Social Psychiatry and Psychiatric Epidemiology

, Volume 47, Issue 7, pp 1099–1109

Prevalence of child and adolescent psychiatric disorders in Santiago, Chile: a community epidemiological study

  • Benjamin Vicente
  • Flora de la Barra
  • Sandra Saldivia
  • Robert Kohn
  • Pedro Rioseco
  • Roberto Melipillan
Original Paper

Abstract

Purpose

To determine the prevalence of DSM-IV psychiatric disorders in a representative sample of children and adolescents living in Santiago, Chile, as part of a national sample.

Method

Subjects aged 4–18 were selected using a stratified multistage design. First, ten municipalities/comunas of Santiago were selected; then the blocks, homes, and child or adolescent to be interviewed were chosen. Psychology graduate students administered the Spanish-language, computer-assisted version of DISC-IV that estimated DSM-IV 12-month prevalence.

Results

A total of 792 children and adolescents were evaluated, with a participation rate of 76.7%. The most stringent impairment DSM-IV DISC algorithm for psychiatric disorders revealed a prevalence of 25.4% (20.7% for boys and 30.3% for girls). The majority of the diagnoses corresponded to anxiety and affective disorders. Prevalence was higher in children aged 4–11 (31.9%) than in adolescents aged 12–18 (18.2%). This difference was mainly accounted for by disruptive disorders in the younger age group. Anxiety disorders had the highest prevalence, although impairment was low. In contrast, most children and adolescents with affective disorders were impaired.

Conclusions

In Santiago, the prevalence of psychiatric disorders in children and adolescents was high. This study helps raise awareness of child and adolescent mental health issues in Spanish-speaking Latin America and serves as a basis for improving mental health services.

