Prevalence, comorbidity, risk factors and service utilisation of disruptive behaviour disorders in a community sample of children in Valencia (Spain)

Abstract

Background: The importance of cultural and adverse family-environment variables as risk factors for Disruptive Behaviour Disorder has been repeatedly shown, and hence a variation in rates and risk factors between cultures could be expected. Lower rates should be found in countries with strong and stable family ties, such as Spain.

Objective: Prevalence rate, severity and comorbidity of Disruptive Behaviour Disorder, as well as risk factors and help-seeking behaviour relating to this disorder, were studied in a general population random sample of 387 10 year-old children living in Valencia (Spain).

Methods: DSM-III-R diagnosis was established by means of the KIDDY-SADS (Kiddy Schedule for affective diseases and Schizophrenia (epidemiological version)) interview and severity of the disorder was evaluated with the General Assessment Functioning (GAF) Scale. Other variables measured were: sex, number of siblings, parental occupation, single-parent home, school failure, socioeconomic level, chronic somatic ailments and use of mental health services.

Results: Prevalence and severity parameters were low (for GAF<70, prevalence = 11.1; for GAF<60, prevalence = 4.9), albeit falling within the range reported in other countries. Morbidity profile and use of services did not substantially depart from the findings reported in other cultures. Different risk factors were associated with Attention Deficit Hyperactivity Disorder, Conduct Disorder and Oppositional Defiant Disorder, thus confirming the validity of considering them as separate dimensions.

Conclusions: The findings did not support the hypothesis of lower rates and different risk factors and morbidity patterns in the Spanish sample studied.