Early vulnerabilities for psychiatric disorders in elementary schoolchildren from four Brazilian regions

• Published in: Social Psychiatry and Psychiatric Epidemiology 2018-05, Vol.53 (5), p.477-486
• Main Authors: Paula, Cristiane S., Mari, Jair J., Bordin, Isabel Altenfelder Santos, Miguel, Euripedes C., Fortes, Isabela, Barroso, Natalia, Rohde, Luis Augusto, Coutinho, Evandro Silva Freire
• Format: Article
• Language: English
• Subjects: Adolescent; Anxiety; Anxiety - epidemiology; Anxiety - psychology; Brazil - epidemiology; Child; Child & adolescent psychiatry; Child abuse; Child Abuse - psychology; Child Abuse - statistics & numerical data; Child psychology; Child psychopathology; Children; Children & youth; Communities; Cross-Sectional Studies; Depression - epidemiology; Depression - psychology; Disease susceptibility; Elementary school students; Epidemiology; Female; Humans; Junior high school students; Logistic Models; Male; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Mental depression; Mental disorders; Mental Disorders - epidemiology; Mental Disorders - psychology; Mental health; Mothers; Original Paper; Poverty; Prevalence; Psychiatry; Regression models; Residence Characteristics - statistics & numerical data; Risk factors; Schools; Social Class; Students - psychology; Surveys and Questionnaires; Violence
• ISSN: 0933-7954; 1433-9285
• DOI: 10.1007/s00127-018-1503-4

Purpose The purpose of the study is to identify early vulnerabilities for psychiatric disorders among Brazilian elementary school children, controlling for familial and community adversities. Methods This is a cross-sectional study examining the association between child psychiatric disorders and potential early vulnerabilities (disability, low intellectual quotient, and negative dimensions of the temperament trait self-directedness (low resourcefulness, low purposefulness, low enlightened second nature), controlling for the potential confounders: familial and community adversities. Sample: Four probabilistic samples of second-to-sixth grade students from public schools in four towns from different Brazilian regions ( N  = 1620). The following instruments were applied: the K-SADS-PL (to assess child/adolescent psychiatric disorders); the Ten-Question Screen (to measure child disability); three structured questions used as proxy of self-directedness; and the reduced version of the WISC-III to measure IQ. To evaluate familial/community adversities: Self-Report Questionnaire—SRQ-20 (to assess maternal/primary caretaker anxiety/depression); questions derived from structured questionnaires (to measure child abuse, marital physical violence, neighborhood violence); Brazilian Association of Research Companies questionnaire (to evaluate poverty/socioeconomic status). Trained psychologists interviewed mothers/primary caretakers and evaluated children/adolescents individually. Results A final logistic regression model showed that children/adolescents with low resourcefulness, low purposefulness, low enlightened second nature, lower IQ and disability were more likely to present any child psychiatric disorders. Conclusion Early vulnerabilities such as low IQ, presence of disability, and dimensions of temperament were associated with psychiatric disorders among Brazilian elementary school children, after controlling for familial and ecological confounders. These early vulnerabilities should be considered in mental health prevention/intervention programs in low-middle-income countries like Brazil.