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Le Vu MN, Do AL, Boyer L, Tran QC, Kohler S, Ahmed SI, Molnar A, Vu TS, Vo NTH, Nguyen LMV, Vu LG, Dam VAT, Duong T, Do DLN, Do NM, Mclntyre RS, Latkin C, Ho RCM, Ho CSH. A Review of the Effectiveness, Feasibility, and Acceptability of Art Therapy for Children and Adolescents during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811612. [PMID: 36141885 PMCID: PMC9517402 DOI: 10.3390/ijerph191811612] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/04/2022] [Accepted: 09/09/2022] [Indexed: 06/01/2023]
Abstract
Art therapy has been widely offered to reduce symptoms of psychological disturbance. Pooled evidence about its effectiveness in epidemic contexts, particularly during the COVID-19 pandemic, has not been yet established. This study reviewed the effectiveness, feasibility, and acceptability of art therapy on children and adolescents during the COVID-19 pandemic and past epidemics. We searched PubMed/Medline, PsycINFO, CENTRAL (Cochrane Library), and CINAHL for articles on art therapy during COVID-19. Included studies reported improvements in measures of mental health, sleep quality, and psychological well-being in children with or without disabilities in the epidemic context. Results also showed that art therapy was highly feasible and accepted by children and adolescents as well as their families during epidemics in reviewed studies. Art therapy can be effective at improving various aspects of mental health, sleep quality, and psychological well-being. More empirical evidence is needed with larger sample sizes and longer duration of interventions.
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Affiliation(s)
- Minh Ngoc Le Vu
- Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam
| | - Anh Linh Do
- Institute of Health Economics and Technology, Hanoi 100000, Vietnam
| | - Laurent Boyer
- Research Centre on Health Services and Quality of Life, Aix Marseille University, 13385 Marseille, France
| | - Quy Chi Tran
- High School for Gifted Students, Hanoi University of Science, Hanoi 100000, Vietnam
| | - Stefan Kohler
- Heidelberg Institute of Global Health, Heidelberg University, 69120 Heidelberg, Germany
| | - Syed Ishtiaque Ahmed
- Department of Computer Science, University of Toronto, Toronto, ON M5T 2S8, Canada
| | - Andreea Molnar
- Department of Computer Science and Software Engineering, School of Software and Electrical Engineering, Swinburne University of Technology, Melbourne, VIC 3122, Australia
| | - Tung Son Vu
- Institute of Health Economics and Technology, Hanoi 100000, Vietnam
| | | | | | - Linh Gia Vu
- Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam
- Faculty of Medicine, Duy Tan University, Da Nang 550000, Vietnam
| | - Vu Anh Trong Dam
- Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam
- Faculty of Medicine, Duy Tan University, Da Nang 550000, Vietnam
| | - Thomy Duong
- Institute of Health Economics and Technology, Hanoi 100000, Vietnam
| | | | - Ngoc Minh Do
- Vinschool Education System, Hanoi 100000, Vietnam
| | - Roger S. Mclntyre
- Institute of Medical Sciences, University of Toronto, Toronto, ON M5T 2S8, Canada
| | - Carl Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Roger Chun Man Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore 119077, Singapore
| | - Cyrus Su Hui Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
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2
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Verheyden C, Van Holen F, West D, Vanderfaeillie J. Psychosocial well-being of Flemish foster children residing in their foster homes during the COVID-19 lockdown. CHILDREN AND YOUTH SERVICES REVIEW 2022; 139:106535. [PMID: 35582523 PMCID: PMC9098417 DOI: 10.1016/j.childyouth.2022.106535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 04/11/2022] [Accepted: 05/07/2022] [Indexed: 06/15/2023]
Abstract
The measures implemented to contain the COVID-19 pandemic profoundly affected the lives of children and families all around the world, probably affecting children's psychosocial well-being. The negative consequences of lockdowns are presumed to hit even harder on vulnerable groups such as foster children who already struggle with their psychosocial well-being in normal circumstances and who face specific challenges during lockdowns such as: additional help that is no longer available or only offered digitally and physical contact with birth parents that is forbidden. Nevertheless, some scholars point to the positive side of lockdowns (e.g.: relief due to closure of schools). This study aims to asses the psychosocial well-being of Flemish foster children residing in their foster homes during the COVID-19 lockdown and the factors that are associated with the change in their psychosocial well-being. 888 foster parents reported on the psychosocial well-being of just as many foster children through the Brief Assessment Checklist for Children and Adolescents. The COVID-19 lockdown was not associated with a decreased psychosocial well-being of Flemish foster children residing in their foster homes during the lockdown. Foster parents reported a slight improvement in their relationship with their foster child during the lockdown which points to a positive consequence of the lockdown. In addition, this improvement was positively associated with an increased psychosocial well-being during adverse circumstances and should therefore be enhanced. The type and amount of contact with birth parents is significantly associated with foster children's changed psychosocial well-being during the lockdown. Foster parents who reported an increase in alternative contact (e.g., (video)calls and messages) between their foster child and his/her birth parent(s) during the lockdown, also reported an increase in their foster child's psychosocial well-being during that period.
