The British Child and Adolescent Mental Health Survey 1999: the prevalence of DSM-IV disorders

J Am Acad Child Adolesc Psychiatry. 2003 Oct;42(10):1203-11. doi: 10.1097/00004583-200310000-00011.


Objective: To describe the prevalence of DSM-IV disorders and comorbidity in a large population-based sample of British children and adolescents.

Method: Using a one-phase design, 10,438 children were assessed using the Development and Well-Being Assessment (DAWBA), a structured interview with verbatim reports reviewed by clinicians so that information from parents, teachers, and children was combined in a manner that emulated the clinical process. The authors' analysis examined comorbidity and the influence of teacher reports.

Results: The overall prevalence of DSM-IV disorders was 9.5% (95% confidence interval 8.8-10.1%), but 2.1% of children were assigned "not otherwise specified" rather than operationalized diagnoses. After adjusting for the presence of a third disorder, there was no longer significant comorbidity between anxiety and conduct disorder or attention-deficit/hyperactivity disorder (ADHD), or between depression and oppositional defiant disorder. A comparison of the disorders in children with and without teacher reports suggested that the prevalence of conduct disorders and ADHD would be underestimated in the absence of teacher information.

Conclusions: Roughly 1 in 10 children have at least one DSM-IV disorder, involving a level of distress or social impairment likely to warrant treatment. Comorbidity reported between some childhood diagnoses may be due to the association of both disorders with a third. Diagnoses of conduct disorder and ADHD may be missed if information is not sought from teachers about children's functioning in school.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Comorbidity
  • Diagnostic and Statistical Manual of Mental Disorders
  • Female
  • Health Surveys
  • Humans
  • Male
  • Mental Disorders / epidemiology*
  • Mental Health / statistics & numerical data*
  • Prevalence
  • Social Behavior
  • United Kingdom / epidemiology