1
|
Ferrara M, Domenicano I, Marchi A, Zaffarami G, Onofrio A, Benini L, Sorio C, Gentili E, Murri MB, Toffanin T, Little J, Grassi L. First episode psychoses in people over-35 years old: uncovering potential actionable targets for early intervention services. Psychiatry Res 2024; 339:116034. [PMID: 38906051 DOI: 10.1016/j.psychres.2024.116034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 03/25/2024] [Accepted: 06/13/2024] [Indexed: 06/23/2024]
Abstract
The traditional youth-oriented design of Early Intervention Services (EIS) may lead to the exclusion of patients who have their psychotic onset later in life. A retrospective study was conducted to compare first-episode psychosis (FEP) patients who accessed treatment when aged ≤ 35 years with those ≥36+. A total of 854 patients were identified among 46,222 individuals who had access to community psychiatric services from 1991 to 2021. FEP were aged 18-65, received care between 2012 and 2021 and had a diagnosis of affective or non-affective FEP. Two groups were identified (FEP diagnosed at age ≤ 35 vs ≥ 36) and compared for sociodemographic and clinical characteristics. Most patients were diagnosed when aged ≥ 36+ (61.8%). Compared to the ≤ 35 group, older patients were more likely to be women, married and diagnosed with affective psychosis, and they were less frequently hospitalized. Long-acting injectables antipsychotics (LAI) were less frequently prescribed in the ≥ 36+ group, whereas antidepressants were more frequently prescribed compared to those aged ≤ 35. In both age groups, women were less frequently prescribed LAIs compared to men. These findings highlight the need to reorient EIS to accommodate the needs of older FEP, especially women.
Collapse
Affiliation(s)
- Maria Ferrara
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy; Department of Psychiatry, Yale School of Medicine, New Haven CT, USA; Department of Mental Health and Pathological Addiction, Local Health Trust (AUSL) Ferrara, Ferrara, Italy.
| | - Ilaria Domenicano
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Aurora Marchi
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Giulia Zaffarami
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Alice Onofrio
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Lorenzo Benini
- Department of Mental Health and Pathological Addiction, Local Health Trust (AUSL) Ferrara, Ferrara, Italy
| | - Cristina Sorio
- Department of Mental Health and Pathological Addiction, Local Health Trust (AUSL) Ferrara, Ferrara, Italy
| | | | - Martino Belvederi Murri
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy; Department of Mental Health and Pathological Addiction, Local Health Trust (AUSL) Ferrara, Ferrara, Italy
| | - Tommaso Toffanin
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy; Department of Mental Health and Pathological Addiction, Local Health Trust (AUSL) Ferrara, Ferrara, Italy
| | - Julian Little
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy; School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Luigi Grassi
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy; Department of Mental Health and Pathological Addiction, Local Health Trust (AUSL) Ferrara, Ferrara, Italy
| |
Collapse
|
2
|
McGovern R, Balogun-Katung A, Artis B, Bareham B, Spencer L, Alderson H, Brown E, Brown J, Lingam R, McArdle P, Newham JJ, Wojciechowska A, Rankin J, Redgate S, Thomason P, Kaner E. The Effectiveness of Preventative Interventions to Reduce Mental Health Problems in at-risk Children and Young People: A Systematic Review of Reviews. JOURNAL OF PREVENTION (2022) 2024; 45:651-684. [PMID: 38884876 PMCID: PMC11271346 DOI: 10.1007/s10935-024-00785-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/13/2024] [Indexed: 06/18/2024]
Abstract
Mental health problems are the leading cause of childhood disability worldwide, resulting in poor outcomes for children and young people that persist into adulthood. It is essential that those young people most at risk of developing mental health problems receive effective preventative interventions. Whilst there have been a number of systematic reviews which have examined the effectiveness of secondary prevention interventions for specific groups of children and young people, or to address identified mental health concerns, no review has engaged with the breadth of this literature. We conducted a systematic review of systematic reviews to map this complex field of secondary preventative interventions and identify effective interventions to prevent mental health problems in children and adolescents aged 3-17 years. The review protocol was registered on PROSPERO. We searched five electronic databases from inception to February 2023. The certainty of the evidence was appraised using the AMSTAR 2. We included 49 unique systematic reviews each including between 2 and 249 (mean 34) unique studies; the majority of which were reviews which included only or mostly randomised controlled trials (70%). The reviews examined selective interventions (defined as interventions which are delivered to sub-group populations of young people at increased risk of mental health problems) (n = 22), indicated interventions (defined as interventions which target young people who are found to have pre-clinical symptoms) (n = 15) or a synthesis of both (n = 12). The certainty of the evidence in the reviews was rated as high, (n = 12) moderate (n = 5), low (n = 9) and critically low (n = 23). We found evidence to support both selective and indicated interventions in a range of populations and settings, with most of this evidence available for children and young people in their mid-years (6-10 years) and early adolescence (11-13 years). There was a large body of evidence suggesting that resilience enhancing, cognitive behaviour therapy-based and psychoeducational interventions for children who experience adversity, or those with subclinical externalising problems may offer promise. Early selective interventions for a subpopulation of children and young people who have experienced adversity which combines risk reduction and resilience enhancing approaches directed at children and their families may be effective at reducing mental health problems.
Collapse
Affiliation(s)
- R McGovern
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK.
| | - A Balogun-Katung
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - B Artis
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - B Bareham
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - L Spencer
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - H Alderson
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - E Brown
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - J Brown
- Children's Social Care, Newcastle City Council, Newcastle upon Tyne, UK
| | - R Lingam
- Population Child Health Research Group, School of Women and Children's Health, University New South Wales, Sydney, Australia
| | - P McArdle
- Child and Adolescent Mental Health Services, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - J J Newham
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - A Wojciechowska
- Disabilities Integrated Team at the Tees, Esk and Wear Valleys, NHS Foundation Trust, Newcastle upon Tyne, UK
| | - J Rankin
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - S Redgate
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| | - P Thomason
- Children's Social Care, Gateshead Council, Tyne and Wear, UK
| | - E Kaner
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK
| |
Collapse
|
3
|
Thorup AAE. The Invisible Children: Is the Glass Half Full or Half Empty? Am J Psychiatry 2024; 181:702-704. [PMID: 39086291 DOI: 10.1176/appi.ajp.20240516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/02/2024]
Affiliation(s)
- Anne A E Thorup
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen; Child and Adolescent Mental Health Center, Capital Region of Denmark, Copenhagen
| |
Collapse
|
4
|
Piché G, Villatte A, Clément MÈ, Morin MH, Maybery D, Reupert A, Richard-Devantoy S, Fournier-Marceau M. Predictors of family-focused practices among mental health workers in Quebec. Front Psychiatry 2024; 15:1380001. [PMID: 38803674 PMCID: PMC11128615 DOI: 10.3389/fpsyt.2024.1380001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 04/15/2024] [Indexed: 05/29/2024] Open
Abstract
Context Engaging family members in the ongoing care of individuals with mental illness is a practice known to bolster the client's recovery journey and enhance the overall wellbeing of both children and families involved. Despite its potential benefits, there remains a dearth of understanding surrounding the implementation of family-focused practices (FFP) by mental health professionals serving adults, as well as the factors that could either promote or hinder such practices. This knowledge gap is particularly pronounced within North American settings. Goal The goal of this study was to identify potential hindering and enabling factors of FFP used in adult mental health services. Methods A sample of 512 professionals working with adult mental health clients, from all regions of Quebec, Canada, with a variety of disciplinary backgrounds and working in different work settings, completed the Family Focused Mental Health Practice Questionnaire (FFMHPQ). Multinominal logistic regression analysis was performed to assess the impact of several factors - organizational, professional, and personal - on the degree of family-based practices of mental health workers. Results and discussion Findings of this study show that the strongest predictors for the adoption of higher FFP levels among adult mental health professionals in Quebec, are being employed on a full-time basis, perceiving a higher level of skills, knowledge, and confidence toward FFP, and having a supportive workplace environment. Results underscore the need to address both organizational and worker-related aspects to effectively promote better FFP in mental health services.
