)) were both higher among children at risk for autism. While developmental delay did not vary by race/ethnicity, prevalence of DSM-IV disorders was lower among African-American/Black (10.6%; CI: 2.9-18.3) and Hispanic/Latino children (11.1%; CI: 4.3-17.9). Developmental delays and emotional-behavioral disorders among young children seen in pediatric settings are characterized by high prevalence and substantial co-occurrence.

Childhood trauma and bullying-victimization as an explanation for differences in mental disorders by sexual orientation

Sexual minority individuals are more likely to have mental disorders, including mood, anxiety, and substance use disorders, compared to heterosexual individuals. Whether experiencing trauma or bullying-victimization during childhood explains these differences is currently unclear. We used a psychiatric epidemiological general population-based study to assess whether childhood trauma severity and bullying-victimization before age 16 explains the difference by sexual attraction in mental disorders. Data from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2; N = 6392) were used to examine (1) whether same/both-sex attraction and predominantly other-sex attraction is linked to self-reports of childhood trauma (types and severity) and bullying-victimization, and (2) whether these experiences explain differences between these groups in lifetime and 12-month prevalence of DSM-IV disorders assessed by the Composite International Diagnostic Interview 3.0. Same/both-sex attracted individuals reported a higher childhood trauma severity score compared to exclusively other-sex attracted individuals (B = 0.93, SE = 0.20, p < .001), and were more likely to report bullying-victimization (OR = 2.51 95%CI[1.68, 3.74]). DSM-IV disorders were more prevalent among same/both-sex attracted individuals than among exclusively other-sex attracted individuals (ORs ranged from 1.57 to 4.68). There were no differences in DSM-IV disorders for predominantly other-sex attracted individuals. Childhood trauma severity explained between 9.0% and 57.0% of significant indirect associations between same/both-sex attraction and DSM-IV disorders. Sexual minority individuals experience more types of, and more severe childhood trauma, and are more likely to experience bullying-victimization. These negative experiences partly explained disparities in mental disorders.

Prevalence of DSM-IV disorders in a population-based sample of 5- to 8-year-old children: the impact of impairment criteria.

This study determined the impact of impairment criteria on the prevalence and patterns of comorbidity of child DSM-IV disorders. The validity of these impairment criteria was tested against different measures of mental health care referral and utilization. We interviewed parents of 1,154 children aged 5–8 years in-depth using the Diagnostic Interview Schedule for Children in Rotterdam, the Netherlands, to establish DSM-IV diagnosis. These children were randomly selected or oversampled based on Child Behavior Checklist ratings from a large population-based study (N = 6,172). Referral data were extracted from the psychiatric interview as well as from a follow-up questionnaire. The results showed an overall prevalence of DSM-IV disorders of 31.1 % when impairment was not considered. This rate declined to 22.9 % when mild impairment was required and declined even further, to 10.3 %, for more severe levels of impairment. Similarly, the overall comorbidity rate declined from 8.5 to 6.7 and 2.7 % when mild and severe impairment were required, respectively. Virtually all children who attained symptom thresholds for a specific disorder, and had been referred to a mental health care professional because of the associated symptoms, also had mild impairment. The requirement of severe impairment criteria significantly increased diagnostic thresholds, but for most disorders, this definition captured only half of the clinically referred cases. In conclusion, prevalence was highly dependent upon the criteria used to define impairment. If severe impairment is made a diagnostic requirement, many children with psychiatric symptoms and mild impairment seeking mental health care will be undiagnosed and possibly untreated.

Prevalence of psychiatric disorders among children and adolescents in northeast China.

