[Little recognition of mental problems in children by parents and family physicians]

To determine the prevalence of psychic problems in children in the Dutch GP-practice and to determine how often parents and general practitioners (GPs) recognize psychic problems in children.

Descriptive.

World Health Organisation Collaborating Centre for Primary Health Care (NIVEL) and Academic Hospital, Department of Child and Adolescent Psychiatry, Utrecht, the Netherlands.

In 810 children presence or absence of emotional and behavioural problems was studied by means of the Child Behaviour Checklist (CBCL) filled out by a parent at the moment of contact with a GP. The GPs findings in these were also recorded.

7.7% of all children obtained a total CBCL score indicating presence of emotional and behavioural problems (> P90). These children had problems at school, had repeated a school year, and followed special education more often. Nevertheless most of their parents (86%) did not experience problems with their children and 40% of the parents did not report any psychic problem in the preceding 2 weeks. Only 15% of these children were completely free of signs and symptoms, however, as against 40% of children with low scores. The percentages of children with high scores consulting a GP, social work or mental health care agency were somewhat higher than the percentages of children without these problems, but only the last-mentioned difference was significant. Children saw the GP rarely because of psychosocial problems (n = 7; less than 1%; 1 had a high CBCL score). Regardless of the presence of emotional and behavioural problems, as assessed by the CBCL, the GP seldom diagnosed psychological or social problems in children (n = 11; 1.4%; 2 had a high CBCL score) and rarely suspected the complaints had a psychosocial background.

Children with a high CBCL score did not visit their GPs more often. The perception by the parent appears to be crucial in the help-seeking process. In many children in whom the screening instrument indicated the presence of emotional and behavioural problems, parents did not consider their children as problematic and did not seek the help of a GP.