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Prevalence of suicidal ideation and self-harm behaviours in children aged 12 years and younger: a systematic review and meta-analysis. Lancet Psychiatry 2022; 9:703-714. [PMID: 35907406 DOI: 10.1016/s2215-0366(22)00193-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 05/10/2022] [Accepted: 05/11/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Suicide in children is a pressing public health concern. The increasing number of deaths by suicide and emergency visits for suicidal ideation and self-harm in children might not be fully representative; it is likely that many more children are in distress but do not seek out help. We conducted a systematic review and meta-analysis of existing studies to quantify the prevalence of suicidal ideation and self-harm behaviours among children in the community aged 12 years and younger. METHODS In this systematic review and meta-analysis, we searched PsycINFO, MEDLINE, and Web of Science via OVID from database inception to Feb 28, 2022, for articles published in French or English that reported estimates of prevalence of suicidal ideation (including suicide planning) and self-harm behaviours (namely, self-harm, suicide attempts, and non-suicidal self-injury) in children aged 12 years and younger. Reference lists were also searched; case studies, qualitative studies, and health-care visit studies were excluded. The outcomes were suicidal ideation, suicide plan or attempts, and self-harm. We used a random-effects model to calculate the overall pooled prevalence of suicidal ideation and self-harm behaviours for all timeframes combined and for ever versus the past 12 months for suicidal ideation. We used the Joanna Briggs Institute Critical Appraisal tool to evaluate the risk of bias in each study. This study is registered with PROSPERO, CRD42020179041. FINDINGS 28 articles, encompassing 30 studies overall, met the inclusion criteria, aggregating findings from 98 044 children (of whom 46 980 [50·5%] were girls and 46 136 [49·5%] were boys; six articles did not report sex or gender) aged 6-12 years. The pooled prevalence estimate was 7·5% (95% CI 5·9-9·6) for suicidal ideation from 28 studies and 2·2% (2·0-2·5) for suicide planning from three studies. The pooled prevalence was 1·4% (0·4-4·7) for self-harm from four studies, 1·3% (1·0-1·9) for suicide attempt from six studies, and 21·9% (6·2-54·5) for non-suicidal self-injury from two studies. The prevalence of suicidal ideation was higher in studies that included child-reported outcomes (10·9% [95% CI 8·1-14·5] for child only and 10·4% [6·8-15·5] for child and parent combined) than for parent-only reported outcomes (4·7% [3·4-6·6]; p=0·0004). The prevalence of suicidal ideation and self-harm behaviours was similar in boys and girls (suicidal ideation, 7·9% [95% CI 5·2-12·0] for boys vs 6·4% [3·7-10·7] for girls; self-harm behaviours, 3·5% [1·6-7·2] for boys vs 3·0% [1·4-6·4%] for girls). Detailed ethnicity data were not available. High heterogeneity was identified across estimates (I2>90%), which was not well explained by the characteristics of the studies. INTERPRETATION A high number of children in the general population can experience suicidal ideation and self-harm behaviours, thus underlining the need for more research on childhood suicide, including developmentally appropriate preventive strategies, such as youth-nominated support teams or dialectical behavioural therapy. FUNDING Canada Research Chair in Youth Mental Health and Suicide Prevention.
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Xu DD, Rao WW, Cao XL, Wen SY, An FR, Che WI, Bressington DT, Cheung T, Ungvari GS, Xiang YT. Prevalence of depressive symptoms in primary school students in China: A systematic review and meta-analysis. J Affect Disord 2020; 268:20-27. [PMID: 32158003 DOI: 10.1016/j.jad.2020.02.034] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 02/07/2020] [Accepted: 02/18/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUNDS Depression in children and adolescents is usually under-recognized. The findings of epidemiological studies on depressive symptoms in primary school students are inconsistent across studies. This study reports a systematic review and meta-analysis on the prevalence of depressive symptoms in primary school students in China. METHODS Literature search was performed in both international (PubMed, PsycINFO, EMBASE) and Chinese (China National Knowledge Internet, WANFANG Data and Chinese Biological Medical Literature) databases. The random-effects model was used to analyze data. RESULTS Twenty-seven studies involving 42,374 subjects were included. The pooled prevalence of depressive symptoms in Chinese primary school students was 17.2% (95% CI: 14.3%-20.5%). Subgroup analyses found that the prevalence significantly varied between geographic regions, with western China reporting the highest prevalence. Meta-regression analyses found that year of survey and study quality were significantly associated with the prevalence of depressive symptoms. CONCLUSIONS Given the high prevalence of depressive symptoms and its negative health outcomes, preventive measures, regular screening and effective treatments need to be implemented for this population.
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Affiliation(s)
- Dan-Dan Xu
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China; Department of Biology, Faculty of Sciences, Harbin University, Harbin, China
| | - Wen-Wang Rao
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Xiao-Lan Cao
- Shenzhen Key Laboratory for Psychological Healthcare & Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital & Shenzhen Mental Health Center, Shenzhen, China
| | - Si-Ying Wen
- Shenzhen Key Laboratory for Psychological Healthcare & Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital & Shenzhen Mental Health Center, Shenzhen, China
| | - Feng-Rong An
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Weng-Ian Che
- Unit of Clinical Epidemiology, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden; Department of Public Health Science, Karolinska Institutet, Stockholm, Sweden
| | | | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Gabor S Ungvari
- Division of Psychiatry, School of Medicine, University of Western Australia, Perth, Australia; University of Notre Dame Australia, Fremantle, Australia
| | - Yu-Tao Xiang
- Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China; Center for Cognition and Brain Sciences, University of Macau, Macao SAR, China.
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Sokratis S, Christos Ζ, Despo P, Maria K. Prevalence of depressive symptoms among schoolchildren in Cyprus: a cross-sectional descriptive correlational study. Child Adolesc Psychiatry Ment Health 2017; 11:7. [PMID: 28184243 PMCID: PMC5289050 DOI: 10.1186/s13034-017-0145-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 01/21/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Depressive symptoms in the young constitute a public health issue. The current study aims to estimate: (a) the frequency of depressive symptoms in a sample of final grade elementary-school children in Cyprus, (b) the association among frequency of depressive symptoms, gender and nationality and, (c) the metric properties of the Greek-Cypriot version of the children's depression inventory (CDI). METHODS A descriptive cross-sectional study with internal comparison was performed. The occurrence of depressive symptoms was assessed with the CDI, which includes 5 subscales: depressive mood, interpersonal difficulties, ineffectiveness, anhedonia and negative self-esteem. Clinical depressive symptoms were reported as CDI score ≥19. CDI was anonymously and voluntarily completed by 439 schoolchildren [mean age 12.3 (±0.51) years old] from fifteen public elementary schools (217 boys and 222 girls), yielding a response rate of 58.2%. The metric properties of the CDI were assessed in terms of internal consistency reliability and construct validity via exploratory factor analysis (rotated and unrotated principal component analysis). Descriptive and inferential statistics were explored. RESULTS 10.25% of Cypriot schoolchildren reported clinical depressive symptoms (CDI score ≥19). Statistically significant differences were reported between boys and girls in all five subscales of the CDI. Girls reported higher scores in "Depressive mood", "Negative self-esteem" and "Anhedonia" subscales, while boys scored higher in "Interpersonal difficulties" and "Ineffectiveness" subscales. There were no statistically significant differences among ethnicity groups regarding the entire CDI or the subscales of it. Concerning the metric properties of the Greek-Cypriot version of the CDI, internal consistency reliability was adequate (Cronbach's alpha = 0.84). Factor analysis with varimax rotation resulted in five factors explaining 42% of the variance. CONCLUSIONS The Greek-Cypriot version of the CDI is a reliable tool for the assessment of the severity of depressive symptoms in schoolchildren. Institutional counseling services, as well as interventions aiming to empower the young need to address the different psychological needs of boys and girls. Longitudinal studies within this cultural context may be warranted, with special attention to other factors related to depressive symptoms and low self-esteem in schoolchildren, such as suicidality or bullying.
