Using the Strengths and Difficulties Questionnaire (SDQ) to screen for child psychiatric disorders in a community sample

TLDR

Child psychiatric disorders are common, treatable, yet frequently undetected and untreated. The study aimed to evaluate the Strengths and Difficulties Questionnaire (SDQ) as a tool to improve detection of child psychiatric disorders in the community. The authors compared SDQ predictions with independent psychiatric diagnoses in a community sample of 7,984 children aged 5–15 from the 1999 British Child Mental Health Survey. Multi‑informant SDQs achieved 94.6 % specificity and 63.3 % sensitivity, detecting over 70 % of conduct, hyperactivity, depressive, and some anxiety disorders but fewer than 50 % of specific phobias, separation anxiety, and eating disorders, with single‑informant sensitivity markedly lower, suggesting that community screening using multi‑informant SDQs could increase detection and improve treatment access.

Abstract

Child psychiatric disorders are common and treatable, but often go undetected and therefore remain untreated. To assess the Strengths and Difficulties Questionnaire (SDQ) as a potential means for improving the detection of child psychiatric disorders in the community, SDQ predictions and independent psychiatric diagnoses were compared in a community sample of 7984 5-15 year olds from the 1999 British Child Mental Health Survey. Multi-informant (parents, teachers, older children) SDQs identified individuals with a psychiatric diagnosis with a specificity of 94.6% (95% Cl, 94.1-95.1%) and a sensitivity of 63.3% (59.7-66.9%). The questionnaires identified over 70% of individuals with conduct, hyperactivity, depressive, and some anxiety disorders, but fewer than 50% of individuals with specific phobias, separation anxiety and eating disorders. Sensitivity was substantially poorer with single-informant rather than multi-informant SDQs. Community screening programmes based on multi-informant SDQs could potentially increase the detection of child psychiatric disorders, thereby improving access to effective treatments.