Cristiane S Paula1,2, Jair J Mari3, Isabel Altenfelder Santos Bordin3, Euripedes C Miguel4, Isabela Fortes5,6, Natalia Barroso3, Luis Augusto Rohde7, Evandro Silva Freire Coutinho8. 1. Development Disorders Program, Mackenzie University, Rua da Consolação 930, Edifício 28, 01302-907, Sao Paulo, SP, Brazil. csilvestrep09@gmail.com. 2. Department of Psychiatry, Federal University of Sao Paulo (UNIFESP), Rua Borges Lagoa 570, 1° andar, 04023-061, Sao Paulo, SP, Brazil. csilvestrep09@gmail.com. 3. Department of Psychiatry, Federal University of Sao Paulo (UNIFESP), Rua Borges Lagoa 570, 1° andar, 04023-061, Sao Paulo, SP, Brazil. 4. Department of Psychiatry, University of Sao Paulo, Medical School (USP), Rua Dr. Ovídio Pires de Campos, 785, 1° andar, 05403-010, Sao Paulo, SP, Brazil. 5. National Institute of Developmental Psychiatry for Children and Adolescents, University of Sao Paulo, Medical School (USP), Sao Paulo, SP, Brazil. 6. Núcleo de Intervenção Precoce (NIP), Av. das Américas 1155, sala 2010, 22631-000, Rio de Janeiro, Brazil. 7. Department of Psychiatry, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, 4° andar, Rua Ramiro Barcelos 2350, 90035-003, Porto Alegre, Brazil. 8. Department of Epidemiology, Oswaldo Cruz Foundation, Fiocruz, Rua Leopoldo Bulões, 1480/8° andar, 21041-210, Rio de Janeiro, RJ, Brazil.
Abstract
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.
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 childpsychiatric 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 childpsychiatric 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.
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