European Child & Adolescent Psychiatry

, Volume 25, Issue 2, pp 195–207 | Cite as

A cross-sectional study to assess the prevalence of DSM-5 specific learning disorders in representative school samples from the second to sixth grade in Brazil

  • Isabela S. FortesEmail author
  • Cristiane S. Paula
  • Melaine C. Oliveira
  • Isabel A. Bordin
  • Jair de Jesus Mari
  • Luis A. Rohde
Original Contribution


Little is known about specific learning disorder (SLD) in low- and middle-income countries (LMICs), and even less from representative school samples in small size cities outside huge urban centers. Few studies addressed the new DSM-5 criteria for SLDs. We investigated the prevalence of DSM-5 SLDs, their comorbidities and correlates in school samples of students from the second to sixth grades living in median cities from four different geographic regions in Brazil. A national test for academic performance covering reading, writing and mathematical abilities was applied. Psychiatric diagnoses were assessed by the K-SADS-PL applied to the primary caregiver. A total of 1618 children and adolescents were included in the study. The following prevalence rates of SLDs were found: 7.6 % for global impairment, 5.4 % for writing, 6.0 % for arithmetic, and 7.5 % for reading impairment. Attention-deficit/hyperactivity disorder (ADHD) was the only comorbidity significantly associated with SLD with global impairment (p = 0.031). Anxiety disorders and ADHD were associated with SLD with arithmetic impairment. Significant differences were detected in prevalence rates among cities, and several socio-demographic correlates (age, gender, IQ, and socioeconomic status) were significantly associated with SLD with global impairment in our sample. Careful validation and normatization of instruments to assess academic performance is a major problem in LMICs. As expected, we found a significant heterogeneity in prevalence rates of SLD according to geographic regions considering that Brazil is a country with a robust diversity. SLD with global and arithmetic impairment was significantly associated with psychiatric comorbidities.


Specific learning disorder Mental health disorders Children and adolescents Academic performance Comorbidity DSM-5 



This work was supported by a grant from Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq, Brazil), number 573974/2008-0 and Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP), number 2008/57896-8. JJM is an I-A level Researcher from the National Research Council (CNPq). CSP is a Researcher from the CNPq (level 2).

Conflict of interest

Dr. Luis Augusto Rohde has been a member of the speakers’ bureau/advisory board and/or acted as a consultant for Eli-Lilly, Janssen-Cilag, Novartis and Shire in the last 3 years. He receives authorship royalties from Oxford Press and ArtMed. He has also received travel awards from Shire for his participation of the 2014 APA meeting. The ADHD and Juvenile Bipolar Disorder Outpatient Programs chaired by him received unrestricted educational and research support from the following pharmaceutical companies in the last three years: Eli-Lilly, Janssen-Cilag, Novartis, and Shire.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Isabela S. Fortes
    • 1
    • 2
    Email author
  • Cristiane S. Paula
    • 4
    • 5
  • Melaine C. Oliveira
    • 6
  • Isabel A. Bordin
    • 5
  • Jair de Jesus Mari
    • 5
  • Luis A. Rohde
    • 1
    • 2
    • 3
    • 7
  1. 1.National Institute of Developmental Psychiatry for Children and AdolescentsPorto AlegreBrazil
  2. 2.Graduate Program in PsychiatryUniversidade de São PauloSão PauloBrazil
  3. 3.Hospital de Clínicas de Porto AlegreUniversidade Federal do Rio Grande do SulPorto AlegreBrazil
  4. 4.Programa de Pós-Graduação em Distúrbios do DesenvolvimentoUniversidade Presbiteriana MackenzieSão PauloBrazil
  5. 5.Departamento de PsiquiatriaUniversidade Federal de São PauloSão PauloBrazil
  6. 6.Instituto de Matemática e EstatísticaUniversidade de São PauloSão PauloBrazil
  7. 7.ADHD Outpatient Program (ProDAH) at the Child and Adolescent Psychiatric DivisionHospital de Clínicas de Porto AlegrePorto AlegreBrazil

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