Prevalence and treatment of mental disorders among US children in the 2001-2004 NHANES.

OBJECTIVE: This article presents the 12-month prevalence estimates of specific mental disorders, their social and demographic correlates, and service use patterns in children and adolescents from the National Health and Nutrition Examination Survey, a nationally representative probability sample of noninstitutionalized US civilians. METHODS: The sample includes 3042 participants 8 to 15 years of age from cross-sectional surveys conducted from 2001 to 2004. Data on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for mental disorders were derived from administration of selected modules of the National Institute of Mental Health Diagnostic Interview Schedule for Children, version IV, a structured diagnostic interview administered by lay interviewers to assess psychiatric diagnoses of children and adolescents. RESULTS: Twelve-month prevalence rates of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-defined disorders in this sample were 8.6% for attention-deficit/hyperactivity disorder, 3.7% for mood disorders, 2.1% for conduct disorder, 0.7% for panic disorder or generalized anxiety disorder, and 0.1% for eating disorders. Boys had 2.1 times greater prevalence of attention-deficit/hyperactivity disorder than girls, girls had twofold higher rates of mood disorders than boys, and there were no gender differences in the rates of anxiety disorders or conduct disorder. Only approximately one half of those with one of the disorders assessed had sought treatment with a mental health professional. CONCLUSION: These data constitute a first step in building a national database on mental health in children and adolescents.

U.S. children with emotional and behavioral difficulties: data from the 2001, 2002, and 2003 National Health Interview Surveys.

OBJECTIVE: This report presents selected prevalence estimates for children ages 4-17 years with difficulties in emotions, concentration, behavior, or being able to get along with others using data from the 2001, 2002, and 2003 National Health Interview Surveys (NHIS). METHODS: Data for the U.S. civilian noninstitutionalized population were collected using computer-assisted personal interviews (CAPI). In 2001, a total of 10,367 interviews were completed about sample children ages 4-17 years by the member of the household most knowledgeable about the child's health. The number of completed interviews about sample children ages 4-17 years was 9,512 in 2002 and 9,399 in 2003. Questions on children's emotional and behavioral difficulties from the Strengths and Difficulties Questionnaire (SDQ) were first asked in the NHIS in 2001. SUDAAN software was used to tabulate statistics shown in this report. RESULTS: In 2001, 2002, and 2003, approximately 5% of U.S. children ages 4-17 years had emotional or behavioral difficulties, and for approximately 80% of these children, there was an impact on their functioning. Children with difficulties in emotions, concentration, behavior, or being able to get along with others varied by sex, age, race, family structure, poverty status, and health insurance status. About 50% of these children were upset or distressed by their emotional or behavioral difficulties, and about 80% had difficulties that impacted their family life, friendships, learning, or leisure activities.

The Strengths and Difficulties Questionnaire: U.S. normative data and psychometric properties.

OBJECTIVE: To evaluate the Strengths and Difficulties Questionnaire in a U.S. national population sample of children and adolescents, develop normative scoring bands, and test the association of high-scoring groups with service contacts or use for mental health reasons. METHOD: An Americanized version of the Strengths and Difficulties Questionnaire parent report was administered to parents of 10,367 4- to 17 -year-olds in the 2001 National Health Interview Survey. Scoring bands were developed to differentiate low, medium, and high levels of emotional or behavioral difficulties. Children at high risk of serious difficulties were identified by three different scoring methods: (1) high symptom scores, (2) parental perception of definite or severe difficulties, and (3) high symptoms plus impairment. These ratings were validated against service contact or use and other well-established demographic and broader risk factors for child emotional and behavioral problems. RESULTS: Results indicated good acceptability and internal consistency. Normative scoring bands were similar, though not identical, to the original British bands. Results of each scoring method had a strong association with service contact/use. CONCLUSIONS: This study supports the usefulness of the Strengths and Difficulties Questionnaire as an effective and efficient screener for child and adolescent mental health problems in the United States.