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Cited by 346Child Welfare and AdoptionChild and Adolescent Psychosocial and Emotional DevelopmentMental Health Treatment and Access

The Prevalence of Mental Disorders Among Children and Adolescents in the Child Welfare System: A Systematic Review and Meta-Analysis

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Bronsard, Guillaume, Alessandrini, Marine, Fond, Guillaume, Loundou, Anderson, Auquier, Pascal, Tordjman, Sylvie, Boyer, Laurent·2016·Medicine
DOI 10.1097/md.0000000000002622PMC PMC4998603
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Abstract

It remains unclear whether children and adolescents in the child welfare system (CWS) exhibit a higher prevalence of mental disorders compared with the general population. The objective of this study was to perform a systematic review and meta-analysis to assess the prevalence of mental disorders in the CWS.A ll of the epidemiological surveys assessing the prevalence of mental disorders in children and adolescents in the CWS were included. The pooled prevalence was estimated with random effect models. Potential sources of heterogeneity were explored using meta-regression analyses.E ight studies provided prevalence estimates that were obtained from 3104 children and adolescents. Nearly 1 child or adolescent of every 2 (49%; 95% confidence interval (CI) 43-54) was identified as meeting criteria for a current mental disorder. The most common mental disorder was disruptive disorder (27%; 95% CI 20-34), including conduct disorder (20%; 95% CI 13-27) and oppositional defiant disorder (12%; 95% CI 10-14). The prevalence of attention-deficit/hyperactivity disorder was estimated to be 11% (95% CI 6-15). The prevalence estimates of anxiety and depressive disorders were 18% (95% CI 12-24) and 11% (95% CI 7-15). Posttraumatic stress disorder had the lowest prevalence (4%; 95% CI 2-6). High prevalences of mental disorders in the CWS were reported, which highlights the need for the provision of qualified service. The substantial heterogeneity of our findings is indicative of the need for accurate epidemiological data to effectively guide public policy.

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  • Care-experienced populations report relatively pronounced adversity when compared to non-care-experienced peers.

    “research indicates that care-experienced populations report relatively pronounced adversity when compared to non-care-experienced peers (Bronsard et al., 2016; Engler et al., 2022; Ford et al., 2018; Long et al., 2017).”

    From Effectiveness of Mental Health and Wellbeing Interventions for Children and Young People in Foster, Kinship, and Residential Care: Systematic Review and Meta-Analysis (2024) · cites this paper as Bronsard et al., 2016

    The Introduction (page unavailable) describes histories of abuse, neglect, separation and placement instability among children in the child welfare system. The Discussion (page unavailable) compares their mental-disorder prevalence with that of the general population, but says adverse-experience data were unavailable for analysis. The paper therefore does not establish the claimed comparison in adversity with non-care-experienced peers. (LLM, conf=0.85)

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Research works printed but not linked: 53

