RESEARCH UPDATE REVIEW
10-Year Research Update Review: The Epidemiology of Child and Adolescent Psychiatric Disorders: II. Developmental Epidemiology

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ABSTRACT

Objective:

To describe the growth of developmental epidemiology in the past decade and to illustrate it with examples of recent studies.

Method:

A review of publications on developmental epidemiology in the past 10 years and a discussion of some key examples.

Results:

The authors describe how the interaction between developmental psychopathology and psychiatric epidemiology has produced developmental epidemiology, the study of patterns of distribution of psychiatric disorders in time as well as in space. They give two examples of the kinds of questions that developmental epidemiology can help to answer: (1) Is the prevalence of autism increasing? Does the use of vaccines explain the increase? (2) Is there an epidemic of child and adolescent depression? Finally, they describe two areas of science that are beginning to inform developmental epidemiology: molecular genetics and the use of biological measures of stress.

Conclusions:

While child and adolescent psychiatric epidemiology continues, as described in the first of these reviews, to address questions of prevalence and burden, it has also expanded into new areas of research in the past decade. In the next decade, longitudinal epidemiological data sets with their rich descriptive data on psychopathology and environmental risk over time and the potential to add biological measures will provide valuable resources for research into gene-environment correlations and interactions.

Section snippets

FROM DEVELOPMENTAL PSYCHOPATHOLOGY TO DEVELOPMENTAL EPIDEMIOLOGY

To understand how the epidemiological study of child and adolescent psychiatric disorders has changed in the past decade, we need to go back in history to the 1980s and examine the integration of child psychiatric and normative developmental research that created a new discipline: developmental psychopathology.

The relationship between child and adolescent psychiatry and developmental psychology has waxed and waned during the past century. In its earliest decades, child and adolescent psychiatry

RECENT RESEARCH ON PREVALENCE, ONSET, AND COMORBIDITY

There are two important measures of disorder in the population: prevalence, the proportion of the population with a disorder, and incidence, the rate at which new cases arise. Changes in the prevalence of a disorder over time can provide clues about etiology. We briefly review some recent findings from studies of both children and adults and then discuss two cases in which the possibility of recent increases in prevalence has caused a public furor: autism and early-onset depression. Then we

EARLY RISK FOR PSYCHIATRIC DISORDERS

Developmental science has expanded our understanding of risk and protective factors so dramatically in the past decade that it is beyond the scope of this review to cover the whole area. Instead, we focus on two topics of particular interest for child and adolescent psychiatry: the interrelationship between medical and psychiatric risk factors and outcomes and the causal role of vaccines in autism and PDD.

AREAS OF FUTURE GROWTH IN DEVELOPMENTAL EPIDEMIOLOGY

It would be agreeable to think that the tasks involved in monitoring the prevalence and burden of child and adolescent psychiatric disorders-the “public health” duties of epidemiology-would in the next decade be taken over by the agencies tasked to carry out surveillance studies of disease, above all the Centers for Disease Control and Prevention. Then the research funding available from the National Institutes of Health could be used, as intended, for scientific, etiological research rather

CONCLUSIONS AND IMPLICATIONS FOR TREATMENT AND PREVENTION

In summary, developmental epidemiology has made considerable progress in the past decade as both a descriptive and an analytic science. Descriptively, it has shown that there are clear timing patterns in the onset of different psychiatric disorders, that the onset of one disorder affects the timing of others, and that individual development intertwines with the development of the disease process. Analytically, it has begun to make use of new techniques to move beyond what epidemiologists Mervin

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  • Cited by (0)

    Work on this article was supported in part by grants 06937, 01002, and 01167 from the National Institute of Mental Health, and grants 011301 and 016977 from the National Institute on Drug Abuse.

    Disclosure: The authors have no financial relationships to disclose.

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