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Camprodon-Boadas P, Gil-Dominguez A, De la Serna E, Sugranyes G, Lázaro I, Baeza I. Mediterranean Diet and Mental Health in Children and Adolescents: A Systematic Review. Nutr Rev 2024:nuae053. [PMID: 38758659 DOI: 10.1093/nutrit/nuae053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2024] Open
Abstract
CONTEXT Childhood and adolescence are periods of critical importance in the development of mental health disorders. The Mediterranean diet (MD) has been linked to multiple positive health outcomes, including reduced incidence of mental health disorders and fewer psychiatric symptoms. OBJECTIVE This study aimed to investigate the association between adherence to an MD and mental health outcomes in children and adolescents. METHODS A systematic literature review was conducted of original research that explored the relationship between psychiatric symptoms or disorders and adherence to an MD. The literature search was conducted on PubMed, Scopus, Web of Science, MEDES, Dialnet, and Latindex from inception to November 2022, and the Newcastle-Ottawa Scale was used to evaluate the quality of studies. RESULTS A total of 13 studies (6 cross-sectional, 4 case-control, 2 randomized clinical trials, and 1 longitudinal cohort) out of 450 met the inclusion criteria. A total of 3058 children or adolescents with a mean age range from 8.6 to 16.2 years were included. Among the reviewed studies, 5 (71.42%) of those looking at attention-deficit/hyperactivity disorder, 4 (80%) examining depression, and 2 (50%) assessing anxiety found a significant protective association. Seven articles (53.84%) were found to be of high quality and 6 (46.15%) of moderate quality. CONCLUSION Adherence to an MD could be a protective factor for mental health in child and adolescent populations. This suggests that promoting an MD could help prevent the onset of clinical psychiatric symptoms, reduce symptom severity, and improve prognosis in young patients. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42021276316.
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Affiliation(s)
- Patricia Camprodon-Boadas
- Department of Child and Adolescent Psychiatry and Psychology, 2021SGR01319, Institut Clinic de Neurociències, Hospital Clínic Universitari, Barcelona, 08036, Spain
- Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, 08036, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, 28029, Spain
- Department of Medicine, Institute of Neurosciences, Universitat de Barcelona, Barcelona, 08036, Spain
| | - Aitana Gil-Dominguez
- Department of Medicine, Institute of Neurosciences, Universitat de Barcelona, Barcelona, 08036, Spain
| | - Elena De la Serna
- Department of Child and Adolescent Psychiatry and Psychology, 2021SGR01319, Institut Clinic de Neurociències, Hospital Clínic Universitari, Barcelona, 08036, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, 28029, Spain
| | - Gisela Sugranyes
- Department of Child and Adolescent Psychiatry and Psychology, 2021SGR01319, Institut Clinic de Neurociències, Hospital Clínic Universitari, Barcelona, 08036, Spain
- Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, 08036, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, 28029, Spain
| | - Iolanda Lázaro
- Cardiovascular Risk and Nutrition, Hospital del Mar Medical Research Institute (IMIM), Barcelona, 08003, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, 28029, Spain
| | - Immaculada Baeza
- Department of Child and Adolescent Psychiatry and Psychology, 2021SGR01319, Institut Clinic de Neurociències, Hospital Clínic Universitari, Barcelona, 08036, Spain
- Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, 08036, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, 28029, Spain
- Department of Medicine, Institute of Neurosciences, Universitat de Barcelona, Barcelona, 08036, Spain
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Prino LE, Arace A, Zonca P, Agostini P, Scarzello D. Preschool Emotional Problems in the Post-Pandemic Era between Parental Risk and Protective Factors. Healthcare (Basel) 2023; 11:2862. [PMID: 37958006 PMCID: PMC10647701 DOI: 10.3390/healthcare11212862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/25/2023] [Accepted: 10/27/2023] [Indexed: 11/15/2023] Open
Abstract
The psychosocial adaptation of children born or experiencing their early years during the COVID-19 pandemic remains uncertain. In order to implement prevention strategies, it is, therefore, a priority to deeply analyze children's mental health in this post-pandemic phase and to identify family risk and protective factors. Indeed, recent studies reveal that children's emotional distress increased with the COVID-19 pandemic, especially in situations of high parental stress. The study investigates associations between some parental characteristics (coping strategies, parental burnout, resilience, perception of social support, and promotion of children's social-emotional competence) and children's emotional symptoms, considering gender differences. A total of 358 parents of children aged 2 to 6 years participated in this study. Regression analyses show that parental burnout is a predictor of emotional symptoms; moreover, for females, higher levels of emotional symptoms are associated with parental maladaptive coping strategies, whereas for males, the parent's ability to promote children's emotional competence is a protective factor. Results emphasize the importance of supporting parental well-being as a critical factor in shielding children from the repercussions of adverse situations.
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Affiliation(s)
- Laura Elvira Prino
- Department of Philosophy and Education Sciences, University of Turin, 10124 Turin, Italy; (A.A.); (P.Z.); (P.A.); (D.S.)
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Zhang E, Bellinger S, Swails L, Punt S, Tepper K, Nelson EL. Connecting Behavioral Health Specialists With Schools: Adapting a Telementoring Series During COVID-19. RURAL SPECIAL EDUCATION QUARTERLY 2023; 42:94-104. [PMID: 37265709 PMCID: PMC9908514 DOI: 10.1177/87568705231152619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
To address the daunting behavioral and mental health needs of Kansas' rural and underserved communities, Telehealth ROCKS (Rural Outreach for the Children of Kansas) Schools project partnered with school-based health centers, school districts, and special education cooperatives to provide a range of telebehavioral health intervention services and teletraining. This project used the Project Extension for Community Healthcare Outcomes (ECHO) telementoring framework to connect specialty providers with school/community providers for web-based continuing education and case consultation to support students with special education needs. Our team created the Function Friday for Better Behavior ECHO series to address challenging behaviors in schools, based on the concept of functional behavior assessment and function-based treatment. Part of the ECHO series came into being after the onset of the COVID-19 pandemic. This article describes how our ECHO series provided an effective mechanism for supporting school and community providers during the pandemic, and participating educators utilized skills as they transitioned from onsite education to the virtual learning environment with students.
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Affiliation(s)
- E Zhang
- University of Kansas Medical Center,
Kansas City, USA
| | | | - Leni Swails
- University of Kansas Medical Center,
Kansas City, USA
| | - Stephanie Punt
- University of Kansas Medical Center,
Kansas City, USA
- University of Kansas, Kansas City,
USA
| | - Katy Tepper
- University of Kansas Medical Center,
Kansas City, USA
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Kallas KA, Marr K, Moirangthem S, Heude B, Koehl M, van der Waerden J, Downes N. Maternal Mental Health Care Matters: The Impact of Prenatal Depressive and Anxious Symptoms on Child Emotional and Behavioural Trajectories in the French EDEN Cohort. J Clin Med 2023; 12:jcm12031120. [PMID: 36769767 PMCID: PMC9917852 DOI: 10.3390/jcm12031120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/21/2023] [Accepted: 01/30/2023] [Indexed: 02/04/2023] Open
Abstract
Few studies have investigated longitudinal trajectories of child socioemotional and behavioural development in relation to maternal prenatal mental health exposure or taken into consideration of the potential buffering effects of psychological intervention during pregnancy. Using data from 1135 mother-child dyads from the EDEN cohort from the general French population, Group-based trajectory modelling was used to model trajectories of behavioural and emotional characteristics measured at four timepoints via a parent-administered Strengths and Difficulties Questionnaire. Using propensity scores and inverse probability weighting to account for confounding factors, multinomial logistic regressions were used to quantify the associations with maternal symptoms of prenatal depression and anxiety. Stratified analyses were conducted by reporting psychologist and psychiatrist consultations during pregnancy. Compared to those without psychological problems, children of mothers with comorbid anxiety and depression retained a higher probability of following high and intermediate trajectories of emotional problems and a high trajectory of conduct problems throughout childhood. This increased risk was not present in the children of mothers who sought support through a prenatal psychologist or psychiatrist consultation. This article adds to a body of evidence underlining the importance of mental health care for expecting mothers.
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Affiliation(s)
- Kadri-Ann Kallas
- Social Epidemiology Research Team, Institut Pierre Louis d’Épidémiologie et de Santé Publique, INSERM U1136, Sorbonne Université, 75012 Paris, France
| | - Ketevan Marr
- Social Epidemiology Research Team, Institut Pierre Louis d’Épidémiologie et de Santé Publique, INSERM U1136, Sorbonne Université, 75012 Paris, France
| | - Simi Moirangthem
- Social Epidemiology Research Team, Institut Pierre Louis d’Épidémiologie et de Santé Publique, INSERM U1136, Sorbonne Université, 75012 Paris, France
| | - Barbara Heude
- Orchad Team, Epidemiology and Biostatistics Sorbonne Paris Cité Center, INSERM UMR1153, INRAE, Université de Paris, 75001 Paris, France
| | - Muriel Koehl
- Neurogenesis and Pathophysiology Group, Neurocentre Magendie, INSERM U1215, Université de Bordeaux, 33000 Bordeaux, France
| | - Judith van der Waerden
- Social Epidemiology Research Team, Institut Pierre Louis d’Épidémiologie et de Santé Publique, INSERM U1136, Sorbonne Université, 75012 Paris, France
- Correspondence:
| | - Naomi Downes
- Social Epidemiology Research Team, Institut Pierre Louis d’Épidémiologie et de Santé Publique, INSERM U1136, Sorbonne Université, 75012 Paris, France
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Washington-Nortey M, Granger K, Sutherland KS, Conroy M, Kaur N, Hetrick A. Sustaining BEST in CLASS: Teacher-Reported Evidence-Based Practice Use with Students at Risk for Emotional and Behavioral Disorders Amidst the COVID-19 Pandemic. SCHOOL MENTAL HEALTH 2022; 15:1-14. [PMID: 36569406 PMCID: PMC9767394 DOI: 10.1007/s12310-022-09561-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2022] [Indexed: 12/24/2022]
Abstract
There is growing evidence of the efficacy of evidence-based interventions in improving the academic and social outcomes of children who exhibit challenging behaviors during program implementation periods. However, less is known about the extent to which practices learned as part of these interventions are sustained after these projects end, when funding is paused temporarily, and in less-than-ideal conditions. This study used qualitative methods to investigate whether teachers previously trained in the BEST in CLASS-Elementary intervention continued to use the program's evidence-based practices with students 1-2 years after completing the program and in the context of the COVID-19 pandemic. It also examined teachers' perceptions of the impact of practice use on students' academic and social outcomes. Thirteen BEST in CLASS-Elementary teachers from elementary schools in two southeastern states in the USA where the program was implemented completed semi-structured interviews on the topic. Data were coded thematically, and the results indicated that over 50% of teachers reported using "rules," "supportive relationships," and "praise" frequently with their students. However, "precorrection" and "opportunities to respond" were reportedly used less often. Teachers also perceived that their use of these evidence-based practices was linked to increases in their students' academic engagement and academic performance and knowledge, improvements in students' behaviors, their relationships with teachers, and general comfort and self-confidence. The discussion highlights modality-specific patterns noted in the results that might influence sustainment and the implication of these findings for interventions and programs aimed at promoting positive behavioral outcomes for early elementary school students.
