Abstract Background Maternal depression is known to be a risk for abnormal child development. Girls and boys have been found to respond differently to maternal depression. Although prenatal and ...postnatal depression has been widely studied, longitudinal studies of adolescent outcome are still rare. Methods The original sample of 349 mothers in this longitudinal study was collected in 1989–1990 in Tampere, Finland. At the latest stage, of the 327 contacted in 2006, 191 mothers and 192 adolescents aged 16 to 17 years participated in the study. Maternal depressive symptoms were screened using the Edinburgh Postnatal Depression Scale (EPDS) prenatally, postnatally and at the latest stage. Adolescent outcome was examined using the Child Behavior Checklist (CBCL) and the Youth Self Report (YSR). Results Maternal concurrent depressive symptoms were associated with adolescent behavioral and emotional problems in both genders. Maternal prenatal depressive symptoms were associated with Externalizing Problems in the YSR and boys' lower Social Competence in both the CBCL and YSR. Maternal postnatal depressive symptoms were associated with boys' lower Social Competence both in the CBCL and YSR and Externalizing Problems in the YSR. Limitations Being a longitudinal normal population sample, the number of symptomatic mothers and adolescents is relatively small and the number of drop-outs is relatively high. Clinical evaluation of mothers and adolescents is also lacking. Conclusions Maternal prenatal and postnatal depressive symptoms are a risk to adolescent boys' wellbeing and concurrent depressive symptoms a risk for both girls' and boys' well-being. This long-term influence should be noted when treating women with depressive symptoms throughout motherhood.
The examination of the data from a sample of 5,302 Finnish children who were born in 1981 finds that bullying at age eight years and later is associated with later suicide attempts and completed ...suicide for boys but not after controlling for conduct and depression symptoms. For girls, the association is still seen even after controlling for conduct and depression symptoms.
Our goal was to study predictive associations between bullying and victimization at age 8 years and psychiatric disorders in early adulthood.
The sample comprised 2540 boys born in 1981. Information ...about bullying and victimization was gathered in 1989 when the boys were 8 years old from parents, teachers, and children. Information about psychiatric disorders was based on military call-up examination and army registry when the subjects were 18 to 23 years old.
In univariate logistic regression analysis, frequent bullying-only status predicted antisocial personality, substance abuse, and depressive and anxiety disorders; frequent victimization-only status predicted anxiety disorder, whereas frequent bully-victim status predicted antisocial personality and anxiety disorder. When controlled against the effects of parental education level and parent and teacher reports of emotional and behavioral symptoms by using Rutter scales, frequent victimization-only status predicted anxiety disorders, and frequent bullying-only predicted antisocial personality disorder, whereas frequent bully-victimization predicted both anxiety and antisocial personality disorder. Information about frequent bullying and victimization as primary screening for children at risk identified approximately 28% of those with a psychiatric disorder 10 to 15 years later.
Both bullying and victimization during early school years are public health signs that identify boys who are at risk of suffering psychiatric disorders in early adulthood. The school health and educational system has a central role to play in detecting these boys at risk.
Objective: To study associations between comorbid psychopathology and long-term outcomes in a large birth cohort sample from age 8 to early adulthood. Method: The sample included long-term outcome ...data on 2,556 Finnish boys born in 1981. The aim was to study the impact of early childhood psychopathology types (externalizing versus internalizing versus both) and informant sources (self-report versus parent/teacher reports) on young adult outcomes, based on data from a military registry of psychiatric diagnosis, a police registry on criminal and drug offenses, and self-reported problems in late adolescence and early adulthood. Results: Children with combined conduct and internalizing problems at age 8 had the worst outcomes and highest risk of subsequent psychiatric disorders, criminal offenses, and self-reported problems at follow-up, with 62% of these boys manifesting psychiatric disorders, committing criminal offenses, or both at follow-up. Although these children included only 4% of the sample, they were responsible for 26% of all criminal offenses at follow-up. In contrast, children with conduct problems without internalizing problems and those with attention problems had much less severe but nonetheless elevated levels of risk of antisocial personality disorder and criminal offenses. Long-term outcomes for these two groups were substantially better than for children with combined conduct and internalizing problems. Children with "pure" emotional problems had an elevated risk only of similar emotional problems at follow-up. Conclusions: The subjective suffering and long-term burden to society is especially high among children with comorbid conduct and internalizing problems in childhood. A major challenge for child and adolescent psychiatric, education, and social services is to develop effective intervention strategies focusing on these children. Additional longitudinal epidemiological studies of this comorbidity group are needed, and, if replicated, such findings will have important implications for future diagnostic classification systems (DSM-V). (Contains 2 tables.) This study was supported by the Sigrid Juselius Foundation, Yrjo Jahnsson Foundation, and Signe and Arne Gyllenberg Foundation.
