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Medicine (Baltimore). 2016 Feb;95(7):e2622. doi: 10.1097/MD.0000000000002622.

The Prevalence of Mental Disorders Among Children and Adolescents in the Child Welfare System: A Systematic Review and Meta-Analysis.

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From the Maison Départementale de l'Adolescent et CMPPD (GB), Conseil Départemental des Bouches-du-Rhône, Marseille, France; Service d'épidémiologie et d'économie de la santé (MA, PA, LB), Pôle de Santé Publique, Hôpital La Timone, Assistance Publique-Hôpitaux de Marseille, Marseille, France; Aix-Marseille University (MA, AL, PA, LB), Marseille, France; INSERM U955 (GF), Translational Psychiatry team, Paris Est University, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France; Fondation Fondamental (GF), Fondation de Coopération en Santé Mentale; Network of Expert Centres for Schizophrenia (GF), Créteil, France; Laboratoire Psychologie de la Perception (ST), Université Paris Descartes, Paris, France; and Service Hospitalo-Universitaire de Psychiatrie de l'Enfant et de l'Adolescent de Rennes (ST), Université de Rennes 1, Rennes, France.


It remains unclear whether children and adolescents in the child welfare system (CWS) exhibit a higher prevalence of mental disorders compared with the general population. The objective of this study was to perform a systematic review and meta-analysis to assess the prevalence of mental disorders in the CWS.A ll of the epidemiological surveys assessing the prevalence of mental disorders in children and adolescents in the CWS were included. The pooled prevalence was estimated with random effect models. Potential sources of heterogeneity were explored using meta-regression analyses.E ight studies provided prevalence estimates that were obtained from 3104 children and adolescents. Nearly 1 child or adolescent of every 2 (49%; 95% confidence interval (CI) 43-54) was identified as meeting criteria for a current mental disorder. The most common mental disorder was disruptive disorder (27%; 95% CI 20-34), including conduct disorder (20%; 95% CI 13-27) and oppositional defiant disorder (12%; 95% CI 10-14). The prevalence of attention-deficit/hyperactivity disorder was estimated to be 11% (95% CI 6-15). The prevalence estimates of anxiety and depressive disorders were 18% (95% CI 12-24) and 11% (95% CI 7-15). Posttraumatic stress disorder had the lowest prevalence (4%; 95% CI 2-6). High prevalences of mental disorders in the CWS were reported, which highlights the need for the provision of qualified service. The substantial heterogeneity of our findings is indicative of the need for accurate epidemiological data to effectively guide public policy.

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