  1. [1]Achenbach TM Rescorla LA Ivanova MY International epidemiology of child and adolescent psychopathology I: diagnoses, dimensions, and conceptual issues. J Am Acad Child Adolesc Psychiatry 2012; 51: 1261– 1272. 23200283
  2. [3]Rescorla L Ivanova MY Achenbach TM International epidemiology of child and adolescent psychopathology ii: integration and applications of dimensional findings from 44 societies. J Am Acad Child Adolesc Psychiatry 2012; 51: 1273– 1283. e1278. 23200284
  3. [4]McMillen JC Zima BT Scott LD Jr Prevalence of psychiatric disorders among older youths in the foster care system. J Am Acad Child Adolesc Psychiatry 2005; 44: 88– 95. 15608548
  4. [5]Ford T Vostanis P Meltzer H Psychiatric disorder among British children looked after by local authorities: comparison with children living in private households. Br J Psychiatry 2007; 190: 319– 325. 17401038
  5. [6]Rosenfeld AA Pilowsky DJ Fine P Foster care: an update. J Am Acad Child Adolesc Psychiatry 1997; 36: 448– 457. 9100418
  6. [7]Bailleau G Trespeux F Les bénéficiaires de l’aide sociale des départements en 2006. Document de travail, Série statistiques DREES 2008; 1: 12– 22.
  7. [9]Lehmann S Havik OE Havik T Mental disorders in foster children: a study of prevalence, comorbidity and risk factors. Child Adolesc Psychiatry Ment Health 2013; 7: 39. 24256809 PMC3922948
  8. [10]Bronsard G Lancon C Loundou A Prevalence rate of DSM mental disorders among adolescents living in residential group homes of the French child welfare system. Child Youth Serv Rev 2011; 33: 1886– 1890.
  9. [12]Oswald SH Heil K Goldbeck L History of maltreatment and mental health problems in foster children: a review of the literature. J Pediatr Psychol 2010; 35: 462– 472. 20007747
  10. [13]Blower A Addo A Hodgson J Mental health of looked after children: a needs assessment. Clin Child Psychol Psychiatry 2004; 9: 117– 119.
  11. [14]Garland AF Hough RL McCabe KM Prevalence of psychiatric disorders in youths across five sectors of care. J Am Acad Child Adolesc Psychiatry 2001; 40: 409– 418. 11314566
  12. [15]Schmid M Goldbeck L Nuetzel J Prevalence of mental disorders among adolescents in German youth welfare institutions. Child Adolesc Psychiatry Ment Health 2008; 2: 2. 18226213 PMC2262059
  13. [16]Bronsard G Lancon C Loundou A Quality of life and mental disorders of adolescents living in French residential group homes. Child Welfare 2013; 92: 47– 71. 24818430
  14. [17]Burns BJ Phillips SD Wagner HR Mental health need and access to mental health services by youths involved with child welfare: a national survey. J Am Acad Child Adolesc Psychiatry 2004; 43: 960– 970. 15266190
  15. [18]Levitt JM Identification of mental health service need among youth in child welfare. Child Welfare 2009; 88: 27– 48. 19653452
  16. [19]Pecora PJ Jensen PS Romanelli LH Mental health services for children placed in foster care: an overview of current challenges. Child Welfare 2009; 88: 5– 26. 19653451 PMC3061347
  17. [20]Yampolskaya S Chuang E Effects of mental health disorders on the risk of juvenile justice system involvement and recidivism among children placed in out-of-home care. Am J Orthopsychiatry 2012; 82: 585– 593. 23039356
  18. [22]Scott S Knapp M Henderson J Financial cost of social exclusion: follow up study of antisocial children into adulthood. BMJ 2001; 323: 191. 11473907 PMC35269
  19. [23]von Elm E Altman DG Egger M Strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. BMJ 2007; 335: 806– 808. 17947786 PMC2034723
  20. [24]DerSimonian R Laird N Meta-analysis in clinical trials. Controlled Clin Trials 1986; 7: 177– 188. 3802833
  21. [25]Higgins J Thompson S Deeks J Statistical heterogeneity in systematic reviews of clinical trials: a critical appraisal of guidelines and practice. J Health Serv Res Policy 2002; 7: 51– 61. 11822262
  22. [26]Higgins JP Thompson SG Deeks JJ Measuring inconsistency in meta-analyses. BMJ 2003; 327: 557– 560. 12958120 PMC192859
  23. [27]Borenstein M Hedges LV Higgins JPT Rothstein HR Introduction to Meta-Analysis. Wiley. 2008.
  24. [28]Ambrosini PJ Historical development and present status of the schedule for affective disorders and schizophrenia for school-age children (K-SADS). J Am Acad Child Adolesc Psychiatry 2000; 39: 49– 58. 10638067
  25. [29]Breton JJ Bergeron L Valla JP Diagnostic Interview Schedule for Children (DISC-2.25) in Quebec: reliability findings in light of the MECA study. J Am Acad Child Adolesc Psychiatry 1998; 37: 1167– 1174. 9808928
  26. [30]Chambers WJ Puig-Antich J Hirsch M The assessment of affective disorders in children and adolescents by semistructured interview. Test-retest reliability of the schedule for affective disorders and schizophrenia for school-age children, present episode version. Arch Gen Psychiatry 1985; 42: 696– 702. 4015311
  27. [32]Kaufman J Birmaher B Brent D Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry 1997; 36: 980– 988. 9204677
