Prevalence of psychosocial problems in Dutch children aged 8-12 years and its association with risk factors and quality of life

Behavioral difficulties and associated factors among the 'lost generation' of Syrian children and adolescents

Childhood and adolescence, vital in shaping adult life and society, are profoundly impacted during conflicts like Syria's devastating war. This study explores the prevalence of behavioral disorders in Syrian children and adolescents, examining the influence of war and family-related factors. This cross-sectional study was conducted on children aged 2-17 years at a children's outpatient clinic in Damascus, Syria. We assessed parents' quality of life, war and family-related factors, and behavioral difficulties through parental interviews using two questionnaires: the Arabic version of the Strengths & Difficulties Questionnaire (SDQ) and the brief Arabic version of the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF). 74.67% of children aged 2-4 years and 61.29% of children aged 5-17 years were experiencing behavioral difficulties, with emotional difficulties being the most prevalent ones. Children exposed to kidnapping, family losses, lack of school enrollment, and those with parents having lower education, lower socioeconomic status, and poorer quality of life exhibited higher Total SDQ scores. The high prevalence of behavioral difficulties among children and adolescents in Syria is a major concern, with both direct and indirect war-related factors contributing to this issue.

Impact of a pediatric primary care health-coaching program on change in health-related quality of life in children with mental health problems: results of the PrimA-QuO cohort study

Mental health problems (MHP) have a considerable negative impact on health-related quality of life (HRQoL) in children and their families. A low threshold Health Coaching (HC) program has been introduced to bring MH services to primary care and strengthen the role of pediatricians. It comprised training concepts as a hands-on approach for pediatricians, standardization of diagnosis and treatment, and extended consultations. The aim of this study was to evaluate the potential effects of the HC on HRQoL in children with MHP and their parents.We used data from the PrimA-QuO cohort study conducted in Bavaria, Germany from November 2018 until November 2019, with two assessments one year apart. We included children aged 17 years or younger with developmental disorder of speech and language, non-organic enuresis, head and abdominal pain, and conduct disorder. All included children were already part of the Starke Kids (SK) program, a more general preventive care program, which includes additional developmental check-ups for children enrolled in the program. In addition,  treatment according to the HC guidelines can be offered to children and adolescents with mental health problems, who are already enrolled in the SK program. These children form the intervention group; while all others (members of BKK and SK but not HC) served as controls. HRQoL in children was assessed using the KINDL questionnaire. Parental HRQoL was measured by the visual analogue scale. To analyze the effects of the intervention on children´s HRQoL over the 1-year follow-up period, we used linear mixed effects models.We compared 342 children receiving HC with 767 control patients. We could not detect any effects of the HC on HRQoL in children and their parents. This may be attributed to the relatively high levels of children´s HRQoL at baseline, or because of highly motivated pediatricians for the controls because of the selection of only participant within the Starke Kids program. Generally, HRQoL was lower in older children (-0.42 points; 95% CI [-0.73; -0.11]) and in boys (-1.73 points; 95% CI [-3.11; -0.36]) when reported by proxy. Parental HRQoL improved significantly over time (2.59 points; 95% CI [1.29; 3.88]).Although this study was not able to quantitatively verify the positive impact of this HC that had been reported by a qualitative study with parents and other stakeholders, and a cost-effectiveness study, the approach of the HC may still be valid and improve health care of children with MHP and should be evaluated in a more general population.

Emotional and Behavioural Problems among Preschool Children in Northeast Peninsular Malaysia: Parent Report Version

The rising prevalence of mental health disorders among children is a serious concern. Young children who exhibit early warning signs of mental health issues are more likely to develop symptoms in the same or overlapping regions years later. The research aimed to identify emotional and behavioural problems and associated factors in Malaysian preschools. A sample of young children aged 4-6 years from public and private preschools was chosen using a multistage random sampling method. Data were collected from 18 preschools via a parent survey using the Strengths and Difficulties Questionnaire (SDQ). The sample involved 557 children in the SDQ assessment (92%). The overall estimated prevalence of emotional and behavioural problems was 8.4%. Peer problems were the most prevalent attribute, with a percentage of 19.7%. Conduct problems were found in 5.2%, hyperactivity problems in 5.6%, prosocial behaviours in 13.5%, and emotional problems in 6.8%. Girls showed a significant increase in behavioural and emotional problems compared to boys. Having one parent working, having more than two siblings, and having a single-parent family were associated with emotional and behavioural problems. The prevalence of emotional and behavioural problems in Malaysian children was relatively low compared to data from previous studies and other Asian countries but consistent with European studies. Measuring mental health disparities in young children helps stakeholders launch local early intervention programmes.

