Recognition of psychiatric disorders, and self-perceived problems. A follow-up study from age 8 to age 18.
OBJECTIVE
To study the rate of, and factors associated with, recognition of psychiatric disorders and self-perceived problems among 18-year-old adolescent boys.


METHODS
The study population consisted of 2347 Finnish boys born during 1981 attending military call-up (79.7% of the original sample). At age 8, the boys were evaluated by parental and teacher Rutter scales and by self-reports using the Child Depression Inventory (CDI). At military call-up 10 years later, the boys filled in the Young Adult Self-Report (YASR). Information about psychiatric disorders recognized at the military call-up health examination was obtained from the national military register.


RESULTS
About 4.6% of boys were recognized as having a psychiatric disorder at the military call-up medical examination. In addition, 23.1% of boys reported emotional, behavioral or relational difficulties but were not recognized as having an ICD 10 psychiatric diagnosis at the military call-up medical examination. A higher level of psychopathology, problems across different life domains and early onset of problems were more strongly associated with recognition of psychiatric disorder than with self-reports of difficulties without a recognized psychiatric disorder. All informant sources, parents, teachers and children themselves at age 8, independently predicted recognition of psychiatric disorders and perceived difficulties 10 years later.


CONCLUSIONS
Only a minority of adolescents with psychiatric problems are recognized as having a psychiatric disorder in the health services. Efforts to prevent psychiatric disturbance in early life are emphasized. The use of screening methods in school health settings to detect children in need of child mental health services is justified.
Sourander
Andre
A
Department of Child Psychiatry, Turku University Hospital, Finland. andre.suorander@utu.fi
Haavisto
Antti
A
Ronning
John A
JA
Multimäki
Petteri
P
Parkkola
Kai
K
Santalahti
Päivi
P
Nikolakaros
Georgios
G
Helenius
Hans
H
Moilanen
Irma
I
Tamminen
Tuula
T
Piha
Jorma
J
Kumpulainen
Kirsti
K
Almqvist
Fredrik
F
D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D005190:Family / Q000523:psychology; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening; D001523:Mental Disorders / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology*; D008889:Military Personnel / Q000523:psychology; D015999:Multivariate Analysis; D012307:Risk Factors; D012309:Risk-Taking; D012649:Self Concept