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Affiliation(s)
- Melissa Washington-Nortey
- Department of Psychology, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, Addison House, Guy’s Campus, London, SE1 1UL UK
| | - Kristen Granger
- Department of Special Education, Peabody College, Vanderbilt University, 230 Appleton Place, Nashville, TN 37203 USA
| | - Kevin S. Sutherland
- Department of Counseling and Special Education, School of Education, Virginia Commonwealth University, Box 842020, Richmond, VA 23284-2020 USA
| | - Maureen Conroy
- Anita Zucker Center for Excellence in Early Childhood Studies, University of Florida, PO Box 117050, Gainesville, FL 32611 USA
| | - Navneet Kaur
- Department of Psychology, Virginia Commonwealth University, Box 842020, Richmond, VA 23284-2020 USA
| | - Allyse Hetrick
- Institute for Child Health Policy, University of Florida, 2004 Mowry Rd, Gainesville, FL 32603 USA
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Co-occurrence, stability and manifestation of child and adolescent mental health problems: a latent transition analysis. BMC Psychol 2022; 10:267. [PMID: 36376939 PMCID: PMC9664619 DOI: 10.1186/s40359-022-00969-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 10/29/2022] [Indexed: 11/16/2022] Open
Abstract
Background Complex constellations of socio-emotional and behavioural problems (i.e., mental health problems) in childhood and adolescence are common and heighten the risk for subsequent personality, anxiety and mood disorders in adulthood. Aims of this study included the examination of patterns of mental health problems (e.g., externalizing-internalizing co-occurrence) and their transitions to reported mental disorders by using a longitudinal person-centered approach (latent class and latent transition analysis). Methods The sample consisted of 1255 children and adolescents (51.7% female, mean age = 12.3 years, age range 8–26 years) from three time points of the comprehensive mental health and wellbeing BELLA study. Children and their parents completed the German SDQ (Strength and Difficulties Questionnaire, Goodman, 1997) and reported on diagnoses of ADHD, depression, and anxiety. Results Latent class analysis identified a normative class, an emotional problem class, and a multiple problem class. According to latent transition analysis, the majority of the sample (91.6%) did not change latent class membership over time; 14.7% of individuals showed a persistent pattern of mental health problems. Diagnoses of mental disorders were more likely to be reported by individuals in the emotional problem or multiple problem class.
Conclusions Results highlight the need for early prevention of mental health problems to avoid accumulation and manifestation in the transition to adolescence and young adulthood.
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Luo J, Raat H, Franse CB, Bannink R, Bai G, van Grieken A. Correlates of help-seeking by parents for the socioemotional development of their 3-year-old children: a longitudinal study. BMJ Open 2022; 12:e052595. [PMID: 35017243 PMCID: PMC8753387 DOI: 10.1136/bmjopen-2021-052595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 12/07/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Timely parental help-seeking regarding their child's socioemotional development is associated with a lower rate and lower severity of psychosocial problems in later life. This study aimed to examine the correlates of parental help-seeking for the socio-emotional development of 3-year-old children. DESIGN Retrospective cohort study. SETTING Community-based survey in Rotterdam. PARTICIPANTS Of 2305 parents and their 2-year-old children at baseline, 1507 who completed follow-up questionnaires were included in the analyses when children were 3 years old. OUTCOME MEASURES Parental help-seeking regarding their child's socioemotional development and types of formal and informal help sources (eg, general practitioner, internet) used in the past 12 months were measured. Hierarchical logistic regression models were applied to identify factors correlates of parental help-seeking among 13 predisposing, enabling and need factors according to Andersen's behavioural model. RESULTS In total, 22.6% of parents reported help-seeking in the past 12 months for socioemotional development of their 3-year-old child; 6.8% addressed formal help sources and 17.5% addressed informal help sources. General practitioner (2.7%) and family (12.5%) were the most frequently used formal and informal sources, respectively. In the full model, predisposing factors associated with higher odds of parental help-seeking were child's other western ethnic background (OR=1.66, 95% CI 1.02 to 2.68) and parental age ≤29 years old (OR=1.71, 95% CI 1.01 to 2.92). No associated factors were found among enabling factors. The need factors associated with higher odds of parental help-seeking were having previous help-seeking (OR=2.52, 95% CI 1.83 to 3.48) and discussing child's socioemotional development in the well-child visit (OR=2.47, 95% CI 1.73 to 3.53). CONCLUSIONS Predisposing and need factors were associated with parental help-seeking for socioemotional development of 3-year-old children. The findings can be used to further develop support for parents accessing adequate information, prevention and anticipatory care with regards to the child's socio-emotional development.
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Affiliation(s)
- Jie Luo
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Hein Raat
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Carmen Betsy Franse
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | - Guannan Bai
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Amy van Grieken
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Eijgermans DGM, Raat H, Jansen PW, Blok E, Hillegers MHJ, Jansen W. Teacher-reported emotional and behavioural problems and ethnic background associated with children's psychosocial care use: a longitudinal population-based study. Eur Child Adolesc Psychiatry 2022:10.1007/s00787-021-01937-w. [PMID: 35006343 DOI: 10.1007/s00787-021-01937-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 12/22/2021] [Indexed: 11/28/2022]
Abstract
Approximately, 15% of children in Western countries suffer from emotional and behavioural problems. However, not all children receive the psychosocial care they need, especially children with a non-Western background experience an unmet need for care. This might be because parents of non-Western children report a lower need for care than parents of Western children, unrelated to the actual need. This study examined the association between teacher-reported problems and psychosocial care use, independent of mother-reported problems. Further, the role of ethnic background in this association was investigated. The study sample of 9-year-old children was retrieved from the Generation R Study (N = 3084), a prospective, population-based cohort of children born in Rotterdam, the Netherlands. Teacher- and mother-reported problems were measured via questionnaire when the children were 6/7 years old. Psychosocial care use was mother-reported at the research centre when children were 9 years old (8.1%). Hierarchical logistic regressions showed significant positive associations between teacher-reported total, externalising and internalising problems and later psychosocial care use. These associations were independent of mother-reported problems. Children with a non-Western background used less care, but ethnic background did not moderate the association between teacher-reported problems and care use. Our findings suggest that teachers might have an important role, next to parents, in the identification of problems and children's access to care. This may be particularly important for non-Western children, as they use less psychosocial care than Western children, despite other research showing that they generally display higher levels of problems. Directions for future research and implications are discussed.
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Affiliation(s)
- D G M Eijgermans
- The Generation R Study Group, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.,Department of Public Health, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - H Raat
- Department of Public Health, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - P W Jansen
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.,Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - E Blok
- The Generation R Study Group, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.,Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - M H J Hillegers
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - W Jansen
- Department of Public Health, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands. .,Department of Social Development, City of Rotterdam, P. O. Box 70032, 3000 LP, Rotterdam, The Netherlands.
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Roubinov DS, Epel ES, Adler NE, Laraia BA, Bush NR. Transactions between Maternal and Child Depressive Symptoms Emerge Early in Life. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2022; 51:61-72. [PMID: 31453717 PMCID: PMC7044043 DOI: 10.1080/15374416.2019.1644649] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Maternal depression is a robust risk factor for children's internalizing symptoms; however, the intergenerational transmission of mood disorders is likely more complex than unidirectional parent-directed effects. Theoretical models support transactional associations between maternal and child symptomatology over time but have not been well examined, especially in younger high-risk samples. The present investigation examined predictive transactional relations between maternal depression and children's internalizing in toddlerhood and early childhood using a cross-lagged panel model. Participants were 162 low-income, largely racial/ethnic minority mothers and their offspring (32% African American, 16% White, 52% Other/Multiethnic; 53% female) who were assessed when children were 18 months and 4 years old. There were significant cross-sectional relations between maternal depressive and child internalizing symptoms when children were 18 months but not 4 years of age. Cross-lagged associations were evident such that maternal depression symptoms at 18 months were positively associated with internalizing symptoms among children at 4 years, adjusting for prior maternal symptom levels and the cross-sectional correlations between maternal-child symptoms at 18 months. Within the same model, children's internalizing symptoms at 18 months were also positively associated with maternal depressive symptoms at 4 years, adjusting for prior child symptom levels and cross-sectional correlations. This study is among the first to demonstrate that transactional relations between maternal and child mood symptoms occur as early as toddlerhood/early childhood. Findings highlight the potential utility of inclusive, family-focused interventions that support both parents and children in the treatment of early emotional problems.
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Affiliation(s)
| | - Elissa S. Epel
- Department of Psychiatry, University of California, San Francisco
| | - Nancy E. Adler
- Department of Psychiatry, University of California, San Francisco
| | - Barbara A. Laraia
- Community Health Sciences, Berkeley School of Public Health, University of California, Berkeley
| | - Nicole R. Bush
- Department of Psychiatry, University of California, San Francisco,Department of Pediatrics, University of California, San Francisco
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Seker S, Bürgin D, d’Huart D, Schmid M, Schmeck K, Jenkel N, Fegert JM, Steppan M, Boonmann C. Der Verlauf von psychischen Problemen bei fremdplatzierten Kindern und Jugendlichen bis in deren Erwachsenenalter. KINDHEIT UND ENTWICKLUNG 2022. [DOI: 10.1026/0942-5403/a000365] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Zusammenfassung. Theoretischer Hintergrund: Fremdplatzierte Kinder und Jugendliche sind psychisch hoch belastet, jedoch ist der Verlauf von psychischen Problemen bis in deren Erwachsenenalter weitgehend unbekannt. Fragestellung: Die Prävalenz und der Verlauf von psychischen Problemen bei fremdplatzierten Kindern und Jugendlichen bis ins Erwachsenenalter wurden in dieser Studie untersucht und mögliche Prädiktoren identifiziert. Methode: 164 Kinder und Jugendliche wurden während der Fremdplatzierung und im Erwachsenenalter längsschnittlich mittels Selbstbeurteilungsfragebogen auf psychische Gesamtauffälligkeit, internalisierende und externalisierende Probleme untersucht. Ergebnisse: 62.2 % der Kinder und Jugendlichen zeigten auffällige Werte für die Gesamtauffälligkeit wohingegen es im Erwachsenenalter noch 35.7 % waren. Die stärksten Prädiktoren für die jeweiligen Skalen im Erwachsenenalter waren die psychischen Probleme im Kindes- und Jugendalter. Mädchen zeigten eine erhöhte Wahrscheinlichkeit für internalisierende Probleme im Erwachsenenalter im Vergleich zu Jungen. Diskussion und Schlussfolgerung: Die psychischen Probleme bei fremdplatzierten Kindern und Jugendlichen verringerten sich bis ins junge Erwachsenenalter, dennoch blieb ein beachtlicher Teil chronisch auffällig. Implikationen für die Forschung und Praxis werden diskutiert.
