Child and Adolescent Psychiatry

Epidemiology 33

negative’ subjects makes it possible to determine how often the

screening procedure generates false negatives.

Epidemiological findings in child
and adolescent psychiatry

The first major epidemiological study of psychiatric disorders in childhood
was carried out by Michael Rutter and his colleagues on the Isle of
Wight in the late 1960s. It is hardly an exaggeration to say that this
study was the beginning of scientific child and adolescent psychiatry; its
findings have withstood the test of time remarkably well, with subsequent
epidemiological studies from many countries confirming the main findings
and extending them in various directions. Box 3.1 illustrates the sorts
of findings to have emerged from epidemiological surveys over the past
50 years, drawing on some recent British nationwide surveys.

Box 3.1 British nationwide surveys of child and adolescent mental

health

Since 1999, the British Office for National Statistics has been carrying out an

extensive ongoing programme of cross-sectional and longitudinal studies of child

and adolescent mental health. This box summarises some key aspects of the

methods and findings.

Design

The main measures of psychopathology were the Strengths and Difficulties

Questionnaire (www.sdqinfo.org) generating scores, and the Development and

Well-Being Assessment (www.dawba.info) generating diagnoses. There were ad-

ditional measures of individual risk factors, family adversities, school factors, and

neighbourhood disadvantage. Measures were obtained from multiple informants

(parent, teacher and self-report) in a one-phase design, that is, applying all

relevant measures on all participants.

Survey of 5–16-year-olds

The sampling frame was a government register of children and adolescents living

in private households. Information was collected on around 10,000 5–15-year-

olds in 1999 and a separate sample of around 8,000 5–16-year-olds in 2004

(representing a 69% participation rate).

Prevalence of disorders

Disorder (DSM-IV or ICD-10) (%)

Behavioural disorders (DSM-IV or ICD-10) 5.3

Anxiety disorders (DSM-IV or ICD-10) 3.8

Hyperkinesis (ICD-10) 1.4

ADHD (DSM-IV) 2.2

Depression (DSM-IV or ICD-10) 0.9

Autistic spectrum disorder (DSM-IV or ICD-10) 0.9

Any DSM-IV disorder∗ 9.8

Any ICD-10 disorder∗ 9.5

Note:∗Less than the sum of the individual diagnoses because of comorbidity.