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Verlauf psychischer Auffälligkeiten von Kindern und Jugendlichen

Ergebnisse der BELLA-Kohortenstudie

Published Online:February 11, 2016https://doi.org/10.1026/0942-5403/a000184

Abstract

Zusammenfassung. Psychische Auffälligkeiten sind in der Kindheit und Jugend häufig und weisen geschlechts- und altersbedingte Unterschiede auf. Aktuelle, bundesweit repräsentative Daten über den Verlauf von psychischen Auffälligkeiten fehlen bisher. Anhand der Angaben von 3 256 Teilnehmern (7 – 19 Jahre) der prospektiven und für Deutschland repräsentativen BELLA-Kohortenstudie wurde mit Mehrebenenmodellen der Verlauf von Depression (CES-DC), Angst (SCARED-5), ADHS (Conners 3) und Störungen des Sozialverhaltens (CBCL) untersucht. Insgesamt zeigten im Elternbericht 11.2 % der Kinder und Jugendlichen klinisch bedeutsame Anzeichen für Depression, 10.6 % für Angst, 5.7 % für ADHS und 12.2 % für Störungen des Sozialverhaltens. Im Selbstbericht wiesen 16.1 % klinisch bedeutsame Symptome für Depression, 15.1 % für Angst und 2.0 % für ADHS auf. Mit zunehmendem Alter nahmen Symptome von ADHS und Störungen des Sozialverhaltens ab, während internalisierende Auffälligkeiten zunahmen. Symptome von Depression und Angst traten häufiger bei Mädchen auf, Symptome von ADHS und Störungen des Sozialverhaltens häufiger bei Jungen. Eltern schätzten die internalisierenden Auffälligkeiten ihrer Kinder niedriger ein als diese selbst. Für die klinische Praxis sind eine störungsspezifische, entwicklungs- und geschlechtssensitive Diagnostik und Behandlung von großer Bedeutung.


Trajectories of Mental Health Problems in Children and Adolescents: Results of the BELLA Cohort Study

Abstract. Mental health problems in childhood and adolescence are widespread. Current results from longitudinal studies give inconsistent information about the trajectories of internalizing and externalizing problems. Studies show inconsistent prevalence rates of mental health problems depending on gender and age as well as between self- and parent report. So far, little is known about the developmental course of mental health problems over the entire childhood and adolescence period in Germany. The aim of the present study was to identify the trajectories of mental health problems in childhood and adolescence for (a) different psychiatric disorders, (b) for boys and girls separately, and (c) for self- and parent report. The longitudinal BELLA study is the mental health module of the German National Health Interview and Examination Survey among children and adolescents (KiGGS). Data of 3,256 participants of the BELLA study aged between 7 and 19 years from up to four measurement points were analyzed to estimate the trajectories of depression (CES-DC), anxiety disorders (SCARED-5), attention deficit hyperactivity disorder (ADHD; Conners Global Index), and conduct disorder (CBCL) using mixed models for longitudinal data. According to parent report, 11.2 % of the children and adolescents showed clinically relevant symptoms of depression, 10.6 % of anxiety, 5.7 % of ADHD, and 12.2 % of conduct disorder. According to self-report 16.1 % showed clinically relevant symptoms of depression, 15.1 % of anxiety, and 2.0 % of ADHD. Over the entire period of childhood and adolescence, symptoms of ADHD and conduct disorder decreased and were more frequent in boys, whereas internalizing problems (depression and anxiety) increased and were about twice as high in girls compared with boys. Furthermore, girls rated their internalizing problems approximately 10 % higher than their parents did (depression: 20.8 % vs. 12.3 %; anxiety: 21.4 % vs. 12.3 %). The prevalence rate for internalizing problems among boys was about 10 % for the parent as well as self-report. For boys, parents indicated more symptoms of ADHD than their children themselves (7 % vs. 4.3 %). For girls, there was no difference between parent and child report (2 %, respectively). Prevalence rates for parent-rated conduct disorder were about 12 % for girls and boys. A substantial percentage of children and adolescents in Germany show clinically relevant symptoms in any developmental stage. The trajectories of mental health problems over the entire childhood and adolescence period differ between depression, anxiety disorders, ADHD, and conduct disorder as well as between parent and self-report. Children’s gender and age influence the developmental course meaningfully. These aspects should be taken into account for future prevention programs, diagnostics, and interventions.

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