Are children with unrecognised psychiatric disorders being excluded from school? A secondary analysis of the British Child and Adolescent Mental Health Surveys 2004 and 2007

BackgroundThere is limited research that explores the association between exclusion from school and mental health, but it seems intuitively plausible that the recognition of mental difficulties by key teachers and parents would influence the likelihood of exclusion from school.MethodsA secondary analysis of the British Child and Adolescent Mental Health survey 2004, (n = 7997) and the 2007 follow-up (n = 5326) was conducted. Recognition of difficulty was assessed via a derived variable that combined the first item of the Impact supplement of the Strengths and Difficulties Questionnaire which asked parents and teachers if they thought that the child has difficulties with emotions, behaviour and concentration, and the presence/absence of psychiatric disorder measured by the Development and Well-being Assessment.ResultsAdjusted logistic regression models demonstrated that children with recognised difficulties were more likely to be excluded [adjusted odds ratio (OR) 5.78, confidence interval 3.45–9.64, p < 0.001], but children with unrecognised difficulties [adjusted OR 3.58 (1.46–8.81) p < 0.005] or recognised subclinical difficulties [adjusted OR 3.42 (2.04–5.73) p < 0.001] were also more likely to be excluded than children with no difficulties. Children with conduct disorder and attention deficit hyperactivity disorder were most likely to be excluded compared with other types of disorder.ConclusionExclusion from school may result from a failure to provide timely and effective support rather than a failure to recognise psychopathology.

Strengths and difficulties questionnaire (SDQ): a study of school children in Ribeirão Preto

OBJECTIVE: The objective of this study is to investigate possible child psychiatric disorders using the strengths and difficulties questionnaire (SDQ). METHOD: SDQ is a questionnaire that screens child mental health problems, comprising a total of 25 items divided in five subscales: emotional problems, hyperactivity, relationship, conduct and pro-social behavior, with five items in each subscale. We also used the impact supplement that evaluates the impairment caused by symptoms. Out of 143 children randomly chosen from a public school of Ribeirão Preto, 107 questionnaires were correctly filled in by parents. Teachers received 114 questionnaires (regarding children with parents' consent), and 108 questionnaires were correctly filled in. As a final sample, we obtained 112 questionnaires answered by parents or teachers. RESULTS: In the questionnaires answered by the parents, we obtained high scorings such as 30.8% for emotional symptoms, 17,7% for conduct disorders, 16.8% for hyperactivity, 14% for interpersonal relationships, 18,7% for the total scores and 10.2% for the impact supplement. Questionnaires answered by the teachers had 1.83% for emotional symptoms, 8.25% for conduct disorders, 8.25% for hyperactivity, 2.75% for interpersonal relationships, 8.25% for the total scoring and 4.58% for the impact supplement. Combining the results obtained from parents and teachers we have diagnostic hypotheses in the frequencies of 7.14% for emotional disorders, 9.82% for conduct disorders, and 12.5% for psychiatric disorder not otherwise specified and no combination was noted between parents and teachers for hyperactivity. Mean age was 8.18 years, with 63% of the children being male and 37% female. CONCLUSION: SDQ can be useful for a preliminary screening in the investigation of possible psychiatric disorders in childhood.