Collapse
Affiliation(s)
- Geneviève Piché
- Département de psychoéducation et de psychologie, Université du Québec en Outaouais, Saint-Jérôme, QC, Canada
- Centre de Recherche Universitaire Sur les Jeunes et les Familles (CRUJEF), Québec, QC, Canada
- Réseau de recherche en santé des populations du Québec (RRSPQ), Montréal, QC, Canada
| | - Aude Villatte
- Centre de Recherche Universitaire Sur les Jeunes et les Familles (CRUJEF), Québec, QC, Canada
- Unité de Formation et de Recherches (UFR) de Psychologie, Université Toulouse Jean Jaurès, Laboratoire Psychologie de la Socialisation - Développement et Travail (PSDT), Toulouse, France
| | - Marie-Ève Clément
- Département de psychoéducation et de psychologie, Université du Québec en Outaouais, Saint-Jérôme, QC, Canada
| | - Marie-Hélène Morin
- Département de travail social, Université du Québec à Rimouski, Rimouski, QC, Canada
| | - Darryl Maybery
- Department of Rural and Indigenous Health, Monash University, Melbourne, VIC, Australia
| | - Andrea Reupert
- School of Educational Psychology and Counseling, Monash University, Melbourne, VIC, Australia
| | - Stéphane Richard-Devantoy
- Department of Psychiatry and Douglas Mental Health University Institute, McGill Group for Suicide Studies, McGill University, Montréal, QC, Canada
| | - Marianne Fournier-Marceau
- Département de psychoéducation et de psychologie, Université du Québec en Outaouais, Saint-Jérôme, QC, Canada
| |
Collapse
|
5
|
Shestiperov A, Grinstein-Cohen O, Lindell D, Irani E, Kagan I. Lived experiences: Growing up with a seriously mentally ill parent. J Nurs Scholarsh 2024; 56:357-370. [PMID: 38168092 DOI: 10.1111/jnu.12955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/11/2023] [Accepted: 12/20/2023] [Indexed: 01/05/2024]
Abstract
INTRODUCTION Individuals with serious mental illness often have persistent and disruptive symptoms. These can profoundly affect their children's lives, exposing them to adverse social and psychological conditions. Such conditions can result in traumatic lived experiences during childhood, which can carry over into adulthood, influencing their self-perceptions and shaping their attitudes toward themselves and society. To gain insights into this phenomenon, this study explored the lived experiences of adults who grew up with a parent with serious mental illness and their perceptions of their lives in adulthood. DESIGN This study used an interpretive phenomenological design. METHODS Participants were invited to voluntarily participate in the study through a call posted on social media. Semi-structured interviews were conducted with 30 adults (age range, 20-55 years) who grew up with a parent with serious mental illness. The interviews were recorded and transcribed, and inductive thematic analysis was used to identify main and overarching themes. RESULTS The overarching theme of transition from childhood survival to adulthood survival emerged and included four main themes: (1) a traumatic childhood, (2) perceived control, (3) resilience and general self-efficacy, and (4) adult quality of life. A traumatic childhood consisted of experiences of neglect and abuse, while participants used perceived control to achieve personal growth, self-care, and care of others. Resilience and general self-efficacy emerged during the transition to adulthood and helped participants further their social status and strengthen family bonds. Lastly, adult quality of life was described as being disturbed by feelings of loneliness and being burdensome, stemming from an inherent tendency to rely solely on themselves, leading to trust issues and mental health complications. Therefore, these adults found it difficult to reach out and get help or treatment for their concerns, as they initially did not want to appear dysfunctional or in need. CONCLUSION This study has illuminated the lived experiences of a specific, vulnerable population that has not been intentionally explored until now. To delve into these experiences, we employed a distinctive qualitative approach, merging the interpretive phenomenological perspective with an inductive thematic analysis. This allowed for rich insight with a relatively large group of participants and enabled an in-depth exploration within this methodological framework. Consequently, this study constitutes a notable contribution to the extant body of knowledge, exploring the intricacies of personal growth and its impact on participants' quality of life. It uncovers the essence of resilience and general self-efficacy, revealing how these elements intertwine with the negative results observed. However, the study findings emphasize the need for healthcare professionals, including nurses and other caregivers, to be mindful of the long-lasting effects of the adverse experiences of children of patients with serious mental illness. Prioritizing active clinical assessment and implementing tailored interventions to address such children's specific needs and difficulties across different developmental stages is imperative. Such comprehensive and targeted approaches are crucial in providing appropriate support and promoting the well-being of these individuals. CLINICAL RELEVANCE Enhanced clinical attention in holistic psychiatric care is crucial for individuals and their relatives, especially children. Comprehensive assessments of children and adults raised by seriously mentally ill parents can enable tailored and preventive interventions, positively impacting overall quality of life.
Collapse
Affiliation(s)
- Alexander Shestiperov
- Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev Recanati School for Community Health Professions, BE'ER SHEVA, Israel
- Merhavim-Mental Health Center, Beer-Yaakov, Israel
| | - Orli Grinstein-Cohen
- Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev Recanati School for Community Health Professions, BE'ER SHEVA, Israel
| | - Deborah Lindell
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, USA
| | - Elliane Irani
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, USA
| | - Ilya Kagan
- Ashkelon Academic College, Ashkelon, Israel
| |
Collapse
|
6
|
Bauer A, Cartagena-Farias J, Christiansen H, Goodyear M, Schamschula M, Zechmeister-Koss I, Paul J. Acceptability, engagement and exploratory outcomes and costs of a co-designed intervention to support children of parents with a mental illness: Mixed-methods evaluation and descriptive analysis. Int J Ment Health Nurs 2024. [PMID: 38500242 DOI: 10.1111/inm.13324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 02/21/2024] [Accepted: 03/11/2024] [Indexed: 03/20/2024]
Abstract
Children whose parents have a mental illness are much more likely to experience mental health problems and other adverse long-term impacts. Child-centred psychosocial interventions can be effective, but not much is known about how to design and implement them in different settings. A pre-post, mixed methods, single-arm evaluation of a co-designed social support intervention with parents and children (4-18 years) measured parents' mental health (PHQ-9), perceived social support (ENRICHD), parental self-efficacy (PSAM) and children's mental health (SDQ), quality of life (Kidscreen-27), and child service use (CAMHSRI-EU) at baseline and 6 months. Qualitative data were gathered at 6 months to explore parents' and children's experience with the intervention. Twenty-nine parents and 21 children completed baseline and follow-up questionnaires; 22 parents and 17 children participated in interviews. Parents' depression (MD -1.36, SD 8.08), perceived social support (MD 1, SD 5.91), and children's mental health potentially improved, and children's service use and costs potentially reduced (€224.6 vs. €122.2, MD 112.4). Parental self-efficacy was potentially reduced (MD -0.11, SD 3.33). The sample was too small to perform statistical analysis. Favourable themes emerged describing the high satisfaction with the intervention, parents' improved understanding of the impact of their mental health problems on children, and improvements in parent-child relationships. This study contributes to an emerging evidence base for co-designed child-centred interventions to prevent the transgenerational transmission of poor mental health.
Collapse
Affiliation(s)
- Annette Bauer
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | | | - Hanna Christiansen
- Clinical Child and Adolescent Psychology, Department of Psychology, Philipps University Marburg, Marburg, Germany
| | - Melinda Goodyear
- School of Rural Health, Monash University, Melbourne, Victoria, Australia
| | - Mona Schamschula
- Mental Health Research Program, The Village, Ludwig Boltzmann Gesellschaft, Wien, Austria
| | | | - Jean Paul
- Division of Psychiatry I, Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria
| |
Collapse
|
7
|
Moltrecht B, Lange AMC, Merrick H, Radley J. Whole-family programmes for families living with parental mental illness: a systematic review and meta-analysis. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02380-3. [PMID: 38393370 DOI: 10.1007/s00787-024-02380-3] [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: 08/15/2023] [Accepted: 01/08/2024] [Indexed: 02/25/2024]
Abstract
Several interventions have been developed to support families living with parental mental illness (PMI). Recent evidence suggests that programmes with whole-family components may have greater positive effects for families, thereby also reducing costs to health and social care systems. This review aimed to identify whole-family interventions, their common characteristics, effectiveness and acceptability. A systematic review was conducted according to PRISMA 2020 guidelines. A literature search was conducted in ASSIA, CINAHL, Embase, Medline, and PsycINFO in January 2021 and updated in August 2022. We double screened 3914 abstracts and 212 papers according to pre-set inclusion and exclusion criteria. The Mixed Methods Appraisal Tool was used for quality assessment. Quantitative and qualitative data were extracted and synthesised. Randomised-control trial data on child and parent mental health outcomes were analysed separately in random-effects meta-analyses. The protocol, extracted data, and meta-data are accessible via the Open Science Framework ( https://osf.io/9uxgp/ ). Data from 66 reports-based on 41 independent studies and referring to 30 different interventions-were included. Findings indicated small intervention effects for all outcomes including children's and parents' mental health (dc = -0.017, -027; dp = -0.14, -0.16) and family outcomes. Qualitative evidence suggested that most families experienced whole-family interventions as positive, highlighting specific components as helpful, including whole-family components, speaking about mental illness, and the benefits of group settings. Our findings highlight the lack of high-quality studies. The present review fills an important gap in the literature by summarising the evidence for whole-family interventions. There is a lack of robust evidence coupled with a great need in families affected by PMI which could be addressed by whole-family interventions. We recommend the involvement of families in the further development of these interventions and their evaluation.
Collapse
Affiliation(s)
- B Moltrecht
- Evidence-Based Practice Unit, Anna Freud Centre, University College London, London, UK.
- Centre for Longitudinal Studies, University College London, London, UK.
| | - Aurelie M C Lange
- Centre for Applied Research on Social Sciences and Law, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - H Merrick
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - J Radley
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| |
Collapse
|
8
|
Waldmann T, Schaible J, Stiawa M, Becker T, Wegscheider K, Adema B, Wiegand-Grefe S, Kilian R. The cost-utility of an intervention for children and adolescents with a parent having a mental illness in the framework of the German health and social care system: a health economic evaluation of a randomized controlled trial. Child Adolesc Psychiatry Ment Health 2023; 17:141. [PMID: 38129868 PMCID: PMC10740235 DOI: 10.1186/s13034-023-00693-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Children of families with a parent with a mental illness have an increased risk of developing social and mental health problems resulting in decreased quality of life. Therefore, children and adolescents living in families with a parent with mental illness are regarded as a target group for preventive interventions. To date, only a few economic evaluation studies for interventions directed at preventing the intergenerational transmission of mental health problems exist. In this investigation we estimated the cost utility of an intervention for the support of children and adolescents with a parent having a mental illness from the perspective of the German health and social care system. METHODS We randomly assigned a total of 214 families with 337 children and adolescents to the intervention (INT) group (108/170) or the control (TAU) group (106/167). Families in the intervention group received on average eight intervention sessions (50-90 min) over 6 months. We estimated total cost of illness by means of the Children and Adolescent Mental Health Service Receipt Inventory (CAMHSRI) over 24 months. For the estimation of Quality-Adjusted Live Years (QALYs) we applied the KIDSCREEN-10. For estimating the incremental cost-utility of the intervention compared to treatment as usual we used the net-benefit approach. RESULTS We estimated the annual cost of illness amounting to € 3784.59 (SD € 8581.11) in the TAU group and € 3264.44 (SD € 9431.89) in the INT group. The annual cost difference between INT and TAU was € - 516.14 (SE 1124.95) which was not significant (p ≤ 0.05). We estimated the average QALY to be 0.759 (SD 0.073) in the TAU group and 0.763 (SD 0.072). The QALY difference between INT and TAU was 0.0037 (SE 0.0092) which was not significant (p ≤ 0.05). The incremental cost utility ratio (ICUR) indicated that the gain of one additional year in full health by means of the intervention was associated with the saving of € 139.49. However, the stochastic insecurity of the ICUR did not allow a unique decision about the cost-utility of the intervention. CONCLUSIONS More information on the economic value of the intervention for families with a parent with mental illness in comparison to treatment as usual in Germany is needed. TRIAL REGISTRATION ClinicalTrials.gov, identifier NCT02308462; German Clinical Trials Register: DRKS00006806.
Collapse
Affiliation(s)
- Tamara Waldmann
- Department of Psychiatry and Psychotherapy at BKH Günzburg II, Ulm University, Lindenallee 2, 89312, Günzburg, Germany
| | - Jochen Schaible
- Department of Psychiatry and Psychotherapy at BKH Günzburg II, Ulm University, Lindenallee 2, 89312, Günzburg, Germany
- Abteilung für Psychiatrie und Psychotherapie des Kindes- und Jugendalters, ZfP Südwürttemberg, Ravensburg, Germany
| | - Maja Stiawa
- Department of Psychiatry and Psychotherapy at BKH Günzburg II, Ulm University, Lindenallee 2, 89312, Günzburg, Germany
| | - Thomas Becker
- Department of Psychiatry and Psychotherapy at BKH Günzburg II, Ulm University, Lindenallee 2, 89312, Günzburg, Germany
- Universitätsklinikum Leipzig, Klinik und Poliklinik für Psychiatrie und Psychotherapie, Leipzig, Germany
| | - Karl Wegscheider
- Institute for Medical Biometry and Epidemiology, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Bonnie Adema
- Department for Psychiatry and Psychotherapy, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Silke Wiegand-Grefe
- Department for Psychiatry and Psychotherapy, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Reinhold Kilian
- Department of Psychiatry and Psychotherapy at BKH Günzburg II, Ulm University, Lindenallee 2, 89312, Günzburg, Germany.
| |
Collapse
|
9
|
Uher R, Pavlova B, Radua J, Provenzani U, Najafi S, Fortea L, Ortuño M, Nazarova A, Perroud N, Palaniyappan L, Domschke K, Cortese S, Arnold PD, Austin JC, Vanyukov MM, Weissman MM, Young AH, Hillegers MH, Danese A, Nordentoft M, Murray RM, Fusar‐Poli P. Transdiagnostic risk of mental disorders in offspring of affected parents: a meta-analysis of family high-risk and registry studies. World Psychiatry 2023; 22:433-448. [PMID: 37713573 PMCID: PMC10503921 DOI: 10.1002/wps.21147] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/17/2023] Open
Abstract
The offspring of parents with mental disorders are at increased risk for developing mental disorders themselves. The risk to offspring may extend transdiagnostically to disorders other than those present in the parents. The literature on this topic is vast but mixed. To inform targeted prevention and genetic counseling, we performed a comprehensive, PRISMA 2020-compliant meta-analysis. We systematically searched the literature published up to September 2022 to retrieve original family high-risk and registry studies reporting on the risk of mental disorders in offspring of parents with any type of mental disorder. We performed random-effects meta-analyses of the relative risk (risk ratio, RR) and absolute risk (lifetime, up to the age at assessment) of mental disorders, defined according to the ICD or DSM. Cumulative incidence by offspring age was determined using meta-analytic Kaplan-Meier curves. We measured heterogeneity with the I2 statistic, and risk of bias with the Quality In Prognosis Studies (QUIPS) tool. Sensitivity analyses addressed the impact of study design (family high-risk vs. registry) and specific vs. transdiagnostic risks. Transdiagnosticity was appraised with the TRANSD criteria. We identified 211 independent studies that reported data on 3,172,115 offspring of parents with psychotic, bipolar, depressive, disruptive, attention-deficit/hyperactivity, anxiety, substance use, eating, obsessive-compulsive, and borderline personality disorders, and 20,428,575 control offspring. The RR and lifetime risk of developing any mental disorder were 3.0 and 55% in offspring of parents with anxiety disorders; 2.6 and 17% in offspring of those with psychosis; 2.1 and 55% in offspring of those with bipolar disorder; 1.9 and 51% in offspring of those with depressive disorders; and 1.5 and 38% in offspring of those with substance use disorders. The offspring's RR and lifetime risk of developing the same mental disorder diagnosed in their parent were 8.4 and 32% for attention-deficit/hyperactivity disorder; 5.8 and 8% for psychosis; 5.1 and 5% for bipolar disorder; 2.8 and 9% for substance use disorders; 2.3 and 14% for depressive disorders; 2.3 and 1% for eating disorders; and 2.2 and 31% for anxiety disorders. There were 37 significant transdiagnostic associations between parental mental disorders and the RR of developing a different mental disorder in the offspring. In offspring of parents with psychosis, bipolar and depressive disorder, the risk of the same disorder onset emerged at 16, 5 and 6 years, and cumulated to 3%, 19% and 24% by age 18; and to 8%, 36% and 46% by age 28. Heterogeneity ranged from 0 to 0.98, and 96% of studies were at high risk of bias. Sensitivity analyses restricted to prospective family high-risk studies confirmed the pattern of findings with similar RR, but with greater absolute risks compared to analyses of all study types. This study demonstrates at a global, meta-analytic level that offspring of affected parents have strongly elevated RR and lifetime risk of developing any mental disorder as well as the same mental disorder diagnosed in the parent. The transdiagnostic risks suggest that offspring of parents with a range of mental disorders should be considered as candidates for targeted primary prevention.
Collapse
Affiliation(s)
- Rudolf Uher
- Dalhousie UniversityDepartment of PsychiatryHalifaxNSCanada
- Nova Scotia Health AuthorityHalifaxNSCanada
| | - Barbara Pavlova
- Dalhousie UniversityDepartment of PsychiatryHalifaxNSCanada
- Nova Scotia Health AuthorityHalifaxNSCanada
| | - Joaquim Radua
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Instituto de Salud Carlos IIIUniversity of BarcelonaBarcelonaSpain
| | - Umberto Provenzani
- Department of Brain and Behavioral SciencesUniversity of PaviaPaviaItaly
| | - Sara Najafi
- Dalhousie UniversityDepartment of PsychiatryHalifaxNSCanada
- Nova Scotia Health AuthorityHalifaxNSCanada
| | - Lydia Fortea
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Instituto de Salud Carlos IIIUniversity of BarcelonaBarcelonaSpain
| | - Maria Ortuño
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Instituto de Salud Carlos IIIUniversity of BarcelonaBarcelonaSpain
| | - Anna Nazarova
- Dalhousie UniversityDepartment of PsychiatryHalifaxNSCanada
- Nova Scotia Health AuthorityHalifaxNSCanada
| | - Nader Perroud
- Service of Psychiatric Specialties, Department of PsychiatryUniversity Hospitals of GenevaGenevaSwitzerland
- Department of PsychiatryUniversity of GenevaGenevaSwitzerland
| | - Lena Palaniyappan
- Douglas Mental Health University Institute, Department of PsychiatryMcGill UniversityMontrealQBCanada
- Robarts Research InstituteWestern UniversityLondonONCanada
- Department of Medical BiophysicsWestern UniversityLondonONCanada
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of MedicineUniversity of FreiburgFreiburgGermany
| | - Samuele Cortese
- School of Psychology, and Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of MedicineUniversity of SouthamptonSouthamptonUK
- Solent NHS TrustSouthamptonUK
- Division of Psychiatry and Applied PsychologyUniversity of NottinghamNottinghamUK
- Hassenfeld Children's Hospital at NYU LangoneNew YorkNYUSA
| | - Paul D. Arnold
- Mathison Centre for Mental Health Research & EducationUniversity of CalgaryCalgaryALCanada
| | - Jehannine C. Austin
- Departments of Psychiatry and Medical GeneticsUniversity of British ColumbiaVancouverBCCanada
| | - Michael M. Vanyukov
- Departments of Pharmaceutical Sciences, Psychiatry, and Human GeneticsUniversity of PittsburghPittsburghPAUSA
| | - Myrna M. Weissman
- Department of Psychiatry, Vagelos College of Physicians and SurgeonsColumbia UniversityNew YorkNYUSA
- Division of Translational EpidemiologyNew York State Psychiatric InstituteNew YorkNYUSA
- Mailman School of Public HealthColumbia UniversityNew YorkNYUSA
| | - Allan H. Young
- Centre for Affective Disorders, Institute of Psychiatry, Psychology, and NeuroscienceKing's College LondonLondonUK
| | - Manon H.J. Hillegers
- Department of Child and Adolescent Psychiatry/PsychologyErasmus University Medical Center, Sophia Children's HospitalRotterdamThe Netherlands
| | - Andrea Danese
- Social, Genetic and Developmental Psychiatry Centre and Department of Child and Adolescent PsychiatryInstitute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
- National and Specialist CAMHS Clinic for Trauma, Anxiety, and DepressionSouth London and Maudsley NHS Foundation TrustLondonUK
| | - Merete Nordentoft
- Copenhagen Research Center for Mental Health, Mental Health ServicesCapital Region of DenmarkCopenhagenDenmark
