The Youth Risk Behavior Surveillance System (YRBSS), conducted in 2003, was a national school-based survey of 15,214 students in grades 9 to 12. Students were asked about depressive symptoms and suicide during the 12 months preceding the survey. Over a quarter (28.6 percent) of students nationwide reported that they felt so sad or hopeless almost every day for more than two weeks that they stopped doing some usual activities. The prevalence rate was higher among girls (35.5 percent) than boys (22 percent). The prevalence rate was higher among Hispanic (35 percent) than white (26 percent) and black (26.3 percent) students. Combining gender and ethnicity, the prevalence rates were as follows: Hispanic girls (45 percent), white girls (33 percent), black girls (31 percent), Hispanic boys (26 percent), black boys (22 percent), and white boys (19.6 percent). During the 12 months preceding this survey, 17 percent of students reported that they had seriously considered suicide, 8.5 percent of students attempted suicide one or more times, and 3 percent of students made a suicide attempt that resulted in an injury, poisoning, or overdose that required treatment.

Anxiety disorders have a high prevalence rate in youth. The rate of childhood anxiety disorders in a primary care setting has been reported to be 35 percent (Chavira el al., 2004). In a sample of incoming college freshman, 11.8 percent of the students reported experiencing a panic attack during the past year (Valentiner, Mounts, and Deacon, 2004).

Differences in assignment of diagnoses have been found to be based on the ethnicity of the youth. For example, one study reported that blacks were more likely to be assigned a diagnostic code related to abuse or neglect of a child and were less likely to be diagnosed with a mood disorder when compared with non-Hispanic whites. Hispanics were more likely than non-Hispanic whites to be diagnosed with adjustment disorders, anxiety disorders, and psychotic disorders and were less likely to be diagnosed with attention deficit hyperactivity disorder (Yeh et al., 2002).

In summary, a synthesis of these varying prevalence rates suggests that, in the youth population from which the military draws its enlistees, roughly 10 to 15 percent of older adolescents will have at least one criterion-based psychiatric diagnosis that causes a high level of functional impairment (other than attention deficit hyperactivity disorder), with a significant proportion of those suffering from two or more psychiatric disorders.

Psychotropic Medication Use

There has been a substantial increase in the use of psychotropic medications, particularly antidepressants and stimulants, for children and adolescents with psychiatric disorders.



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