Mental illness starts in childhood but treatment lags by many years

June 20, 2005

Mental illness is—or should be—a pediatric concern. According to a new survey supported by the National Institute of Mental Health, one half the cases of mental illness in the United States developed by the time the patient was 14 years old. The really bad news? Treatment for most of these children didn't start until years—even decades—after symptoms first appeared, rendering their illness more severe and more difficult to treat.

Mental illness is-or should be-a pediatric concern. According to a new survey supported by the National Institute of Mental Health, one half the cases of mental illness in the United States developed by the time the patient was 14 years old. The really bad news? Treatment for most of these children didn't start until years-even decades-after symptoms first appeared, rendering their illness more severe and more difficult to treat.

The most important message of the study, says NIMH Director Thomas Insel, MD, is that mental disorders are the chronic disease of young people. Anxiety disorders make their appearance by late childhood; mood disorders, in late adolescence; and substance abuse, in the early 20s. The actual prevalence of mental disorders in the pediatric age group is probably considerably higher than this study reveals, because complex disorders-including schizophrenia and autism-were not assessed in the study and because the sample did not include homeless or institutionalized children and young people.

Most of these patients are treated eventually, but the consequences of delay are serious, study authors say. Untreated psychiatric illness can lead to more frequent and more severe episodes, and is associated with school failure, teenage childbearing, unstable employment, early marriage, and marital instability and violence. The study is reported in the June 6, 2005, issue of the Archives of General Psychiatry.

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