Maternal recognition of child mental health problems in two Brazilian cities

Objective: To identify child behaviors and types of impairment that increase the likelihood of maternal recognition of emotional/behavioral problems (EBP) in children and adolescents. Methods: Maternal-reported data were obtained from two subsamples of 11-to-16-year-olds derived from cross-sectional studies conducted in two Brazilian municipalities: Itaborai, state of Rio de Janeiro (n=480), and Embu, state of Sao Paulo (n=217). The Itaborai study involved a representative sample of 6-to-16-year-olds (n=1,248response rate = 86.0%) selected from the Family Health Program registry, which covered 85.5% of the municipal population. The Embu study was based on a probabilistic sample of clusters of eligible households (women aged 15-49 years, child < 18 years), with one mother-child pair selected randomly per household (n=813response rate = 82.4%). The outcome variable was mother's opinion of whether her child had EBP. Potential correlates included types of child behaviors (hyperactivity/conduct/emotional problems as isolated or combined conditions) and impairment, assessed using the Strengths and Difficulties Questionnaire (SDQ)child's age and gendermaternal education and anxiety/depression (assessed using the Self-Reporting Questionnaire [SRQ]). Results: Multivariate regression models identified the following correlates of maternal perception of child EBP: comorbidity (co-occurring hyperactivity/conduct/emotional problems), emotional problems alone, and interference of problems with classroom learning and friendships. Conclusion: Comorbidity of different problem types, emotional problems alone, and interference with classroom learning and friendships increase the likelihood of maternal recognition of EBP in children.Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPqMCT/CNPq/CT-Saude/MS/SCTIE/DECIT grant) [33/2008]Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP) [00/14555-4]Univ Fed Sao Paulo UNIFESP, Dept Psiquiatria, Sao Paulo, SP, BrazilUniv Cambridge, Dept Psychiat, Cambridge, EnglandUniv Fed Pelotas, Programa Posgrad Epidemiol, Pelotas, RS, BrazilUniv Fed Sao Paulo UNIFESP, Dept Psiquiatria, Sao Paulo, SP, BrazilCNPqMCT/CNPq/CT-Saude/MS/SCTIE/DECIT grant) [33/2008]FAPESP [00/14555-4]Web of Scienc

Influence of psychosocial risk factors on the trajectory of mental health problems from childhood to adolescence: a longitudinal study

Background\ud Longitudinal epidemiological studies involving child/adolescent mental health problems are scarce in developing countries, particularly in regions characterized by adverse living conditions. We examined the influence of psychosocial factors on the trajectory of child/adolescent mental health problems (CAMHP) over time.\ud \ud Methods\ud A population-based sample of 6- to 13-year-olds with CAMHP was followed-up from 2002–2003 (Time 1/T1) to 2007–2008 (Time 2/T2), with 86 out of 124 eligible children/adolescents at T1 being reassessed at T2 (sample loss: 30.6%). Outcome: CAMHP at T2 according to the Child Behavior Checklist/CBCL’s total problem scale. Psychosocial factors: T1 variables (child/adolescent’s age, family socioeconomic status); trajectory of variables from T1 to T2 (child/adolescent exposure to severe physical punishment, mother exposure to severe physical marital violence, maternal anxiety/depression); and T2 variables (maternal education, child/adolescent’s social support and pro-social activities).\ud \ud Results\ud Multivariate analysis identified two risk factors for child/adolescent MHP at T2: aggravation of child/adolescent physical punishment and aggravation of maternal anxiety/depression.\ud \ud Conclusions\ud The current study shows the importance of considering child/adolescent physical punishment and maternal anxiety/depression in intervention models and mental health care policies.We thank all study participants, professionals and employees from the health centre where data were collected, Embu Health Secretariat and Mental Health Coordination, and all research team members of the Brazilian Studies of Abuse in the Family Environment (BrazilSAFE) and it’s Follow-Up Study for the valuable collaboration.The study was financially supported by the São Paulo State Research Foundation (Fundação de Amparo à Pesquisa do Estado de São Paulo/FAPESP – Process no. 00/14555-4) in 2002/2003 and by Mackpesquisa of the Mackenzie Presbyterian University in 2007

