Question Mental disorders typically start in childhood and persist, causing high individual and collective burdens. To inform policymaking to address children’s mental health in high-income countries we aimed to identify updated data on disorder prevalence. Methods We identified epidemiological studies reporting mental disorder prevalence in representative samples of children aged 18 years or younger—including a range of disorders and ages and assessing impairment (searching January 1990 through February 2021). We extracted associated service-use data where studies assessed this. We conducted meta-analyses using a random effects logistic model (using R metafor package). Findings Fourteen studies in 11 countries met inclusion criteria, published from 2003 to 2020 with a pooled sample of 61 545 children aged 4–18 years, including eight reporting service use. (All data were collected pre-COVID-19.) Overall prevalence of any childhood mental disorder was 12.7% (95% CI 10.1% to 15.9%; I2=99.1%). Significant heterogeneity pertained to diagnostic measurement and study location. Anxiety (5.2%), attention-deficit/hyperactivity (3.7%), oppositional defiant (3.3%), substance use (2.3%), conduct (1.3%) and depressive (1.3%) disorders were the most common. Among children with mental disorders, only 44.2% (95% CI 37.6% to 50.9%) received any services for these conditions. Conclusions An estimated one in eight children have mental disorders at any given time, causing symptoms and impairment, therefore requiring treatment. Yet even in high-income countries, most children with mental disorders are not receiving services for these conditions. We discuss the implications, particularly the need to substantially increase public investments in effective interventions. We also discuss the policy urgency, given the emerging increases in childhood mental health problems since the onset of the COVID-19 pandemic (PROSPERO CRD42020157262). Data covered in this systematic review and meta-analysis are available from the corresponding author, upon reasonable request.

中文翻译：

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高收入国家儿童精神障碍的患病率：系统评价和荟萃分析，为决策提供信息

问题 精神障碍通常始于儿童时期并持续存在，造成个人和集体的沉重负担。为了为解决高收入国家儿童心理健康问题的政策制定提供信息，我们旨在确定有关疾病流行率的最新数据。方法 我们确定了在 18 岁或以下儿童的代表性样本中报告精神障碍患病率的流行病学研究——包括一系列障碍和年龄以及评估障碍（检索 1990 年 1 月至 2021 年 2 月）。我们提取了相关的服务使用数据，研究对此进行了评估。我们使用随机效应逻辑模型（使用 R metafor 包）进行了荟萃分析。结果 11 个国家的 14 项研究符合纳入标准，于 2003 年至 2020 年发表，汇集了 61545 名 4-18 岁儿童的样本，包括八项报告服务的使用。（所有数据均在 COVID-19 之前收集。）任何儿童精神障碍的总体患病率为 12.7%（95% CI 10.1% 至 15.9%；I2=99.1%）。显着的异质性与诊断测量和研究地点有关。焦虑（5.2%）、注意力缺陷/多动（3.7%）、对立违抗（3.3%）、物质使用（2.3%）、品行（1.3%）和抑郁（1.3%）障碍是最常见的。在患有精神障碍的儿童中，只有 44.2%（95% CI 37.6% 至 50.9%）接受了针对这些疾病的任何服务。结论 估计有八分之一的儿童在任何特定时间都有精神障碍，导致症状和损害，因此需要治疗。然而，即使在高收入国家，大多数患有精神障碍的儿童也没有接受针对这些疾病的服务。我们讨论影响，特别是需要大幅增加对有效干预的公共投资。鉴于自 COVID-19 大流行 (PROSPERO CRD42020157262) 开始以来儿童心理健康问题不断增加，我们还讨论了政策紧迫性。本系统评价和荟萃分析中涵盖的数据可根据合理要求从相应的作者处获得。