An epidemiological study of childhood development in an urban setting in Brazil

Abstract

Objective: Mental illness is an important public health concern, often starting early in life and particularly impacting children from low-and middle-income countries. Our aims were to 1) determine, in a representative sample of public preschool 4-to 5-year old children in Brazil, the prevalence of internalizing and externalizing disorders and socioemotional development delays; and 2) to identify modifiable risk factors associated with mental, behavioral, or developmental disorders (MBDD), such as microsystem (i.e., parent-child relationship), mesosystem (social support), and macrosystem contextual factors (neighborhood disadvantage). Methods: A random sample of public preschool children was recruited in the city of Embu das Artes (Sã o Paulo metropolitan area) (n=1,292 from 30 public preschools). Six-month prevalence of MBDD was measured using the Child Behavior Checklist (CBCL) and the Ages and Stages Questionnaires: Social-Emotional (ASQ:SE). Results: Six-month prevalence estimates were 25.4% for internalizing disorders, 12.1% for externalizing disorders, and 30.3% for socioemotional development delays. MBDD prevalence estimates were higher in families with stressful relationships and parental depression or anxiety, and in families with lower social capital. Conclusion: At least 25% of preschool children living in an urban area in Brazil presented a mental health disorder. These mental disorder were associated with modifiable factors such as stressful family relationships and lower social capital. Prevention and intervention measures such as family therapy are needed to decrease such high prevalence.

Subjective Well-being of Brazilian Children Over Time: Comparing Children’s Worlds 1st and 3rd Wave of 10 and 12-year-olds Samples

“…With the limitations on investments to conditional cash transfer programs, such as Bolsa Família , poverty levels have also been increasing (Leal et al, 2018 ). Changes in the investment in mental health should also be considered, once it is known that not only children with higher parental stress, parental psychopathology, and lower social capital tend to present more behavioral, developmental or mental health disorders (Caetano et al, 2021 ), but also that parents’ SWB might have an impact on their children’s (Bedin & Sarriera, 2014 ). The perils of these reductions are also the effects on community’s assistance programs that have been showing good results between 1990–2015, with major implications on public policies operationalized through Brazilian’s both Unified Health System (SUS) and Social Assistance Unified System (SUAS), with direct repercussions on family’s lives.…”

“…Lawler et al ( 2016 ) have also found family and peer relationships, school, and neighborhood quality to be strong predictors of SWB. Parental stress and psychopathology, as well as lower social capital also contributed to poorer outcomes in children’s mental health (Caetano et al, 2021 ). And, children from countries with more consistent family policies presented higher indexes of SWB, supporting the hypothesis of state level decisions and their impact on children’s lives (Mínguez, 2017 ).…”

“…Historically, Brazil faces strong challenges when it comes to guarantying children’s rights, that goes from child mortality, poverty, violence as disciplinary actions (Caetano et al, 2021 ), to economic crisis and unequal distribution of resources. As children from privileged backgrounds have access to means that are unavailable for vulnerable children, these differences are also relevant when it comes to child well-being.…”

“…The last decade in Brazil has also been of diminished investments in education (Arelaro, 2017) and the failure to provide rights has been evident. There were expressive changes in Brazilian children's contexts, such as alterations in the allocation of resources, changes on mortality rates and political policies (Caetano et al, 2021;Marinho et al, 2020), which could implicate in their relationship with families, friends and school, and therefore in children's well-being. Thus, we wish to broaden this perspective and evaluate the difference in children's well-being in a 7-year time range.…”

Effectiveness of the Elos 2.0 prevention programme for the reduction of problem behaviours and promotion of social skills in schoolchildren: study protocol for a cluster-randomized controlled trial

“…One fifth of children worldwide are affected by emotional and behavioural problems. The disease burden associated with these mental disorders includes the costs of their reduced chance of completing basic education, lack of social cohesion and reduced ability to cope with future adversities, which are also associated with negative outcomes later in life if no preventive measures are taken [1][2][3][4].…”