Prevalência de transtornos mentais e fatores associados em crianças de 6 - 7 anos pertencentes à coorte de nascimentos de Pelotas de 2004

Abstract

Mental disorders represents an important cause of incapacity, dependence and suffering in population, affecting 20 to 30% adults all over the world. Environment, genetics, biological and behavioral determinants has been researched as their etiology. There is crescent evidence showing at least 50%of all mental disorders has beginnings in childhood and adolescence. The great majority of scientific studies on prevalence of mental disorders were conducted in high income countries, although 90% of world population under 18 years old lives in low to mid income countries. These thesis evaluated different psychiatric disorders prevalence in 3,585 (84.7% of 4,231 live births) 6 to 7 years old children belonging to the Pelotas Birth Cohort 2004 and analysed the presence of psychiatric comorbidities in those children, different diagnoses distribution according to sex and family income, afterwards trying to verify possible risk factors. Development and Well-being Assessment (DAWBA) applied by trained psychologists and supervised by a doctor degreed psychologist and a clinically experienced childhood psychiatrist was used to evaluate the presence of psychiatric disorder in cohort children. Around 13% of the children shown a psychiatric diagnosis according to DSMIV, there was a preponderance of anxiety disorders (8.8%), being most frequent among them: specific phobia (5.4%) and separation anxiety (3.2%). Behavior disorders were less frequent, 2.6% Attention Deficit Hyperactivity Disorder, 2.6% Oppositional Defiant Disorder/ Conduct Disorder combined. Also 1.3% of depressive disorders were found. Seventeen percent of the children presented more than one simultaneous psychiatric disorder. Boys shown a higher prevalence of psychiatric disorder than girls (14.7% versus 11.7%) and this difference was statistically significant (p=0.009). Lower income family children had greater probability of present psychiatric disorders, 1.6, 2.4 and 3.0 times greater chance of show respectively any psychiatric disorder, externalization disorders and Oppositional Defiant Disorder/ Conduct Disorder compared to children of richer families. Our findings confirmed those of high income countries and reinforce the necessity of early strategies to prevent mental disorders, specially in low income families, in addition to alert to the need to offer early childhood care services.