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 (São 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.

中文翻译：

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巴西城市环境中儿童发展的流行病学研究

目标 精神疾病是一个重要的公共卫生问题，通常在生命早期就开始，尤其影响来自低收入和中等收入国家的儿童。我们的目标是： 1) 在巴西公立学前 4 至 5 岁儿童的代表性样本中，确定内化和外化障碍以及社会情感发育迟缓的流行率；2) 识别与精神、行为或发育障碍 (MBDD) 相关的可改变风险因素，例如微观系统（即亲子关系）、中系统（社会支持）和宏观系统背景因素（邻里劣势）。方法 在 Embu das Artes 市（圣保罗市区）（来自 30 所公立学前班的 n=1,292）招募了公立学龄前儿童的随机样本。使用儿童行为检查表 (CBCL) 和年龄和阶段问卷：社会情绪 (ASQ:SE) 测量 MBDD 的六个月患病率。结果 内化障碍的 6 个月患病率估计为 25.4%，外化障碍为 12.1%，社会情感发育迟缓为 30.3%。MBDD 患病率估计值在关系紧张、父母抑郁或焦虑的家庭以及社会资本较低的家庭中更高。结论 生活在巴西城市地区的学龄前儿童中至少有 25% 存在心理健康障碍。这些精神障碍与家庭关系紧张和社会资本较低等可变因素有关。需要采取家庭治疗等预防和干预措施来降低如此高的患病率。