Assessment of Mental Health Problems of School Children Using Self Report Strengths and Difficulties Questionnaire

Keywords: Emotion, Mental health, Peer problem, School children, Strength Difficulty Questionnaire


Introduction: Psychological disorders among children and adolescents are the least discussed health problems in pediatrics. There is limited data on the prevalence of mental health problems among adolescents in low-income countries like Nepal. This study intended to find the prevalence of mental health problems among school children in a secondary school in western Nepal. Methods: In this descriptive cross-sectional study, students of grades six to eleven of two private schools of a district in Nepal were randomly selected. The self-rated version of Goodman’s Strength and Difficulty Questionnaire were used to assess mental health problem in these adolescents. Outcomes were measured in a scale of zero to 10 for each of emotional, conduct, hyperactivity, peer problem and pro-social behavior. Difficulty scale and its impact on life were also measured. Results: Out of 902 students, 5% (n=49) had significant and 14% (n=127) had probable mental health problem. Peer problems was the commonest (25%) followed by emotional (15%) and conduct problem (15%) and hyperactivity and pro-social problems were seen in 7% each. Boys had more mental health problem than girls except emotional problem. Mental health problem was more common in lower grade or younger age students. Its impact on life were 0-7.4%. Abnormal internalizing and externalizing problems were reported in 20% and 11% respectively. Conclusion: Mental health problem was prevalent (5 to 25%) in secondary school children. Screening school children for the same would be beneficial for early diagnosis.


Download data is not yet available.

Author Biographies

Uma Maharjan Chhetri, Lumbini Medical College and Teaching Hospital

Associate Professor,

Department of Pediatrics.

Anita Lamichhane, Lumbini Medical College and Teaching Hospital

Associate Professor,

Department of Pediatrics. 

Shami Pokhrel, Lumbini Medical College and Teaching Hospital


Department of Pediatrics.

Bhaskkar Sharma, Lumbini Medical College and Teaching Hospital

Assistant Professor,

Department of Pediatrics.


Kieling C, Baker-Henningham H, Belfer M, Conti G, Ertem I, Omigbodun O, et al. Child and adolescent mental health worldwide: evidence for action. Lancet. 2011;378(9801):1515-25. PMID: 22008427 DOI:

World Health Organization. Adolescent mental health. Geneva: WHO; 2020. Available from:

Chhabra GS, Sodhi MK. Impact of Family Conflict on the Psychosocial Behavior in Male Adolescents. Journal of Nepal Paediatric Society. 2012;32(2):124-131. DOI:

Hamoda H, Ferrin M. International Association for Child and Adolescent Psychiatry and Allied Professions. IACAPAP Bulletin: Issue 57. Geneva; 2020. Available from:

Palfrey JS, Tonniges TF, Green M, Richmond J. Introduction: Addressing the millennial morbidity — The context of community paediatrics. Pediatrics. 2005;115(Suppl 3):1121- 23. DOI:

Sharma B, Rai MK, Sharma A, Karki S. Emotional and Behavioral Problems among Adolescents in Pokhara City in Nepal. J Nepal Health Res Counc. 2018;16(41):419-24. PMID: 30739933

Goodman R, Meltzer H, Bailey V. The Strengths and Difficulties Questionnaire: a pilot study on the validity of the self-report version. Eur Child Adolesc Psychiatry. 1998;7(3):125-30. PMID: 9826298 DOI:

Muris P, Meesters C, van den Berg F. The Strengths and Difficulties Questionnaire (SDQ)- -further evidence for its reliability and validity in a community sample of Dutch children and adolescents. Eur Child Adolesc Psychiatry. 2003;12(1):1-8. PMID: 12601558 DOI:

Goodman R, Scott S. Comparing the Strengths and Difficulties Questionnaire and the Child Behavior Checklist: is small beautiful? J Abnorm Child Psychol. 1999;27(1):17-24. PMID: 10197403 DOI:

Goodman R. Psychometric properties of the strengths and difficulties questionnaire. J Am Acad Child Adolesc Psychiatry. 2001;40(11):1337-45. PMID: 11699809 DOI:

Banstola RS. Psychosocial Problem among School-going Adolescents in Pokhara, Western Nepal. Janapriya Journal of Interdisciplinary Studies, 2017;6(0):121-33. Available from:

Khattri JB, Poudel BM, Thapa P, Godar ST, Tirkey S, Ramesh K, et al. An Epidemiological Study of Psychiatric Cases in a Rural Community of Nepal. Nepal Journal of Medical Sciences 2013;2(1):52-6. DOI:

K Bhola , Sathyanarayanan V, Rekha DP, Daniel S, Thomas T. Assessment of Self- Reported Emotional and Behavioral Difficulties Among Pre-University College Students in Bangalore, India. Indian J Community Med. 2016;41(2):146-50. PMID: 27051090 DOI:

Keyho K, Gujar NM, Ali A. Prevalence of mental health status in adolescent school children of Kohima District, Nagaland. Annals of Indian Psychiatry. 2019;3(1):39-42. Available from:

George M, Chandak S, Wasnik M, Khekade S, Gahlod N, Shukla H. Assessment of child’s mental health problems using strengths and difficulties questionnaire. Journal of Oral Research and Review. 2019;11(1):7-11. Available from:

Banerjee M, Bhat AA, Chatterjee A. A comparative study of mental health problems among 11-17 year old Indian school children living in areas with persistent political violence and children of the same age group living under standard conditions using self rated Strength and Difficulty Questionnaire. Sri Lanka Journal of Child Health. 2015;44(2):88-91. Available from:

Chaulagain A, Kunwar A, Watts S, Guerrero APS, Skokauskas N. Child and adolescent mental health problems in Nepal: a scoping review. International Journal of Mental Health System. 2019;13(0):53. DOI:

Rimal HS, Pokharel A. Assessment of Mental Health Problems of School Children Aged 11-17 Years Using Self Report Strength and Difficulty Questionnaire (SDQ). Journal of Nepal Paediatric Society. 2013;33(3):172-76. DOI:

Thapa B, Powell J, Yi J, McGee J, Landis J, Rein L, et al. Adolescent Health Risk and Behavior Survey: A School Based Survey in Central Nepal. Kathmandu Univ Med J (KUMJ). 2017;15(60):301-7. PMID: 30580346

Wolf RT, Jeppesen P, Gyrd-Hansen D, The CCC2000 Study Group, Oxholm AS. Evaluation of a screening algorithm using the strengths and difficulties questionnaire to identify children with mental health problems: A five-year register-based follow-up on school performance and healthcare use. PLoS ONE. 2019;14(10):0223314. DOI:

Atilola O, Balhara YPS, Stevenovic D, Avicenna M, Kandemir H. Self-Reported Mental Health Problems Among Adolescents in Developing Countries: results from an international pilot sample. J Dev Behav Pediatr. 2013;34(2):129- 137. PMID: 23369959 DOI:

How to Cite
Chhetri U, Lamichhane A, Pokhrel S, Sharma B. Assessment of Mental Health Problems of School Children Using Self Report Strengths and Difficulties Questionnaire. J Lumbini Med Coll [Internet]. 24May2021 [cited 28Jul.2021];9(1):6 pages. Available from:
Original Research Article