Troubling tally of kids' mental disorders
Two large surveys, one focusing on U.S. pediatric practice and the other sampling communities throughout Puerto Rico, indicate that a surprisingly large percentage of children -- about 1 in 5 -- have moderate to severe psychiatric disorders. The reports, both in the December ARCHIVES OF GENERAL PSYCHIATRY, reinforce similar estimates in recent studies in New Zealand and North America and suggest that many such children do not receive mental health care.
"Rates this high would clearly imply a major public health problem, if these disorders led to significant long-term impairment," write psychologist Elizabeth J. Costello of Duke University Medical Center in Durham, N.C., and her colleagues, who conducted the U.S. pediatric study. Unfortunately, they note, researchers know little about what happens to children with untreated psychiatric disorders they reach adolescence and adulthood.
Nevertheless, according to psychiatrist Hector R. Bird of Columbia University College of Physicians and Surgeons in New York City and his co-workers, their findings in Puerto Rico "indicate a major public health problem for the children in the island."
Costello and her colleagues studies 789 children aged 7 to 11 years visiting their pediatrician over a one-year period. Each child and his or her parent (usually the mother) filled out a standard questionnaire on the child's behavior problems and social skills. The children attended two medical centers run by a health maintenance organization. One is located in Pittsburgh and serves both affluent and poor families; the other serves a suburgan, mainly blue-collar population.
To estimate the occurrence of different psychiatric disorders, the experimenters interviewed 126 children with high scores for behavior and emotional problems, as well as their parents. They also interviewed another 174 children scoring in the normal range and their parents. A statistical analysis was used to calculate the prevalence of mental disorders in the entire sample.
Based on interviews with the …