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Prevalence of childhood mental disorders in high-income countries: a systematic review and meta-analysis to inform policymaking

期刊

EVIDENCE-BASED MENTAL HEALTH
卷 25, 期 1, 页码 36-44

出版社

BMJ PUBLISHING GROUP
DOI: 10.1136/ebmental-2021-300277

关键词

child & adolescent psychiatry

资金

  1. British Columbia Ministry of Children and Family Development, Child and Youth Mental Health Branch [SL00444S01]

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The research found that approximately one in eight children in 11 countries have mental disorders at any given time, yet most children with mental disorders, even in high-income countries, are not receiving services for these conditions. Anxiety, attention-deficit/hyperactivity, oppositional defiant disorders are among the most common.
Question Mental disorders typically start in childhood and persist, causing high individual and collective burdens. To inform policymaking to address children's mental health in high-income countries we aimed to identify updated data on disorder prevalence. Methods We identified epidemiological studies reporting mental disorder prevalence in representative samples of children aged 18 years or younger-including a range of disorders and ages and assessing impairment (searching January 1990 through February 2021). We extracted associated service-use data where studies assessed this. We conducted meta-analyses using a random effects logistic model (using R metafor package). Findings Fourteen studies in 11 countries met inclusion criteria, published from 2003 to 2020 with a pooled sample of 61 545 children aged 4-18 years, including eight reporting service use. (All data were collected pre-COVID-19.) Overall prevalence of any childhood mental disorder was 12.7% (95% CI 10.1% to 15.9%; I-2=99.1%). Significant heterogeneity pertained to diagnostic measurement and study location. Anxiety (5.2%), attention-deficit/hyperactivity (3.7%), oppositional defiant (3.3%), substance use (2.3%), conduct (1.3%) and depressive (1.3%) disorders were the most common. Among children with mental disorders, only 44.2% (95% CI 37.6% to 50.9%) received any services for these conditions. Conclusions An estimated one in eight children have mental disorders at any given time, causing symptoms and impairment, therefore requiring treatment. Yet even in high-income countries, most children with mental disorders are not receiving services for these conditions. We discuss the implications, particularly the need to substantially increase public investments in effective interventions. We also discuss the policy urgency, given the emerging increases in childhood mental health problems since the onset of the COVID-19 pandemic (PROSPERO CRD42020157262).

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