Children with depression or ADHD and their parents not only face the challenge of an illness, but may confront the stigma that accompanies treatment and social rejection, according to the first-ever national study to examine Americans' views of mental health issues in children.

The four-part study, conducted by sociologists at Indiana University and colleagues from the University of Virginia and Columbia University, found a high level of skepticism regarding psychiatric medications, with 66 percent of respondents saying the medications just delayed solving the "real" behavior-related problems, and 86 percent saying physicians overmedicate children for common behavior problems. Most Americans were concerned about confidentiality and the immediate and long-term effects of treatment on children's futures.

While levels of prejudice appear to be lower than in studies related to adults, the researchers found that Americans report believing children with depression are more likely to behave in a violent manner, compared to their expectations of adults with depression. In fact, Americans see childhood depression as more serious, more in need of treatment and more problematic overall than adult depression .

Regardless of how much truth lies in the stigma, these common perceptions color the support and advice people get from their friends, family and even their physicians. It can create a reluctance to seek help, fears of exclusion for children and their parents, and a feeling of lower self-worth among children, all fears that can make a difficult situation worse.

"These findings are stunning," says Bernice Pescosolido, the IU sociology professor who led the national study. "We see a kinder response toward children than adults with mental health problems. However, the concerns about children's identity and opportunities being spoiled because they had challenges that could be helped by mental health treatment signal delays in treatment, misinformation and stigma."

This first set of results from the National Stigma Study-Children is appearing in a special section of the May issue of Psychiatric Services. The four-part study draws from nationally representative surveys and addresses attitudes toward treatment and medications, perceived danger of children with mental health problems, comparisons between attitudes toward adults with depression verses children, and public awareness and beliefs concerning attention-deficit hyperactivity disorder.

"Given the high level of public and professional discussion about the rise in children's use of psychiatric medication, we knew surprisingly little about what the public thought about child and adolescent disorders, available treatments or the parents and children who experience these disorders," Pescosolido says.

Most of the findings were based on a 2002 nationally representative survey involving 1,393 adults who were interviewed in person. They were interviewed as part of the General Social Survey, which is conducted by the National Opinion Research Center at the University of Chicago. The findings in the article, "Comparison of public attributions, attitudes and stigma in regard to depression among children and adults," also compare responses from the 2002 survey to similar questions in the 1996 GSS.

Below are some key findings: