Author:
Bachmann Christian J,Scholle Oliver,Bliddal Mette,dosReis Susan,Odsbu Ingvild,Skurtveit Svetlana,Wesselhoeft Rikke,Vivirito Annika,Zhang Chengchen,Scott Stephen
Abstract
Abstract
Background
Conduct disorders (CD) are among the most frequent psychiatric disorders in children and adolescents, with an estimated worldwide prevalence in the community of 2–4%. Evidence-based psychological outpatient treatment leads to significant improvement in about two-thirds of cases. However, there seems to be considerable variation in rates of CD diagnoses and implementation of evidence-based interventions between nations. The aim of this study was to compare administrative prevalence and treatment patterns for CD in children and adolescents seen in health care systems across four Western countries (Denmark, Germany, Norway, and the USA).
Methods
Cross-sectional observational study using healthcare data to identify children and adolescents (aged 0–19 years) with an ICD-10 code for CD within the calendar year 2018. Within each country’s study population, the prevalence of CD, psychiatric comorbidity, psychopharmacological treatment, and psychiatric hospitalisation was calculated.
Results
The prevalence of diagnosed CD differed 31-fold between countries: 0.1% (Denmark), 0.3% (Norway), 1.1% (USA) and 3.1% (Germany), with a male/female ratio of 2.0–2.5:1. The rate of psychiatric comorbidity ranged from 69.7 to 86.1%, with attention-deficit/hyperactivity disorder being most common. Between 4.0% (Germany) and 12.2% (USA) of youths with a CD diagnosis were prescribed antipsychotic medication, and 1.2% (Norway) to 12.5% (Germany) underwent psychiatric hospitalisation.
Conclusion
Recognition and characteristics of youths diagnosed with CD varied greatly by country. In some countries, the administrative prevalence of diagnosed CD was markedly lower than the average estimated worldwide prevalence. This variation might reflect country-specific differences in CD prevalence, referral thresholds for mental health care, diagnostic tradition, and international variation in service organisation, CD recognition, and availability of treatment offers for youths with CD. The rather high rates of antipsychotic prescription and hospitalisation in some countries are remarkable, due to the lack of evidence for these therapeutic approaches. These findings stress the need of prioritising evidence-based treatment options in CD. Future research should focus on possible reasons for inter-country variation in recognition and management of CD, and also address possible differences in patient-level outcomes.
Publisher
Springer Science and Business Media LLC
Reference61 articles.
1. Scott S. Oppositional and conduct disorders. In: Rutter’s child and adolescent psychiatry 6 edn. Edited by Thapar A, Pine DS, Leckman JF, Scott S, Snowling MJ, Taylor E. Chichester: Wiley Blackwell; 2015: 913–930.
2. Sadler K, Vizard T, Ford T, Marcheselli F, Pearce N, Mandalia D, Davis J, Brodie E, Forbes N, Goodman A et al. Mental health of children and young people in England, 2017. In. London: NHS Digital; 2018.
3. Statistisches Bundesamt (Destatis). Tiefgegliederte Diagnosedaten Der Krankenhauspatientinnen und -patienten 2018. Artikelnummer: 5231301187015. Wiesbaden: Statistisches Bundesamt (Destatis); 2020.
4. Polanczyk GV, Salum GA, Sugaya LS, Caye A, Rohde LA. Annual research review: a meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. J Child Psychol Psychiatry. 2015;56(3):345–65.
5. Sacco R, Camilleri N, Eberhardt J, Umla-Runge K, Newbury-Birch D. A systematic review and meta-analysis on the prevalence of mental disorders among children and adolescents in Europe. Eur Child Adolesc Psychiatry. 2022:1–18.
Cited by
3 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献