Prevalence of child and adolescent mental disorders in Chile: A community epidemiological study

Abstract

Background: In Latin America, there is limited research on the prevalence of mental disorders in children and adolescents. This Chilean survey is the first national representative survey in the Latin American region to examine the prevalence of Diagnostic and Statistical Manual-IV (DSM-IV) psychiatric disorders in the region in children and adolescents. Methods: Subjects aged 4–18 were selected using a stratified multistage design. The Diagnostic Interview Schedule for Children version IV (DISC-IV) was used to obtain 12-month DSM-IV diagnoses of affective, anxiety, conduct and substance use disorders, and supplemented with questionnaires examining family risk factors, family income, and service utilization. The parent or the primary caretaker was interviewed for children, aged 4–11, using the DISC-IV; however, adolescents, aged 12–18, were directly interviewed. Results: A sample of 1558 children and adolescents was evaluated. Using the most stringent DISC-IV impairment algorithm, the prevalence rate for any psychiatric disorders was 22.5% (19.3% for boys and 25.8% for girls). The prevalence rate was higher among the children, aged 4–11, in comparison with adolescents, aged 12–18 (27.8% and 16.5%, respectively). Less than half of the subjects in need of services sought some form of assistance. Nearly a quarter of those using services did not present with a psychiatric diagnosis in the past year. Comorbidity was found in 24.8% of those with a disorder, but only 6.3% had three or more diagnoses. Conclusions: The prevalence of psychiatric disorders in Chile is high among children and adolescents. This study highlights the increasing need to reevaluate mental health services provided to children and adolescents in Latin America. Keywords: Children, adolescent, epidemiology, mental disorders, prevalence, Latin America. Abbreviations: ADHD, attention-deficit hyperactivity disorder; CIDI-A, Composite Diagnostic Interview; DISC-IV, Diagnostic Interview Schedule for Children version IV; DAWBA, Developmental and Well-Being Assessment; DSM-IV, Diagnostic and Statistical Manual-IV; FAD, Family Assessment Device; GAD, generalized anxiety disorder; MDD, major depressive disorder; ODD, oppositional-defiant-disorder; OR, odds ratio; SACA, Service Assessment for Children and Adolescents; WHO, World Health Organization; 95% CI, 95% confidence interval.