Maternal recognition of child mental health problems in two Brazilian cities

Objective: To identify child behaviors and types of impairment that increase the likelihood of maternal recognition of emotional/behavioral problems (EBP) in children and adolescents. Methods: Maternal-reported data were obtained from two subsamples of 11-to-16-year-olds derived from cross-sectional studies conducted in two Brazilian municipalities: Itaboraí, state of Rio de Janeiro (n=480), and Embu, state of São Paulo (n=217). The Itaboraí study involved a representative sample of 6-to-16-year-olds (n=1,248; response rate = 86.0%) selected from the Family Health Program registry, which covered 85.5% of the municipal population. The Embu study was based on a probabilistic sample of clusters of eligible households (women aged 15-49 years, child < 18 years), with one mother-child pair selected randomly per household (n=813; response rate = 82.4%). The outcome variable was mother’s opinion of whether her child had EBP. Potential correlates included types of child behaviors (hyperactivity/conduct/emotional problems as isolated or combined conditions) and impairment, assessed using the Strengths and Difficulties Questionnaire (SDQ); child’s age and gender; maternal education and anxiety/depression (assessed using the Self-Reporting Questionnaire [SRQ]). Results: Multivariate regression models identified the following correlates of maternal perception of child EBP: comorbidity (co-occurring hyperactivity/conduct/emotional problems), emotional problems alone, and interference of problems with classroom learning and friendships. Conclusion: Comorbidity of different problem types, emotional problems alone, and interference with classroom learning and friendships increase the likelihood of maternal recognition of EBP in children

Influence of psychosocial risk factors on the trajectory of mental health problems from childhood to adolescence: a longitudinal study

Abstract Background Longitudinal epidemiological studies involving child/adolescent mental health problems are scarce in developing countries, particularly in regions characterized by adverse living conditions. We examined the influence of psychosocial factors on the trajectory of child/adolescent mental health problems (CAMHP) over time. Methods A population-based sample of 6- to 13-year-olds with CAMHP was followed-up from 2002–2003 (Time 1/T1) to 2007–2008 (Time 2/T2), with 86 out of 124 eligible children/adolescents at T1 being reassessed at T2 (sample loss: 30.6%). Outcome: CAMHP at T2 according to the Child Behavior Checklist/CBCL’s total problem scale. Psychosocial factors: T1 variables (child/adolescent’s age, family socioeconomic status); trajectory of variables from T1 to T2 (child/adolescent exposure to severe physical punishment, mother exposure to severe physical marital violence, maternal anxiety/depression); and T2 variables (maternal education, child/adolescent’s social support and pro-social activities). Results Multivariate analysis identified two risk factors for child/adolescent MHP at T2: aggravation of child/adolescent physical punishment and aggravation of maternal anxiety/depression. Conclusions The current study shows the importance of considering child/adolescent physical punishment and maternal anxiety/depression in intervention models and mental health care policies

Severe physical punishment: risk of mental health problems for poor urban children in Brazil

Objective To examine the relationship between specific types of child mental health problems and severe physical punishment, in combination with other important known risk factors.Methods We conducted a cross-sectional study in Embu, São Paulo, Brazil, as the Brazilian component of a multicountry survey on abuse in the family environment. From a probabilistic sample of clusters that included all eligible households (women aged 15-49 years with a son or daughter 7). Backward logistic regression analysis identified independent correlates and significant interactions.Findings Multivariate modelling showed that severe punishment wash an independent correlate of comorbid internalizing and externalizing problems but was not associated with internalizing problems only. It increased the risk of externalizing problems alone only for children and adolescents not exposed to maternal anxiety or depression. Maternal anxiety or depression increased the risk only for children or adolescents not exposed to severe punishment.Conclusion Severe punishment may be related to child mental health problems, with the mechanism depending on the type of problem. Its influence persists in the presence of family stressors such as the father's absence and maternal anxiety or depression.Universidade Federal de São Paulo, Escola Paulista Med, BR-04023061 São Paulo, BrazilColumbia Univ, New York State Psychiat Inst, New York, NY USAUniv Presbiteriana Mackenzie, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, BR-04023061 São Paulo, BrazilWeb of Scienc