RESUMEN
The extended Strengths and Difficulties Questionnaire (SDQ) provides information on problem behaviours and impairment measures. Western studies found impairment measures to be as good as symptom scores in predicting clinical caseness. The high levels of comorbidities among child psychiatric disorders also meant that disorders not specifically captured by the questionnaire could be identified. This study examines its applicability among Chinese school children in Hong Kong. Results found that impairment measures were more predictive of clinical status than were symptom scores. Children with low symptom but high impairment ratings had profiles that were intermediate between the low symptom low impairment and high symptom low impairment groups. The extended SDQ is useful in identifying children who might otherwise be missed if symptom scores alone were used in screening. The acceptance of child psychiatric care in Hong Kong is a multi-step process that depends on how symptoms are perceived.