BackgroundTo describe the prevalence of DSM-IV disorders and comorbidity in a large school-based sample of 6–17 year old children and adolescents in northeast China.MethodsA two-phase cross-sectional study was conducted on 9,806 children. During the screening phase, 8848 children (90.23%) and their mothers and teachers were interviewed using the Strengths and Difficulties Questionnaire (SDQ). During the diagnostic phase, 1129 children with a positive SDQ and 804 randomly selected children with a negative SDQ (11%), and their mothers and teachers, were interviewed using the Development and Well-Being Assessment (DAWBA).ResultsThe overall prevalence of DSM-IV disorders was 9.49% (95% CI = 8.10–11.10%). Anxiety disorders were the most common (6.06%, 95% CI = 4.92–7.40), followed by depression (1.32%, 95% CI = 0.91–1.92%), oppositional defiant disorder (1.21%, 95%CI = 0.77–1.87) and attention-deficit hyperactivity disorder (0.84%, 95% CI = 0.52–1.36%). Of the 805 children with a psychiatric disorder, 15.2% had two or more comorbid disorders.ConclusionsApproximately one in ten Chinese school children has psychiatric disorders involving a level of distress or social impairment likely to warrant treatment. Prevention, early identification and treatment of these disorders are urgently needed and pose a serious challenge in China.

Estimating the burden of psychiatric disorders in adolescence: the impact of subthreshold disorders

We examine the impact of including subthreshold disorders on estimating psychiatric morbidity burden in adolescents. To more fully understand this burden it is important to focus on both full syndrome and subthreshold disorders and the impairment associated with each, since evidence suggests prevalence of subthreshold disorders is substantial as is impairment. Data were analyzed from a probability sample of 4,175 youths 11-17years of age. We examine the prevalence of DSM-IV disorders (FS) and subthreshold (SUB) disorders, with and without impairment. Diagnostic categories examined were anxiety, mood, attention deficit hyperactivity disorder, disruptive, and substance use disorders in the past year. The prevalence of any FS disorders was 16.1 and 42.3% for SUB. The combined prevalence was 58.4%. By requiring impairment, the prevalence of any FS in the past year dropped to 8% and for SUB to 15.7%, with a combined overall rate of 23.7%. For FS disorders, 49.6% met criteria for moderate to severe impairment, compared to 37.8% for SUB. One in four adolescents had either an FS or SUB disorder with impairment. The results indicate that SUB disorders constitute a major public health burden in terms of psychiatric morbidity among adolescents. Given their substantial impairment and their high prevalence, consideration should be given to including SUB disorders in estimates of the public health burden psychiatric morbidity. Doing so would provide a more accurate estimate of psychiatric morbidity.

Prevalence of DSM-IV disorders, comorbidity and impairment in 3-year-old Spanish preschoolers

The goal is to examine the prevalence, comorbidity and impairment of DSM-IV disorders in 3-year-old children from the Spanish general population. A sample of 1,341 3-year-old preschoolers were randomly selected and screened for a double-phase design. In total, 622 families were assessed with a diagnostic semi-structured interview and functional impairment measures. Prevalence of any diagnosis was 29.9%, the most prevalent disorders being primary insomnia (11.7%) and oppositional defiant disorder (ODD) (6.9%). There were no sex differences in the prevalence. One-third of the families had sought professional help for the child's symptoms, and 9.4% received treatment (4.4% psychological and 2.1% pharmacological). After controlling for other comorbidities, ADHD was significantly associated with ODD, CD, insomnia and social phobia; ODD was associated with CD, separation anxiety, specific phobia and major depression. Diagnostic categories were associated with impairment, family burden, seeking professional help and receiving treatment. A diagnosis was more frequent in children of low socioeconomic status, born outside Spain, from one-parent families, with younger parents and with parents of lower educational level. Psychopathology, comorbidity and associated factors are very frequent from age three, suggesting a need for efforts of detection, prevention and treatment in the different societies.

Severity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Supplement.

