Articles
Prevalence of Psychiatric Disorders in Youths Across Five Sectors of Care

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ABSTRACT

Objective

To examine the prevalence of psychiatric disorders among youths from the following five public sectors of care: alcohol and drug services (AD), child welfare (CW), juvenile justice (JJ), mental health (MH), and public school services for youths with serious emotional disturbance (SED) in San Diego, California.

Method

The Diagnostic Interview Schedule for Children was administered between October 1997 and January 1999 for 1,618 randomly selected youths aged 6–18 years who were active in at least one of the five sectors.

Results

Fifty-four percent of the participants met criteria for at least one study disorder. Attention-deficit/hyperactivity disorder (ADHD) and disruptive behavior disorders (50%) were much more common than anxiety (10%) or mood (7%) disorders. Youths who were active in the MH and SED sectors were more likely than those not in these sectors to meet criteria for a disorder; youths in the CW sector were least likely.

Conclusions

Rates of psychiatric disorders, specifically ADHD and disruptive behavior disorders, are extremely high for youths in public sectors of care. Rates are generally higher in sectors designed to serve youths with psychiatric needs, but the prevalence of disorders was also high in sectors not specifically designed for this need (e.g., CW and JJ).

Section snippets

Participants

The Patterns of Care study included a survey of a random sample of 1,715 children and adolescents aged 6–17 years from open cases of youths active in one or more of five San Diego County public sectors of care (AD, CW, JJ, MH, SED) during the second half of fiscal year 1996–1997. All children and youths aged 6–17 years and enrolled in AD, MH, and school SED services were included in the eligible sampling frame. In JJ and CW, only children whose placement was under court jurisdiction (JJ “wards

Prevalence of Diagnoses for Total Sample and by Service Sector

The past year prevalence of psychiatric disorders was high, with 54% of the total sample meeting criteria for at least one of the study diagnoses; 23% met criteria for two or more disorders. Rates of ADHD, ODD, and CD were much higher than rates of anxiety or mood disorders (49.7% compared with 9.9% and 7.0%, respectively). The disorders with the highest prevalence overall were CD and ADHD. Table 3 presents the prevalence estimates for each diagnosis for the total sample (far right column) and

DISCUSSION

This study reports the past year prevalence estimates for selected DSM-IV psychiatric disorders among 1,618 youths aged 6–18 years identified from five public sectors of care (AD, CW, JJ, MH, and SED). The prevalence of psychiatric disorders in this multiservice, public sector, high-risk sample was very high, with 54% of the youths meeting criteria for at least one study disorder. This is much higher than most estimates of community rates of psychiatric disorders, which approximate 20% (

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    This research was supported by NIMH grant U01MH 55282 to Dr. Hough and by grants MH01544, MH01767, MH01695, and MH01924.

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