Keywords

Child Adolescent Psychiatric epidemiology Psychiatric disorders Mental health 

References

  1. 1.
    Vicente B, Kohn R, Rioseco S, Saldivia S, Levav I, Torres S (2006) Lifetime and 12-month prevalence of DSM-III-R disorders in the Chile psychiatric prevalence study. Am J Psychiatry 163(8):1362–1370PubMedCrossRefGoogle Scholar
  2. 2.
    Burke KC, Burke JD Jr, Regier DA, Rae DS (1990) Age at onset of selected mental disorders in 5 community populations. Arch Gen Psychiatry 47(6):511–518PubMedCrossRefGoogle Scholar
  3. 3.
    Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE (2005) Lifetime prevalence and age of onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 62(6):593–602PubMedCrossRefGoogle Scholar
  4. 4.
    Rutter M, Sroufe LA (2000) Developmental psychopathology: concepts and challenges. Dev Psychopathol 12(3):265–296PubMedCrossRefGoogle Scholar
  5. 5.
    Costello E, Foley DL, Angold A (2006) 10-year research update review: the epidemiology of child and adolescent psychiatric disorders: II. developmental epidemiology. J Am Acad Child Adolesc Psychiatry 45(1):8–25PubMedCrossRefGoogle Scholar
  6. 6.
    Leckman JF, Leventhal BL (2008) Editorial: a global perspective on child and adolescent mental health. J Child Psychol Psychiatr 49(3):221–225CrossRefGoogle Scholar
  7. 7.
    Patel V, Flischer AJ, Hetrick S, McGorry P (2007) Mental health of young people: a global public health challenge. Lancet 369(9569):1302–1313PubMedCrossRefGoogle Scholar
  8. 8.
    Barker DJ (2003) The developmental origins of adult disease. Eur J Epidemiol 18(8):733–736PubMedCrossRefGoogle Scholar
  9. 9.
    Mäntymaa M, Puura K, Luoma I, Salmelin R, Davis H, Tsiantis J, Ispanovic-Radojkovic V, Paradisiotou A, Tamminen T (2003) Infant-mother interaction as a predictor of child′s chronic health problems. Child Care Health Dev 29(3):181–191PubMedCrossRefGoogle Scholar
  10. 10.
    Brown AS, Sussex ES (2002) In utero infection and adult schizophrenia. Ment Retard Dev Disabil Res Rev 8(1):51–57PubMedCrossRefGoogle Scholar
  11. 11.
    O’Connell ME, Boat T, Warner KE (eds) (2009) Preventing mental, emotional, and behavioral disorders among young people: progress and possibilities. The National Academies Press, Washington, DC, pp 191–220Google Scholar
  12. 12.
    World Health Organization (2005) Atlas child and adolescent mental health resources global concerns: implications for the future. World Health Organization, GenevaGoogle Scholar
  13. 13.
    Belfer ML (2008) Child and adolescent mental disorders: the magnitude of the problem across the globe. J Child Psychol Psychiatr 49(3):226–236CrossRefGoogle Scholar
  14. 14.
    Roberts RE, Attkinson CC, Rosenblatt A (1998) Prevalence of psychopathology among children and adolescents. Am J Psychiatry 155(6):715–725PubMedGoogle Scholar
  15. 15.
    Breton J, Bergeron L, Valla JP, Berthiaume C, Gaudet N, Lambert J, St-Georges M, Houde L, Lépine S (1999) Quebec child mental health survey: prevalence of DSM-II-R mental health disorders. J Child Psychol Psychiat 40(3):375–384PubMedCrossRefGoogle Scholar
  16. 16.
    Costello EJ, Angold A, Burns BJ, Stangl DK, Tweed DL, Erkanli A, Worthman CM (1996) The Great Smoky Mountains Study of Youth: goals, design, methods and the prevalence of DSM-III-R disorders. Arch Gen Psychiatry 53(12):1129–1136PubMedCrossRefGoogle Scholar
  17. 17.
    Shaffer D, Gould MS, Brasic J, Ambrosini PJ, Fisher PW, Bird HR, Aluwahlia S (1983) A children’s global assessment scale (CGAS). Arch Gen Psychiatry 40(11):1228–1231PubMedCrossRefGoogle Scholar
  18. 18.
    Goodman R, Ford T, Richards H, Meltzer H, Gatward R (2000) The development and well-being assessment: description and initial validation of an integrated assessment of child and adolescent psychopathology. J Child Psychol Psychiatry 41(5):645–657PubMedCrossRefGoogle Scholar
  19. 19.
    Angold A, Prendergast M, Cox A, Harrington R, Simonoff E, Rutter M (1995) The Child and Adolescent Psychiatric Assessment (CAPA). Psychol Med 25(4):739–753PubMedCrossRefGoogle Scholar
  20. 20.
    Shaffer D, Fischer P, Lucas CP, Dulcan MK, Schwab-Stone ME (2000) 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 39(1):28–38PubMedCrossRefGoogle Scholar
