Brief communicationThe contribution of neurologic disorders to the national prevalence of depression and anxiety problems among children and adolescents
Introduction
Mental health disorders are growing global public health issues [1], [2]. Depression and anxiety disorders are leading contributors to the mental health–related disease [2] and economic [3] burden and affect nearly 2 million and 4 million children and adolescents, respectively, in the United States [1]. Depression or anxiety disorders in adolescence are strong predictors of these mental health disorders in adulthood [4]. Children and adolescents with neurologic disorders (NDs) are at increased risk of depression and anxiety disorders because of a variety of physical and social factors, [5], [6], [7] which can be inherent to the condition (e.g., communication impairments) or associated with the condition (e.g., participation restriction). The purpose of this study was to characterize the prevalence of depression and anxiety disorders in children and adolescents by the presence of various NDs. Knowing this information would greatly assist public health efforts toward early identification of mental health needs in high-risk subpopulations.
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Material and methods
Data were from the 2016 National Survey of Children's Health (NSCH). The NSCH was developed to produce state- and national-level data on demographic and health characteristics of American children aged 0–17 years, their families, and their communities. The survey used a self-administered data collection design using both Internet and mailed paper data collection instruments between June 2016 and February 2017. There were more than 360,000 sampled household addresses that were allocated within
Results
Of the 35,718 (weighted estimate: 49,642,709) individuals aged 6–17 years identified in the 2016 NSCH, 4.0% had at least one of the six NDs. The combined group of NDs had a prevalence of 15.3% and 37.9% for depression and anxiety problems, respectively, whereas individuals without NDs had a prevalence of 3.4% and 7.3%, respectively (Table 1). Of the children and adolescents with depression (weighted estimate: 1,925,131) or anxiety problems (weighted estimate: 4,201,418), children and
Discussion
The key finding of this investigation was that in a nationally representative sample, children and adolescents with NDs contribute to a considerable portion of the overall prevalence of depression and anxiety problems, despite only representing 4% of the population. This pattern was consistent across all ND groups, except for Down syndrome. For example, youth with intellectual disabilities represented 1.2% of the total sample but represented 4.5% of the overall prevalence of depression and 4.6%
Conclusions
Study findings suggest that children and adolescents with NDs represent a considerable portion of the national prevalence of depression and anxiety problems. Within a pediatric clinical setting, routine screening, increased awareness and knowledge, and adequate resources to treat mental health disorders could be an avenue that leads to significant benefits in the national mental health–related burden among children and adolescents.
Acknowledgments
Dr. Whitney is supported by the University of Michigan, USA Advanced Rehabilitation Research Training Program in Community Living and Participation from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) [90AR5020-0200]. Dr. Peterson is funded by the National Institutes of Health (NIH), USA [1KO1 HD074706] and NIDILRR [90IF0102-01]. Dr. Warschausky is funded by the NIH [5 UL1 TR002240-05], the Cerebral Palsy Alliance, and the Mildred E. Swanson
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