The Great Smoky Mountains Study of Youth. Goals, design, methods, and the prevalence of DSM-III-R disorders.

Authors: Costello EJ, Angold A, Stangl DK, Tweed, DL, Erkanli A, Worthman CM, Burns BJ
Publication Year: 1996
Last Updated: 2010-01-21 08:14:08
Journal: Archives of General Psychiatry
Keywords: youth, psychiatric disorder, mental health, behavioral health, anxiety, hyperactivity, tic disorder, oppositional defiant disorder, conduct disorder, poverty

Short Abstract:

BACKGROUND:  The Great Smoky Mountains Study of youth focuses on the relationship between the development of psychiatric disorder and the need for and use of mental health services.

Abstract: BACKGROUND: The Great Smoky Mountains Study of youth focuses on the relationship between the development of psychiatric disorder and the need for and use of mental health services. METHODS: A multistage, overlapping cohorts design was used, in which 4500 of the 11758 children aged 9, 11, and 13 years in an 11-county area of the southeastern United States were randomly selected for screening for psychiatric symptoms. Children who scored in the top 25% on the screening questionnaire, together with a 1 in 10 random sample of the rest, were recruited for 4 waves of intensive, annual interviews (n = 1015 at wave 1). In a parallel study, all American Indian children aged 9, 11, and 13 years were recruited (N = 323 at wave 1). RESULTS: The 3-month prevalence (+/-SE) of any DSM-III-R axis I disorder in the main sample, weighted to reflect population prevalence rates, was 20.3% +/- 1.7%. The most common diagnoses were anxiety disorders (5.7% +/- 1.0%), enuresis (5.1% +/- 1.0%), tic disorders (4.2% +/- 0.9%), conduct disorder (3.3% +/- 0.6%), oppositional defiant disorder (2.7% +/- 0.4%), and hyperactivity (1.9% +/- 0.4%). CONCLUSIONS: The prevalence of psychiatric disorder in this rural sample was similar to rates reported in other recent studies. Poverty was the strongest demographic correlate of diagnosis, in both urban and rural children. 

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Funding: This project was supported by grant MH48085 from the National Institute of Mental Health, Bethesda, MD. Additional support was provided through a project grant (Dr Worthman) and a Faculty Scholars award (Drs Costello, Angold and Worthman) from the William T. Grant Foundation and a Center grant from the Leon Lowenstein Foundation, New York, NY (Dr Angold).We gratefully acknowledge support of the psychometric studies of the Child and Adolescent Psychiatric Assessment from the William T Grant Found
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