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The British Child and Adolescent Mental Health Survey 1999: The Prevalence of DSM-IV Disorders
Open accessAbstract
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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“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]
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“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].”
From Mental disorders in foster children: a study of prevalence, comorbidity and risk factors (2013) · cites this paper as [23]
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“Previous studies based on this dataset have shown that although weighting, stratification and clustering need to be taken into account when calculating exact prevalences (Ford et al., 2003), these design effects were sufficiently small that no adjustment was necessary when patterns of association are being established…”
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“However, unlike other German and international studies which report higher prevalence rates in samples of older children and adolescents [8, 23 ], our findings suggest a small decrease in overall mental health problems in the older age group.”
ResultKey findings from the second Australian Child and Adolescent Survey of Mental Health and Wellbeing
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“Our results regarding sociodemographic variables are largely consistent with previous research (McGee et al. 1992; Costello et al. 1996, 2005b; Verhulst et al. 1997; Fergusson & Horwood, 2001; Ford et al. 2003; Merikangas et al. 2010; Kessler et al. 2012a).”
BackgroundResultInfluentialWhat causes attention deficit hyperactivity disorder?
Thapar, A., Cooper, M., Jefferies, R., & Stergiakouli, E. (2011) · Archives of Disease in Childhood · doi:10.1136/archdischild-2011-300482 · Cited by 327
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“Similarly, in the United Kingdom, Ford et al. (2003b) found that only 22% of those with significant mental health disorders had received treatment from specialist child and adolescent mental health services in the past 18 months, with those with emotional disorders being the least likely to receive…”
BackgroundResultInfluentialInternational trends in antipsychotic use: A study in 16 countries, 2005–2014
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BackgroundZwierzynska, K., Dieter Wolke, C., & Lereya, S. T. (2012) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-012-9678-8 · Cited by 314
“5% and 5%, in a nationally representative UK sample (Ford et al. 2003).”
BackgroundKiGGS Study Group, Hölling, H., Schlack, R., Petermann, F., Ravens‐Sieberer, U., & Mauz, E. (2014) · Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz · doi:10.1007/s00103-014-1979-3 · Cited by 268
Prevalence of Parent-Reported ASD and ADHD in the UK: Findings from the Millennium Cohort Study
Russell, G., Rodgers, L. R., Ukoumunne, O. C., & Ford, T. J. (2013) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-013-1849-0 · Cited by 296
“5 % is very similar to previous estimates for ADHD and hyperkinetic disorder in the UK based on research diagnosis (Ford et al. 2003; Green et al. 2005).”
ResultSelf-citationComorbidity of internalizing disorders in children with oppositional defiant disorder
Boylan, K., Vaillancourt, T., Boyle, M., & Szatmári, P. (2007) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-007-0624-1 · Cited by 285
Bøe, T., Sivertsen, B., Heiervang, E. R., Goodman, R., Lundervold, A. J., & Hysing, M. (2013) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-013-9818-9 · Cited by 287
“In addition, epidemiological studies of child and adolescent mental health problems have found large degrees of overlap between diagnostic groups (Ford et al. 2003; Heiervang et al. 2007; Merikangas et al. 2010), but few studies of the family process model have considered comorbidity (i.e. presence…”
BackgroundSelf-citationForness, S. R., Freeman, S. F. N., Paparella, T., Kauffman, J. M., & Walker, H. M. (2011) · Journal of Emotional and Behavioral Disorders · doi:10.1177/1063426611401624 · Cited by 271
PTSD in children and adolescents: toward an empirically based algorithma
Scheeringa, M. S., Zeanah, C. H., & Cohen, J. A. (2011) · Depression and Anxiety · doi:10.1002/da.20736 · Cited by 249
Transition of care from child to adult mental health services: the great divide
Singh, S. P. (2009) · Current Opinion in Psychiatry · doi:10.1097/yco.0b013e32832c9221 · Cited by 246
“common in adolescence, both in terms of psychiatric disorder and additional problems; and comorbidity among those attending CAMHS is likely to be even higher [5, 6].”
Goodman, A., & Goodman, R. (2010) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2010.02278.x · Cited by 244
Self-citationInfluence of gender on Attention-Deficit/Hyperactivity Disorder in Europe – ADORE
Nøvik, T. S., Amaia Hervas, G., Ralston, S. J., Dalsgaard, S., Pereira, R. R., Lorenzo, M. J., & ADORE Study Group* (2006) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-006-1003-z · Cited by 240
“2 % of any ADHD,and a 1:4 ratio in girls compared to boys [11].”