  21. 21.
    Merikangas K, Avenevoli S, Costello J, Koretz D, Kessler RC (2009) National comorbidity survey replication adolescent supplement (NCS-A): I. Background and measures. J Am Acad Child Adolesc Psychiatry 48(4):367–369PubMedCrossRefGoogle Scholar
  22. 22.
    de la Barra F, Toledo V, Rodríguez J (2004) Estudio de salud mental en dos cohortes de niños escolares de Santiago Occidente. IV: desórdenes psiquiátricos, diagnóstico psicosocial y discapacidad. Rev Chil Neuro-Psiquiat 42(4):259–272Google Scholar
  23. 23.
    Vicente B, Saldivia S, Rioseco P, de la Barra F, Valdivia M, Melipillan R, Zùñiga M, Escobar B, Pihan R (2010) Epidemiología de trastornos mentales infanto-juveniles en la Provincia de Cautín. Rev Med Chile 138:965–973PubMedGoogle Scholar
  24. 24.
    Benjet C, Borges G, Medina-Mora ME, Zambrano J, Aguilar-Gaxiola S (2009) Youth mental health in a populous city of the developing world: results from the Mexican Adolescent Mental Health Survey. J Child Psychol Psychiatry 50(4):386–395PubMedCrossRefGoogle Scholar
  25. 25.
    Canino G, Shrout P, Rubio-Stipec M, Bird HR, Bravo M, Ramirez R, Chavez L, Alegria M, Bauermeister JJ, Hohmann A, Ribera J, Garcia P, Martinez-Taboas A (2004) The DSM-IV rates of child and adolescent disorders in Puerto Rico: prevalence, correlates, service use, and the effects of impairment. Arch Gen Psychiatry 61(1):85–93PubMedCrossRefGoogle Scholar
  26. 26.
    Bravo M, Ribera J, Rubio-Stipeck M, Rubio-Stipec M, Canino G, Shrout P, Ramírez R, Fábregas L, Chavez L, Alegría M, Bauermeister JJ, Martínez Taboas A (2001) Test-retest reliability of the Spanish version of the Diagnostic Interview Schedule for Children (DISC-IV). J Abnorm Child Psychol 29(5):433–444PubMedCrossRefGoogle Scholar
  27. 27.
    Saldivia S, Vicente B, Valdivia M, Zúñiga M, Llorente C, Condeza MI (2008) Validación de la entrevista diagnóstica estructurada DISC-IV para la identificación de trastornos psicopatológicos en niños y adolescentes chilenos. Rev Chil Neuro-Psiquiat 62:86Google Scholar
  28. 28.
    Polanczyk G, de Lima MS, Horta BL, Biederman J, Rohde LA (2007) The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry 164(6):942–948PubMedCrossRefGoogle Scholar
  29. 29.
    Leventhal T, Brooks-Gunn J (2000) The neighborhoods they live in: the effects of neighborhood residence on child and adolescent outcomes. Psychol Bull 126(2):309–337PubMedCrossRefGoogle Scholar
  30. 30.
    Ayer L, Hudziak JJ (2009) Socioeconomic risk for psychopathology: the search for causal mechanisms. J Am Acad Child Adolesc Psychiatry 48(10):982–983PubMedCrossRefGoogle Scholar
  31. 31.
    Costello EJ, Angold A, Burns BJ, Erkanli A, Stangl DK, Tweed DL (1996) The Great Smoky Mountains Study of Youth. Functional impairment and serious emotional disturbance. Arch Gen Psychiatry 53(12):1137–1143PubMedCrossRefGoogle Scholar
  32. 32.
    Vostanis P, Graves A, Meltzer H, Goodman R, Jenkins R, Brugha T (2006) Relationship between parental psychopathology, parenting strategies and child mental health—findings from the GB national study. Soc Psychiatry Psychiatr Epidemiol 41(7):509–514PubMedCrossRefGoogle Scholar
  33. 33.
    Goodman R, Slobodskaya H, Knyazev G (2005) Russian child mental health: a cross-sectional study of prevalence and risk factors. Eur Child Adolesc Psychiatry 14(1):28–33PubMedCrossRefGoogle Scholar
  34. 34.
    Lipman EL, Offord DR, Boyle MH (1996) What if we could eliminate child poverty? The theoretical effect on child psychosocial morbidity. Soc Psychiatry Psychiatr Epidemiol 31(5):303–307PubMedGoogle Scholar
  35. 35.
    Carter AS, Wagmiller RJ, Gray SA, McCarthy KJ, Horwitz SM, Briggs-Gowan MJ (2010) Prevalence of DSM-IV disorder in a representative, healthy birth cohort at school entry: sociodemographic risks and social adaptation. J Am Acad Child Adolesc Psychiatry 49(7):686–698PubMedGoogle Scholar
  36. 36.
    Roberts RE, Roberts CR, Xing Y (2007) Rates of DSM-IV psychiatric disorders among adolescents in a large metropolitan area. J Psychiatr Res 41(11):959–967PubMedCrossRefGoogle Scholar
