Search

The objective of this study was to evaluate associations between sleep problems and psychiatric symptoms at school. A random sample consisting of 5813 eight- to nine-year-old children was selected from ordinary schools. Both parents' and children's reports of sleep problems were taken into account. The psychiatric symptoms were addressed according to the teachers' reports (the Rutter Scale B). Children with severe sleep problems were more likely to have a psychiatric disturbance according to the Rutter B Scale (OR 2.45, 95 % CI 1.85–3.25). Logistic regression models showed that severe sleep problems were highly associated with emotional problems (OR 2.74, 95 % CI 1.84–4.13), school attendance problems (OR 2.53, 95 % OR 1.45–4.41), behavioural problems (OR 2.44, 95 % CI 1.59–3.75) and hyperactivity (OR 2.02, 95 % CI 1.30–3.13). Over 95 % of severe sleep problems were reported only by the children themselves. In conclusion, children with severe sleep problems have substantially more teacher-reported psychiatric symptoms than those with no or mild sleep complaints. In diagnosing sleep disorders, it is important to include children as informants because relevant information may be overlooked when only parents are questioned.

We present epidemiological data from a multi-centre study on psychiatric symptoms among 6017 8-9-year-old children representing a total annual birth cohort (N = 60007) in Finland. The results are based on three questionnaires: the Rutter Parent Scale (RA2), the Rutter Teacher Scale (RB2), the Children's Depression Inventory (CDI). The proportion of children that scored above the cutoff points, indicating probable psychiatric disturbance, were 11.2% for the RA2, 13.9% for the RB2 and 6.9% for the CDI. Twenty-four percent of the subjects scored above the cutoff point on at least one of the questionnaires. Low family social status and disrupted family relations correlated strongly with high rates of symptoms in the children.

Using three questionnaires, the Rutter Parent Questionnaire (RA2), The Rutter Teacher Questionnaire (RB2) and the Children's Depression Inventory (CDI), we screened 8-9-year-old children representing a total annual birth cohort (N = 60007) in Finland. In a second stage we interviewed the parents of 119 screen negative, and 316 screen positive children by using a structured parent interview. At the population level the overall prevalence rate for psychiatric disturbance was 21.8%, higher among boys (29.8%) than among girls (12.8%). Nine percent of the children were in urgent need of treatment and, in addition, 25% were in need of assessment. The prevalence of different levels of disturbance was: reactive 9.5%; neurotic 18.4%; borderline 3.1%; and other severe disorders 2.3%. The prevalence of different diagnostic groups were: anxiety disorder 5.2%; depressive disorder 6.2%; specific fears 2.4%; defiant and conduct disorder 4.7%; and attention-deficit hyperactivity-disorder 7.1%. The prevalence for the most common single first Axis-I DSM-III-R diagnoses were: attention-deficit hyperactivity-disorder 7%; dysthymia 4.6%; adjustment disorder with mixed disturbance of emotion and conduct 3.4%; oppositional defiant disorder 2.7%; specific fear 1.7%; anxiety disorder 1.5%; enuresis nocturnal 1.5%; and depression 1.4%. Only 3.1% of the children had visited health professionals for psychiatric problems during the previous three months. Only a minority of the children with psychiatric disturbances had ever consulted health professionals for their problems. Of all the children, 7.5% had a severe psychiatric disturbance that had lasted for more than 3 years.