The Strengths and Difficulties Questionnaire is a usable way to address mental health at well-child visits in general practice - a qualitative study of feasibility

Abstract

Background: Mental health problems is frequent among children and psychopathology in early childhood seems to predict mental disorders in adulthood. All Danish children are offered seven free well-child visits at their General Practitioner (GP) during their first 5 years of life. GPs have a unique position to address mental health problems at the well-child visits, but they lack a systematic approach when assessing children's mental health. The purpose of this study was to investigate if the Strengths and Difficulties Questionnaire (SDQ) is a usable way to address preschool children's mental health in general practice. Methods: A qualitative study of feasibility. Parents completed an online version of the SDQ at home. At the wellchild visit, the GP used the SDQ results as a basis for a talk about the child's mental health. Afterwards the author JS conducted semistructured interviews with both the parent and the GP over the phone. The interviews were descriptively analyzed using the Framework Approach. Results: Five primary care centres with 22 general practitioners in both Copenhagen and Region Zealand participated. Twenty four parents completed the SDQ and were interviewed. Participating parents and GPs agreed, that the SDQ introduced mental health as a natural and important part of the well-child visit. Online access had clear advantages: time for reflection at home and preparation, plus a clear result summary for the GP. Some of the GPs were worried that the questionnaire would be too time consuming, and might compromise the individualistic style of general practice. Some parents were worried if children with minor problems would be diagnosed. Conclusions: The online SDQ was well-accepted and feasible in daily practice. Implementing the SDQ into the well-child visit could strengthen the focus on the child's mental health. However, before the SDQ can be generally implemented a guideline on how to utilize it in the well-child visit is needed, as well as studies of efficacy in this setting. Trial registration: Not relevant.

Self-reported mental health in adolescents attending school and its association with later school dropout: A prospective 2.5-year follow-up study

“…Among markers of child and adolescent mental health, the Strength and Difficulties Questionnaire (SDQ) is a widely used self-report general psychiatric assessment and screening tool, applied formerly in both community and clinical samples of adolescents [11–13]. In a Danish setting, the SDQ is considered valuable in the primary sector when screening for childhood and adolescent mental disorders [14]. In adolescents, SDQ scores are associated with symptoms of depression and anxiety [15].…”

Psycho-Emotional and Behavioral Problems in Children With Growth Hormone Deficiency

“…The research methods include robust testing with a previously well-described set of instruments. The main focus of this study is based on the SDQ, which was developed primarily as a screening tool for behavioral and emotional problems in children and adolescents, but increasingly being used for assessment of psychosocial problems in the clinical setting (17)(18)(19). The bifactor SDQ models of externalizing and internalizing disorders have recently obtained more attention (6,19).…”

Psychosocial Impact of Electrical Burn in Children: A Follow-Up Study Conducted at a Tertiary Care Hospital

“…The SDQ is sensitive to change over a short period of time and is a widely used instrument in research related to mental health. Though not a diagnostic tool, SDQ efficiently measures in which areas of life, a child is facing difficulty and also appropriately gauges the impact of any such difficulty in everyday life [ 6 ]…”

“…The SDQ is sensitive to change over a short period of time and is a widely used instrument in research related to mental health. Though not a diagnostic tool, SDQ efficiently measures in which areas of life, a child is facing difficulty and also appropriately gauges the impact of any such difficulty in everyday life [6] The SDQ covers 25 attributes grouped into five subscales: 1) emotional symptoms (for example "I am often unhappy, downhearted, or tearful"), 2) conduct problems (for example, "I fight a lot"), 3) hyperactivity problems (for example, "I think before I do things"), 4) peer problems (for example, "I have one good friend or more"), and 5) prosocial behavior (for example "I try to be nice to other people") [7] Psychometric properties of the SDQ have been assessed in a representative sample of 10,000 children aged 5 to 15 years, all of whom also had psychiatric assessments. Findings confirmed and extended previous reports of satisfactory reliability and validity.…”