  28. [33]Robins LN Helzer JE Croughan J National Institute of Mental Health Diagnostic Interview Schedule. Its history, characteristics, and validity. Arch Gen Psychiatry 1981; 38: 381– 389. 6260053
  29. [34]Shaffer D Fisher P Lucas CP NIMH Diagnostic Interview Schedule for Children Version IV (NIMH DISC-IV): description, differences from previous versions, and reliability of some common diagnoses. J Am Acad Child Adolesc Psychiatry 2000; 39: 28– 38. 10638065
  30. [37]Birmaher B Brent D Bernet W Practice parameter for the assessment and treatment of children and adolescents with depressive disorders. J Am Acad Child Adolesc Psychiatry 2007; 46: 1503– 1526. 18049300
  31. [38]Bowlby J The making and breaking of affectional bonds. I. Aetiology and psychopathology in the light of attachment theory. An expanded version of the Fiftieth Maudsley Lecture, delivered before the Royal College of Psychiatrists, 19 November 1976. Br J Psychiatry 1977; 130: 201– 210. 843768
  32. [39]Bowlby J The making and breaking of affectional bonds. II. Some principles of psychotherapy. The fiftieth Maudsley Lecture. Br J Psychiatry 1977; 130: 421– 431. 861423
  33. [40]Bowlby J Developmental psychiatry comes of age. Am J Psychiatry 1988; 145: 1– 10. 3276225
  34. [41]Cassidy J Jones JD Shaver PR Contributions of attachment theory and research: a framework for future research, translation, and policy. Dev Psychopathol 2013; 25: 1415– 1434. 24342848 PMC4085672
  35. [42]Mikulincer M Shaver PR An attachment perspective on psychopathology. World Psychiatry 2012; 11: 11– 15. 22294997 PMC3266769
  36. [43]Bruskas D Developmental health of infants and children subsequent to foster care. J Child Adolesc Psychiatr Nurs 2010; 23: 231– 241. 21073598
  37. [44]Kessler RC Avenevoli S Costello EJ Prevalence, persistence, and sociodemographic correlates of DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Supplement. Arch Gen Psychiatry 2012; 69: 372– 380. 22147808 PMC3445020
  38. [45]Merikangas KR Nakamura EF Kessler RC Epidemiology of mental disorders in children and adolescents. Dialogues Clin Neurosci 2009; 11: 7– 20. 19432384 PMC2807642
  39. [46]Brinkman WB Epstein JN Auinger P Association of attention-deficit/hyperactivity disorder and conduct disorder with early tobacco and alcohol use. Drug Alcohol Depend 2014; 147: 183– 189. 25487225 PMC4297712
  40. [47]Chamberlain P Leve LD Smith DK Preventing Behavior Problems and Health-risking Behaviors in Girls in Foster Care. Int J Behav Consult Ther 2006; 2: 518– 530. 18176629 PMC2174788
  41. [49]Doria GM Antoniuk SA Assumpcao Junior FB Delinquency and association with behavioral disorders and substance abuse. Rev Assoc Med Bras 2015; 61: 51– 57. 25909209
  42. [50]Firdion JM Influence des événements de jeunesse et héritage social au sein de la population des utilisateurs des services d’aide aux sans-domicile. Économie et Statistiques 2006; 12: 391– 392.
  43. [52]Crum RM Green KM Storr CL Depressed mood in childhood and subsequent alcohol use through adolescence and young adulthood. Arch Gen Psychiatry 2008; 65: 702– 712. 18519828 PMC4151267
  44. [53]Marmorstein NR White HR Loeber R Anxiety as a predictor of age at first use of substances and progression to substance use problems among boys. J Abnorm Child Psychol 2009; 38: 211– 224. 19821024 PMC2857386
  45. [57]Browne K Hamilton-Giachritsis C Johnson R Overuse of institutional care for children in Europe. BMJ 2006; 332: 485– 487. 16497769 PMC1382554
  46. [58]Fisher PA Chamberlain P Leve LD Improving the lives of foster children through evidenced-based interventions. Vulnerable Child Youth Stud 2009; 4: 122– 127. 20396626 PMC2853965
  47. [60]Romano E Tremblay RE Vitaro F Sex and informant effects on diagnostic comorbidity in an adolescent community sample. Can J Psychiatry 2005; 50: 479– 489. 16127966
  48. [61]Fazel M Wheeler J Danesh J Prevalence of serious mental disorder in 7000 refugees resettled in western countries: a systematic review. Lancet 2005; 365: 1309– 1314. 15823380
  49. [63]Adornetto C Suppiger A In-Albon T Concordances and discrepancies between ICD-10 and DSM-IV criteria for anxiety disorders in childhood and adolescence. Child Adolesc Psychiatry Ment Health 2012; 6: 40. 23267678 PMC3556103
  50. [64]Romano E Tremblay RE Vitaro F Prevalence of psychiatric diagnoses and the role of perceived impairment: findings from an adolescent community sample. J Child Psychol Psychiatry 2001; 42: 451– 461. 11383961
  51. [65]Costello EJ Egger H Angold A 10-year research update review: the epidemiology of child and adolescent psychiatric disorders: I. Methods and public health burden. J Am Acad Child Adolesc Psychiatry 2005; 44: 972– 986. 16175102
  52. [66]Fisher PA Mannering AM Van Scoyoc A A translational neuroscience perspective on the importance of reducing placement instability among foster children. Child Welfare 2013; 92: 9– 36. 24923133 PMC4396742
  53. [67]Romanelli LH Landsverk J Levitt JM Best practices for mental health in child welfare: screening, assessment, and treatment guidelines. Child Welfare 2009; 88: 163– 188. 19653458

