Almost a quarter of adolescents in Austria are currently suffering from a mental health problem - First Austria-wide epidemiological study, 27 mental health problems recorded. Credit: Medical University of Vienna

A reported 23.93 percent of all adolescents in Austria are currently suffering from a mental health problem, and over a third of all adolescents have had a mental health problem at some stage in their lives. That is the central finding of the first Austria-wide epidemiological study into the prevalence of mental health problems in Austria, conducted under the supervision of Andreas Karwautz and Gudrun Wagner at MedUni Vienna's Department of Child and Adolescent Psychiatry in collaboration with the Ludwig Boltzmann Institute Health Promotion Research and published in a leading child and adolescent psychiatry journal.

This study is not only the first to cover the whole of Austria but also unique in its range: For the first time in the world, 27 mental health problems were recorded, on application of the DSM-5 criteria (Diagnostic and Statistic Manual of Mental Disorders - US classification system) and this involved questioning around 4,000 adolescents aged between 10 and 18 from throughout Austria, nearly 500 of these in one-on-one interviews. A total of 340 Austrian schools took part.

"The commonest type of problems are anxiety disorders, followed by psychological and neuronal development problems and depressive disorders," summarises child and adolescent psychiatrist Karwautz. When it comes down to the details, there are marked gender differences. While male adolescents are three times more likely to suffer from psychological and neuronal development disorders (e.g. ADHS/Attention Deficit and Hyperactivity Syndrome) than girls and six times more likely to suffer from behavioural disorders (e.g. impulse control), twice as many female adolescents suffer from anxiety disorders and ten times as many from eating disorders compared with males.

Only one in two seeks help

Another finding of the study: Less than half of those adolescents that had suffered from a mental health problem at least once in their lives so far sought professional help from a child and adolescent psychiatrist. Whether or not they go to see the relevant specialist depends largely upon the specific problem: around 63 percent of the questioned adolescents with ADHS had been to see a specialist, barely 20 percent in the case of eating disorders and even fewer in the case of suicidal behaviour disorders (16.7 percent) and non-suicidal, self-harming behaviour (10.0 percent).

According to Karwautz, this is partially due to the stigma that still persists around mental health problems and the associated high inhibition threshold to confide in a doctor, lack of understanding about mental health problems on the part of caregivers, so that the manifest problem often goes unrecognised, but also to the lack of sufficient child and adolescent psychiatrists and associated institutions in Austria, since this was only recognised as a specialism 10 years ago.

Says Karwautz: "Currently there are 26 child and adolescent psychiatrists registered with health insurers for the whole of Austria and 0.04 beds per 1,000 inhabitants. Since the specialism was recently defined as being under-subscribed, it is hoped that more training places will be provided, since this is a prerequisite for ensuring that there are sufficient practitioners in future. This can only be achieved if healthcare providers, political structures and professional societies pull together."

Karwautz is appealing to parents in particular to seek the help of a child and adolescent psychiatrist if they notice significant changes in their child's behaviour: "If you notice a change in behaviour or your child becomes extremely withdrawn or develops tics, you should have them seen by a specialist. And very importantly: the earlier treatment is started, the better the prognosis for the future." Expert help is available!

The study was the result of a joint initiative between MedUni Vienna and Ludwig Boltzmann Institute Health Promotion Research (which has meanwhile ceased its activity) and was funded from "Common Health Goals" within the framework pharmaceutical contract, a cooperative agreement between the Austrian pharmaceutical industry and the social insurance system.

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More information: Gudrun Wagner et al. Mental health problems in Austrian adolescents: a nationwide, two-stage epidemiological study applying DSM-5 criteria, European Child & Adolescent Psychiatry (2017). Gudrun Wagner et al. Mental health problems in Austrian adolescents: a nationwide, two-stage epidemiological study applying DSM-5 criteria,(2017). DOI: 10.1007/s00787-017-0999-6