Estimates of DSM-IV disorder prevalence are high; stringent criteria to define need for services are desired. To present US national data on the prevalence and sociodemographic correlates of 12-month serious emotional disturbance (SED), defined by the US Substance Abuse and Mental Health Services Administration, from the National Comorbidity Survey Replication Adolescent Supplement. The National Comorbidity Survey Replication Adolescent Supplement is a national survey of DSM-IV anxiety, mood, behavior, and substance disorders among US adolescents. Dual-frame household and school samples of US adolescents. Total of 6483 pairs of adolescents aged 13 to 17 (interviews) and parents (questionnaires). The DSM-IV disorders were assessed with the World Health Organization Composite International Diagnostic Interview and validated with blinded clinical interviews based on the Schedule for Affective Disorders and Schizophrenia for School-Age Children. Serious emotional disturbance was operationalized as a DSM-IV/Composite International Diagnostic Interview disorder with a score of 50 or less on the Children's Global Assessment Scale (ie, moderate impairment in most areas of functioning or severe impairment in at least 1 area). Concordance of Composite International Diagnostic Interview SED diagnoses with blinded Schedule for Affective Disorders and Schizophrenia for School-Age Children diagnoses was good. The estimated prevalence of SED was 8.0%. Most SEDs were due to behavior (54.5%) or mood (31.4%) disorders. Although respondents with 3 or more disorders made up only 29.0% of those with 12-month DSM-IV/Composite International Diagnostic Interview disorders, they constituted 63.5% of SEDs. Predictive effects of high comorbidity were significantly greater than the product of their disorder-specific odds ratios and consistent across disorder types. Associations of sociodemographic variables with SED were generally nonsignificant after controlling for disorder type and number. The high estimated 12-month prevalence of DSM-IV disorders among US adolescents is largely due to mild cases. The significant between-disorder differences in risk of SED and the significant effect of high comorbidity have important public health implications for targeting interventions.

Prevalence of lifetime DSM-IV affective disorders among older African Americans, Black Caribbeans, Latinos, Asians and non-Hispanic White people.

The purpose of this study is to estimate lifetime prevalence of seven psychiatric affective disorders for older non-Hispanic White people, African Americans, Caribbean Black people, Latinos, and Asian Americans and examine demographic, socioeconomic, and immigration correlates of those disorders. Data are taken from the older sub-sample of the Collaborative Psychiatric Epidemiology Surveys. Selected measures of lifetime DSM-IV psychiatric disorders were examined (i.e., panic disorder, agoraphobia, social phobia, generalized anxiety disorder, post-traumatic stress disorder, major depressive disorder, and dysthymia). Community epidemiologic survey. Nationally representative sample of adults 55 years and older (n = 3046). Disorders were assessed using the DSM-IV World Mental Health Composite International Diagnostic Interview. Major depressive disorder and social phobia were the two most prevalent disorders among the seven psychiatric conditions. Overall, non-Hispanic White people and Latinos consistently had higher prevalence rates of disorders, African Americans had lower prevalence of major depression and dysthymia, and Asian Americans were typically less likely to report affective disorders than those of their counterparts. There is variation across groups in the association of demographic, socioeconomic, and immigration variables with disorders. This study furthers our understanding of the racial and ethnic differences in the prevalence of DSM-IV disorders among older adults and the correlates of those disorders. It highlights the importance of examining both between-group and within-group differences in disorders and the complexity of the mechanisms associated with differences across groups. Findings from this study underscore the need for future research that more clearly delineates subgroup differences and similarities.

Age Variation in the Prevalence of DSM-IV Disorders in Cases of Suicide of Middle-Aged and Older Persons in Sydney

Data concerning 127 persons aged 35 years or above who died by suicide (as determined in consecutive cases by a Sydney coroner) were analyzed. Psychological autopsy (PA) interviews were conducted in 52 cases, and details were compared with the 75 cases where data were available only from coroner's files (CF). Most characteristics of the two groups were similar, although more CF suicide victims were of Asian background and unable to speak English fluently. Consensus diagnoses were reached following detailed discussion about PA and CF cases. Logistic regression showed no significant difference between age-groups in the proportion diagnosed with major depression, which contrasts with the results of an earlier U.S. study.