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Affiliation(s)
- Sokratous Sokratis
- Department of Nursing, Faculty of Health Sciences, Cyprus University of Technology, 15, Vragadinou Street, Limassol, Cyprus
| | - Ζilides Christos
- Department of Medicine and Epidemiology, Faculty of Health Sciences, Larissa University, Larissa, Greece
| | - Panagi Despo
- Nursing Division, Community Mental Health Services, Limassol, Cyprus
| | - Karanikola Maria
- Department of Nursing, Faculty of Health Sciences, Cyprus University of Technology, 15, Vragadinou Street, Limassol, Cyprus
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Lalouni M, Olén O, Bonnert M, Hedman E, Serlachius E, Ljótsson B. Exposure-Based Cognitive Behavior Therapy for Children with Abdominal Pain: A Pilot Trial. PLoS One 2016; 11:e0164647. [PMID: 27736943 PMCID: PMC5063361 DOI: 10.1371/journal.pone.0164647] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 09/22/2016] [Indexed: 12/13/2022] Open
Abstract
Background Children with pain-related functional gastrointestinal disorders (P-FGIDs) have an increased risk for school absenteeism, depression, anxiety and low quality of life. Exposure-based cognitive behavior therapy (CBT) has shown large treatment effects in adults with irritable bowel syndrome, but has not been tested for children 8–12 years with P-FGIDs. Aim The aim of this trial was to test the feasibility, acceptability and potential efficacy of a newly developed exposure-based CBT for children with P-FGIDs. Method The children (n = 20) with a P-FGID, were referred by their treating physicians. The participants received 10 weekly sessions of exposure-based CBT and were assessed at pre-treatment, post-treatment and 6-month follow-up. Results Children improved significantly on the primary outcome measure pain intensity at post (Cohen’s d = 0.40, p = 0.049) and at 6-month follow-up (Cohen’s d = 0.85, p = 0.004). Improvements were also seen in pain frequency, gastrointestinal symptoms, quality of life, depression, anxiety, school absenteeism and somatic symptoms. Improvements were maintained or further increased at 6-month follow-up. The children engaged in the exposures and were satisfied with the treatment. Conclusions Exposure-based CBT for children with P-FGIDs is feasible, acceptable and potentially efficacious.
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Affiliation(s)
- Maria Lalouni
- Department of Medicine Solna, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden
- Stockholm Health Care Services, Stockholm County Council, Sweden
- * E-mail:
| | - Ola Olén
- Department of Medicine Solna, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden
- Department of pediatric gastroenterology and nutrition, Sachs’ Children’s hospital, Stockholm, Sweden
| | - Marianne Bonnert
- Stockholm Health Care Services, Stockholm County Council, Sweden
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden
| | - Erik Hedman
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden
| | - Eva Serlachius
- Stockholm Health Care Services, Stockholm County Council, Sweden
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - Brjánn Ljótsson
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
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Abdel-Khalek AM. The Multidimensional Child and Adolescent Depression Scale: Psychometric Properties. Psychol Rep 2016; 93:544-60. [PMID: 14650690 DOI: 10.2466/pr0.2003.93.2.544] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Based on previous factor analyses of child and adolescent depression inventories, the following eight basic dimensions were identified, i.e., Pessimism, Weak Concentration, Sleep Problems, Anhedonia, Fatigue, Loneliness, Low Self-esteem, and Somatic Complaints. Each dimension was assessed by five items, so the Multidimensional Child and Adolescent Depression Scale has 40 brief statements answered on a 3-point intensity scale, i.e., None, Some, and A lot. The eight dimensions have good factorial validity and acceptable to good alpha and test-retest reliability, and good criterion-related validity using three self-report depression scales. The total scale score has from good to high coefficients of reliability and validity. The highest mean scores were on Fatigue and Anhedonia for Kuwaiti boys and girls, respectively, while the Loneliness subscale has the lowest mean score for both sexes. Girls attained significantly higher mean scores than boys for the total score as well as on all dimensions, with the exception of weak concentration. The scale has two compatible Arabic and English versions. It was designed to be useful in defining the profile of children's and adolescents' depression.
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Affiliation(s)
- Ahmed M Abdel-Khalek
- Department of Psychology, College of Social Sciences, Kuwait University, Kaifan.
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Lemétayer F, Lanfranchi JB, Chastagner P. [Assessment of daily quality of life in children surviving cancer]. Arch Pediatr 2016; 23:447-54. [PMID: 27021879 DOI: 10.1016/j.arcped.2016.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 12/09/2015] [Accepted: 02/16/2016] [Indexed: 10/22/2022]
Abstract
INTRODUCTION The purpose of this study was to identify the daily problems experienced by school-age children in remission from cancer. It also sought to assess the predictive value of these problems on the mental health of these children 1 year after the first assessment. PATIENTS AND METHOD Against this background, 50 children in remission from cancer and in mainstream education, aged 8-12 years, completed two questionnaires: the Quality of Life Systemic Inventory for Children (QLSI-C) (Missotten et al., 2007) and the Child Depression Inventory (CDI). THE QLSI-C consists of 20 life areas: Sleep, Diet, Physical pain, Health, Clothing, Physical appearance, Bedroom, Grandparents, Mother, Father, Siblings, Friends, How my friends talk about me, School, School results, Sport, Non-sporting activities, Autonomy, Obedience to authority, and Tolerance of frustration. Each of these 20 life areas was evaluated by the child by reference on each occasion to an ideal situation, first in relation to their current situation and then in relation to their personal goals, in order to measure the gap between these two evaluations. This difference was then weighted by the importance given to each life area and the dynamic situation of approximation to or distance from the goals. All the children in this study were seen in person for two interviews 1 year apart (T1 and T2). RESULTS The analyses conducted following the PLS-PM approach enabled eight of the 20 life areas evaluated to be identified as difficult to access by the children in this study. These analyses also showed that the difficulties perceived by children in remission from cancer have mainly proximal effects (i.e., short-term) on the discomfort experienced (direct effect of difficulties expressed in T1 on discomfort felt at T1; idem for T2). However, the areas perceived as difficult at T1 did not enable distal effects (i.e., effect over a year) on the discomfort expressed in T2 to be updated. Nonetheless, the conflicts at T1 fed the conflicts at T2 and, as a consequence, indirectly affected the experience of depression at T2. DISCUSSION The discussion examines the nature of the daily difficulties perceived by school-age children in remission from cancer and the short-term psychological distress experienced by these children. It concludes that the difficulties encountered by children in remission from cancer are not necessarily cumulative over time and that they do not inevitably result in permanent psychological suffering.