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Affiliation(s)
- Camille Verheyden
- Vrije Universiteit Brussel, Department of Psychology, Pleinlaan 2, 1050 Brussels, Belgium
| | - Frank Van Holen
- Vrije Universiteit Brussel, Department of Psychology, Pleinlaan 2, 1050 Brussels, Belgium
- Pleegzorg Vlaams-Brabant en Brussel, Sainctelettesquare 17, 1000 Brussels, Belgium
| | - Delphine West
- Vrije Universiteit Brussel, Department of Psychology, Pleinlaan 2, 1050 Brussels, Belgium
| | - Johan Vanderfaeillie
- Vrije Universiteit Brussel, Department of Psychology, Pleinlaan 2, 1050 Brussels, Belgium
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3
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Christodoulou J, Jane Rotheram-Borus M, Hayati Rezvan P, Weiss RE, Tomlinson M. Association of Early Migration with Child Growth, Cognition and Behavior in South Africa. Trop Med Int Health 2022; 27:218-225. [PMID: 34997984 DOI: 10.1111/tmi.13719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Examine the association of migration with child growth, cognition, and behavior in South Africa. METHODS Secondary analysis assessing effects of migration on child outcomes among a population cohort of women and children (n=1,238) recruited in Cape Town, South African townships and repeatedly assessed from birth to age eight. Logistic regression models analyzed sociodemographic predictors of migration and longitudinal models assessed the association of child migration, with or without their mother, on child growth, cognition, and behavioral outcomes. RESULTS By 8 years post-birth, 41% of children born in the townships in Cape Town had migrated to the rural Eastern Cape. Staying in Cape Town, or not migrating, was associated with having an older mother. Children who migrated with their mother were shorter and weighed less than those who did not migrate. Children who migrated had larger vocabularies and those who migrated with their mothers had fewer behavioral problems than children who stayed in Cape Town. CONCLUSION Migration in South Africa between peri-urban Cape Town and rural Eastern Cape areas during a child's early years is common and is associated with both positive and negative child outcomes.
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Affiliation(s)
- Joan Christodoulou
- Department of Psychology, Palo Alto University, Palo Alto, California, USA
| | - Mary Jane Rotheram-Borus
- Department of Psychiatry & Biobehavioral Sciences, Semel Institute, University of California, Los Angeles, USA
| | - Panteha Hayati Rezvan
- Department of Psychiatry & Biobehavioral Sciences, Semel Institute, University of California, Los Angeles, USA
| | - Robert E Weiss
- Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, USA
| | - Mark Tomlinson
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Cape Town, South Africa.,School of Nursing and Midwifery, Queens University, Belfast, UK
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4
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Ramadhan MHA, Putri AK, Melinda D, Habibah U, Fajriyah UN, Aini S, Prananjaya BA, Ikhsan DS. Children's Mental Health in the Time of COVID-19: How Things Stand and the Aftermath. Malays J Med Sci 2020; 27:196-201. [PMID: 33154711 PMCID: PMC7605835 DOI: 10.21315/mjms2020.27.5.15] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 07/16/2020] [Indexed: 11/09/2022] Open
Abstract
Currently, the world is facing immediate and unexpected changes every day due to the coronavirus disease 2019 (COVID-19) pandemic. These environmental stimulations have an impact on mental health, particularly in the case of children. Worldwide measures such as quarantine, social and physical distancing, and school closure can potentially take a toll on children’s mental health, in both the short and long terms. Grief, adjustment disorder and acute stress disorder (ASD) are some of the mental health issues that children are prone to suffer during a pandemic, leading to mood disorder, psychosis and even suicidal tendency, if not addressed and treated timely. As the pandemic continues, it is crucial to monitor children’s mental health status. Parents/caregivers must receive continuous guidance on handling the situation appropriately. Both professionals and families/caregivers must tend to children’s mental health needs to safeguard their overall well-being.