BackgroundMental disorders in foster children: a study of prevalence, comorbidity and risk factors
Lehmann, S., Havik, O. E., Havik, T., & Heiervang, E. R. (2013) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/1753-2000-7-39 · Cited by 236
“Age, sex, and learning difficulties [31,32], as well as low socioeconomic status [33,34], are well-established predictors of mental health problems in children in general.”
BackgroundSchrieken, M., Visser, J. C., Oosterling, I. J., van Steijn, D. J., Bons, D. M. A., Draaisma, J. M. T., van der Gaag, R. J., Buitelaar, J. K., Donders, R., & Rommelse, N. N. J. (2012) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-012-0318-1 · Cited by 233
Finning, K., Ukoumunne, O. C., Ford, T. J., Danielsson-Waters, E., Shaw, L., Jager, I. R. D., Stentiford, L., & Moore, D. A. (2018) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.11.055 · Cited by 238
Self-citationYoshimasu, K., Barbaresi, W. J., Colligan, R. C., Voigt, R. G., Killian, J. M., Weaver, A. L., & Katusic, S. K. (2012) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2012.02567.x · Cited by 290
“The strongest association was between ADHD and ODD/CD, generally consistent with previous school/ community-based studies (Ford et al., 2003; Kadesjo & Gillberg, 2001; Romano et al., 2005; Smalley et al., 2007).”
BackgroundResultInvolvement in bullying and depression in a 2-year follow-up in middle adolescence
Kaltiala‐Heino, R., Fröjd, S. A., & MARTTUNEN, M. J. (2009) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-009-0039-2 · Cited by 232
“For example, in depression research the usefulness of samples with both children and adolescents in studies of risk factors has been criticised, considering the increase in prevalence of during transition from childhood to adolescence [14, 20, 40].”
BackgroundZwi, M., Jones, H. G., Thorgaard, C., York, A., & Dennis, J. A. (2011) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003018.pub3 · Cited by 247
Practitioner Review: Non‐pharmacological treatments for ADHD: A lifespan approach
Young, S., & Amarasinghe, M. (2009) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2009.02191.x · Cited by 225
de Wied, M. A., Boxtel, A. V., Matthys, W., & Meeus, W. (2011) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-011-9557-8 · Cited by 251
“Disruptive behavior disorders (DBD), including oppositional defiant disorder (ODD) and conduct disorder (CD), are the most prevalent psychiatric disorders in children and adolescents (e.g., Ford et al. 2003; Verhulst et al. 1997).”
BackgroundFrancis, D. A., Caruana, N., Hudson, J. L., & McArthur, G. M. (2018) · Clinical Psychology Review · doi:10.1016/j.cpr.2018.09.002 · Cited by 225
250 labels used to stigmatise people with mental illness
Rose, D. S., Thornicroft, G., Pinfold, V., & Kassam, A. (2007) · BMC Health Services Research · doi:10.1186/1472-6963-7-97 · Cited by 245
“Yet mental illnesses among children and adolescents are common, affecting about 10% of young people [6,7].”
BackgroundNiclasen, J., Teasdale, T. W., Andersen, A. N., Skovgaard, A. M., Elberling, H., & Obel, C. (2012) · PLoS ONE · doi:10.1371/journal.pone.0032025 · Cited by 247
“Mental health problems of children and adolescents occur frequently in the general population with prevalence rates of psychopathology estimated from 7% in rural Brazil and Norway, 10% in Britain and Denmark and up to 15% in Russia and Bangladesh [1–6].”
Mullick, M. S. I., & Goodman, R. (2005) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-005-0939-5 · Cited by 216
“The prevalence is probably higher still in adolescents [9].”
BackgroundInfluentialSelf-citationRamchandani, P. G., O’Connor, T. G., Evans, J., Heron, J., Murray, L., & Stein, A. L. (2008) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2008.02000.x · Cited by 216
Attention-deficit hyperactivity disorder: treatment discontinuation in adolescents and young adults
McCarthy, S., Asherson, P., Coghill, D., Hollis, C., Murray, M., Potts, L., Sayal, K., de Soysa, R., Taylor, E., Williams, T., et al. (2009) · British Journal of Psychiatry · doi:10.1192/bjp.bp.107.045245 · Cited by 215
Rates of DSM-IV psychiatric disorders among adolescents in a large metropolitan area.
