Starting at the Beginning

Laying the Foundation for Lifelong Mental Health

Matthew Hodes, Susan Shur-Fen Gau, Petrus J. De Vries

• Publisher: Academic Press
• Year: 2020
• Print ISBN: 9780128197493
• eBook ISBN: 9780128223963
• Topic: Psicología
• Subtopic: Psicología educativa

Starting at the Beginning: Laying the Foundation for Lifelong Mental Health coincides with the 24th International Association for Child and Adolescent Psychiatry and Allied Professions (IACAPAPA) Congress in Singapore, June 2020. This book examines the determinates of individual differences in children and young people, along with the origins of maladjustment and psychiatric disorders. It addresses the ways in which interventions and mental health services can be developed and shaped to address individual differences among children. Additional topics include environmental hazards and mental health and cultural psychiatry as a basic science for addressing mental health disparities. Chapters dive deeper into anxiety disorders in infants, gaming disorder, the pitfalls of treatment in OCD, and ADHD developmental neuropsychiatry. Another targeted section focuses on policies for child and adolescent mental health, including a review of mental health services in China, Oceania and East Asia. - Emphasizes social and environmental influences - Focuses on early developmental and infancy processes - Addresses the training of child and adolescent psychiatrists across Europe - Covers a range of illustrative psychiatric disorders and problems - Works toward the goal of producing a mental health workforce with internationally recognized competencies

Part I

Epidemiological and cultural perspectives in child and adolescent mental health

Chapter 1: Prevalence, risk factors, and disease burden of child and adolescent mental disorders: Taiwanese and global aspects

Susan Shur-Fen Gau^a,b; Yi-Lung Chen^{a a} Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
^b Graduate Institute of Brain and Mind Sciences, National Taiwan University, Taipei, Taiwan

Abstract

Despite several national epidemiological studies of child and adolescent mental disorders in the world with varied prevalence estimates according to DSM-III, DSM-III-R, or DSM-IV, there is a lack of their prevalence estimates according to DSM-5 criteria. The discrepant prevalence rates may be explained by different populations, sampling methods, age groups, instruments (interviews vs questionnaires), and diagnostic criteria (different editions of DSM and ICD). In terms of major risk factors for mental disorders in the child and adolescent populations, including sex, age, urban–rural, and socioeconomic status, the magnitudes and directions of their associations with mental disorders also vary across countries and studies. The uncertainty of the disease burden of child and adolescent mental disorders is caused by heterogeneous prevalence estimates cross countries and between community-based and clinic-based settings. This chapter reviews the prevalence and major risk factors of child and adolescent mental disorders as well as the disease burden caused by varied prevalence rates of child and adolescent mental disorders based on the representative studies in the past decades and the recent National Epidemiological Study of Child Mental Disorders in Taiwan (Taiwan’s survey).

Keywords

Child mental disorders; Sex; Age effects; Taiwan’s national survey; Attention-deficit hyperactivity disorder; Autism; Disease burden

1: Introduction

Although mental health issues across the lifespan have attracted tremendous attention during recent decades, mental illnesses in the child and adolescent population remain a global public-health challenge (Patel, Flisher, Hetrick, & McGorry, 2007). Mental disorders have been reported to contribute a substantial proportion of Global Burden of Disease (GBD) in terms of disability-adjusted life years (DALYs), years of life lost to premature mortality (YLLs), and years lived with disability (YLDs), especially for YLDs (Eaton et al., 2008; Kessler et al., 2009; Whiteford et al., 2013). It was estimated that 7.4% of the global burden of the disease had been attributed to mental disorders in the GBD Study 2010 (Whiteford et al., 2013). Some common child and adolescent mental disorders, such as autism spectrum disorder (ASD) (Baxter et al., 2015), attention-deficit/hyperactivity disorder (ADHD), and conduct disorder (CD) (Erskine et al., 2014), accounted for a notable proportion in the GBD caused by mental disorders. Furthermore, it is observed that there is an increasing trend of the disease burden of mental disorders since 1990 (Whiteford et al., 2013). These results have drawn attention to the importance of prevention of mental disorders, especially for children and adolescents because the relevant data are relatively less in these populations (Ustün, 1999). Since the core symptoms of childhood-onset mental disorders may last to adolescence and adulthood, they are very likely to cause functional impairment and psychopathology in adulthood (Costello, Mustillo, Erkanli, Keeler, & Angold, 2003). Hence, regular surveillance of mental conditions in the child and adolescent population is one fundamental element to prevent mental illness and improve mental well-being across the lifespan.

