CDC Estimates Prevalence of Mental Health Issues Among Children

On May 17, 2013, the Centers for Disease Control (CDC) released Mental Health Surveillance Among Children—United States, 2005-2011, which summarizes the findings of several different surveys by government agencies. The CDC estimated that between 13 percent and 20 percent of children experience a mental disorder in any given year. The disorders included attention deficit hyperactivity disorder (ADHD), anxiety, autism spectrum disorders, behavioral or conduct problems, alcohol or illicit drug use, cigarette dependence, depression, and Tourette’s syndrome.

The various surveys focused on different issues and age groups, and interviewers with different levels of skill or training spoke with children and parents at school, at home or in other settings. Children also completed written surveys at school. The CDC used data from a variety of networks and surveillance systems, including the its own data from several ongoing surveys and reporting systems, state vital statistics systems, the National Survey on Drug Use and Health published by the Substance Abuse and Mental Health Services Administration, and the Autism and Developmental Disabilities Monitoring Network.

ADHD, Behavioral and Conduct Disorders

Several surveillance systems measured the prevalence of ADHD, and their results varied between depending on the age groups studied; some focused on children between the ages of three and 17 years; others, on children from eight to 15 years old. In 2011, 8.4 percent of parents with children between the ages of three and 17 had been told by a doctor that their child had ADHD, an increase from 6.8 percent of parents who reported that a child had ADHD in 2007. Oppositional defiance disorder (ODD) and conduct disorder were measured in only one survey, which asked parents whether a health professional had ever told them that their child had a behavioral or conduct disorder and whether the child had it currently. Parent reports indicated that 4.6 percent of children aged three to 17 years had such a history, and 3.5 percent had a current behavioral or conduct problem. The report stated that these disorders are predictive of antisocial personality disorder, bipolar disorder, smoking, and substance use.

Mood Disorders

Mood and anxiety disorders include a variety of conditions, such as generalized anxiety or separation anxiety, major depression, post-traumatic stress disorder, obsessive-compulsive disorder, and a variety of phobias. More than 25 percent of children between the ages of 14 and 18 years reported symptoms consistent with major depression, i.e., feeling so sad or hopeless nearly every day for two weeks or more that they stopped doing some usual activities. The CDC also measured suicide rates and reports of the estimated number of “mentally unhealthy days” experienced during the previous month.

Need for Further Study

The CDC acknowledged that validation work and complementary approaches are needed to develop reliable information about the prevalence of mental health conditions among children. Consistency is lacking to the extent that surveillance systems use different definitions of conditions or different techniques. The authors suggested that additional studies include surveillance of the use of mental health services and psychotropic medications and that longitudinal studies be conducted to learn about the course of conditions and the effects of treatments.