Portuguese preschool study links mental health difficulties with socioeconomic and family circumstances

A cross-sectional study of 453 preschool children recruited through Lisbon-area primary care centres found that 23.6% had borderline or abnormal parent-reported mental health difficulty scores. Income, family arrangements and lack of sports participation were associated with higher adjusted odds, while immigrant background showed no clear independent association.

Borderline or abnormal SDQ scores occurred in 23.6% of children.
No sports participation was associated with higher adjusted odds.
Immigrant background showed no clear independent association after adjustment.
Cross-sectional findings cannot establish causality or preventive benefits.

Researchers analysed baseline data from children recruited through primary health care centres in Portugal’s Lisbon Metropolitan Area between May 2022 and December 2024. Of 760 participants, 453 children aged ≥4 years had valid parent-reported Strengths and Difficulties Questionnaire (SDQ) Total Difficulties scores. The cross-sectional study defined mental health difficulties as borderline or abnormal scores (≥14); adjusted analyses included 417 children with complete data.

Overall, 23.6% met this threshold. Adjusted odds were higher for monthly household income >€750–€1,500 versus >€1,500 (aOR 2.10, 95% CI 1.13–3.90), extended or other family arrangements versus nuclear households (1.82, 1.02–3.26), and no sports participation (2.80, 1.59–4.94).

Children with an immigrant background—defined as the child or at least one parent born outside the European Union—more often had abnormal peer relationship scores (12.5% versus 5.7%). However, immigrant background had no clear independent association with overall difficulties after adjustment (aOR 1.09, 95% CI 0.66–1.79). Analysis of the full SDQ score supported the sports participation association, but income and family-structure estimates were less conclusive.

The findings support considering economic circumstances, family context and daily routines when identifying support needs in primary care. Parent-reported SDQ thresholds are not clinical diagnoses, and this regional, cross-sectional analysis cannot establish causality or show that sports participation prevents mental health difficulties.

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Source

BMC Public Health: Early mental health inequalities among preschool children in Portugal: a cross-sectional study of social, family and health behaviour correlates ↗

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