• Vol. 30 No. 2, 155–163
  • 15 March 2001

Behavioural Disorders in Childhood: A Singapore Perspective

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ABSTRACT

Introduction: Behaviour disturbances in preadolescent children are common, ranging from mild disturbances to full disorders meeting official nosological criterion. The objective of this paper was to review behavioural disorders occurring in the preadolescent child using up-to-date published data supplemented by available local published data on the subject.

Methods: Recent reviews of the various psychological disorders in childhood that have a significant behavioural component were identified through a MEDLINE search (from 1990). Information from these reviews was supplemented with relevant local studies cited on MEDLINE from 1990. Information on common behavioural disturbances facing parents locally was obtained from questions submitted to the author over a 3-year period by a local parenting magazine. A search was also conducted on the DOW JONES publications archives for relevant information from the local news media.

Results: The perception of a problem may arise from the child, family, school, community or society’s perspective. Behavioural problems can be conceptualised to exist in the following broad categories: Behaviour problems/disorders related to daily physiological activities; disruptive behavioural problems and disorders; pervasive developmental disorders and disorders of social behaviour; behaviour problems related to emotional disorders; and behaviour problems associated with other mental conditions in children. Family, behavioural and multisystemic interventions are the commonest non-drug interventions. Drug use is on the increase, especially in disruptive, affective and anxiety disorders.

Conclusions: Behavioural disorders in children are common. They are often under-recognised and under-treated. Improved recognition demands that a good assessment is being carried out and a heightened index of suspicion for the commoner behavioural disorders. Adopting an evidence-based medicine approach and utilising recent advances in psychopharmacology and psychotherapy may improve outcome.


A review of five Western epidemiological studies of children aged 6 to 11 years revealed an average prevalence of 25% for psychiatric disorder (ranging from 12.4% to 48%). Asian studies show a similar prevalence range, with a 6.1% prevalence in a Malaysian study of 1- to 15-year-old children, a 8.3% prevalence for a cohort of 7- to 14-year-old children in Beijing, a 16.3% rate in primary school age children from Hong Kong, to a 49.1% rate in a cohort of 8-year-old Japanese children.

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