Journal of affective disorders · 2025
Associations between multiple neurodevelopmental disorders and mental health in children.
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Zhou Xiaoyun, Jia Frank, Bambling Matthew, Edirippulige Sisira, Whiteford Harvey, Lin Jialing
Аннотация
OBJECTIVE: This study investigated the association between multiple NDDs and the prevalence and severity of current depression and anxiety among children aged 3-17 years.
METHODS: We analyzed parent- or caregiver-reported data from 2016 to 2023 US National Survey of Children's Health. Children aged 3-17 years were included. We considered a broader spectrum of NDDs by including behavioral problems and grouped children based on the number of NDDs (out of ten): no multiple NDDs (none or one NDD), two NDDs, three NDDs, four NDDs, and five or more NDDs. Four mental health outcomes were measured: depression (yes/no), anxiety (yes/no), depression severity (mild/moderate/severe), and anxiety severity (mild/moderate/severe). Multinomial logistic regression models were used.
RESULTS: Among 267,044 children (mean age = 10.2 years; male = 51.8 %), 10.6 % had multiple NDDs. The increasing number of co-occurring NDDs was associated with higher odds of prevalence and severity of depression and anxiety. Children with multiple NDDs were 4.7-5.3 times more likely to have depression and 5.8-12.9 times more likely to have anxiety compared with those without multiple NDDs. These positive associations remained consistent for mild or moderate depression (adjusted odds ratios [ORs]: 5.0-5.6) and for mild or moderate anxiety (adjusted ORs: 5.6-8.9). The associations were more pronounced for severe mental health conditions, with children being 7.8-16.9 times more likely to experience severe depression and 8.1-34.9 times more likely to experience severe anxiety.
CONCLUSIONS: The cumulative mental health burden associated with multiple NDDs emphasizes the need for integrated screening and tailored interventions to support this population.
METHODS: We analyzed parent- or caregiver-reported data from 2016 to 2023 US National Survey of Children's Health. Children aged 3-17 years were included. We considered a broader spectrum of NDDs by including behavioral problems and grouped children based on the number of NDDs (out of ten): no multiple NDDs (none or one NDD), two NDDs, three NDDs, four NDDs, and five or more NDDs. Four mental health outcomes were measured: depression (yes/no), anxiety (yes/no), depression severity (mild/moderate/severe), and anxiety severity (mild/moderate/severe). Multinomial logistic regression models were used.
RESULTS: Among 267,044 children (mean age = 10.2 years; male = 51.8 %), 10.6 % had multiple NDDs. The increasing number of co-occurring NDDs was associated with higher odds of prevalence and severity of depression and anxiety. Children with multiple NDDs were 4.7-5.3 times more likely to have depression and 5.8-12.9 times more likely to have anxiety compared with those without multiple NDDs. These positive associations remained consistent for mild or moderate depression (adjusted odds ratios [ORs]: 5.0-5.6) and for mild or moderate anxiety (adjusted ORs: 5.6-8.9). The associations were more pronounced for severe mental health conditions, with children being 7.8-16.9 times more likely to experience severe depression and 8.1-34.9 times more likely to experience severe anxiety.
CONCLUSIONS: The cumulative mental health burden associated with multiple NDDs emphasizes the need for integrated screening and tailored interventions to support this population.