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Affiliation(s)
- Süheyla Seker
- Kinder- und jugendpsychiatrische Forschungsabteilung, Universitäre Psychiatrische Kliniken Basel, Universität Basel, Schweiz
| | - David Bürgin
- Kinder- und jugendpsychiatrische Forschungsabteilung, Universitäre Psychiatrische Kliniken Basel, Universität Basel, Schweiz
- Universitätsklinikum Ulm, Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Ulm
| | - Delfine d’Huart
- Kinder- und jugendpsychiatrische Forschungsabteilung, Universitäre Psychiatrische Kliniken Basel, Universität Basel, Schweiz
| | - Marc Schmid
- Kinder- und jugendpsychiatrische Forschungsabteilung, Universitäre Psychiatrische Kliniken Basel, Universität Basel, Schweiz
| | - Klaus Schmeck
- Kinder- und jugendpsychiatrische Forschungsabteilung, Universitäre Psychiatrische Kliniken Basel, Universität Basel, Schweiz
| | - Nils Jenkel
- Kinder- und jugendpsychiatrische Forschungsabteilung, Universitäre Psychiatrische Kliniken Basel, Universität Basel, Schweiz
| | - Jörg M. Fegert
- Universitätsklinikum Ulm, Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Ulm
| | - Martin Steppan
- Abteilung für Persönlichkeits- und Entwicklungspsychologie, Fakultät für Psychologie, Universität Basel, Schweiz
| | - Cyril Boonmann
- Kinder- und jugendpsychiatrische Forschungsabteilung, Universitäre Psychiatrische Kliniken Basel, Universität Basel, Schweiz
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Levendosky AA, Bogat GA, Lonstein J, Muzik M, Nuttall AK. Longitudinal prospective study examining the effects of the timing of prenatal stress on infant and child regulatory functioning: the Michigan Prenatal Stress Study protocol. BMJ Open 2021; 11:e054964. [PMID: 34535489 PMCID: PMC8451297 DOI: 10.1136/bmjopen-2021-054964] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION A considerable literature implicates prenatal stress as a critical determinant of poor psychological functioning in childhood and beyond. However, knowledge about whether the timing of prenatal stress differentially influences the development of child outcomes, including psychopathology, is virtually unknown. The primary aim of our study is to examine how the timing of prenatal stress differentially affects early childhood regulatory functioning as a marker of psychopathology. Our second aim is to examine the mediating effects of maternal physiological and psychological factors during pregnancy. Our third aim is to examine the moderating effects of postnatal factors on child regulatory functioning. Our project is the first longitudinal, prospective, multimethod study addressing these questions. METHODS AND ANALYSIS Our ongoing study recruits pregnant women, oversampled for intimate partner violence (a common event-based stressor allowing examination of timing effects), with data collection starting at pregnancy week 15 and concluding 4 years post partum. We aim to have n=335 mother-child dyads. We conduct a granular assessment of pregnancy stress (measured weekly by maternal report) in order to reveal sensitive periods during fetal life when stress particularly derails later functioning. Pattern-based statistical analyses will be used to identify subgroups of women who differ in the timing of their stress during pregnancy and then test whether these patterns of stress differentially predict early childhood self-regulatory outcomes. ETHICS AND DISSEMINATION Due to the high-risk nature of our sample, care is taken to ensure protection of their well-being, including a safety plan for suicidal ideation and a safety mechanism (exit button in the online weekly survey) to protect participant data privacy. This study was approved by Michigan State University Institutional Review Board. Dissemination will be handled by data sharing through National Institute of Child Health and Human Development Data and Specimen Hub (DASH), as well as through publishing the findings in journals spanning behavioural neuroendocrinology to clinical and developmental psychology.
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Affiliation(s)
| | - G Anne Bogat
- Psychology, Michigan State University, East Lansing, Michigan, USA
| | - Joseph Lonstein
- Psychology, Michigan State University, East Lansing, Michigan, USA
| | - Maria Muzik
- Psychiatry, University of Michigan-Michigan Medicine, Ann Arbor, Michigan, USA
| | - Amy K Nuttall
- Human Development and Family Studies, Michigan State University, East Lansing, Michigan, USA
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Neu MA, Schlecht J, Schmidt MF, Robinson AL, Spix C, Grabow D, Kaatsch P, Erdmann F, Faber J, Urschitz MS. Mental health and health-related quality of life in preschool-aged childhood cancer survivors. Results of the prospective cohort study ikidS-OEVA. Pediatr Blood Cancer 2021; 68:e29039. [PMID: 33960635 DOI: 10.1002/pbc.29039] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 03/09/2021] [Accepted: 03/15/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVES Long-term survivors of childhood cancer are at increased risk for sequelae such as poor mental health (MH) or impaired health-related quality of life (HrQoL). We aimed to evaluate early adverse effects on MH and HrQoL in young childhood cancer survivors (YCCS) before school entry. METHODS In a nationwide prospective cohort study, children with cancer other than brain tumors diagnosed at preschool age and completed cancer treatments were identified from the German Childhood Cancer Registry. The comparison group was children of the same age without a cancer diagnosis who participated in the prospective population-based health survey ikidS. MH problems and HrQoL were assessed by parental versions of the Strengths and Difficulties Questionnaire (SDQ) and the questionnaire for health-related quality of life in children (KINDL), respectively. Associations between cancer and MH as well as HrQoL were analyzed by multivariable linear regression. RESULTS Of 382 YCCS contacted, 145 were enrolled (mean age 6.6 years) and 124 analyzed. Compared to children without a cancer diagnosis (3683 contacted, 2003 enrolled, 1422 analyzed), YCCS had more MH problems (13% vs. 3%) and slightly worse HrQoL (median 78.7 vs. 80.2 points). In the adjusted analysis, YCCS had higher SDQ scores (2.2 points, 95% confidence interval [CI] 1.3, 3.0) and lower KINDL scores (-2.4 points, 95% CI -3.7, -1.1) compared to children without cancer diagnosis. CONCLUSION Already at preschool age, YCCS may be at increased risk of MH problems and impaired HrQoL. This could have impacts on subsequent school performance and educational attainment. Follow-up health care for YCCS may include early screening for MH problems and reasons for HrQoL deficits.
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Affiliation(s)
- Marie A Neu
- Department of Pediatric Hematology/Oncology/Hemostaseology, Center for Pediatric and Adolescent Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Jennifer Schlecht
- Division of Pediatric Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Martina F Schmidt
- Division of Pediatric Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Abigale L Robinson
- Department of Pediatric Hematology/Oncology/Hemostaseology, Center for Pediatric and Adolescent Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Claudia Spix
- Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Desiree Grabow
- Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Peter Kaatsch
- Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Friederike Erdmann
- Division of Childhood Cancer Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Jörg Faber
- Department of Pediatric Hematology/Oncology/Hemostaseology, Center for Pediatric and Adolescent Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Michael S Urschitz
- Division of Pediatric Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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- Department of Pediatric Hematology/Oncology/Hemostaseology, Center for Pediatric and Adolescent Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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Lipscomb ST, Hatfield B, Lewis H, Goka-Dubose E, Abshire C. Adverse childhood experiences and children's development in early care and education programs. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2021. [DOI: 10.1016/j.appdev.2020.101218] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Cruz SH, Piccinini CA, Matijasevich A, Santos IS. Behavior Problems in Four-Year-Old Children from a Brazilian Birth Cohort. PSICOLOGIA: TEORIA E PESQUISA 2021. [DOI: 10.1590/0102.3772e37301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract This study aimed to investigate the occurrence of behavior problems in 3750 four years old children from a birth cohort. Children were followed from birth to four years old through home visits, and questionnaires on child health and development and the Child Behavior Checklist 4-18/CBCL were applied. Prevalence rates were high (total problems 35.6%), particularly externalizing problems, which occurred in 44.4 % of children (48.3% girls; 40.6% boys; p < 0.001). Internalizing problems were less prevalent, occurring in 15.5 % of children (19.1% boys; 11.6% girls; p < 0.001). Regardless of sex, there was a higher prevalence of behavioral problems in children with younger siblings, whose mothers had less education and had no partner.
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England-Mason G, Grohs MN, Reynolds JE, MacDonald A, Kinniburgh D, Liu J, Martin JW, Lebel C, Dewey D. White matter microstructure mediates the association between prenatal exposure to phthalates and behavior problems in preschool children. ENVIRONMENTAL RESEARCH 2020; 182:109093. [PMID: 32069753 PMCID: PMC7050961 DOI: 10.1016/j.envres.2019.109093] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 11/27/2019] [Accepted: 12/26/2019] [Indexed: 05/30/2023]
Abstract
BACKGROUND Previous research reports associations between prenatal exposure to phthalates and childhood behavior problems; however, the neural mechanisms that may underlie these associations are relatively unexplored. OBJECTIVE This study examined microstructural white matter as a possible mediator of the associations between prenatal phthalate exposure and behavior problems in preschool-aged children. METHODS Data are from a subsample of a prospective pregnancy cohort, the Alberta Pregnancy Outcomes and Nutrition (APrON) study (n = 76). Mother-child pairs were included if mothers provided a second trimester urine sample, if the child completed a successful magnetic resonance imaging (MRI) scan at age 3-5 years, and if the Child Behavior Checklist was completed within 6 months of the MRI scan. Molar sums of high (HMWP) and low molecular weight phthalates (LMWP) were calculated from levels in urine samples. Associations between prenatal phthalate concentrations, fractional anisotropy (FA) and mean diffusivity (MD) in 10 major white matter tracts, and preschool behavior problems were investigated. RESULTS Maternal prenatal phthalate concentrations were associated with MD of the right inferior fronto-occipital fasciculus (IFO), right pyramidal fibers, left and right uncinate fasciculus (UF), and FA of the left inferior longitudinal fasciculus (ILF). Mediation analyses showed that prenatal exposure to HMWP was indirectly associated with Internalizing (path ab = 0.09, CI.95 = 0.02, 0.20) and Externalizing Problems (path ab = 0.09, CI.95 = 0.01, 0.19) through MD of the right IFO, and to Internalizing Problems (path ab = 0.11, CI.95 = 0.01, 0.23) through MD of the right pyramidal fibers. DISCUSSION This study provides the first evidence of childhood neural correlates of prenatal phthalate exposure. Results suggest that prenatal phthalate exposure may be related to microstructural white matter in the IFO, pyramidal fibers, UF, and ILF. Further, MD of the right IFO and pyramidal fibers may transmit childhood risk for behavioral problems.
