Abstract
Background
This study investigated the prevalence of DSM-IV Axis 1 mental disorders, deliberate self-harm and suicidal ideation in a sample of Irish adolescents aged 11–13 years.
Methods
A total of 1131 students was surveyed for general psychopathology using the Strengths and Difficulties Questionnaire. Following this, a representative sample of 212 adolescents was assessed for mental disorders, deliberate self-harm and suicidal ideation using the Schedule for Affective Disorders and Schizophrenia for School-Aged Children.
Introduction
As a distinct phase of the lifespan adolescence is now considered to begin at around the age of 10 years (World Health Organisation) with biological changes related to puberty marking the transition from childhood to adolescence (Smetana, Campione-Barr, & Metzger, 2006). This heterogeneous period of life requires young people to negotiate a range of biological, psychological and social processes as they prepare for the roles and responsibilities that await them in adulthood (Sawyer et al., 2012). The onset of any mental disorder by or during adolescence is a risk factor for future mental ill-health (Kessler et al., 2005b and Kessler et al., 2007). In addition, the impact and consequences of mental disorder during the adolescent years are concerning as mental ill-health during this phase of the lifespan has been found to carry the greatest burden of disease, accounting for 45% of years lost to disability among young people aged 10–24 (Gore et al., 2011 and World Health Organisation, 2008). With an estimated 1 in 5 young people between the ages of 12 and 19 years experiencing a mental disorder at any given time (Costello, Copeland, & Angold, 2011), adolescence has been recognised as a period of significant mental health vulnerability and risk for young people (Coughlan et al., 2013, Jones, 2013 and Patel et al., 2007).
In spite of calls for progressive international research programmes on adolescent health (Patton et al., 2012), epidemiological studies quantifying the prevalence of mental disorder in adolescents have been limited. Of the studies that have been conducted, most have focused on young people aged 13 years and older (Benjet et al., 2009, Farbstein et al., 2010, Gau et al., 2005, Kessler et al., 2012, Lynch et al., 2006, Merikangas et al., 2010, Vicente et al., 2012 and Wittchen et al., 1998) during the developmental phases of mid and late adolescence (Smetana et al., 2006). The focus on adolescents in this mid-late adolescent age range has resulted in a dearth of evidence on rates of disorder among younger adolescents during their formative early adolescent (Smetana et al., 2006) years. Although a number of studies has included younger adolescents in their samples (Costello et al., 2003, Ford et al., 2003, Martin et al., 2006, Meltzer et al., 2000 and Roberts et al., 2009) few provide age-specific data on adolescents aged 10–13 years and, to our knowledge, none has used a sample of young people specifically targeting this early adolescent age range. In the context of such limited data on rates of mental disorder among early adolescents, this study, as part of the Adolescent Brain Development Study (Kelleher et al., 2012), aimed to investigate the prevalence of DSM-IV Axis 1 mental disorders in a school-based sample of Irish adolescents aged 11–13 years.
Conclusion
In the context of limited international prevalence data on early adolescence, findings from this study offer a valuable contribution to the body of knowledge on mental disorders among young adolescents. It is clear from this study that young people in their early adolescent years in Ireland are experiencing high rates of Axis 1 disorders. Estimates based on findings from this study suggest that over 1 in 4 Irish adolescents aged 11–13 years may be experiencing a mental disorder at any given time; that, by age 13 over 1 in 3 will have had some experience of mental ill-health over the course of his or her life; and that almost 1 in 20 are either engaging in DSH or experiencing suicidal thoughts. With evidence of both homotypic and heterotypic continuities across a range of mental disorders from childhood to adolescence and from adolescence to adulthood (Copeland et al., 2009, Costello et al., 2011, Fergusson et al., 2007, Jones, 2013 and Rutter et al., 2006) this study has shown that over 1 in 3 Irish adolescents may be at increased risk for future mental ill-health in adulthood. Given their young age, they are also at risk of developing substance use disorders as they progress through their adolescent and emerging adult years (Costello et al., 2011). As this study did not examine any specific psychological or socio-cultural factors that may have been implicated in the rates of disorder found among such young adolescents, further research in this area would help to establish the determinants of mental disorder in Irish adolescent populations more clearly. From a population health perspective, more comprehensive early prevention, detection and intervention services for adolescents in Ireland are essential to respond to the high level of mental health need among young people and to reduce the risk of enduring mental ill-health across the lifespan.
Funding
This research was funded by the Health Research Board, Ireland under grant HRA_PHS/2010/4. MC was supported by a Clinician Scientist Award from the Health Research Board (CSA 2004/1). CM, LT and JT were supported by Alumni studentships from RCSI. The Health Research Board had no involvement in the design of this study, the collection of data, the analysis or interpretation of the data, the writing of this paper or the decision to submit this paper for publication. We wish to thank all the young people and their parents who took part in this study.
