Services for Adolescents With Psychiatric Disorders: 12-Month Data From the National Comorbidity Survey–Adolescent
Abstract
Objective
Methods
Results
Conclusions
Methods
Sample and procedure
Measures
Diagnostic assessment.
Service use.
Analytic procedures
Results
Diagnostic variable | N | Mental health specialty | General medical | Human services | CAMa | Juvenile justice | School | Any | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
% | SE | % | SE | % | SE | % | SE | % | SE | % | SE | % | SE | ||
Anxiety disorder | |||||||||||||||
Panic disorder | 120 | 26.1 | 5.5 | 14.2 | 3.7 | 14.0 | 4.0 | 13.1 | 4.7 | 2.2 | .7 | 28.7 | 6.6 | 49.1 | 7.2 |
Agoraphobia without panic | 100 | 28.8 | 6.6 | 8.3 | 3.0 | 13.7 | 8.1 | 7.4 | 3.9 | 2.8 | 1.5 | 37.3 | 9.4 | 52.0 | 8.7 |
Specific phobia | 1,000 | 20.0 | 2.9 | 9.2 | 1.6 | 8.7 | 1.5 | 3.9 | 1.0 | 2.3 | .5 | 20.7 | 2.0 | 40.7 | 2.6 |
Social phobia | 778 | 24.9 | 3.1 | 10.0 | 2.0 | 6.9 | 1.3 | 5.0 | 1.2 | 3.2 | 1.4 | 22.5 | 3.0 | 42.2 | 3.2 |
Generalized anxiety disorder | 106 | 35.0 | 8.3 | 9.6 | 3.4 | 9.2 | 3.3 | 13.7 | 3.5 | 3.3 | 1.6 | 36.2 | 9.0 | 56.7 | 7.4 |
Separation anxiety disorder | 92 | 27.0 | 8.0 | 12.6 | 4.7 | 12.0 | 4.8 | 13.6 | 5.0 | 4.2 | 2.3 | 21.1 | 7.9 | 47.3 | 7.8 |
Posttraumatic stress disorder | 210 | 37.0 | 4.1 | 11.4 | 3.1 | 11.5 | 2.8 | 11.8 | 2.8 | 4.1 | 2.0 | 32.8 | 6.0 | 60.2 | 5.8 |
Any anxiety disorder | 1,506 | 22.3 | 2.4 | 9.3 | .8 | 8.0 | 1.0 | 5.0 | .8 | 2.7 | .6 | 20.9 | 1.8 | 41.4 | 1.9 |
Mood disorder | |||||||||||||||
Major depressive disorder or dysthymia | 544 | 36.9 | 3.6 | 17.6 | 2.8 | 14.8 | 2.3 | 8.6 | 1.7 | 3.7 | 1.3 | 29.5 | 3.1 | 62.1 | 3.7 |
Bipolar I or II disorder | 329 | 33.6 | 3.7 | 7.4 | 2.6 | 14.7 | 3.0 | 6.0 | 1.2 | 8.7 | 2.4 | 35.2 | 3.3 | 58.4 | 3.6 |
Any mood disorder | 820 | 35.4 | 3.0 | 13.9 | 2.3 | 14.1 | 1.7 | 7.7 | 1.4 | 5.7 | 1.3 | 30.5 | 2.2 | 60.1 | 2.9 |
Impulse control disorder | |||||||||||||||
Attention-deficit hyperactivity disorder | 408 | 37.3 | 3.6 | 17.3 | 3.7 | 11.7 | 2.3 | 6.5 | 1.4 | 9.1 | 2.5 | 54.5 | 3.9 | 73.8 | 3.2 |
Oppositional defiant disorder | 519 | 42.6 | 3.1 | 15.0 | 2.3 | 11.5 | 2.0 | 8.4 | 1.7 | 12.6 | 2.8 | 42.4 | 2.7 | 71.0 | 2.8 |
Eating disorder (anorexia, bulimia, or binge eating) | 191 | 43.0 | 8.1 | 14.8 | 5.4 | 13.3 | 5.3 | 5.2 | 1.7 | 3.2 | 1.2 | 20.9 | 4.7 | 58.7 | 6.4 |
Intermittent explosive disorder | 691 | 24.1 | 2.5 | 8.5 | 1.9 | 10.5 | 1.8 | 5.3 | 1.2 | 4.3 | 1.1 | 29.8 | 2.8 | 47.6 | 2.9 |
Conduct disorder | 305 | 45.9 | 4.0 | 14.9 | 3.2 | 14.3 | 2.8 | 11.4 | 2.0 | 20.3 | 4.8 | 44.0 | 3.5 | 73.4 | 5.9 |
Any impulse control disorder | 1,465 | 28.6 | 2.3 | 11.5 | 1.1 | 10.4 | 1.1 | 6.0 | .9 | 6.7 | 1.3 | 32.3 | 1.8 | 55.1 | 2.2 |
Substance use disorder | |||||||||||||||