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Affiliation(s)
- F Lemétayer
- Unité de recherche-APEMaC équipe de psychologie de la santé-Metz [EPSaM] EA 4360, université de Lorraine, île du Saulcy, CS 60228, 57045 Metz cedex 01, France.
| | - J-B Lanfranchi
- Unité de recherche-APEMaC équipe de psychologie de la santé-Metz [EPSaM] EA 4360, université de Lorraine, île du Saulcy, CS 60228, 57045 Metz cedex 01, France
| | - P Chastagner
- Service d'oncologie pédiatrique, CHU de Nancy, rue du Morvan, 54511 Vandœuvre-lès-Nancy, France
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Min HJ, Jon DI, Jung MH, Hong N, Song MA, Kim YS, Harkavy-Friedman JM, Im HJ, Hong HJ. Depression, aggression, and suicidal ideation in first graders: a school-based cross-sectional study. Compr Psychiatry 2012; 53:1145-52. [PMID: 22748971 DOI: 10.1016/j.comppsych.2012.05.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2011] [Revised: 05/06/2012] [Accepted: 05/09/2012] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVE This study explored the clinical characteristics and risk factors of suicidal ideation in a sample of first graders from South Korea. Children's depression and aggression and maternal depression were examined as possible risk factors. METHODS This study is a school-based, cross-sectional study of 5 elementary schools in Gunpo City, South Korea. Participants were 707 first graders (mean age, 6.54 years) and their mothers. We assessed children's depressive and aggressive symptoms using the Behavior Assessment System for Children-2 (BASC-2) and maternal depression using the Beck Depression Inventory (BDI). Two items from BASC-2 and 1 item from BDI identified children's and maternal suicidal ideation. RESULTS Twenty-seven (3.8%) children evidenced suicidal ideation. Children with suicidal ideation had higher mean scores of depression domain (10.11 ± 5.34 vs 4.57 ± 3.44, P < .0001) and aggression domain (7.78 ± 3.84 vs 3.80 ± 2.85, P < .0001) on BASC-2 and maternal depression (9.78 ± 6.45 vs 7.28 ± 5.38, P = .02) on BDI. In regression analysis, children's depression (odds ratio [OR], 1.19; 95% confidence interval [CI], 1.07-1.32; P = .001) and aggression (OR, 1.24; 95% CI, 1.08-1.41; P = .002) contributed significantly to children's suicidal ideation, whereas maternal depression was not significantly related to children's suicidal ideation (OR, 0.99; 95% CI, 0.92-1.06; P = .75). CONCLUSIONS This study demonstrated that even first graders had a considerable prevalence of suicidal ideation and that depression and aggression were associated with suicidal ideation in young children.
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Affiliation(s)
- Hye Ji Min
- Seoul National Hospital, Seoul 143-711, South Korea
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Ahlen J, Breitholtz E, Barrett PM, Gallegos J. School-based prevention of anxiety and depression: a pilot study in Sweden. ACTA ACUST UNITED AC 2012. [DOI: 10.1080/1754730x.2012.730352] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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O'Neil KA, Puleo CM, Benjamin CL, Podell JL, Kendall PC. Suicidal ideation in anxiety-disordered youth. Suicide Life Threat Behav 2012; 42:305-17. [PMID: 22509976 DOI: 10.1111/j.1943-278x.2012.00091.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Evidence is mixed regarding an independent association between anxiety and suicidality in youth. Study 1 examined suicidal ideation in treatment-referred, anxiety-disordered youth (N = 312, aged 7-17). Forty-one percent of anxiety-disordered youth endorsed suicidal ideation. Anxiety disorder severity, global impairment, and current depressive symptoms predicted suicidal ideation in a multivariate model. Study 2 compared youth (N = 216, aged 7-14) with and without anxiety disorders. Higher rates of suicidal ideation were associated with anxiety diagnosis, and levels of anxiety predicted suicidal ideation after controlling for comorbid depressive disorders, current depressive symptoms, and global impairment. Results support an association between anxiety disorders and suicidal ideation in treatment-referred youth and recommend routine screening for suicidal ideation in this population.
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Affiliation(s)
- Kelly A O'Neil
- Department of Psychology, Temple University, Philadelphia, PA 19122, USA.
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Abstract
Major depressive disorder (MDD) is one of the most prevalent psychiatric disorders affecting children and adolescents. The significant psychiatric, social, and functional impairments associated with this disorder coupled with the high incidence of relapse indicate a need for continued efforts to enhance treatment. Current empirically supported treatments for childhood and adolescent MDD include psychotropic medications, psychotherapy, and a combination of both treatments, with selection of the most appropriate strategy depending on symptom severity. One strategy to enhance treatment outcome is the use of measurement-based care. This article provides a systematic review of measurement-based care in the treatment of childhood and adolescent MDD. It also presents a comprehensive analysis of widely used depression rating scales and discusses their utility in clinical practice. This review found evidence supporting the utility and benefit of depression rating scales to document depression severity in children and adolescents. We also found evidence suggesting that many of these scales are time efficient, and that both clinician-rated and self-rated scales provide accurate assessment of depressive symptomatology. Future research is warranted to examine the utility of measurement-based care in clinical practice with child and adolescent populations.
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Heidmets L, Samm A, Sisask M, Kõlves K, Aasvee K, Värnik A. Sexual Behavior, Depressive Feelings, and Suicidality Among Estonian School Children Aged 13 to 15 Years. CRISIS 2010; 31:128-36. [DOI: 10.1027/0227-5910/a000011] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background: The present paper is based on a WHO Collaborative Cross-National Study “Health Behavior in School-Aged Children (HBSC).” Aims: It aimed at describing and analyzing how the sexual behaviors of 13- to 15-year-old Estonian school children were associated with self-reported depressive feelings and suicidality. Distinctive behavioral traits in relation to age of first sexual intercourse were also investigated. Methods: Self-reported questionnaires from school children (n = 3,055) were analyzed. Results: In total, 15.2% of school children reported being nonvirgin. Among 13-year-olds, 2.9% of girls and 6.8% of boys were nonvirgins. Approximately 25% of the 15-year-old girls and boys were nonvirgins. The likelihood of depressive feelings and suicidal ideation increased significantly in both genders with loss of virginity. Boys who had lost their virginity at 13 years or younger were 4.2 times more likely to have suicidal thoughts; comparable girls were 7.8 times more likely to have suicidal thoughts. Compared to virgins, youths who had lost their virginity reported poor self-assessed health and more risk behaviors in themselves and their peers. Conclusion: Experiences of sexual intercourse increased the odds ratios for depressive feelings and suicidality. The earlier sexual intercourse was initiated, the greater were the odds of lower mental well-being. Risk behaviors emerged as a complex phenomenon requiring complex prevention.
