Treated Prevalence

Background Prevalence of mental disorders is often assessed using survey techniques. Although providing good estimates of prevalence, these techniques are time-consuming & expensive.

Objective To estimate the prevalence of mental disorders among children aged 0 to 17 years living in Alberta, Canada, using health care administrative data.

Design This was a cross-sectional study. International Classification of Diseases, Ninth Revision, Clinical Modification chapter 5 diagnostic codes from physician billing data were used. Codes were grouped into 10 categories. Prevalence rates for each category were calculated, stratified by age, sex, and premium subsidy status (a proxy for socioeconomic status). The age pattern, times of greatest risk, and the effect of sex on type and prevalence of mental disorder were estimated.

Setting All fee-for-service health care venues in Alberta between April 1, 1995, & March 31, 1996, providing services to children registered with the Health Care Insurance Commission on March 31, 1996.

Results Prevalence of mental disorders varied by disorder category, age, sex, and premium subsidy status. For boys, maximum prevalence of 9.5% (any disorder) occurred at age 10 years; for girls, maximum prevalence of 12.0% occurred at age 17 years [see top Figure]. Mental disorders were most common in young boys and adolescent girls, and [in bottom Figure] among children receiving welfare. Distinct patterns of disorder were evident and comorbidity was common.

Conclusions Administrative data can be used to estimate the prevalence of mental disorders in a pediatric population. The estimates made are lower than those obtained by using surveys of similar populations, perhaps indicating the difference between treated and untreated prevalence. Strengths of this study are that the estimates reflect the entire population, are more easily and obtained at less cost, and are useful for the planning of mental health services.