The Ilha de Mar� study: a survey of child mental health problems in a predominantly African-Brazilian rural community

Abstract

There have been very few Brazilian epidemiological surveys of child mental health problems. The only recent survey to have used internationally recognised measures and diagnostic criteria was carried out in Southeast Brazil in a relatively prosperous setting where the population was predominantly urban and white. The setting was an island community in Northeast Brazil that is rural, relatively poor and has a strong African heritage. In an initial phase, a simple random sample of 519 children aged 5-14 was assessed by screening questionnaires completed by parents, teachers and older children. In a second phase, a sub-sample of 100 children was selected for more detailed diagnostic assessments. Conduct and hyperactivity problems were commoner in boys; emotional symptoms were commoner in girls; and hyperactivity declined with age. By contrast with previously collected data from Southeast Brazil, there were more reported symptoms, but less resultant impact. Using a variety of indices, the rate of disorder on Ilha de Maré was around half that previously found in Southeast Brazil. The measures and diagnostic criteria that were employed appeared valid for use in Northeast Brazil, though there was evidence for consistent over-reporting of symptoms on the screening questionnaire. Rates of child mental health problems appear to differ substantially between sites, confirming the need for a multi-site Brazilian study of the prevalence of child psychiatric disorders.