RESUMO
Many countries have applied mandatory confinement measures in response to the COVID-19 pandemic, such as school and kindergarten closures, which confined families to their homes. The study concerns the impacts of the first COVID-19 lockdown on the relationships between Portuguese parents and their children, in a non-clinical population composed of fathers and mothers of children between the ages of 12 months and 3 years and 364 days. An online questionnaire (set by the research team) and the Parenting Daily Hassles Scale (PDHS) concerning the confinement period were applied between 17 June and 29 July 2020. To assess the impacts of the lockdown, outcomes regarding the impacts perceived by the parents, the potential regression in the development of children, and the willingness to promote changes in family routines in the future, were considered. Of the total sample (n = 1885), 95.4% of the parents (n = 1798) said that, after confinement, the relationship with their children had improved or remained similar to the pre-confinement period; 97.3% (n = 1835) noticed positive changes in the development of their children, and 63.7% (n = 1200) noted that the relationships with their children during the confinement period would lead to some changes in family routines in the future. Multivariate regression analyses showed that most of the sociodemographic variables chosen were not associated with the outcomes. However, significant levels of pressure over parenting and parental overload (reported by high scores in the PDHS intensity and frequency scales), challenging behaviors of the children, and the impacts they had on parental tasks had negative influences on the studied outcomes. On the contrary, the number of adults living with their children, the perceptions regarding the development of their children, and sharing new experiences with them were significant factors for positively-perceived impacts on the relationships between them or in the desire to bring about changes in family routines in the future. The impacts of the lockdown on the relationships between parents and children aged between 1 and 3 years old were more dependent on relational aspects and on the parents' sense of competence in exercising parental functions. We conclude that, despite the increased demands imposed by the lockdown, nearly all of the parents evaluated the quality of the relationship with their children as positive after this period.
RESUMO
Child Mental Health Services have been dealing¸ over the last decades, with a growing number of children in need of evaluation and treatment. Recent studies estimate that 10 to 20% of children and adolescents met criteria for, at least, one psychiatric diagnosis, and that only one fifth gets appropriate treatment. Thus, in order to optimize service planning and management we performed an analysis of the cases referred to and observed at one Child and Adolescent Psychiatry Clinic between 2004 and 2007, as well as descriptive analysis of the youth population observed at the same clinic during 2007. In the 4 year period studied, 1923 children were consulted in a total of 9609 appointments. Sample mean age was 9.89 years with a clear male gender preponderance. During 2007, 480 patients were consulted and it was possible to observe a predominance of nuclear family structure and around 71% of cases living in Sintra. Regarding the source of referral, 29% of the cases were referred by the assistant physician and in 26% by school teachers; the main complaints were behavior problems (30%) and learning disabilities (15%). It was also possible to characterize complaints according to the different referral sources. On a psychodynamic diagnostic level, 56% of all cases met criteria for a Depressive Organization. According to DSM-IV-TR diagnostic criteria for Axis I disorders, we found 30% of Emotional Disorders and 24.8% of Conduct Disorders and Attention Deficit and Hyperactive Disorder. Mean waiting times between referral and the first appointment varied between 55 days (cases referred from the Emergency Department) and 141 days (school referrals). Only a deeper and detailed analysis of this reality will allow the planning and implementation of measures needed to optimize Child and Adolescent Mental Health services and the answer they can give to patients and families.
