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Classification, prevalence and integrated care for neurodevelopmental and child mental health disorders: A brief
Michael O Ogundele1, Michael Morton2
1Department of Community Paediatrics, Bridgewater Community Healthcare NHS Foundation Trust, Runcorn WA7 1TW, Halton, United Kingdom. m.ogundele@nhs.net.
Insights
Neurodevelopmental, emotional, behavioural, and intellectual disorders (NDEBIDs) affect up to 15% of children. Current classification challenges hinder integrated care, necessitating a unified approach for improved clinical outcomes.
Area of Science:
- Paediatric neurodisability
- Child and adolescent mental health
- Neurodevelopmental disorders
Background:
- Neurodevelopmental disorders (NDEBIDs) encompass a range of conditions like autism and ADHD, often co-occurring with mental health issues.
- Prevalence rates in developed countries vary up to 15%, complicated by diverse diagnostic criteria and methodologies.
- Management typically involves multidisciplinary teams but is often fragmented for children with complex needs.
Purpose of the Study:
- To review the aetiology and prevalence of NDEBIDs.
- To identify challenges in current classification systems for these disorders.
- To recommend an integrated approach for nosology and clinical care.
Main Methods:
- Narrative literature review.
- Analysis of extant research on NDEBID aetiology, prevalence, and classification.
- Discussion of International Classification of Diseases-11 (ICD-11) advancements.
Main Results:
- NDEBIDs present with high co-morbidity, impacting service delivery.
- Inconsistent classification systems impede research-based service improvements.
- The ICD-11 offers a potential framework for better integration.
Conclusions:
- A unified approach to NDEBID classification and care is crucial.
- Addressing classification limitations can enhance clinical practice and research.
- Integrated care models are essential for improving outcomes in paediatric neurodisability.
Abstract:
'Neurodevelopmental disorders' comprise a group of congenital or acquired long-term conditions that are attributed to disturbance of the brain and or neuromuscular system and create functional limitations, including autism spectrum disorder, attention deficit/ hyperactivity disorder, tic disorder/ Tourette's syndrome, developmental language disorders and intellectual disability. Cerebral palsy and epilepsy are often associated with these conditions within the broader framework of paediatric neurodisability. Co-occurrence with each other and with other mental health disorders including anxiety and mood disorders and behavioural disturbance is often the norm. Together these are referred to as neurodevelopmental, emotional, behavioural, and intellectual disorders (NDEBIDs) in this paper. Varying prevalence rates for NDEBID have been reported in developed countries, up to 15%, based on varying methodologies and definitions. NDEBIDs are commonly managed by either child health paediatricians or child/ adolescent mental health (CAMH) professionals, working within multidisciplinary teams alongside social care, education, allied healthcare practitioners and voluntary sector. Fragmented services are common problems for children and young people with multi-morbidity, and often complicated by sub-threshold diagnoses. Despite repeated reviews, limited consensus among clinicians about classification of the various NDEBIDs may hamper service improvement based upon research. The recently developed "Mental, Behavioural and Neurodevelopmental disorder" chapter of the International Classification of Diseases-11 offers a way forward. In this narrative review we search the extant literature and discussed a brief overview of the aetiology and prevalence of NDEBID, enumerate common problems associated with current classification systems and provide recommendations for a more integrated approach to the nosology and clinical care of these related conditions.
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