Alcohol abuse or dependence | 289 | 31.4 | 5.0 | 7.7 | 2.9 | 5.9 | 1.5 | 13.8 | 3.3 | 15.1 | 4.1 | 31.3 | 3.7 | 52.8 | 5.4 |
Drug abuse or dependence | 330 | 44.4 | 6.1 | 11.7 | 2.7 | 8.2 | 2.7 | 11.8 | 2.7 | 12.6 | 2.4 | 32.9 | 4.9 | 64.6 | 4.9 |
Alcohol or drug abuse or dependence | 496 | 36.6 | 4.8 | 9.7 | 2.0 | 7.1 | 1.9 | 11.1 | 2.2 | 12.0 | 2.1 | 29.4 | 3.5 | 56.9 | 4.3 |
Composite | |||||||||||||||
Any disorder | 2,757 | 22.8 | 1.5 | 10.1 | .8 | 7.9 | .8 | 5.3 | .6 | 4.5 | .8 | 23.6 | 1.4 | 45.0 | 1.5 |
No disorder | 3,726 | 6.2 | .7 | 1.7 | .2 | 2.0 | .4 | 1.9 | .3 | 1.2 | .4 | 6.3 | .7 | 14.4 | 1.0 |
1 disorder | 1,332 | 12.5 | 1.4 | 7.1 | .9 | 4.8 | 1.1 | 3.4 | .7 | 2.4 | .8 | 14.0 | 1.4 | 31.9 | 1.9 |
2 disorders | 672 | 20.6 | 2.1 | 11.2 | 2.1 | 7.0 | 1.2 | 4.3 | .9 | 2.3 | .6 | 22.9 | 3.5 | 44.0 | 3.2 |
≥3 disorders | 753 | 42.7 | 3.4 | 14.5 | 2.2 | 14.2 | 2.2 | 9.6 | 1.7 | 10.2 | 2.1 | 40.9 | 2.5 | 68.7 | 2.9 |
Any anxiety or mood disorder | 1,873 | 23.4 | 2.0 | 10.1 | 1.0 | 8.8 | 1.0 | 5.1 | .7 | 3.4 | .7 | 22.8 | 1.7 | 44.3 | 1.8 |
Any impulse control or substance use disorder | 1,699 | 28.3 | 2.2 | 11.3 | 1.1 | 9.6 | 1.1 | 6.7 | .9 | 7.0 | 1.3 | 30.4 | 1.8 | 53.6 | 2.2 |
Any anxiety, mood, impulse control, or substance use disorder | 815 | 35.0 | 3.5 | 12.5 | 1.5 | 13.3 | 1.9 | 7.5 | 1.4 | 7.1 | 1.5 | 35.4 | 3.0 | 60.6 | 3.0 |
Total sample | 6,483 | 13.5 | .9 | 5.4 | .4 | 4.6 | .3 | 3.4 | .3 | 2.6 | .5 | 13.8 | .8 | 27.8 | 1.1 |
Sources of services
Correlates of service use
Variable | Mental health specialty | General medical | Human services | CAMb | Juvenile justice | School | Any | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
AOR | 95% CI | AOR | 95% CI | AOR | 95% CI | AOR | 95% CI | AOR | 95% CI | AOR | 95% CI | AOR | 95% CI | |
Female (reference: male) | 1.42 | .95–2.11 | .92 | .50–1.67 | 1.88* | 1.09–3.24 | 1.16 | .68–1.96 | .39*** | .24–.66 | .49** | .32–.74 | .73* | .57–.94 |
Race-ethnicity (reference: non-Hispanic white) | ||||||||||||||
Hispanic | 1.04 | .52–2.08 | .81 | .41–1.60 | .66 | .23–1.91 | .43 | .16–1.18 | 1.14 | .49–2.61 | .51 | .25–1.03 | .75 | .51–1.12 |
Non-Hispanic black | .39** | .22–.70 | .64 | .31–1.31 | 1.39 | .75–2.59 | .36* | .17–.74 | .67 | .25–1.84 | .95 | .51–1.75 | .63* | .43–.93 |
Other | .40** | .20–.79 | 1.55 | .70–3.45 | .51 | .17–1.48 | .50 | .18–1.33 | .69 | .21–2.27 | .88 | .36–2.20 | 1.17 | .49–2.78 |
Region (reference: West) | ||||||||||||||
Northeast | 1.2 | .62–2.33 | .59 | .30–1.15 | .66 | .29–1.53 | 1.38 | .66–2.91 | .98 | .28–3.39 | 1.42 | .74–2.76 | 1.01 | .67–1.53 |
Midwest | 1.12 | .68–1.84 | .65 | .37–1.12 | .89 | .51–1.53 | .78 | .45–1.37 | 2.32 | .88–6.13 | 1.34 | .71–2.53 | .86 | .56–1.31 |
