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Arch Gen Psychiatry. 2012 Apr;69(4):381-9. doi: 10.1001/archgenpsychiatry.2011.1603.

Severity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Supplement.

Author information

1
Department of Health Care Policy, Harvard Medical School, Boston, MA 02115, USA. ncs@hcp.med.harvard.edu

Abstract

CONTEXT:

Estimates of DSM-IV disorder prevalence are high; stringent criteria to define need for services are desired.

OBJECTIVE:

To present US national data on the prevalence and sociodemographic correlates of 12-month serious emotional disturbance (SED), defined by the US Substance Abuse and Mental Health Services Administration, from the National Comorbidity Survey Replication Adolescent Supplement.

DESIGN:

The National Comorbidity Survey Replication Adolescent Supplement is a national survey of DSM-IV anxiety, mood, behavior, and substance disorders among US adolescents.

SETTING:

Dual-frame household and school samples of US adolescents.

PARTICIPANTS:

Total of 6483 pairs of adolescents aged 13 to 17 (interviews) and parents (questionnaires).

MAIN OUTCOME MEASURES:

The DSM-IV disorders were assessed with the World Health Organization Composite International Diagnostic Interview and validated with blinded clinical interviews based on the Schedule for Affective Disorders and Schizophrenia for School-Age Children. Serious emotional disturbance was operationalized as a DSM-IV/Composite International Diagnostic Interview disorder with a score of 50 or less on the Children's Global Assessment Scale (ie, moderate impairment in most areas of functioning or severe impairment in at least 1 area). Concordance of Composite International Diagnostic Interview SED diagnoses with blinded Schedule for Affective Disorders and Schizophrenia for School-Age Children diagnoses was good.

RESULTS:

The estimated prevalence of SED was 8.0%. Most SEDs were due to behavior (54.5%) or mood (31.4%) disorders. Although respondents with 3 or more disorders made up only 29.0% of those with 12-month DSM-IV/Composite International Diagnostic Interview disorders, they constituted 63.5% of SEDs. Predictive effects of high comorbidity were significantly greater than the product of their disorder-specific odds ratios and consistent across disorder types. Associations of sociodemographic variables with SED were generally nonsignificant after controlling for disorder type and number.

CONCLUSIONS:

The high estimated 12-month prevalence of DSM-IV disorders among US adolescents is largely due to mild cases. The significant between-disorder differences in risk of SED and the significant effect of high comorbidity have important public health implications for targeting interventions.

[Indexed for MEDLINE]
Free PMC Article

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