Hazardous Child Labour, Psychosocial Functioning, and School Dropouts among Children in Bangladesh: A Cross-Sectional Analysis of UNICEF's Multiple Indicator Cluster Surveys (MICS)

Child labour is a common financial coping strategy in poor households, especially in low-and middle-income countries with many children working under hazardous conditions. Little is known about the linkages between hazardous work conditions and psycho-social and educational outcomes. We analysed the Bangladesh Multiple Indicator Cluster Survey (BMICS) round 6 to assess the association between the exposure variables, including child labour, hazardous child labour (HZCL) and hazardous work, and outcome variables, including psychosocial functioning difficulty and school dropout, in children aged 5 to 17 years. We conducted bivariable and multivariable analyses to examine the association. In the adjusted analyses, children engaged in HZCL had increased odds of psychosocial functioning difficulty (aOR: 1.41; 95% CI: 1.16-1.72) and school dropout (aOR: 5.65; 95% CI: 4.83-6.61) among 5-14-year-olds compared to children who did not engage in child labour and hazardous work. Other independent factors associated with psychosocial functioning difficulty and school dropout included being male, living in a deprived neighbourhood, being exposed to violent punishment, the caregiver's attitude towards physical punishment, the mother's functional difficulty and lower maternal education. The linkages between hazardous work and psychosocial functioning difficulty appear more prominent among children not in school. Further, the evidence on the relationship between hazardous work and school dropout is stronger among children with psychosocial functioning difficulty. Policies and programmes that target the most hazardous forms of work are likely to have the greatest benefits for children's mental health, social well-being and educational attainment.

Longitudinal changes in quality of life and psychosocial problems of primary school children in a deprived urban neighborhood over the course of a school-based integrated approach

The municipality of Amsterdam implemented a 2-year school-based integrated approach in schools in a deprived neighborhood. The integrated approach targeted the domains of education, health and poverty and the children's school, neighborhood and home environment by involving various agencies and actors. In this study, changes in children's quality of life and psychosocial problems over the course of the integrated approach were examined and evaluated. A dynamic cohort design was used. At five measurement occasions (T1-T5) during 2 years, children from four consecutive grades in five schools filled out a questionnaire (total n = 614). In children between 7 and 13 years, quality of life was measured with the KIDSCREEN-10. In children between 9 and 13 years, psychosocial problems were measured with the Strengths and Difficulties Questionnaire. Generalized estimating equations were applied. Time, sex, age, socio-economic status, ethnic background, grade, and school were included as independent variables. Quality of life was higher from the first follow-up during the approach (T2) until the end of the approach (T4) compared to at the start of the approach (T1). At T5, several months after the approach ended, scores returned back to baseline. Likewise, a reduction in children's psychosocial problems was detected at the end of the approach (T4) compared to at the start of the approach (T1). However, both before and after that time point, no improvements were detected. This study shows that integrated approaches can be beneficial for children's quality of life and psychosocial health, but continued investments may be needed to maintain established improvements.Trial registration NTR6571 (NL6395), August 4 2017 retrospectively registered.

Impact of Neurodevelopmental Disorders on Bowel Management Outcomes in Children with Functional Constipation

OBJECTIVES

Patients experiencing functional constipation (FC) can participate in structured bowel management programs (BMPs) to manage constipation or fecal incontinence when standard management fails. We sought to evaluate the efficacy of BMPs for children with FC with and without neurodevelopmental disorders.

METHODS

We performed a retrospective review of children with FC who participated in our BMP from 2014 to 2021. Stool/urinary continence, bowel regimen, surgical history, parent-reported outcomes measures (PROMs: Cleveland Clinic Constipation Score, Baylor Continence Scale, Vancouver Symptom Score for Dysfunctional Elimination), and Pediatric Quality of Life Inventory (PedsQL) were assessed pre- and at least 9 months post-BMP.