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Affiliation(s)
- L. Heidmets
- Tallinn University, Tallinn, Estonia
- Estonian-Swedish Mental Health and Suicidology Institute, Estonian Centre of Behavioral and Health Sciences, Tallinn, Estonia
| | - A. Samm
- Estonian-Swedish Mental Health and Suicidology Institute, Estonian Centre of Behavioral and Health Sciences, Tallinn, Estonia
- University of Tartu, Tartu, Estonia
| | - M. Sisask
- Tallinn University, Tallinn, Estonia
- Estonian-Swedish Mental Health and Suicidology Institute, Estonian Centre of Behavioral and Health Sciences, Tallinn, Estonia
| | - K. Kõlves
- Estonian-Swedish Mental Health and Suicidology Institute, Estonian Centre of Behavioral and Health Sciences, Tallinn, Estonia
- Australian Institute for Suicide Research and Prevention (AISRAP), Griffith University, Brisbane, Australia
| | - K. Aasvee
- National Institute for Health Development, Tallinn, Estonia
| | - A. Värnik
- Tallinn University, Tallinn, Estonia
- Estonian-Swedish Mental Health and Suicidology Institute, Estonian Centre of Behavioral and Health Sciences, Tallinn, Estonia
- University of Tartu, Tartu, Estonia
- National Institute for Health Development, Tallinn, Estonia
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Samm A, Tooding LM, Sisask M, Kõlves K, Aasvee K, Värnik A. Suicidal thoughts and depressive feelings amongst Estonian schoolchildren: effect of family relationship and family structure. Eur Child Adolesc Psychiatry 2010; 19:457-68. [PMID: 19946721 DOI: 10.1007/s00787-009-0079-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2008] [Accepted: 11/10/2009] [Indexed: 10/20/2022]
Abstract
Depressive feelings and suicidal ideation in a non-clinical sample of adolescents in Estonia were analysed in the context of family structure, mutual relationships amongst family members and schoolchildren's preferences regarding intimate personal contacts with particular family members. Data from the WHO collaborative study 'Health Behaviour in School-aged Children 2005/2006' (HBSC) were used. A representative sample of schoolchildren aged 11, 13 and 15 years completed the semi-structured questionnaire. The analyses included only adolescents living in households with at least one birth parent. The subjects were 4,389 schoolchildren (2,178 boys and 2,211 girls), who were divided into three groups based on: (1) suicidal thoughts, with or without depressive feelings; (2) depressive feelings; and (3) neither suicidal thoughts nor depressive feelings. Multinomial logistic regression was used. The proportion of depressive feelings increased with age for both boys and girls. Girls expressed depressive feelings more frequently than boys from ages 13 and 15 years, and suicidal thoughts from age 15 years. Self-reported satisfaction with relationships in the family reduced the likelihood of depressive feelings and suicidal thoughts. Good communication with the parents reduced the likelihood of suicidal thoughts in all age groups. Adolescents who were satisfied with their family relationships suffered less frequently from depressive feelings and suicidal thoughts. The best environment for an adolescent was a family with both birth parents. Of the adolescents in 'non-intact' families, those with a step-parent in the family showed suicidal thoughts more frequently than those in single-parent families. Associations between family-related variables and suicidal thoughts were significant even after adjusting for family economic deprivation score.
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Affiliation(s)
- Algi Samm
- Faculty of Social Sciences, University of Tartu, Tartu, Estonia.
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Screening for children's depression symptoms in Greece: the use of the Children's Depression Inventory in a nation-wide school-based sample. Eur Child Adolesc Psychiatry 2009; 18:485-92. [PMID: 19255802 DOI: 10.1007/s00787-009-0005-z] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2008] [Accepted: 01/19/2009] [Indexed: 10/21/2022]
Abstract
The objective of this study is to determine the level of depressive symptoms among a sample of Greek children aged 8-12 years, as measured by the Greek Children's Depression Inventory (CDI), as well as to examine CDI's psychometric properties. A nationwide school-based sample of 650 children was initially recruited and depressive symptoms were assessed with the CDI among 538 children who provided all relevant information. Statistical evaluation included assessment of CDI internal reliability, test-retest reliability, determination of age, gender and socioeconomic status (SES) effects. Based on the distributions of CDI scores observed in this normative sample, a recommended cutoff score, identifying a high probability of serious levels of depressive symptoms that need to be further evaluated, was defined. Internal reliability and test-retest reliability were satisfactory and the expected associations with age and gender were observed. High SES was correlated with significantly less depression symptoms. The prevalence of depressive risk, when the cutoff point of 19 or 13 was taken as threshold, was much lower than those obtained from studies in other countries. The cutoff point of 15, corresponding to 90th percentile of the present sample, may be used as a screening threshold for further assessment. The present results are encouraging providing evidence about the psychometric properties of the CDI and implications for child mental health promotion planning in Greece. Further validation of the CDI against other measures and psychiatric diagnoses is needed.
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Kiss E, Kapornai K, Baji I, Mayer L, Vetró A. Assessing quality of life: mother-child agreement in depressed and non-depressed Hungarian. Eur Child Adolesc Psychiatry 2009; 18:265-73. [PMID: 19165536 DOI: 10.1007/s00787-008-0727-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2008] [Accepted: 09/02/2008] [Indexed: 10/21/2022]
Abstract
PURPOSE An important question in child psychiatry is the agreement between parents and children. We studied mother-child concordance about the quality of life of children (QoL). We hypothesized that mothers of depressed children rate lower QoL than children for themselves while mothers of non-depressed children rate better QoL; that inter-informant agreement is higher in the non-depressed sample; and finally that agreement increases with age of the child. METHODS QoL of depressed children (N = 248, mean age 11.45 years, SD 2.02) were compared to that of non-depressed children (N = 1695, mean age 10.34 years, SD 2.19). QoL was examined by a 7 item questionnaire (ILK). RESULTS Mothers of depressed children rated lower QoL than their children while mothers of nondepressed children rated higher QoL than their children. Agreement was low in both samples but higher in the controls. Inter-informant agreement was only influenced by depression. CONCLUSIONS Our results show that mothers relate more serious negative effects to childhood depression than their children and rate less problems for their non-depressed children compared to self-reports. Mother-child agreement is negatively influenced by depression which further stresses the importance of obtaining reports from the child and at least one parent in order to understand the subjective experiences caused by the illness.
