European Child & Adolescent Psychiatry

, Volume 27, Issue 6, pp 785–795 | Cite as

Self-reported mental health in children ages 6–12 years across eight European countries

  • Mathilde M. HuskyEmail author
  • Anders Boyd
  • Adina Bitfoi
  • Mauro Giovanni Carta
  • Christine Chan-Chee
  • Dietmar Goelitz
  • Ceren Koç
  • Sigita Lesinskiene
  • Zlatka Mihova
  • Roy Otten
  • Ondine Pez
  • Taraneh Shojaei
  • Viviane Kovess-Masfety
Original Contribution


Worldwide, approximately one in eight children or adolescents suffers from a mental disorder. The present study was designed to determine the self-reported prevalence of mental health problems in children aged 6–11 years across eight European countries including Italy, France, Germany, the Netherlands, Lithuania, Bulgaria, Romania, and Turkey. Data were drawn from 6245 children participating in the School Children Mental Health in Europe (SCHME) study and a large cross-sectional survey in France. Self-reported child mental health was assessed using the Dominique Interactive (DI). Overall, 22.0% of children were identified per their own evaluation as having at least one mental disorder, ranging from 16.4% in the Netherlands to 27.9% in Bulgaria. The prevalence of internalizing disorders was 18.4% across countries and ranged from 11.8% in the Netherlands to 24.3% in Turkey. The prevalence of externalizing disorders was lower with an average of 7.8%, ranging from 3.5% in Turkey to 10.5% in Bulgaria. Combining samples across European countries, 1 in 5 children reported internalizing problems and 1 in 12 children externalizing problems. The net completion rates of 4.1–74.3% preclude conclusions about national differences in prevalence rates.


Child mental health Europe Prevalence Self-reported mental health 



This study was funded by the European Union, Grant number 2006336.

Compliance with ethical standards

Conflict of interest

On behalf of all the authors, the corresponding author states that there is no conflict of interest.

Supplementary material

787_2017_1073_MOESM1_ESM.docx (83 kb)
Supplementary material 1 (DOCX 83 kb)