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Affiliation(s)
| | | | - Diana Melinda
- Faculty of Medicine, Universitas Sriwijaya, Palembang, Indonesia
| | - Umrohtul Habibah
- Faculty of Medicine, Universitas Sriwijaya, Palembang, Indonesia
| | | | - Syarifah Aini
- Department of Psychiatry, Faculty of Medicine, Universitas Sriwijaya, Palembang, Indonesia
| | | | - Diyaz Syauqi Ikhsan
- Department of Psychiatry, Faculty of Medicine, Universitas Sriwijaya, Palembang, Indonesia
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Imran N, Aamer I, Sharif MI, Bodla ZH, Naveed S. Psychological burden of quarantine in children and adolescents: A rapid systematic review and proposed solutions. Pak J Med Sci 2020; 36:1106-1116. [PMID: 32704298 PMCID: PMC7372688 DOI: 10.12669/pjms.36.5.3088] [Citation(s) in RCA: 93] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 06/22/2020] [Indexed: 01/02/2023] Open
Abstract
As COVID-19 grips the world, many people are quarantined or isolated resulting in adverse consequences for the mental health of youth. This rapid review takes into account the impact of quarantine on mental health of children and adolescents, and proposes measures to improve psychological outcomes of isolation. Three electronic databases including PubMed, Scopus, and ISI Web of Science were searched. Two independent reviewers performed title and abstract screening followed by full-text screening. This review article included 10 studies. The seven studies before onset of COVID 19 about psychological impact of quarantine in children have reported isolation, social exclusion stigma and fear among the children. The most common diagnoses were acute stress disorder, adjustment disorder, grief, and post-traumatic stress disorder. Three studies during the COVID-19 pandemic reported restlessness, irritability, anxiety, clinginess and inattention with increased screen time in children during quarantine. These adverse consequences can be tackled through carefully formulated multilevel interventions.
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Affiliation(s)
- Nazish Imran
- Nazish Imran, MBBS; FRCPsych (London); MRCPsych (London); MHPE. Associate Professor, Department of Child and Family Psychiatry, King Edward Medical University/Mayo Hospital, Lahore, Pakistan
| | - Irum Aamer
- Irum Aamer, MBBS; FCPS. Senior Registrar, Academic Department of Psychiatry and Behavioral Sciences, King Edward Medical University/Mayo Hospital, Lahore, Pakistan
| | - Muhammad Imran Sharif
- Muhammad Imran Sharif, MBBS; FCPS. Senior Registrar, Department of Child and Family Psychiatry, King Edward Medical University/Mayo Hospital, Lahore, Pakistan
| | - Zubair Hassan Bodla
- Zubair Hassan Bodla, MBBS. Medical Officer, Department of Child and Family Psychiatry, King Edward Medical University/Mayo Hospital, Lahore, Pakistan
| | - Sadiq Naveed
- Sadiq Naveed, MD; MPH. Assistant Professor of Psychiatry and Behavioral Sciences, University of Kansas Medical Center, Kansas, USA
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6
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Liu JJ, Bao Y, Huang X, Shi J, Lu L. Mental health considerations for children quarantined because of COVID-19. THE LANCET. CHILD & ADOLESCENT HEALTH 2020; 4:347-349. [PMID: 32224303 PMCID: PMC7118598 DOI: 10.1016/s2352-4642(20)30096-1] [Citation(s) in RCA: 382] [Impact Index Per Article: 95.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 03/19/2020] [Accepted: 03/23/2020] [Indexed: 01/15/2023]
Affiliation(s)
- Jia Jia Liu
- Peking University Health Science Center, Peking University, Beijing 100191, China,National Institute on Drug Dependence, Peking University, Beijing 100191, China
| | - Yanping Bao
- Peking University Health Science Center, Peking University, Beijing 100191, China,National Institute on Drug Dependence, Peking University, Beijing 100191, China
| | - Xiaolin Huang
- Savaid Medical School, University of Chinese Academy of Sciences, Beijing, China
| | - Jie Shi
- Peking University Health Science Center, Peking University, Beijing 100191, China,National Institute on Drug Dependence, Peking University, Beijing 100191, China
| | - Lin Lu
- Institute of Mental Health, Peking University Sixth Hospital and National Clinical Research Center for Mental Disorders, Peking University, Beijing 100191, China; Peking-Tsinghua Center for Life Sciences, Peking University, Beijing 100191, China; International Data Group/Mcgovern Institute for Brain Research at Peking University, Peking University, Beijing 100191, China.
