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Ferro MA, Chan CKY. P factor in children with chronic physical illness. J Psychosom Res 2024; 184:111863. [PMID: 39059044 DOI: 10.1016/j.jpsychores.2024.111863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Revised: 07/16/2024] [Accepted: 07/21/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND The p factor represents the overall liability for the development of mental illness. While evidence supporting the p factor in adults has been reported, studies in children are fewer, and none have examined the p factor in children with chronic physical illness (CPI). OBJECTIVE We aimed to model the p factor in a longitudinal sample of children with CPI using a parent-reported checklist and examine its construct validity against a structured diagnostic interview. METHODS We used data from 263 children aged 2-16 years diagnosed with a CPI who were enrolled in the Multimorbidity in Children and Youth across the Life-course (MY LIFE) study. The p factor was modelled using the Emotional Behavioural Scales over 24 months using confirmatory factor analysis. Validation of the p factor was set against the Mini International Neuropsychiatric Interview for Children and Adolescents. RESULTS Factorial evidence supported the p factor, modelled using a bi-factor structure, compared to a standard correlated-factors (i.e., two-factor) structure [Δχ2 = 9.66(4), p = 0.047]. p factor scores were correlated with the number of different mental illness diagnoses (r = 0.71) and total number of diagnoses (r = 0.72). Dose-response relationships were shown for the number of different diagnoses (p < 0.001) and total number of diagnoses (p < 0.001). CONCLUSION In this first study of the p factor in children with CPI, we showed evidence of its bi-factor structure and associations with mental illness diagnoses. Mental comorbidity in children with CPI is pervasive and warrants transdiagnostic approaches to integrated pediatric care.
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Affiliation(s)
- Mark A Ferro
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada.
| | - Christy K Y Chan
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada
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2
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Ames ME, Robillard CL, Turner BJ, Garcia-Barrera M, Rush J, Craig SG. Associations between physical activity, affect regulation difficulties, and mental health among Canadian adolescents at two different points of the COVID-19 pandemic. Psychol Health 2024; 39:1042-1058. [PMID: 36184947 DOI: 10.1080/08870446.2022.2127718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 08/09/2022] [Accepted: 09/18/2022] [Indexed: 11/06/2022]
Abstract
Objective. Although physical activity declined with social distancing measures and stay-at-home orders during the COVID-19 pandemic, youth who engaged in more physical activity experienced fewer mental health problems. If and how physical activity maintained its protective role throughout the ongoing pandemic remains unclear. This study models associations between three types of physical activity (indoor, outdoor, with parents), affect regulation, and anxious and depressive symptoms in two independent adolescent samples (T1: Summer 2020; T2: Winter 2020/21). Methods and Measures. Six hundred sixty-two Canadian adolescents (T1: Mage = 15.69, SD = 1.36; 52% girls; 5% trans+) and 675 Canadian adolescents (T2: Mage = 15.80, SD = 1.46; 50% girls; 6% trans+) participated in an online survey. Data included frequency of physical activity indoors, outdoors, and with parents, affect regulation difficulties, and measures of anxious and depressive symptoms. Results. Multiple-group path analysis showed indoor physical activity had an indirect effect on anxiety and depressive symptoms through affect dysregulation, but only at T1. Physical activity with parents was protective for adolescent anxiety and depressive symptoms at both T1 and T2 and had an indirect effect through affect dysregulation and suppression. Conclusion. Findings contribute to our understanding of how physical activity protects adolescent mental health, and point to strengthening family supports and recreation opportunities.
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Affiliation(s)
- Megan E Ames
- University of Victoria, Department of Psychology, Victoria, British Columbia, Canada
- Centre for Youth and Society, University of Victoria, Victoria, British Columbia, Canada
- Institute on Aging and Lifelong Health, Victoria, British Columbia, Canada
| | - Christina L Robillard
- University of Victoria, Department of Psychology, Victoria, British Columbia, Canada
| | - Brianna J Turner
- University of Victoria, Department of Psychology, Victoria, British Columbia, Canada
- Centre for Youth and Society, University of Victoria, Victoria, British Columbia, Canada
- Institute on Aging and Lifelong Health, Victoria, British Columbia, Canada
| | | | - Jonathan Rush
- University of Victoria, Department of Psychology, Victoria, British Columbia, Canada
- Institute on Aging and Lifelong Health, Victoria, British Columbia, Canada
| | - Stephanie G Craig
- York University, LaMarsh Centre for Child and Youth Research, Toronto, Ontario, Canada
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Ferro MA, Arimoro OI, Ayilara OF, Dhuga GK, Duncan L, Sajobi TT. Validating the Ontario Child Health Study Emotional Behavioural Scales-Brief Version (OCHS-EBS-B) in children with chronic physical illness. Child Care Health Dev 2024; 50:e13300. [PMID: 38953538 DOI: 10.1111/cch.13300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 06/05/2024] [Accepted: 06/06/2024] [Indexed: 07/04/2024]
Abstract
BACKGROUND A substantial proportion of children have a physical illness; these children commonly experience physical-mental comorbidity. To assess child mental health, brief scales that can be used in clinical and research settings are needed. This study assessed the validity and reliability of parent-reported Ontario Child Health Study Emotional Behavioural Scale-Brief Version (OCHS-EBS-B) scores. METHODS Data come from a longitudinal study of children aged 2-16 years with a physical illness recruited from outpatient clinics at a pediatric hospital. Confirmatory factor analysis and McDonald's coefficient assessed the factor structure and internal consistency reliability of the OCHS-EBS-B, respectively. Point biserial correlations assessed agreement between the OCHS-EBS-B and Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID), a structured diagnostic interview. The Wilcoxon rank sum test compared OCHS-EBS-B scores between children with versus without physical-mental comorbidity (known-group validity). RESULTS The three-factor structure of the OCHS-EBS-B was replicated in this sample of children with physical illness (χ2 = 196.23(272), p < 0.001; CFI = 0.98; TLI = 0.98; SRMR = 0.06; RMSEA [90% CI] = 0.034 [0.027, 0.044]). It had excellent internal consistency reliability (ω = 0.86-0.92) and was moderately correlated with the MINI-KID (baseline: rpb = 0.43-0.51; 6 months: rpb = 0.55-0.65). OCHS-EBS-B scores were significantly higher among children with versus without physical-mental comorbidity. CONCLUSIONS Findings confirm psychometric evidence that the OCHS-EBS-B is a valid and reliable measure of mental health in children with chronic physical illness. Its brevity and robust psychometric properties make the OCHS-EBS-B a strong candidate for routine use in integrated pediatric physical and mental health services.
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Affiliation(s)
- Mark A Ferro
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Olayinka I Arimoro
- Department of Community Health Sciences, University of Calgary, Calgary, Canada
| | - Olawale F Ayilara
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Gurkiran K Dhuga
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Laura Duncan
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Tolulope T Sajobi
- Department of Community Health Sciences, University of Calgary, Calgary, Canada
- O'Brien Institute for Public Health, University of Calgary, Calgary, Canada
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Aitken M, Perquier F, Haltigan JD, Wang L, Andrade BF, Battaglia M, Szatmari P, Georgiades K. Individual- and family-level associations between child psychopathology and parenting. Dev Psychopathol 2024; 36:944-952. [PMID: 37017128 DOI: 10.1017/s0954579423000202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
Parenting can protect against the development of, or increase risk for, child psychopathology; however, it is unclear if parenting is related to psychopathology symptoms in a specific domain, or to broad liability for psychopathology. Parenting differs between and within families, and both overall family-level parenting and the child-specific parenting a child receives may be important in estimating transdiagnostic associations with psychopathology. Data come from a cross-sectional epidemiological sample (N = 10,605 children ages 4-17, 6434 households). Parents rated child internalizing and externalizing symptoms and their parenting toward each child. General and specific (internalizing, externalizing) psychopathology factors, derived with bifactor modeling, were regressed on parenting using multilevel modeling. Less warmth and more aversive/inconsistent parenting in the family, and toward an individual child relative to family average, were associated with higher general psychopathology and specific externalizing problems. Unexpectedly, more warmth in the family, and toward an individual child relative to family average, was associated with higher specific internalizing problems in 4-11 (not 12-17) year-olds. Less warmth and more aversive/inconsistent parenting are broad correlates of child psychopathology. Aversive/inconsistent parenting, is also related to specific externalizing problems. Parents may behave more warmly when their younger children have specific internalizing problems, net of overall psychopathology.