RESULTS

The cohort included 156 patients with a median age of 9 years and follow-up of 627 days (IQR: 389-808 days). Two sub-cohorts included patients with FC only (69%) and FC plus a neurodevelopmental disorder (31%): 59% attention-deficit/hyperactivity disorder, 33% autism spectrum disorder, and 8% obsessive-compulsive disorder. Both groups had significantly improved follow-up bowel movement frequency and continence (39%-90% neurodevelopmental, 44%-82% FC only, P < 0.001) and urinary continence (65%-90% neurodevelopmental, 69%-91% FC only, P < 0.02). There was a significant improvement in most of the PROMs at follow-up. Both groups experienced a clinically meaningful improvement in overall PedsQL scores (pre- and postBMP difference of >4.5).

CONCLUSIONS

Patients with FC with and without a neurodevelopmental disorder had significant improvement in stool and urinary continence after undergoing a BMP. Further studies are needed to see if this improvement is durable over a longer period of time in this challenging cohort.

Internalizing and externalizing mental health problems affect in-school adolescent’s health-related quality of life in eastern Ethiopia: A cross-sectional study

Aims

This study aimed to examine the association between mental health problems and health-related quality of life (HrQoL) among in-school adolescents 13–19 years in the Harari region, eastern Ethiopia.

Materials and methods

A cross-sectional study was conducted on 3227 in-school adolescents aged 13 to 19 using multistage sampling. The KIDSCREEN-10 questionnaire assessed health-related quality of life (HrQoL), while a self-administered version of the strength and difficulty questionnaire (SDQ) examined mental health issues. Data were double entered, validated, and cleaned using EpiData version 3.1 and analyzed using STATA 14.1. An ordinal logistic regression model investigated the link between the outcome variable and the predictors. The results were reported using an odds ratio with a 95% confidence interval (CI), and a p-value of less than 0.05 was considered statistically significant.

Results

A quarter of the adolescents (23%) reported poor health-related quality of life; adolescents with internalizing and externalizing mental health problems had the lowest health-related quality of life. After controlling for potential confounders, adolescents with abnormal (AOR = 0.48, 95% CI: 0.39, 0.59) and borderline (AOR = 0.59, 95% CI: 0.45, 0.78) levels of internalizing problems had a 52% and 41% lower probability of having high HrQoL than those with normal levels. Furthermore, individuals with abnormal (AOR = 0.59, 95% CI: 0.45, 0.77) and borderline (AOR = 0.64, 95% CI: 0.45, 0.92) levels of externalizing difficulties had a 41% and 36% lower chance of having a high health-related quality of life.

Conclusions

Nearly a quarter of in-school adolescents had poor health-related quality of life. High scores for internalizing and externalizing mental health problems significantly impacted the adolescents’ health-related quality of life. This emphasizes the need to address mental health issues in the school setting to improve adolescents’ overall quality of life.

Neurobehavioral Impairment in Pediatric Brain Tumor Survivors: A Meta-Analysis

Purpose: The neurocognitive outcomes of pediatric brain tumor survivors have been extensively studied but the risk and predictors for neurobehavioral impairment are less clearly defined. We systematically analyzed the rates of emotional, psychosocial, and attention problems in pediatric brain tumor survivors. Methods: PubMed, Web of Science, Embase, Scopus, and Cochrane were searched for articles published between January 2012 to April 2022. Eligible studies reported neurobehavioral outcomes for PBTS aged 2 to <23 years with a brain tumor diagnosis before 18 years of age. A random-effect meta-analysis was performed in R. Results: The search yielded 1187 unique publications, of which 50 were included in the quantitative analysis. The estimated risk of having emotional, psychosocial, and attention problems were 15% (95%CI 10−20%), 12% (95%CI 9−16%), and 12% (95%CI 9−16%), respectively. PBTS were more likely to have emotional difficulties (Hedge’s g = 0.43 [95%CI 0.34−0.52]), psychosocial problems (Hedge’s g = 0.46 [95%CI 0.33−0.58]), and attention problems (Hedge’s g = 0.48 [95%CI 0.34−0.63]) compared to normal/healthy control subjects. There was no significant difference in the rates of neurobehavioral impairment between children with and without history of cranial radiotherapy. Conclusions: PBTS are at elevated risk of neurobehavioral impairment. Neurobehavioral monitoring should be considered as the standard of care for PBTS.

