Detailed interviews with parents of 128 children aged 7 to 12 years consecutively referred to general paediatric clinics identified psychiatric disturbance in 36 (28%) of the children. Emotional disorders were the commonest psychiatric diagnoses (present in two thirds); less frequent diagnoses were conduct disorders (5/36, 14%), mixed conduct/emotional disorders (six, 17%), and hyperkinetic syndrome (three, 8%). Disturbance was related to level of energy, with disturbed children being described significantly more frequently as 'bounding with energy' or conversely 'tired and apathetic'. Psychosocial problems (broken homes, mentally distressed mothers, family stress including financial stress and marital difficulty) were also increased in the disturbed group, but most of all these mothers reported feeling stressed in relation to the children. Psychiatric disorders, particularly emotional disorders, are common associated problems in paediatric referrals. Family stress, specially that focused on parenting, is likely to be an important factor contributing to disturbed children's consultations in general paediatric clinics.
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