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Affiliation(s)
- Madison Aitken
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Canada
| | - Florence Perquier
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, Canada
| | - John D Haltigan
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Canada
- Hospital for Sick Children, Toronto, Canada
| | - Li Wang
- Department of Psychiatry and Behavioural Neurosciences & Offord Centre for Child Studies, McMaster University, Hamilton, Canada
| | - Brendan F Andrade
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Canada
| | - Marco Battaglia
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Canada
| | - Peter Szatmari
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Canada
- Hospital for Sick Children, Toronto, Canada
| | - Katholiki Georgiades
- Department of Psychiatry and Behavioural Neurosciences & Offord Centre for Child Studies, McMaster University, Hamilton, Canada
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Halladay J, MacKillop J, Acuff S, Amlung M, Munn C, Georgiades K. Early substance use and the school environment: A multilevel latent class analysis. JOURNAL OF THE CANADIAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY = JOURNAL DE L'ACADEMIE CANADIENNE DE PSYCHIATRIE DE L'ENFANT ET DE L'ADOLESCENT 2024; 33:33-56. [PMID: 38449719 PMCID: PMC10914148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
Background Early substance use is associated with increased risks for mental health and substance use problems which are compounded when using several substances (i.e., polysubstance use). A notable increase in substance use occurs when adolescents transition from elementary to secondary schooling. Objective This study seeks to characterize student and school classes of substance use. Methods A cross-sectional multilevel latent class analysis and regression was conducted on a representative sample of 19,130 grade 6-8 students from 180 elementary schools in Ontario, Canada to: 1) identify distinct classes of student substance use; 2) identify classes of schools based on student classes; and 3) explore correlates of these classes, including mental health, school climate, belonging, safety, and extracurricular participation. Results Two student and two school classes were identified. 4.1% of students were assigned to the high probability of early polysubstance use class while the remaining 95.9% were in the low probability class. Students experiencing depressive and externalizing symptoms had higher odds of being in the early polysubstance use class (Odds Ratio [OR]s=1.1-1.25). At the school level, 19% of schools had higher proportions of students endorsing polysubstance use. Perceptions of positive school climate, belonging, and safety increased the odds of students being in the low probability of early polysubstance use student-level class (ORs=0.85-0.93) and lower probability of early polysubstance use school-level class. Associations related to extracurricular participation were largely not statistically significant. Conclusions Student and school substance use classes may serve as targets for tailored prevention and early interventions. Results support examining school-based interventions targeting school climate, belonging, and safety.
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Affiliation(s)
- Jillian Halladay
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Camperdown NSW, Australia
- Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, Hamilton, Ontario
| | - James MacKillop
- Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, Hamilton, Ontario
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario
| | - Samuel Acuff
- Recovery Research Institute, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States
| | - Michael Amlung
- Cofrin Logan Center for Addiction Research and Treatment, The University of Kansas, Lawrence, Kansas, United States
| | - Catharine Munn
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario
| | - Katholiki Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario
- Offord Centre for Child Studies, McMaster University, Ron Joyce Children's Health Centre, Hamilton, Ontario
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Halladay J, Georgiades K, MacKillop J, Lipman E, Pires P, Duncan L. Identifying patterns of substance use and mental health concerns among adolescents in an outpatient mental health program using latent profile analysis. Eur Child Adolesc Psychiatry 2024; 33:739-747. [PMID: 36947251 PMCID: PMC10031175 DOI: 10.1007/s00787-023-02188-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 03/08/2023] [Indexed: 03/23/2023]
Abstract
Though mental health and substance use concerns often co-occur, few studies have characterized patterns of co-occurrence among adolescents in clinical settings. The current investigation identifies and characterizes these patterns among adolescents presenting to an outpatient mental health service in Ontario, Canada. Data come from cross-sectional standardized patient intake assessments from 916 adolescents attending an outpatient mental health program (January 2019-March 2021). Latent profile analysis identified patterns of substance use (alcohol, cannabis, (e-) cigarettes) and emotional and behavioral disorder symptoms. Sociodemographic and clinical correlates of these patterns were examined using multinomial regression. Three profiles were identified including: 1) low substance use and lower frequency and/or severity (relative to other patients in the sample) emotional and behavioral disorder symptoms (26.2%), 2) low substance use with higher emotional and behavioral disorder symptoms (48.2%), and 3) high in both (25.6%). Profiles differed in sociodemographic and clinical indicators related to age, gender, trauma, harm to self, harm to others, and service use. Experiences of trauma, suicide attempts, and thoughts of hurting others increased the odds of adolescents being in the profile high in both substance use and symptoms compared to other profiles. These findings further document the high rates of substance use in adolescents in mental health treatment and the profiles generally map onto three out of four quadrants in the adapted four-quadrant model of concurrent disorders, indicating the importance of assessing and addressing substance use in these settings.
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Affiliation(s)
- Jillian Halladay
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Australia Level 6, Jane Foss Russell Building, G02, Camperdown, NSW, 2006, Australia.
- The Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, 100 West 5Th St, Hamilton, ON, L8N 3K7, Canada.
| | - Katholiki Georgiades
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4S4, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, Canada
| | - James MacKillop
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4S4, Canada
- The Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, 100 West 5Th St, Hamilton, ON, L8N 3K7, Canada
| | - Ellen Lipman
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4S4, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, Canada
| | - Paulo Pires
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4S4, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, Canada
| | - Laura Duncan
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4S4, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, Canada
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Sajobi TT, Ayilara OF, Dhuga GK, Ferro MA. Response shift in parent-reported psychopathology in children with chronic physical illness. Qual Life Res 2023; 32:3099-3108. [PMID: 37326699 DOI: 10.1007/s11136-023-03458-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2023] [Indexed: 06/17/2023]
Abstract
PURPOSE Because physical-mental comorbidity in children is relatively common, this study tested for response shift (RS) in children with chronic physical illness using a parent-reported measure of child psychopathology. METHODS Data come from Multimorbidity in Children and Youth across Life-course (MY LIFE), a prospective study of n = 263 children aged 2-16 years with physical illness in Canada. Parents provided information on child psychopathology using the Ontario Child Health Study Emotional Behavioral Scales (OCHS-EBS) at baseline and 24 months. Oort's structural equation modeling was used to test for different forms of RS in parent-reported assessments between baseline and 24 months. Model fit was evaluated using root mean square error of approximation (RMSEA), comparative fit index (CFI), and standardized root mean residual (SRMR). RESULTS There were n = 215 (81.7%) children with complete data and were included in this analysis. Of these, n = 105 (48.8%) were female and the mean (SD) age was 9.4 (4.2) years. A two-factor measurement model provided good fit to the data [RMSEA (90% CI) = 0.05 (0.01, 0.10); CFI = 0.99; SRMR = 0.03]. Non-uniform recalibration RS was detected on the conduct disorder subscale of the OCHS-EBS. This RS effect had negligible impact on the longitudinal change in externalizing and internalizing disorders construct over time. CONCLUSIONS Response shift detected on the conduct disorder subscale of the OCHS-EBS, indicated that parents of children with physical illness may recalibrate their responses on child psychopathology over 24 months. Researchers and health professionals should be aware of RS when using the OCHS-EBS to assess child psychopathology over time.
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Affiliation(s)
- Tolulope T Sajobi
- Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.
- O'Brien Institute for Public Health, University of Calgary, Calgary, Canada.
| | - Olawale F Ayilara
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Gurkiran K Dhuga
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Mark A Ferro
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
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Dufour R, Breton É, Morin AJS, Côté SM, Dubois L, Vitaro F, Boivin M, Tremblay RE, Booij L. Childhood hyperactivity, eating behaviours, and executive functions: Their association with the development of eating-disorder symptoms in adolescence. J Eat Disord 2023; 11:183. [PMID: 37833803 PMCID: PMC10571422 DOI: 10.1186/s40337-023-00902-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 09/27/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Cross-sectional studies have shown that hyperactivity and impaired executive functioning are associated with symptoms of eating disorders in adolescence and adulthood. Whether hyperactivity and executive functions in early life can prospectively predict the emergence of eating disorder symptoms in adolescence remains unknown. The present study relies on a longitudinal design to investigate how hyperactivity at age 3, eating behaviours at age 3.5 and cognition at ages 3-6 were associated with the development of eating-disorder symptoms from 12 to 20 years old. METHODS Using archival data collected since 1997 from the Quebec Longitudinal Study of Child Development cohort (N = 2, 223), we used Latent Curve Models to analyse predictors of youth's trajectories of eating-disorder symptoms at four timepoints. RESULTS A quadratic (curvilinear) trajectory of eating-disorder symptoms was found to be most representative of the data. Higher hyperactivity at age 3 was associated with higher levels of eating-disorder symptoms at age 12, and this association was partially mediated by higher levels of overeating and cognitive inflexibility in childhood. Cognitive inflexibility in childhood also mediated the association between hyperactivity at age 3 and increases in eating-disorder symptoms during adolescence. Furthermore, working memory was indirectly related to eating-disorder symptoms via the mediational role of cognitive flexibility. CONCLUSIONS Hyperactivity, overeating, cognitive inflexibility, and working memory early in life might precede the onset of eating-disorder symptoms in adolescence. Early behavioural and cognitive screening may help to identify children who are most at risk for eating disorders. This, in turn, could guide preventive interventions.
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Affiliation(s)
- Rachel Dufour
- Sainte-Justine Hospital Research Centre, Montreal, Canada
- Department of Psychology, Concordia University, Montreal, Canada
- Research centre, Douglas Mental Health University Institute, Montreal, Canada
- Eating Disorders Continuum, Douglas Mental Health University Institute, Montreal West Island Integrated University Health and Social Service Centre, 6603-05 LaSalle Blvd, Montreal, QC, H4H 1R3, Canada
| | - Édith Breton
- Sainte-Justine Hospital Research Centre, Montreal, Canada
- Department of Psychiatry and Addictology, Université de Montréal, Montreal, Canada
| | | | - Sylvana M Côté
- Sainte-Justine Hospital Research Centre, Montreal, Canada
- School of Public Health, Université de Montréal, Montreal, Canada
| | - Lise Dubois
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Frank Vitaro
- Sainte-Justine Hospital Research Centre, Montreal, Canada
- School of Psychoeducation, Université de Montréal, Montreal, Canada
| | - Michel Boivin
- Department of Psychology, Université Laval, Québec City, QC, Canada
| | - Richard E Tremblay
- Sainte-Justine Hospital Research Centre, Montreal, Canada
- Department of Psychology and Pediatrics, Université de Montréal, Montreal, Canada
| | - Linda Booij
- Sainte-Justine Hospital Research Centre, Montreal, Canada.
