Child psychiatric epidemiology differs from clinical work. Clinical work deals with children (and their families), usually one at a time, who seek help because of troublesome symptoms or signs of psychiatric disorder affecting psychosocial adjustment. Conversely, epidemiology is devoted to studying psychiatric disorder in populations of children and adolescents.(1) It is concerned not just with describing the incidence or prevalence of a disorder in a population, but with its distribution not only at one point in time, but over time. In addition to its descriptive function, child psychiatric epidemiology is interested in discovering causal factors, predicting number of disorders overall and in high-risk groups, and most importantly in reducing the number of disorders in a population primarily through the prevention of new occurrences/2) It is an especially important discipline for child psychiatry because the burden of suffering from child psychiatric disorder is of such high magnitude that clinical services alone can never markedly reduce this burden of suffering.(3) What is needed are prevention programmes for populations of children. For these to be successful, it is essential to know the causal chains leading to the development of the disorder so that a prevention programme can centre on breaking the causal chain at some point. Fjgure.1 presents a hypothesized causal chain for childhood onset antisocial behaviour. The incidence of this behaviour could be reduced by breaking the causal chain at any of points (a) to (f). Epidemiological studies can also provide information on the identification of groups at increased risk for disorder that could be the focus of a targeted intervention programme.(4) Thus, epidemiological studies can furnish essential data needed to support the prevention initiative in child psychiatry.
This chapter deals with the epidemiology of child and adolescent psychiatric disorders overall; details about the epidemiology of individual disorders are covered in the relevant chapters. It begins by discussing major issues in the field, then presents selected findings, and finally suggests future directions.
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