The Global Prevalence of Conduct Disorder: A Systematic Review and Meta-Analysis

Objective: There has been little effort to conduct systematic reviews or meta-analyses of the available literature to find global prevalence rates of conduct disorder and analyze the sources of heterogeneity. Method : We searched multiple databases, including Web of Science, PubMed, Scopus, and Google Scholar to identify cross-sectional studies with random or nonrandom sampling to assess the global prevalence of conduct disorder in children and adolescents aged under 18 in the general or school-based populations. Quality assessment and data extraction were independently carried out by two authors. Subgroup analysis was used to find the potential sources of heterogeneity. Results: We reached 50 studies, incorporating 186,056 children and adolescents from 35 countries. The total prevalence of conduct disorder was 8% (CI: 7-9%; I2: 99.77%), including 7% in females (CI: 4-9%; I2: 99.56%) and 11% in males (CI: 7-15%; I2: 99.74%). The results of subgroup analysis showed that total heterogeneity could be explained by measurement tools. When diagnostic interviews such as the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL) and Development and Well-Being Assessment (DAWBA) were employed, the pooled prevalence rates for conduct disorder were 0.4% and 0.7%, respectively, and heterogeneity decreased. However, the use of the screening tools such as the Strengths and Difficulties Questionnaire (SDQ)-parent or teacher report and SDQ-self report increased the pooled prevalence of conduct disorder to 10% and 16% respectively. Conclusion: The prevalence of conduct disorder in the epidemiological studies should be estimated by employing the diagnostic interviews to reach accurately assessments.

Health Behavior, Health-Related Quality of Life, and Mental Health Among Canadian Children: A Population-Based Cohort Study

Objective: Studies that have reported the associations of diet quality, physical activity (PA), sedentary behavior (SB), and health-related quality of life (HRQoL) with mental health among children and adolescents are predominantly cross-sectional in design. Very few studies have examined the longitudinal relationship of mental health with health behavior and HRQoL among children. This study aimed to investigate the associations of diet quality, PA, SB, and HRQoL among children with mental health disorders throughout childhood.

Methods: We linked data from grade five students aged primarily 10 and 11 years who participated in the Raising Healthy Eating and Active Living (REAL) Kids Alberta survey in 2012 in the Canadian province of Alberta with their administrative health care data from birth to 2012. Mental health outcomes included internalizing disorder and attention deficit and hyperactivity disorder (ADHD) defined by the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) or Tenth Revision, Canadian version (ICD-10-CA). The HRQoL was measured by the EQ-5D-Y, a five-dimensional descriptive system for children and youth. We applied negative binomial regressions to examine the associations between health behaviors, HRQoL, and mental health.

Results: Of the 1,352 participating students, 12.31 and 8.32% had a diagnosis of internalizing disorders and ADHDs, respectively, during childhood from birth to the ages of 10–11 years. Students in the highest tertile for diet quality, relative to the lowest tertile, were 56% less likely to have diagnoses of internalizing disorders (incidence rate ratio, IRR = 0.44, 95% CI = 0.23–0.85). Students engaged in less PA (vs. more PA) were more likely to be diagnosed for internalizing disorders (IRR = 1.98, 95% CI = 1.19–3.30). Poorer diet quality, low PA, excessive use of computers/video games, and watching TV were significantly associated with more diagnoses of ADHDs. Children who experienced some or a lot of problems in “feeling worried, sad, or unhappy” and “having pain or discomfort” were more likely to receive diagnoses of internalizing disorders and ADHDs, respectively.

Conclusions: These observed associations suggest that health promotion programs targeting promoting diet quality, PA, and HRQoL and reducing SB among children may contribute to improving mental health.

Effects of Topper Training on psychosocial problems, self-esteem, and peer victimisation in Dutch children: A randomised trial

Most interventions aimed at improving social interactions either target internalising or externalising problem behaviour in children. However, a recent review shows that a transdiagnostic approach might fit better to the diversity of problems within a group and within an individual (comorbidity). We examined the effectiveness of a transdiagnostic intervention, called Topper Training: a cognitive behavioural intervention in the peer group with parents included, that targets both internalising and externalising behaviour problems. A randomised trial with a waiting list control group was conducted, using 132 children with mild to severe psychosocial problems. Children were randomised into 77 intervention and 55 waiting list children (50% boys; age = 8-11 years). GLM repeated measures analyses yielded significant intervention effects directly after the training on parent-reported (but not teacher-reported) emotional symptoms (Cohen's d = .70), peer relationship problems (d = .41), and impact of these problems (d = .59). Significant effects were also found for child-perceived peer victimisation (d = .62), self-esteem (d = .45) and teacher-reported conduct problems (d = .42). Parent-reported effects on emotional, conduct problems and impact of the problems and child-reported effects on self-esteem were clinically relevant. No significant effects of Topper Training were found for prosocial behaviour and bullying. Within-participant t-tests in the intervention group between post-intervention and follow-up indicated that effects extended over a six-month follow-up period. Depression decreased significantly from post-test to follow-up. In conclusion, children with mild to severe internalising and/or externalising problems can benefit from the transdiagnostic Topper Training intervention.