  37. 37.
    Farbstein I, Mansbach-Kleinfeld I, Levinson D, Goodman R, Levav I, Vograft I, Kanaaneh R, Ponizovsky AM, Brent DA, Apter A (2010) Prevalence and correlates of mental disorders in Israeli adolescents: results from a national mental health survey. J Child Psychol Psychiatry 51(5):630–639PubMedCrossRefGoogle Scholar
  38. 38.
    McLoyd VC (1998) Socioeconomic disadvantage and child development. Am Psychol 53(2):185–204PubMedCrossRefGoogle Scholar
  39. 39.
    Amone-P’Olak K, Ormel J, Huisman M, Verhulst FC, Oldehinkel AJ, Burger H (2009) Life stressors as mediators of the relation between socioeconomic position and mental health problems in early adolescence: the TRAILS study. J Am Acad Child Adolesc Psychiatry 48(10):1031–1038PubMedCrossRefGoogle Scholar
  40. 40.
    Polanczyk G, Rohde LA (2007) Epidemiology of attention-deficit/hyperactivity disorder across the lifespan. Curr Opin Psychiatry 20(4):386–392PubMedCrossRefGoogle Scholar
  41. 41.
    Skounti M, Philalithis A, Galanakis E (2007) Variations in prevalence of attention deficit hyperactivity disorder worldwide. Eur J Pediatr 166(2):117–123PubMedCrossRefGoogle Scholar
  42. 42.
    Rohde LA, Biederman J, Busnello EA, Zimmermann H, Schmitz M, Martins S, Tramontina S (1999) ADHD in a school sample of Brazilian adolescents: a study of prevalence, comorbid conditions, and impairments. J Am Acad Child Adolesc Psychiatry 38(6):716–722PubMedCrossRefGoogle Scholar
  43. 43.
    Montiel-Nava C, Peña JA, López M, Salas M, Zurga JR, Montiel-Barbero I, Pirela D, Cardozo JJ (2002) Estimations of the prevalence of attention deficit hyperactivity disorder in Marabino children. Rev Neurol 35(11):1019–1024PubMedGoogle Scholar
  44. 44.
    Cornejo JW, Osío O, Sánchez Y, Carrizosa J, Sánchez G, Grisales H, Castillo-Parra H, Holguín J (2005) Prevalence of attention deficit hyperactivity disorder in Colombian children and teenagers. Rev Neurol 40(12):716–722PubMedGoogle Scholar
  45. 45.
    Pineda D, Ardila A, Rosselli M, Arias BE, Henao GC, Gomez LF, Mejia SE, Miranda ML (1999) Prevalence of attention-deficit/hyperactivity disorder symptoms in 4- to 17-year-old children in the general population. J Abnorm Child Psychol 27(6):455–462PubMedCrossRefGoogle Scholar
  46. 46.
    Ford T, Goodman R, Meltzer H (2003) The British Child and Adolescent Mental Health Survey 1999: the prevalence of DSM-IV disorders. J Am Acad Child Adolesc Psychiatry 42(10):1203–1211PubMedCrossRefGoogle Scholar
  47. 47.
    Fleitlich-Bilyk B, Goodman R (2004) Prevalence of child and adolescent psychiatric disorders in southern Brazil. J Am Acad Child Adolesc Psychiatry 43(6):727–734PubMedCrossRefGoogle Scholar
  48. 48.
    Goodman R, Neves dos Santos D, Robatto Nunes AP, Pereira de Miranda D, Fleitlich-Bilyk B, Almeida Filho N (2005) The Ilha de Maré study: a survey of child mental health problems in a predominantly African-Brazilian rural community. Soc Psychiatry Psychiatr Epidemiol 40(1):11–17PubMedCrossRefGoogle Scholar
  49. 49.
    Mullick MS, Goodman R (2005) The prevalence of psychiatric disorders among 5–10 year olds in rural, urban and slum areas in Bangladesh: an exploratory study. Soc Psychiatry Psychiatr Epidemiol 40(8):663–671PubMedCrossRefGoogle Scholar
  50. 50.
    Heiervang E, Stormark KM, Lundervold AJ, Heimann M, Goodman R, Posserud MB, Ullebø AK, Plessen KJ, Bjelland I, Lie SA, Gillberg C (2007) Psychiatric disorders in Norwegian 8- to 10-year-olds: an epidemiological survey of prevalence, risk factors, and service use. J Am Acad Child Adolesc Psychiatry 46(4):438–447PubMedCrossRefGoogle Scholar
  51. 51.
    Pillai A, Patel V, Cardozo P, Goodman R, Weiss HA, Andrew G (2008) Non-traditional lifestyles and prevalence of mental disorders in adolescents in Goa, India. Br J Psychiatry 192(1):45–51PubMedCrossRefGoogle Scholar
  52. 52.
    Alyahri A, Goodman R (2008) The prevalence of DSM-IV psychiatric disorders among 7–10 year old Yemeni schoolchildren. Soc Psychiatry Psychiatr Epidemiol 43(3):224–230PubMedCrossRefGoogle Scholar
  53. 53.