Abstract Background Little is known about the predictive association between childhood bullying behavior with depression and suicidal ideation at age 18. Methods The sample included 2348 boys born in ...1981. Information about bullying was gathered at the age of 8 from self, parent and teacher's reports. Depression and suicidal ideation were assessed during the Finnish military call-up examination. Results Based on regression models, boys who were bullies frequently, but not merely sometimes, were more likely to be severely depressed and to report suicidal ideation compared to boys who were not bullies. When controlling for depression at age 8 the association between frequent bullying and severe depression was maintained but the association with suicidal ideation became non-significant. Boys who were only victimized were not more likely to be depressed or to report suicidal ideation at age 18. Boys who were frequently both bullies and victims were found to be at risk for later depression. Limitations Our finding can only be generalized to boys who were involved in bullying at elementary school age. Data at age 18 was based only on self-reports and the bullying/victimization questions were very general. Conclusions Childhood bullying behavior is a risk factor for later depression. Screening and intervention for bullying behavior in the early school years is recommended to avoid subsequent internalizing problem in late adolescence.
To investigate whether prenatal, postnatal, and/or current maternal depressive symptoms are associated with low level of psychosocial functioning or high level of emotional/behavioral problems in ...school-age children.
As part of a prospective longitudinal study, maternal depressive symptoms were screened with the Edinburgh Postnatal Depression Scale prenatally, postnatally, and when the children were 8 to 9 years old. The original sample of 349 mothers was collected in 1989-1990 in Tampere, Finland. Of the 270 mother-child pairs at the latest stage of the study in 1997-1998, 188 mother-child pairs participated and 147 were included. The associations between maternal depressive symptoms at different points in time and the level of children's psychosocial functioning and problems reported on the Child Behavior Checklist and Teacher's Report Form were examined.
Children's low social competence and low adaptive functioning were associated with concurrent maternal depressive symptoms. Maternal postnatal depressive symptoms predicted low social competence. The presence of prenatal depressive symptoms in the mother was a strong predictor of child's high externalizing and total problem levels (odds ratio 3.1, 95% confidence interval 1.1-8.9 and odds ratio 8.5, 95% confidence interval 2.7-26.5). Prenatal as well as recurrent maternal depressive symptoms were associated with the least favorable child outcome.
Maternal depressive symptomatology at any time, especially prenatally, is a risk factor for the child's well-being. This should be noted already in prenatal care. The timing and the recurrence of maternal depressive symptoms affect the outcome for the child.
Objective
To examine cross-informant agreement and whose information (parents, teachers, children) about childhood bullying and victimization carry the strongest weight to late adolescent psychiatric ...outcome. The importance of frequency of bullying in such predictions is addressed.
Methods
Information from 2,713 boys about bullying and victimization at the age of eight was correlated with information about psychiatric disorder at 18–23.
Results
Agreement between informants was poor. Teachers reported higher levels of frequent bullying than others, whereas children reported the highest percentage of victimization. All three informant groups’ reports of “frequent bullying” predicted later psychiatric disorder. Teachers’ reports of “frequent victimization” was the strongest predictor of later psychiatric disorder. Informants’ report about “infrequent bullying” showed at most a rather low risk of adverse outcome. When the associations between bullying/victimization and psychiatric outcome were adjusted with total psychopathology score at age 8, none of the associations remained significant.