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Affiliation(s)
- Eniko Kiss
- Dept. of Child Psychiatry, University of Szeged, Szeged, Hungary.
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Carter R, Silverman WK, Allen A, Ham L. Measures matter: the relative contribution of anxiety and depression to suicidal ideation in clinically referred anxious youth using brief versus full length questionnaires. Depress Anxiety 2009; 25:E27-35. [PMID: 18729149 DOI: 10.1002/da.20468] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND A cross-sectional design was used to examine links between suicidal ideation, depression, and anxiety using brief [Stark and Laurent, 2001: J Clin Child Psychol 30:552-567] and full length versions of the Children's Depression Inventory [CDI; Kovacs, 1980/1981: Acta Paedopsychiatr 46:305-315] and Revised Children's Manifest Anxiety Scale [RCMAS; Reynolds and Richmond, 1985: Revised Children's Manifest Anxiety Scale. California: Western Psychological Services]. METHODS The sample consisted of 252 children and adolescents (ages 7-16 years, M=9.94 years (SD=2.4)) seeking treatment at a childhood anxiety disorders specialty research clinic. RESULTS Using structural equation modeling, results indicated that the relative contribution of anxiety and depression in the presence of suicidal ideation varies depending on the measures used. Specifically, anxiety had a significant direct and indirect effect on suicidal ideation presence using a brief version of the RCMAS, but only an indirect effect using the full length version. Depression had a significant direct effect on suicidal ideation presence using both brief and full versions of the CDI. CONCLUSIONS These findings suggest that anxiety may play a role in predicting suicidal ideation in clinic-referred anxious youth, but whether this role is detected depends on the measurement strategy. Given that "measures matter," future studies using similar as well as different samples as the one used in this study need to consider careful measurement strategies, as different findings may emerge depending on whether brief or full length versions of questionnaires are used.
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Affiliation(s)
- Rona Carter
- Child Anxiety and Phobia Program, Department of Psychology, Florida International University, Miami, Florida 33199, USA
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Samm A, Värnik A, Tooding LM, Sisask M, Kölves K, von Knorring AL. Children's Depression Inventory in Estonia. Single items and factor structure by age and gender. Eur Child Adolesc Psychiatry 2008; 17:162-70. [PMID: 17876502 DOI: 10.1007/s00787-007-0650-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/08/2007] [Indexed: 10/22/2022]
Abstract
The aim of study was to estimate the score of symptoms of depression with the Children's Depression Inventory (CDI) among Estonian schoolchildren aged 7-13-year-old, according to age and gender differences, and to identify the components in factor analysis characterising self-reported childhood symptoms of depression. The applicability of the CDI in 7-year-old children was also estimated. The number of subjects in the study was 725 (342 girls and 383 boys), and the mean age was 10.2 (SD 1.7). The mean total score of the CDI for the whole sample was 9.96 (SD = 6.3, range 0-39, median 9.0). The mean scores of symptoms of depression among children did not differ by gender or age. There were no significant differences in the CDI mean scores between 7-year-old compared to older schoolchildren in the present study. Factor analysis obtained five factors: anhedonia, ineffectiveness, negative self-esteem, negative mood and interpersonal problems. Significant gender and age differences were found: girls reported more symptoms of anhedonia and negative self-esteem, and boys reported more symptoms of ineffectiveness. Younger children reported more symptoms of anhedonia and ineffectiveness, and older children negative self-esteem. The study serves as baseline data before intervention of the EC project "European Alliance Against Depression".
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Affiliation(s)
- Algi Samm
- Estonian-Swedish Mental Health and Suicidology Institute, Estonian Centre of Behaviour & Health Science, Oie 39, Tallinn 11615, Estonia.
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Goldin S, Hägglöf B, Levin L, Persson LA. Mental health of Bosnian refugee children: a comparison of clinician appraisal with parent, child and teacher reports. Nord J Psychiatry 2008; 62:204-16. [PMID: 18622884 DOI: 10.1080/08039480801983604] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study compares clinician appraisal of Bosnian refugee children with independent parent, child and teacher reports. From whom and by what means can children "at risk" be reasonably identified? Forty-eight Bosnian refugee children (aged 7-20), resettled in Sweden 1994-95, were assessed clinically by means of a semi-structured interview. Thereafter, standardized mental health questionnaires were administered to parents (Achenbach's Child Behavior Checklist), children (Achenbach's Youth Self-Report and Macksoud's Posttraumatic Stress Reaction Checklist) and teachers (clinician designed School Competence Scale and Achenbach's Teacher's Report Form). On clinician interview, nearly half of the children (48%) were identified with one or more mental health problem "demanding further attention". Depressiveness was the single most prevalent symptom (31%); followed by post-traumatic stress (23%), and anxiety-regressiveness (15%). At the same time, 75% of the children were rated by teachers as "quite competent" in school. Parent, child and clinician appraisals of primary school children showed broad similarities. Teachers reported a similar prevalence of child distress, but identified different symptoms and different children demanding attention. Evaluation of teenage youths showed greater disparity: teenagers labeled their own symptoms more often as post-traumatic stress reactions and teachers identified few youths in need of attention. Inter-relatedness among parent, child and clinician appraisals supports the robustness of our semi-structured interview. At the same time, apartness of teacher report underscores the need to incorporate an outside-world vantage point in the process of risk assessment. Also, a more concrete presentation of post-traumatic stress reactions and a higher "further attention" threshold for inward emotional problems seem called for.
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Affiliation(s)
- Stephen Goldin
- Division of Child and Adolescent Psychiatry, Department of Clinical Sciences, Norrlands University Hospital, S-901 87 Umeå, Sweden.
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McMahon SD, Parnes AL, Keys CB, Viola JJ. School belonging among low-income urban youth with disabilities: Testing a theoretical model. PSYCHOLOGY IN THE SCHOOLS 2008. [DOI: 10.1002/pits.20304] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Ivarsson T, Svalander P, Litlere O, Nevonen L. Weight concerns, body image, depression and anxiety in Swedish adolescents. Eat Behav 2006; 7:161-75. [PMID: 16600844 DOI: 10.1016/j.eatbeh.2005.08.005] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2005] [Revised: 06/27/2005] [Accepted: 08/03/2005] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To assess weight problems and correlates in respect of body image, depression, anxiety and demographic background factors. METHOD 405 Swedish adolescents were assessed in respect of Body Mass Index (BMI), biographical data, the Body Esteem Scale for Adolescents and Adults (BESAA), the Multidimensional Anxiety Scale for Children (MASC) and the Children's Depression Inventory (CDI). RESULTS Boys were in the positive and girls in the negative direction from ideal BMI for age and gender. Girls and boys differed in respect of CDI, MASC and of BESAA where girls generally were shifted in the "pathological" direction. DISCUSSION The adolescents' own positive attitude to slimness, negative mood (girls), and anxiety symptoms that reflect social fears (boys) and physical aspects of anxiety (girls and boys) were important correlates of lower BMI than ideal. Adolescent cultural norms need to be addressed in preventive work. However, in girls' separation anxiety might be a protective factor against underweight. In girls, overweight seems to be associated with negative self-esteem.
