Introduction. Recent studies have suggested a secular increase in the prevalence of self-harm, suicidal ideation and depression in young people. This study aims to report the changes in prevalence of psychological disturbance over time in a clinic population. Method: Data on the prevalence of psychological symptoms was measured by the Youth Self-Report (YSR) and Child Behaviour Checklist (CBCL), in a 21-year clinic cohort of adolescents aged from 12 to 17. This data was analysed to investigate secular changes and predictors of disorder. Results: Significant secular increases were demonstrated in parent reports of self-harm and suicidal ideation, of 5percent and 4percent per cohort year respectively, but there was no significant change in the anxious/depressed sub-scale. There were no changes demonstrated in self-reports of self-harm, suicidal ideation or anxiety/depression. Self-harm and suicidal ideation, both parent reported and self-reported, significantly increased with increasing age, female gender, drug use, anxiety/depression and other clinically significant scores on the YSR and CBCL sub-scales. The YSR was a more accurate predictor of both self-harm and suicidal ideation than the CBCL. Conclusions: The results of this study suggest that there has not been a significant increase in psychological disorder in this population. There was, however, an apparent increase due to increasing parental awareness of some symptoms, particularly self-harm and suicidal ideation. While parents have a higher rate of reporting disorder, young people's self-reports remain a more accurate predictor of specific symptoms, including self-harm and suicidal ideation.

Introduction. Recent studies have suggested a secular increase in the prevalence of self-harm, suicidal ideation and depression in young people. This study aims to report the changes in prevalence of psychological disturbance over time in a clinic population. Method: Data on the prevalence of psychological symptoms was measured by the Youth Self-Report (YSR) and Child Behaviour Checklist (CBCL), in a 21-year clinic cohort of adolescents aged from 12 to 17. This data was analysed to investigate secular changes and predictors of disorder. Results: Significant secular increases were demonstrated in parent reports of self-harm and suicidal ideation, of 5percent and 4percent per cohort year respectively, but there was no significant change in the anxious/depressed sub-scale. There were no changes demonstrated in self-reports of self-harm, suicidal ideation or anxiety/depression. Self-harm and suicidal ideation, both parent reported and self-reported, significantly increased with increasing age, female gender, drug use, anxiety/depression and other clinically significant scores on the YSR and CBCL sub-scales. The YSR was a more accurate predictor of both self-harm and suicidal ideation than the CBCL. Conclusions: The results of this study suggest that there has not been a significant increase in psychological disorder in this population. There was, however, an apparent increase due to increasing parental awareness of some symptoms, particularly self-harm and suicidal ideation. While parents have a higher rate of reporting disorder, young people's self-reports remain a more accurate predictor of specific symptoms, including self-harm and suicidal ideation.