Family-Based Interventions for Childhood Depression

Family cumulative risk, life satisfaction, and anxiety and depression in adolescents: A developmental cascades model

INTRODUCTION

Family cumulative risk (FCR) is predominantly regarded as an antecedent for adolescent mental health, as the prevailing perspective continues to emphasize the influential role of parents, despite recognizing the child's influence. To identify the interplay between family adversity (FCR, process-related FCR, and sociodemographic-related FCR), life satisfaction (LS), and anxiety and depression (AD), this study examined the cascade effects among these constructs.

METHOD

Participants (N = 707; 52.9% male; grades 10 and 11) from four high schools in Wuhan, China, were recruited to participate, and they completed the measures in October 2018, April 2019, and November 2019. Family sociodemographic risk (e.g., single parenthood) and family process risk (e.g., low family cohesion) were simulated in the models for FCR, sociodemographic-related FCR, and process-related FCR.

RESULTS

The random intercept cross-lagged panel models (RI-CLPMs) revealed a lagged effect from LS to FCR; lagged effects from LS and AD to process-related FCR at the within-person level; and significant associations between LS, AD, and family adversity at the between-person level.

CONCLUSIONS

The lagged effects provide evidence for the influential child perspective and suggest that FCR and family process risk are sensitive to adolescent well-being and psychopathological symptoms. School mental health prevention and intervention programs that take a complete mental health approach to enhance children's well-being and alleviate symptoms would help prevent increases in family risk.

Low mood in a sample of 5-12 year-old child psychiatric patients: a cross-sectional study

BACKGROUND

Not much is known about low mood and its associates in child psychiatric patients. In this study, we examined the prevalence of low mood, how it associates with disruptive behaviour, and affects clinician-rated global functioning in child psychiatric outpatients.

METHODS

The study population consisted of 862 5-12 year-old child psychiatric patients. The study sample was a subsample of all 1251 patients attending a child psychiatric outpatient clinic at Helsinki University Hospital in 2013-2015 formed by excluding 4 year-old and 13 year-old patients and those with missing or incomplete data. The parent-rated Strengths and Difficulties Questionnaire, collected as part of the routine clinical baseline measure, was used as a measure of psychiatric symptoms. The diagnoses were set according to ICD-10 by the clinician in charge after an initial evaluation period. The Children's Global Assessment Scale (CGAS) score set by clinicians provided the measure of the patients' global functioning. All information for the study was collected from hospital registers. Associations between emotional symptoms and conduct problems/hyperactivity scores were examined using ordinal regression in univariate and multivariate models, controlling for age and sex. The independent samples T test was used to compare the CGAS values of patient groups with low/normal mood.

RESULTS

In our sample, 512 children (59.4%) showed low mood. In multivariate ordinal regression analysis, low mood associated with conduct problems (OR 1.93, 95% CI 1.39-2.67), but no association was found between low mood and hyperactivity. Low mood was prevalent among children with oppositional defiant disorder or conduct disorder (51.8%). The global functioning score CGAS was lower among children with parent-reported low mood (52.21) than among children with normal mood (54.62, p < 0.001). The same was true in the subgroup of patients with no depression diagnosis (54.85 vs. 52.82, p = 0.001).

CONCLUSIONS

Low mood is prevalent in child psychiatric outpatients regardless of depression diagnosis and it has a negative effect on global functioning. Low mood and behavioural problems are often associated. It is important to pay attention to low mood in all child psychiatric patients. We recommend prevention measures and low-threshold services for children with low mood.