- Department of Clinical Medicine, Faculty of Health SciencesUniversity of CopenhagenCopenhagenDenmark
| | - Robin M. Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Paolo Fusar‐Poli
- Department of Brain and Behavioral SciencesUniversity of PaviaPaviaItaly
- Early Psychosis: Intervention and Clinical‐detection (EPIC) lab, Department of Psychosis StudiesKing's College LondonLondonUK
- Outreach and Support in South‐London (OASIS) NHS Foundation Trust, South London and Maudsley NHS Foundation TrustLondonUK
| |
Collapse
|
10
|
Ribette C, Rosenthal L, Raynaud JP, Franchitto L, Revet A. Primary care physicians' experience of caring for children with parents with mental health illness: a qualitative study among French general practitioners and paediatricians. BMC PRIMARY CARE 2023; 24:190. [PMID: 37718455 PMCID: PMC10506299 DOI: 10.1186/s12875-023-02145-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 08/30/2023] [Indexed: 09/19/2023]
Abstract
BACKGROUND Parental psychiatric disorders can have a significant impact on child development and the parent-infant bond, with a high risk of attachment disorders. Early identification of difficulties in the parent-child relationship is essential to prevent consequences for the child. Childcare practitioners have a major role to play in this early detection process, through regular mandatory consultations during the first two years of a child's life. Thus, the aim of this study was to collect the experience of private practitioners in their care of children of parents with a mental health illness. METHOD This is a cross-sectional, observational, qualitative study. Data were collected by means of semi-structured interviews with eleven general practitioners and private paediatricians between February and July 2021 in Toulouse and its suburbs. We only included practitioners who had followed children of parents with a mental health illness. The interviews were recorded with the agreement of the participants, before being transcribed anonymously. The data were analysed with NVivo software using interpretative phenomenological analysis. RESULTS Three main themes emerged from the results, which were further divided into several sub-themes. Addressing psychiatric disorders presents a risk for the therapeutic relationship. Practitioners express a need to preserve this relationship with the parent in joint care. Care is difficult and is permeated by the parents' emotional issues. Furthermore, practitioners face a conflict between their concerns for the parent-child bond and their desire not to stigmatise these families. They express a feeling of isolation in these follow-ups. This stressful care has a significant emotional impact on the doctors. Access to psychiatric training and multidisciplinary collaboration seem to be essential to improve the follow-up experience for practitioners, as these factors strengthen inter-professional connections. CONCLUSION Practitioners describe a parent-doctor relationship at risk, which is underpinned by the fear of care placement. This study illustrates the need to strengthen multidisciplinary work by promoting interprofessional exchanges, in order to improve the experience of practitioners in this care process. Addressing practitioners' fear of discussing parental psychiatric illness is very important, so as not to delay the implementation of preventive actions that are likely to improve the developmental prognosis for children.
Collapse
Affiliation(s)
- Cécile Ribette
- Department of Child and Adolescent Psychiatry, Toulouse University Hospital, Toulouse, France.
| | - Lucie Rosenthal
- Department of Child and Adolescent Psychiatry, Toulouse University Hospital, Toulouse, France
| | - Jean-Philippe Raynaud
- Department of Child and Adolescent Psychiatry, Toulouse University Hospital, Toulouse, France
- CERPOP, University of Toulouse, Inserm, UPS, Toulouse, France
| | - Ludivine Franchitto
- Department of Child and Adolescent Psychiatry, Toulouse University Hospital, Toulouse, France
| | - Alexis Revet
- Department of Child and Adolescent Psychiatry, Toulouse University Hospital, Toulouse, France
- CERPOP, University of Toulouse, Inserm, UPS, Toulouse, France
| |
Collapse
|
11
|
Puchol-Martínez I, Vallina Férnandez Ó, Santed-Germán MA. Preventive interventions for children and adolescents of parents with mental illness: A systematic review. Clin Psychol Psychother 2023; 30:979-997. [PMID: 36997159 DOI: 10.1002/cpp.2850] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 01/25/2023] [Accepted: 03/09/2023] [Indexed: 04/01/2023]
Abstract
BACKGROUND Children of parents with mental disorders have a relatively high risk of developing a mental illness or behavioural disorder. OBJECTIVE The aim of this systematic review was to evaluate the efficacy of preventive psychotherapeutic interventions in children of parents with mental illness. In particular, the development of mental illness and/or psychological symptomatology in this population was assessed. METHOD This qualitative systematic review looked at interventions targeting children aged 4-18 years without a diagnosed mental disorder, alone or with their families, with a parent with a diagnosed mental disorder. The protocol was pre-registered in Open Science Framework. A total of 1255 references were retrieved from MEDLINE, PsychArticles, PsycINFO, Springer Link, Science Direct, Scopus and WOS databases, and 12 references from grey literature. This search was replicated by an external reviewer. RESULTS Fifteen studies involving 1941 children and 1328 parents were included. Interventions were based on cognitive-behavioural and/or psychoeducational components, including six randomized controlled trials. Internalizing symptomatology was assessed in 80% of the studies, externalizing and prosocial behaviour in 47%, and coping style in 33%. Only two studies measured the future risk of developing a mental disorder (ORs of 2.37 and 6.6). There was variability in the format of the intervention (group; family) as well as in the type of intervention and its duration (from one session to 12 sessions). CONCLUSIONS Interventions for children of parents with mental disorder were clinically and statistically significant, especially in preventing internalizing symptomatology at one-year follow-up, with effect sizes ranging from d = -0.28 to 0.57 (95% CI).
Collapse
Affiliation(s)
- Itzal Puchol-Martínez
- Escuela Internacional de Doctorado, Institute of Public and Occupational Health of Navarre, Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
| | | | - Miguel A Santed-Germán
- Department of Personality Evaluation and Psychological Treatment, Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
| |
Collapse
|
12
|
Zechmeister-Koss I, Strohmaier C, Hölzle L, Bauer A, Goodyear M, Christiansen H, Paul JL. Economic Evaluation of Family-Focused Programs When Parents Have a Mental Health Problem: Methodological Considerations. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2023; 26:704-711. [PMID: 36503037 DOI: 10.1016/j.jval.2022.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 11/18/2022] [Accepted: 11/27/2022] [Indexed: 05/03/2023]
Abstract
OBJECTIVES The nature of adverse effects of parental mental health problems and of the interventions to address them may require specific designs of economic evaluation studies. Nevertheless, methodological guidance is lacking. We aim to understand the broad spectrum of adverse effects from parental mental health problems in children and the economic consequences on an individual and societal level to navigate the design of economic evaluations in this field. METHODS We conducted a systematic literature search of empirical studies on children's adverse effects from parental mental illness. We clustered types of impact, identified individual and public cost consequences, and illustrated the results in an impact inventory. RESULTS We found a wide variety of short- and long-term (mental) health impacts, impacts on social functioning and socioeconomic implications for the children individually, and adverse effects on the societal level. Consequently, public costs can occur in various public sectors (eg, healthcare, education), and individuals may have to pay costs privately. CONCLUSIONS Existing evaluations in this field mostly follow standard methodological approaches (eg, cost-utility analysis using quality-adjusted life-years) and apply a short-time horizon. Our findings suggest applying a long-term time horizon (at least up to early adulthood), considering cost-consequence analysis and alternatives to health-related quality of life and quality-adjusted life-years as outcome measures, and capturing the full range of possible public and private costs.
Collapse
Affiliation(s)
| | | | - Laura Hölzle
- Village Research Group, Medical University Innsbruck, Innsbruck, Austria
| | - Annette Bauer
- London School of Economics, Care Policy and Evaluation Centre (CPEC), London, England, UK
| | - Melinda Goodyear
- Monash University Australia, School of Rural Health, Melbourne, VIC, Australia
| | | | - Jean L Paul
- Village Research Group, Medical University Innsbruck, Innsbruck, Austria
| |
Collapse
|
13
|
Zechmeister-Koss I, Aufhammer S, Bachler H, Bauer A, Bechter P, Buchheim A, Christiansen H, Fischer M, Franz M, Fuchs M, Goodyear M, Gruber N, Hofer A, Hölzle L, Juen E, Papanthimou F, Prokop M, Paul JL. Practices to support co-design processes: A case-study of co-designing a program for children with parents with a mental health problem in the Austrian region of Tyrol. Int J Ment Health Nurs 2023; 32:223-235. [PMID: 36226745 DOI: 10.1111/inm.13078] [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] [Accepted: 09/18/2022] [Indexed: 01/14/2023]
Abstract
Forms of collaborative knowledge production, such as community-academic partnerships (CAP), have been increasingly used in health care. However, instructions on how to deliver such processes are lacking. We aim to identify practice ingredients for one element within a CAP, a 6-month co-design process, during which 26 community- and 13 research-partners collaboratively designed an intervention programme for children whose parent have a mental illness. Using 22 published facilitating and hindering factors for CAP as the analytical framework, eight community-partners reflected on the activities which took place during the co-design process. From a qualitative content analysis of the data, we distilled essential practices for each CAP factor. Ten community- and eight research-partners revised the results and co-authored this article. We identified 36 practices across the 22 CAP facilitating or hindering factors. Most practices address more than one factor. Many practices relate to workshop design, facilitation methods, and relationship building. Most practices were identified for facilitating 'trust among partners', 'shared visions, goals and/or missions', 'effective/frequent communication', and 'well-structured meetings'. Fewer practices were observed for 'effective conflict resolution', 'positive community impact' and for avoiding 'excessive funding pressure/control struggles' and 'high burden of activities'. Co-designing a programme for mental healthcare is a challenging process that requires skills in process management and communication. We provide practice steps for delivering co-design activities. However, practitioners may have to adapt them to different cultural contexts. Further research is needed to analyse whether co-writing with community-partners results in a better research output and benefits for participants.
