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Burden of mental disorders in children in the general population and in health facilities: discrepancies in years lived with disability based on national prevalence estimates between populations receiving care or not

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Abstract

Little is known about the discrepancies in the burden of child mental disorders based on differences in prevalence between populations with and without care. Identifying such discrepancies may help to elucidate the unmet needs related to child mental disorders. We compared the years lived with disability (YLD) between children with and without care for mental disorders using a representative national survey, Taiwan’s National Epidemiological Study of Child Mental Disorders (TNESCMD), and a national health facility database, the Taiwan National Health Insurance Research Database (TNHIRD). The comorbidity-adjusted YLD rate ratio (RR) was reported to quantify the YLD discrepancy. The overall YLD rate for all mental disorders in the TNESCMD was 9.05 times higher than that in the TNHIRD with the lowest and highest YLD RRs for autism spectrum disorder (RR 3.51) and anxiety disorders (RR 360.00). Unlike the YLD proportion explained by attention-deficit/hyperactivity disorder and autism spectrum disorder, the proportions explained by anxiety disorders and conduct disorder/oppositional defiant disorder relative to the total YLD were relatively lower in the TNHIRD than in TNESCMD and the Global Burden of Disease 2016. The discrepancies in YLD between populations with and without care in child mental disorders ranged from ± 55% to 99% and had an overall value of ± 80.1%. High YLD discrepancies in child mental disorders between estimates based on the general population and those in health facilities suggest significant unmet needs for care in child mental disorders and that estimates of disease burden that rely heavily on a single source may result in unreliable results.

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Availability of data and material

These data are owned by the Taiwan Ministry of Health and Welfare. If researchers are interested in applying the data from the Taiwan Ministry of Health and Welfare, information is available at http://www.mohw.gov.tw.

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Acknowledgements

We want to thank Dr. Hsien-Ho Lin and Dr. Shu-Sen Chang for sharing their knowledge and suggestions about the estimation of YLDs in this study.

Funding

This work was supported by grants from the Ministry of Health and Welfare [M03B3374], National Health Research Institute [NHRI-EX104-10404PI, NHRI-EX105-10404PI, NHRI-EX106-10404PI], and Ministry of Science and Technology [MOST 103-2314-B-002-021-MY3, 109-2314-B-468-001-MY2], Taiwan.

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Authors and Affiliations

  1. Department of Healthcare Administration, Asia University, Taichung, Taiwan

    Yi-Lung Chen

  2. Department of Psychology, Asia University, Taichung, Taiwan

    Yi-Lung Chen

  3. Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan

    Raymond Nien-Chen Kuo

  4. Department of Psychiatry, National Taiwan University Hospital and College of Medicine, No. 7, Chung-Shan South road, Taipei, 10002, Taiwan

    Susan Shur-Fen Gau

  5. Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan

    Susan Shur-Fen Gau

  6. Graduate Institute of Clinical Medicine, and Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan

    Susan Shur-Fen Gau

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  1. Yi-Lung Chen
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  2. Raymond Nien-Chen Kuo
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  3. Susan Shur-Fen Gau
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Correspondence to Susan Shur-Fen Gau.

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Conflict of interest

The author(s) declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Ethical statement

All procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Ethics approval

The conduction of Taiwan’s National Epidemiological Study of Child Mental Disorders study and the analysis of secondary data using the National Health Insurance Research Database were approved by the Research Ethics Committee of National Taiwan University Hospital, Taiwan, with approval numbers 201411056RINA and 201711077RINB, respectively.

Consent to participate

Informed consent was obtained from all individual participants included in Taiwan’s National Epidemiological Study of Child Mental Disorders; whereas, informed consent was not necessary because the TNHIRD data did not contain identifying information.

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Chen, YL., Kuo, R.NC. & Gau, S.SF. Burden of mental disorders in children in the general population and in health facilities: discrepancies in years lived with disability based on national prevalence estimates between populations receiving care or not. Eur Child Adolesc Psychiatry 31, 1–9 (2022). https://doi.org/10.1007/s00787-021-01769-8

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