JS03-03 - Prevalence and Impact of Common Mental Disorders: International Similarities & Differences. Results of the Who World Mental Health (WMH) Surveys Initiative

Introduction A number of studies have shown that there is international variation in the prevalence of common mental disorders. Several factors have been suggested to explain such differences. Methodological challenges to comparability include: differences in settings, samples, assessment methods, and reporting practices. Also, cultural differences have been pointed out as possible cause of differential recognition and reporting of mental health issues. There is still uncertainty about the degree of international variation in the prevalence of mental disorders, and the lack of comparability of results is still an issue.Objectives We assessed the prevalence and impact of mental disorders in the WHO World Mental Health (WMH) Survey Initiative, using common survey, assessment and reporting methods.Methods The WMH surveys were completed in 24 countries from Africa, the Americas, Asia, Europe, the Middle-East and the Pacific. Representative samples of the adult, non-institutionalizes population were interviewed face-to-face, with the aim of estimating the prevalence, burden and unmet need for treatment of common mental disorders. The Composite International Diagnostic Interview (CIDI, 3.0) was used in all surveys to assess mental health status. Common mental disorders assessed included: anxiety, mood, disruptive behaviour, and substance disorders. Several standard measures of disability, both generic and disorder-specific, and role impairment were administered.Results Results show that the mental disorders are commonly occurring in all participating countries. The inter-quartile range (IQR: 25th–75th percentiles) of lifetime DSM-IV disorder prevalence estimates (combining anxiety, mood, disruptive behaviour, and substance disorders) is 18.1–31.1%. The IQR of 12 month prevalence estimates is 9.8–19.1%. Prevalence estimates of 12-month Serious Mental Illness (SMI) are 4–6.8% in half of the countries, 2.3–3.6% in one-fourth and 0.8–1.9% in one-fourth. Possible causes of international variation will be addressed. Analysis of age-of-onset reports shows that many mental disorders begin in childhood-adolescence and have significant adverse effects on subsequent role transitions. Mental disorders are found in the WMH data to be associated with high levels of role impairment.Conclusions Despite this burden, the majority of mental disorders go untreated. Although these results suggest that expansion of treatment could be cost-effective form both the employer perspective and the societal perspective, treatment effectiveness trials are needed to confirm this suspicion. The WMH results regarding impairments are being used to target several of these interventions.Additional information about the WMH Surveys Initiative and the funing of the project can be found at: http://www.hcp.med.harvard.edu/wmh/

Childhood adversities and adult psychopathology in the National Comorbidity Survey Replication (NCS-R) III: Associations with functional impairment related to DSM-IV disorders

Despite evidence that childhood adversities (CAs) are associated with increased risk of mental disorders, little is known about their associations with disorder-related impairment. We report the associations between CAs and functional impairment associated with 12-month DSM-IV disorders in a national sample. We used data from the US National Comorbidity Survey Replication (NCS-R). Respondents completed diagnostic interviews that assessed 12-month DSM-IV disorder prevalence and impairment. Associations of 12 retrospectively reported CAs with impairment among cases (n=2242) were assessed using multiple regression analysis. Impairment measures included a dichotomous measure of classification in the severe range of impairment on the Sheehan Disability Scale (SDS) and a measure of self-reported number of days out of role due to emotional problems in the past 12 months. CAs were positively and significantly associated with impairment. Predictive effects of CAs on the SDS were particularly pronounced for anxiety disorders and were significant in predicting increased days out of role associated with mood, anxiety and disruptive behavior disorders. Predictive effects persisted throughout the life course and were not accounted for by disorder co-morbidity. CAs associated with maladaptive family functioning (MFF; parental mental illness, substance disorder, criminality, family violence, abuse, neglect) were more consistently associated with impairment than other CAs. The joint effects of co-morbid MFF CAs were significantly subadditive. Simulations suggest that CAs account for 19.6% of severely impairing disorders and 17.4% of days out of role. CAs predict greater disorder-related impairment, highlighting the ongoing clinical significance of CAs at every stage of the life course.

