Psychiatric Diagnoses and Treatment in Nine- to Ten-Year-Old Participants in the ABCD Study

Abstract

Objective

Psychiatric disorders commonly emerge before adulthood. Identification and intervention may vary significantly across populations. A large population-based study was leveraged to estimate the prevalence of psychiatric disorders and treatments and evaluate predictors of treatment in children ages 9 and 10 in the United States.

Method

Cross-sectional data from the Adolescent Brain Cognitive Developmental (ABCD) Study were analyzed. The Schedule for Affective Disorders and Schizophrenia for School-Age Children–Computerized version (K-SADS-COMP) was used to estimate clinical diagnoses, and the Child Behavior Checklist (CBCL) was used to assess internalizing and externalizing psychopathology. Parents reported on prescription medications and other mental health interventions. Prevalence rates of K-SADS diagnoses and treatments were calculated. Logistic regression analyses estimated associations between clinical and sociodemographic predictors (sex at birth, race, ethnicity, income, education, urbanicity) and treatments.

Results

The most common K-SADS diagnoses were anxiety disorders, followed by attention-deficit/hyperactivity disorder, and oppositional defiant disorder. Attention-deficit/hyperactivity disorder and depression diagnoses predicted stimulant and antidepressant medication use, respectively. Bipolar and attention-deficit/hyperactivity disorder diagnoses also predicted antidepressant medications, outpatient treatment, and psychotherapy. The odds of reporting specific treatments varied by sex, ethnic and racial identities, urbanicity, and income.

Conclusion

Expected rates of K-SADS-based psychiatric symptoms are present in the ABCD sample at ages 9 and 10, with treatment patterns broadly mapping onto psychopathology in expected ways. However, important variations in reported treatment utilization across sociodemographic groups were observed, likely reflecting societal and cultural influences. Findings are considered in the context of potential mental health disparities in US children.