Conclusion
“Frequent bullying” behaviour of boys is a marker of present and later psychopathology. The education system and school health-care service in mid- childhood are of great importance for the early detection of bullying and prevention of later adverse outcomes. A closer integration of these systems in the context of school should be promoted.
Background: Early recognition of children's mental health problems calls for structured methods in front line services. The Strengths and Difficulties Questionnaire (SDQ) is a commonly used short ...questionnaire in screening child's mental difficulties. Aim: To test the reliability and descriptive properties of the SDQ in a community sample of Finnish 4-9-year-old children (n = 4178). Methods: Both parents, two teachers in day-care or a teacher at school completed the SDQ. To control for possible bias, public health nurses rated their concern about every child's mental health, including non-participants. Results: The internal consistencies of the SDQ total score in all informants' reports were satisfactory to good. Agreement (Spearman rho) in total scores between parents was 0.65, between parent and teacher 0.43 and between two teachers in day-care 0.81. The stability in parent's reports over 12 weeks was good. The distributions of the informant-rated scores indicated significant and clinically important gender differences, and the 80th and 90th percentiles were generally below the international cut-off points. Public health nurses reported emotional or behavioural difficulties more commonly in non-participants (12%) than in participants (7%; p < 0.001). Conclusions: The results supported earlier findings of good internal consistency, inter-rater and cross-informant agreements and test-retest of the method. However, the gender and age of the child, the number of informants and cultural differences in reporting styles affected the results and thus confirmed the need to re-evaluate the SDQ in the culture and population in question.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Background and Aims. Assessing young children’s mental health is a crucial and challenging task. The aim of the study was to evaluate the clinical relevance of asking parents, nurses, and young ...children themselves to identify children’s mental health problems by only one or two questions. Methods. In regular health check-ups of 4- to 9-year-old children ( n = 2682 ) , parents and public health nurses assessed by one question whether the child had any emotional or behavioral difficulties. The child completed a self-evaluation enquiry on his/her emotional well-being. A stratified proportion of the participating parents were invited to a diagnostic interview. Results. Sensitivities were fairly good for the parents’ (68%), nurses’ (65%), and their combined (79%) one-question screens. Difficulties identified by parents and nurses were major risks (OR 10–14) for any child psychiatric disorders ( P < 0.001 ) . The child’s self-evaluation was related to 2-fold to 3-fold risks ( P < 0.05 ) for any psychiatric diagnosis, for any emotional diagnosis, and for negative situational factors. Conclusion. The one-question screen for parents and public health nurses together quite adequately identified the young children with mental health problems. The child’s self-evaluation provided relevant and complementary information on his/her mental health and especially emotional problems.
Abstract Background The use of second-generation antipsychotic (SGA) medication among child and adolescent psychiatric patients has increased worldwide in recent years. The increase appears to have ...been more extensive in the USA than in European countries, but the tendency is similar. However, after a peak the use seems to have declined in the USA. Simultaneously with the increasing numbers, the duration of SGA use has lengthened, indications have broadened, and off-label use has increased. Despite existing follow-up recommendations and evidence for the metabolic adverse effects of SGAs in children, research evidence has not translated into clinical practice. Objective The aim of this study was to assess the clinical use and follow-up practices of SGA medication among child psychiatric patients of one university hospital in Finland. Method This retrospective patient report-based study was conducted at the Child Psychiatric Clinic of Tampere University Hospital, Finland. The study sample consisted of 133 patients who were younger than 13 years when initiating SGA treatment and had an ongoing SGA medication during the study period. The study sample was divided into two groups according to diagnosis to examine whether there were differences between patients with an autistic or a developmental disorder (F83-84) and patients with other psychiatric diagnoses. Results: This study showed that SGA use in children younger than 13 years was mainly off-label. Irrespective of diagnosis, the most common indication was aggression. Especially children with psychiatric diagnoses other than developmental disorders had multiple socio-demographic risk factors and adverse life experiences in their background. The follow-up practices were diverse and partly irregular. Conclusions: A need for systematic SGA monitoring practices and dialogue between the medical specialities treating children and their families is evident.
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