title: Twenty-year trends in emotional and behavioral problems in Dutch children in a changing society.
abstract: OBJECTIVE
  Research into changes in the prevalence of children's psychiatric diagnoses has indicated an increase in recent decades. However, methodological problems may have influenced results. This study compared children's emotional and behavioral problem levels across three population samples from different time points across 20 years, assessed with identical methodologies.
  
  
  METHODS
  We compared Child Behavior Checklists and Teacher's Report Forms across three population samples of 6- to 16-year olds, assessed in 1983, 1993, and 2003.
  
  
  RESULTS
  We found evidence for small increases in the mean population levels of parent-reported problems, and in the percentages of children with serious problems. These changes concerned mostly internalizing problems. Teacher reports showed less changes. Decreases in scores were found on several areas of competence. Changes were the strongest between 1993 and 2003.
  
  
  CONCLUSIONS
  We found evidence for small increases in Dutch children's problems. Further developments must be monitored, as this trend may continue and have serious societal consequences.
authors.affiliation: Department of Child and Adolescent Psychiatry, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands.
authors.forename: N T
authors.initials: NT
authors.lastname: Tick
authors.forename: J
authors.initials: J
authors.lastname: van der Ende
authors.forename: F C
authors.initials: FC
authors.lastname: Verhulst
mesh_terms: D000293:Adolescent; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000208:ethnology*; D002675:Child, Preschool; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000208:ethnology*; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D012922:Social Change; D011795:Surveys and Questionnaires