{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T11:01:20Z","timestamp":1790766080782,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001320","name":"Wolfson Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001320","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acamh.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Child Psychology Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Child and adolescent psychiatric disorders are common, now affecting at least one in eight children. Evidence points towards an increase in prevalence over time, but very few studies have tested whether longitudinal outcomes for children with mental health problems have changed. This study is the first to test whether mental health and functional outcomes for children with a diagnosed psychiatric disorder have improved or worsened across time in England.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Three national probability surveys were undertaken in England in 1999, 2004, and 2017, each with respective 3\u2010year follow\u2010ups in 2002, 2007, and 2020. We include children at baseline aged 5\u201313\u2009years and compare outcomes for those with baseline psychiatric diagnosis (mental health disorder or ADHD). Three\u2010year mental health symptom severity and functional impairment were assessed using the parent\u2010 and self\u2010rated total difficulties score and impact supplement from the Strengths and Difficulties Questionnaire.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Across all surveys, having a psychiatric disorder at baseline predicted greater difficulty and impact scores at follow\u2010up. The magnitude of these associations increased sequentially over time, such that having a disorder at baseline was more strongly associated with parent\u2010 and self\u2010rated difficulties in the 2017 survey compared with the 1999 and 2004 surveys. Children in the 2017 survey were also more likely to report a greater impact of problems. Patterns of individual change also showed a temporal gradient. For children with a psychiatric disorder in 1999, 34% experienced deterioration in mental health at the three\u2010year follow\u2010up, compared to 52% of those with a disorder in 2017. The proportion of those who improved decreased correspondingly.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Children with a psychiatric condition are experiencing increased difficulties in their daily lives compared to previous generations. Understanding why children are now more likely to experience impaired functioning is a major public concern.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jcpp.70231","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T10:17:25Z","timestamp":1790763445000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Change in the severity and impact of child psychiatric disorders over 3\u2009years: an analysis of trends using the national child mental health surveys of England from 1999, 2004, and 2017"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0929-9956","authenticated-orcid":false,"given":"Jessica M.","family":"Armitage","sequence":"first","affiliation":[{"name":"Wolfson Centre for Young People's Mental Health Cardiff University  Cardiff UK"},{"name":"Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics Cardiff University School of Medicine, Cardiff University  Cardiff UK"},{"name":"Medical School University of Exeter  Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5192-3724","authenticated-orcid":false,"given":"Tamsin","family":"Newlove\u2010Delgado","sequence":"additional","affiliation":[{"name":"Medical School University of Exeter  Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5295-4904","authenticated-orcid":false,"given":"Tamsin J.","family":"Ford","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Cambridge University  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally","family":"McManus","sequence":"additional","affiliation":[{"name":"National Centre for Social Research  London UK"},{"name":"School of Health and Medicine City St George's, University of London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5470-3770","authenticated-orcid":false,"given":"Sharon A. S.","family":"Neufeld","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Cambridge University  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanfei","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Cambridge University  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4296-820X","authenticated-orcid":false,"given":"Stephan","family":"Collishaw","sequence":"additional","affiliation":[{"name":"Wolfson Centre for Young People's Mental Health Cardiff University  Cardiff UK"},{"name":"Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics Cardiff University School of Medicine, Cardiff University  Cardiff UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"issue":"14","key":"e_1_2_10_2_1","article-title":"Explaining long\u2010term trends in adolescent emotional problems: what we know from population\u2010based studies","volume":"4","author":"Armitage J.M.","year":"2024","journal-title":"Discover Social Science and Health"},{"issue":"7","key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1016\/S2215-0366(23)00175-X","article-title":"Cross\u2010cohort change in parent\u2010reported emotional problem trajectories across childhood and adolescence in the UK","volume":"10","author":"Armitage J.M.","year":"2023","journal-title":"The Lancet Psychiatry"},{"issue":"2","key":"e_1_2_10_4_1","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1111\/jcpp.14040","article-title":"Characteristics of children with a psychiatric disorder in 1999, 2004 and 2017: An analysis of the national child mental health surveys of England","volume":"66","author":"Armitage J.M.","year":"2025","journal-title":"Journal of Child Psychology and Psychiatry"},{"issue":"7","key":"e_1_2_10_5_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0288882","article-title":"Validation of the Strengths and Difficulties Questionnaire (SDQ) emotional subscale in assessing depression and anxiety across development","volume":"18","author":"Armitage J.M.","year":"2023","journal-title":"PLoS One"},{"key":"e_1_2_10_6_1","unstructured":"Children's Commissioner. (2021).The state of children's mental health services 2020\/21.https:\/\/assets.childrenscommissioner.gov.uk\/wpuploads\/2021\/01\/cco\u2010the\u2010state\u2010of\u2010childrens\u2010mental\u2010health\u2010services\u20102020\u201021\u2010tech\u2010report.pdf"},{"key":"e_1_2_10_7_1","doi-asserted-by":"crossref","first-page":"1547","DOI":"10.1007\/s00787-019-01305-9","article-title":"Brief report: a comparison of