Mental disorders common among US children, CDC says

BMJ 2013; 346 doi: (Published 20 May 2013) Cite this as: BMJ 2013;346:f3281
  1. Michael McCarthy
  1. 1Seattle

As many as one in five US children suffers from a mental disorder in a given year, according to a new report from the US Centers for Disease Control and Prevention (CDC).

The article, “Mental health surveillance among children—United States, 2005-2011,” which was published as a supplement of the 17 May issue of Morbidity and Mortality Weekly Report (MMWR), is the first comprehensive report on children’s mental health in the US, the CDC said.

The report summarizes information gathered from a wide variety of federal surveillance programs, including those of the CDC, the Health Resources and Services Administration, and the Substance Abuse and Mental Health Services Administration.

The report finds that a total of 13-20% of children, defined as people under 18 years old, in the US will experience a mental disorder in a given year and that the prevalence of these conditions has been increasing.

The most common diagnosis was attention-deficit/hyperactivity disorder (ADHD), which, based on parent reports, affected 6.8% of children aged 3-17 years. Behavioral or conduct problems were the next most prevalent disorders, affecting 3.5%, followed by depression (affecting 2.1%), autism spectrum disorders (1.1%), and Tourette syndrome (0.2%).

Illicit drug use and alcohol abuse disorders were common, with an estimated 4.7% of adolescents aged 12 to 17 reporting illicit drug use disorder and 4.2% reporting an alcohol abuse disorder.

The suicide rate for people aged 10-19 years was 4.5 suicides per 100 000 people in 2010, making it the second leading cause of death, after unintentional injuries, among children aged 12-17 in 2010.

The cost of these disorders to the US was estimated at $247bn a year, when the costs of healthcare, the use of such services as special education and the juvenile justices system, and lost productivity were factored in, the report found.

Boys were more likely than girls to be diagnosed with ADHD, behavioral or conduct problems, autism spectrum disorders, anxiety, or Tourette syndrome. Boys were also more likely to die by suicide.

Girls, on the other hand, were more likely to have alcohol use disorder, and adolescent girls, defined as girls age 12 to 17, were more likely to have depression.

An estimated 40% of children with one mental disorder had at least one other mental disorder. Children with mental disorders were also more likely to have other chronic conditions, such as asthma and diabetes, than were children who did not have mental disorders.

The report notes that there are substantial challenges in conducting surveillance of mental disorders. Different surveillance systems use different methods that make comparisons difficult, and changes case definitions, improvements in diagnosis, and even changes in the public perception of disorders can change prevalence statistics.

“An overall challenge is the establishment of consistent surveillance case definitions that allow for comparability and reliability of estimates among surveillance systems,” the report said.


Cite this as: BMJ 2013;346:f3281