[How to measure the migration status of the child and young population? Studies on health and inequalities in health in Europe]

OBJECTIVE

To analyse how the migration status of the child and young population is measured in the scientific literature on health and social inequalities in health in Europe.

METHOD

A systematic search of the literature published in Spanish, English and French between 2007 and 2017 in PubMed and Social Sciences Citation Index was carried out. The included studies analysed health and social inequalities in health of a population under 18 years old according to its migration origin in Europe. The variables used to measure the migration status were described.

RESULTS

50 articles were included. Twenty studies analysed perinatal health, eleven mental health, nine dental health, and ten studies other variables. The main variables to define migration status were the country of birth (32 studies), either of the child, the mother, or one of the parents, and sometimes in a complementary way. Less frequent was the use of nationality (15 studies), of the child, or of the parents, especially the mother. Migration status is referred to in very different ways, not always comparable and sometimes the variable used is not clearly explained.

CONCLUSIONS

There is a great diversity of ways to measure migration status in the child and young population. A better definition and consensus is needed to improve the temporal and geographical comparability of knowledge in this area, which will help to design public policies aimed at reducing social inequalities in health from childhood.

Health-related quality of life (HRQoL) in children of ill or substance abusing parents: examining factor structure and sub-group differences

PURPOSE

Health-related quality of life (HRQoL) may be helpful in identifying children at risk of developing adjustment problems. Few studies have focused on HRQoL among children of ill or substance abusing parents despite their considerable risk status. In the present study, we used the KIDSCREEN-27 to assess self-reported HRQoL in children and adolescents living in families with parental illness, or substance dependence. First, we tested whether the factor structure of the KIDSCREEN-27 was replicated in this population of children. Next, we examined differences in HRQoL according to age, gender, and type of parental illness. Finally, we compared levels of HRQoL in our sample to a normative reference population.

METHOD

Two hundred and forty-six children and adolescents aged 8-17 years and their ill parents participated. The construct validity of the KIDSCREEN-27 questionnaire was examined by confirmatory factor analysis (CFA). T-tests and ANOVA were used to test differences in HRQoL levels according to age, gender, and parental patient groups, and for comparisons with reference population.

RESULTS

The KIDSCREEN-27 fit the theoretical five-factor model of HRQoL reasonably well. Boys and younger children reported significantly greater well-being on physical well-being, psychological well-being, and peers and social support, compared to girls and older children. Younger children also reported significantly greater well-being at school than did older children. There were no significant differences in HRQoL between groups of children living with different type of parental illness. The children in our sample reported their physical well-being significantly lower than the reference population.

CONCLUSION

The KIDSCREEN-27 questionnaire appears to work satisfactorily among children of ill or substance abusing parents.

Mental Health and Quality of Life Among Spanish-born and Immigrant Children in Years 2006 and 2012

BACKGROUND

One of every five children and adolescents in the European Union suffers from behavioural, and emotional disturbances.

OBJECTIVES

To compare factors associated with the quality of life and mental health of immigrant and Spanish children aged 4-14years both during the years 2006 and 2012 and to evaluate changes over this time period.

DESIGN AND METHODS

An epidemiologic age and sex matched case-control study (1:2) was conducted. The study group were 677 immigrant children and 1354 matched Spanish children (controls). This study was conducted using data obtained from the Spanish National Health Surveys done in 2006 and 2012. We used the Strengths and Difficulties Questionnaire to obtain the score for variables derived from mental health and the Kidscreen-10 questionnaire to score the Health-Related Quality of Life.

