Epidemiological Study on the Early Detection of Mental Disorders in Young Children in Russia

Abstract

BACKGROUND: Assessing the risk of children developing mental, behavioral, and developmental disorders (MBDDs), including autism spectrum disorders (ASDs), as well as achieving early detection of such disorders, has become one of the most important undertakings for public mental health professionals worldwide.

AIM: This study aims to evaluate the risk of developing MBDDs and the prevalence of MBDDs among young children (18–48 months old) in Russia.

METHODS: A two-level epidemiological screening approach was developed and adopted for the purposes of this study. At the first level, the parents of all children between 18 and 48 months old were questioned using Russian national validated Screening Checklist for Parents for Identification of the Risk of Mental, Behavioral, and Developmental Disorders in Early Childhood in nine regions of Russia (Volgograd, Kirov, Moscow, Novosibirsk, Orenburg, Tver, Chelyabinsk, Yaroslavl, and Stavropol). At the second level, children identified at the first level of screening as being at risk of developing MBDDs were assessed by a child psychiatrist on a voluntary basis and diagnosed according to the International Classification of Diseases, Tenth Revision criteria.

RESULTS: The present study revealed that the risk of developing MBDDs stands at 13.07% or 1,307 cases per 10,000 child population aged 18–48 months, whereas the prevalence of confirmed MBDDs is 1.51% or 151 cases per 10,000 among a Russian child population aged 18–48 months.

CONCLUSION: Screening for the risk of developing MBDDs, including ASDs, in Russia among very young children is a promising area of preventive medicine. This initiative allows us to develop optimal algorithms for specialized care measures that could help prevent the development and aggravation of children mental health issues.

Keywords

early detection / epidemiology / screening / early childhood / mental / behavioral and developmental disorders / autism spectrum disorders / primary healthcare

References

[1] WHO. World mental health report: Transforming mental health for all — executive summary [cited 16 June 2022]. Geneva: World Health Organization; 2022. Available from: https://www.who.int/publications/i/item/9789240050860.

[2] WHO. Adolescent mental health [cited 17 November 2021]. Geneva: World Health Organization; 2019. Available from: https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health.

[3] Malhotra S, Patra BN. Prevalence of child and adolescent psychiatric disorders in India: A systematic review and meta-analysis. Child Adolesc Psychiatry Ment Health. 2014 Jul;8:22. doi: 10.1186/1753-2000-8-22. PMID: 25071865. PMCID: PMC4113132.

[4] Merikangas KR, Nakamura EF, Kessler RC. Epidemiology of mental disorders in children and adolescents. Dialogues Clin Neurosci. 2009;11(1):7–20. doi: 10.31887/dcns.2009.11.1/krmerikangas. PMID: 19432384. PMCID: PMC2807642.

[5] Verhulst FC, Tiemeier H. Child psychiatric epidemiology: Stars and hypes. Eur Child Adolesc Psychiatry. 2015 Jun;24(6):603–6. doi: 10.1007/s00787-015-0722-4. PMID: 25991558.

[6] Bitsko RH, Holbrook JR, Robinson LR, et al. Health care, family, and community factors associated with mental, behavioral, and developmental disorders in early childhood — United States, 2011–2012. MMWR Morb Mortal Wkly Rep. 2016 Mar;65(9):221–6. doi: 10.15585/mmwr.mm6509a1. PMID: 26963052.

[7] Ozonoff S. Editorial: Early detection of mental health and neurodevelopmental disorders: The ethical challenges of a field in its infancy. J Child Psychol Psychiatry. 2015 Sep;56(9):933–5. doi: 10.1111/jcpp.12452. PMID: 26257104.

[8] Polanczyk GV, Salum GA, Sugaya LS, Caye A, Rohde LA. Annual research review: A meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. J Child Psychol Psychiatry. 2015 Mar;56(3):345–65. doi: 10.1111/jcpp.12381. PMID: 25649325.

[9] Kieling C, Baker-Henningham H, Belfer M, et al. Child and adolescent mental health worldwide: Evidence for action. Lancet. 2011 Oct;378(9801):1515–25. doi: 10.1016/S0140-6736(11)60827-1. PMID: 22008427.

