Patterns of Mental Disorders in a Large Child Psychiatric Sample (N = 65,363): A DREAMS Study

To provide a comprehensive overview of the prevalence and comorbidity patterns of mental disorders in a large child and adolescent psychiatry sample.

Data on DSM diagnoses were retrieved from medical records of children (0.5-18 years old) who received care at a DREAMS center between 2015 and 2019. DREAMS is a consortium of 4 academic centers for child and adolescent psychiatry in the Netherlands that provide both outpatient and inpatient care. Diagnoses were assigned in regular clinical practice.

Between 2015 and 2019, 65,363 children received care at a DREAMS center (mean [SD] age at admission = 10.8 [4.1] years; 60.7% male). Of these children, 46,762 (71.5%) had a registered DSM disorder. The most prevalent primary diagnoses were autism (34.6%), attention-deficit/hyperactivity disorder (24.6%), and trauma and stressor-related disorders (8.4%). Approximately half of all children (47.2%) had at least 1 comorbid diagnosis, of which intellectual disabilities were the most prevalent (29.5%).

Diagnostic patterns across sex and age as well as comorbidity patterns were generally consistent with previous research, but the prevalence of autism and attention-deficit/hyperactivity disorder was higher than in other studies. Real-world diagnostic information such as presented here is essential to understand the use of DSM-5 in clinical practice, put differences between contexts and countries into perspective, and ultimately improve our diagnostic protocols and treatments.