Roberts, R. E., Roberts, C. R., & Xing, Y. (2007) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2006.09.006 · Cited by 213
“Similar to the findings from other studies of children and adolescents, without adjusting for impairment, we found many of the expected associations of psychiatric disorders with gender and age (Costello et al., 1997; Ford et al., 2003; Feehan et al., 1994; Lewinsohn et al., 1993; Bird et al., 1989; Simpson et al., 20…”
BackgroundResultInfluentialSubthreshold depression in children and adolescents – a systematic review
Wesselhoeft, R. T., Sørensen, M. J., Heiervang, E. R., & Bilenberg, N. (2013) · Journal of Affective Disorders · doi:10.1016/j.jad.2013.06.010 · Cited by 241
Long-term outcomes of obsessive–compulsive disorder: follow-up of 142 children and adolescents
Micali, N., Heyman, I., Pérez, M., Hilton, K., Nakatani, E., Turner, C. M., & Mataix‐Cols, D. (2010) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.109.075317 · Cited by 216
Prevalence of DSM-IV Disorder in a Representative, Healthy Birth Cohort at School Entry
Carter, A. S., Wagmiller, R. J., Gray, S. A. O., McCarthy, K. J., Horwitz, S. M., & Briggs‐Gowan, M. J. (2010) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2010.03.018 · Cited by 212
The Co-Development of Parenting Stress and Childhood Internalizing and Externalizing Problems
Stone, L. L., Mares, S. H., Otten, R., Engels, R., & Janssens, J. (2015) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-015-9500-3 · Cited by 181
“Regarding internalizing problems, no such gender differences were found (Ford et al. 2003).”
BackgroundViner, R., Booy, R., Johnson, H., Edmunds, W. J., Hudson, L. D., Bedford, H. E., Kaczmarski, E., Rajput, K. M., Ramsay, M. E., & Christie, D. (2012) · The Lancet Neurology · doi:10.1016/s1474-4422(12)70180-1 · Cited by 207
Seixas, M., Weiss, M., & Müller, U. (2012) · Journal of Psychopharmacology · doi:10.1177/0269881111412095 · Cited by 197
“…hyperactivity disorder (ADHD) is a common neurodevelopmental disorder, with a worldwide prevalence estimated to lie between 0.85% and 10% in childhood and adolescence, and between 0.5% and 4.4% in adulthood (Fayyad et al., 2007; Ford et al., 2003; Kessler et al., 2006; Polanczyk et al., 2007).”
BackgroundInfluentialEconomic cost of severe antisocial behaviour in children - and who pays it
Romeo, R., Knapp, M. R. J., & Scott, S. (2006) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.104.007625 · Cited by 199
Mental Health and Childhood Adversities: A Longitudinal Study in Kabul, Afghanistan
Panter‐Brick, C., Goodman, A., Tol, W. A., & Eggerman, M. (2011) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2010.12.001 · Cited by 219
Lyneham, H. J., & Rapee, R. M. (2005) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-200503000-00012 · Cited by 198
Epidemiologic Considerations in Attention Deficit Hyperactivity Disorder: A Review and Update
Polanczyk, G., & Jensen, P. (2008) · Child and Adolescent Psychiatric Clinics of North America · doi:10.1016/j.chc.2007.11.006 · Cited by 198
“ontana, et al [37] Brazil 6–12 DSM-IV An ord, et al [38] Great Britain 5–15 DSM-IV Bes adow, et al [39] Ukraine 10–12 DSM-IV Par au, et al [40] South Taiwan 13–15 DSM-IV Bes aub and Carlson [41] United States Grades 1–5 DSM-IV Tea omez, et al [42] Australia 5–11 DSM-IV An oodman, et al [43] England and Scotland 5–15 D…”
Backgroundthe BELLA study group, Döpfner, M., Breuer, D., Wille, N., Erhart, M., & Ravens‐Sieberer, U. (2008) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-008-1007-y · Cited by 196
“The influence of age on the prevalence of ADHD was strongly supported by the findings of several studies from the United States, the United Kingdom, Spain, Canada and Germany, all of which show a decline in prevalence rates with age [14, 24, 27, 31].”
Result
Metadata
- 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
- bronze
- doi.org
- 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
- Health Sciences › Medicine › Psychiatry and Mental health › 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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