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Authors
Bronsard, G., Alessandrini, M., Fond, G., Loundou, A., Auquier, P., Tordjman, S., & Boyer, L.
Affiliations
  • Inserm (FR)
  • Aix-Marseille Université (FR)
  • Laboratoire Psychologie de la Perception (FR)
Corresponding author
Bronsard, Guillaume
ORCID
Venue
Medicine
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2016-02
Volume
95
Issue
7
Pages
e2622
ISSN
0025-7974 (ISSN-L)
DOI
10.1097/md.0000000000002622
PMC
PMC4998603
OpenAlex
W2330096486
Cited by
346
References
11
Citations by year
2026: 45 · 2025: 54 · 2024: 51 · 2023: 44 · 2022: 40 · 2021: 35 · 2020: 37 · 2019: 13 · 2018: 20 · 2017: 7
FWCI
4.25
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Medicine (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • HAL AMU (submittedVersion)
Topics
  • Social Sciences › Safety Research › Child Welfare and Adoption
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords
child welfare system, mental illness, prevalence, children and adolescents, disruptive behavior disorders, conduct disorder, oppositional defiant disorder, attention deficit hyperactivity disorder, anxiety disorders, depressive disorders, post-traumatic stress disorder, child mental health services
MeSH terms
Adolescent, Anxiety Disorders, Attention Deficit Disorder with Hyperactivity, Mental Disorders, Child, Child Welfare, Depressive Disorder, Humans, Prevalence, Conduct Disorder, Observational Studies as Topic

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