Epidemiology of psychiatric disability in childhood and adolescence

The goal of the study was to ascertain the factor structure and prevalence of psychiatric disability in children and adolescents in relation to demogr aphic variables and diagnosis. A representative sample of 1420 children (9- 13 years) from 11 countries in North Carolina was followed for up to 6 year s. Children and caretakers were interviewed with the Child and Adolescent P sychiatric Assessment, which generates DSM-IV diagnoses and includes a meas ure of disability secondary to psychological symptoms. Three broad areas of disability were identified (relating to family, school, and peers), School disabilities were more common in boys than girls, while the reverse was tr ue of family disability. Effects of age were complex, and partially gender- differentiated. Children from minority ethnic groups had a higher overall p revalence of school disabilities, and were more prone than Whites to the di sabling effects of disruptive behavior disorders. Anxiety disorders were as likely to result in disability as depressive disorders, and oppositional d efiant disorders were more strongly associated with disability in some area s than was conduct disorder. The areas where disability is manifested are d ifferent depending on race, gender, age, and the type of disorder suffered. The implications of these findings for nosology and prevention are discuss ed.