Prevalence of childhood mental disorders in high-income countries: a systematic review and meta-analysis to inform policymaking

Abstract

QuestionMental disorders typically start in childhood and persist, causing high individual and collective burdens. To inform policymaking to address children’s mental health in high-income countries we aimed to identify updated data on disorder prevalence.MethodsWe identified epidemiological studies reporting mental disorder prevalence in representative samples of children aged 18 years or younger—including a range of disorders and ages and assessing impairment (searching January 1990 through February 2021). We extracted associated service-use data where studies assessed this. We conducted meta-analyses using a random effects logistic model (using R metafor package).FindingsFourteen studies in 11 countries met inclusion criteria, published from 2003 to 2020 with a pooled sample of 61 545 children aged 4–18 years, including eight reporting service use. (All data were collected pre-COVID-19.) Overall prevalence of any childhood mental disorder was 12.7% (95% CI 10.1% to 15.9%; I2=99.1%). Significant heterogeneity pertained to diagnostic measurement and study location. Anxiety (5.2%), attention-deficit/hyperactivity (3.7%), oppositional defiant (3.3%), substance use (2.3%), conduct (1.3%) and depressive (1.3%) disorders were the most common. Among children with mental disorders, only 44.2% (95% CI 37.6% to 50.9%) received any services for these conditions.ConclusionsAn estimated one in eight children have mental disorders at any given time, causing symptoms and impairment, therefore requiring treatment. Yet even in high-income countries, most children with mental disorders are not receiving services for these conditions. We discuss the implications, particularly the need to substantially increase public investments in effective interventions. We also discuss the policy urgency, given the emerging increases in childhood mental health problems since the onset of the COVID-19 pandemic (PROSPERO CRD42020157262).

Pharmacological and non-pharmacological interventions for adults with ADHD: protocol for a systematic review and network meta-analysis

“…Attention-deficit/hyperactivity disorder (ADHD) is the most common neurodevelopmental condition in children,1 2 and its impairing symptoms persist into adulthood in up to ~75% of childhood cases 3 4. Adult ADHD has a prevalence estimated at ~2.5%5 and is commonly comorbid with other disorders (eg, depression or anxiety)6 and with problems such as emotional dysregulation, which are often the main trigger for a referral to clinical services 6.…”

Incidence of Attention Deficit Hyperactivity Disorder (ADHD) Diagnoses in Navarre (Spain) from 2003 to 2019

“…Another review that included studies published between 1985 and 2012 estimated a worldwide ADHD prevalence of 3.4% (95% CI 2.6-4.5) for children and adolescents in the same age range [17]. A recently published review covering the period 2003-2020 reported a prevalence of 3.7% (95% CI 2.3-5.7%) in children and adolescents up to 18 years of age from high-income countries [18]. The variability observed in the ADHD prevalence estimates may also be influenced by the studied time period; therefore, analyzing the trends in ADHD diagnoses over time is of particular interest.…”

Teachers With Special Needs. De-Psychiatrization of Children in Schools

“…Compared with adult mental health care, the mental health care of young people in Western countries has increased even more rapidly ( Olfson et al, 2014 ; Steinhausen, 2015 ). Epidemiological studies estimate that one in eight children nowadays meet criteria for a mental disorder ( Polanczyk et al, 2015 ; Barican et al, 2021 ). Parent surveys in the US found child diagnosis rates of 9.5% for ADHD, 7.4% for behavioral/conduct disorders, 7.1% for anxiety, 3.2% for depression, and 2.5% for autism spectrum disorder ( Ghandour et al, 2019 ; Zablotsky et al, 2019 ).…”