Mental health issues develop from early childhood through adolescence, impacting adaptation processes and future adult roles. Addressing these problems in young children should be a public health priority. Globally, one in five children and adolescents suffers from a mental disorder (World Health Organization, 2021). By 2030, childhood neuropsychiatric disorders are expected to rise over 50%, becoming one of the top five causes of morbidity, mortality, and disability among children (National Institute of Mental Health and Neurosciences, 2016).

In contemporary society, school-age children and adolescents face various psychological conditions often linked to negative consequences on behavioral problems and social competence development (Achenbach & Rescorla, 2001). Behavioral problems refer to abnormal behaviors that exceed the normal range for the corresponding age in severity and duration. These issues arise during development and can lead to more serious behavioral deficits and emotional problems (Kashyap & Choudhury, 2018). Adolescents experience various internal conflicts while growing up, which might impair normal psychosocial development. Lack of attention to their mental well-being during socialization can lead to persistent mental health consequences, reducing society’s economic productivity (Singh & Yeh, 2018).

This study aims to explore behavioral disorders and associated risk factors among school-going children in Bikaner city, highlighting the necessity for timely intervention.

Research has demonstrated that early intervention strategies, including school-based mental health services and parental involvement, significantly reduce the prevalence of behavioral disorders in children (Sharma & Gupta, 2020). Several studies have linked socio-economic disparities to behavioral problems, showing that children from lower-income backgrounds are more susceptible to aggression, attention deficits, and anxiety-related disorders (Kaur et al., 2006). Additionally, recent findings emphasize the growing role of technology and screen time in influencing children's behavior, often exacerbating attention and emotional regulation problems (Ghandour et al., 2019).

AIMS AND OBJECTIVES:

• To study the prevalence of different types of behavioral disorders among children and early adolescents aged between 6 and 14 years.
• To identify the risk factors for behavioral problems in children and early adolescents.

This hospital-based cross-sectional observational study was conducted in the Department of Pediatrics, Sardar Patel Medical College and PBM Hospital, Bikaner, over a duration of one year. The study population consisted of 500 school-going children aged 6–14 years, assessed for behavioral disorders using a structured questionnaire (Achenbach & Rescorla, 2001). Socio-demographic data, BMI, academic performance, and engagement in activities were also recorded. Statistical analysis was conducted using SPSS to determine prevalence rates and identify significant associations between behavioral disorders and risk factors.

• The majority of participants were aged 6–8 years (48%), followed by 9–11 years (41.7%) and 12–14 years (10.1%).
• Gender distribution was 53% male and 47% female.
• Socioeconomic status: 54.8% lower middle class, 39% upper middle, and 6.2% upper class.
• BMI: 3.4% underweight, 76.2% normal weight, and 20.4% overweight.
• Reading was the most engaged school activity, whereas dancing had the lowest participation.
• At home, reading was the most common hobby, followed by mobile & TV use. Sports had moderate participation.
• Behavioral assessment showed that 77% of students achieved an ‘A’ grade, 14.2% received a ‘B’, and 8.8% earned a ‘C’.
• 2% of students exhibited behavioral problems, while 76.8% showed no issues.
• Aggressive behavior (11.2%) and somatic complaints (10.8%) were the most prevalent behavioral disorders (Bansal, Goyal, & Srivastava, 2009). Other issues included thought problems (7.2%), anxious/depressed symptoms (5.4%), and withdrawn disorder (1.4%).
• Gender differences: Males had significantly higher delinquent behavior (4.9%), while females exhibited more social, thought, and attention problems. Aggressive behavior was slightly more common in females but not statistically significant.
• Age differences: Somatic complaints and aggressive behavior were more common in ages 12–14, while thought problems were prevalent in ages 9–11.
• Socioeconomic status: Thought problems and delinquent behavior were significantly higher in the upper middle-class group.
• BMI: Thought problems and delinquent behavior were significantly more prevalent in overweight children.
• Academic performance: Social problems were significantly higher among students with grade B, and anxious/depressed symptoms were more prevalent in grade C students.

Table 1: Demographic Characteristics of Study Population

Table 2: Behavioral Disorders among Participants

The study highlights the multifaceted nature of behavioral disorders in children, emphasizing the role of environmental and familial influences (Kaur et al., 2006). Children from lower-income families showed higher levels of behavioral issues due to increased exposure to stress and lack of parental guidance (Ghandour et al., 2019). Family environment, school performance, and BMI were major factors influencing behavioral outcomes (Indian Council of Medical Research, 2020). School-based mental health interventions, including counseling services and awareness programs, could play a significant role in early identification and support.

A significant number of children require support to cope with emotional and behavioral issues. Schools should implement mental health services, including counseling and awareness programs (American Psychiatric Association, 2013). Academic achievement and structured interventions targeting behavioral problems should be encouraged. Community programs like student drama clubs and street plays can further spread awareness.

1. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Washington, DC: APA.
2. Achenbach, T. M., & Rescorla, L. A. (2001). Manual for the ASEBA School-Age Forms & Profiles. Burlington, VT: University of Vermont.
3. Bansal, V., Goyal, S., & Srivastava, K. (2009). Study of prevalence of behavioral problems among primary school children. Indian Journal of Psychiatry, 51(1), 27-32. https://doi.org/10.4103/0019-5545.44900
4. Ghandour, R. M., Sherman, L. J., Vladutiu, C. J., Ali, M. M., Lynch, S. E., Bitsko, R. H., & Blumberg, S. J. (2019). Prevalence and treatment of depression, anxiety, and conduct problems in US children. JAMA Pediatrics, 173(11), e191451.https://doi.org/10.1001/jamapediatrics.2019.1451
5. Indian Council of Medical Research (ICMR). (2020). National Mental Health Survey of India 2015-16. Retrieved from https://main.icmr.nic.in/
6. Kaur, R., Chavan, B. S., Lata, S., Arun, P., Mehta, M., & Kaur, M. (2006). Screening for behavioral problems in school-going children. Indian Journal of Pediatrics, 73(1), 17-25. https://doi.org/10.1007/BF02757455
7. Kashyap, H., & Choudhury, P. (2018). Behavioral disorders in children and adolescents: An overview. Indian Journal of Psychological Medicine, 40(5), 451-455. https://doi.org/10.4103/IJPSYM.IJPSYM_148_18
8. World Health Organization. (2021). Mental health and psychosocial well-being of children and adolescents. Retrieved from https://www.who.int/mental_health
9. Singh, A., & Yeh, C. J. (2018). Impact of family dynamics on child behavioral problems. Child Development Research, 2018, 1-8. https://doi.org/10.1155/2018/2909723
10. National Institute of Mental Health and Neurosciences (NIMHANS). (2016). Child and adolescent mental health in India: A national concern. Retrieved from https://nimhans.ac.in/