Approximately 13% to 20% of U.S. children and adolescents experience a mental disorder in a given year, and data from 1994 to 2011 indicate increasing prevalences of these conditions. In the May 17 Morbidity and Mortality Weekly Report (MMWR), CDC also reported that about $247 billion is spent on children’s mental health annually.
During 1997–2006, National Health Interview Survey (NHIS) data indicated an average annual increase in ADHD diagnosis of 3%, whereas National Survey of Children's Health (NSCH) data showed a 21.8% increase in ADHD during 2003–07. Nearly a fourfold increase in autism spectrum disorders (ASDs) was indicated by NHIS data from 1997–99 to 2006–08, with NSCH data also indicating increases in ASDs. CDC noted the following: "Changes in estimated prevalence over time might be associated with an actual change in prevalence, changes in case definition, changes in the public perception of mental disorders, or improvements in diagnosis, which might be associated with changes in policies and access to health care."
Findings from CDC's surveillance report included the following:
- Among children aged 3 to 17 years, ADHD (6.8%) was the most prevalent parent-reported diagnosis, followed by behavioral or conduct problems (reported by 3.5% of parents), anxiety (3.0%), depression (2.1%), ASDs (1.1%), and Tourette syndrome (0.2%; among individuals aged 6–17 years).
- Substance use disorders affected 1.7 million adolescents aged 12 to 17 years. Of adolescents in this age group, an estimated 4.7% reported an illicit drug use disorder in the previous year, 4.2% reported an alcohol abuse disorder in the past year, and 2.8% reported cigarette dependence in the previous month.
- In 2010, suicide was the second highest cause of death among adolescents aged 12 to 17 years and suicides occurred at a rate of 4.5 per 100,000 individuals aged 10 to 19 years.
- The presence of 14 or more "mentally unhealthy days" in the previous month was reported by about 8% of individuals aged 12 to 17 years.
- With the exception of ASDs, which were highest children aged 6 to 11 years, the prevalence of all conditions and indicators increased with age.
- Compared with girls, boys were more likely to have most of the disorders, including ADHD, behavioral or conduct problems, ASDs, anxiety, Tourette syndrome, and cigarette dependence. Suicide deaths also were common in boys than girls. Alcohol use disorders were more common in girls, and adolescent girls were more likely to suffer from depression.
- Regarding race/ethnicity, children in the non-Hispanic multirace group generally had the highest prevalence of ADHD, depression, and substance use disorders. ASDs tended to be higher among white non-Hispanic children, behavioral or conduct problems were highest among black non-Hispanic children, and ADHD was lowest among Hispanic children. White non-Hispanic children were more likely to have anxiety compared with black non-Hispanic children. A lower prevalence of alcohol use disorder was reported for black non-Hispanic children and non-Hispanic children of other races. Tourette syndrome was more common among white non-Hispanic children than among black non-Hispanic children or Hispanic children.
- The prevalence of parent-reported behavioral or conduct problems, depression, and anxiety increased as household education decreased.
- With increasing levels of poverty, ADHD, behavioral or conduct problems, depression, and anxiety increased; illicit drug use disorders and cigarette dependence also increased.
- Regional differences generally were less clear; however, alcohol and illicit drug use disorders were higher in the West and lower in the South, while ADHD was higher in the South and lower in the West.
Data for the MMWR report were gathered from several independent federal surveillance systems, including the NHIS, NSCH, and the School-Associated Violent Death Surveillance Study. CDC stated: "Substantial but not insurmountable challenges to surveillance of mental disorders in children exist. An overall challenge is the establishment of consistent surveillance case definitions that allow for comparability and reliability of estimates among surveillance systems."