- Department of Psychology, Concordia University, Montreal, Canada.
- Department of Psychiatry and Addictology, Université de Montréal, Montreal, Canada.
- Department of Psychiatry, McGill University, Montreal, Canada.
- Research centre, Douglas Mental Health University Institute, Montreal, Canada.
- Eating Disorders Continuum, Douglas Mental Health University Institute, Montreal West Island Integrated University Health and Social Service Centre, 6603-05 LaSalle Blvd, Montreal, QC, H4H 1R3, Canada.
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Owais S, Savoy CD, Hill T, Lai J, Burack JA, Van Lieshout RJ. Mental Health Challenges Among First Nations Adolescents Living Off-Reserve in Ontario, Canada. Child Psychiatry Hum Dev 2023; 54:1242-1249. [PMID: 35201524 DOI: 10.1007/s10578-022-01333-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/09/2022] [Indexed: 11/03/2022]
Abstract
Limited data exist on the mental health challenges facing First Nations adolescents and the factors that modify these difficulties. The current study compared levels of common mental health challenges among 112 off-reserve First Nations and 3334 non-First Nations adolescents (12-17 years old) and examined the impact of maternal psychological distress on these mental health challenges. First Nations adolescents self-reported higher symptoms of conduct, oppositional-defiant, attention-deficit hyperactivity, major depressive, social phobia, generalized anxiety, and separation anxiety disorders and all associations remained statistically significant after adjusting for covariates. Moderation analyses found that increasing levels of maternal distress were associated more strongly with symptoms of oppositional defiant, attention-deficit hyperactivity, major depressive, and generalized anxiety disorders in First Nations adolescents. Future work aimed at improving the mental health of First Nations youth that focus on supporting these adolescents, and their mothers in particular, could result in substantial benefits.
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Affiliation(s)
- Sawayra Owais
- MD/PhD Program, McMaster University, Hamilton, L8N 3Z5, Canada.
| | - Calan D Savoy
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, L8N 3Z5, Canada
| | - Troy Hill
- Department of Education, Brock University, Hamilton, ON, L8K 1V7, Canada
| | - Jessica Lai
- Department of Education & Counselling Psychology, McGill University, Montreal, QC, H3A 2T5, Canada
| | - Jacob A Burack
- Department of Education & Counselling Psychology, McGill University, Montreal, QC, H3A 2T5, Canada
| | - Ryan J Van Lieshout
- MD/PhD Program, McMaster University, Hamilton, L8N 3Z5, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, L8N 3Z5, Canada
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10
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Comeau J, Wang L, Duncan L, Edwards J, Georgiades K, Anderson KK, Wilk P, Lau T. Correlates of child mental health and substance use related emergency department visits in Ontario: A linked population survey and administrative health data study. Int J Popul Data Sci 2023; 8:2152. [PMID: 37670954 PMCID: PMC10476702 DOI: 10.23889/ijpds.v8i1.2152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2023] Open
Abstract
Introduction Knowledge of the sociodemographic, behavioural, and clinical characteristics of children visiting emergency departments (EDs) for mental health or substance use concerns in Ontario, Canada is lacking. Objectives Using data from a population-based survey linked at the individual level to administrative health data, this study leverages a provincially representative sample and quasi-experimental design to strengthen inferences regarding the extent to which children's sociodemographic, behavioural, and clinical characteristics are associated with the risk of a mental health or substance use related ED visit. Methods 9,301 children aged 4-17 years participating in the 2014 Ontario Child Health Study were linked retrospectively (6 months) and prospectively (12 months) with administrative health data on ED visits from the National Ambulatory Care Reporting System. Modified Poisson regression was used to examine correlates of mental health and substance use related ED visits among children aged 4-17 years over a 12-month period following their survey completion date, adjusting for ED visits in the 6 months prior to their survey completion date. Subgroup analyses of youths aged 14-17 years who independently completed survey content related to peer victimisation, substance use, and suicidality were also conducted. Results Among children aged 4-17 years, older age, parental immigrant status, internalising problems, and perceived need for professional help were statistically significant correlates that increased the risk of a mental health or substance use related ED visit; low-income and suicidal ideation with attempt were statistically significant only among youths aged 14-17 years. Conclusions Knowledge of the sociodemographic, behavioural, and clinical characteristics of children visiting EDs for mental health and substance use related concerns is required to better understand patient needs to coordinate effective emergency mental health care that optimises child outcomes, and to inform the development and targeting of upstream interventions that have the potential to prevent avoidable ED visits. Highlights Growing rates of child mental health and substance use related ED visits have been observed internationally.A population-based survey linked at the individual level to administrative health data was used to examine the extent to which children's sociodemographic, behavioural, and clinical characteristics are associated with the risk of a mental health or substance use related ED visit in Ontario, Canada.Older age, low-income, parental immigrant status, perceived need for professional help, internalising problems, and suicidality increase the risk of an ED visit.Knowledge of the characteristics of children visiting EDs can be used to coordinate effective emergency mental health care that optimises child outcomes, and to inform the development and targeting of upstream interventions that have the potential to prevent avoidable ED visits.
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Affiliation(s)
- Jinette Comeau
- King’s University College at Western University
- Children’s Health Research Institute, Division of Children’s Health and Therapeutics, Lawson Health Research Institute, Western University, London, ON, Canada
| | - Li Wang
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Laura Duncan
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Jordan Edwards
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Katholiki Georgiades
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Kelly K. Anderson
- Children’s Health Research Institute, Division of Children’s Health and Therapeutics, Lawson Health Research Institute, Western University, London, ON, Canada
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Canada
- Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Piotr Wilk
- Children’s Health Research Institute, Division of Children’s Health and Therapeutics, Lawson Health Research Institute, Western University, London, ON, Canada
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Canada
- Department of Paediatrics, Schulich School of Medicine and Dentistry, Western University, London, Canada
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Tammy Lau
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Canada
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Kamali M, Edwards J, Anderson LN, Duku E, Georgiades K. Social Disparities in Mental Health Service Use Among Children and Youth in Ontario: Evidence From a General, Population-Based Survey. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2023; 68:596-604. [PMID: 36503305 PMCID: PMC10411367 DOI: 10.1177/07067437221144630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To examine differences in mental health-related service contacts between immigrant, refugee, racial and ethnic minoritized children and youth, and the extent to which social, and economic characteristics account for group differences. METHODS The sample for analyses includes 10,441 children and youth aged 4-17 years participating in the 2014 Ontario Child Health Study. The primary caregiver completed assessments of their child's mental health symptoms, perceptions of need for professional help, mental health-related service contacts, experiences of discrimination and sociodemographic and economic characteristics. RESULTS Adjusting for mental health symptoms and perceptions of need for professional help, children and youth from immigrant, refugee and racial and ethnic minoritized backgrounds were less likely to have mental health-related service contacts (adjusted odds ratios ranged from 0.54 to 0.79), compared to their non-immigrant peers and those who identified as White. Group differences generally remained the same or widened after adjusting for social and economic characteristics. Large differences in levels of perceived need were evident across non-migrant and migrant children and youth. CONCLUSION Lower estimates of mental health-related service contacts among immigrant, refugee and racial and ethnic minoritized children and youth underscore the importance and urgency of addressing barriers to recognition and treatment of mental ill-health among children and youth from minoritized backgrounds.
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Affiliation(s)
- Mahdis Kamali
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, Ron Joyce Children's Health Centre, Hamilton, ON, Canada
| | - Jordan Edwards
- Offord Centre for Child Studies, Ron Joyce Children's Health Centre, Hamilton, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Laura N. Anderson
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Eric Duku
- Offord Centre for Child Studies, Ron Joyce Children's Health Centre, Hamilton, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Katholiki Georgiades
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, Ron Joyce Children's Health Centre, Hamilton, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
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Goulter N, Balanji S, Davis BA, James T, McIntyre CL, Smith E, Thornton EM, Craig SG, Moretti MM. Psychometric Evaluation of the Affect Regulation Checklist: Clinical and Community Samples, Parent-Reports and Youth Self-Reports. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2023; 33:344-360. [PMID: 35699159 DOI: 10.1111/jora.12779] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The Affect Regulation Checklist (ARC) was designed to capture affect dysregulation, suppression, and reflection. Importantly, affect dysregulation has been established as a transdiagnostic mechanism underpinning many forms of psychopathology. We tested the ARC psychometric properties across clinical and community samples and through both parent-report and youth self-report information. Clinical sample: Participants included parents (n = 814; Mage = 43.86) and their child (n = 608; Mage = 13.98). Community sample: Participants included independent samples of parents (n = 578; Mage = 45.12) and youth (n = 809; Mage = 15.67). Exploratory structural equation modeling supported a three-factor structure across samples and informants. Dysregulation was positively associated with all forms of psychopathology. In general, suppression was positively associated with many forms of psychopathology, and reflection was negatively associated with externalizing problems and positively associated with internalizing problems.