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7
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Andersson Y, Holmqvist R, Nilsson D. Child Evacuations During World War II: This Should Not Happen Again. JOURNAL OF LOSS & TRAUMA 2019. [DOI: 10.1080/15325024.2018.1549198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Yvonne Andersson
- Department for Behavioral Sciences and Learning, Linköping University, Linköping, Sweden
| | - Rolf Holmqvist
- Department for Behavioral Sciences and Learning, Linköping University, Linköping, Sweden
| | - Doris Nilsson
- Department for Behavioral Sciences and Learning, Linköping University, Linköping, Sweden
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8
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Work careers in adults separated temporarily from their parents in childhood during World War II. J Psychosom Res 2019; 118:63-68. [PMID: 30782356 DOI: 10.1016/j.jpsychores.2019.01.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 01/21/2019] [Accepted: 01/23/2019] [Indexed: 01/17/2023]
Abstract
INTRODUCTION Traumatic experiences, such as separation from parents in childhood causing early life stress (ELS) may increase the risk of adverse long-term health outcomes and biological age-related changes. This may have an impact on work career. Our aim was to examine long term consequences of ELS due to temporary separation from parents during World War II (WWII) in relation to work career. MATERIAL AND METHODS The Helsinki Birth Cohort Study comprises 13,345 individuals born in Helsinki, Finland, between the years 1934-1944. From the original cohort, 1781 individuals were identified as being separated temporarily from their parents due to World War II. Information on date and type of pension was provided by the Finnish Centre for Pensions and the Social Insurance Institution of Finland. The cohort members either transitioned into old age pension at the statutory retirement age or retired earlier and transitioned into disability, unemployment, part-time pension or died before retirement. RESULTS Those who were separated were more likely to have transitioned into disability pension (RRR: 1.26: 95% CI: 1.06-1.48), especially due to diseases of the musculoskeletal system (OR: 1.57; 95% CI: 1.20-2.07), or into unemployment pension (RRR: 1.25; 95% CI: 1.02-1.53) compared with those not separated from their parents. Longer duration of separation was associated with early exit from the workforce compared with non-separation. CONCLUSIONS Exposure to ELS may have an impact upon lifetime work career. Early interventions preventing exposure to ELS or mitigating its negative effects may prolong future work careers along with healthier aging across the life-span.
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Clow B, Haworth-Brockman M, Boily-Larouche G, Qadar Z, Keynan Y. Looking for Evidence of Public Health's Role for Long-Term Evacuees. Front Public Health 2019; 7:15. [PMID: 30809517 PMCID: PMC6379342 DOI: 10.3389/fpubh.2019.00015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 01/17/2019] [Indexed: 11/24/2022] Open
Abstract
Many Canadians have had personal experience of a major emergency or disaster at some point in their lifetime and close to a third of those affected were evacuated from their homes or communities. Most evacuations have lasted less than 2 weeks, but in some instances, people have been displaced for months or years. For example, hundreds of residents evacuated following flooding in Lake St. Martin, Manitoba in 2011, remain displaced today. In order to learn more about the roles and responses of public health for long-term evacuees (LTEs) in Canada, we conducted a narrative review of published English-language documents, beginning with literature specific to Canada and then expanding to include literature on other high-income countries. We found that while researchers have explored public health considerations in emergency preparedness, acute disaster management, and resettlement in these contexts there is a dearth of published evidence regarding the public health implications of prolonged evacuation and the public health responses to long-term evacuation in Canada and in other high-income countries. Because the public health needs of diverse populations of LTEs have not been fully investigated, it is likely that they are neither well-understood nor adequately addressed in public health policy and practice.
