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

Published

Journal Article

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.

Full Text

Duke Authors

Cited Authors

  • Kessler, RC; Avenevoli, S; Costello, J; Green, JG; Gruber, MJ; McLaughlin, KA; Petukhova, M; Sampson, NA; Zaslavsky, AM; Merikangas, KR

Published Date

  • April 2012

Published In

Volume / Issue

  • 69 / 4

Start / End Page

  • 381 - 389

PubMed ID

  • 22474106

Pubmed Central ID

  • 22474106

Electronic International Standard Serial Number (EISSN)

  • 1538-3636

Digital Object Identifier (DOI)

  • 10.1001/archgenpsychiatry.2011.1603

Language

  • eng

Conference Location

  • United States