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Comparing youth with vs without outpatient mental health services on subsequent acute mental health care visits. Soc Psychiatry Psychiatr Epidemiol 2023; 58:501-504. [PMID: 36627382 DOI: 10.1007/s00127-022-02418-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 12/21/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Use of acute care for mental health concerns has been increasing among youth in recent years. Improving access to outpatient mental health services may prevent downstream acute care visits. PURPOSE To examine differences in rates of acute mental health care visits among youth with- versus without prior outpatient mental health services. METHODOLOGY A total of 2,442 youth ages 14-17 years participated in a provincially representative cross-sectional epidemiological survey, the 2014 Ontario Child Health Study. This sample was individually linked to health administrative databases, with nearly universal coverage of all medically necessary physician and acute care visits. Our exposure was parent and youth reported outpatient mental health service use in the six-month period prior to completing the survey. Exposed youth (n=691) were matched with unexposed youth using a propensity score informed by a range of clinical and socio-demographic factors. Our outcome was acute mental health care visits in the 18-month period following completion of the survey, ascertained though the linked health administrative data. RESULTS In our propensity score matched sample, we found no difference in rates of subsequent acute mental health care visits (HR= 1.14, 95%CI 0.44, 2.98) between youth with- versus without prior outpatient mental health services. CONCLUSIONS There is a need to further understand the types of services youth are receiving in outpatient settings to determine if, and for whom, outpatient mental health services reduces the likelihood of future acute mental health care visits.
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Boyle MH, Duncan L, Wang L, Georgiades K. Problem checklists and standardized diagnostic interviews: evidence of psychometric equivalence for classifying psychiatric disorder among children and youth in epidemiological studies. J Child Psychol Psychiatry 2022; 64:779-786. [PMID: 36504296 DOI: 10.1111/jcpp.13735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/25/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND The standard approach for classifying child/youth psychiatric disorder as present or absent in epidemiological studies is lay-administered structured, standardized diagnostic interviews (interviews) based on categorical taxonomies such as the DSM and ICD. Converting problem checklist scale scores (checklists) to binary classifications provides a simple, inexpensive alternative. METHODS Using assessments obtained from 737 parents, we determine if child/youth behavioral, attentional, and emotional disorder classifications based on checklists are equivalent psychometrically to interview classifications. We test this hypothesis by (1) comparing their test-retest reliabilities based on kappa (κ), (2) estimating their observed agreement at times 1 and 2, and (3) in structural equation models, comparing their strength of association with clinical status and reported use of prescription medication to treat disorder. A confidence interval approach is used to determine if parameter differences lie within the smallest effect size of interest set at ±0.125. RESULTS The test-retest reliabilities (κ) for interviews compared with checklists met criteria for statistical equivalence: behavioral, .67 and .70; attentional, .64 and .66; and emotional, .61 and .65. Observed agreement between the checklist and interviews on classifications of disorder at times 1 and 2 was, on average, κ = .61. On average, the β coefficients estimating associations with clinical status were .59 (interviews) and .63 (checklists); and with prescription medication use, .69 (interviews) and .71 (checklists). Behavioral and attentional disorders met criteria for statistical equivalence. Emotional disorder did not, although the coefficients were stronger numerically for the checklist. CONCLUSIONS Classifications of child/youth psychiatric disorder from parent-reported checklists and interviews are equivalent psychometrically. The practical advantages of checklists over interviews for classifying disorder (lower administration cost and respondent burden) are enhanced by their ability to measure disorder dimensionally. Checklists provide an option to interviews in epidemiological studies of common child/youth psychiatric disorders.
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Affiliation(s)
- Michael H Boyle
- Department of Psychiatry and Behavioural Neurosciences, Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada
| | - Laura Duncan
- Department of Psychiatry and Behavioural Neurosciences, Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada
| | - Li Wang
- Department of Psychiatry and Behavioural Neurosciences, Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada
| | - Katholiki Georgiades
- Department of Psychiatry and Behavioural Neurosciences, Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada
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15
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Halladay J, MacKillop J, Munn C, Amlung M, Georgiades K. Individual- and school-level patterns of substance use and mental health symptoms in a population-based sample of secondary students: A multilevel latent profile analysis. Drug Alcohol Depend 2022; 240:109647. [PMID: 36244138 DOI: 10.1016/j.drugalcdep.2022.109647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND While substance use and mental health symptoms commonly co-occur among adolescents, few population-level studies have examined profiles of co-occurrence to inform tailored prevention and early interventions. METHODS A multilevel latent profile analysis was conducted on a representative sample of 11,994 students in 68 secondary schools to: 1) identify distinct profiles of co-occurring substance use and mental health symptoms; 2) identify types of schools based on student profiles; and 3) explore school correlates of student profiles and school types, including school climate, belonging, and safety. RESULTS Five student profiles and three school types were identified. Among students, 57.6 % were in a low substance use and mental health profile, 22.5 % were in a high mental health but low substance use profile, 9.7 % were in a heavy drinking and cannabis use profile, 3.7 % were in a heavy drinking and smoking profile, and 6.5 % were in a high substance use and mental health profile. Positive school climate, belonging, and safety increased the odds of students being in the low profile, with belonging yielding larger effects among females. Among schools, 28 % had low, 57 % had moderate, and 15 % had high levels of student substance use and comorbid mental health symptoms. Rural schools were disproportionately represented in higher risk school types. CONCLUSIONS The identified student substance use and mental health symptom profiles can serve as targets for tailored prevention and early interventions. Results support examining school-based interventions targeting school climate, belonging, and safety with potential benefits to both substance use and mental health.
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Affiliation(s)
- Jillian Halladay
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, L8S 4S4, ON, Canada.
| | - James MacKillop
- Department of Psychiatry & Behavioral Neurosciences, McMaster University, Canada; Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, 100 West 5th St, Hamilton, Ontario, Canada L8N 3K7; Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University, Canada.
| | - Catharine Munn
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, L8S 4S4, ON, Canada; Department of Psychiatry & Behavioral Neurosciences, McMaster University, Canada; Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, 100 West 5th St, Hamilton, Ontario, Canada L8N 3K7.
| | - Michael Amlung
- Department of Psychiatry & Behavioral Neurosciences, McMaster University, Canada; Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, 100 West 5th St, Hamilton, Ontario, Canada L8N 3K7; Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, 1000 Sunnyside Avenue, Lawrence, KS 66045, the United States of America.
| | - Katholiki Georgiades
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, L8S 4S4, ON, Canada; Department of Psychiatry & Behavioral Neurosciences, McMaster University, Canada; Offord Centre for Child Studies, McMaster University, Canada.
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16
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McKenzie KNA, Comeau J, Reid GJ. Examining the interactive association of family- and neighborhood-level socio-economic characteristics on children's sleep beyond the associations of residency and neighborhood violence. Sleep Health 2022; 8:458-466. [PMID: 35927180 DOI: 10.1016/j.sleh.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 05/30/2022] [Accepted: 06/06/2022] [Indexed: 10/16/2022]
Abstract
OBJECTIVE To examine the interactive association of neighborhood and family socio-economic characteristics (SEC) on children's sleep. DESIGN Secondary data analyses were completed on the 2014 Ontario Child Health Study, a cross-sectional sample of 10,802 children aged 4-17. PARTICIPANTS Children (aged 4-11, 50% male; N = 6264) with available sleep outcome data. METHODS Multilevel modeling was used to assess the interactive relationship between family- and neighborhood-level poverty in relation to child sleep outcomes (problems falling asleep, problems staying asleep, weekday and weekend time in bed), above the associations of variables known to be related to sleep at the child (ie, child age, sex, internalizing problems, externalizing problems, chronic illness), family (ie, negative parenting behaviors, family structure, parent mental health, years lived in neighborhood, parent education level), and neighborhood levels (ie, neighborhood size, antisocial behavior). RESULTS Neighborhood poverty (p < .01, ß = -0.001, 95% confidence interval [-0.007, -0.002]) was significantly related to shorter weekday time in bed and the interactive association of family and neighborhood poverty was significantly related to weekend time in bed (p < .05, ß = 0.012, 95% confidence interval [0.004, 0.021]). Children living in low poverty neighborhoods with families of higher SEC backgrounds, and children living in high poverty neighborhoods with families of lower SEC backgrounds had the shortest weekend time in bed (9.7 hours). CONCLUSIONS There is a compound relationship of family and neighborhood poverty on children's sleep above and beyond family- and child-level risk factors.
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Affiliation(s)
| | - Jinette Comeau
- Department of Sociology, King's University College at Western University, London, ON, Canada; Division of Children's Health and Therapeutics, Children's Health Research Institute, Lawson Health Research Institute, Western University, London, ON, Canada
| | - Graham J Reid
- Department of Psychology, The University of Western Ontario, London, ON, Canada; Division of Children's Health and Therapeutics, Children's Health Research Institute, Lawson Health Research Institute, Western University, London, ON, Canada; Department of Family Medicine, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada; Department of Pediatrics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada
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Ferro MA, Chan CKY, Vanderkooy JD, Horricks L, Duncan L, Lipman EL. Mental and psychosocial health among youth after their first psychiatric hospitalization: a feasibility study. BMC Res Notes 2022; 15:233. [PMID: 35765046 PMCID: PMC9237987 DOI: 10.1186/s13104-022-06132-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 06/21/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE This pilot study investigated the feasibility of studying 12-month readmission of youth aged 10-16 years following their first psychiatric hospitalization and changes in youth mental and psychosocial health prospectively. RESULTS Inpatient youth with a first psychiatric hospitalization and their parents were recruited from a regional hospital in Canada. Data were collected at recruitment, and at 3-, 6-, and 12-months post-discharge. Repeated measures ANOVA was performed to assess changes in health outcomes. Nineteen eligible youth were approached and 15 (78.9%) consented to participate (13.9 ± 2.0 years, 73.3% female). Eleven youth (73.3%) gave permission to contact their parents, all of whom participated (39.2 ± 7.6 years). Four youth dropped out of the study (26.7%) and six youth-parent dyads completed all four follow-ups. The readmission rate was 20.0% (n = 3) over 12 months. Significant changes in youth-reported symptoms of conduct disorder (F = 3.0, p = 0.06) and adverse childhood experiences (F = 3.4, p = 0.05) were found. Changes in parent-reported youth mental health symptoms (F = 3.1, p = 0.06), particularly among internalizing disorders, youth health-related quality of life (F = 11.3, p < 0.01), and youth disability (F = 2.7, p = 0.08) were significant. This preliminary work demonstrates the feasibility of, and need to, engage youth and their families to understand their mental and psychosocial health during this vulnerable period of time.