RESULTS

Spanish girls scored higher in conduct problems (2.04±0.1) and better in problems with peers (1.21±0.08) regarding immigrant girls (1.82±0.12-1.92±0.13 respectively). Concerning total scores, immigrant children obtained significantly lower scores in quality of life (81.29±0.76) and in problems with peers (2.04±0.09) than their matched Spanish children (84.4±0.45 and 1.26±0.06) in 2006. Immigrant children had lower total scores in prosocial behaviour (8.62±0.11) compared to the matched Spanish children (8.92±0.06) in 2012. The total average scores of immigrant children in terms of quality of life, emotional symptoms, behavioural problems, hyperactivity and problems with peers were significantly better in 2012 (86.58; 1.84; 1.46; 3.77 and 1.48 respectively) than in 2006 (81.29; 2.15; 1.90; 4.58 and2.04).

CONCLUSIONS

Immigrant children had a poorer quality of life and mental health than matched Spanish children in 2006.

Taxometric analyses and predictive accuracy of callous-unemotional traits regarding quality of life and behavior problems in non-conduct disorder diagnoses

Callous-unemotional (CU) traits have mainly been studied in relation to conduct disorder (CD), but can also occur in other disorder groups. However, it is unclear whether there is a clinically relevant cut-off value of levels of CU traits in predicting reduced quality of life (QoL) and clinical symptoms, and whether CU traits better fit a categorical (taxonic) or dimensional model. Parents of 979 youths referred to a child and adolescent psychiatric clinic rated their child's CU traits on the Inventory of Callous-Unemotional traits (ICU), QoL on the Kidscreen-27, and clinical symptoms on the Child Behavior Checklist. Experienced clinicians conferred DSM-IV-TR diagnoses of ADHD, ASD, anxiety/mood disorders and DBD-NOS/ODD. The ICU was also used to score the DSM-5 specifier 'with limited prosocial emotions' (LPE) of Conduct Disorder. Receiver operating characteristic (ROC) analyses revealed that the predictive accuracy of the ICU and LPE regarding QoL and clinical symptoms was poor to fair, and similar across diagnoses. A clinical cut-off point could not be defined. Taxometric analyses suggested that callous-unemotional traits on the ICU best reflect a dimension rather than taxon. More research is needed on the impact of CU traits on the functional adaptation, course, and response to treatment of non-CD conditions.

Exploring the relationship between quality of life and mental health problems in children: implications for measurement and practice

Quality of life is typically reduced in children with mental health problems. Understanding the relationship between quality of life and mental health problems and the factors that moderate this association is a pressing priority. This was a cross-sectional study involving 45,398 children aged 8-13 years from 880 schools in England. Self-reported quality of life was assessed using nine items from the KIDSCREEN-10 and mental health was assessed using the Me and My School Questionnaire. Demographic information (gender, age, ethnicity, socio-economic status) was also recorded. Quality of life was highest in children with no problems and lowest in children with both internalising and externalising problems. There was indication that quality of life may be reduced in children with internalising problems compared with externalising problems. Approximately 12 % children with mental health problems reported high quality of life. The link between mental health and quality of life was moderated by gender and age but not by socio-economic status or ethnicity. This study supports previous work showing mental health and quality of life are related but not synonymous. The findings have implications for measuring quality of life in child mental health settings and the need for approaches to support children with mental health problems that are at particular risk of poor quality of life.

Cortical activation changes and sub-threshold affective symptoms are associated with social functioning in a non-clinical population: A multi-channel near-infrared spectroscopy study

Few studies have examined the relationship between social function and brain activation in non-clinical populations. The aim of the present study was to assess this relationship and examine the underlying cortical mechanisms in a non-clinical population. Eighty healthy volunteers performed a serial arithmetic task according to the Uchida-Kraepelin performance test while hemoglobin concentration changes were assessed on the surface of the prefrontal cortex (PFC) using 32-channel near-infrared spectroscopy. Participants were also assessed for quality of life (QOL) using the Short-Form 36-item Questionnaire (SF-36), for affective symptoms using the Zung Self-rating Depression Scale (SDS), for apathy using the Apathy Scale, for feelings of stress using the Stress Arousal Checklist (SACL), and for task performance using the number of answers in a serial arithmetic task. Activity in the frontopolar PFC displayed a significant positive correlation with social functioning on the SF-36. SDS and SACL scores correlated negatively with social functioning. Furthermore, in multiple regression analysis, social functioning was predicted by activity of the frontopolar PFC and SDS scores. These results suggest that the association between changes in cortical activation and sub-threshold affective symptoms may objectively identify individuals with QOL on social functioning.

