Common mental health problems in childhood and adolescence: the broad and varied landscape

Approximately one in 10 children is affected by mental health problems at any time (Ford et al. 2003). These high rates of problems emerge across high-income, and increasingly lowand middle-income, countries (Cortina et al. 2008). The range of mental health problems is broad, and varies with developmental changes through infancy, childhood and adolescence. The commoner disorders in childhood and adolescence include conduct disorder, attention deficit hyperactivity disorder (ADHD), autistic spectrum disorders, depression and the range of anxiety disorders (Green et al. 2005). The National Service Framework for Children, Young People and Maternity Services emphasized that the mental health of the next generation was ‘everybody’s business’ (Department of Health 2004). This approach is critical as child mental health problems can lead to contact with all the major public services, and particularly health professionals, such as paediatricians (Ford et al. 2007; Marcer et al. 2008). It is therefore essential that all professionals working with children and young people have basic skills in the identification and management of minor difficulties, and knowledge about how to access more specialized services for the children that they are unable to manage themselves. We are therefore delighted to introduce this special issue of Child: care, health and development devoted to mental health. The papers in this special issue span the age range from infancy to adolescence and incorporate many different types of research methodology including a cluster randomized controlled trial, several surveys and the use of focus groups to develop a questionnaire through to a review of parent training as an effective intervention for ADHD among pre-school children (Daley et al. 2009). For those interested in other factors influencing development in the pre-school years, Barnes and her colleagues (Barnes et al. 2009) report a cluster randomized trial of volunteer visiting for vulnerable mothers to try to prevent depression, which is known to be a risk factor for a range of later adverse outcomes, including mental health problems and cognitive and language delay (Goodman & Gotlib 1999; Stein et al. 2008). In theory, vulnerable families might be more willing to accept a volunteer visitor than a professional, although the effectiveness of professional home visiting in improving child outcomes has been demonstrated (Olds et al. 2002). In addition, Hwang and colleagues (2009) examine the influence and possible interaction of biological risk and temperament on pre-school development of babies born at term and pre-term in a small Taiwanese cohort. Two studies examine fear in school age children. Meltzer and colleagues (2009) examine the prevalence of specific fears (rather than phobias) among school-age children in the 2004 British Child and Adolescent Mental Health Survey (Green et al. 2005). To be diagnosed as a phobia, a fear must be out of proportion to the perceived threat and associated with significant impairment (ICD 10, World Health Organization 1993); however, fears below this threshold are common (Ollendick et al. 2002) and, as Meltzer and colleagues argue, can also significantly interfere with daily activities and family life. This highlights the fact that many childhood (and adulthood) mental health difficulties are normally distributed within the population, and thus any cut point between ‘disorder’ and ‘no disorder’ is necessarily somewhat arbitrary. There is growing evidence that risk for dysfunction and for development is not confined to those at the higher end of the psychopathology dimension, particularly in the case of challenging behaviour (Fergusson et al. 2005; Goodman & Goodman 2009). Many societies are intermittently preoccupied with children’s exposure to television and the effects it may have on their health and development. It is something that also concerns many parents, and yet good informative research can be hard to come by. Paavonen and colleagues (2009) report an investigation Child: care, health and development Editorial doi:10.1111/j.1365-2214.2009.01022.x