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Affiliation(s)
- Tord Ivarsson
- Department of Child- and Adolescent Psychiatry Centre, Queen Silvia Children's Hospital SE-416 85, Göteborg University, Göteborg, Sweden.
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Ivarsson T, Svalander P, Litlere O. The Children's Depression Inventory (CDI) as measure of depression in Swedish adolescents. A normative study. Nord J Psychiatry 2006; 60:220-6. [PMID: 16720513 DOI: 10.1080/08039480600636395] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Self-rating scales are an economical and practical aid in the diagnostic work-up. However, normative data from the general population are needed to interpret scores. Four hundred and five adolescents selected to be fairly representative of the general population (both ethnical Swedes and born abroad) filled in a questionnaire containing the Children's Depression Inventory (CDI), the Multidimensional Anxiety Scale for Children (MASC) and background data (including socio-economic status (SES). The CDI was reliable in terms of internal consistency (0.86) with a mean inter-item correlation of 0.18 and item-total score correlations ranging from 0.26 to 0.57. The CDI sub-scales (Negative Mood, Ineffectiveness, Anhedonia and Negative Self-esteem had good internal consistency values slightly above 0.60, except for sub-scale Interpersonal Problems with poor internal consistency (0.36). The 90th and 95th percentiles respectively were defined by scores 15 and 18 and above for boys and by scores 20 and 23 and above for girls. Common correlates of high scores were female gender, broken family but not SES, nor ethnicity. Also, some estimates of the convergent validity of the CDI were found in a Pearson correlation of 0.40 with the MASC total score and in the capacity of the CDI (predictive validity); OR = 1.1 in predicting suicidal ideation. The CDI has some, but as of yet not sufficient indications of being a valid and reliable measure of depression in adolescence and scores can be used to indicate, though not prove the absence or presence of, depression.
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Affiliation(s)
- Tord Ivarsson
- Department of Child & Adolescent Psychiatry, Göteborg University, Sweden.
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21
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Ivarsson T. Normative data for the Multidimensional Anxiety Scale for Children (MASC) in Swedish adolescents. Nord J Psychiatry 2006; 60:107-13. [PMID: 16635928 DOI: 10.1080/08039480600588067] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The Swedish translation of a new scale developed for childhood and adolescent anxiety, the Multidimensional Anxiety Scale for Children (MASC), was studied regarding reliability and convergent validity and to obtain norms in a general population. Four hundred and five adolescents, reasonably representative of Swedish adolescents, were asked to rate their anxiety symptoms on the MASC. In order to study the convergent validity, they also rated their depressive symptoms on the Children's Depression Inventory (CDI), their attitude to their body on the Body Esteem Scale for Adolescents and Adults (BESAA) and filled in demographical data on themselves. The MASC showed adequate internal consistency both for the whole scale (alpha = 0.87) and for subscales (range 0.64-0.84). The scale showed convergent validity through a moderate correlation with the CDI (r=0.400, P=0.0001) and the BESAA (r= - 0.29, P=0001). Girls scored higher (mean = 38.9) than boys (mean = 31.9) on the MASC total score (t(385) = 5.14, P=0.0001) and on the subscales, except Harm avoidance. Using the MASC as a general screen for anxiety, scores of 48 for boys and 56 for girls using MASC total scores, or scores of 15 for boys and 17 for girls using the Anxiety Disorders Index could be employed (both representing the 90th percentiles). The MASC appears to be a reliable and valid scale both on the global and on the subscale level.
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Affiliation(s)
- Tord Ivarsson
- Department of Child & Adolescent Psychiatry, Göteborg University, Sweden.
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Hermansson L, Eliasson AC, Engström I. Psychosocial adjustment in Swedish children with upper-limb reduction deficiency and a myoelectric prosthetic hand. Acta Paediatr 2005; 94:479-88. [PMID: 16092464 DOI: 10.1111/j.1651-2227.2005.tb01921.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM To study psychosocial adjustment and mental health in children with upper-limb reduction deficiency and a myoelectric prosthetic hand. METHODS Sixty-two parents of children aged 8 to 18 y old answered a questionnaire concerning competence and behaviour/emotional problems in their children. Of the 62 children, 37 adolescents aged 11 to 18 y old answered questionnaires concerning competence, problems and mood state. The results were compared with Swedish normative data. The children were divided into five groups based on degree of myoelectric prosthetic use. RESULTS Children with upper-limb reduction deficiency and a myoelectric prosthetic hand showed social competence and behaviour/emotional problems similar to Swedish standardized norms. However, withdrawn behaviour was significantly higher in all children, social competence was significantly lower in girls, and social activities were significantly lower in older children with upper-limb reduction deficiency. There was a significant difference between prosthetic use groups. Non-users had significantly more delinquent behaviour problems than full-time users. There was an interaction between gender and prosthetic use in their affect on competence and behaviour/emotional problems, yielding two contrasting patterns. CONCLUSION Children with upper-limb reduction deficiency and a myoelectric prosthetic hand are as well adjusted psychosocially as their able-bodied peers. There are indications, however, of social stigmata related to the deficiency, which have to be considered differently in boys and girls.
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Affiliation(s)
- L Hermansson
- Limb Deficiency and Arm Prosthesis Centre, Department of Paediatrics, Orebro University Hospital, Orebro, Sweden.
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Fergusson DM, Wanner B, Vitaro F, Horwood LJ, Swain-Campbell N. Deviant peer affiliations and depression: confounding or causation? JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2004; 31:605-18. [PMID: 14658741 DOI: 10.1023/a:1026258106540] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Data gathered from 2 longitudinal studies (the Christchurch Health and Development study of a birth cohort of 1,265 New Zealand participants studied to 21 years and the Quebec Study of 240 Canadian participants studied to 13 years) was used to examine the linkages between deviant peer affiliations and depression in adolescence. Both studies produced similar conclusions: a) increasing peer affiliations were associated with significant (p < .0001) increases in depressive symptoms; b) the associations between peer affiliations and depression could not be fully explained by confounding factors; and c) peer affiliations and depressive symptoms were linked by a causal chain process in which deviant peer affiliations led to increased externalizing behaviors with the negative consequences of these behaviors leading to depression.
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Affiliation(s)
- David M Fergusson
- Christchurch Health and Development Study, Christchurch School of Medicine and Health Sciences, P.O. Box 4345, Christchurch, New Zealand.