Psycho‐cutaneous disorders: an epidemiologic study

Psycho-dermatology addresses the interaction between mind and the skin. Effective management of at least one third of the patients attending the skin department depends, to some extent, upon the recognition of emotional and psychologic factors. The aim of this study was to provide epidemiologic data about common psycho-dermatoses and their prevalence in dermatologic patients in Iran. Patients suspicious to have psychocutaneous problem with primary dermatologic chief complaint were included. After detailed dermatologic evaluation, all patients were visited by an expert psychologist to determine prevalence of DSM-IV disorders in each psychocutaneous category including delusion of parasitosis, trichotillomania, dermatitis artefacta and neurotic excoriation. A total of 178 patients including 78 (43.8%) males and 100 (56.2%) females entered the study. The commonest psychocutaneous disorder was neurotic excoriation followed by trichotillomania, delusion of parasitosis and dermatitis artefacta. Mood disorder was the commonest DSM-IV disorder in our patients, then anxiety disorder and drug-induced symptoms. According to our results, it seems that all psychocutaneous disorders but delusion of parasitosis are commoner in females. Mood and anxiety disorders were common in patients with dermatitis artefacta, as patients with neurotic excoriation. In trichotillomania, obsessive compulsive disorder was the commonest disorder. Drug abuse is a major background of delusional parasitosis.

National Comorbidity Survey Replication Adolescent Supplement (NCS-A): II. Overview and Design

ObjectiveTo present an overview of the design and field procedures of the National Comorbidity Survey Replication Adolescent Supplement (NCS-A). MethodThe NCS-A is a nationally representative face-to-face household survey of the prevalence and correlates of DSM-IV mental disorders among U.S. adolescents (aged 13–17 years) that was performed between February 2001 and January 2004 by the Survey Research Center of the Institute for Social Research at the University of Michigan. The sample was based on a dual-frame design that included 904 adolescent residents of the households that participated in the National Comorbidity Survey Replication (response rate 85.9%) and 9,244 adolescent students selected from a representative sample of 320 schools in the same nationally representative sample of counties as the National Comorbidity Survey Replication (response rate 74.7%). ResultsComparisons of sample and population distributions on census sociodemographic variables and, in the school sample, school characteristics documented only minor differences that were corrected with poststratification weighting. Comparisons of DSM-IV disorder prevalence estimates among household versus school sample respondents in counties that differed in the use of replacement schools for originally selected schools that refused to participate showed that the use of replacement schools did not introduce bias into prevalence estimates. ConclusionsThe NCS-A is a rich nationally representative dataset that will substantially increase understanding of the mental health and well-being of adolescents in the United States.

The global burden of mental disorders: An update from the WHO World Mental Health (WMH) Surveys

The paper reviews recent findings from the WHO World Mental Health (WMH) surveys on the global burden of mental disorders. The WMH surveys are representative community surveys in 28 countries throughout the world aimed at providing information to mental health policy makers about the prevalence, distribution, burden, and unmet need for treatment of common mental disorders. The first 17 WMH surveys show that mental disorders are commonly occurring in all participating countries. The inter-quartile range (IQR: 25th-75th percentiles) of lifetime DSM-IV disorder prevalence estimates (combining anxiety, mood, externalizing, and substance use disorders) is 18.1-36.1%. The IQR of 12-month prevalence estimates is 9.8-19.1%. Prevalence estimates of 12-month Serious Mental Illness (SMI) are 4-6.8% in half the countries, 2.3-3.6% in one-fourth, and 0.8-1.9% in one-fourth. Many mental disorders begin in childhood-adolescence and have significant adverse effects on subsequent role transitions in the WMH data. Adult mental disorders are found to be associated with such high role impairment in the WMH data that available clinical interventions could have positive cost-effectiveness ratios. Mental disorders are commonly occurring and often seriously impairing in many countries throughout the world. Expansion of treatment could be cost-effective from both employer and societal perspectives.

The WHO World Mental Health (WMH) Surveys

The paper presents an overview of the WHO World Mental Health (WMH) Survey Initiative and summarizes recent WMH results regarding the prevalence and societal costs of mental disorders. The WMH surveys are representative community surveys that were carried out in 28 countries throughout the world aimed at providing information to mental health policy makers about the prevalence, burden, and unmet need for treatment of common mental disorders. Results show that mental disorders are commonly occurring in all participating countries. The inter-quartile range (IQR: 25(th)-75(th) percentiles) of lifetime DSM-IV disorder prevalence estimates (combining anxiety, mood, disruptive behavior, and substance disorders) is 18.1-36.1%. The IQR of 12-month prevalence estimates is 9.8-19.1%. Analysis of age-of-onset reports shows that many mental disorders begin in childhood-adolescence and have significant adverse effects on subsequent role transitions. Adult mental disorders are found in the WMH data to be associated with high levels of role impairment. Despite this burden, the majority of mental disorders go untreated. Although these results suggest that expansion of treatment could be cost-effective from both the employer perspective and the societal perspective, treatment effectiveness trials are needed to confirm this suspicion. The WMH results regarding impairments are being used to target several such interventions.