Collapse
Affiliation(s)
| | | | | | - Annette Bauer
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | | | - Anna Buchheim
- Institute of Psychology, University of Innsbruck, Innsbruck, Austria
| | - Hanna Christiansen
- Institut für Klinische Kinder- und Jugendpsychologie, Philipps-University, Marburg, Germany
| | - Maria Fischer
- Hilfe für Angehörige Psychisch Erkrankter Menschen in Tirol, Innsbruck, Austria
| | - Marianne Franz
- Mental Health Research Program, The Village, Ludwig Boltzmann Gesellschaft, Innsbruck, Austria.,Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry I, Medical University Innsbruck, Innsbruck, Austria
| | - Martin Fuchs
- Medical University Innsbruck, Innsbruck, Austria.,Abteilung für Kinder- und Jugendpsychiatrie, Tirol Kliniken GmbH, Hall in Tirol, Austria
| | - Melinda Goodyear
- School of Rural Health, Monash University, Melbourne, Victoria, Australia.,Emerging Minds, Hilton, South Australia, Australia
| | - Nadja Gruber
- Mental Health Research Program, The Village, Ludwig Boltzmann Gesellschaft, Innsbruck, Austria.,Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry I, Medical University Innsbruck, Innsbruck, Austria
| | - Alex Hofer
- Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry I, Medical University Innsbruck, Innsbruck, Austria
| | - Laura Hölzle
- Mental Health Research Program, The Village, Ludwig Boltzmann Gesellschaft, Innsbruck, Austria.,Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry I, Medical University Innsbruck, Innsbruck, Austria
| | - Evi Juen
- Kinder- und Jugendhilfe, Landeck, Austria
| | | | - Mathias Prokop
- Univ. Klinik für Psychiatrie, Landeskrankenhaus-Universitätskliniken Innsbruck Tirol Kliniken GmbH, Innsbruck, Austria
| | - Jean Lillian Paul
- Mental Health Research Program, The Village, Ludwig Boltzmann Gesellschaft, Innsbruck, Austria.,Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry I, Medical University Innsbruck, Innsbruck, Austria
| |
Collapse
|
14
|
Vaezghasemi M, Vogt T, Lindkvist M, Pulkki-Brännström AM, Richter Sundberg L, Lundahl L, Silfverdal SA, Feldman I, Ivarsson A. Multifaceted determinants of social-emotional problems in preschool children in Sweden: An ecological systems theory approach. SSM Popul Health 2023; 21:101345. [PMID: 36785550 PMCID: PMC9918800 DOI: 10.1016/j.ssmph.2023.101345] [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: 10/06/2022] [Revised: 01/03/2023] [Accepted: 01/20/2023] [Indexed: 01/23/2023] Open
Abstract
Social-emotional problems occurring early in life can place children at future risk of adverse health, social and economic outcomes. Determinants of social-emotional problems are multi-layered and originate from different contexts surrounding children, though few studies consider them simultaneously. We adopted a holistic approach by using Bronfenbrenner's process-person-context-time model as a structuring device. We aimed to assess what characteristics of families and children from pregnancy, over birth, and up to 3 years of age are associated with social-emotional problems in boys and girls. This study used regional data from the Salut Programme, a universal health promotion programme implemented in Antenatal and Child Health Care, and data from national Swedish registers. The study population included 6033 3-year-olds and their parents during the period 2010-2018. Distinct logistic regression models for boys and girls were used to assess associations between the family social context, parents' lifestyle, parent's mental health, children's birth characteristics, and indicators of proximal processes (the independent variables); and children's social-emotional problems as measured by the parent-completed Ages and Stages Questionnaire: Social-Emotional between 33 and 41 months of age (the outcome). Overall, a less favourable family social context, detrimental lifestyle of the parents during pregnancy, and parents' mental illness from pregnancy onwards were associated with higher odds of social-emotional problems in 3-year-olds. Higher screentime and infrequent shared book-reading were associated with higher odds of social-emotional problems. The multifaceted determinants of children's social-emotional problems imply that many diverse targets for intervention exist. Additionally, this study suggests that Bronfenbrenner's process-person-context-time theoretical framework could be relevant for public health research and policy.
Collapse
Affiliation(s)
- Masoud Vaezghasemi
- Department of Epidemiology and Global Health, Umeå University, 901 87, Umeå, Sweden,Corresponding author. Norrlands universitetssjukhus Epidemiologi och Global Hälsa, Umeå University, B, Målpunkt P, Försörjningsvägen 7 B, 90185, Umeå, Sweden.
| | - Thomas Vogt
- Department of Epidemiology and Global Health, Umeå University, 901 87, Umeå, Sweden
| | - Marie Lindkvist
- Department of Epidemiology and Global Health, Umeå University, 901 87, Umeå, Sweden
| | | | | | - Lisbeth Lundahl
- Department of Applied Educational Science, Umeå University, 901 87, Umeå, Sweden
| | - Sven-Arne Silfverdal
- Department of Clinical Science, Pediatrics, Umeå University, 901 87, Umeå, Sweden
| | - Inna Feldman
- Department of Public Health and Caring Sciences, Uppsala University, 751 22, Uppsala, Sweden
| | - Anneli Ivarsson
- Department of Epidemiology and Global Health, Umeå University, 901 87, Umeå, Sweden
| |
Collapse
|
15
|
Protocol for the Feasibility Randomised Controlled Trial of Being a Parent- Enjoying Family Life (BAP-EFL): A peer-led group intervention for parents and caregivers with significant emotional and interpersonal difficulties. Contemp Clin Trials 2023; 124:107014. [PMID: 36410690 DOI: 10.1016/j.cct.2022.107014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 11/14/2022] [Accepted: 11/15/2022] [Indexed: 11/22/2022]
Abstract
Group-format parenting interventions are well-established at reducing challenging child behavior and risk for psychopathology. However, there is significantly less evidence about the performance of these interventions for parents with significant emotional and interpersonal difficulties, including personality disorder. This protocol presents the rationale and design of a two-arm parallel group feasibility Randomised Controlled Trial and nested process evaluation of Being a Parent (BaP)- Enjoying Family Life, a novel peer-led intervention. The trial compares BaP-Enjoying Family Life to the well-established Empowering Parents Empowering Communities-Being a Parent (EPEC-Being a Parent) in a sample of parents who experience significant emotional and interpersonal difficulties and who are concerned about their child's, aged 2-11 years, behavior. 72 parents will be recruited and randomised to receive either BaP-Enjoying Family Life or EPEC-Being a Parent group-format interventions. The primary aim of this study is to examine the feasibility and acceptability of BaP-Enjoying Family Life and the proposed trial methods. Secondary clinical outcomes include child behavioral difficulties, parenting, parental reflective function, parent wellbeing, satisfaction and self-efficacy. An observational assessment of parent and index child will also assess changes in the home environment. Outcome measures will be collected pre-intervention, post-intervention and at 6-month follow up. A parallel process evaluation will use qualitative data from interviews to assess parents' experience of the intervention delivery and trial methods. Findings will be evaluated against pre-determined feasibility criteria. The results will be used to determine the planning of a definitive clinical trial. The wider methodological and clinical implications are also discussed.
Collapse
|
16
|
Wirehag Nordh EL, Grip K, Thorvaldsson V, Priebe G, Afzelius M, Axberg U. Preventive interventions for children of parents with depression, anxiety, or bipolar disorder: A quasi-experimental clinical trial. Acta Paediatr 2023; 112:132-142. [PMID: 36169579 PMCID: PMC10092553 DOI: 10.1111/apa.16555] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 09/06/2022] [Accepted: 09/27/2022] [Indexed: 12/24/2022]
Abstract
AIM To investigate the effectiveness of preventive interventions for 8-17-year-old children of patients diagnosed with depression, anxiety, or bipolar disorder. METHODS Sixty-two families including 89 children received either the more extensive Family Talk Intervention (FTI; n = 35), the brief Let's Talk about Children (LTC; n = 16), or Interventions as Usual (IAU; n = 38) in routine care in adult psychiatry. Parent-rated questionnaire data were collected at baseline, after 6 and 12 months. We used growth curve models to investigate the effect of intervention on child mental health problems (SDQ-P Total Difficulties) and perceived parental control of child behaviour (PLOC-PPC). RESULTS Parents in the FTI and LTC groups, versus the IAU group, reported more favourable development in terms of preventing increase in child mental health problems with standardised intervention effects of d = -0.86 and -0.88 respectively, by study end, and reported improved perceived parental control, d = 1.08 and 0.71, respectively, by study end. No significant differences in effect were found when FTI and LTC were compared. CONCLUSIONS The results support continued use of FTI and LTC in adult psychiatry, and since LTC is a brief intervention, it might be useful as a minimum-level preventive intervention.