Health-Related Quality of Life and Behavioral Functioning after Intrauterine Transfusion for Alloimmune Anemia

OBJECTIVE

To assess health-related quality of life (HRQOL) and behavioral functioning in children and adolescents treated before birth with intrauterine intravascular blood transfusion for alloimmune anemia.

STUDY DESIGN

Cross-sectional cohort study conducted at the Dutch referral center for the management of fetal alloimmune anemia. Follow-up data were available for 285 children at a mean age of 10.5 years (range, 3-21.5 years) with a response rate for questionnaires of 97%. Child-, adolescent-, and parent-rated HRQOL was evaluated with The Netherlands Organization for Applied Scientific Research Child/Adult Quality of Life Questionnaire (TACQOL/TAAQOL). Parents reported on behavioral functioning with the Strengths and Difficulties Questionnaire. Scores were compared with Dutch norm data.

RESULTS

Significantly lower scores were reported by parents of children 6-11 years of age compared with Dutch norms on 3 scales: cognitive functioning, social functioning, and positive emotions (P < .00, P = .02, and P = .04). In children aged 8-11 years only the cognitive functioning scale score was significantly lower compared with Dutch norms (P = .01). The children aged 12-15 years reported higher scores on the negative emotions scale (P = .02). When corrected for multiple testing, only the parent-rated cognitive functioning scale remained significant (P < .001). Regarding the HRQOL scores of adolescents aged ≥16 years, no differences were detected. Overall, behavioral difficulties were reported in 37/246 (15%) children aged 3-16 years, and were associated with maternal educational levels (P < .001).

CONCLUSION

Parents reported lower scores on cognitive functioning in their children aged 6-11 years compared with norms. Behavioral difficulties were more prevalent than norms, and were associated with maternal educational level. Outcomes of children after intrauterine intravascular blood transfusion were quite good overall.

[Health-related quality of life in children and adolescents in Germany: results of the KiGGS study: first follow-up (KiGGS Wave 1)]

In recent years, there has been a change in the health and disease spectrum among children and adolescents, with an increase in mental health problems and a shift from acute to chronic illness. In this phase, the health-related quality of life (HRQoL) has increased in importance as a dimension of subjective health. The aim of this study is to describe the HRQoL of children and adolescents measured with the internationally standardized screening instrument KIDSCREEN-10. In the follow-up of the KiGGS study in 2009-2012 (KiGGS Wave 1), 2,567 parents of children aged 7-10 years and 4,878 adolescents aged 11 years or older completed the KIDSCREEN-10 questionnaire. In all, 94% of parents of 7- to 10-year-old girls and boys estimate the HRQoL of their children to be "very good" or "good." Of the 11- to 17-year-old adolescents, 96% report their HRQoL as "very good" or "good." Somatic diseases and pain as well as mental health problems and a low social status are included in the HRQoL in only a limited way. Potential differences in HRQoL by social status were not confirmed in multivariate models. The HRQoL of the examined children and adolescents is predominantly very good or good. Interventions to improve the HRQoL of children and adolescents with diseases and psychopathological problems are necessary, regardless of their social status.

Mental health problems among adolescents with early-onset and long-duration type 1 diabetes and their association with quality of life: a population-based survey

Objective

To evaluate mental health problems and associations between mental health problems and health-related quality of life in adolescents with type 1 diabetes in comparison with the general population.

Method

A total of 629 11- to 17-year-olds with early-onset and long-lasting type 1 diabetes and their parents completed comprehensive questionnaires. Mental health was assessed using the parent- and self-report versions of the Strengths and Difficulties Questionnaire (SDQ). The Revised Children's Quality of Life Questionnaire (KINDL-R) was used to measure quality of life. The comparison group (n = 6,813) was a representative sample from the German KiGGS study.

Results

The proportion of youths with mental health problems (defined as abnormal SDQ total difficulties score) was, based on self-reports, 4.4% in the patient group and 2.9% in the general population (adjusted OR = 1.61, p = 0.044); and based on proxy reports, 7.9% in the patient group and 7.2% in the general population (OR = 1.05, p = 0.788). Youths with type 1 diabetes and self-reported mental health problems scored worse in the KINDL-R subscales of physical well-being (adjusted average difference β = −16.74, p<0.001) and family (β = −11.09, p = 0.017), and in the KINDL-R total score (β = −8.09, p<0.001), than peers with self-reported mental health problems. The quality of life of diabetic adolescents and proxy-reported mental health problems did not differ from peers with proxy-reported mental health problems adjusted for confounders.

