Time trends in reported diagnoses of childhood neuropsychiatric disorders: a Danish cohort study
Hjördís Osk Atladóttir1, Erik T Parner, Diana Schendel
1North Atlantic Neuro-Epidemiology Alliances at Department of Epidemiology, Institute of Public Health, University of Aarhus, Aarhus, Denmark. hoa@soci.au.dk
Insights
Increases in autism diagnoses are not unique, paralleling trends in other childhood neurodevelopmental disorders like hyperkinetic disorder and Tourette syndrome. This suggests a broader epidemiological shift in diagnosis and service demand.
Area of Science:
- Child and Adolescent Psychiatry
- Epidemiology
- Neurodevelopmental Disorders
Background:
- Autism spectrum disorder (ASD) and childhood autism diagnoses have increased.
- Trends in other childhood neuropsychiatric disorders require examination for context.
Purpose of the Study:
- To investigate trends in autism spectrum disorder (ASD) and childhood autism.
- To compare these trends with hyperkinetic disorder, Tourette syndrome, and obsessive-compulsive disorder (OCD).
Main Methods:
- Population-based cohort study of 669,995 children born in Denmark (1990-1999).
- Data linkage between the Danish Medical Birth Registry and the Danish National Psychiatric Register through 2004.
- Analysis of cumulative incidence proportion by age, stratified by birth year, using ICD-10 criteria.
Main Results:
- Statistically significant increases in cumulative incidence observed for ASD, childhood autism, hyperkinetic disorder, and Tourette syndrome.
- No significant change in cumulative incidence was found for obsessive-compulsive disorder.
- A common pattern of increasing incidence was noted across several neurodevelopmental disorders.
Conclusions:
- Rising reported autism diagnoses may reflect a wider epidemiological phenomenon affecting multiple childhood neuropsychiatric disorders.
- The observed pattern suggests increased awareness and demand for services for neurodevelopmental disorders in general.
- Further research is needed to determine the underlying causes of these shared epidemiological trends.
Objectives:
To examine trends in autism (autism spectrum disorder and childhood autism) in the context of 3 additional childhood neuropsychiatric disorders: hyperkinetic disorder, Tourette syndrome, and obsessive-compulsive disorder.
Design:
Population-based cohort study.
Setting:
Children were identified in the Danish Medical Birth Registry. Relevant outcomes were obtained via linkage with the Danish National Psychiatric Register, which included reported diagnoses through 2004 by psychiatrists using diagnostic criteria from the International Statistical Classification of Diseases, 10th Revision.
Participants:
All children born in Denmark from 1990 through 1999, a total of 669 995 children.
Main Outcome Measures:
Cumulative incidence proportion by age, stratified by year of birth, for each disorder.
Results:
Statistically significant increases were found in cumulative incidence across specific birth years for autism spectrum disorder, childhood autism, hyperkinetic disorder, and Tourette syndrome. No significant change in cumulative incidence was observed for obsessive-compulsive disorder.
Conclusions:
Recent increases in reported autism diagnoses might not be unique among childhood neuropsychiatric disorders and might be part of a more widespread epidemiologic phenomenon. The reasons for the observed common pattern of change in reported cumulative incidence could not be determined in this study, but the data underscore the growing awareness of and demand for services for children with neurodevelopmental disorders in general.
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