Psychiatric Disorders in Children and Adolescents

Primary Disorders

The American Academy of Child and Adolescent Psychiatry notes that ADHD is particularly prominent in children with intellectual disability, where rates are substantially elevated compared to typically developing children 1, 2
Anxiety disorders show particularly high rates in children with intellectual disability, according to the American Academy of Child and Adolescent Psychiatry 1, 2
Oppositional defiant disorder (ODD) shows particularly high rates in psychiatric evaluations, especially among children with intellectual disability, as reported by the American Academy of Child and Adolescent Psychiatry 1, 2

Children with intellectual disability experience psychiatric disorders at least three times more often than typically developing children, according to the American Academy of Child and Adolescent Psychiatry 1, 2
Autism spectrum disorder commonly co-occurs with intellectual disability, as noted by the American Academy of Child and Adolescent Psychiatry 1, 2
Serious behavioral problems occur 2.5 to 4 times more frequently in children with intellectual disability, as reported by the American Academy of Child and Adolescent Psychiatry 1, 2

The American Academy of Child and Adolescent Psychiatry recommends that clinicians assess for ADHD and ODD, as these frequently underlie or co-occur with mood and anxiety symptoms 1, 2
Avoid "diagnostic overshadowing" where behavioral symptoms are attributed to intellectual disability rather than recognizing comorbid psychiatric disorders, as advised by the American Academy of Child and Adolescent Psychiatry 5

Family psychiatric history, particularly for bipolar disorder, psychotic disorders, and substance abuse, is a risk factor requiring assessment, according to the American Academy of Child and Adolescent Psychiatry 6, 4
Severity of cognitive, adaptive, and language impairments is a risk factor requiring assessment, as noted by the American Academy of Child and Adolescent Psychiatry 1, 2
Trauma exposure and abuse history is a risk factor requiring assessment, with children with intellectual disability having a higher rate of substantiated maltreatment, as reported by the American Academy of Child and Adolescent Psychiatry 5

Approximately 50% of adolescents with bipolar disorder may be initially misdiagnosed as schizophrenia, according to Praxis Medical Insights 3
Medical causes account for approximately 20% of acute psychosis cases and must be systematically excluded, as noted by Praxis Medical Insights 4, 3
African-American youth are more likely to be misdiagnosed with psychotic conditions and less likely to receive mood disorder diagnoses due to clinician bias, as reported by Praxis Medical Insights 4