The Global Burden of Disease Study 2010 (GBD 2010) was launched in December 2012 and a special issue of The Lancet was published, dedicated to reporting the results [1]. GBD 2010 is a systematic and comprehensive assessment of data on 291 diseases and injuries and 235 causes of death for 20 age groups, both sexes, and for 187 countries, producing estimates of mortality and of non-fatal health outcomes [1]. GBD 2010 assessed significantly more health conditions than the previous version of the study and for the first time included attention-deficit/hyperactivity disorder, conduct disorder, and autism. This is an important advance to our field because the objective estimates of the burden of childhood mental disorders contextualize these conditions among all other medical conditions and support governmental and societal actions. Results show that there is an increasing burden of non-communicable diseases and mental illnesses and substance use disorders are among the main causes of disability [1]. Mental and behavioral disorders caused approximately 185 million disability-adjusted life years (DALYs) accounting for 7.4 % of DALYs globally [2]. Pervasive development disorders caused approximately 7.5 million, conduct disorder caused approximately 6 million and ADHD caused approximately half a million DALYs [2]. Mental and behavioral disorders caused approximately 177 million years lived with disability (YLDs) accounting for 22.7 % of YLDs globally [3]. Pervasive development disorders caused approximately 7.6 million, conduct disorder caused approximately 5.7 million and ADHD caused approximately 400,000 YLDs [3]. The process of estimating DALYs and YLDs is complex and depends on the available literature, which imposed limitations in the process possible resulting in underestimates of the burden of childhood mental disorders. Due to the limitations imposed by the literature, mortality was not calculated for childhood mental disorders [4]. There is no doubt that mental disorders in childhood are associated with premature death, as Halfon’s et al. [5] study demonstrated by examining studies on suicidality in youth bipolar disorder and summarizing the risk and protective factors detected by individual studies. Youth bipolar disorder is strongly associated with suicidal behavior, as indicated by several studies and more recently by the National Comorbidity Survey Replication Adolescent Supplement in the general population of the US [6]. A number of clinical characteristics that further increase the risk for suicidal behavior were identified, such as an acute episode, psychotic symptoms, and comorbid conditions, in conjunction with psychological characteristics, family and social factors. Of note, dialectical behavior therapy was found to protect against suicidality by improving emotional regulation and depressive symptoms. Additionally, authors were not able to find studies assessing the effect of lithium on suicidal risk. As this medication was found to decrease the risk of suicide in adults with bipolar disorder, it would be highly relevant to test if this effect also applies to youths. Another limitation imposed to the GBD 2010 study is the fact that childhood disorders are associated to complex chains of risk factors as causes and consequences, G. V. Polanczyk (&) Department of Psychiatry, Medical School and Research Support Center on Neurodevelopment and Mental Health, University of Sao Paulo, Rua Dr. Ovidio Pires de Campos 785, Sao Paulo, SP 05403-010, Brazil e-mail: gvp@usp.br