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Incidence and comorbidities of disruptive behavior disorders diagnosed in Finnish specialist psychiatric services

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Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Purpose

Disruptive behavior disorders (DBD), including oppositional defiant disorder (ODD) and conduct disorder (CD), are some of the most common psychiatric conditions in childhood. Despite this, there has been limited research on DBDs. We examined the incidence, comorbidity and gender differences of DBDs diagnosed by specialist services.

Method

This was a nationwide register study of 570,815 children and adolescents born in 1996–2005. The 7050 individuals diagnosed with DBD by specialist healthcare services were matched to 26,804 controls.

Results

By the age of 15, the cumulative incidence of diagnosed DBDs was 3.5% for boys and 1.4% for girls. The yearly incidence rate increased for girls after 13 years of age, while the incidence for boys was relatively stable between 8 and 15 years of age. When we compared subjects born between 1996–1998 and 1999–2001, we found that by the age of 12, the cumulative incidence per 100 people had increased from 0.56 to 0.68 among girls and from 2.3 to 2.6 among boys. This indicated a minor increase in treated incidence. The parents of children diagnosed with DBDs had lower educational levels than the parents of controls. Children with DBD were also more likely to have been diagnosed with other psychiatric disorders.

Conclusion

Although DBDs were 3.5 times more common among boys during the whole follow-up period, the yearly incidence during adolescence was fairly similar between boys and girls. DBD existed alongside various psychiatric disorders at a relatively young age and only a minor increase in treated incidence was found during childhood.

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Data availability

The datasets analyzed during the current study are not publicly available, as a condition of the authorization and ethical approval of the study.

Abbreviations

CD:

Conduct disorder

DBD:

Disruptive behavior disorder

FHDR:

Finnish Hospital Discharge Register

FCPR:

The Finnish Central Population Register

HD:

Hyperkinetic disorder

ICD:

International Statistical Classification of Diseases and Related Health Problems

ODD:

Oppositional defiant disorder

OR:

Odds ratio

SES:

Socioeconomic

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Acknowledgements

BSc Juha-Pekka Virtanen (Research Center for Psychiatry, University of Turku) is acknowledged for data management

Funding

This study was part of the PSYCOHORTS and INVEST consortia funded by the Finnish Academy (320162, 308552). Gyllenberg has received funding from the Finnish Academy and a NARSAD Young Investigator Award from the Brain and Behavior Research Foundation.

Author information

Authors and Affiliations

  1. Department of Child Psychiatry, University of Turku, Lemminkäisenkatu 3, 3rd floor, 20014, Turku, Finland

    Jaakko Uotila, David Gyllenberg, Susanna Hinkka-Yli-Salomäki, Emmi Heinonen, Roshan Chudal, Mika Gissler & André Sourander

  2. Department of Adolescent Psychiatry, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland

    David Gyllenberg

  3. Finnish Institute of Health and Welfare, Helsinki, Finland

    David Gyllenberg & Mika Gissler

  4. Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden

    Laura Korhonen

  5. Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden

    Mika Gissler

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  1. Jaakko Uotila
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  8. André Sourander
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Contributions

JU, LK, MG. DG, SH and AS designed the study. SH and EH carried out the statistical analyses. JU drafted the initial report. All the authors contributed to the interpretation of the data, drafted the manuscript and approved it for submission.

Corresponding author

Correspondence to Jaakko Uotila.

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Conflict of interests

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethics approval and consent to participate

The study was approved by the ethics committees of the hospital district of Southwest Finland (111/180/2008) and the Finnish Institute for Health and Welfare.

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Uotila, J., Gyllenberg, D., Korhonen, L. et al. Incidence and comorbidities of disruptive behavior disorders diagnosed in Finnish specialist psychiatric services. Soc Psychiatry Psychiatr Epidemiol 56, 2063–2072 (2021). https://doi.org/10.1007/s00127-020-02015-3

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