The risk factors for preschoolers' behavioral problems in a low/middle-income country.

Background: Children have a greater risk of mental health problems in low/middle-income countries. Determining the risk factors and earlier identification of young children at high risk for behavioral problems are central to cost-effective intervention with positive long-term outcomes. The aim of this study was to examine the prevalence and risk factors of behavioral problems of preschoolers in three different cities located in eastern, western, and central Türkiye, a low/middle-income country.

Methods: In total, 300 children (4-6 years old) without any chronic diseases participated the study. The parents completed the Children's Behavior Checklist/4-18 (CBCL/4-18), the Children's Sleep Habits Questionnaire, the Pittsburgh Sleep Quality Index, and the Beck Depression Inventory. Daily activities were evaluated using questionnaires that were specifically developed for the present study.

Results: Based on the CBCL4-18, 12.3% of children were at high risk for behavioral problems. Paternal unemployment, screen time, maternal depressive symptoms, and maternal and child sleep problems were associated with internalizing behavioral problems; maternal depressive symptoms and watching videos on touch-screen devices were associated with externalizing behavioral problems. Total behavioral problems were associated with maternal unemployment, maternal depressive symptoms, being the eldest child, and child sleep problems.

Conclusion: Preventable risk factors such as daily activities and maternal mental health should be evaluated as well as sociodemographic factors among preschoolers who may be at high risk of behavioral problems. The results of this study contribute toward drawing attention to preventable risk factors in a low/middle-income country.