Objective To describe the psychometric properties of the Strengths and Difficulties Questionnaire (SDQ), a brief measure of the prosocial behavior and psychopathology of 3–16-year-olds that can be completed by parents, teachers, or youths. Method A nationwide epidemiological sample of 10,438 British 5–15-year-olds obtained SDQs from 96% of parents, 70% of teachers, and 91% of 11–15-year-olds. Blind to the SDQ findings, all subjects were also assigned DSM-IV diagnoses based on a clinical review of detailed interview measures. Results The predicted five-factor structure (emotional, conduct, hyperactivity-inattention, peer, prosocial) was confirmed. Internalizing and externalizing scales were relatively "uncontaminated" by one another. Reliability was generally satisfactory, whether judged by internal consistency (mean Cronbach α: .73), cross-informant correlation (mean: 0.34), or retest stability after 4 to 6 months (mean: 0.62). SDQ scores above the 90th percentile predicted a substantially raised probability of independently diagnosed psychiatric disorders (mean odds ratio: 15.7 for parent scales, 15.2 for teacher scales, 6.2 for youth scales). Conclusion The reliability and validity of the SDQ make it a useful brief measure of the adjustment and psychopathology of children and adolescents.

Psychometric properties of the strengths and difficulties questionnaire.

Results: Although 3-month prevalence of any disorder averaged 13.3% (95% confidence interval [CI], 11.7%15.0%), during the study period 36.7% of participants (31% of girls and 42% of boys) had at least 1 psychiatric disorder. Some disorders (social anxiety, panic, depression, and substance abuse) increased in prevalence, whereas others, including separation anxiety disorder and attention-deficit/hyperactivity disorder (ADHD), decreased. Lagged analyses showed that children with a history of psychiatric disorder were 3 times more likely than those with no previous disorder to have a diagnosis at any subsequent wave (odds ratio, 3.7; 95% CI, 2.94.9; P.001). Risk from a previous diagnosis was high among both girls and boys, but it was significantly higher among girls. Continuity of the same disorder (homotypic) was significant for all disorders except specific phobias. Continuity from one diagnosis to another (heterotypic) was significant from depression to anxiety and anxiety to depression, from ADHD to oppositional defiant disorder, and from anxiety and conduct disorder to substance abuse. Almost all the heterotypic continuity was seen in girls. Conclusions: The risk of having at least 1 psychiatric disorder by age 16 years is much higher than point estimates would suggest. Concurrent comorbidity and homotypic and heterotypic continuity are more marked in girls than in boys.

https://jamanetwork.com/journals/jamapsychiatry/articlepdf/207725/YOA20769.pdf

Prevalence and Development of Psychiatric Disorders in Childhood and Adolescence

https://www.ecnp.eu/~/media/Files/ecnp/communication/reports/ECNP%20EBC%20Report.pdf

The size and burden of mental disorders and other disorders of the brain in Europe 2010

Many people who would benefit from mental health services opt not to pursue them or fail to fully participate once they have begun. One of the reasons for this disconnect is stigma; namely, to avoid the label of mental illness and the harm it brings, people decide not to seek or fully participate in care. Stigma yields 2 kinds of harm that may impede treatment participation: It diminishes self-esteem and robs people of social opportunities. Given the existing literature in this area, recommendations are reviewed for ongoing research that will more comprehensively expand understanding of the stigma-care seeking link. Implications for the development of antistigma programs that might promote care seeking and participation are also reviewed.

/pdf/how-stigma-interferes-with-mental-health-care-35qwi45aiy.pdf

How stigma interferes with mental health care.

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(07)61238-0.pdf

No health without mental health.

Background Child psychiatric disorders are common and treatable, but often go undetected and therefore remain untreated.

Aims To assess the Strengths and Difficulties Questionnaire (SDQ) as a potential means for improving the detection of child psychiatric disorders in the community.

Method SDQ predictions and independent psychiatric diagnoses were compared in a community sample of 7984 5- to 15-year-olds from the 1999 British Child Mental Health Survey.

Results Multi-informant (parents, teachers, older children) SDQs identified individuals with a psychiatric diagnosis with a specificity of 94.6% (95% Cl 94.1-95.1%) and a sensitivity of 63.3% (59.7-66.9%). The questionnaires identified over 70% of individuals with conduct, hyperactivity, depressive and some anxiety disorders, but under 50% of individuals with specific phobias, separation anxiety and eating disorders. Sensitivity was substantially poorer with single-informant rather than multi-informant SDQs.

Conclusions Community screening programmes based on multi-informant SDQs could potentially increase the detection of child psychiatric disorders, thereby improving access to effective treatments.

/pdf/using-the-strengths-and-difficulties-questionnaire-sdq-to-hwusjdvmmv.pdf

Using the Strengths and Difficulties Questionnaire (SDQ) to screen for child psychiatric disorders in a community sample

The self-report version of the Strengths and Difficulties Questionnaire (SDQ) was administered to two samples of 11-16 year olds: 83 young people in the community and 116 young people attending a mental health clinic. The questionnaire discriminated satisfactorily between the two samples. For example, the clinic mean for the total difficulties score was 1.4 standard deviations above the community mean, with clinic cases being over six times more likely to have a score in the abnormal range. The correlations between self-report SDQ scores and teacher- or parent-rated SDQ scores compared favourably with the average cross-informant correlations in previous studies of a range of measures. The self-report SDQ appears promising and warrants further evaluation.

The strengths and difficulties questionnaire: A pilot study on the validity of the self-report version

The findings described in this report and summarized here focus on the prevalence of mental disorders among 5-15 year olds and on the associations between the presence of a mental disorder and biographic, sociodemographic, socio-economic, and social functioning characteristics of the child and the family. Causal relationships should not be assumed for any of the results presented in this report.

/pdf/mental-health-of-children-and-adolescents-in-great-britain-upsma4gj8c.pdf

Mental health of children and adolescents in Great Britain.

The self-report version of the Strengths and Difficulties Questionnaire (SDQ) was administered to two samples of 11-16 year olds: 83 young people in the community and 116 young people attending a mental health clinic. The questionnaire discriminated satisfactorily between the two samples. For example, the clinic mean for the total difficulties score was 1.4 standard deviations above the community mean, with clinic cases being over six times more likely to have a score in the abnormal range. The correlations between self-report SDQ scores and teacher--or parent rated SDQ scores--compared favourably with the average cross informant correlations in previous studies of a range of measures. The self-report SDQ appears promising and warrants further evaluation.

H Meltzer

Papers

Using the Strengths and Difficulties Questionnaire (SDQ) to screen for child psychiatric disorders in a community sample

The strengths and difficulties questionnaire: A pilot study on the validity of the self-report version

Mental health of children and adolescents in Great Britain.

The Strengths and Difficulties Questionnaire: a pilot study on the validity of the self-report version.

Mental Health of Children and Young People in Great Britain, 2004