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Affiliation(s)
- Gillian England-Mason
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Canada; Owerko Centre, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada
| | - Melody N Grohs
- Owerko Centre, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada; Department of Neuroscience, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Jess E Reynolds
- Owerko Centre, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada; Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Canada; Hotchkiss Brain Institute, Calgary, Canada
| | - Amy MacDonald
- Alberta Centre for Toxicology, University of Calgary, Calgary, Canada
| | - David Kinniburgh
- Alberta Centre for Toxicology, University of Calgary, Calgary, Canada
| | - Jiaying Liu
- Department of Laboratory Medicine and Pathology, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada
| | - Jonathan W Martin
- Department of Laboratory Medicine and Pathology, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada; Science for Life Laboratory, Department of Analytical Chemistry and Environmental Sciences, Stockholm University, Stockholm, Sweden
| | - Catherine Lebel
- Owerko Centre, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada; Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Canada; Hotchkiss Brain Institute, Calgary, Canada
| | - Deborah Dewey
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Canada; Owerko Centre, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada; Hotchkiss Brain Institute, Calgary, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada.
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Morgan AJ, Tamir E, Rapee RM, Lyneham HJ, McLellan LF, Bayer JK. Online Assessment of Preschool Anxiety: description and initial validation of a new diagnostic tool. Child Adolesc Ment Health 2019; 24:259-265. [PMID: 32677211 DOI: 10.1111/camh.12324] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/17/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND The Online Assessment of Preschool Anxiety (OAPA) is a newly developed measure that assesses anxiety disorders in preschool children aged 3-6 years. This study aimed to explore the OAPA's initial psychometric properties with a particular focus on examining its construct validity, both convergent and discriminant. METHOD The OAPA was completed online by a community sample of 319 Australian parents of temperamentally inhibited preschool children (M: 5.3 years). Preliminary diagnoses were automatically generated before assessment reports were reviewed by a psychologist. Construct validity was examined by assessing the degree of agreement between the OAPA and existing valid questionnaire measures that were simultaneously administered online. RESULTS Nearly half of participants met criteria for a child anxiety disorder according to the OAPA, most commonly social phobia. Findings supported convergent validity with the Revised Preschool Anxiety Scale (an anxiety symptom measure), the Children's Anxiety Life Interference Scale - Preschool Version (a measure of life interference from anxiety), the Emotional Symptoms scale of the Strengths and Difficulties Questionnaire-Parent Version (a measure of broader internalizing symptoms), as well as an over-involved/protective parenting scale. Findings also supported initial discriminant validity with the Conduct Problems scale of the Strengths and Difficulties Questionnaire-Parent Version. CONCLUSIONS Results of this study provide evidence for the OAPA's preliminary construct validity. With further research into the OAPA's reliability (test-retest and interrater) and confirming construct validity, the OAPA may be a useful instrument for use in research settings and clinical practice.
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Affiliation(s)
- Amy J Morgan
- School of Psychology and Public Health, La Trobe University, Bundoora, Vic., Australia.,Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia
| | - Elli Tamir
- School of Psychology and Public Health, La Trobe University, Bundoora, Vic., Australia
| | - Ronald M Rapee
- Centre for Emotional Health, Macquarie University, Sydney, NSW, Australia
| | - Heidi J Lyneham
- Centre for Emotional Health, Macquarie University, Sydney, NSW, Australia
| | - Lauren F McLellan
- Centre for Emotional Health, Macquarie University, Sydney, NSW, Australia
| | - Jordana K Bayer
- School of Psychology and Public Health, La Trobe University, Bundoora, Vic., Australia.,Murdoch Childrens Research Institute, Melbourne, Vic., Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Vic., Australia
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Polygenic and environmental influences on the course of African Americans' alcohol use from early adolescence through young adulthood. Dev Psychopathol 2019; 32:703-718. [PMID: 31256767 DOI: 10.1017/s0954579419000701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The study examined (a) whether alcohol use subgroups could be identified among African Americans assessed from adolescence through early adulthood, and (b) whether subgroup membership was associated with the interaction between internalizing symptoms and antisocial behavior polygenic risk scores (PRSs) and environmental characteristics (i.e., parental monitoring, community disadvantage). Participants (N = 436) were initially recruited for an elementary school-based prevention trial in a Mid-Atlantic city. Youths reported on the frequency of their past year alcohol use from ages 14-26. DNA was obtained from participants at age 21. Internalizing symptoms and antisocial behavior PRSs were created based on a genome-wide association study (GWAS) conducted by Benke et al. (2014) and Tielbeek et al. (2017), respectively. Parental monitoring and community disadvantage were assessed at age 12. Four classes of past year alcohol use were identified: (a) early-onset, increasing; (b) late-onset, moderate use; (c) low steady; and (d) early-onset, decreasing. In high community disadvantaged settings, participants with a higher internalizing symptoms PRS were more likely to be in the early-onset, decreasing class than the low steady class. When exposed to elevated community disadvantage, participants with a higher antisocial behavior PRS were more likely to be in the early-onset, increasing class than the early-onset, decreasing and late-onset, moderate use classes.
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Jobs I, Müller JM, Skorozhenina O, Romer G. Homo- and Heterotypic Trajectories in a Preschool to Primary-School Clinical Sample: A Prospective Study Related to Maternal Psychopathology. Front Psychiatry 2019; 10:153. [PMID: 30967803 PMCID: PMC6440442 DOI: 10.3389/fpsyt.2019.00153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 03/01/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Most longitudinal or follow-up mental health studies describe developmental pathways using dimensional measures of psychopathology, but seldom using pathways described by clinical disorders. Objective: We aim to describe diagnostic pathways by homotypic (within the disorder continuity) and heterotypic development (between the disorder continuity), with maternal psychopathology as moderator for both trajectories. Methods: Clinically referred children (0-7 years; N = 83) were assessed at preschool age and at primary-school age through a clinical interview. We built a disorder cluster of emotional disorders (ED; F32, F40, F42, F43, F93.0, F93.1, F93.2, F93.8, F95), behavioral disorders (BD; F68.8, F90, F91, F91.3, F93.3, F93.9, F94), and specific early onset disorders (SEO; F50, F51, F70, F98.0, F98.1, F98.2, F98.8, F98.9). We describe the prevalence, comorbidity, and clinical trajectories of various types of homotypic and heterotypic development. Results: We observed a high rate of comorbidity throughout the study (62.6% at admission and 67.5% at follow-up) and in general, a high continuity of mental health problems from preschool to primary-school age children (69.9% of the sample showed continuity), with 50.6% of the sample showing homotypic and 44.6% showing heterotypic development. Hierarchical multiple regression analyses suggest that heterotypic development may be influenced by maternal psychopathology. Conclusion: Currently, evidence-based mental health guidelines for preschool populations are designed and evaluated assuming a homotypic development. However, our findings indicate that treatment interventions and outcome measures should also be designed and evaluated for heterotypic development especially in case of increased maternal psychopathology.
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Affiliation(s)
- Isabell Jobs
- Department of Child and Adolescent Psychiatry, University Hospital Münster, Münster, Germany
| | - Jörg Michael Müller
- Department of Child and Adolescent Psychiatry, University Hospital Münster, Münster, Germany
- Health Psychology and Applied Diagnostics, University of Wuppertal, Münster, Germany
| | - Olena Skorozhenina
- Department of Child and Adolescent Psychiatry, University Hospital Münster, Münster, Germany
| | - Georg Romer
- Department of Child and Adolescent Psychiatry, University Hospital Münster, Münster, Germany
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Helle N, Barkmann C, Ehrhardt S, Wense AVD, Nestoriuc Y, Bindt C. Internalizing symptoms in very low birth weight preschoolers: Symptom level and risk factors from four rating perspectives in a controlled multicenter study. J Affect Disord 2019; 246:74-81. [PMID: 30578949 DOI: 10.1016/j.jad.2018.12.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 10/29/2018] [Accepted: 12/15/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Preterm births rates of infants with very low birth weight (VLBW < 1500 g) are increasing. Prematurity poses several risks for emotional child development, e.g., internalizing symptoms. Our understanding of this condition in young children is limited, for at preschool age, symptoms have mostly been assessed from the mother's perspective only. METHODS As part of the longitudinal HaFEn cohort-study in Hamburg, Germany, we measured the level of internalizing symptoms in VLBW and term preschoolers as well as predictors from four informants' perspectives: mother, father, teacher, and child. A multilevel model was constructed to examine predictors of internalizing symptoms. n = 104 VLBW and n = 79 term children were included. RESULTS From both their parents' perspective, children with VLBW had a significantly higher level of internalizing symptoms. From the teacher's and child's own perspectives, there were no significant mean group differences. In the multilevel analyses, the results were different regarding the four perspectives. VLBW did not predict internalizing symptoms. From mother's perspective, her own postpartum psychological distress, and from father's perspective, his postpartum and current psychological distress predicted a higher level of internalizing symptoms in their offspring. From teacher's perspective, socio-economic status predicted internalizing symptoms. LIMITATIONS The sample size was relatively small. Exclusion criteria and drop out of families could have created some selection bias. CONCLUSIONS Our findings point to the importance of early identification of parental postpartum psychological distress given the potential for later internalizing symptoms in their children or the perception of their offspring as vulnerable and symptomatic, which may also impact the child's development.
