Prevalence of emotional and behavioural problems among primary school children in Karachi, Pakistan--multi informant survey.

OBJECTIVE To determine emotional and behavioural problem among school going children in Pakistan. METHODS A cross sectional survey of school children of certain towns within Karachi metropolitan area, aged 5 to 11 years during 1(st) half of 2006. SDQ was filled out by parents and school teachers for the same children. Demographic data of parents, teachers and children were also collected using a separate performa. RESULTS 7 private and 8 community schools agreed to participate. 1488 consent forms were sent to 700 parents of private school and 788 parents of community school children. A total of 675 parents agreed to participate in the study. The response rate was 45.3%. Assessment of children's mental health was conducted using Strength and Difficulties Questionnaire (SDQ). Parents rated 34.4% of children as falling under the "abnormal category on SDQ, slightly higher estimates 35.8% were reported by the teacher. The findings suggest a striking difference between the informants' ratings as well as gender wise difference in prevalence of common child mental health problems. CONCLUSION In the present study prevalence of child mental health problems was higher than reported in studies from other countries. There was also a gender difference in prevalence; boys had higher estimates of behavior/externalizing problems, whereas emotional problems were more common amongst females. There is a need for developing programs to train, sensitise and mobilize teachers and parents regarding child's psychological, emotional and behavioral problems.