Collapse
Affiliation(s)
| | - Karin Grip
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
| | | | - Gisela Priebe
- Department of Social and Psychological Studies and CBU, Centre for Research on the Mental Health and Life Circumstances of Children and Youth, Karlstad University, Karlstad, Sweden
| | - Maria Afzelius
- Department of Social Work, Malmo University, Malmo, Sweden
| | - Ulf Axberg
- Faculty of Social Studies, VID Specialized University, Oslo, Norway
| |
Collapse
|
17
|
Radley J, Barlow J, Johns LC. A family perspective on parental psychosis: An interpretative phenomenological analysis study. Psychol Psychother 2022; 96:347-363. [PMID: 36463435 DOI: 10.1111/papt.12443] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 11/22/2022] [Accepted: 11/24/2022] [Indexed: 12/05/2022]
Abstract
OBJECTIVES While one third of people with a psychotic disorder are a parent, there has been little research to date examining the consequences of this from a whole family perspective. This study investigates families where a parent has experienced an episode of psychosis and compares and contrasts the family members' perspectives. DESIGN This study was rooted in phenomenology and data were derived from in-depth semi-structured interviews. METHODS Parents with a psychotic disorder who had a child aged between 3 and 11 in a UK NHS Trust were invited to take part in the study. Semi-structured interviews were conducted with these parents, with their child (if they were between the ages of 8 and 11), and with their partner or another close family member. Data were analysed using multiperspectival interpretive phenomenological analysis (m-IPA). RESULTS Thirteen participants took part comprising of five parents, four children, three partners and one grandmother. Four themes were developed using m-IPA: (1) Parental psychosis impacts the whole family, (2) Psychosis and my role as a parent, (3) Secrecy and concealment surrounding parental psychosis, and (4) Pressures and vulnerabilities within the family system. CONCLUSION Psychosis had a negative impact on all family members and secrecy existed between family members. The children in particular only had partial information about their parent's mental illness, which left them worried and confused. More work is needed to support these families to explain psychosis to the children.
Collapse
Affiliation(s)
- Jessica Radley
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - Jane Barlow
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Louise C Johns
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK.,Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| |
Collapse
|
18
|
Farářová A, Papežová H, Gricová J, Štěpánková T, Čapek V, Reedtz C, Lauritzen C, van Doesum K. ChildTalks+: a study protocol of a pre-post controlled, paired design study on the use of preventive intervention for children of parents with a mental illness with focus on eating disorders. BMC Psychiatry 2022; 22:715. [PMID: 36384579 PMCID: PMC9670502 DOI: 10.1186/s12888-022-04349-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 10/29/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Children of parents with a mental illness are at high risk of developing a mental disorder as a result of transgenerational transmission. Without effective intervention, they could form the next generation of psychiatric patients. ChildTalks+ is a preventive intervention involving four structured psychoeducational sessions designed for parents affected by a mental disorder and their children. Its aim is to reduce the risk of mental disorders in children of parents with mental illness. This study draws on our clinical practice and involves a group of patients with eating disorders. The aim of the project, which will run in the Czech Republic, is to evaluate the effectiveness of ChildTalks+ methodology. METHODS ChildTalks+ therapists (professionals from health, social, and educational facilities) will recruit 66 families where a parent is treated for a mental disorder and the family includes children aged 6-18. Paired allocation into an intervention group (N = 33) and a control group (N = 33) will be based on the number of risk factors identified in the family. Both groups will complete questionnaires at the baseline, post-test, and follow-up assessments after six and 12 months. The intervention group will receive the ChildTalks+ intervention within 2 months of the baseline assessment; the control group after the last assessment. Questionnaires will be completed by parents and children aged 12+ and, in two cases, 15+ years. Quantitative data will be supplemented with qualitative data from ChildTalks+ therapists working with patients with eating disorders. DISCUSSION The ChildTalks+ intervention is expected to strengthen parenting competencies and family protective factors, improve family communication, increase awareness of parental mental health issues, and improve the wellbeing of children of parents with mental illness with long-term sustainable outcomes. The study should contribute to the evidence base for the ChildTalks+ program and help identify key themes in the implementation of similar preventive interventions. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05554458. Registered 26 September 2022. Retrospectively registered.
Collapse
Affiliation(s)
- Adéla Farářová
- First Faculty of Medicine, Charles University, Prague, Czech Republic. .,Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic.
| | - Hana Papežová
- grid.4491.80000 0004 1937 116XFirst Faculty of Medicine, Charles University, Prague, Czech Republic ,grid.411798.20000 0000 9100 9940Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Jana Gricová
- grid.4491.80000 0004 1937 116XFirst Faculty of Medicine, Charles University, Prague, Czech Republic ,grid.411798.20000 0000 9100 9940Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Tereza Štěpánková
- grid.4491.80000 0004 1937 116XFirst Faculty of Medicine, Charles University, Prague, Czech Republic ,grid.411798.20000 0000 9100 9940Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Václav Čapek
- grid.4491.80000 0004 1937 116XFirst Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Charlotte Reedtz
- grid.10919.300000000122595234RKBU North, Faculty of Health, UiT – Arctic University of Norway, Tromsø, Norway
| | - Camilla Lauritzen
- grid.10919.300000000122595234RKBU North, Faculty of Health, UiT – Arctic University of Norway, Tromsø, Norway
| | - Karin van Doesum
- grid.5590.90000000122931605Department of Clinical Psychology, Radboud University, Nijmegen, Netherlands
| |
Collapse
|
19
|
Gregersen M, Søndergaard A, Brandt JM, Ellersgaard D, Rohd SB, Hjorthøj C, Ohland J, Krantz MF, Wilms M, Andreassen AK, Knudsen CB, Veddum L, Greve A, Bliksted V, Mors O, Clemmensen L, Møllegaard Jepsen JR, Nordentoft M, Hemager N, Thorup AAE. Mental disorders in preadolescent children at familial high-risk of schizophrenia or bipolar disorder - a four-year follow-up study: The Danish High Risk and Resilience Study, VIA 11: The Danish High Risk and Resilience Study, VIA 11. J Child Psychol Psychiatry 2022; 63:1046-1056. [PMID: 34918345 DOI: 10.1111/jcpp.13548] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/27/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Children at familial high-risk of schizophrenia and bipolar disorder have an elevated prevalence of mental disorders but studies of children within a narrow age range are lacking and there are few conjoint studies of these two groups. Knowledge on their mental health is important for prevention and early intervention. METHODS The authors examined mental disorders and global functioning in children at familial high-risk of schizophrenia (FHR-SZ) and bipolar disorder (FHR-BP) compared with population-based controls. In a longitudinal cohort study, 450 children (FHR-SZ, n = 171; FHR-BP, n = 104; controls, n = 175), were assessed for Axis I disorders at baseline and four-year follow-up (mean age 11.9, SD 0.2) with the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children and for global functioning with Children's Global Assessment Scale. RESULTS Cumulative incidence of Any Axis I disorder was elevated by age 11 in children at FHR-SZ (54.4%, OR 3.0, 95% CI 1.9-4.7, p < .001) and children at FHR-BP (52.9%, OR 2.8, 95% CI 1.7-4.7, p < .001) compared with controls (28.6%). Children at FHR-SZ and FHR-BP had higher rates of affective disorders (OR 4.4, 95% CI 1.4-13.5, p = .009; OR 5.1, 95% CI 1.6-16.4, p = .007), anxiety disorders (OR 2.1, 95% CI 1.1-4.0, p = .02; OR 3.0, 95% CI 1.5-6.1, p = .002), and stress and adjustment disorders (OR 3.3, 95% CI 1.4-7.5, p = .006; OR 5.3, 95% CI 2.2-12.4, p < .001). Disruptive behavior disorders (OR 2.8, 95% CI 1.0-7.3, p = .04) and ADHD (OR 2.9, 95% CI 1.6-5.3, p < .001) were elevated in children at FHR-SZ. Both FHR groups had lower global functioning than controls. Cumulative incidence of disorders increased equally across the three groups from early childhood to preadolescence and level of functioning did not change differentially. CONCLUSIONS Children at FHR-SZ and FHR-BP have an elevated prevalence of mental disorders and poorer functioning than controls. Vulnerability in children at FHR manifests early and remains stable throughout childhood. Early attention toward their mental health and identification of those in need of intervention is warranted.
