Journal of the American Academy of Child & Adolescent Psychiatry
Research Update Review10-Year Research Update Review: The Epidemiology of Child and Adolescent Psychiatric Disorders: I. Methods and Public Health Burden
Section snippets
WHAT IS EPIDEMIOLOGY?
Epidemiology is the study of patterns of disease in human populations (Kleinbaum et al., 1982). Patterns are nonrandom distributions, and patterns of disease distribution occur in both time and space. Whenever we observe a nonrandom distribution, we have the opportunity to identify causal factors that influence who gets a disease and who does not. For example, we observe that depression rises rapidly after puberty in girls, but not to the same extent in boys (Angold and Worthman, 1993). This
EPIDEMIOLOGICAL METHODS: ASSESSING CHILD AND ADOLESCENT PSYCHIATRIC DISORDERS IN NONCLINICAL SAMPLES
Counting cases is an important first step toward measuring the social burden caused by a disease and the effectiveness of prevention. For most diseases, simply counting the number of individuals presenting for treatment will produce estimates that are seriously biased by referral practices, ability to pay, and other factors; a particular problem in child psychiatry because parents, teachers, and pediatricians all serve as “gatekeepers” to treatment (Horwitz et al., 1998). Community surveys are
SURVEILLANCE FOR CHILD AND ADOLESCENT PSYCHIATRIC DISORDERS: ESTIMATING THE BURDEN OF DISEASE
In the past decade, progress has been made not only in epidemiological methods but also in using them to assess the prevalence of child psychiatric disorder. In a world of scarce healthcare resources, it is important to understand the size of the burden to the community caused by these disorders. Burden, in terms of numbers affected, have an impact on the individual, and cost to the community is a crucial factor in the battle for resources for treatment and prevention. One of the most important
CONCLUSIONS: WHAT HAVE WE LEARNED IN THE PAST DECADE ABOUT THE BURDEN OF CHILD AND ADOLESCENT PSYCHIATRIC DISORDERS?
From the public health viewpoint, child and adolescent psychiatric epidemiology in the past decade can be said to have come to terms with reality. It has stopped agonizing over how many children have this or that disorder as if there were a “true” answer to the question. It is now clear that measures of psychopathology, whether they take the form of interviews, questionnaires, or so-called objective tests, can be set to generate a wide range of prevalence estimates, depending on the severity of
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Work on this paper was supported in part by grants06937, 01002, and 01167fromthe National Institute of Mental Health, grants011301 and 016977fromthe National Institute on Drug Abuse, and a Pfizer Faculty Scholar Award in Clinical Epidemiology to Dr. Egger.
Disclosure: Dr. Egger holds a Pfizer Foundation Faculty Scholar Award in Clinical Epidemiology. The other authors have no financial relationships to disclose.