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http://www.guardian.co.uk/society/2007/feb/06/health.childrensservices

Study shows increase in mental disorders among children

James Randerson 6th February 2007

Mental disorders in children are on the rise, according to a study of nearly 700,000 young people.

Researchers have known for several years that diagnoses of autism are increasing, but the new research suggests that Tourette syndrome and hyperkinetic disorder are also being more commonly identified in children. The researchers say it is not clear if the apparent rise is real and caused by environmental factors or whether it is due to increased awareness and diagnosis of child mental health problems by doctors.

The team collected data from the Danish National Psychiatric Registry on the mental health of every child born between 1990 and 1999. They focused on diagnoses of childhood autism, autism spectrum disorder, Tourette syndrome, obsessive compulsive disorder (OCD) and hyperkinetic disorder. All except OCD increased.

Diagnosis of hyperkinetic disorder at the age of five nearly tripled between 1992 and 1999. Tourette syndrome more than doubled between the 1990 and 1995 cohort. The study also found increases in both childhood autism and autism spectrum disorder.

One possibility is that something about modern living or the environment - perhaps diet or vaccines - is contributing to increases in all the mental health problems. But Robert Goodman at the Institute of Psychiatry at King's College London said that it would be wrong to jump to that conclusion. "They have no way of distinguishing between it having got more common and their clinicians having got better at recognising it."

"The autism trend has been reported in a lot of other studies and it has been a big focus of interest," said Diana Schendel at the Centres for Disease Control in Atlanta, Georgia, part of the team which produced the study. "What this shows is that in fact the apparent rise in autism might not be a solitary event. We do see a similar pattern of increase in these other conditions."

The research, published in the Archives of Paediatric and Adolescent Medicine, is the first study to look at diagnoses of hyperkinetic disorder and Tourette syndrome in such detail.

The layman's image of Tourette syndrome, in which sufferers have pronounced verbal and physical tics, would seem easy to diagnose, but Prof Goodman said the condition can manifest itself much more mildly.

Despite numerous studies showing that diagnoses of autism are rising, it is still not clear why this is.

One study in 2005 suggested it is due to better diagnosis. Researchers at the child development centre in Stafford screened every child born between 1992 and 1995 and living in Staffordshire for autism - 15,500 children in total. They then did exactly the same for children born between 1996 and 1998, crucially using exactly the same diagnostic criteria. The prevalence of autism stayed roughly the same at 62 children per 10,000 suggesting that the actual rate of autism in the community is staying the same, but doctors are just getting better at recognising autistic children.

At a glance

Autism

Symptoms include lack of imagination, communication difficulties and problems with social interaction. According to the Office of National Statistics, autism spectrum disorders affect 0.9% of the population.

Hyperkinetic disorder

People affected by this condition tend to move from one activity to another without completing any. They tend to be disorganised, excessively active and have low concentration levels. Around 1.5% of people in Britain have hyperkinetic disorder.

Tourette syndrome

Tourette's symptoms include repetitive physical and verbal tics, such as swearing, twitching and sniffing. Tic disorders including Tourette's affect 0.1% of the UK population.

Obsessive compulsive disorder

The condition is characterised by obsessive thoughts leading to compulsive acts such as repeatedly checking that the front door is locked.

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