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Affiliation(s)
- Nadine Helle
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, W29, 20246 Hamburg, Germany
| | - Claus Barkmann
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, W29, 20246 Hamburg, Germany.
| | - Stephan Ehrhardt
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Axel von der Wense
- Department of Neonatology and Paediatric Critical Care, Neonatal Intensive Care Unit, Altona Children's Hospital, Hamburg, Germany
| | - Yvonne Nestoriuc
- Department of Clinical Psychology, Helmut-Schmidt-University, Hamburg, Germany
| | - Carola Bindt
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, W29, 20246 Hamburg, Germany
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Philippot G, Hallgren S, Gordh T, Fredriksson A, Fredriksson R, Viberg H. A Cannabinoid Receptor Type 1 (CB1R) Agonist Enhances the Developmental Neurotoxicity of Acetaminophen (Paracetamol). Toxicol Sci 2018; 166:203-212. [DOI: 10.1093/toxsci/kfy199] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Affiliation(s)
- Gaëtan Philippot
- Department of Environmental Toxicology, Evolutionary Biology Centre
| | - Stefan Hallgren
- Department of Environmental Toxicology, Evolutionary Biology Centre
| | | | | | - Robert Fredriksson
- Department of Molecular Neuropharmacology, Uppsala Biomedical Centre, Husargatan 3, 751 24 UPPSALA, Sweden
| | - Henrik Viberg
- Department of Environmental Toxicology, Evolutionary Biology Centre
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Predicting Temperamentally Inhibited Young Children’s Clinical-Level Anxiety and Internalizing Problems from Parenting and Parent Wellbeing: a Population Study. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2018; 47:1165-1181. [DOI: 10.1007/s10802-018-0442-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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O'Connor C, Reulbach U, Gavin B, McNicholas F. A prospective longitudinal investigation of the (dis)continuity of mental health difficulties between mid- to late-childhood and the predictive role of familial factors. Eur Child Adolesc Psychiatry 2018; 27:289-300. [PMID: 28884353 DOI: 10.1007/s00787-017-1044-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 08/23/2017] [Indexed: 11/26/2022]
Abstract
Understanding individual variation in the continuity of youth mental health difficulties is critical for identifying the factors that promote recovery or chronicity. This study establishes the proportion of children showing psychopathology at 9 years, whose pathology had either remitted or persisted at 13. It describes the socio-demographic and clinical profiles of these groups, and examines the factors in 9-year-olds' familial environments that predict longitudinal remission vs. persistence of psychopathology. The study utilised data from a prospective longitudinal study of 8568 Irish children. Child psychopathology was assessed using the Strengths and Difficulties Questionnaire (SDQ). Analysis established the rates of continuity of SDQ classifications between 9 and 13 years. Analysis also investigated the familial factors that predicted the remission vs. persistence of psychopathological symptoms, controlling for socio-demographic and child factors. Average SDQ scores improved between the ages of 9 and 13, F(1, 7292) = 276.52, p < 0.001, [Formula: see text] = 0.04. Of children classified Abnormal aged 9, 41.1% remained so classified at 13, 21.4% were reclassified Borderline, and 37.6% Normal. Demographic and child risk factors for persistence of pathology were maleness (β = -1.00, p = 0.001, CI = 0.20-0.67), one-carer households (β = -0.71, p = 0.04, CI = 0.25-0.97), poor physical health (β = -0.64, p = 0.03, CI = 0.30-0.92), and low cognitive ability (β = 0.61, p = 0.002, CI = 1.26-2.70). Controlling for these factors, the only familial variable at 9 years that predicted subsequent pathological persistence was caregiver depression (β = -0.07, p = 0.03, CI = 0.87-0.99). The analysis highlights substantial rates of psychopathological discontinuity in a community sample and identifies the children most at risk of chronic mental health problems. These results will inform the targeting of early interventions and distribution of clinical resources.
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Affiliation(s)
- Cliodhna O'Connor
- School of Medicine & Medical Science, University College Dublin, Dublin, Ireland.
- School of Psychology, University College Dublin, Dublin, Ireland.
| | - Udo Reulbach
- School of Medicine & Medical Science, University College Dublin, Dublin, Ireland
- Child & Family Centre, Drogheda, Ireland
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Blanaid Gavin
- School of Medicine & Medical Science, University College Dublin, Dublin, Ireland
- Children's Mental Health Clinic, Dublin, Ireland
| | - Fiona McNicholas
- School of Medicine & Medical Science, University College Dublin, Dublin, Ireland
- Lucena Clinic, Dublin, Ireland
- Our Lady's Children's Hospital, Crumlin, Dublin, Ireland
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Vlenterie R, Wood ME, Brandlistuen RE, Roeleveld N, van Gelder MM, Nordeng H. Neurodevelopmental problems at 18 months among children exposed to paracetamol in utero: a propensity score matched cohort study. Int J Epidemiol 2018; 45:1998-2008. [PMID: 27585674 DOI: 10.1093/ije/dyw192] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2016] [Indexed: 12/22/2022] Open
Abstract
Background Previous studies showed that children exposed to paracetamol during fetal life might have an increased risk of neurodevelopmental problems. Since paracetamol is one of the most commonly used medications during pregnancy, even small increases in the risk of neurodevelopmental problems may have considerable implications for public health. Methods Using data from the Norwegian Mother and Child Cohort Study, we applied propensity score (PS) matching to examine associations between prenatal paracetamol exposure and neurodevelopmental problems among children at 18 months of age. Paracetamol use was classified into short-term (< 28 days) and long-term (≥ 28 days) of exposure. Results Of the 51 200 pregnancies included in our study, 40.5% of mothers ( n = 20 749) used paracetamol at least once during pregnancy. In the PS-matched analyses, long-term paracetamol exposure during pregnancy was associated with communication problems [odds ratio (OR): 1.38, 95% confidence interval (CI) 0.98-1.95) and delayed motor milestone attainment (OR: 1.35, 95% CI 1.07-1.70). We did not observe increased risks after short-term exposure. Sensitivity analyses for several indications showed similar effects as the PS-matched analyses, suggesting no confounding by indication. Conclusion Long-term exposure to paracetamol in utero was associated with modestly increased risks of motor milestone delay and impaired communication skills among children at 18 months. Caution is warranted when considering long-term use of paracetamol during pregnancy; however, women with severe pain conditions should not be deprived of appropriate pharmacotherapy.
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Affiliation(s)
- Richelle Vlenterie
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.,PharmacoEpidemiology & Drug Safety Research Group, School of Pharmacy, University of Oslo, Oslo, Norway
| | - Mollie E Wood
- PharmacoEpidemiology & Drug Safety Research Group, School of Pharmacy, University of Oslo, Oslo, Norway
| | - Ragnhild Eek Brandlistuen
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.,PharmacoEpidemiology & Drug Safety Research Group, School of Pharmacy, University of Oslo, Oslo, Norway
| | - Nel Roeleveld
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Pediatrics, Radboudumc Amalia Children's Hospital
| | - Marleen Mhj van Gelder
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.,Radboud REshape Innovation Center, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Hedvig Nordeng
- PharmacoEpidemiology & Drug Safety Research Group, School of Pharmacy, University of Oslo, Oslo, Norway.,Domain for Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
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Wlodarczyk O, Pawils S, Metzner F, Kriston L, Klasen F, Ravens-Sieberer U. Risk and protective factors for mental health problems in preschool-aged children: cross-sectional results of the BELLA preschool study. Child Adolesc Psychiatry Ment Health 2017; 11:12. [PMID: 28286550 PMCID: PMC5341413 DOI: 10.1186/s13034-017-0149-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 02/08/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mental health problems (MHPs) in preschoolers are precursors of mental disorders which have shown to be associated with suffering, functional impairment, exposure to stigma and discrimination, as well as enhanced risk of premature death. A better understanding of factors associated with MHPs in preschoolers can facilitate early identification of children at risk and inform prevention programs. This cross-sectional study investigated the association of risk and protective factors with MHPs within a German representative community sample. METHODS MHPs were assessed in a sample of 391 preschoolers aged 3-6 years using the Strength and Difficulties Questionnaire (SDQ). The effects of parental MHPs, children's temperament, parental socioeconomic status (SES), social support and perceived self-competence on MHPs were assessed using bivariate and multivariate logistic regression analyses that controlled for sociodemographic characteristics. RESULTS Overall, 18.2% of preschoolers were classified as 'borderline or abnormal' on the total difficulties score of the SDQ. Bivariate analyses showed that parental MHPs, children's difficult temperament, and parental low SES increased the likelihood, whereas high perceived parental competence decreased the likelihood of preschool MHPs. In the multivariate analyses, only difficult child temperament remained significantly associated with preschool MHPs when other variables were controlled. CONCLUSIONS The results underline the importance of children's difficult temperamental characteristics as a risk factor for mental health in preschoolers and suggest that these may also be an appropriate target for prevention of preschool MHPs. More research on specific aspects of preschool children's temperament, the socioeconomic environment and longitudinal studies on the effects of these in the development of preschool MHPs is needed.
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Affiliation(s)
- Olga Wlodarczyk
- 0000 0001 2180 3484grid.13648.38Institute and Outpatients Clinic of Medical Psychology, Centre for Psychosocial Medicine, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52 (Building W26), 20246 Hamburg, Germany
| | - Silke Pawils
- 0000 0001 2180 3484grid.13648.38Institute and Outpatients Clinic of Medical Psychology, Centre for Psychosocial Medicine, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52 (Building W26), 20246 Hamburg, Germany
| | - Franka Metzner
- 0000 0001 2180 3484grid.13648.38Institute and Outpatients Clinic of Medical Psychology, Centre for Psychosocial Medicine, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52 (Building W26), 20246 Hamburg, Germany
| | - Levente Kriston
- 0000 0001 2180 3484grid.13648.38Institute and Outpatients Clinic of Medical Psychology, Centre for Psychosocial Medicine, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52 (Building W26), 20246 Hamburg, Germany
| | - Fionna Klasen
- 0000 0001 2180 3484grid.13648.38Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Research Division “Child Public Health”, Centre for Psychosocial Medicine, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52 (Building W26), 20246 Hamburg, Germany
| | - Ulrike Ravens-Sieberer
- 0000 0001 2180 3484grid.13648.38Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Research Division “Child Public Health”, Centre for Psychosocial Medicine, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52 (Building W26), 20246 Hamburg, Germany
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Effect of Caregiver Training on the Neurodevelopment of HIV-Exposed Uninfected Children and Caregiver Mental Health: A Ugandan Cluster-Randomized Controlled Trial. J Dev Behav Pediatr 2017; 38:753-764. [PMID: 28991146 PMCID: PMC5668186 DOI: 10.1097/dbp.0000000000000510] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Early childhood development programs typically combine healthy nutrition and cognitive stimulation in an integrated model. We separately delivered these 2 components in a cluster-randomized controlled trial to evaluate their comparative effectiveness in promoting healthy child development and caregiver mental health. This is the first study to do so for HIV-affected children and their infected mothers. METHODS Two hundred twenty-one HIV-exposed but uninfected child (2-3 years old) and caregiver dyads in 18 geographic clusters in Eastern Uganda were randomized by cluster to receive biweekly individualized sessions of either (1) Mediational Intervention for Sensitizing Caregivers (MISC) training emphasizing cognitive stimulation or (2) Uganda Community Based Association for Child Welfare (UCOBAC) program that delivered health and nutrition training. Children were evaluated at baseline, 6 months, 1 year (training conclusion), and 1-year posttraining with the Mullen Scales of Early Learning (MSEL), the Color-Object Association Test for memory, the Early Childhood Vigilance Test of attention, and the Behavior Rating Inventory of Executive Function (BRIEF-parent). The Caldwell Home Observation for the Measurement of the Environment (HOME) was completed by observers to gauge caregiving quality after training. Caregiver depression/anxiety (Hopkins Symptom Checklist-25) and functionality (list of activities of daily living) were also evaluated. Data collectors were blinded to trial arm assignment. RESULTS Mediational Intervention for Sensitizing Caregivers resulted in significantly better quality of caregiving compared with UCOBAC midintervention with an adjusted mean difference (MadjDiff) of 2.34 (95% confidence interval [CI]: 1.54-3.15, p < .01), postintervention (MadjDiff = 2.43, 95% CI: 1.61-3.25, p < .01), and at 1-year follow-up (MadjDiff = 2.07, 95% CI: 1.23-2.90, p < .01). MISC caregivers reported more problems on the BRIEF for their child at 1-year posttraining only (p < .01). Caregiving quality (HOME) was significantly correlated with MSEL composite performance 1-year posttraining for both the MISC and the UCOBAC trial arms. Likewise, physical growth was significantly related to child development outcomes even though it did not differ between trial arms. CONCLUSION Even though MISC demonstrated an advantage of improving caregiving quality, it did not produce better child cognitive outcomes compared with health and nutrition training. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01640561.