[10] Stiffler M, Dever B. History of screening practices, mental health assessment, and classification in the USA. Mental health screening at school. Contemporary issues in psychological assessment. Cham: Springer; 2015. doi: 10.1007/978-3-319-19171-3_2.

[11] Jackson S, Volkmar F. Diagnosis and definition of autism and other pervasive developmental disorders. In: Volkmar F, ed. Autism and pervasive developmental disorders. Cambridge University Press; 2019. р. 1–24. doi: 10.1017/9781108297769.002.

[12] Koch SV, Andersson M, Hvelplund C, Skovgaard AM. Mental disorders in referred 0–3-year-old children: A population-based study of incidence, comorbidity and perinatal risk factors. Eur Child Adolesc Psychiatry. 2021 Aug;30(8):1251–1262. doi: 10.1007/s00787-020-01616-2. PMID: 32815033.

[13] Skovgaard AM. Mental health problems and psychopathology in infancy and early childhood. An epidemiological study. Dan Med Bull. 2010 Oct;57(10):B4193. PMID: 21040689.

[14] Valla L, Wentzel-Larsen T, Hofoss D, Slinning K. Prevalence of suspected developmental delays in early infancy: Results from a regional population-based longitudinal study. BMC Pediatrics. 2015 Dec;15:215. doi: 10.1186/s12887-015-0528-z. PMID: 26678149. PMCID: PMC4683867.

[15] Bazhenova O, Gorunova A, Kozlovskaya G, Skoblo G. An epidemiological study of mental disorders during early childhood in the Soviet Union. In: Albee GW, Bond LA, Monsey TV, eds. Primary prevention of psychopathology. Improving children’s lives: Global perspectives on prevention. Vol. 14. Newbury Park, CA: SAGE Publications; 1992. р. 49–57.

[16] Kalinina MA. [Long-term follow up of children with high risk of schizophrenia]. Psychiatry (Moscow). 2018;(2):41–47. doi: 10.30629/2618-6667-2018-78-41-47. Russian.

[17] Kozlovskaya GV, Skoblo GV, Gorunova AV, Rimashevskaya NV. [Clinical and psychopathological aspects of mental disorders in infancy]. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 1991;91(8):62–66. Russian.

[18] Pierce K, Gazestani VH, Bacon E, et al. Evaluation of the diagnostic stability of the early autism spectrum disorder phenotype in the general population starting at 12 months. JAMA Pediatrics. 2019 Jun;173(6):578–587. doi: 10.1001/jamapediatrics.2019.0624. PMID: 31034004. PMCID: PMC6547081.

[19] Lipkin PH, Macias MM, Council on children with disabilities, section on developmental and behavioral pediatrics. Promoting optimal development: Identifying infants and young children with developmental disorders through developmental surveillance and screening. Pediatrics. 2020 Jan;145(1):e20193449. doi: 10.1542/peds.2019-3449. PMID: 31843861.

[20] Izett E, Rooney R, Prescott SL, De Palma M, McDevitt M. Prevention of mental health difficulties for children aged 0–3 years: A review. Frontiers in Psychology. 2021 Sep;11:500361. doi: 10.3389/fpsyg.2020.500361. PMID: 34777074. PMCID: PMC8579481.

[21] Lyons-Ruth K, Todd Manly J, Von Klitzing K, et al. The worldwide burden of infant mental and emotional disorder: Report of the task force of the world association for infant mental health. Infant Mental Health J. 2017 Nov;38(6):695–705. doi: 10.1002/imhj.21674. PMID: 29088514.

[22] Micali N. The effect of early developmental problems in infancy: Perspectives and clinical implications. Eur Child Adolesc Psychiatry. 2017 Nov;26(11):1281–1282. doi: 10.1007/s00787-017-1065-0. PMID: 29052013.

[23] Mukaetova-Ladinska EB, Perry E, Baron M., Povey C; Autism Ageing Writing Group. Ageing in people with autistic spectrum disorder. Int J Geriatr Psychiatry. 2012 Feb;27(2):109–18. doi: 10.1002/gps.2711. PMID: 21538534.

