Prevalence and Development of Psychiatric Disorders in Childhood and Adolescence

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Abstract
STUDIES THAT follow the same subjects as they grow up are the best source of information about the prevalence and causes of continuity and discontinuity of psychiatric disorders. A review1 of the few studies that cover both child and adolescent psychiatric disorders2-9 showed that between 23% and 61% of children with a diagnosis at one wave had a diagnosis, although not necessarily the same one, at a subsequent wave. This suggests quite a high level of continuity. However, few studies have the power to distinguish between homotypic continuity (the same diagnosis at different assessments) and heterotypic continuity (continuity of disorder but a different diagnosis). Homotypic continuity is evidence for a disorder that has a similar manifestation across the age range of the study, whereas heterotypic continuity suggests an underlying vulnerability to psychiatric illness that may expose children to different disorders at different ages or an underlying disorder that has different manifestations at different ages. The clinical and research implications of homotypic and heterotypic continuity are quite different.