Cited by 1,227Child and Adolescent Psychosocial and Emotional DevelopmentMental Health Treatment and AccessAttention Deficit Hyperactivity Disorder

The British Child and Adolescent Mental Health Survey 1999: The Prevalence of DSM-IV Disorders

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FORD, TAMSIN, GOODMAN, ROBERT, MELTZER, HOWARD·2003·Journal of the American Academy of Child & Adolescent Psychiatry

Abstract

Objective To describe the prevalence of DSM-IV disorders and comorbidity in a large population-based sample of British children and adolescents.Method Using a one-phase design, 10,438 children were assessed using the Development and Well-Being Assessment (DAWBA), a structured interview with verbatim reports reviewed by clinicians so that information from parents, teachers, and children was combined in a manner that emulated the clinical process. The authors' analysis examined comorbidity and the influence of teacher reports.Results The overall prevalence of DSM-IV disorders was 9.5% (95% confidence interval 8.8-10.1%), but 2.1% of children were assigned "not otherwise specified" rather than operationalized diagnoses. After adjusting for the presence of a third disorder, there was no longer significant comorbidity between anxiety and conduct disorder or attention-deficit/hyperactivity disorder (ADHD), or between depression and oppositional defiant disorder. A comparison of the disorders in children with and without teacher reports suggested that the prevalence of conduct disorders and ADHD would be underestimated in the absence of teacher information.Conclusions Roughly 1 in 10 children have at least one DSM-IV disorder, involving a level of distress or social impairment likely to warrant treatment. Comorbidity reported between some childhood diagnoses may be due to the association of both disorders with a third. Diagnoses of conduct disorder and ADHD may be missed if information is not sought from teachers about children's functioning in school.

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  • DSM diagnostic criteria for adolescent MDD have low diagnostic validity and specificity, resulting in unclear diagnostic boundaries especially with regard to generalized and social anxiety.

    “the DSM diagnostic criteria for adolescent MDD have low diagnostic validity and specificity, resulting in unclear diagnostic boundaries especially with regard to generalized and social anxiety”

    From Feasibility and preliminary efficacy of a novel RDoC-based treatment program for adolescent depression: "Training for Awareness Resilience and Action" (TARA)-A pilot study (2017) · cites this paper as [10]

    The “Not Otherwise Specified” Disorders section says some impaired children have symptoms spanning DSM-IV categories without meeting criteria for one diagnosis, and the Comorbidity section reports overlap between anxiety and depression. These findings support a general concern about classification boundaries, but the paper does not establish that adolescent MDD criteria have low validity or specificity, or that boundaries are especially unclear with generalized and social anxiety. Page numbers are unavailable in our copy. (LLM, conf=0.82)

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  • Children exposed to early adverse childhood experiences in general, and more specifically children placed in foster care, have a heightened risk of attachment difficulties.

    “Findings indicate that children exposed to early adverse childhood experiences in general [22] and more specifically children placed in foster care have a heightened risk of attachment difficulties [23,24].”

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  1. Stata Corporation (1997), STATA Reference Manual, Release 6, Volume 4, Su-Z. College Station, TX: Stata Press, pp 15-99

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Authors
FORD, T., GOODMAN, R., & MELTZER, H.
Affiliations
  • King's College London (GB)
  • Office for National Statistics (GB)
Venue
Journal of the American Academy of Child & Adolescent Psychiatry
Publisher
Elsevier BV
Published
2003-10
Volume
42
Issue
10
Pages
1203-1211
ISSN
0890-8567 (ISSN-L)
OpenAlex
W2057670386
Cited by
1,227
References
37
Citations by year
2026: 7 · 2025: 14 · 2024: 18 · 2023: 25 · 2022: 33 · 2021: 40 · 2020: 54 · 2019: 44 · 2018: 53 · 2017: 59 · 2016: 75 · 2015: 88 · 2014: 102 · 2013: 84 · 2012: 103
FWCI
32.91
Type
journal article
Language
en
Open access
Locations
  • Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • Research Portal (King's College London) (submittedVersion)
  • Leicester Research Archive (University of Leicester) (submittedVersion)
Funders
Wellcome Trust
Topics
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
Keywords
child and adolescent mental health, DSM-IV disorders, prevalence, comorbidities, conduct disorder, attention deficit hyperactivity disorder, anxiety disorders, depression, oppositional defiant disorder, teacher reports, Development and Well-Being Assessment, school functioning
MeSH terms
Adolescent, Mental Disorders, Child, Child, Preschool, Female, United Kingdom, Health Surveys, Humans, Male, Mental Health, Social Behavior, Comorbidity, Prevalence, Diagnostic and Statistical Manual of Mental Disorders

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