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Child psychiatric disorder and relative age within school year: cross sectional survey of large population sample

BMJ 2003; 327 doi: (Published 28 August 2003) Cite this as: BMJ 2003;327:472

Rapid Response:

What Are the Specific DSM4 Psychiatric Diagnoses?

Goodman R, Gledhill J & Ford T have studied almost 10,500 school
children, and they have concluded that younger children in the school year
are more likely to have a psychiatric diagnosis (BMJ 2003;327:472-5).

They say that the youngest third of children in a school year have a
psychiatric diagnosis at the rate of 9.9%, compared to 8.8% for the middle
third and 8.3% for the oldest third in the school year. These percentages
are for their "Any Psychiatric Diagnosis" category.

The statistical significance for these three percentages for "Any
Psychiatric Diagnosis" is P = 0.03 (significant). This is not nearly as
high a level of statistical significance compared to the 0.001 (very
highly significant) which they get for both the parent and for the teacher
reported symptoms for All Ages and for the 5-10 year old group.

Please will Goodman R et al provide us with the breakdown they must
have of this "Any Psychiatric Diagnosis" category they use. Please will
they post on the BMJ website the percentages for each of the three thirds
of a year in each of the three age categories for each and every
psychiatric diagnosis by name.

It is important for the rest of us, especially clinicians, to know
which psychiatric diagnoses were more common and which were less common.
I suggest that the category of "Any Psychiatric Diagnosis" may not be very
helpful, although I suspect that the limitation on space in the journal
may have required this "mixed-bag" category from them.

If the Editor cannot accept a full breakdown of the "Any Psychiatric
Diagnosis" according to the specific DSM4 diagnosis, then please would the
authors email this data to me, and we can then discuss it on

This is an important study and deserves discussion. Please may we
have this data within the next seven days.

Competing interests:  
None declared

Competing interests: No competing interests

01 September 2003
Dr P V Finn Cosgrove
Consultant All-Age Psychiatrist
The Bristol Priority Clinic, BA2 5YD