Collapse
Affiliation(s)
- Maja Gregersen
- CORE-Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anne Søndergaard
- CORE-Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Julie Marie Brandt
- CORE-Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ditte Ellersgaard
- CORE-Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
| | - Sinnika Birkehøj Rohd
- CORE-Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark
| | - Carsten Hjorthøj
- CORE-Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark.,Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Jessica Ohland
- CORE-Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark
| | - Mette Falkenberg Krantz
- CORE-Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Martin Wilms
- CORE-Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark
| | - Anna Krogh Andreassen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark.,Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark
| | - Christina Bruun Knudsen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark.,Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark
| | - Lotte Veddum
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark.,Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark
| | - Aja Greve
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark.,Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark
| | - Vibeke Bliksted
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark.,Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark
| | - Ole Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark.,Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark
| | - Lars Clemmensen
- Child and Adolescent Mental Health Center, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
| | - Jens Richardt Møllegaard Jepsen
- CORE-Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark.,Child and Adolescent Mental Health Center, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark.,Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
| | - Merete Nordentoft
- CORE-Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Nicoline Hemager
- CORE-Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anne Amalie Elgaard Thorup
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Child and Adolescent Mental Health Center, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
| |
Collapse
|
20
|
Fricke M, Morawietz C, Wunderlich A, Muehlbauer T, Jansen CP, Gramann K, Wollesen B. Successful wayfinding in age: A scoping review on spatial navigation training in healthy older adults. Front Psychol 2022; 13:867987. [PMID: 36051192 PMCID: PMC9424919 DOI: 10.3389/fpsyg.2022.867987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 07/13/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Spatial navigation is a complex cognitive function that declines in older age. Finding one’s way around in familiar and new environments is crucial to live and function independently. However, the current literature illustrates the efficacy of spatial navigation interventions in rehabilitative contexts such as pathological aging and traumatic injury, but an overview of existing training studies for healthy older adults is missing. This scoping review aims to identify current evidence on existing spatial navigation interventions in healthy older adults and analyze their efficacy. Methods To identify spatial navigation interventions and assessments and investigate their effectiveness, four electronic databases were searched (Pubmed, Web of Science, CINAHL and EMBASE). Two independent reviewers conducted a screening of title, abstract and full-texts and performed a quality assessment. Studies were eligible if (1) published in English, (2) the full text was accessible, (3) at least one group of healthy older adults was included with (4) mean age of 65 years or older, (5) three or more spatial navigation-related training sessions were conducted and (6) at least one spatial ability outcome was reported. Results Ten studies were included (N = 1,003, age-range 20–95 years, 51.5% female), only healthy older adults (n = 368, mean age ≥ 65) were assessed further. Studies differed in sample size (n = 22–401), type of training, total intervention duration (100 min–50 h), and intervention period (1–16 weeks). Conclusion The spatial navigation abilities addressed and the measures applied to elicit intervention effects varied in quantity and methodology. Significant improvements were found for at least one spatial ability-related outcome in six of 10 interventions. Two interventions achieved a non-significant positive trend, another revealed no measurable post-training improvement, and one study did not report pre-post-differences. The results indicate that different types of spatial navigation interventions improve components of spatial abilities in healthy older adults. The existing body of research does not allow conclusions on transferability of the trained components on everyday life spatial navigation performance. Future research should focus on reproducing and extending the promising approaches of available evidence. From this, valuable insights on healthy aging could emerge. Trial Registration This scoping review was preregistered at Open Science Framework (https://osf.io/m9ab6).
Collapse
Affiliation(s)
- Madeleine Fricke
- Department of Biological Psychology and Neuroergonomics, Technical University of Berlin, Berlin, Germany
- *Correspondence: Madeleine Fricke,
| | - Christina Morawietz
- Division of Movement and Training Sciences/Biomechanics of Sport, University of Duisburg-Essen, Essen, Germany
| | - Anna Wunderlich
- Department of Biological Psychology and Neuroergonomics, Technical University of Berlin, Berlin, Germany
| | - Thomas Muehlbauer
- Division of Movement and Training Sciences/Biomechanics of Sport, University of Duisburg-Essen, Essen, Germany
| | - Carl-Philipp Jansen
- Institute of Sports and Sports Sciences, Heidelberg University, Heidelberg, Germany
- Clinic for Geriatric Rehabilitation, Robert-Bosch-Krankenhaus Stuttgart, Stuttgart, Germany
| | - Klaus Gramann
- Department of Biological Psychology and Neuroergonomics, Technical University of Berlin, Berlin, Germany
| | - Bettina Wollesen
- Department of Biological Psychology and Neuroergonomics, Technical University of Berlin, Berlin, Germany
- Department of Human Movement Science, University of Hamburg, Hamburg, Germany
| |
Collapse
|
21
|
Sabella K, Baczko A, Lane IA, Golden L, Pici-D'Ottavio E, O'Neill M. A Challenging Yet Motivating Journey: The Experiences of Young Adult Parents With Serious Mental Health Conditions in the USA. Front Psychiatry 2022; 13:814185. [PMID: 35370850 PMCID: PMC8967164 DOI: 10.3389/fpsyt.2022.814185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 02/07/2022] [Indexed: 11/13/2022] Open
Abstract
In recent decades the average age of becoming a parent has increased, the rate of teen pregnancies has decreased, and a new developmental period of emerging adulthood is marked by diverse pathways into adulthood. Today, those who become parents in young adulthood (18-24 years old) and their children may be vulnerable to poor outcomes observed in teen parents (13-19 years old) of previous generations. Young adults with serious mental health conditions (SMHC) who encounter additional challenges navigating young adulthood and tend to parent earlier than their peers may be at particularly increased risk of poor outcomes. To date, little research has been done to understand the experiences of young adult parents, especially those with SMHC. This study describes themes from qualitative interviews with 18 young adults with SMHC in the United States who became parents before the age of 25. Life story narrative interviews, conducted mostly by young adults with lived experience, asked participants to describe their parenting and mental health experiences and their school, training, and work experiences. Participants described the challenges of simultaneously parenting young children and managing a mental health condition, experiences of discrimination, and fear of future discrimination related to their mental health condition. However, parents also expressed that their children motivated them to maintain recovery and build a good life for their family. This is the first study to qualitatively explore the experiences of young adult parents with SMHC. While many of these findings align with prior qualitative research on mothers with mental illness, by exclusively focusing on individuals who become parents earlier than their peers and including father experiences, this research adds to our understanding of how individuals simultaneously navigate parenting and managing a serious mental health condition. These findings should inform larger-scale research studies on the experiences and outcomes of young adults with SMHC who become parents in their late teens or early twenties. A better understanding of their experiences should inform public mental health services that incorporate parenting as an important element of an individual's personal recovery model.
Collapse
Affiliation(s)
- Kathryn Sabella
- Transitions to Adulthood Center for Research, Implementation Science and Practice Advances Research Center (iSPARC), Department of Psychiatry, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Amanda Baczko
- Transitions to Adulthood Center for Research, Implementation Science and Practice Advances Research Center (iSPARC), Department of Psychiatry, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Ian A. Lane
- Transitions to Adulthood Center for Research, Implementation Science and Practice Advances Research Center (iSPARC), Department of Psychiatry, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Laura Golden
- Sociology Department, University of Massachusetts Boston, Boston, MA, United States
| | - Emma Pici-D'Ottavio
- Transitions to Adulthood Center for Research, Implementation Science and Practice Advances Research Center (iSPARC), Department of Psychiatry, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Murron O'Neill
- School of Social Work, Boston University, Boston, MA, United States
| |
Collapse
|
22
|
Goodyear M, Zechmeister-Koss I, Bauer A, Christiansen H, Glatz-Grugger M, Paul JL. Development of an Evidence-Informed and Codesigned Model of Support for Children of Parents With a Mental Illness- "It Takes a Village" Approach. Front Psychiatry 2022; 12:806884. [PMID: 35173638 PMCID: PMC8841827 DOI: 10.3389/fpsyt.2021.806884] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 12/22/2021] [Indexed: 11/29/2022] Open
Abstract
Providing support to parents and their children to help address the cycle of intergenerational impacts of mental illness and reduce the negative consequences for children is a key focus of selective prevention approaches in public mental health. However, a key issue for children of parents with a mental illness is the lack of access to early intervention and prevention support when needed. They are not easily identifiable (until presenting with significant mental health issues of their own) and not easily accessing the necessary support that address the complex interplay of parental mental illness within families. There are significant barriers to the early identification of these children, particularly for mental health care. Furthermore, there is a lack of collaborative care that might enhance identification as well as offer services and support for these families. The "It takes a Village" project seeks to improve mental health outcomes for children through the co-development, implementation and evaluation of an approach to collaborative practice concerned with the identification of families where a parent has a mental illness, and establishing a service model to promote child-focused support networks in Austria. Here we describe the development of service delivery approach for the "It takes a Village" project that aims to improve identification and support of these children within enhancements of the existing service systems and informal supports. The paper describes the use of codesign and other implementation strategies, applied to a research setting, with the aim of impacting the sustainability of workforce reform to achieve lasting social impact. Results highlight the steps involved in translating evidence-based components, local practice wisdom and lived experience into the "It takes a Village" practice model for Tyrol, Austria. We highlight through this paper how regional context-specific solutions are essential in the redesign of care models that meet the complex needs of children of parents with a mental illness. Service system and policy formation with local and experienced stakeholders are also vital to ensure the solutions are implementation-ready, particularly when introducing new practice models that rely on organizational change and new ways of practice with vulnerable families. This also creates a solid foundation for the evaluation of the "It take a Village" approach for children of parents with a mental illness in Austria.
