Mental health problems in Austrian adolescents: a nationwide, two-stage epidemiological study applying DSM-5 criteria

European Child & Adolescent Psychiatry, May 2017

This is a nationwide epidemiological study using DSM-5 criteria to assess the prevalence of mental disorders in a large sample of Austrian adolescents between 10 and 18 years including hard-to-reach samples. A sample of 3615 adolescents from four cohorts (school grades 5, 7, 9, 11; age range 10–18 years) was recruited from 261 schools, samples of unemployed adolescents (n = 39) and adolescents from mental health institutions (n = 137) were added. The Youth Self-Report and SCOFF were used to screen for mental health problems. In a second phase, the Childrens’ Diagnostic Interview for Mental Disorders was used to make point and lifetime psychiatric diagnoses. Mental health service use was also assessed. Point prevalence and lifetime prevalence rates for at least one psychiatric disorder were 23.9% and 35.8%. The highest lifetime prevalence rates were found for anxiety disorders (15.6%), neurodevelopmental disorders (9.3%; ADHD 5.2%) and depressive disorders (6.2%). Forty-seven percent of adolescents with a lifetime psychiatric disorder had a second diagnosis. Internalising disorders were more prevalent in girls, while neurodevelopmental disorders and disruptive, impulse control and conduct disorders were more prevalent in boys. Of those with a lifetime psychiatric disorder, 47.5% had contacted mental health services. Of the residual 52.5% who had not contacted mental health services, 18.1% expressed an interest in treatment. DSM-5 mental health disorders are highly prevalent among Austrian adolescents. Over 50% had or were interested in accessing treatment. Early access to effective interventions for these problems is needed to reduce burden due to mental health disorders.

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Mental health problems in Austrian adolescents: a nationwide, two-stage epidemiological study applying DSM-5 criteria

Eur Child Adolesc Psychiatry Mental health problems in Austrian adolescents: a nationwide, two‑stage epidemiological study applying DSM‑5 criteria Gudrun Wagner 0 1 2 4 Michael Zeiler 0 1 2 4 Karin Waldherr 0 1 2 4 Julia Philipp 0 1 2 4 Stefanie Truttmann 0 1 2 4 Wolfgang Dür 0 1 2 4 Janet L. Treasure 0 1 2 4 Andreas F. K. Karwautz 0 1 2 4 0 FernFH Distance - Learning University of Applied Sciences , Zulingergasse 4, 3200 Wiener Neustadt , Austria 1 Ludwig Boltzmann Institute Health Promotion Research , Untere Donaustraße 47/3, 1020 Vienna , Austria 2 Department for Child and Adolescent Psychiatry, Medical University of Vienna , Waehringer Guertel 18-20, 1090 Vienna , Austria 3 Andreas F. K. Karwautz 4 Institute of Psychiatry, Psychology and Neuroscience, Kings College University , London , UK This is a nationwide epidemiological study using DSM-5 criteria to assess the prevalence of mental disorders in a large sample of Austrian adolescents between 10 and 18 years including hard-to-reach samples. A sample of 3615 adolescents from four cohorts (school grades 5, 7, 9, 11; age range 10-18 years) was recruited from 261 schools, samples of unemployed adolescents (n = 39) and adolescents from mental health institutions (n = 137) were added. The Youth Self-Report and SCOFF were used to screen for mental health problems. In a second phase, the Childrens' Diagnostic Interview for Mental Disorders was used to make point and lifetime psychiatric diagnoses. Mental health service use was also assessed. Point prevalence and lifetime prevalence rates for at least one psychiatric disorder were 23.9% and 35.8%. The highest lifetime prevalence rates were found for anxiety disorders (15.6%), neurodevelopmental disorders (9.3%; ADHD 5.2%) and depressive disorders (6.2%). Forty-seven percent of adolescents with a lifetime psychiatric disorder had a second diagnosis. Internalising disorders were more prevalent in girls, while neurodevelopmental disorders and disruptive, impulse control and conduct disorders were more prevalent in boys. Of those with a lifetime psychiatric disorder, 47.5% had contacted mental health services. Of the residual 52.5% who had not contacted mental health services, 18.1% expressed an interest in treatment. DSM-5 mental health disorders are highly prevalent among Austrian adolescents. Over 50% had or were interested in accessing treatment. Early access to effective interventions for these problems is needed to reduce burden due to mental health disorders. Mental disorders; DSM-5; Adolescents; Epidemiology Introduction Epidemiological studies are essential not only to provide data on children and adolescents who are affected by mental health problems, but also to provide information on the need, availability and access to mental health services. Information about prevalence and incidence is useful for planning primary, secondary and tertiary prevention and treatment services [ 1 ]. A meta-analysis of population studies assessing the prevalence of mental disorders in children and adolescents found a worldwide pooled prevalence rate of 13.4% for any mental disorder, surveys including epidemiological studies from 1970 to 2000 found median prevalence rates of 18%, and a US sample in 2010 revealed 20% of adolescents between 13 and 18 years with mental health problems who need treatment [ 2–7 ]. The most frequent psychiatric disorders in childhood and adolescence are anxiety disorders (up to 31.9%), behaviour disorders (16.3–19.1%), substance use disorders (8.3–11.4%), emotional disorders (3.7–14.3%), hyperkinetic disorders (2.2–8.6%) and aggressive dissocial disorders (2.1–7.6%) [2]. In childhood, mental health problems in general are more frequent in boys than in girls (2:1), but from the age of 13 years onward, the prevalence rates are higher for girls. However, there are gender differences between various disorders. For example, adolescent boys suffer more often from externalising and substance use disorders, while female adolescents are more often affected by internalising disorders, such as eating disorders and depressive disorders [ 3 ]. The severity and persistence of adolescent mental health problems are also of relevance [ 8–11 ]. In the Dutch TRAILS report, 22% out of 45% youth with a lifetime mental health disorder showed severe impairment. Functional impairment can be assessed from disorder-specific measures or a global measure such as the CGAS (Child Global Assessment Scale) [12]. Although anxiety disorders are most prevalent they are usually less severe, whereas the less prevalent mood and behaviour disorders are more severe [ 11 ]. The longitudinal BELLA study in Germany revealed a high persistence rate of mental health problems (>30% in a 6 year follow-up). Mental health service use was limited to only 33% with acute or recurrent mental health problems and 63.9% with persistent mental health problems [ 13 ]. A similar pattern was identified in the Dutch TRAILS cohort stud (...truncated)


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Gudrun Wagner, Michael Zeiler, Karin Waldherr, Julia Philipp, Stefanie Truttmann, Wolfgang Dür, Janet L. Treasure, Andreas F. K. Karwautz. Mental health problems in Austrian adolescents: a nationwide, two-stage epidemiological study applying DSM-5 criteria, European Child & Adolescent Psychiatry, 2017, pp. 1483-1499, Volume 26, Issue 12, DOI: 10.1007/s00787-017-0999-6