Predisposing factors

Most cases probably have a multifactorial causation, including genetic predisposition to psychiatric disorder, biological factors such as poor nutrition before and/or after birth, and a psychologically stressful and/or deprived environment. Individual factors associated with childhood psychiatric disorder include the following:

• organic brain disease

• chronic physical disease

• low intelligence

• discord within the family, and undesirable parental attitudes, which include overprotection as well as hostility or neglect

• physical or mental illness in another family member, especially the mother; in the case of psychiatric disorder, the child's mental health may be at risk because of genetic factors as well as disruption of the home environment

• separation from the mother, especially if there is no adequate substitute; Bowlby's work on maternal deprivation formed the basis of 'attachment theory', emphasizing the importance of a consistent caregiver, who is usually but not necessarily the biological mother, during early life

• single parent family

• lower social class

• antisocial behaviour in family

• ethnic minority.

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