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Affiliation(s)
- Mark A Ferro
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada.
| | - Christy K Y Chan
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - John D Vanderkooy
- Child and Adolescent Inpatient Psychiatry, Grand River Hospital, Kitchener, Canada
| | - Laurie Horricks
- Child and Youth Mental Health Program, McMaster Children's Hospital, Hamilton, Canada
| | - Laura Duncan
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Ellen L Lipman
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
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18
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Edwards J, Wang L, Duncan L, Comeau J, Anderson KK, Georgiades K. Characterizing mental health related service contacts in children and youth: a linkage study of health survey and administrative data. Child Adolesc Psychiatry Ment Health 2022; 16:48. [PMID: 35729646 PMCID: PMC9215063 DOI: 10.1186/s13034-022-00483-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 06/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To inform the provision and organization of care, and to improve equitable access to mental health services for children and youth, we must first characterize the children and youth being served, taking into consideration factors related to mental health need. Our objective was to use a population-based survey linked with health administrative data to estimate mental health related contacts and determine socio-demographic correlates, after adjusting for factors related to mental health need. METHODS Data from the 2014 Ontario Child Health Study (OCHS) were linked at the individual level to health administrative databases from Ontario's Ministry of Health and Long-Term Care (MOHLTC). Mental health related service contacts were identified in the 6-months prior to the OCHS survey date. Service contacts with physicians were obtained from health administrative data, and non-physician service contacts from survey data (parent-report). RESULTS 21.7% of Ontarian children (4-11 years) and youth (12-17 years) had at least one mental health related contact in the 6-months prior to their OCHS survey date (18.8% non-physician, 8.0% physician, 5.2% both). Children and youth contacting both physician and non-physician services (ref. contact with physician or non-physician services alone) had higher mean symptom ratings of mental disorders across all classes of disorder. After adjusting for total symptom ratings, children and youth with immigrant parent(s) (ref. non-immigrant) (Prevalence Ratio: 0.65, 95% CI 0.55, 0.75) were less likely to have any mental health related service contact. CONCLUSIONS Results indicate that children and youth with the highest mental health symptom ratings are more likely to have contact with multiple providers across sectors. As such, the coordination of care across and within sectors are critical components of mental health related services for children and youth. Our results indicate that the greatest disparities in mental health related service contacts may exist for children and youth with immigrant parent(s) and that targeted outreach efforts are required to reduce barriers to care and improve equitable access to mental health related services for children and youth in Ontario.
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Affiliation(s)
- Jordan Edwards
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada. .,Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada.
| | - Li Wang
- grid.25073.330000 0004 1936 8227Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON Canada
| | - Laura Duncan
- grid.25073.330000 0004 1936 8227Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON Canada ,grid.25073.330000 0004 1936 8227Offord Centre for Child Studies, McMaster University, Hamilton, ON Canada
| | - Jinette Comeau
- grid.39381.300000 0004 1936 8884Department of Sociology, King’s University College, Western University, London, ON Canada
| | - Kelly K. Anderson
- grid.39381.300000 0004 1936 8884Department of Epidemiology & Biostatistics, Western University, London, ON Canada ,grid.39381.300000 0004 1936 8884Department of Psychiatry, Schulich School of Medicine, Western University, London, ON Canada ,grid.415847.b0000 0001 0556 2414Lawson Health Research Institute, London, ON Canada
| | - Katholiki Georgiades
- grid.25073.330000 0004 1936 8227Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON Canada ,grid.25073.330000 0004 1936 8227Offord Centre for Child Studies, McMaster University, Hamilton, ON Canada
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Development and psychometric evaluation of a teacher version of the Ontario child health study emotional behavioural scales (OCHS-EBS-T) for measuring selected DSM-5 disorders in elementary school-aged children. Psychiatry Res 2022; 312:114574. [PMID: 35533590 DOI: 10.1016/j.psychres.2022.114574] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 04/20/2022] [Accepted: 04/21/2022] [Indexed: 11/23/2022]
Abstract
This paper describes the development and psychometric properties of a teacher version of the Ontario Child Health Study Emotional Behavioural Scales (OCHS-EBS-T) for dimensional measurement of six psychiatric disorders in elementary school-aged children based on DSM-5 criteria. Psychometric evaluation of the item and scale properties was conducted in a large, general population study of elementary teacher assessments of 3,072 children aged 4 to 13 years in 2,354 families in Ontario, Canada. Content validity, internal construct validity and internal consistency reliability of the six disorder subscales were assessed. Structural equation modelling was used to assess measurement invariance, internal and external convergent and discriminant validity. Confirmatory factor analyses confirmed unidimensionality of subscales and adequate item-fit to all scales. Measurement equivalence was demonstrated fully for four subscales and partially for two. Internal consistency reliability for all subscales exceeded 0.78, except for the conduct disorder scale in 12- to 13-year-olds. Evidence of internal convergent validity was demonstrated in all cases. Discriminant validity was demonstrated in 27 out of 30 correlation comparisons. External convergent and discriminant validity was demonstrated when comparing the OCHS-EBS-T to a parent/caregiver measure of disorders in 48 out of 60 correlation comparisons. All subscales independently predicted child mental health-related service contact.
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Turner BJ, Robillard CL, Ames ME, Craig SG. Prevalence and Correlates of Suicidal Ideation and Deliberate Self-harm in Canadian Adolescents During the Coronavirus Disease 2019 Pandemic. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2022; 67:403-406. [PMID: 34378420 PMCID: PMC9065494 DOI: 10.1177/07067437211036612] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE In light of recent evidence that the coronavirus disease 2019 (COVID-19) pandemic has resulted in marked increases in depression, anxiety, substance use, and other mental health concerns among Canadian adolescents, we investigated the rates of self-harm thoughts and behaviours in this population. Specifically, this study explored: (1) the demographic and geographic distributions of suicidal ideation (SI) and deliberate self-harm (DSH), and (2) the associations of mental health and substance use with SI and DSH. METHOD A total of 809 Canadian adolescents, aged 12-18 years, completed an online survey between June 17, 2020 and July 31, 2020. RESULTS 44% of adolescents reported experiencing SI since the pandemic began, while 32% reported engaging in DSH. SI and DSH were more common among youth who: identified as transgender, non-binary or gender fluid; who did not reside with both parents; and who reported psychiatric concerns or frequent cannabis use. CONCLUSION Canadian adolescents appear to be experiencing higher rates of self-harm thoughts and behaviours relative to before the COVID-19 pandemic. It is important for adults who are likely to interact with distressed youth to be aware of potential warning signs that a youth is struggling with self-harm, and to refer youth to specialty mental health services where appropriate.
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Affiliation(s)
- Brianna J. Turner
- Department of Psychology, University of Victoria, Victoria, British Columbia
- Brianna J. Turner, PhD, Department of Psychology, University of Victoria, PO Box 1700, STN CSC, Victoria, BC, Canada V8W 2Y2.
| | | | - Megan E. Ames
- Department of Psychology, University of Victoria, Victoria, British Columbia
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21
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Khoury JE, Tanaka M, Kimber M, MacMillan HL, Afifi TO, Boyle M, Duncan L, Joshi D, Georgiades K, Gonzalez A. Examining the unique contributions of parental and youth maltreatment in association with youth mental health problems. CHILD ABUSE & NEGLECT 2022; 124:105451. [PMID: 34991012 DOI: 10.1016/j.chiabu.2021.105451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 12/08/2021] [Accepted: 12/15/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Extensive research seeks to understand the intergenerational impact of child maltreatment. However, it remains unclear how parent's history of child maltreatment (PCM) is associated with child mental health, after accounting for children's experiences of maltreatment and other proximal risk factors. OBJECTIVE This study examines the associations between PCM and youth internalizing and externalizing problems, while accounting for youth experiences of maltreatment (YM), and parent mental health and positive parenting. PARTICIPANTS AND SETTING Youth aged 14 to 17 years (N = 2266) participated in the 2014 Ontario Child Heath Study. METHODS Parents and youth reported their experiences of child maltreatment. Parent-report and self-reports of youth internalizing and externalizing problems were also collected. Number of subtypes of maltreatment and specific subtypes of maltreatment were examined. Parents reported their own mental health problems and positive parenting practices. RESULTS Regarding number of maltreatment subtypes, initially PCM was associated with parent-reported, but not self-reported, youth internalizing and externalizing problems. After accounting for YM, parent mental health problems and positive parenting, only YM remained significant. Regarding specific subtypes of maltreatment, both parent and youth emotional abuse were related to parent- and youth-reported internalizing and externalizing problems, after controlling for other maltreatment subtypes. However, the effects of parent emotional abuse became nonsignificant after accounting for YM and proximal risk factors. CONCLUSIONS Findings indicate: 1) the unique associations between specific PCM and YM subtypes and youth mental health problems; 2) the role of proximal risk factors in explaining the association between PCM and youth mental health; and 3) the importance of multiple informants of youth mental health problems.