South | .74 | .38–1.43 | .57 | .30–1.07 | .90 | .42–1.94 | .40* | .19–.82 | 1.30 | .45–3.78 | 2.68** | 1.47–4.87 | .85 | .53–1.34 |
Urbanicity (reference: rural) | ||||||||||||||
Metro | 1.08 | .64–1.81 | .85 | .50–1.43 | 1.52 | .73–3.19 | 1.51 | .52–4.35 | .43 | .16–1.17 | 2.50*** | 1.54–4.08 | 1.32 | .81–2.14 |
Other | 1.48 | .89–2.46 | .79 | .45–1.40 | 1.03 | .58–1.81 | 1.57 | .52–4.73 | .91 | .35–2.32 | 1.41 | .82–2.45 | 1.4 | .90–2.16 |
Parent education (reference: ≥4 years of college) | ||||||||||||||
Less than high school | .44*** | .24–.82 | .91 | .33–2.52 | 2.07 | .91–4.70 | .40* | .17–.93 | 1.57 | .78–3.16 | .74 | .42–1.28 | .95 | .63–1.45 |
High school | .44*** | .27–.71 | 1.05 | .52–2.11 | 1.14 | .65–1.97 | .48* | .25–.90 | .87 | .33–2.29 | .95 | .57–1.57 | .88 | .63–1.23 |
Some college | .50*** | .32–.80 | 1.22 | .57–2.60 | 1.04 | .59–1.85 | .48* | .24–.95 | 1.13 | .53–2.38 | 1.01 | .66–1.54 | 1.02 | .72–1.43 |
Lives with biological parents (reference: 2 biological parents) | ||||||||||||||
None | 2.27** | 1.18–4.38 | .80 | .36–1.79 | .63 | .27–1.49 | .66 | .18–2.47 | 3.62** | 1.61–8.14 | .87 | .50–1.50 | 2.77*** | 1.88–4.08 |
1 biological parent | 1.61** | 1.07–2.43 | .83 | .52–1.32 | .88 | .50–1.56 | .85 | .44–1.65 | 1.28 | .86–1.92 | 1.14 | .81–1.61 | 1.76*** | 1.28–2.43 |
Birth order (reference: oldest) | ||||||||||||||
Youngest | 1.12 | .67–1.87 | .57* | .34–.96 | .92 | .47–1.79 | .80 | .33–1.96 | 1.26 | .51–3.09 | 1.04 | .68–1.59 | .97 | .61–1.51 |
Middle | .84 | .47–1.50 | .48* | .26–.90 | 1.06 | .60–1.89 | 1.80 | .90–3.59 | 1.16 | .57–2.38 | 1.17 | .79–1.72 | .93 | .63–1.37 |
Poverty index ratio (reference: >6)c | ||||||||||||||
≤1.5 (poor) | 1.3 | .76–2.22 | .68 | .28–1.66 | .55 | .27–1.14 | .63 | .24–1.64 | 3.51* | 1.28–9.61 | 1.07 | .59–1.96 | .78 | .47–1.27 |
≤3 | .96 | .56–1.66 | 1.40 | .71–2.76 | .88 | .38–2.05 | .97 | .44–2.13 | 1.00 | .39–2.54 | 1.76* | 1.06–2.91 | .96 | .67–1.37 |
≤6 | 1.04 | .59–1.84 | 1.10 | .58–2.10 | 1.08 | .60–1.93 | .75 | .42–1.35 | 1.95 | .99–3.84 | .98 | .54–1.79 | .99 | .67–1.45 |
Age | .98 | .86–1.12 | 1.00 | .84–1.19 | 1.08 | .88–1.32 | 1.02 | .85–1.22 | 1.40*** | 1.21–1.61 | .99 | .87–1.13 | .95 | .87–1.03 |
N of siblings | 1.03 | .96–1.10 | 1.08 | .98–1.18 | 1.09 | .98–1.21 | .95 | .71–1.27 | 1.00 | .88–1.15 | 1.02 | .95–1.08 | 1.00 | .94–1.06 |
Discussion
Conclusions
Acknowledgments and disclosures
References
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Cover: Young Girl Playing, by Jessie Willcox Smith, 1902. Watercolor and charcoal on board. © Copyright 2014 National Museum of American Illustration™, Newport, Rhode Island. Photo courtesy of Archives of the American Illustrators Gallery™, New York.
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