Child and Adolescent Psychiatry

Epidemiology 35

Looked-after children and adolescents

Roughly 0.5% of British children and adolescents are looked after by local

authorities, either living with foster parents or in special institutions. In 2002–3,

a national sample of over a thousand looked-after children and adolescents in

Britain were assessed using the same measures employed in the previous surveys

of children and adolescents living in private households.

Prevalence of disorder

Any Conduct Emotional Hyperkinetic

0

10

20

%

30

Looked-after

Comparison

40

50

Overall, rates of psychiatric disorder were five times higher than in population

controls. Rates were particularly high when children and adolescents were living

in institutions rather than with foster families, and when they had experienced

repeated changes in placement. It is not clear what is cause and what is effect.

Box 3.2 compares rates of disorders in several countries, all based on
surveys using the same measures of psychopathology employed in the
British surveys. Such comparisons of findings across countries that differ
in language, culture and economic development are obviously are not
straightforward to interpret, but using equivalent measures in each coun-
try does at least reduce one source of confusion. The findings suggest that
there are clinically significant differences in prevalence between countries,
but that these differences are moderate rather than large in magnitude.

Box 3.2Prevalence of psychiatric disorders in five contrasting

countries

0

5

10

15

20

Norway Britain Brazil Russia Yemen