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Affiliation(s)
- Jennifer E Khoury
- Department of Psychology, Mount Saint Vincent University, Halifax, NS B3M 2J6, Canada
| | - Masako Tanaka
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8S 4K1, Canada; Offord Centre for Child Studies, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Melissa Kimber
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8S 4K1, Canada; Offord Centre for Child Studies, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Harriet L MacMillan
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8S 4K1, Canada; Offord Centre for Child Studies, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Tracie O Afifi
- University of Manitoba, Department of Community Health Sciences at the University of Manitoba, Winnipeg, MB R3E 0W3, Canada
| | - Michael Boyle
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8S 4K1, Canada; Offord Centre for Child Studies, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Laura Duncan
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8S 4K1, Canada; Offord Centre for Child Studies, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Divya Joshi
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Katholiki Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8S 4K1, Canada; Offord Centre for Child Studies, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Andrea Gonzalez
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8S 4K1, Canada; Offord Centre for Child Studies, McMaster University, Hamilton, ON L8S 4K1, Canada.
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Robillard CL, Turner BJ, Ames ME, Craig SG. Deliberate self-harm in adolescents during COVID-19: The roles of pandemic-related stress, emotion regulation difficulties, and social distancing. Psychiatry Res 2021; 304:114152. [PMID: 34371298 PMCID: PMC8424292 DOI: 10.1016/j.psychres.2021.114152] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 07/29/2021] [Accepted: 07/31/2021] [Indexed: 11/28/2022]
Abstract
The objective of this study was to conduct an ecologically valid test of etiological models of deliberate self-harm (DSH) during the COVID-19 pandemic. Using a sample of Canadian adolescents, we investigated: (1) the association between COVID-19-related stress and DSH; (2) whether emotion regulation (ER) difficulties mediated/moderated this association, including whether these effects differed by age; and (3) whether the mediating/moderating effects of ER difficulties were stronger among socially distanced youth. Canadian adolescents (N = 809) aged 12-18 were recruited on social media and completed an online survey. COVID-19-related stress was associated with recent DSH. Nonacceptance of emotional responses and limited access to ER strategies fully mediated this association. The indirect effect through nonacceptance of emotional responses was stronger among more socially distanced youth, whereas the indirect effect through limited access to ER strategies was stronger among older and more socially distanced youth. COVID-19-related stress and ER difficulties did not interact to predict DSH, nor did age or social distancing moderate these interactions. These results align with etiological models proposing central roles for stress and ER difficulties in DSH. Furthermore, this study underscores a need to support adolescents, particularly older teens with reduced in-person interactions, in adaptively coping with pandemic-related stress.
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Affiliation(s)
- Christina L Robillard
- Department of Psychology, University of Victoria, Victoria, British Columbia, Canada.
| | - Brianna J Turner
- Department of Psychology, University of Victoria, Victoria, British Columbia, Canada
| | - Megan E Ames
- Department of Psychology, University of Victoria, Victoria, British Columbia, Canada
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Craig SG, Robillard CL, Turner BJ, Ames ME. Roles of Family Stress, Maltreatment, and Affect Regulation Difficulties on Adolescent Mental Health During COVID-19. JOURNAL OF FAMILY VIOLENCE 2021; 37:787-799. [PMID: 34539061 PMCID: PMC8440145 DOI: 10.1007/s10896-021-00320-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/07/2021] [Indexed: 05/16/2023]
Abstract
This study examines the indirect effects of affect dysregulation and suppression on the associations between family stress from confinement, maltreatment, and adolescent mental health during COVID-19. We examined both adolescent and caregiver perspectives to yield a more well-rounded understanding of these associations than afforded in previous research. Using both adolescent (N = 809, Mage = 15.66) and caregiver (N = 578) samples, family stress from confinement, exposure to physical and psychological maltreatment, affect dysregulation and suppression, and youth internalizing and externalizing symptoms were measured in the summer of 2020, following three months of stay-at-home orders due to COVID-19. Affect dysregulation partially accounted for the associations between family stress from confinement and psychological maltreatment on both internalizing and externalizing symptoms for youth and caregiver report. Suppression partially accounted for the associations between family stress and maltreatment on internalizing and externalizing symptoms in the youth sample, but only for internalizing symptoms in the caregiver sample. Understanding family predictors of adolescents' mental health concerns and their underlying mechanisms, affect dysregulation and suppression, can inform mental health interventions during and following the COVID-19 pandemic.
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Affiliation(s)
- Stephanie G. Craig
- Department of Psychology, York University, 5021 Dahdaleh Building, 4700 Keele St, Toronto, ON M3J 1P3 Canada
| | | | - Brianna J. Turner
- Department of Psychology, University of Victoria, Victoria, BC Canada
| | - Megan E. Ames
- Department of Psychology, University of Victoria, Victoria, BC Canada
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Halladay J, Horricks L, Amlung M, MacKillop J, Munn C, Nasir Z, Woock R, Georgiades K. The CAMP study: feasibility and clinical correlates of standardized assessments of substance use in a youth psychiatric inpatient sample. Child Adolesc Psychiatry Ment Health 2021; 15:48. [PMID: 34517903 PMCID: PMC8439003 DOI: 10.1186/s13034-021-00403-4] [Citation(s) in RCA: 3] [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: 05/21/2021] [Accepted: 09/03/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND To determine: (a) the feasibility and acceptability of administering a standardized electronic assessment of substance use and other mental health concerns to youth admitted to an inpatient psychiatric unit, and (b) the prevalence and clinical correlates of substance use in this sample. METHODS The sample included 100 youth between the ages of 13 to 17 years admitted to an inpatient psychiatric unit in Ontario, Canada between September and November 2019 (78% response rate). Youth data were comprised of electronic self-reported assessments (during hospitalization and 6-months following) and chart reviews (99% consented; historical and prospective). Frontline staff completed a self-report survey assessing their perceptions of the need for standardized substance use assessments, training, and interventions on the unit (n = 38 Registered Nurses and Child and Youth Workers; 86% response rate). Analyses included descriptive statistics, correlations, regression, and qualitative content analysis. RESULTS Feasibility of standardized youth self-reported mental health and substance use assessments was evident by high response rates, little missing data, and variability in responses. 79% of youth had used at least one substance in their lifetime; 69% reported use in the last 3 months. Substance use was positively correlated with severity of psychiatric symptoms (τb 0.17 to 0.45) and number of psychiatric diagnoses (τb 0.17 to 0.54) at index. Based on prospective and retrospective data, substance use was also positively related to mental health symptom severity at follow-up and repeat mental health related hospital visits. Frontline staff reported a need for standardized assessment, training, and interventions on the unit, indicative of acceptability. CONCLUSIONS This study demonstrated the feasibility, acceptability and clinical importance of administering a standardized mental health and substance use assessment among youth experiencing psychiatric hospitalization.
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Affiliation(s)
- Jillian Halladay
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, ON, L8S 4S4, Hamilton, Canada. .,Child and Youth Mental Health Program, McMaster Children's Hospital, 1200 Main St W, ON, L8N 3Z5, Hamilton, Canada.
| | - Laurie Horricks
- grid.422356.40000 0004 0634 5667Child and Youth Mental Health Program, McMaster Children’s Hospital, 1200 Main St W, ON L8N 3Z5 Hamilton, Canada
| | - Michael Amlung
- grid.266515.30000 0001 2106 0692Department of Applied Behavioral Science, Cofrin Logan Center for Addiction Research and Treatment, Addictions Lab at The University of Kansas, 1000 Sunnyside Avenue, KS 66045 Lawrence, United States ,grid.25073.330000 0004 1936 8227Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - James MacKillop
- grid.25073.330000 0004 1936 8227Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada ,grid.25073.330000 0004 1936 8227Peter Boris Centre for Addictions Research, McMaster University/St. Joseph’s Healthcare Hamilton, 100 West 5th St, ON L8N 3K7 Hamilton, Canada ,grid.25073.330000 0004 1936 8227Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University, Hamilton, Canada
| | - Catharine Munn
- grid.25073.330000 0004 1936 8227Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, ON L8S 4S4 Hamilton, Canada ,grid.25073.330000 0004 1936 8227Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada ,grid.25073.330000 0004 1936 8227Peter Boris Centre for Addictions Research, McMaster University/St. Joseph’s Healthcare Hamilton, 100 West 5th St, ON L8N 3K7 Hamilton, Canada ,grid.25073.330000 0004 1936 8227Resident Affairs, Postgraduate Medical Education (PGME), McMaster University, 1280 Main Street West, ON L8S 4S4 Hamilton, Canada
| | - Zil Nasir
- grid.25073.330000 0004 1936 8227Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, ON L8S 4S4 Hamilton, Canada ,grid.413615.40000 0004 0408 1354Hamilton Health Sciences, 1200 Main St W, ON L8N 3Z5 Hamilton, Canada
| | - Rachel Woock
- grid.413615.40000 0004 0408 1354Hamilton Health Sciences, 1200 Main St W, ON L8N 3Z5 Hamilton, Canada
| | - Katholiki Georgiades
- grid.25073.330000 0004 1936 8227Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, ON L8S 4S4 Hamilton, Canada ,grid.25073.330000 0004 1936 8227Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada ,grid.25073.330000 0004 1936 8227Offord Centre for Child Studies, McMaster University, McMaster Innovation Park, Suite 201A, 1280 Main Street West, ON L8S 4K1 Hamilton, Canada
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Ferro MA, Lipman EL, Van Lieshout RJ, Timmons B, Shanahan L, Gorter JW, Georgiades K, Boyle M. Cohort Profile: Multimorbidity in Children and Youth Across the Life-course (MY LIFE) Study. JOURNAL OF THE CANADIAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY = JOURNAL DE L'ACADEMIE CANADIENNE DE PSYCHIATRIE DE L'ENFANT ET DE L'ADOLESCENT 2021; 30:104-115. [PMID: 33953762 PMCID: PMC8056956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 11/12/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE This manuscript serves to provide an overview of the methods of the Multimorbidity in Children and Youth across the Life-course (MY LIFE) study, profile sample characteristics of the cohort, and provide baseline estimates of multimorbidity to foster collaboration with clinical and research colleagues across Canada. METHOD MY LIFE is comprised of 263 children (2-16 years) with a physical illness recruited from McMaster Children's Hospital, their primary caregiving parent, and their closest-aged sibling. Participants are followed with data collection at recruitment, 6, 12, and 24 months which includes structured interviews, self-reported measures, and biological samples and occur in a private research office or at participants' homes. Post-COVID-19, data collection transitioned to mail and telephone surveys. RESULTS At recruitment, children were 9.4 (4.2) years of age and 52.7% were male. The mean duration of their physical illness was 4.5 (4.1) years; 25% represent incident cases (duration <1 year). Most (69.7%) had healthy body weight and intelligence in the average range (73.5%). Overall, 38.2% of children screened positive for ≥1 mental illness according to parent report (24.8% screened positive based on child self-report). Compared to 2016 Census data, the MY LIFE cohort overrepresents families of higher socioeconomic status. CONCLUSIONS Multimorbidity is common among children and these baseline data will serve to measure relative changes in the mental health of children with physical illness over time. MY LIFE will provide new information for understanding multimorbidity among children, though underrepresentation of lower socioeconomic families may have implications for the generalizability of findings.