[24] Makushkin EV, Baybarina EN, Chumakova OV, Demcheva NK. [Fundamental tasks and problems of a mental health care of children in Russia]. Psychiatry (Moscow). 2015;4:5–11.

[25] Simashkova NV, Klyushnik TP, Boksha IS, Ivanov MV, Iakupova LP. Approccio differenziato nei riguardi di pazienti di età infantile con disturbi dello spettro autistico in Russia. Autismo e disturbi del neurosviluppo. 2022;20(2):113–124. doi: 10.14605/AUT2022201.

[26] Baranov AA, Namazova-Baranova LS, Albitckii VI, Terletckaia RN. [The prevention of disability as a leading priority of caring of mother and child health]. Probl Sotsialnoi Gig Zdravookhranenniia i Istor Med. 2019 May;27(3):216–221. doi: 10.32687/0869-866X-2019-27-3-216-221. PMID: 31251850. Russian.

[27] Ivanov MV, Simashkova NV, Kozlovskaya GV. Diagnosis of mental health and developmental disorders in early childhood (screening tool). In: Zvereva NV, Roshchina IF, eds. Methodological and applied problems of medical (clinical) psychology. Moscow; 2018. р. 212–221. Russian.

[28] Ivanov MV, Simashkova NV, Kozlovskaya GV, Makushkin EV. [The epidemiologic study of the risk of autism spectrum disorders in children of 16–24 months in Russia, 2015–2016]. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2018;118(5-2):12–19. doi: 10.17116/jnevro20181185212. PMID: 30141782. Russian.

[29] Ivanov M, Simashkova N, Kozlovskaya G, Makushkin E. [The screening of the risk of autism spectrum disorders in children aged 16–24 months in Russia, 2015]. European Psychiatry. 2017 Apr;41(S1):S442. doi: 10.1016/j.eurpsy.2017.01.448. Russian.

[30] Gillberg C. The ESSENCE in child psychiatry: Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations. Res Dev Disabil. 2010 Nov-Dec;31(6):1543–51. doi: 10.1016/j.ridd.2010.06.002. PMID: 20634041.

[31] Simpson TE, Condon E, Price RM, Finch BK, Sadler LS, Ordway MR. Demystifying Infant Mental Health: What the Primary Care Provider Needs to Know. J Pediatr Health Care. 2016 Jan-Feb; 30(1):38–48. doi: 10.1016/j.pedhc.2015.09.011.

[32] Simashkova NV, Boksha IS, Klyushnik TP, Iakupova LP, Ivanov MV, Mukaetova-Ladinska EB. Diagnosis and management of autism spectrum disorders in Russia: Clinical-biological approaches. J Autism Dev Disord. 2019 Sep;49(9):3906–3914. doi: 10.1007/s10803-019-04071-4. PMID: 31124027.

[33] Simashkova NV, Ivanov MV, Makushkin EV, Sharlay IA, Klyushnik TP, Kozlovskaya GV. [Screening of the risk of mental and developmental disorders in children of early age in the Russian population (2017–2019)]. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2020;120(11):79–86. doi: 10.17116/jnevro202012011179.

[34] Salamanca-Buentello F, Seeman MV, Daar AS, Upshur RE. The ethical, social, and cultural dimensions of screening for mental health in children and adolescents of the developing world. PLoS ONE. 2020 Aug;15(8):e0237853. doi: 10.1371/journal.pone.0237853. PMID: 32834012. PMCID: PMC7446846.

[35] DuBay M, Watson LR, Méndez LI, Rojevic C. Psychometric comparison of the English and Spanish western-hemisphere versions of the modified checklist for autism in toddlers-revised. J Dev Behav Pediatr. 2021 Dec;42(9):717–725. doi: 10.1097/DBP.0000000000000968. PMID: 34840315.

[36] Order of the Ministry of Health of Russia dated June 13, 2019 No. 396n “O vnesenii izmenenii v Poryadok provedeniya profilakticheskikh meditsinskikh osmotrov nesovershennoletnikh, utverzhdennyi prikazom Ministerstva zdravookhraneniya Rossiiskoi Federatsii ot 10 avgusta 2017 g. № 514n”. Available from: https://minjust.consultant.ru/special/documents/document/44211. Russian.