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Poli P, Sbrana B, Marcheschi M, Masi G. Self-reported depressive symptoms in a school sample of Italian children and adolescents. Child Psychiatry Hum Dev 2003; 33:209-26. [PMID: 12564623 DOI: 10.1023/a:1021404613832] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
This study reports on self-reported depressive symptoms, assessed with the Children's Depression Inventory (CDI), in a school sample of 685 Italian students. The participants were 254 males and 431 females, the age range of the subjects was 8 to 17 years (mean age 13.0 +/- 2.8 years). The CDI mean score was 10.49 +/- 2.76. According to our data, about 10% of the subjects scored higher than the clinical threshold of 20. More than 1/3 of the students reported thoughts of death, but only 2.2% had explicit suicidal ideation. Girls scored higher than boys, and young adolescents (11-13 years) scored lower than pre-pubertal children and older adolescents, and showed fewer thoughts of death. Factorial analysis yielded seven factors, a general factor with no predominant theme, two factors related to academic self-image and body image, and four related to anhedonia-withdrawal, hypocondria-asthenia, irritability-opposition, and loss of appetite.
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Affiliation(s)
- Paola Poli
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone (Pisa), Italy
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25
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Abstract
AIMS This study describes the early needs for support that families with small children have in the context of their own life situations. The study population consisted of Finnish families (n = 551) who participated in a project titled 'Families with Children' (1996-2001). The project supplemented the existing public services. The information provided by the study was utilized in supporting families and developing family work in seven experimental areas. METHODS The data were collected between 1997 and 2000 using family service plans and client reports. The data were analysed with inductive content analysis and using the SPSS software (version 7.5). FINDINGS The families needed support in the areas of parenthood, upbringing and child care, marital problems and social support networks. The need for early support was also connected to health problems of the children or the parents, problems with work or studies, unemployment, problems in economic or living conditions, or family crises. In addition to support, the families searched for help from family workers in disputes over child custody and visitation rights, intoxicant abuse and violence, and problems in adjusting to society. Each family had 4-5 needs for early support. CONCLUSIONS The results demonstrate that families with small children have many needs for which they seek help when there are available services supplementing the existing public services. The information provided by the study can be utilized in maternity and child welfare clinics, in social services and in family work provided by civic organizations to define the early needs of families for support and to develop services.
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ABDEL-KHALEK AHMEDM. THE MULTIDIMENSIONAL CHILD AND ADOLESCENT DEPRESSION SCALE: PSYCHOMETRIC PROPERTIES. Psychol Rep 2003. [DOI: 10.2466/pr0.93.6.544-560] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Abstract
OBJECTIVE To study the relationships between depressive and psychosomatic symptoms at the age of 12 years and heavy use of alcohol 3 years later, and to determine whether certain depressive symptoms are more predictive than others in regard to later heavy alcohol use. METHODS The Children's Depression Inventory (CDI) with added questions concerning psychosomatic symptoms and bullying was used to reveal psychiatric symptoms among children at the age of 12 years. Information concerning alcohol use was obtained from the children at the age of 15 years. RESULTS Disordered mood at the age of 12 years was not related to heavy alcohol use at the age of 15 years. Perceiving oneself as failing to perform well at school and low self-esteem at the age of 12 years were related to heavy use of alcohol 3 years later among girls, as were interpersonal problems with aggressive tendencies among boys. CONCLUSIONS Further studies are urgently needed to determine the relationships between the expectations of the school system and deviant behaviors such as substance use among dysphoric children.
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Affiliation(s)
- Kirsti Kumpulainen
- Department of Child Psychiatry, Kuopio University Hospital, University of Kuopio, Finland.
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Abdel-Khalek AM, Soliman HH. Sex differences in symptoms of depression among American children and adolescents. Psychol Rep 2002; 90:185-8. [PMID: 11898981 DOI: 10.2466/pr0.2002.90.1.185] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The Arabic Children's Depression Inventory in its English version was administered to a sample of 535 U.S. school students (11 to 18 years old). By sex, differences on total score and on 19 of 27 items (70.4%) were not statistically significant. Nevertheless, differences were significant for 8 (29.6%) items on which girls had higher mean scores. Half of the items were positive indicators of depression (I am sad, I feel lonely, I feel miserable, and I hate myself), while the other half were negative (I feel happy, Life is rosy, A lot of people like me, and I am optimistic).
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Frigerio A, Pesenti S, Molteni M, Snider J, Battaglia M. Depressive symptoms as measured by the CDI in a population of northern Italian children. Eur Psychiatry 2001; 16:33-7. [PMID: 11246290 DOI: 10.1016/s0924-9338(00)00533-2] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
The aim of this study was to evaluate some Children's Depression Inventory (CDI) psychometric properties and the prevalence of depressive symptoms in an unselected Italian sample of two hundred and eighty-four children aged 8 years. The CDI internal consistency was adequate (Cronbach's alpha:.80). The mean and standard deviation of CDI and the percentage of children at risk of depression (10.6%) in this sample are consistent with the figures reported by other studies carried out in northern Europe and North America. There were differences in gender and socioeconomic level in that boys scored higher than girls, and in the lower socioeconomic level there were more children at risk of depression. Ten items best discriminated children at risk for depression with 94% of correct classification. Most of these items consisted of observable signs. It is suggested that the CDI has noteworthy consistency across samples of relatively different cultures, that it can reliably be employed in the assessment of young children, and that observable signs outnumber internalizing symptoms of depression among children at risk
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Affiliation(s)
- A Frigerio
- Child Psychiatry Unit, Scientific Institute "Eugenio Medea", via D. L. Monza 7, Bosisio Parini, Lecco, Italy.
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Almqvist F, Kumpulainen K, Ikäheimo K, Linna SL, Henttonen I, Huikko E, Tuompo-Johansson E, Aronen E, Puura K, Piha J, Tamminen T, Räsänen E, Moilanen I. Behavioural and emotional symptoms in 8-9-year-old children. Eur Child Adolesc Psychiatry 2000; 8 Suppl 4:7-16. [PMID: 10654129 DOI: 10.1007/pl00010698] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
We present epidemiological data from a multi-centre study on psychiatric symptoms among 6017 8-9-year-old children representing a total annual birth cohort (N = 60007) in Finland. The results are based on three questionnaires: the Rutter Parent Scale (RA2), the Rutter Teacher Scale (RB2), the Children's Depression Inventory (CDI). The proportion of children that scored above the cutoff points, indicating probable psychiatric disturbance, were 11.2% for the RA2, 13.9% for the RB2 and 6.9% for the CDI. Twenty-four percent of the subjects scored above the cutoff point on at least one of the questionnaires. Low family social status and disrupted family relations correlated strongly with high rates of symptoms in the children.
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Affiliation(s)
- F Almqvist
- Department of Child Psychiatry, University of Helsinki, Finland.