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Affiliation(s)
- Mark A Ferro
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario
| | - Ellen L Lipman
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario
| | - Ryan J Van Lieshout
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario
| | - Brian Timmons
- Department of Pediatrics, McMaster University, Hamilton, Ontario
| | - Lilly Shanahan
- Department of Psychology, University of Zurich, Zurich, Switzerland
- Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland
| | | | - Kathy Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario
| | - Michael Boyle
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario
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Examining Associations Between Physical Activity and Academic Performance in a Large Sample of Ontario Students: The Role of Inattention and Hyperactivity. J Phys Act Health 2020; 17:1231-1239. [PMID: 33217724 DOI: 10.1123/jpah.2020-0174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 09/18/2020] [Accepted: 09/21/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Participation in physical activity (PA) is a modifiable factor that contributes to academic success, yet the optimal dose (ie, frequency) and mechanisms underlying the effect require further exploration. METHODS Using data from 19,886 elementary and 11,238 secondary school students across Ontario, Canada, this study examined associations between PA participation frequency, academic achievement, and inattention and hyperactivity. RESULTS Among elementary students, there was a positive association between PA frequency and academic achievement. Participating in 1 to 2 days per week of PA related to higher academic achievement compared with no days, whereas 7 days per week had the largest associations. For secondary students, a minimum of 3 to 4 days per week was associated with higher academic achievement with no significant benefit of additional days. Indirect effects of inattention and hyperactivity were found for both groups, suggesting that the benefits of PA on academic achievement may be partly explained by reductions in inattention and hyperactivity, especially for secondary school students. CONCLUSION Students may experience academic benefits from PA even if they are not meeting the guidelines of exercising daily. These benefits may occur, in part, through reductions in inattention and hyperactivity. Further work is needed to determine the temporality and mechanism of these associations.
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Hesse M, Vallentin-Holbech L, Thomsen KR. Which Youth Are at Risk for Cannabis Use Disorders? Boys and Girls Are Not the Same! J Adolesc Health 2020; 67:7-8. [PMID: 32564808 DOI: 10.1016/j.jadohealth.2020.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 04/08/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Morten Hesse
- Centre for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark
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Girgis J, Pringsheim T, Williams J, Shafiq S, Patten S. Cannabis Use and Internalizing/Externalizing Symptoms in Youth: A Canadian Population-Based Study. J Adolesc Health 2020; 67:26-32. [PMID: 32115324 DOI: 10.1016/j.jadohealth.2020.01.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 11/12/2019] [Accepted: 01/04/2020] [Indexed: 12/25/2022]
Abstract
PURPOSE With the recent legalization of cannabis for nonmedicinal purposes in Canada, it is becoming increasingly important to understand the potential mental health risks that cannabis may present. The objective of this study was to estimate associations between the frequency of cannabis use and the presence of elevated internalizing (e.g., anxiety and depression) and externalizing (e.g., conduct disorder and attention deficit hyperactivity disorder) symptoms within Ontario youth aged 12-17 years. METHODS The 2014 Ontario Child Health Study included Emotional and Behavioural Scales used to assess internalizing and externalizing symptoms. To assess associations between internalizing/externalizing symptoms and cannabis use, the Ontario Child Health Study-Emotional and Behavioural Scales were dichotomized using the upper quintile (those with the most severe symptoms). Logistic regression was used to estimate odds ratios (ORs) to quantify the association between the frequency of cannabis use and the presence of elevated internalizing and externalizing symptoms. Estimates used a recommended procedure (replicate bootstrap weighting) to address design effects. RESULTS A significant association between frequent cannabis use and elevated externalizing symptoms was observed with an OR of 2.17 (1.80-2.62) in males and 5.13 (4.24-6.21) in females. Similar significant associations were also observed between frequent cannabis use and elevated internalizing symptoms with an OR of 2.07 (1.74-2.47) in males and an OR of 3.40 (2.73-4.24) in females. These associations were still present after adjusting for age, binge drinking, smoking, and negative/positive parenting. CONCLUSIONS Cannabis use, especially in females and frequent users, is associated with elevated levels of internalizing and externalizing symptoms.
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Affiliation(s)
- Joseph Girgis
- Faculty of Medicine and Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Tamara Pringsheim
- Department of Clinical Neurosciences and Pediatrics, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada; Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada.
| | - Jeanne Williams
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Samreen Shafiq
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Scott Patten
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada; Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
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Halladay J, Bennett K, Weist M, Boyle M, Manion I, Campo M, Georgiades K. Teacher-student relationships and mental health help seeking behaviors among elementary and secondary students in Ontario Canada. J Sch Psychol 2020; 81:1-10. [PMID: 32711720 DOI: 10.1016/j.jsp.2020.05.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 02/04/2020] [Accepted: 05/29/2020] [Indexed: 12/18/2022]
Abstract
This study examined associations between teacher-student relationship quality at school and teachers' responsiveness to students' emotional concerns in a classroom and (a) students' intention to seek help at school for mental health concerns and (b) mental health-related service use. Data for analyses came from the School Mental Health Survey, a cross-sectional survey of 31,120 grade 6-12 students, in 1968 classrooms, attending 248 schools in Ontario, Canada. Three-level (student, classroom, school) binary logistic regression was used to address the study objectives. Student ratings of the quality of teacher-student relationships and teachers' responsiveness were included as predictors, both at the individual student level and aggregated to represent a contextual level characteristic at the school and classroom level, respectively. At the student level, both teacher-student relationship quality and teacher responsiveness were positively associated with intentions to seek help at school among both elementary and secondary students (ORs ranged from 1.14-1.19 for relationships and 1.06-1.08 for responsiveness). Aggregated to the school level, teacher-student relationship quality was positively associated with mental health service use for secondary students (OR = 1.36, 95% CI [1.10, 1.69]). Positive and responsive teacher-student relationships were associated with help-seeking behaviors among students. Longitudinal studies are warranted to disentangle the temporality of these associations.
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Affiliation(s)
- Jillian Halladay
- Department of Health Research, Methods, Evidence, and Impact at McMaster University, Canada
| | - Kathryn Bennett
- Department of Health Research Methods, Evidence, and Impact and Department of Psychiatry & Behavioral Neurosciences at McMaster University, Offord Centre for Child Studies, Canada
| | - Mark Weist
- Department of Psychology at the University of South Carolina, United States of America
| | - Michael Boyle
- Department of Health Research Methods, Evidence, and Impact and Department of Psychiatry & Behavioral Neurosciences at McMaster University, Offord Centre for Child Studies, Canada
| | - Ian Manion
- Youth Research Unit at The Royal's Institute of Mental Health Research and the School of Psychology at the University of Ottawa, Canada
| | | | - Katholiki Georgiades
- Department of Health Research Methods, Evidence, and Impact and Department of Psychiatry & Behavioral Neurosciences at McMaster University, Offord Centre for Child Studies, Canada.
