Among Children, Mental Disorders Associate With Gender, Family Income, Obesity

The prevalence of mental disorders among children was higher in those with families that had lower annual incomes and high BMI.

Risk for any child mental disorder was elevated among boys and children from homes with lower annual incomes and high BMI, according to results of a study published in the Journal of the American Academy of Child & Adolescent Psychiatry.

There have been few robust and recent studies about trends in mental disorders among children in the United States. As such, this study was designed to be a current snapshot of the prevalence of and trends in mental disorders among children aged 9 to 10 years in the US.

Investigators at Columbia University, New York, sourced data from the Adolescent Brain Cognitive Development (ABCD) study which recruited 11,874 children from 21 sites in the US between 2016 and 2018. The overall prevalence of mental disorders and associations with sociodemographic and physical characteristics were evaluated.

The children comprised 52.15% boys, 55.79% were White, 24.18% were Hispanic, 13.78% were Black, 62.51% had a healthy weight, 73.60% were born to a mother that was aged 20 to 34 years, 67.18% of parents were married or living with a partner, and 43.43% lived in a home with an annual income of $75,000 or higher.

[T]he findings highlight the threat posed by poverty to the mental health of children, especially to their liability to develop disruptive behavior disorders.

Any mental disorder was observed among 10.11% of children. The most prevalent conditions were mood disorders (3.11%), anxiety disorders (2.90%), attention-deficit/hyperactivity disorder (ADHD; 2.73%), and disruptive behavior disorders (2.52%). The average number of disorders per child was 0.15.

When requirements for teacher ratings were relaxed, the prevalence of ADHD (10.10%), oppositional defiant disorders (5.54%), and conduct disorders (3.32%) increased. Consistently, the average Child Behavior Checklist (CBCL) parent scores were higher for the cohort with a mental disorder.

Stratified by gender, the prevalence of mental disorders was 11.48% among boys and 8.68% among girls (P = .006). Boys had higher rates of mood disorders (3.53% vs 2.67%; P = .004), disruptive behavior disorders (3.11% vs 1.90%; P = .02), obsessive-compulsive disorders (OCD; 2.48% vs 1.28%; P <.001), bipolar disorders (2.39% vs 1.81%; P = .03), and conduct disorders (1.67%; vs 0.72%; P = .01) compared with girls, respectively. Boys also had a higher rate of disorders per child (mean, 0.17 vs 0.13; P =.02), respectively.

Risk for any mental disorder was associated with annual family income of under $25,000 (adjusted odds ratio [aOR], 2.04) or $25,000-$49,999 (aOR, 1.90) compared with $75,000 or higher, male gender (aOR, 1.51), and obesity compared with healthy weight (aOR, 1.45).

Stratified by type of disorder, household income below $25,000 was also a predictor for any disruptive behavior disorder (aOR, 4.17), any ADHD (aOR, 3.85) and any mood disorder (aOR, 2.16); male gender for any disruptive behavior disorder (aOR, 2.36), any OCD (aOR, 2.30), and any mood disorder (aOR, 1.46); and obesity for any mood disorder (aOR, 1.37).

These trends may not be generalizable for current populations, as data were sourced before the COVID-19 pandemic.

Study authors concluded, “[T]he findings highlight the threat posed by poverty to the mental health of children, especially to their liability to develop disruptive behavior disorders. The findings support expansion of research as well as primary prevention programs and clinical outreach focused on children from low-income families.”

This article originally appeared on Psychiatry Advisor


Olfson M, Wall M, Wang S, Blanco C. Prevalence and correlates of mental disorders in children aged 9 and 10 years: results from the ABCD study. J Am Acad Child Adolesc Psychiatry. 2023;S0890-8567(23)00178-8. doi:10.1016/j.jaac.2023.04.005