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Affiliation(s)
| | - Margaret Haworth-Brockman
- National Collaborating Centre for Infectious Diseases, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Geneviève Boily-Larouche
- National Collaborating Centre for Infectious Diseases, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Zeeshan Qadar
- National Collaborating Centre for Infectious Diseases, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Yoav Keynan
- National Collaborating Centre for Infectious Diseases, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.,Department of Medical Microbiology, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
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10
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Humphreys KL. Future Directions in the Study and Treatment of Parent-Child Separation. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2018; 48:166-178. [PMID: 30556737 DOI: 10.1080/15374416.2018.1534209] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Children require adult caregivers to survive and thrive. In the absence of committed and nurturing care, children face increased risk for a number of difficulties, including internalizing and externalizing psychopathology, cognitive and language deficits, and social difficulties. Recent changes in the U.S. immigration system have resulted in a large number of children removed from their parents, drawing increased scrutiny to the impact of parent-child separation and best practices for caring for children who have been separated. Drawing from work on children exposed to institutional care, as well as research on children separated from caregivers due to validated abuse and neglect, it is clear that children belong in families that are safe and supportive and that some forms of substitute care (i.e., institutional or group-based care) are insufficient to meet children's needs. However, it is difficult to know the specific impact of parent-child separation on child outcomes given that stressors often cluster and pre-separation experiences and post-separation placements also contribute to the experience of separation from a parent and subsequent functioning. Attempts to parse the specific contributions of each separation-related stressor, examining sensitive periods in the impact of separation, studying the mechanisms by which separations affect children, and consideration of the broader social and political context are useful future directions for moving this area of study forward. We must also more fully probe the roles that caregivers play in child development. Lastly, we must endeavor to cease practices of removing children from loving and capable caregivers and, when necessary, provide support to parents and children who have experienced separation.
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11
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Doyle JJ, Aizer A. Economics of Child Protection: Maltreatment, Foster Care, and Intimate Partner Violence. ANNUAL REVIEW OF ECONOMICS 2018; 10:87-108. [PMID: 31007830 PMCID: PMC6469872 DOI: 10.1146/annurev-economics-080217-053237] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Violence within families and child neglect are strikingly common: 700,000 children are found to be victims of abuse or neglect in the United States each year; over the course of childhood, 6% of children are placed in foster care, and 18% witness intimate partner violence. These children are at much higher risks of homelessness, criminal justice involvement, unemployment, and chronic health conditions compared to their neighbors. This article reviews the state of the economics literature on the causes and consequences of child maltreatment and intimate partner violence and calls for greater research into interventions aimed at improving child well-being.
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Affiliation(s)
- Joseph J Doyle
- Sloan School of Management, Massachusetts Institute of Technology, Cambridge, Massachusetts 02142, USA;
- National Bureau of Economic Research, Cambridge, Massachusetts 02138, USA
| | - Anna Aizer
- National Bureau of Economic Research, Cambridge, Massachusetts 02138, USA
- Department of Economics, Brown University, Providence, Rhode Island 02912, USA
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12
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Santavirta T, Santavirta N, Gilman SE. Association of the World War II Finnish Evacuation of Children With Psychiatric Hospitalization in the Next Generation. JAMA Psychiatry 2018; 75:21-27. [PMID: 29188292 PMCID: PMC5833542 DOI: 10.1001/jamapsychiatry.2017.3511] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Although there is evidence that adverse childhood experiences are associated with worse mental health in adulthood, scarce evidence is available regarding an emerging concern that the next generation might also be affected. OBJECTIVE To compare the risk of psychiatric hospitalization in cousins whose parents were vs were not exposed to the Finnish evacuation policy that involved a mean 2-year stay with a Swedish foster family. DESIGN, SETTING, AND PARTICIPANTS This multigenerational, population-based cohort study of Finnish individuals and their siblings born between January 1, 1933, and December 31, 1944, analyzed the association of evacuee status as a child during World War II in the first generation with the risk of psychiatric hospitalization among offspring in the second generation. Evacuee status during World War II was determined using the Finnish National Archive's registry of participants in the Finnish evacuation. Data on evacuee status were linked to the psychiatric diagnoses in the Finnish Hospital