Prevalence of DSM-IV disorders in Chinese adolescents and the effects of an impairment criterion

To provide preliminary prevalence estimates of common DSM-IV (Diagnostic and Statistical Manual of Mental Disorders-4th Edition) disorders in a sample of Hong Kong Chinese adolescents. 541 Chinese adolescents were recruited from Grades 7, 8 and 9 of 28 mainstream high schools in Hong Kong (mean age=13.8 years; SD=1.2). The adolescents and their parents were separately administered the Youth and Parent versions of DISC-IV (Diagnostic Interview Schedule for Children-Version 4), respectively. Based upon both symptom and impairment criteria, as required by DSM-IV, the overall prevalence estimate of DSM-IV disorders in our sample of Chinese adolescents was 16.4%. Estimates for such individual disorders/diagnostic groupings as anxiety disorders, depressive disorders, attention deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), conduct disorder (CD), and substance use disorders were 6.9, 1.3, 3.9, 6.8, 1.7, and 1.1%, respectively. These rates were largely compatible with those reported in previous studies with perhaps lower rates of generalized anxiety disorder (GAD), depressive disorders, CD, and substance use disorders, but a higher rate of ODD. The rate of ADHD was somewhat higher, but this might reflect the current DSM-IV diagnostic practice. The rate of anxiety disorders was not as high as predicted from some previous questionnaire surveys. The application of an impairment criterion had discernible impacts on prevalence estimates, greater on anxiety and substance use disorders, but smaller on depressive and disruptive behavior disorders. There was a lack of gender difference in rates of ODD and CD. While the findings reported here are broadly compatible with those of other studies, there may be cross-cultural differences in rates of some individual disorders, e.g., GAD, depressive disorders, ODD, CD, and substance use disorders, as well as in gender difference regarding rates of ODD and CD. However, exact comparison between studies is confounded by methodological differences in sample characteristics, measures, and case definition. Standardization of methodology in epidemiological surveys should allow more precise identification of any within- or between-culture variations in prevalence estimation.

The prevalence of DSM-IV psychiatric disorders among 7–10 year old Yemeni schoolchildren

The planning of child mental health services should be based on recent high-quality data on the prevalence and type of mental health disorders, and yet such data are not available in Yemen and many other Arab countries. Representative samples of Yemeni 7-10 year olds (n = 1,210) were assessed using a two-phase design in an urban area and a one-phase design in a rural area. Psychopathology was assessed using the Strengths and Difficulties Questionnaire for screening purposes and the Development and Well-being Assessment to generate psychiatric diagnoses. The overall prevalence of DSM-IV disorders was 15.7% in Yemen (95% CI 11.7-20.2%). Anxiety disorders were the commonest diagnostic grouping in Yemen (9.3%, 95% CI = 5.8-12.8%), followed by behavioural disorders (7.1%, 95% CI = 4.4-9.9%) and attention-deficit/hyperactivity disorder (ADHD; 1.3%, 95% CI = 0.1-2.5%). There were no significant urban-rural differences. Roughly a sixth of Yemeni schoolchildren have at least one DSM-IV psychiatric disorder, involving a level of distress or social impairment likely to warrant treatment.

Prevalence of Psychiatric Disorders Among Children of Different Ethnic Origin

The present study assesses the population prevalence of DSM-IV disorders among native and immigrant children living in low socio-economic status (SES) inner-city neighborhoods in the Netherlands. In the first phase of a two-phase epidemiological design, teachers screened an ethnically diverse sample of 2041 children aged 6-10 years using the Strengths and Difficulties Questionnaire (SDQ). In the second phase, a subsample of 253 children was psychiatrically examined, while their parents were interviewed. In addition, teachers completed a short questionnaire about 10 DSM-IV items. Prevalence was estimated using the best-estimate diagnosis based on parent, child and teacher information. Projected to the total population, 11% of the children had one or more impairing psychiatric disorders, which did not differ between native and non-native children. In the total group a clear relationship was observed between the prevalence of psychiatric disorders and gender, parental psychopathology, peer problems and school problems, but not among all ethnic groups separately. This study suggests that the prevalence of psychiatric disorders among non-treated minority and native children in low SES inner-city neighborhoods does not materially differ. However, associated mechanisms may be influenced by ethnicity.