  1. 1.
    Goodman A, Heiervang E, Fleitlich-Bilyk B, Alyahri A, Patel V, Mullick MI et al (2012) Cross-national differences in questionnaires do not necessarily reflect comparable differences in disorder prevalence. Soc Psychiatry Psychiatr Epidemiol 47(8):1321–1331. CrossRefPubMedGoogle Scholar
  2. 2.
    Achenbach TM, Rescorla LA, Ivanova MY (2012) International epidemiology of child and adolescent psychopathology I: diagnoses, dimensions, and conceptual issues. J Am Acad Child Adolesc Psychiatry 51(12):1261–1272CrossRefPubMedGoogle Scholar
  3. 3.
    Achenbach TM, Edelbrock CS (1983) Manual for the child behavior checklist: and revised child behavior profile. University of Vermont, Department of Psychiatry, Burlington, VTGoogle Scholar
  4. 4.
    Crijnen AA, Achenbach TM, Verhulst FC (1997) Comparisons of problems reported by parents of children in 12 cultures: total problems, externalizing, and internalizing. J Am Acad Child Adolesc Psychiatry 36(9):1269–1277CrossRefPubMedGoogle Scholar
  5. 5.
    Rescorla L, Achenbach T, Ivanova MY, Dumenci L, Almqvist F, Bilenberg N et al (2007) Behavioral and emotional problems reported by parents of children ages 6 to 16 in 31 societies. J Emot Behav Disor 15(3):130–142CrossRefGoogle Scholar
  6. 6.
    Merikangas KR, Nakamura EF, Kessler RC (2009) Epidemiology of mental disorders in children and adolescents. Dialogues Clin Neurosci. 11(1):7PubMedPubMedCentralGoogle Scholar
  7. 7.
    Maughan B, Collishaw S, Meltzer H, Goodman R (2008) Recent trends in UK child and adolescent mental health. Soc Psychiatry Psychiatr Epidemiol 43(4):305–310CrossRefPubMedGoogle Scholar
  8. 8.
    Kovess-Masfety V, Husky MM, Keyes K, Hamilton A, Pez O, Bitfoi A et al (2016) Comparing the prevalence of mental health problems in children 6–11 across Europe. Soc Psychiatry Psychiatr Epidemiol 51(8):1093–1103. CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Vostanis P, Graves A, Meltzer H, Goodman R, Jenkins R, Brugha T (2006) Relationship between parental psychopathology, parenting strategies and child mental health. Soc Psychiatry Psychiatr Epidemiol 41(7):509–514CrossRefPubMedGoogle Scholar
  10. 10.
    Bird HR, Gould MS, Staghezza B (1992) Aggregating data from multiple informants in child psychiatry epidemiological research. J Am Acad Child Adolesc Psychiatry 31(1):78–85CrossRefPubMedGoogle Scholar
  11. 11.
    Achenbach TM, McConaughy SH, Howell CT (1987) Child/adolescent behavioral and emotional problems: implications of cross-informant correlations for situational specificity. Psychol Bull 101(2):213CrossRefPubMedGoogle Scholar
  12. 12.
    Jensen P, Rubio-Stipec E, Canono G, Bird H, Dulcan M, Schwab-Stone M et al (1999) Parent and child contributions to diagnosis mental disorder: are both informants always necessary? J Am Acad Child Adolesc Psychiatry 38:1569–1579CrossRefPubMedGoogle Scholar
  13. 13.
    Salbach-Andrae H, Klinkowski N, Lenz K, Lehmkuhl U (2009) Agreement between youth-reported and parent-reported psychopathology in a referred sample. Eur Child Adolesc Psychiatry 18(3):136–143CrossRefPubMedGoogle Scholar
  14. 14.
    Grills AE, Ollendick TH (2003) Multiple informant agreement and the anxiety disorders interview schedule for parents and children. J Am Acad Child Adolesc Psychiatry 42(1):30–40CrossRefPubMedGoogle Scholar
  15. 15.
    Rothen S, Vandeleur CL, Lustenberger Y, Jeanprêtre N, Ayer E, Gamma F et al (2009) Parent–child agreement and prevalence estimates of diagnoses in childhood: direct interview versus family history method. Int J Methods psychiatric Res 18(2):96–109CrossRefGoogle Scholar
  16. 16.
    Van der Meer M, Dixon A, Rose D (2008) Parent and child agreement on reports of problem behaviour obtained from a screening questionnaire, the SDQ. Eur Child Adolesc Psychiatry 17(8):491–497CrossRefPubMedGoogle Scholar
  17. 17.
    Canning EH (1994) Mental disorders in chronically ill children: case identification and parent-child discrepancy. Psychosom Med 56(2):104–108CrossRefPubMedGoogle Scholar
