A Hidden Epidemic and What You Can Do About It

Introduction: In the United States 3⁄4 of the children of a parent with a mood disorder will develop a major psychiatric diagnosis upon a 7 year follow up. Moreover, the earlier the onset of symptoms, the longer the delay to first treatment, and this is posing major short and long-term health threats for a sizable portion of the population. Methods: We review data that childhood onset mood and behavioral disorders are more frequent in the US than in many European countries and suggest possible approaches to this problem. Results: Despite the high incidence of psychiatric illness in the US, many children are not being evaluated and treated in a timely fashion. Multiple factors including those related to stigma around psychiatric diagnosis and treatment of very young children account for this deficit. There is also a shortage of child psychiatrists, and most children are being seen in primary care settings. We suggest that parents and older children themselves play a key role in screening and longitudinal assessment of mood and behavioral problems to assist physicians in decisions about diagnosis, need and effectiveness of treatment. Conclusions: Childhood onsets of mood and externalizing disorders appear to be increasing in the US population in more recently born individuals reflecting a cohort effect. Greater attention to these problems by pediatricians and primary care providers by enlisting the help of parents and children themselves in screening and monitoring of symptoms may be one way to better address this ongoing and worsening health problem. ReseaRch aRticle