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Wood ME, Frazier JA, Nordeng HME, Lapane KL. Longitudinal changes in neurodevelopmental outcomes between 18 and 36 months in children with prenatal triptan exposure: findings from the Norwegian Mother and Child Cohort Study. BMJ Open 2016; 6:e011971. [PMID: 27625061 PMCID: PMC5030558 DOI: 10.1136/bmjopen-2016-011971] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE This study sought to determine whether changes in neurodevelopmental outcomes between 18 and 36 months of age were associated with prenatal exposure to triptan medications, a class of 5-HT receptor agonists used in the treatment of migraine. METHOD Using data from the Norwegian Mother and Child Cohort Study, a prospective birth cohort that includes nearly 40% of all pregnancies in Norway from 1999 to 2008, we identified 50 469 mother-child dyads who met inclusion criteria and were present for at least one follow-up assessment at 18 or 36 months postpartum. Neurodevelopment was assessed using the Child Behaviour Checklist, the Emotionality, Activity, and Shyness Questionnaire, and the Ages and Stages Questionnaire. We used generalised estimating equations to evaluate change from 18 to 36 months for children prenatally exposed to triptans, relative to contrast groups, and used marginal structural models with inverse probability of treatment and censoring weights to address time-varying exposure and confounding as well as loss to follow-up. RESULTS Among eligible participants (n=50 469), 1.0% used a triptan during pregnancy, 2.0% used triptans prior to pregnancy only, 8.0% reported migraine without triptan use and 89.0% had no history of migraine. Children with prenatal triptan exposure had greater increases in emotionality (r-RR 2.18, 95% CI 1.03 to 4.53) and activity problems (r-RR 1.70, 95% CI 1.02 to 2.8) compared to children born to mothers who discontinued triptan use prior to pregnancy. CONCLUSION Prenatal triptan exposure was associated with changes over time in externalising-type behaviours such as emotionality and activity, but not with internalising-type behaviours.
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Affiliation(s)
- Mollie E Wood
- The University of Oslo School of Pharmacy, Oslo, Norway
- The University of Massachusetts Medical School, Worcester, Massachusetts, USA
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, University of Oslo, Oslo, Norway
| | - Jean A Frazier
- The University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Hedvig M E Nordeng
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, University of Oslo, Oslo, Norway
- The University of Oslo School of Pharmacy and the Norwegian Institute of Public Health, Oslo, Norway
| | - Kate L Lapane
- The University of Massachusetts Medical School, Worcester, Massachusetts, USA
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Wlodarczyk O, Pawils S, Metzner F, Kriston L, Wendt C, Klasen F, Ravens-Sieberer U. Mental Health Problems Among Preschoolers in Germany: Results of the BELLA Preschool Study. Child Psychiatry Hum Dev 2016; 47:529-38. [PMID: 26353908 DOI: 10.1007/s10578-015-0586-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In a cross-sectional study, the prevalence rates of overall and specific mental health problems (MHP), as well as consequential impairments, were examined in a representative community sample of German preschoolers. MHP in 391 children were assessed by applying the Strength and Difficulties Questionnaire, as well as its impact supplement. Furthermore, the child behaviour checklist 1½-5 (CBCL 1½-5) and the IOWA-Conners behaviour rating scale were applied. Prevalence rates of MHP with 95 % confidence intervals (95 % CI) were determined. Odds ratios were calculated to analyse the relationships between MHP, age, gender, socioeconomic status, and geographical region using logistic regression. Overall, 7.4 % of the children showed symptoms of MHP. 12.9 % of the children were considered to be impaired by psychosocial problems. Depressive and anxiety symptoms were present in 4.2 % of the children; 11.8 % showed hyperactivity symptoms. The observed prevalence rates call for early mental health prevention in preschoolers.
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Affiliation(s)
- Olga Wlodarczyk
- Department of Medical Psychology, Centre for Psychosocial Medicine, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52 (W26), 20246, Hamburg, Germany.
| | - Silke Pawils
- Department of Medical Psychology, Centre for Psychosocial Medicine, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52 (W26), 20246, Hamburg, Germany
| | - Franka Metzner
- Department of Medical Psychology, Centre for Psychosocial Medicine, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52 (W26), 20246, Hamburg, Germany
| | - Levente Kriston
- Department of Medical Psychology, Centre for Psychosocial Medicine, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52 (W26), 20246, Hamburg, Germany
| | - Carolin Wendt
- Department of Medical Psychology, Centre for Psychosocial Medicine, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52 (W26), 20246, Hamburg, Germany
| | - Fionna Klasen
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
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Lumu L, Albertyn L, Szabo CP. Psychiatric services for preschoolers: an emerging need. J Child Adolesc Ment Health 2016; 27:113-24. [PMID: 26357917 DOI: 10.2989/17280583.2015.1081207] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To describe clinical presentation and service requirements for those under six years of age referred to a specialised child and adolescent psychiatry unit. METHOD This study used a retrospective review of preschoolers, six years and younger, assessed at a child, family and adolescent psychiatric unit (January 2006 to 31 December 2010). Data analysis established predominant diagnoses (prevalence percentages) and correlations and associations (diagnoses and a range of clinical variables - Fischer's exact test and chi-square test). RESULTS The sample comprised 149 subjects. Males predominated (77.2%; N = 115). Mean age of presentation was 54 months (SD=12.59). Children were referred predominantly by health professionals (36.9%; N = 55) and schools (20.8%; N = 31). Attention-deficit hyperactivity disorder (ADHD) was the most common diagnosis (52.8%; N = 70), and was not over-represented amongst boys. Girls mostly presented with anxiety disorders (44.1%; 15/34) and reactive attachment disorder (RAD) (35.3%; 12/34), and boys mostly with pervasive developmental disorders (PDD) (26%; 30/115). Psychometric testing was frequent (68.5%; N = 102). Pharmacological intervention was common (46.3%; N = 69). The defaulting rate after initial assessment was high (42.1%; 48/114). CONCLUSION The study demonstrates the existence of psychiatric illness in this sample, highlighting service needs. Vulnerability of this age group and limited sub-specialist resources emphasise the need for the development of community services leading to early recognition and intervention.
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Affiliation(s)
- Lavinia Lumu
- a Department of Psychiatry, Faculty of Health Sciences , University of the Witwatersrand, Charlotte Maxeke Johannesburg Academic Hospital , South Africa
| | - Lynda Albertyn
- b Department of Psychiatry, Faculty of Health Sciences , University of the Witwatersrand, Charlotte Maxeke Johannesburg Academic Hospital, Child and Adolescent Family Unit , South Africa
| | - Christopher Paul Szabo
- a Department of Psychiatry, Faculty of Health Sciences , University of the Witwatersrand, Charlotte Maxeke Johannesburg Academic Hospital , South Africa
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29
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Wood ME, Lapane K, Frazier JA, Ystrom E, Mick EO, Nordeng H. Prenatal Triptan Exposure and Internalising and Externalising Behaviour Problems in 3-Year-Old Children: Results from the Norwegian Mother and Child Cohort Study. Paediatr Perinat Epidemiol 2016; 30:190-200. [PMID: 26525300 PMCID: PMC4749405 DOI: 10.1111/ppe.12253] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Triptans are commonly prescribed for migraine, a pain condition that is highly prevalent in women of childbearing age. No prior studies have investigated associations between exposure to triptans during fetal life and risk of externalising and internalising behaviours in children. METHODS This study was set in the Norwegian Mother and Child Cohort study, a prospective birth cohort. A total of 41,173 live, singleton births without major malformations present at 36-month post-partum follow-up were included in this study; 396 used a triptan during pregnancy, 798 used a triptan prior to pregnancy only, 3291 reported migraine without triptan use, and 36,688 reported no history of migraine or triptan use. Marginal structural models were used to analyse the association between timing of triptan exposure and neurodevelopmental outcome. RESULTS Children exposed to triptans during pregnancy had a 1.39-fold increased risk of externalising behaviours compared with those whose mothers used triptans prior to pregnancy only (95% CI 0.97, 1.97), a 1.36-fold increased risk compared with the unmedicated migraine group (95% CI 1.02, 1.81), and a 1.41-fold increased risk compared with the population comparison group (95% CI 1.08, 1.85). The greatest risk was associated with first trimester exposure (RR 1.77, 95% CI 0.98, 3.14). Risk differences were small, ranging from 3-6%. CONCLUSIONS This study found an increased risk of clinically relevant externalising behaviours in children with prenatal exposure to triptans, and this risk was highest for first trimester exposure. Absolute risks were small, and the results may be due to confounding by underlying migraine severity.
