Child health surveillance for psychiatric disorder: Practical guidelines

Abstract

Children who have a psychiatric disorder are often seen as difficult rather than disturbed and the significance of the emotion or the behaviour may easily be missed. The distinction between 'normal' and pathological behaviour is important because reassurance is appropriate in the first case and dangerous in the latter. A psychiatric disorder can be classified as a change in behaviour, emotions, or thought processes (the three main aspects of mental functioning), which is so prolonged and/or so severe that it interferes with everyday life and is a handicap for the child or those who care for the child. The child's stage of development and the sociocultural context in which the disorder occurs must also be taken into account (table 1). Rarely, a child's mental state may be so bizarre or extreme that it only has to occur once to be regarded as abnormal. Deliberate self injury, delusions, or hallucinations are good examples of this. Child psychiatric disorder, as defined above, has a one year prevalence rate of roughly 10% in the general population, which is much the same as it is for adults. This rate is influenced by a number of risk and protective factors.