The DSM-IV Rates of Child and Adolescent Disordersin Puerto Rico

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Abstract
The formulation of explicit diagnostic criteria in the DSM-III1 and its revision, DSM-III-R,2 facilitated several large-scaleepidemiological studies of mental disorder in the United States on the basisof psychiatric diagnosis.3-7 Manyof the revisions in DSM-IV8 followedfrom results of epidemiological and clinical studies suggesting that disorderspreviously thought to develop in adulthood were also evident in childhoodand that children and adolescents could experience a wide variety of problemsand manifestations of distress that fail to satisfy criteria of a mental disorder.9,10 These studies also provided new insightsinto the prevalence and comorbidity of mental disorders, the role of impairmentin arriving at meaningful diagnoses, and the discrepancies between rates ofneed for services and actual service provision. When DSM-IV was developed, epidemiological information based on DSM-III and DSM-III-R study results was criticalin fine-tuning the diagnostic criteria and integrating clinical significancein the formulation of the disorders.