Since 1977 the World Health Organization has suggested that every country should have plans and research for child mental health (World Health Organization, 1977). However, only a few western countries have carried out epidemiological programs. Furthermore, previous national surveys have documented substantial prevalence rates changes between the Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III)-based (American Psychiatric Association, 1980), and Fourth Edition (DSM-IV)-based (American Psychiatric Association, 1994). However, there is a lack of empirical data on the prevalence and distribution of a wide range of mental disorders based on the newly released DSM-5 from a representative sample of children since May 2013 (American Psychiatric Association, 2013). Due to added new disorders and changing diagnostic criteria for some disorders from the DSM-IV to the DSM-5 (van de Glind et al., 2014), there is an urgent need to have epidemiological studies based on DSM-5 to identify up-to-date prevalence rates, risk factors, and disease burden estimates. This chapter consists of four sections: prevalence rates, risk factors, disease burden, and clinical implications.

2: Prevalence rates of child mental disorders

2.1: National epidemiological surveys

Apart from the regular nationwide surveys of the mental health of children and young people in England, carried out in 1999, 2004, and 2017 (Table 1, https://digital.nhs.uk/data-and-information/publications/statistical/mental-health-of-children-and-young-people-in-england/2017/2017, accessed on November 16, 2019) (Ford, Goodman, & Meltzer, 2003), only a few Western countries have conducted national surveys, including Australia (Sawyer et al., 2001), Germany (Ravens-Sieberer et al., 2008), the Netherlands (Verhulst, van der Ende, Ferdinand, & Kasius, 1997), Israel (Farbstein et al., 2010), Italy (Frigerio et al., 2009), and the United States (Kessler et al., 2012; Merikangas, Avenevoli, Costello, Koretz, & Kessler, 2009; Nock et al., 2013) (Table 1). In Taiwan, we conducted the first National Epidemiological Study of Child Mental Disorders (Taiwan’s survey) in 2015–17 in a nationally representative sample of children aged 8–14 years old using the Chinese version of the Kiddie Schedule for Affective Disorders and Schizophrenia Epidemiological version for DSM-5 criteria (K-SADS-E for DSM-5) (Chen et al., 2017; Chen, Chen, Lin, Shen, & Gau, 2020). Amongst these Western studies the national survey in the Netherlands was the first one conducted in 1993, whereas the latest one is conducted in the United Kingdom in 2017. After that, no other Western counties have conducted such national studies in child and adolescent population. The development and well-being assessment (DAWBA) (Goodman, Ford, Richards, Gatward, & Meltzer, 2000) and child behavior checklist (CBCL) (Achenbach & Edelbrock, 1983) are the most commonly used interview assessment and questionnaires tool in these surveys, respectively. The largest and smallest sample size was found in Germany (n = 17,641) and Israel (n = 957), respectively, probably depending on the country’s population. Despite a wide range of varied prevalence rates across these studies (prevalence of any mental disorders: 8.2%–49.5%), it has been sug...

Table of contents

• Cover image
• Title page
• Table of Contents
• Copyright
• Contributors
• Preface
• Introduction
• Part I: Epidemiological and cultural perspectives in child and adolescent mental health
• Part II: Developmental neuropsychiatry: Risk, prevention, and intervention opportunities
• Part III: New perspectives on problems and disorders
• Part IV: Child and adolescent mental health policy and services—Asian perspectives
• Index