Prevalence, Interference with Life and Severity of 12 Month DSM-IV Disorders in Te Rau Hinengaro: The New Zealand Mental Health Survey

To estimate the 12 month prevalence of DSM-IV disorders in New Zealand, and associated interference with life and severity. A nationally representative face-to-face household survey carried out in 2003-2004. A fully structured diagnostic interview, the World Health Organization World Mental Health Survey Initiative version of the Composite International Diagnostic Interview (CIDI 3.0) was used. There were 12,992 completed interviews from participants aged 16 years and over. The overall response rate was 73.3%. In this paper the outcomes reported are 12 month prevalence, interference with life and severity for individual disorders. The prevalence of any disorder in the past 12 months was 20.7%. The prevalences for disorder groups were: anxiety disorders 14.8%, mood disorders 7.9%, substance use disorders 3.5%, eating disorders 0.5%. The highest prevalences for individual disorders were for specific phobia (7.3%), major depressive disorder (5.7%) and social phobia (5.1%). Interference with life was higher for mood disorders than for anxiety disorders. Drug dependence, bipolar disorder and dysthymia had the highest proportion of severe cases (over 50%), when severity was assessed over the disorder itself and all comorbid disorders. Overall, only 31.7% of cases were classified as mild with 45.6% moderate and 22.7% serious. Compared with other World Mental Health survey sites New Zealand has relatively high prevalences, although almost always a little lower than for the US. For all disorders, except specific phobia, interference with life was reported to be moderate, on average, which has lead to less than a third of cases being classified as mild. Most people who have ever met full DSM-IV criteria, including the impairment criterion, and who experience symptoms or an episode in the past 12 months find that their disorders impact on their lives to a non-trivial extent.

Prevalence of DSM-IV Disorders and Attendant Help-Seeking in 2 American Indian Reservation Populations

The American Indian Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project (AI-SUPERPFP) estimated the mental health burden and associated help-seeking in select American Indian reservation communities. To determine the lifetime and 12-month prevalence of common DSM-IV disorders, their demographic correlates, and patterns of help-seeking in 2 culturally distinct American Indian reservation communities in the Southwest and Northern Plains. Completed between 1997 and 2000, a cross-sectional probability sample survey. General community. Three thousand eighty-four (Southwest = 1446 and Northern Plains = 1638) members, aged 15-54 years, of 2 tribal groups living on or near their home reservations were randomly sampled from the tribal rolls. Response rates were 73.7% and 76.8% for the Southwest and Northern Plains tribes, respectively.Main Outcomes Measures The AI-SUPERPFP Composite International Diagnostic Interview, a culturally adapted version of the University of Michigan version of the Composite International Diagnostic Interview, to assess DSM-IV diagnoses and help-seeking. Overall lifetime prevalence of AI-SUPERPFP DSM-IV disorders ranged from 35.7% for Southwest women to near 50% for both groups of men. Alcohol abuse and dependence were the most common disorders for men, with posttraumatic stress disorder most prevalent for women. Many of those with lifetime alcohol problems or posttraumatic stress disorder no longer met criteria for 12-month diagnoses. Significant levels of comorbidity were found between those with depressive and/or anxiety and substance disorders. Demographic correlates other than tribe, sex, and age were generally unrelated to disorder status. A majority of participants with lifetime disorders had sought help from mental health professionals, other medical personnel, or culturally traditional sources. Alcohol disorders and posttraumatic stress disorder were more common in these American Indian populations than in other populations using comparable methods. Substantial comorbidity between depressive and/or anxiety and substance disorders suggests the need for greater coordination of treatment for comorbid disorders.