Estimating the burden of psychiatric disorders in adolescence: the impact of subthreshold disorders
Abstract
Purpose We examine the impact of including subthreshold disorders on estimating psychiatric morbidity burden in adolescents. To more fully understand this burden it is important to focus on both full syndrome and subthreshold disorders and the impairment associated with each, since evidence suggests prevalence of subthreshold disorders is substantial as is impairment.Methods Data were analyzed from a probability sample of 4,175 youths 11-17 years of age. We examine the prevalence of DSM-IV disorders (FS) and subthreshold (SUB) disorders, with and without impairment. Diagnostic categories examined were anxiety, mood, attention deficit hyperactivity disorder, disruptive, and substance use disorders in the past year.Results The prevalence of any FS disorders was 16.1 and 42.3 % for SUB. The combined prevalence was 58.4 %. By requiring impairment, the prevalence of any FS in the past year dropped to 8 % and for SUB to 15.7 %, with a combined overall rate of 23.7 %. For FS disorders, 49.6 % met criteria for moderate to severe impairment, compared to 37.8 % for SUB. One in four adolescents had either an FS or SUB disorder with impairment.Conclusion The results indicate that SUB disorders constitute a major public health burden in terms of psychiatric morbidity among adolescents. Given their substantial impairment and their high prevalence, consideration should be given to including SUB disorders in estimates of the public health burden psychiatric morbidity. Doing so would provide a more accurate estimate of psychiatric morbidity.
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Subclinical symptoms cause considerable functional impairment.
“subclinical symptoms (i.e., psychopathology before diagnostic criteria are fully met) cause considerable functional impairment [10]”
From Efficacy of a transdiagnostic Internet prevention approach in adolescents (EMPATIA study): study protocol of a randomized controlled trial (2024) · cites this paper as [10]
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Clinical and Functional Outcomes of At-Risk Mental State Among Non-Help Seeking AdolescentsPreprint
Švancer, P., Dorazilová, A., Voráčková, V., Knytl, P., Mohr, P., Rodríguez, M., Jonáš, J., & Šebela, A. (2020) · doi:10.21203/rs.3.rs-65345/v1
Švancer, P., Dorazilová, A., Voráčková, V., Knytl, P., Rodríguez, M., Jonáš, J., Šebela, A., & Mohr, P. (2022) · Research Square · doi:10.21203/rs.3.rs-2276857/v1
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Basque, D., Patte, K. A., Leatherdale, S. T., & Ferro, M. A. (2026) · Clinical Child Psychology and Psychiatry · doi:10.1177/13591045261430399
Boonstra, A., van Mastrigt, G. A. P. G., Evers, S., Osstyn, S. L., de Winter, R. F. P., Boonstra, N., van Amelsvoort, T., & Leijdesdorff, S. M. J. (2026) · PLoS ONE · doi:10.1371/journal.pone.0352652
Psychiatric difficulties in females with fragile X syndrome: a systematic review and meta-analyses
Jenner, L., Koenig, C., Hantman, R. M., Hogan, A. L., Roberts, J. E., & Klusek, J. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1886787
- Authors
- Roberts, R. E., Fisher, P. W., Blake Turner, J., & Tang, M.
- Affiliations
- The University of Texas at San Antonio Health Science Center (US)
- New York State Psychiatric Institute (US)
- Corresponding author
- Roberts, Robert E.
- Venue
- Social Psychiatry and Psychiatric Epidemiology
- Published
- 2014-10-31
- Volume
- 50
- Issue
- 3
- Pages
- 397-406
- ISSN
- 0933-7954 (ISSN-L)
- 1433-9285
- OpenAlex
- W2016977838
- Cited by
- 59
- References
- 40
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 11 · 2023: 4 · 2022: 4 · 2021: 4 · 2020: 6 · 2019: 7 · 2018: 2 · 2017: 7 · 2016: 2 · 2015: 2
- FWCI
- 5.39
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Social Psychiatry and Psychiatric Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- U.S. Public Health Service (MHI85150)
- National Institute of Mental Health (R01MH049764, MH65606, R01MH065606, MH 49764)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Keywords
- mental health burden, functional disability, prevalence, anxiety disorders, mood disorders, attention deficit hyperactivity disorder, disruptive behavior disorders, substance use disorders, DSM-IV disorders, public health burden
- MeSH terms
- Adolescent, Mental Disorders, Child, Humans, Severity of Illness Index, Prevalence, Cost of Illness, Diagnostic and Statistical Manual of Mental Disorders
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