Discharge Register from January 1, 1971, through December 31, 2012, for offspring (n = 93 391) born between January 1, 1950, and December 31, 2010. Sex-specific Cox proportional hazards regression models were used to estimate hazard ratios for risk of psychiatric hospitalization during the follow-up period. Because offspring of evacuees and their nonevacuated siblings are cousins, the Cox proportional hazards regression models included fixed effects to adjust for confounding factors in families. Data analysis was performed from June 15, 2016, to August 26, 2017. EXPOSURES Parental participation in the evacuation during World War II (coded 1 for parents who were evacuated and placed in foster care and 0 for those not evacuated). MAIN OUTCOMES AND MEASURES Offspring's initial admission to the hospital for a psychiatric disorder, obtained from the Finnish Hospital Discharge Register from January 1, 1971, through December 31, 2012. RESULTS Of the 93 391 study persons, 45 955 (49.2%) were women and 47 436 (50.8) were men; mean (SD) age in 2012 among survivors was 45.4 (6.58) years. Female offspring of mothers evacuated to Sweden during childhood had an elevated risk of psychiatric hospitalization (hazard ratio for any type of psychiatric disorder: 2.04 [95% CI, 1.04-4.01]; hazard ratio for mood disorder: 4.68 [95% CI, 1.92-11.42]). There was no excess risk of being hospitalized for a psychiatric disorder among women whose fathers were exposed to the Finnish evacuation policy during World War II or among men whose mothers or fathers were exposed. CONCLUSIONS AND RELEVANCE In a prior follow-up study of the Finnish evacuees, girls evacuated to Swedish foster families during World War II were more likely to be hospitalized for a psychiatric disorder-in particular, a mood disorder-in adulthood than their nonevacuated sisters. The present study found that the offspring of these individuals were also at risk for mental health problems that required hospitalization and suggests that early-life adversities, including war-related exposures, may be associated with mental health disorders that persist across generations.
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Affiliation(s)
- Torsten Santavirta
- Institute for Housing and Urban Research, Uppsala University and Swedish Institute for Social Research, Stockholm University, Uppsala, Sweden
| | - Nina Santavirta
- Department of Education, Faculty of Educational Sciences, University of Helsinki, Helsinki, Finland
| | - Stephen E. Gilman
- Health Behavior Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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13
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Wang Z, Zhang L, Li N, Guo C, Chen G, Zheng X. The Effects of Social Reforms on Mental Disability in China: Population-Based Study. Asia Pac J Public Health 2016; 28:253-61. [PMID: 26969637 DOI: 10.1177/1010539516635271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Few studies have explored how mental disabilities have changed with the waves of Chinese social reforms that occurred between 1912 and 2006. The present study evaluated population-based data from the Second China National Sample Survey on Disability to investigate these trends and their effects on mental disabilities. The Cox proportional hazards model was used to estimate the association between social reforms and mental disabilities. The confounding variables considered were as follows: survey age, gender, residence in 2006, ethnicity, and living arrangements in 2006. The highest risks of mental disabilities were observed in subjects born during the Mao Zedong era. Subjects who experienced social turbulence during their early development may have increased risks of mental disabilities in adulthood. The results and discussion herein contribute to our understanding of mental disabilities in China within the context of changing political, socioeconomic, and health system conditions and a developing mental health system.
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Affiliation(s)
- Zhenjie Wang
- Institute of Population Research/WHO Collaborating Center on Reproductive Health and Population Science, Peking University, Beijing, People's Republic of China
| | - Lei Zhang
- Institute of Population Research/WHO Collaborating Center on Reproductive Health and Population Science, Peking University, Beijing, People's Republic of China
| | - Ning Li
- Institute of Population Research/WHO Collaborating Center on Reproductive Health and Population Science, Peking University, Beijing, People's Republic of China
| | - Chao Guo
- Institute of Population Research/WHO Collaborating Center on Reproductive Health and Population Science, Peking University, Beijing, People's Republic of China
| | - Gong Chen
- Institute of Population Research/WHO Collaborating Center on Reproductive Health and Population Science, Peking University, Beijing, People's Republic of China
| | - Xiaoying Zheng
- Institute of Population Research/WHO Collaborating Center on Reproductive Health and Population Science, Peking University, Beijing, People's Republic of China
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14
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Heilala C, Santavirta N. Unveiling the War Child Syndrome: Finnish War Children's Experiences of the Evacuation to Sweden During WWII from a Lifetime Perspective. JOURNAL OF LOSS & TRAUMA 2016. [DOI: 10.1080/15325024.2016.1161425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Cecilia Heilala
- Institute of Behavioral Sciences, University of Helsinki, Helsinki, Finland
| | - Nina Santavirta
- Institute of Behavioral Sciences, University of Helsinki, Helsinki, Finland
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