    Frigerio A, Rucci P, Goodman R, Ammaniti M, Carlet O, Cavolina P, De Girolamo G, Lenti C, Lucarelli L, Mani E, Martinuzzi A, Micali N, Milone A, Morosini P, Muratori F, Nardocci F, Pastore V, Polidori G, Tullini A, Vanzin L, Villa L, Walder M, Zuddas A, Molteni M (2009) Prevalence and correlates of mental disorders among adolescents in Italy: the PrISMA study. Eur Child Adolesc Psychiatry 18(4):217–226PubMedCrossRefGoogle Scholar
  54. 54.
    Anselmi L, Fleitlich-Bilyk B, Menezes AM, Araújo CL, Rohde LA (2010) Prevalence of psychiatric disorders in a Brazilian birth cohort of 11-year-olds. Soc Psychiatry Psychiatr Epidemiol 45(1):135–142PubMedCrossRefGoogle Scholar
  55. 55.
    Wacharasindhu A, Panyyayong B (2002) Psychiatric disorders in Thai school-aged children: I Prevalence. J Med Assoc Thai 85(Suppl 1):S125–S136PubMedGoogle Scholar
  56. 56.
    Angold A, Erkanli A, Farmer EM, Fairbank JA, Burns BJ, Keeler G, Costello EJ (2002) Psychiatric disorder, impairment, and service use in rural African American and white youth. Arch Gen Psychiatry 59(10):893–901PubMedCrossRefGoogle Scholar
  57. 57.
    Costello EJ, Mustillo S, Erkanli A, Keeler G, Angold A (2003) Prevalence and development of psychiatric disorders in childhood and adolescence. Arch Gen Psychiatry 60(8):837–844PubMedCrossRefGoogle Scholar
  58. 58.
    McKelvey RS, Sang DL, Baldassar L, Davies L, Roberts L, Cutler N (2002) The prevalence of psychiatric disorders among Vietnamese children and adolescents. Med J Aust 177(8):413–417PubMedGoogle Scholar
  59. 59.
    Srinath S, Girimaji SC, Gururaj G, Seshadri S, Subbakrishna DK, Bhola P, Kumar N (2005) Epidemiological study of child & adolescent psychiatric disorders in urban & rural areas of Bangalore, India. Indian J Med Res 122(1):67–79PubMedGoogle Scholar
  60. 60.
    Roberts RE, Roberts CR, Xing Y (2006) Prevalence of youth-reported DSM-IV psychiatric disorders among African, European, and Mexican American adolescents. J Am Acad Child Adolesc Psychiatry 45(11):1329–1337PubMedCrossRefGoogle Scholar
  61. 61.
    Leung PW, Hung SF, Ho TP, Lee CC, Liu WS, Tang CP, Kwong ST (2008) Prevalence of DSM-IV disorders in Chinese adolescents and the effects of an impairment criterion: a pilot community study in Hong Kong. Eur Child Adolesc Psychiatry 17(7):452–461PubMedCrossRefGoogle Scholar
  62. 62.
    Merikangas KR, He JP, Brody D, Fisher PW, Bourdon K, Koretz DS (2010) Prevalence and treatment of mental disorders among US children in the 2001–2004 NHANES. Pediatrics 125(1):75–81PubMedCrossRefGoogle Scholar
  63. 63.
    Kroes M, Kalff AC, Kessels AG, Steyaert J, Feron FJ, van Someren AJ, Hurks PP, Hendriksen JG, van Zeben TM, Rozendaal N, Crolla IF, Troost J, Jolles J, Vles JS (2001) Child psychiatric diagnoses in a population of Dutch school children aged 6 to 8 years. J Am Acad Child Adolesc Psychiatry 40(12):1401–1409PubMedCrossRefGoogle Scholar
  64. 64.
    Gau SS, Chong MY, Chen TH, Cheng A (2005) A 3-year panel study of mental disorders among adolescents in Taiwan. Am J Psychiatry 162(7):1344–1350PubMedCrossRefGoogle Scholar
  65. 65.
    Eapen V, Jakka ME, Abou-Saleh MT (2003) Children with psychiatric disorders: the Al Ain Community Psychiatric Survey. Can J Psychiatry 48(6):402–407PubMedGoogle Scholar
  66. 66.
    Petersen DJ, Bilenberg N, Hoerder K, Gillberg C (2006) The population prevalence of child psychiatric disorders in Danish 8- to 9-year-old children. Eur Child Adolesc Psychiatry 15(2):71–78PubMedCrossRefGoogle Scholar
  67. 67.
    Merikangas KR, He JP, Burstein M, Swanson SA, Avenevoli S, Cui L, Benjet C, Georgiades K, Swendsen J (2010) Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication-Adolescent Supplement (NCS-A). J Am Acad Child Adolesc Psychiatry 49(10):980–989PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Benjamin Vicente
    • 1
  • Flora de la Barra
    • 2
  • Sandra Saldivia
    • 1
  • Robert Kohn
    • 3
  • Pedro Rioseco
    • 1
  • Roberto Melipillan
    • 1
  1. 1.Department of Psychiatry and Mental HealthUniversity of ConcepciónConcepciónChile
  2. 2.Medical SchoolUniversity of ChileSantiagoChile
  3. 3.Department of Psychiatry and Human BehaviorWarren Alpert Medical School of Brown UniversityProvidenceUSA

Personalised recommendations