  18. 18.
    De Los Reyes A, Kazdin AE (2005) Informant discrepancies in the assessment of childhood psychopathology: a critical review, theoretical framework, and recommendations for further study. Psychol Bull 131(4):483CrossRefGoogle Scholar
  19. 19.
    Salbach-Andrae H, Lenz K, Lehmkuhl U (2009) Patterns of agreement among parent, teacher and youth ratings in a referred sample. Euro Psychiatry. 24(5):345–351CrossRefGoogle Scholar
  20. 20.
    Sourander A, Helstelä L, Helenius H (1999) Parent-adolescent agreement on emotional and behavioral problems. Soc Psychiatry Psychiatr Epidemiol 34(12):657–663CrossRefPubMedGoogle Scholar
  21. 21.
    Ialongo NS, Edelsohn G, Kellam SG (2001) A further look at the prognostic power of young children’s reports of depressed mood and feelings. Child Dev 72(3):736–747CrossRefPubMedGoogle Scholar
  22. 22.
    Warren SL, Dadson N (2001) Assessment of anxiety in young children. Curr Opin Pediatr 13(6):580–585CrossRefPubMedGoogle Scholar
  23. 23.
    Rebok G, Riley A, Forrest C, Starfield B, Green B, Robertson J et al (2001) Elementary school-aged children’s reports of their health: a cognitive interviewing study. Qual Life Res 10(1):59–70CrossRefPubMedGoogle Scholar
  24. 24.
    Mishara BL (1999) Conceptions of death and suicide in children ages 6–12 and their implications for suicide prevention. Suicide Life Threat Behav 29(2):105–118PubMedGoogle Scholar
  25. 25.
    Valla JP, Bergeron L, Berube H, Gaudet N, St-Georges M (1994) A structured pictorial questionnaire to assess DSM-III-R-based diagnoses in children (6–11 years): development, validity, and reliability. J Abnorm Child Psychol 22(4):403–423CrossRefPubMedGoogle Scholar
  26. 26.
    Valla JP, Bergeron L, Bidaut-Russell M, St-Georges M, Gaudet N (1997) Reliability of the Dominic-R: a young child mental health questionnaire combining visual and auditory stimuli. J Child Psychol Psychiatry 38(6):717–724CrossRefPubMedGoogle Scholar
  27. 27.
    Valla JP, Bergeron L, Smolla N (2000) The Dominic-R: a pictorial interview for 6- to 11-year-old children. J Am Acad Child Adolesc Psychiatry 39(1):85–93. CrossRefPubMedGoogle Scholar
  28. 28.
    Goodman R (1997) The strengths and difficulties questionnaire: a research note. J Child Psychol Psychiatry 38(5):581–586CrossRefPubMedGoogle Scholar
  29. 29.
    Husky MM, Keyes K, Hamilton A, Stragalinou A, Pez O, Kuijpers R et al (2017) Maternal Problem Drinking and Child Mental Health. Subst Use Misuse 1–9. doi: 10.1080/10826084.2017.1312448
  30. 30.
    Kovess-Masfety V, Lesinskiene S, Husky MM, Boyd A, Ha P, Fermanian C et al (2017) Risk factors for child mental health problems in Lithuania: the role of parental nationality. Compr Psychiatry 73:15–22CrossRefPubMedGoogle Scholar
  31. 31.
    Kuijpers RC, Otten R, Vermulst AA, Pez O, Bitfoi A, Carta M et al (2015) Reliability, factor structure, and measurement invariance of the Dominic Interactive across European Countries: cross-country utility of a child mental health self-report. Psychol Assess. PubMedPubMedCentralCrossRefGoogle Scholar
  32. 32.
    Kovess V, Carta MG, Pez O, Bitfoi A, Koç C, Goelitz D et al (2015) The School Children Mental Health in Europe (SCMHE) Project: design and first results. Clin Pract Epidemiol Ment Health. 11(7):113–123. CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Shojaei T, Wazana A, Pitrou I, Kovess V (2009) The strengths and difficulties questionnaire: validation study in French school-aged children and cross-cultural comparisons. Soc Psychiatry Psychiatr Epidemiol 44(9):740–747CrossRefPubMedGoogle Scholar
  34. 34.
    Shojaei T, Wazana A, Pitrou I, Gilbert F, Bergeron L, Valla JP et al (2009) Psychometric properties of the Dominic Interactive in a large French sample. Can J Psychiatry Revue 54(11):767–776 (Canadienne de psychiatrie.) CrossRefGoogle Scholar
  35. 35.
