Increasing prevalence of ADHD, major depression, and conduct disorders among adolescent students in Puerto Rico, 2005-2012

Most mental disorders begin in childhood and adolescence, thus we need to understand their magnitude and distribution in youth.  The objective of this study was to evaluate trends of ADHD, major depression, and conduct disorders symptomatology among Puerto Rican adolescents. This study is a secondary analysis of island-wide school-based cross-sectional surveys conducted in 2005-07 (n=13,819), 2010-12 (n=10,134), and 2012-13 (n=3,982) ("Consulta Juvenil VIII-IX"). The samples were selected using multi-stage stratified cluster sampling designs, and were representative of all 7^th-12^th grade students in PR. Data was collected using pre-coded self-administered questionnaires which included DISC Predictive Scales (DPS) to screen for mental health disorders during the last year.  In each survey, the most common disorder was ADHD; its last year prevalence significantly increased from 13.1% to 25.9%.  Major depression prevalence increased from 11.5% to 19.3%.  The highest increase was found in conduct disorders: from 4.8% to 11.9%.  Prevalence of depression was consistently higher among females, while males had consistently higher prevalence of conduct disorders.  Prevalence of ADHD was higher among females in two of the three years.  All disorders were more prevalent among high school students.  The increasing prevalence trend was seen among both genders and school levels for all disorders.  Early detection of mental disorders using school-based screening allows us to identity teens at high risk for mental illness, thus preventing severe cases and enhancing student success at school.  Ongoing surveillance is essential in dealing with this public health problem.  Understanding the differences between groups may help customize prevention programs.