Hornsey, Heatha Amanda Karen; (2003) An epidemiological study of adolescent psychopathology and Gilles de la Tourette Syndrome in West Essex. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

The principal aims of this study were threefold. Firstly, the study set out to estimate the prevalence of mental health problems in a population of 13-14 year old adolescents attending mainstream secondary schools in West Essex. Using a cross-sectional methodology, standardised screening questionnaires were used to identify the presence of specific disorders, based on information from parents, teachers and adolescents. Comparisons were made between those who were and were not referred for treatment. Secondly, a three-stage ascertainment procedure was embedded in the study methodology to determine the prevalence of Gilles de la Tourette Syndrome (TS) in the same population. This combined the use of screening questionnaires with semi-structured interviews, followed by a systematic assessment by an expert clinician in the field of TS for verification and diagnosis.Thirdly, a longitudinal component of the study was designed to measure academic attainment, using General Certificates of Secondary Education (GCSEs), two years later. An overall prevalence rate of 17.1% for psychiatric disorder was reported. This rate was higher than other study findings in nonmetropolitan areas but comparable to inner city levels, within the UK. Rates for specific disorders were variable. Only 34% of those with positive psychopathology were referred to clinics, suggesting a large percentage of unmet need. The prevalence of TS ranged between 0.76% and 1.85%, which is higher than earlier studies but in line with recent ones. Symptoms were milder than those identified in clinics, but comorbidity was high. None of those attending clinics had been referred for their TS symptomatology. Externalising behaviours were significantly associated with poor GCSE outcome, and path analysis models identified that negative outcomes were best predicted by Conduct Disorder once the number of GCSEs entered for were taken into account. Teachers were found to be good at predicting GCSE passes overall.

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