    Kuijpers R, Otten R, Vermulst A, Pez O, Bitfoi A, Carta M et al (2014) Cross-country construct validity of the ‘Dominic Interactive’. Eur J Public Health 24(suppl 2):046Google Scholar
  36. 36.
    Ware JE, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30(6):473–483CrossRefPubMedGoogle Scholar
  37. 37.
    Kovess V (2004) The state of mental health in the European Union. European Commission, LuxemburgGoogle Scholar
  38. 38.
    Treutler CM, Epkins CC (2003) Are discrepancies among child, mother, and father reports on children’s behavior related to parents’ psychological symptoms and aspects of parent–child relationships? J Abnorm Child Psychol 31(1):13–27CrossRefPubMedGoogle Scholar
  39. 39.
    Van der Toorn SL, Huizink AC, Utens EM, Verhulst FC, Ormel J, Ferdinand RF (2010) Maternal depressive symptoms, and not anxiety symptoms, are associated with positive mother–child reporting discrepancies of internalizing problems in children: a report on the TRAILS Study. Eur Child Adolesc Psychiatry 19(4):379–388CrossRefPubMedGoogle Scholar
  40. 40.
    Vander Stoep A, Mccauley E, Thompson KA, Herting JR, Kuo ES, Stewart DG et al (2005) Universal emotional health screening at the middle school transition. J Emot Behav Disord 13(4):213–223CrossRefGoogle Scholar
  41. 41.
    Mojtabai R, Olfson M (2008) Parental detection of youth’s self-harm behavior. Suicide Life Threat Behav 38:60–72CrossRefPubMedGoogle Scholar
  42. 42.
    Velez CN, Cohen P (1988) Suicidal behavior and ideation in a community sample of children: maternal and youth reports. J Am Acad Child Adolesc Psychiatry 27:349–356CrossRefPubMedGoogle Scholar
  43. 43.
    Brauner CB, Stephens CB (2006) Estimating the prevalence of early childhood serious emotional/behavioral disorders: challenges and recommendations. Public Health Rep 121(3):303–310CrossRefPubMedPubMedCentralGoogle Scholar
  44. 44.
    Polanczyk GV, Salum GA, Sugaya LS, Caye A, Rohde LA (2015) Annual research review: a meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. J Child Psychol Psychiatry 56(3):345–365CrossRefPubMedGoogle Scholar
  45. 45.
    Nolen-Hoeksema S, Girgus JS (1994) The emergence of gender differences in depression during adolescence. Psychol Bull 115:424–443CrossRefPubMedGoogle Scholar
  46. 46.
    Kovess-Masfety V, Van Engelen J, Stone L, Otten R, Carta MG, Bitfoi A et al (2017) Unmet need for specialty mental health services among children across Europe. Psychiatric Serv 68(8):789–795CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  • Mathilde M. Husky
    • 1
    Email author
  • Anders Boyd
    • 2
  • Adina Bitfoi
    • 3
  • Mauro Giovanni Carta
    • 4
  • Christine Chan-Chee
    • 5
  • Dietmar Goelitz
    • 6
  • Ceren Koç
    • 7
  • Sigita Lesinskiene
    • 8
  • Zlatka Mihova
    • 9
  • Roy Otten
    • 10
  • Ondine Pez
    • 11
  • Taraneh Shojaei
    • 12
  • Viviane Kovess-Masfety
    • 11
    • 13
  1. 1.Department of Psychology EA4139, Institut Universitaire de FranceUniversity of BordeauxBordeauxFrance
  2. 2.INSERM, UMR_S1136, Institut Pierre Louis d’Epidémiologie et de Santé PubliqueParisFrance
  3. 3.The Romanian League for Mental HealthBucharestRomania
  4. 4.Centro di Psichiatria di Consulenza e Psicosomatica Azienda OspedalieroUniversitaria di CagliariCagliariItaly
  5. 5.Mental Health Programme, Department of Chronic Disease and TraumaInstitut de Veille SanitaireParisFrance
  6. 6.Institute of PsychologyUniversity of Koblenz-Landau (Campus Koblenz)KoblenzGermany
  7. 7.Yeniden Health and Education SocietyIstanbulTurkey
  8. 8.Clinic of Psychiatry, Faculty of MedicineUniversity of VilniusVilniusLithuania
  9. 9.New Bulgarian UniversitySofiaBulgaria
  10. 10.Behavioural Science InstituteRadboud University Nijmegen, Pluryn, Research and DevelopmentNijmegenThe Netherlands
  11. 11.EHESP RennesSorbonne Paris CiteParisFrance
  12. 12.Screening and Prevention Bureau, SDS/DASESParisFrance
  13. 13.EA 4057Paris Descartes University, Sorbonne Paris CiteParisFrance

Personalised recommendations