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31
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Abdel-Khalek AM, Soliman HH. A cross-cultural evaluation of depression in children in Egypt, Kuwait, and the United States. Psychol Rep 1999; 85:973-80. [PMID: 10672761 DOI: 10.2466/pr0.1999.85.3.973] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The English version of the Arabic Children's Depression Inventory, constructed by Abdel-Khalek, was applied to a sample of 535 U.S. students (11 to 18 years old). Cronbach coefficients alpha were .88, .90, and .89 for boys, girls, and all subjects, respectively. Seven factors were extracted by principal axis factor analysis (Negative mood and self-depreciation, Fatigue, Lack of loneliness, Sleep problems, Weak concentration, Pessimism, and Feeling happy), denoting clear factorial structure; however, the scale was intended to be unidimensional. Sex and racial differences for this American sample were not statistically significant but the correlation of depression scores with age was .22. The scale appears useful in studying depression in American school children and adolescents. Also, cross-cultural differences in childhood depression between samples from Egypt and Kuwait of previous studies and the present American sample were examined. Based on the effect size, female Kuwaiti had a lower mean depression score than either the Egyptian or American groups. The scale can be used in cross-cultural research.
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Affiliation(s)
- A M Abdel-Khalek
- Department of Psychology, College of Social Sciences, Kuwait University, Kaifan, Kuwait
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ABDEL-KHALEK AHMEDM. A CROSS-CULTURAL EVALUATION OF DEPRESSION IN CHILDREN IN EGYPT, KUWAIT, AND THE UNITED STATES. Psychol Rep 1999. [DOI: 10.2466/pr0.85.7.973-980] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Mikkelsson M, Sourander A, Piha J, Salminen JJ. Psychiatric symptoms in preadolescents with musculoskeletal pain and fibromyalgia. Pediatrics 1997; 100:220-7. [PMID: 9240803 DOI: 10.1542/peds.100.2.220] [Citation(s) in RCA: 77] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES To study the association of musculoskeletal pain with emotional and behavioral problems, especially depressive symptoms in Finnish preadolescents. STUDY DESIGN A structured pain questionnaire was completed by 1756 third- and fifth-grade schoolchildren for identifying children with widespread pain (WSP), children with neck pain (NP), and pain-free controls for the comparative study. There were 124 children with WSP (mean age, 10.7 years), 108 children with NP (mean age, 11.1 years), and 131 controls (mean age, 10.7 years) who completed the Children's Depression Inventory (CDI) and a sleep questionnaire. A blinded clinical examination was done to detect fibromyalgia. For parental evaluation, the Child Behavior Checklist and a sociodemographic questionnaire were used. For teacher evaluation the Teacher Report Form was used. RESULTS Children with WSP had significantly higher total emotional and behavioral scores than controls, according to child and parent evaluation. A significant difference in the mean total CDI scores was also found between the WSP and NP groups. Children with fibromyalgia had significantly higher CDI scores than the other children with WSP. CONCLUSIONS Musculoskeletal pain, especially fibromyalgia, and depressive symptoms had high comorbidity. Pain and depressive symptoms should be recognized to prevent a chronic pain problem.
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Affiliation(s)
- M Mikkelsson
- Rehabilitation Center, Rheumatism Foundation Hospital, Heinola, Finland
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Puura K, Tamminen T, Almqvist F, Kresanov K, Kumpulainen K, Moilanen I, Koivisto AM. Should depression in young school-children be diagnosed with different criteria? Eur Child Adolesc Psychiatry 1997; 6:12-9. [PMID: 9112042 DOI: 10.1007/bf00573635] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
In a two-stage epidemiological study 5686 randomly selected 8 to 9-year-old children were screened using the CDI (Children's Depression Inventory), of whom 418 were questioned with the DISC-C1 (Diagnostic Interview Schedule for Children). According to DSM-III criteria the prevalence of MDD (Major Depressive Disorders) was 0.48% and of DD (Dysthymic Disorder) 0.06%. The prevalence rates did not change when DSM-III-R and DSM-IV criteria were employed. Fifteen children reported suicidal thoughts but according to DSM-III criteria only 1 of these children was depressed. Duration and frequency of depressive symptoms are essential for making a diagnosis of depressive disorder by the DSM-III, but children's reliability in reporting them is questionable. Omitting the duration and frequency of symptoms from the DSM-III criteria raised the prevalence of MDD to 4.0% and of DD to 2.2%. Eight of the children with suicidal thoughts were depressed. By the adapted DSM-III-R and DSM-IV criteria the prevalence rate of MDD was 4.0% and of DD 9.7%.
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Affiliation(s)
- K Puura
- University of Tampere, Tampere School of Public Health, Finland
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Verheij RA. Explaining urban-rural variations in health: a review of interactions between individual and environment. Soc Sci Med 1996; 42:923-35. [PMID: 8779004 DOI: 10.1016/0277-9536(95)00190-5] [Citation(s) in RCA: 97] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
In order to gain insight into the relation between health and people's environment, literature published between 1985 and 1994 was gathered from several international databases. An introduction into existing theory regarding geographic disparities is presented: geographical drift and breeder hypotheses are discussed. This is followed by a critical review focusing on interaction effects of urbanicity and individual characteristics on health. This leads to two major conclusions. First, emphasis in past research has been primarily on urban constraints rather than opportunities. Positive aspects of urban living are often insufficiently appreciated. Second, positive and negative environmental aspects have an effect on health that is often dependent on individual characteristics. The extent to which the environment exerts influence on a person's health is dependent on that person's individual characteristics. These conclusions are relevant only for further developing the breeder hypothesis, however. Large scale individual based longitudinal data should be studied in order to gain more insight into the relative importance of the geographical drift hypothesis.
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Affiliation(s)
- R A Verheij
- Netherlands Institute of Primary Health Care, Utrecht, The Netherlands
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Canals J, Marti-Henneberg C, Fernández-Ballart J, Domènech E. A longitudinal study of depression in an urban Spanish pubertal population. Eur Child Adolesc Psychiatry 1995; 4:102-11. [PMID: 7796248 DOI: 10.1007/bf01977738] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Depression characteristics were investigated in 507 adolescents using a two-stage longitudinal study design. The three-year longitudinal study started when the girls and boys were 11 and 12 years, respectively. In the initial (screening) phase the Children's Depression Inventory (CDI) was used to select subjects for phase-II of the study in which the Children's Depression Rating Scale-Revised (CDRS-R) interview was used. The caseness definition of Major Depression (MD) and Dysthymia (D) was based on the DSM-III-R criteria. Pubertal development was assessed by Tanner's staging. Estimated prevalence of Major Depression in the female sample for each increasing year of age was 2.2%, 2.7% and 4.1%. In the male sample the prevalence for the three years was 0.9%, 0.3% and 0.6%. There was no relation to age. The estimated mean prevalence of Dysthymia was 1.4% in girls and 0.8% in boys. No association between pubertal development and depression was found. Longitudinal data support the notion of chronic depression in early adolescence.
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Affiliation(s)
- J Canals
- Departament de Psicologia, Universitat Rovira i Virgili, Tarragona, Spain
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Arnarson EÖ, Smári J, Einarsdóttir H, Jónasdóttir E. The Prevalence of Depressive Symptoms in Pre-adolescent School Children in Iceland. ACTA ACUST UNITED AC 1994. [DOI: 10.1080/16506079409455969] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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