Collapse
Affiliation(s)
- Melinda Goodyear
- School of Rural Health, Monash University, Melbourne, VIC, Australia
- Emerging Minds, National Workforce Centre for Child Mental Health, Hilton, SA, Australia
| | | | - Annette Bauer
- Department of Health Policy, Care Policy and Evaluation Centre, London School of Economics and Political Science, London, United Kingdom
| | - Hanna Christiansen
- Department of Psychology, Clinical Child and Adolescent Psychology, Philipps University Marburg, Marburg, Germany
| | - Martina Glatz-Grugger
- Mental Health Research Program, The Village, Ludwig Boltzmann Gesellschaft, Innsbruck, Austria
| | - Jean Lillian Paul
- Mental Health Research Program, The Village, Ludwig Boltzmann Gesellschaft, Innsbruck, Austria
- Division of Psychiatry I, Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria
| |
Collapse
|
23
|
Thorup AAE, Hemager N, Bliksted VF, Greve AN, Ohland J, Wilms M, Rohd SB, Birk M, Bundgaard AF, Laursen AF, Jefsen OH, Steffensen NL, Andreassen AK, Veddum L, Knudsen CB, Enevoldsen M, Nymand M, Brandt JM, Søndergaard A, Carmichael L, Gregersen M, Krantz MF, Burton BK, Dietz M, Nudel R, Johnsen LK, Larsen KM, Meder D, Hulme OJ, Baaré WFC, Madsen KS, Lund TE, Østergaard L, Juul A, Kjær TW, Hjorthøj C, Siebner HR, Mors O, Nordentoft M. The Danish High-Risk and Resilience Study-VIA 15 - A Study Protocol for the Third Clinical Assessment of a Cohort of 522 Children Born to Parents Diagnosed With Schizophrenia or Bipolar Disorder and Population-Based Controls. Front Psychiatry 2022; 13:809807. [PMID: 35444571 PMCID: PMC9013818 DOI: 10.3389/fpsyt.2022.809807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 01/28/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Children born to parents with severe mental illness have gained more attention during the last decades because of increasing evidence documenting that these children constitute a population with an increased risk of developing mental illness and other negative life outcomes. Because of high-quality research with cohorts of offspring with familial risk and increased knowledge about gene-environment interactions, early interventions and preventive strategies are now being developed all over the world. Adolescence is a period characterized by massive changes, both in terms of physical, neurologic, psychological, social, and behavioral aspects. It is also the period of life with the highest risk of experiencing onset of a mental disorder. Therefore, investigating the impact of various risk and resilience factors in adolescence is important. METHODS The Danish High-Risk and Resilience Study started data collection in 2012, where 522 7-year-old children were enrolled in the first wave of the study, the VIA 7 study. The cohort was identified through Danish registers based on diagnoses of the parents. A total of 202 children had a parent diagnosed with schizophrenia, 120 children had a parent diagnosed with bipolar disorder, and 200 children had parents without these diagnoses. At age 11 years, all children were assessed for the second time in the VIA 11 study, with a follow-up retention rate of 89%. A comprehensive assessment battery covering domains of psychopathology, neurocognition, social cognition and behavior, motor development and physical health, genetic analyses, attachment, stress, parental functioning, and home environment was carried out at each wave. Magnetic resonance imaging scans of the brain and electroencephalograms were included from age 11 years. This study protocol describes the third wave of assessment, the VIA 15 study, participants being 15 years of age and the full, 3-day-long assessment battery this time including also risk behavior, magnetoencephalography, sleep, and a white noise paradigm. Data collection started on May 1, 2021. DISCUSSION We will discuss the importance of longitudinal studies and cross-sectional data collection and how studies like this may inform us about unmet needs and windows of opportunity for future preventive interventions, early illness identification, and treatment in the future.
Collapse
Affiliation(s)
- Anne Amalie Elgaard Thorup
- Child and Adolescent Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Nicoline Hemager
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Research Unit CORE, Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark
| | - Vibeke Fuglsang Bliksted
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Services, Aarhus University, Aarhus, Denmark.,The Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Aja Neergaard Greve
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Services, Aarhus University, Aarhus, Denmark.,The Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Jessica Ohland
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Research Unit CORE, Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark
| | - Martin Wilms
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Research Unit CORE, Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark
| | - Sinnika Birkehøj Rohd
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Research Unit CORE, Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark
| | - Merete Birk
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,The Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Anette Faurskov Bundgaard
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,The Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Andreas Færgemand Laursen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,The Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Oskar Hougaard Jefsen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,The Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Nanna Lawaetz Steffensen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,The Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Anna Krogh Andreassen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Services, Aarhus University, Aarhus, Denmark.,The Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Lotte Veddum
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Services, Aarhus University, Aarhus, Denmark.,The Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Christina Bruun Knudsen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Services, Aarhus University, Aarhus, Denmark.,The Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Mette Enevoldsen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Research Unit CORE, Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark
| | - Marie Nymand
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Research Unit CORE, Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark
| | - Julie Marie Brandt
- Faculty of Health and Medical Sciences, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Research Unit CORE, Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark
| | - Anne Søndergaard
- Faculty of Health and Medical Sciences, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Research Unit CORE, Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark
| | - Line Carmichael
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Research Unit CORE, Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark
| | - Maja Gregersen
- Faculty of Health and Medical Sciences, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Research Unit CORE, Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark
| | - Mette Falkenberg Krantz
- Child and Adolescent Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Birgitte Klee Burton
- Child and Adolescent Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Child and Adolescent Mental Health Center, Roskilde, Denmark
| | - Martin Dietz
- Center of Functionally Integrative Neuroscience, Aarhus University Hospital, Aarhus, Denmark
| | - Ron Nudel
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Research Unit CORE, Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark
| | - Line Korsgaard Johnsen
- Child and Adolescent Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Copenhagen, Denmark
| | - Kit Melissa Larsen
- Child and Adolescent Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark.,Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Copenhagen, Denmark
| | - David Meder
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Copenhagen, Denmark
| | - Oliver James Hulme
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Copenhagen, Denmark
| | - William Frans Christiaan Baaré
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Copenhagen, Denmark
| | - Kathrine Skak Madsen
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Copenhagen, Denmark.,Department of Radiography, Department of Technology, University College Copenhagen, Copenhagen, Denmark
| | - Torben Ellegaard Lund
- Center of Functionally Integrative Neuroscience, Aarhus University Hospital, Aarhus, Denmark
| | - Leif Østergaard
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Copenhagen, Denmark
| | - Anders Juul
- Faculty of Health and Medical Sciences, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Growth and Reproduction, Rigshospitalet, Section 5064, University of Copenhagen, Copenhagen, Denmark
| | | | - Carsten Hjorthøj
- Faculty of Health and Medical Sciences, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Research Unit CORE, Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark.,Department of Public Health, Section of Epidemiology University of Copenhagen, Copenhagen, Denmark
| | - Hartwig Roman Siebner
- Faculty of Health and Medical Sciences, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Copenhagen, Denmark.,Department of Neurology, Hospital Bispebjerg, Copenhagen University, Copenhagen, Denmark
| | - Ole Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Services, Aarhus University, Aarhus, Denmark.,The Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Merete Nordentoft
- Faculty of Health and Medical Sciences, Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.,Research Unit CORE, Mental Health Centre, Copenhagen University Hospital, Mental Health Services, Capital Region Psychiatry, Copenhagen, Denmark
| |
Collapse
|
24
|
Kristensen KB, Lauritzen C, Reedtz C. Support for Children of Parents With Mental Illness: An Analysis of Patients' Health Records. Front Psychiatry 2022; 13:778236. [PMID: 35356710 PMCID: PMC8959383 DOI: 10.3389/fpsyt.2022.778236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 02/14/2022] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Children of parents with a mental illness (COPMI) are at risk of behavioral, emotional, and cognitive difficulties and diagnoses. Support and information about parents' mental illness may contribute to improve their lives, which is the purpose of the intervention Child Talks (CT). This study aimed to investigate the participation rate of CT, characteristics of participating patients and children, and themes in sessions with children. MATERIALS AND METHODS Data were collected from 424 electronic patient journals written by healthcare professionals (H) for patients admitted to a clinic for mental health and substance use disorders in the years 2010-2015. Both quantitative statistical analysis and qualitative thematic analysis were carried out. RESULTS Eighteen percent of assessed parents with minor children received the CT intervention and children participated in half of them. Participating children more often knew about their parent's treatment and condition when initially assessed, and more often lived with the hospitalized parent. Three main themes were identified in sessions with children; communication about parental mental illness within the family, childrens' struggles, and healthcare professionals' (HCPs) evaluation of the child's situation and need for further support. DISCUSSION Sessions with patients' children appeared to be relatively rare, and participating children did not necessarily receive appropriate information, support, or follow-up. To ensure that HCPs provide quality support and follow-up to COPMI, the routines and the training of HCPs need to be improved.
Collapse
Affiliation(s)
- Kjersti Bergum Kristensen
- Regional Center for Child and Adolescent Mental Health and Child Welfare, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Camilla Lauritzen
- Regional Center for Child and Adolescent Mental Health and Child Welfare, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Charlotte Reedtz
- Regional Center for Child and Adolescent Mental Health and Child Welfare, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| |
Collapse
|
25
|
Raballo A, Schultze-Lutter F, Armando M. Editorial: Children, Adolescents and Families With Severe Mental Illness: Toward a Comprehensive Early Identification of Risk. Front Psychiatry 2021; 12:812229. [PMID: 34992558 PMCID: PMC8724427 DOI: 10.3389/fpsyt.2021.812229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 12/03/2021] [Indexed: 12/20/2022] Open
Affiliation(s)
- Andrea Raballo
- Section of Psychiatry, Clinical Psychology and Rehabilitation, Department of Medicine, University of Perugia, Perugia, Italy.,Center for Translational, Phenomenological and Developmental Psychopathology (CTPDP), Perugia University Hospital, Perugia, Italy
| | - Frauke Schultze-Lutter
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany.,Department of Psychology, Faculty of Psychology, Airlangga University, Surabaya, Indonesia.,University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Marco Armando
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| |
Collapse
|