[37] Vasileva M, Graf RK, Reinelt T, Petermann U, Petermann F. Research review: A meta-analysis of the international prevalence and comorbidity of mental disorders in children between 1 and 7 years. J Child Psychol Psychiatry. 2021 Apr;62(4):372–381. doi: 10.1111/jcpp.13261. PMID: 32433792.

[38] von Klitzing K, Döhnert M, Kroll M, Grube M. Mental disorders in early childhood. Dtsch Arztebl Int. 2015 May;112(21-22):375–86; quiz 386. doi: 10.3238/arztebl.2015.0375. PMID: 26149380. PMCID: PMC4496484.

[39] Dokukina TV, Marchuk SA. [Clinical and epidemiological characteristics of autism spectrum disorders in the republic of Belarus]. Vestnik soveta molodykh uchenykh i spetsialistov Chelyabinskoi oblasti. 2016;3(2):51–55. Russian.

[40] Maenner MJ, Shaw KA, Baio J, et al. Prevalence of autism spectrum disorder among children aged 8 years — autism and developmental disabilities monitoring network 11 sites United States, 2016. MMWR Surveill Summ. 2020 Mar;69(4):1–12. doi: 10.15585/mmwr.ss6904a1. PMID: 32214087. PMCID: PMC7119644.

[41] Shaw KA, Maenner MJ, Baio J, et al. Early identification of autism spectrum disorder among children aged 4 years — early autism and developmental disabilities monitoring network, six sites, United States, 2016. MMWR Surveill Summ. 2020 Mar;69(3):1–11. doi: 10.15585/mmwr.ss6903a1. PMID: 32214075. PMCID: PMC7119643.

[42] Kogan MD, Vladutiu CJ, Schieve LA, et al. The prevalence of parent-reported autism spectrum disorder among US children. Pediatrics. 2018 Dec;142(6):e20174161. doi: 10.1542/peds.2017-4161. PMID: 30478241. PMCID: PMC6317762.

[43] Zablotsky B, Black LI, Blumberg SJ. Estimated prevalence of children with diagnosed developmental disabilities in the United States, 2014–2016. NCHS Data Brief. 2017 Nov;291:1–8. PMID: 29235982.

[44] Wang F, Lu L, Wang SB, et al. The prevalence of autism spectrum disorders in China: A comprehensive meta-analysis. Int J Biol Sci. 2018 May;14(7):717–725. doi: 10.7150/ijbs.24063. PMID: 29910682. PMCID: PMC6001678.

[45] Rødgaard E, Jensen K, Vergnes J, Soulières I, Mottron L. Temporal changes in effect sizes of studies comparing individuals with and without autism: A meta-analysis. JAMA Psychiatry. 2019 Nov;76(11):1124–1132. doi: 10.1001/jamapsychiatry.2019.1956. PMID: 31433441. PMCID: PMC6704749.

[46] Fombonne E. Epidemiological controversies in autism. Swiss Arch Neurol Psychiatr Psychother. 2020 Jan;171:w03084. doi: 10.4414/sanp.2020.03084.

[47] Brugha T, Bankart J, McManus S, Gullon-Scott F. CDC autism rate: Misplaced reliance on passive sampling? Lancet. 2018 Sep;392(10149):732–733. doi: 10.1016/s0140-6736(18)31494-6. PMID: 30191823.

[48] Zappella M. [Autism: a diagnostic dilemma]. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2022;122(6):71–76. doi: 10.17116/jnevro202212206171. PMID: 35758950. Russian.

[49] Brugha TS, McManus S, Bankart J, Jenkins R, Smith J, Scott F. The proportion of true cases of autism is not changing. BMJ. 2014 Jun;348:g3774. doi: 10.1136/bmj.g3774. PMID: 24920691.

[50] Myers J, Chavez A, Hill AP, Zuckerman K, Fombonne E. Epidemiological surveys of autism spectrum disorders. In: Volkmar FR, ed. Autism and pervasive developmental disorders. 3rd ed. Cambridge University Press; 2019. р. 25–60. doi: 10.1017/9781108297769.003.

RIGHTS & PERMISSIONS

Eco-Vector