child mental health inequalities in three UK population cohorts","volume":"28","author":"Collishaw S.","year":"2019","journal-title":"European Child & Adolescent Psychiatry"},{"key":"e_1_2_10_8_1","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1007\/978-981-10-2348-4_9","article-title":"Trends in child and adolescent mental health prevalence, outcomes, and inequalities","volume":"20","author":"Collishaw S.","year":"2020","journal-title":"Mental Health and Illness of Children and Adolescents"},{"issue":"5","key":"e_1_2_10_9_1","first-page":"604","article-title":"Associations of Childhood and Adolescent Depression With Adult Psychiatric and Functional Outcomes","volume":"60","author":"Copeland W.E.","year":"2021","journal-title":"Journal of the American Academy of Child and Adolescent Psychiatry"},{"issue":"2","key":"e_1_2_10_10_1","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1093\/ije\/dyz259","article-title":"Data Resource Profile: Mental Health of Children and Young People (MHCYP) Surveys","volume":"49","author":"Ford T.","year":"2020","journal-title":"International Journal of Epidemiology"},{"key":"e_1_2_10_11_1","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1111\/j.1469-7610.1997.tb01545.x","article-title":"The Strengths and Difficulties Questionnaire: A research note","volume":"38","author":"Goodman R.","year":"1997","journal-title":"Journal of Child Psychology and Psychiatry"},{"issue":"5","key":"e_1_2_10_12_1","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1111\/j.1469-7610.2000.tb02345.x","article-title":"The Development and Well\u2010Being Assessment: description and initial validation of an integrated assessment of child and adolescent psychopathology","volume":"41","author":"Goodman R.","year":"2000","journal-title":"Journal of Child Psychology and Psychiatry"},{"key":"e_1_2_10_13_1","doi-asserted-by":"crossref","DOI":"10.1037\/e557702010-001","volume-title":"Mental health of children and young people in Great Britain, 2004","author":"Green H.","year":"2005"},{"key":"e_1_2_10_14_1","doi-asserted-by":"crossref","DOI":"10.1093\/eurpub\/cku161.104","article-title":"Screening for Mental Health Problems in Children and Adolescents by means of the Strengths and Difficulties Questionnaire (SDQ, parental\u2010version) within a Mixed\u2010Mode study","volume":"24","author":"Mauz E.","year":"2014","journal-title":"European Journal of Public Health"},{"key":"e_1_2_10_15_1","volume-title":"Persistence, onset, risk factors and outcomes of childhood mental disorders","author":"Meltzer H.","year":"2003"},{"key":"e_1_2_10_16_1","volume-title":"Mental Health of Children and Young People in England, 2021","author":"Newlove\u2010Delgado T.","year":"2021"},{"key":"e_1_2_10_17_1","volume-title":"Three years on: Survey of the development and emotional wellbeing of children and young people","author":"Parry\u2010Langdon N.","year":"2008"},{"key":"e_1_2_10_18_1","doi-asserted-by":"crossref","first-page":"4237","DOI":"10.1007\/s00787-024-02461-3","article-title":"Emotional problems across development: examining measurement invariance across childhood, adolescence and early adulthood","volume":"33","author":"Riglin L.","year":"2024","journal-title":"European Child & Adolescent Psychiatry"},{"issue":"1","key":"e_1_2_10_19_1","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/S2215-0366(24)00361-4","article-title":"Tracking the course of depressive and anxiety symptoms across adolescence (the CATS study): a population\u2010based cohort study in Australia","volume":"12","author":"Robson E.M.","year":"2025","journal-title":"Lancet Psychiatry"},{"key":"e_1_2_10_20_1","unstructured":"Sadler K. Vizard T. Ford T. Marchesell F. Pearce N. Mandalia D. et\u00a0al. (2018).Mental health of children and young people in England 2017.https:\/\/digital.nhs.uk\/data\u2010and\u2010information\/publications\/statistical\/mental\u2010health\u2010of\u2010children\u2010and\u2010young\u2010peoplein\u2010england\/2017\/2017"},{"issue":"11","key":"e_1_2_10_21_1","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1037\/pas0001237","article-title":"Predictors of time\u2010varying and time\u2010invariant components of psychological distress during COVID\u201019 in the U.K. Household Longitudinal Study (understanding society)","volume":"35","author":"Schlechter P.","year":"2023","journal-title":"Psychological Assessment"},{"issue":"7","key":"e_1_2_10_22_1","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1111\/jcpp.13029","article-title":"Cross\u2010cohort change in adolescent outcomes for children with mental health problems","volume":"60","author":"Sellers R.","year":"2019","journal-title":"Journal of Child Psychology and Psychiatry"},{"key":"e_1_2_10_23_1","volume-title":"Stata Statistical Software: Release 17","author":"StataCorp","year":"2021"},{"issue":"4","key":"e_1_2_10_24_1","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1093\/eurpub\/ckx167","article-title":"Austerity and health: the impact in the UK and Europe","volume":"27","author":"Stuckler D.","year":"2017","journal-title":"European Journal of Public Health"},{"issue":"3","key":"e_1_2_10_25_1","doi-asserted-by":"crossref","first-page":"1074","DOI":"10.1017\/S0033291721002506","article-title":"Changes in the adult consequences of adolescent mental ill\u2010health: findings from the 1958 and 1970 British birth cohorts","volume":"53","author":"Thompson E.J.","year":"2023","journal-title":"Psychological Medicine"},{"key":"e_1_2_10_26_1","volume-title":"Mental health of children and young people in England, 2020","author":"Vizard T.","year":"2020"}],"container-title":["Journal of Child Psychology and Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/acamh.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jcpp.70231","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acamh.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jcpp.70231","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acamh.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jcpp.70231","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T10:17:32Z","timestamp":1790763452000},"score":1,"resource":{"primary":{"URL":"https:\/\/acamh.onlinelibrary.wiley.com\/doi\/10.1111\/jcpp.70231"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,30]]},"references-count":25,"alternative-id":["10.1111\/jcpp.70231"],"URL":"https:\/\/doi.org\/10.1111\/jcpp.70231","archive":["Portico"],"relation":{},"ISSN":["0021-9630","1469-7610"],"issn-type":[{"value":"0021-9630","type":"print"},{"value":"1469-7610","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,30]]},"assertion":[{"value":"2026-09-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"jcpp.70231"}}