Child psychiatric disorders: prevalence and perspectives

This article provides a review of child psychiatric epidemiology, particularly as it applies to community prevalence surveys. By way of introduction, the administrative and scientific uses of epidemiology are outlined. Major issues in the field are discussed including prevalence versus incidence, definition of deviance and correlates, psychometric properties of instruments, sampling, sources of data, general maladjustment versus specific disorder, and comparability and generalizability of results. Current findings presented include a review of prevalence estimates for general maladjustment, conduct disorder, neurotic disorder, hyperactivity, and depressive disorder. Information is presented on the correlates of sex, age, social class, family factors, and school influences. The clinical implications of the correlate data are discussed and include the importance of utilizing multiple sources of data during the assessment phase and basing a treatment plan on a comprehensive assessment in which interventions are aimed at specific risk factors and strengths. Last, future directions of the field are suggested including the importance of gaining data on the correlates of the duration rather than the occurrence of disorders and the need for randomized clinical trials in which innovative prevention and treatment programs are launched and carefully evaluated.