Conclusions

Compared with the general population with mental health problems, the quality of life of adolescents with type 1 diabetes who report mental health problems is more severely impaired. This observation calls for early prevention and intervention as part of pediatric diabetes long-term care.

Behavioral profiles of clinically referred children with intellectual giftedness

It is common that intellectually gifted children--that is, children with an IQ ≥ 130--are referred to paediatric or child neuropsychiatry clinics for socio-emotional problems and/or school underachievement or maladjustment. These clinically-referred children with intellectual giftedness are thought to typically display internalizing problems (i.e., self-focused problems reflecting overcontrol of emotion and behavior), and to be more behaviorally impaired when "highly" gifted (IQ ≥ 145) or displaying developmental asynchrony (i.e., a heterogeneous developmental pattern, reflected in a significant verbal-performance discrepancy on IQ tests). We tested all these assumptions in 143 clinically-referred gifted children aged 8 to 12, using Wechsler's intelligence profile and the Child Behavior Checklist. Compared to a normative sample, gifted children displayed increased behavioral problems in the whole symptomatic range. Internalizing problems did not predominate over externalizing ones (i.e., acted-out problems, reflecting undercontrol of emotion and behavior), revealing a symptomatic nature of behavioral syndromes more severe than expected. "Highly gifted" children did not display more behavioral problems than the "low gifted." Gifted children with a significant verbal-performance discrepancy displayed more externalizing problems and mixed behavioral syndromes than gifted children without such a discrepancy. These results suggest that developmental asynchrony matters when examining emotional and behavioral problems in gifted children.

Psychopathology and adversities from early- to late-adolescence: a general population follow-up study with the CBCL DSM-Oriented Scales

Aims. Adolescence is a critical transition phase between childhood and adulthood, when the burden of mental disorder may still be prevented. The aim of this study was to evaluate the continuity and discontinuity of behavioural problems in adolescence while taking into account the multiple co-variation of psychopathological traits and the complex role of recent stressful life events (SLEs). Methods. This is a 5-year follow-up investigation of emotional and behavioural problems assessed by the newly developed Child Behavior Checklist (CBCL) DSM-Oriented Scales (DOSs) in 420 general population subjects aged 15-19 years. Results. The DOSs showed good stability, even when multiple co-variation was taken into account. Longitudinal data showed that homotypic evolution of psychopathology was to be expected in the first place. Equifinality and multifinality were also found. Oppositional Defiant Problems emerged to be polyvalent predictors of both internalizing and externalizing problems. Furthermore, Oppositional Defiant Problems predicted more SLEs, which in turn predicted more Depression, Anxiety and Oppositional Defiant Problems. Mediational analyses confirmed the role of SLEs in partially accounting for the continuity of Oppositional Defiant Problems and for the heterotypic progression towards Affective Problems. Conclusions. These data underscore early adolescence behavioural problems as an important focus for primary and secondary intervention.

G × E interaction and neurodevelopment I. Focus on maltreatment

In a short series of articles, we will review the evidence for genotype by environment interaction (G × E) in developmental psychopathology. We will focus specifically on the characteristics of types of exposure assessed with respect to both their methods and findings. This article aims to review the studies exploring the effects of child maltreatment on children, adolescents and young adults closer in time to maltreatment experience, in a G × E perspective.

Interaction between cognition and emotion in developmental psychopathology: the role of linguistic stimuli

Investigations on emotional words demonstrated that processing emotional information in child patients with anxiety disorders diagnosed for anxiety (generalized anxiety disorder and post-traumatic stress disorder) or depression is biased towards pathology-related stimuli. Also, neuroimaging studies showed a failure of prefrontal areas in inhibiting the emotional reaction in children with bipolar disorder. Finally, despite several studies investigated memory and attention using emotional words, little is known about the development of emotional lexicon in both healthy and psychopathological children.

Functional MRI studies in disruptive behaviour disorders

Aggressive or antisocial behaviours with violations of social rules are the main features of disruptive behaviour disorders (DBDs), which are developmental diseases and include conduct disorder and oppositional defiant disorder. In the last decade, several efforts have been made to shed light on the biological underpinnings of DBDs. In this context, the main findings of functional magnetic resonance imaging studies in DBD are reported here. There are indications of neural dysfunctions in response to affective stimuli, especially regarding medial and orbitofrontal prefrontal cortex and connected subcortical structures.