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Prevalence of Mental Disorders in Children Living in Alberta, Canada, as Determined From Physician Billing Data
Donald W. Spady, MD;
Donald P. Schopflocher, PhD;
Lawrence W. Svenson, BSc;
Angus H. Thompson, PhD
Arch Pediatr Adolesc Med. 2001;155:1153-1159.
Background The prevalence of mental disorders is often assessed using survey techniques.
Although providing good estimates of prevalence, these techniques are time-consuming
and 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,
and March 31, 1996, providing services to children registered with the Alberta
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% occurred
at age 10 years; for girls, maximum prevalence of 12.0% occurred at age 17
years. Mental disorders were most common in young boys and adolescent girls
and 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.
From the Departments of Pediatrics (Dr Spady) and Psychiatry (Dr Thompson)
and Public Health Sciences (Drs Spady and Thompson), University of Alberta;
and Health Surveillance Branch, Alberta Health and Wellness, Government of
Alberta (Dr Schopflocher and Mr Svenson), Edmonton, Alberta.
Corresponding author and reprints: Donald W. Spady, MD, Department
of Pediatrics, 2C3.00 WMC, University of Alberta, Edmonton, Alberta, Canada
T6G 2R7 (e-mail: dspady{at}ualberta.ca).
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