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Affiliation(s)
- Mollie E. Wood
- Department of Quantitative Health Sciences, Department of Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts, USA,Department of Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts, USA,Pharmacoepidemiology and Drug Safety Research Group, School of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo
| | - Kate Lapane
- Department of Quantitative Health Sciences, Department of Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Jean A. Frazier
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Eivind Ystrom
- Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Eric O. Mick
- Department of Quantitative Health Sciences, Department of Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Hedvig Nordeng
- Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway,Pharmacoepidemiology and Drug Safety Research Group, School of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo
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Elberling H, Linneberg A, Rask CU, Houman T, Goodman R, Mette Skovgaard A. Psychiatric disorders in Danish children aged 5-7 years: A general population study of prevalence and risk factors from the Copenhagen Child Cohort (CCC 2000). Nord J Psychiatry 2016; 70:146-55. [PMID: 26509656 DOI: 10.3109/08039488.2015.1070199] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Knowledge about the presentation of psychopathology in preschool age and associated risk factors is fundamental to preventive intervention before schooling. AIMS To investigate the full spectrum of psychiatric diagnoses in general population children at the period of transition from preschool to school. METHODS A sample of 1585 children from the Copenhagen Child Cohort, CCC2000 aged 5-7 years was assessed using the Development and Well-Being Assessment (DAWBA) with diagnostic classification by experienced clinicians. Perinatal, sociodemographic and socio-economic data was obtained from Danish national registries. RESULTS The prevalence of any ICD-10 psychiatric disorder was 5.7% (95%CI: 4.4-7.1). Pervasive developmental disorders (PDD) were found in 1.3% (95%CI: 0.8-1.8) and behavioural and hyperkinetic disorders were found in 1.5% (95%CI: 0.9-2.1) and 1.0% (95%CI: 0.4-1.6), respectively. Emotional disorders were found in 2.9% (95%CI: 1.9-40). More boys were diagnosed with PDD, behavioural disorders and tics. No gender differences were found in hyperactivity disorders (HD) and emotional disorders. Co-morbidity was frequent, in particular between HD and PDD, but also between HD and emotional disorder and behavioural disorder. Teenage mothers, single parents and low household income the first two years after the child's birth were associated with a three-to fourfold increased risk of psychiatric disorder in the child at age 5-7 years. CONCLUSION The study results point to two "windows of opportunity" for prevention. In the earliest postnatal years, prevention should target families at socio-economic risk; and in the years before schooling, intervention should focus on children with symptoms of PDD, HD, and behavioural disorders.
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Affiliation(s)
- Hanne Elberling
- a Child and Adolescent Mental Health Centre , Mental Services Capital Region of Denmark .,b Research Centre for Prevention and Health, Glostrup, Denmark
| | - Allan Linneberg
- b Research Centre for Prevention and Health, Glostrup, Denmark .,c Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen , Denmark
| | - Charlotte Ulrikka Rask
- d Child and Adolescent Psychiatric Centre, Research Centre for Functional disorders and Psychosomatics, Aarhus University Hospital , Denmark
| | - Tine Houman
- a Child and Adolescent Mental Health Centre , Mental Services Capital Region of Denmark .,c Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen , Denmark
| | - Robert Goodman
- e Department of Child and Adolescent Psychiatry , Institute of Psychiatry, King's College London , UK , and
| | - Anne Mette Skovgaard
- a Child and Adolescent Mental Health Centre , Mental Services Capital Region of Denmark .,f Department of Public Health, Faculty of Health Sciences, University of Copenhagen , Denmark
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Walter D, Dachs L, Faber M, Goletz H, Görtz-Dorten A, Kinnen C, Rademacher C, Schürmann S, Woitecki K, Metternich-Kaizman TW, Plück J, Hautmann C, Ise E, Döpfner M. Alltagswirksamkeit ambulanter Verhaltenstherapie von Kindern und Jugendlichen im Urteil der Eltern in einer universitären Ausbildungsambulanz. ZEITSCHRIFT FUR KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE 2015. [DOI: 10.1026/1616-3443/a000321] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Hintergrund: Die Wirksamkeit von kognitiver Verhaltenstherapie bei Kindern und Jugendlichen unter Routinebedingungen ist bislang noch wenig untersucht. Fragestellung: Es wurden Veränderungen psychischer Auffälligkeiten von Kindern und Jugendlichen im Elternurteil während ambulanter Verhaltenstherapie in einer universitären Ausbildungsambulanz untersucht. Die Therapien wurden durchgeführt von Diplom-Psychologen, Pädagogen, Sozialpädagogen und Sozialarbeitern in fortgeschrittener Ausbildung zum Kinder- und Jugendlichenpsychotherapeuten mit Schwerpunkt Verhaltenstherapie. Alle Therapien wurden im Verhältnis 1:4 supervidiert. Methode: Für 976 Therapien wurden Completeranalysen als Prä-Post-Vergleiche mit Effektstärken auf der Child Behavior Checklist (CBCL) berechnet und die klinische Bedeutsamkeit der Veränderungen analysiert–jeweils für die Gesamtgruppe und für die auf der CBCL zu Therapiebeginn klinisch Auffälligen. Zusätzlich wurde die Repräsentativität dieser Analyse für die gesamte Stichprobe überprüft. Ergebnisse: In der Gesamtgruppe fanden sich kleine bis mittlere, in der Gruppe der im Elternurteil auf der CBCL klinisch Auffälligen hauptsächlich große, statistisch signifikante Verminderungen psychischer Auffälligkeiten, die nicht durch Spontanveränderungen oder Regressionseffekte erklärt werden können. Allerdings wurden 1/4 bis 1/3 der Patienten auch nach Therapieende von ihren Eltern weiterhin als klinisch auffällig eingeschätzt. Schlussfolgerungen: Die Ergebnisse weisen auf die Wirksamkeit kognitiv-behavioraler Therapie bei psychisch kranken Kindern und Jugendlichen unter Anwendungsbedingungen hin. Aufgrund der mangelnden experimentellen Kontrolle ist die Aussagekraft der Ergebnisse begrenzt.
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Affiliation(s)
- Daniel Walter
- Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Medizinische Fakultät, Universität zu Köln
- Ausbildungsinstitut für Kinder- und Jugendlichenpsychotherapie (AKiP) an der Uniklinik Köln
| | - Lydia Dachs
- Ausbildungsinstitut für Kinder- und Jugendlichenpsychotherapie (AKiP) an der Uniklinik Köln
| | - Martin Faber
- Ausbildungsinstitut für Kinder- und Jugendlichenpsychotherapie (AKiP) an der Uniklinik Köln
| | - Hildegard Goletz
- Ausbildungsinstitut für Kinder- und Jugendlichenpsychotherapie (AKiP) an der Uniklinik Köln
| | - Anja Görtz-Dorten
- Ausbildungsinstitut für Kinder- und Jugendlichenpsychotherapie (AKiP) an der Uniklinik Köln
| | - Claudia Kinnen
- Ausbildungsinstitut für Kinder- und Jugendlichenpsychotherapie (AKiP) an der Uniklinik Köln
| | - Christiane Rademacher
- Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Medizinische Fakultät, Universität zu Köln
| | - Stephanie Schürmann
- Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Medizinische Fakultät, Universität zu Köln
| | - Katrin Woitecki
- Ausbildungsinstitut für Kinder- und Jugendlichenpsychotherapie (AKiP) an der Uniklinik Köln
| | - Tanja Wolff Metternich-Kaizman
- Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Medizinische Fakultät, Universität zu Köln
- Ausbildungsinstitut für Kinder- und Jugendlichenpsychotherapie (AKiP) an der Uniklinik Köln
| | - Julia Plück
- Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Medizinische Fakultät, Universität zu Köln
| | - Christopher Hautmann
- Ausbildungsinstitut für Kinder- und Jugendlichenpsychotherapie (AKiP) an der Uniklinik Köln
| | - Elena Ise
- Ausbildungsinstitut für Kinder- und Jugendlichenpsychotherapie (AKiP) an der Uniklinik Köln
| | - Manfred Döpfner
- Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Medizinische Fakultät, Universität zu Köln
- Ausbildungsinstitut für Kinder- und Jugendlichenpsychotherapie (AKiP) an der Uniklinik Köln
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Abstract
This study describes the treatment outcomes of preschoolers with severe mental health problems who were treated at the child psychiatric family day hospital for preschool children in Münster, Germany. The eclectic multi-modal treatment combines behavioral and psychodynamic techniques for both parents and children in various settings within an intermittent attendance structure provided by a multi-disciplinary team. This study evaluated 185 children with the Caregiver-Teacher Report Form (C-TRF/1.5-5), which was completed by therapists, and the Child Behavior Checklist (CBCL/1.5-5), which was completed by mothers, at admission and discharge. The mothers' ratings of their children were statistically adjusted for the distortion caused by their own psychopathology. After treatment, the patients showed significant improvement on the C-TRF/CBCL Total Problem score with an average Cohen's d = -0.50 based on therapists' ratings, d = -0.97 for the non-adjusted maternal ratings, and d = -0.68 for the adjusted maternal ratings. We conclude that specialized family day hospitals may successfully treat preschool psychiatric patients.
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A prospective study of behavioral and emotional symptoms in preschoolers. Eur Child Adolesc Psychiatry 2015; 24:291-9. [PMID: 24972693 DOI: 10.1007/s00787-014-0575-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Accepted: 06/05/2014] [Indexed: 10/25/2022]
Abstract
A substantial number of preschool children exhibit psychological symptoms that have an impact on their own and their families' lives. The aim of the current study was to investigate the prevalence, stability and increase/decrease in emotional and behavioral symptoms and the resultant impairment at two assessment points at preschool age. The sample consisted of 1,034 children drawn from the general population with a mean age of 51 months at t1 and 72 months at t2. Parents completed the Strengths and Difficulties Questionnaire extended version (Goodman, J Child Psychol Psychiatry 38(5):581-586, 1997; Goodman, J Child Psychol Psychiatry 40(5):791-799, 1999). At t1, 6.9 % of the preschoolers had a total difficulties and 6.8 % a total impact score within the abnormal range. At t2, these scores were 5.7 and 6.2 %, respectively. We found moderate stability of symptoms. From t1 to t2, emotional symptoms and prosocial behavior significantly increased, while hyperactivity, conduct problems, peer problems and total difficulties decreased. The mean total impact score did not change. Boys showed higher levels of symptoms (except emotional symptoms) and impact, and lower prosocial behavior, than girls. Moreover, there was a significant time × gender interaction, with girls showing a larger decrease in hyperactivity/inattention and in total difficulties than boys. The stepwise multiple regression analysis revealed that the total impact score at baseline, male gender, conduct problems, hyperactivity and peer problems significantly contributed to the explained variance of the total impact score at follow-up. This is one of very few studies to examine the stability and change of psychological symptoms in a large community sample of preschoolers, assessed twice during preschool age.
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Thomas R, Doust JA, Vasan K, Rajapakse B, McGregor L, Ackermann E, Del Mar CB. Identified health concerns and changes in management resulting from the Healthy Kids Check in two Queensland practices. Med J Aust 2014; 201:404-8. [PMID: 25296062 DOI: 10.5694/mja14.00637] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Accepted: 08/12/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To determine how many children had health problems identified by the Healthy Kids Check (HKC) and whether this resulted in changes to clinical management. DESIGN, SETTING AND PARTICIPANTS A medical records audit from two Queensland general practices, identifying 557 files of children who undertook an HKC between January 2010 and May 2013. MAIN OUTCOME MEASURES Child health problems identified in the medical records before, during and after the HKC. RESULTS Most children in our sample had no problems detected in their medical record (56%), 21% had problems detected during the HKC assessment, 19% had problems detected before, and 4% after. Most frequent health concerns detected during the HKC were speech and language (20%), toileting, hearing and vision (15% each), and behavioural problems (9%). Of the 116 children with problems detected during the HKC, 19 (3% of the total sample) had these confirmed, which resulted in a change of management. No further action was recorded for 9% of children. Missing data from reviews or referral outcomes for 8% precluded analyses of these outcomes. We estimated that the change in clinical management to children with health concerns directly relating to the HKC ranged between 3% and 11%. CONCLUSIONS Overall, data suggest that general practitioners are diligent in detecting and managing child health problems. Some of these problems were detected only during the HKC appointment, resulting in change of management for some children. Further studies are required to estimate the full benefits and harms, and particularly the false negatives and true positives, of the HKC.
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Affiliation(s)
- Rae Thomas
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia.
| | - Jennifer A Doust
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
| | - Kartik Vasan
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
| | - Bianca Rajapakse
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
| | - Leanne McGregor
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
| | - Evan Ackermann
- National Standing Committee - Quality Care, Royal Australian College of General Practitioners, Melbourne, VIC, Australia
| | - Christopher B Del Mar
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
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Möricke E, Lappenschaar GAM, Swinkels SHN, Rommelse NNJ, Buitelaar JK. Different stability of social-communication problems and negative demanding behaviour from infancy to toddlerhood in a large Dutch population sample. Child Adolesc Psychiatry Ment Health 2014; 8:19. [PMID: 25061477 PMCID: PMC4110065 DOI: 10.1186/1753-2000-8-19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2013] [Accepted: 06/25/2014] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Little is known about the stability of behavioural and developmental problems as children develop from infants to toddlers in the general population. Therefore, we investigated behavioural profiles at two time points and determined whether behaviours are stable during early development. METHODS Parents of 4,237 children completed questionnaires with 62 items about externalizing, internalizing, and social-communicative behaviour when the children were 14-15 and 36-37 months old. Factor mixture modelling identified five homogeneous profiles at both time points: three with relatively normal behaviour or with mild/moderate problems, one with clear communication and interaction problems, and another with pronounced negative and demanding behaviour. RESULTS More than 85% of infants with normal behaviour or mild problems at 14-15 months were reported to behave relatively typically as toddlers at 36-37 months. A similar percentage of infants with moderate communication problems outgrew their problems by the time they were toddlers. However, infants with severe problems had mild to severe problems as toddlers, and did not show completely normal behaviour. Improvement over time occurred more often in children with negative and demanding behaviour than in children with communication and interaction problems. The former showed less homotypic continuity than the latter. CONCLUSIONS Negative and demanding behaviour is more often transient and a less specific predictor of problems in toddlerhood than communication and interaction problems.
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Affiliation(s)
- Esmé Möricke
- Department of Psychiatry, Nijmegen Centre for Evidence-Based Practice, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - GA Martijn Lappenschaar
- Department of Psychiatry, Nijmegen Centre for Evidence-Based Practice, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Sophie HN Swinkels
- Department of Psychiatry, Nijmegen Centre for Evidence-Based Practice, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Nanda NJ Rommelse
- Department of Psychiatry, Nijmegen Centre for Evidence-Based Practice, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
- Karakter Child and Adolescent Psychiatry University Centre, Reinier Postlaan 12, 6525 GC Nijmegen, The Netherlands
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands
- Karakter Child and Adolescent Psychiatry University Centre, Reinier Postlaan 12, 6525 GC Nijmegen, The Netherlands
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Benke KS, Nivard MG, Velders FP, Walters RK, Pappa I, Scheet PA, Xiao X, Ehli EA, Palmer LJ, Whitehouse AJO, Verhulst FC, Jaddoe VW, Rivadeneira F, Groen-Blokhuis MM, van Beijsterveldt CEM, Davies GE, Hudziak JJ, Lubke GH, Boomsma DI, Pennell CE, Tiemeier H, Middeldorp CM. A genome-wide association meta-analysis of preschool internalizing problems. J Am Acad Child Adolesc Psychiatry 2014; 53:667-676.e7. [PMID: 24839885 DOI: 10.1016/j.jaac.2013.12.028] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Revised: 11/27/2013] [Accepted: 12/31/2013] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Preschool internalizing problems (INT) are highly heritable and moderately genetically stable from childhood into adulthood. Gene-finding studies are scarce. In this study, the influence of genome-wide measured single nucleotide polymorphisms (SNPs) was investigated in 3 cohorts (total N = 4,596 children) in which INT was assessed with the same instrument, the Child Behavior Checklist (CBCL). METHOD First, genome-wide association (GWA) results were used for density estimation and genome-wide complex trait analysis (GCTA) to calculate the variance explained by all SNPs. Next, a fixed-effect inverse variance meta-analysis of the 3 GWA analyses was carried out. Finally, the overlap in results with prior GWA studies of childhood and adulthood psychiatric disorders and treatment responses was tested by examining whether SNPs associated with these traits jointly showed a significant signal for INT. RESULTS Genome-wide SNPs explained 13% to 43% of the total variance. This indicates that the genetic architecture of INT mirrors the polygenic model underlying adult psychiatric traits. The meta-analysis did not yield a genome-wide significant signal but was suggestive for the PCSK2 gene located on chromosome 20p12.1. SNPs associated with other psychiatric disorders appeared to be enriched for signals with INT (λ = 1.26, p < .03). CONCLUSION Our study provides evidence that INT is influenced by many common genetic variants, each with a very small effect, and that, even as early as age 3, genetic variants influencing INT overlap with variants that play a role in childhood and adulthood psychiatric disorders.
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Affiliation(s)
- Kelly S Benke
- Johns Hopkins Bloomberg School of Public Health, Baltimore, USA and the Samuel Lunenfeld Research Institute, University of Toronto, Toronto, Canada.
| | - Michel G Nivard
- VU University Amsterdam, The Netherlands and the Neuroscience Campus Amsterdam, VU University
| | - Fleur P Velders
- Erasmus Medical Center, Rotterdam, The Netherlands and The Generation R Study Group, Erasmus Medical Center
| | | | - Irene Pappa
- School of Pedagogical and Educational Sciences, Erasmus University Rotterdam, the Generation R Study Group, and Erasmus University Medical Center-Sophia Children's Hospital
| | - Paul A Scheet
- University of Texas / M. D. Anderson Cancer Center, USA
| | | | - Erik A Ehli
- Avera Institute for Human Genetics, Sioux Falls, SD, USA
| | - Lyle J Palmer
- Samuel Lunenfeld Research Institute, University of Toronto, and the Ontario Institute for Cancer Research, Toronto, Canada
| | - Andrew J O Whitehouse
- Telethon Institute for Child Health Research, Subiaco, Australia, The Centre for Child Health Research, The University of Western Australia, Perth and the School of Psychology, The University of Western Australia, Crawley
| | | | | | | | - Maria M Groen-Blokhuis
- VU University Amsterdam and EMGO+ Institute for Health and Care Research, VU University Medical Center
| | | | | | - James J Hudziak
- Vermont Center for Children, Youth, and Families, and the University of Vermont, College of Medicine, Vermont, USA
| | - Gitta H Lubke
- University of Notre Dame and with VU University Amsterdam
| | - Dorret I Boomsma
- Neuroscience Campus Amsterdam, VU University Amsterdam, and EMGO+ Institute for Health and Care Research, VU University Medical Center
| | - Craig E Pennell
- School of Women's and Infants' Health, The University of Western Australia
| | | | - Christel M Middeldorp
- Neuroscience Campus Amsterdam, VU University Amsterdam, and GGZinGeest/ VU University Medical Center
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Traurig, besorgt und ängstlich: Depression und Angststörungen im Vorschulalter - Befunde zu Relevanz, Symptomatik und Beeinträchtigungen. Prax Kinderpsychol Kinderpsychiatr 2014. [DOI: 10.13109/prkk.2014.63.3.154] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Fuchs S, Klein AM, Otto Y, von Klitzing K. Prevalence of emotional and behavioral symptoms and their impact on daily life activities in a community sample of 3 to 5-year-old children. Child Psychiatry Hum Dev 2013; 44:493-503. [PMID: 23111504 DOI: 10.1007/s10578-012-0343-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The aim of the study was to evaluate prevalence and impact of behavioral/emotional symptoms in preschoolers. The sample comprised 1,738 preschoolers with an age range between 37 and 63 months. Parents rated children's symptoms using the Strengths and Difficulties Questionnaire (SDQ) and the impact of perceived difficulties using the impact supplement of the SDQ. The prevalence of a total difficulties score in an abnormal/borderline range was 16.0 % that means lower than rates in schoolchildren. 8.6 % of the preschoolers were rated as symptomatic (borderline/abnormal) and their symptoms were rated as having some or considerable impact on their lives. Parents mostly reported problems of hyperactivity/inattention and their interference with learning abilities. All symptoms scales of the SDQ, except prosocial behavior, significantly explained impact of perceived difficulties. Parents of boys rated significantly higher levels of symptoms and impact. Low parental education was associated with more symptoms and higher impact.
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Affiliation(s)
- Sandra Fuchs
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Leipzig, Liebigstr. 20a, 04103, Leipzig, Germany.
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Daubney MF, Cameron CM, Scuffham PA. Changes to the Healthy Kids Check: will we get it right? Med J Aust 2013; 198:475-7. [PMID: 23682880 DOI: 10.5694/mja12.11455] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Accepted: 03/18/2013] [Indexed: 11/17/2022]
Affiliation(s)
- Michael F Daubney
- School of Medicine, Griffith University – Logan Campus, Brisbane, QLD
| | - Cate M Cameron
- School of Medicine, Griffith University – Logan Campus, Brisbane, QLD
| | - Paul A Scuffham
- School of Medicine, Griffith University – Logan Campus, Brisbane, QLD
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