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Kim S, Martin-Storey A, Drossos A, Barbosa S, Georgiades K. Prevalence and Correlates of Sexting Behaviors in a Provincially Representative Sample of Adolescents. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2020; 65:401-408. [PMID: 31835912 PMCID: PMC7265605 DOI: 10.1177/0706743719895205] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To examine the prevalence and correlates of sending and receiving sexts (i.e., sexually explicit images) in a provincially representative sample of adolescents in Canada. METHODS Data from the 2014 Ontario Child Health Study, a provincial survey of households with children in Ontario, which includes a sample of 2,537 adolescents aged 14 to 17 years (mean age = 15.42, male = 51.6%) were used to address the research objectives. RESULTS The past 12 months prevalence of sending and receiving sexts was 14.4% and 27.0%, respectively. In unadjusted logistic regression analyses, non-White adolescents and those living in low-income households were less likely to send or receive sexts compared to White and non-low-income adolescents. Adolescents who disclosed their sexual and/or gender minority identities were 3 to 4 times more likely to send and receive sexts than youth who had not disclosed these identities. Higher levels of mental health problems generally observed among adolescents who sent or received sexts. In fully adjusted models, low income and ethnic minority status were associated with reduced odds of sending and receiving sexts, while sexual and/or gender minority disclosure status was associated with increased odds. Social anxiety was associated with reduced odds of sending and receiving sexts, while conduct disorder was associated with elevated odds. CONCLUSION The prevalence of sexting behavior was higher among adolescents who disclosed their sexual or gender minority identities. Sexting behaviors were associated with higher levels of mental health problems. Identifying vulnerable populations and the potential mental health ramifications associated with sexting behavior is vital to mitigating negative sequelae.
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Affiliation(s)
- Soyeon Kim
- Offord Centre for Child Studies and Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | | | - Alexander Drossos
- Child and Youth Mental Health Program and Department of Psychiatry and Behavioural Neurosciences, McMaster University, Ron Joyce Children’s Health Centre, Hamilton, Ontario, Canada
| | - Samantha Barbosa
- Offord Centre for Child Studies and Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Katholiki Georgiades
- Offord Centre for Child Studies and Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
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Kornelsen E, Buchan MC, Gonzalez A, Ferro MA. Hair Cortisol Concentration and Mental Disorder in Children With Chronic Physical Illness. ACTA ACUST UNITED AC 2020; 3:2470547019875116. [PMID: 32440601 PMCID: PMC7219865 DOI: 10.1177/2470547019875116] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 08/20/2019] [Indexed: 12/23/2022]
Abstract
Background To examine changes in hair cortisol concentrations (HCC) in children with
chronic physical illness and identify patterns of association between HCC
and mental comorbidity. Methods A sample of 50 children aged 6 to 16 years were recruited within six months
of being diagnosed with a chronic physical illness. Data were collected via
hair samples, structured interviews, and behavioral checklists. Results There was no change in HCC over six months. Baseline HCC was associated with
internalizing—odds ratio (OR) = 1.29 (90% confidence interval (CI):
1.01–1.66)—and externalizing disorders—OR = 1.32 (90% CI: 1.07–1.64).
Externalizing disorder at six months was associated with elevated
baseline—OR = 1.25 (90% CI: 1.02–1.53)—and six-month HCC—OR = 1.25 (90% CI:
1.02–1.54). Associations between HCC and mental disorder weakened over time,
and for internalizing disorders, changed direction (i.e., inverse
association), albeit not significantly. Conclusion Results provide preliminary evidence that physiological stress, measured
using HCC, may be implicated in the relationship between physical and mental
illness, and these associations align with attenuated stress responses over
time.
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Affiliation(s)
- Emily Kornelsen
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - M Claire Buchan
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - Andrea Gonzalez
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Mark A Ferro
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
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Ferro MA, Gonzalez A. Hair cortisol concentration mediates the association between parent and child psychopathology. Psychoneuroendocrinology 2020; 114:104613. [PMID: 32088544 DOI: 10.1016/j.psyneuen.2020.104613] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 02/03/2020] [Accepted: 02/06/2020] [Indexed: 12/25/2022]
Abstract
Parent and child mental health are strongly associated and this association may be transmitted via disruption to the hypothalamic-pituitary-adrenal axis in children. This study examined the potential mediating role of hair cortisol concentration (HCC) in the association between parent psychopathology and child mental disorder. Data come from 100 children diagnosed with a mental disorder [major depression (66 %), generalized anxiety (58 %), attention-deficit hyperactivity (33 %), oppositional defiant (35 %)] and their parents. Parent psychopathology was measured using the Center for Epidemiological Studies Depression Scale and State-Trait Anxiety Inventory. Child mental disorder was measured using the Mini International Neuropsychiatric Interview and hair samples were assayed using high-sensitivity ELISA for cortisol extraction. Sex-specific path models were specified to estimate mediating effects (αβ). Children were, on average, 14.4 (SD 2.3) years of age and 70 % were girls. Adjusting for child age, parent sex, and family income, HCC mediated the association between symptoms of parent psychopathology and major depression and attention-deficit hyperactivity in all children (αβ ranging -0.07 to 0.19; 38-46 % effect mediated). Mediating effects for generalized anxiety and opposition defiant were evident for boys only (αβ ranging -0.26 to 0.14; 31-38 % effect mediated). Evidence suggests HCC partially mediates the association between parent psychopathology and child mental disorder, and for generalized anxiety and oppositional defiant, this effect is specific to boys. Family inventions to reduce child stress may be effective in buffering the consequences of parent psychopathology. Further research that considers sex effects is needed to clarify how HCC conditions risk for mental disorder in children.
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Affiliation(s)
- Mark A Ferro
- School of Public Health and Health Systems, University of Waterloo, Canada.
| | - Andrea Gonzalez
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Canada
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Duncan L, Georgiades K, Reid GJ, Comeau J, Birch S, Wang L, Boyle MH. Area-Level Variation in Children’s Unmet Need for Community-Based Mental Health Services: Findings from the 2014 Ontario Child Health Study. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2020; 47:665-679. [DOI: 10.1007/s10488-020-01016-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Ferro MA, Lipman EL, Van Lieshout RJ, Gorter JW, Shanahan L, Boyle M, Georgiades K, Timmons B. Multimorbidity in Children and Youth Across the Life-course (MY LIFE): protocol of a Canadian prospective study. BMJ Open 2019; 9:e034544. [PMID: 31685517 PMCID: PMC6859408 DOI: 10.1136/bmjopen-2019-034544] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 10/02/2019] [Accepted: 10/03/2019] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Multimorbidity, the co-occurrence of a chronic physical condition and mental disorder, affects a substantial number of children and youth and can lead to compromised quality of life, hardship for families, and an increased burden on the healthcare system. We are conducting a study to document the course of mental disorder in children and youth diagnosed with a chronic physical condition; identify predictors of child and youth multimorbidity; examine whether the effects of these predictors are moderated by relevant psychosocial and biological factors; explore potential inflammatory and stress biomarkers that mediate the onset of child and youth multimorbidity; and, assess whether multimorbidity in children and youth alters patterns of mental health service use. METHODS AND ANALYSIS Multimorbidity in Children and Youth Across the Life-course (MY LIFE) is a prospective study. Two hundred and fifty children and youth aged 2-16 years diagnosed with a chronic physical condition along with one parent will be recruited from the outpatient clinics at a paediatric tertiary care centre. Data will be collected using a multi-informant, multimethod design at four time-points (at recruitment, and at 6, 12 and 24 months postrecruitment). Parents will provide reports for all children/youth. In addition, youth ≥10 years will self-report. Mental disorder will be assessed using structured interviews. On completion of data collection, participant-reported data will be linked to provincial health records to identify mental health services use. Multilevel analyses (survival, proportional hazard, structural equation modelling) will be used to address MY LIFE objectives. ETHICS AND DISSEMINATION This study has been approved by the University of Waterloo Human Research Ethics Board and the Hamilton Integrated Research Ethics Board. Findings will be disseminated to key stakeholders using a number of outlets (peer-reviewed publications and conferences, lay informational pamphlets, social media).
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Affiliation(s)
- Mark A Ferro
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Ellen L Lipman
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Ryan J Van Lieshout
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Jan Willem Gorter
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Lilly Shanahan
- Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Michael Boyle
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Kathy Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Brian Timmons
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
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Reaume SV, Ferro MA. Chronicity of mental comorbidity in children with new-onset physical illness. Child Care Health Dev 2019; 45:559-567. [PMID: 30982997 DOI: 10.1111/cch.12667] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 02/08/2019] [Accepted: 04/09/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Evidence suggests that physical and mental illnesses are strongly correlated in children. This study examined patterns of the chronicity of multimorbidity (co-occurring physical and mental illness); estimated homotypic continuity; and modelled factors associated with chronicity in children newly diagnosed with a chronic physical illness. METHODS Children aged 6-16 years diagnosed with one of asthma, diabetes, epilepsy, food allergy, or juvenile arthritis were recruited from two children's hospitals and followed for 6 months. Child mental illness was measured using the parent-reported Mini International Neuropsychiatric Interview and Ontario Child Health Study Emotional Behavioural Scales at baseline and 6 months later. Children were stratified into three groups: no multimorbidity, acute (multimorbidity at only one assessment), and persistent (multimorbidity at both assessments). RESULTS Forty-nine children were available for analysis: no multimorbidity (n = 18), acute (n = 13), and persistent (n = 18). Homotypic continuity was highest for conduct disorder (67.5%) and lowest for major depression (16.7%). Unadjusted analyses showed positive associations between child and parent behavioural symptoms, as well as family functioning with persistent multimorbidity. These associations remained after adjustment, ranging from odds ratio (OR) = 1.29 [1.01, 1.64] for depression to OR = 1.61 [1.11, 2.33] and OR = 1.61 [1.10, 2.35] for attention-deficit hyperactivity and oppositional defiant, respectively, in child models. In parent models, associations remained for parental anxiety (OR = 1.18 [1.04, 1.34]) and stress (OR = 1.15 [1.02, 1.31]). CONCLUSIONS Multimorbidity is persistent in children newly diagnosed with physical illnesses, regardless of the mental comorbidity experienced. Integrating family-centred mental health services soon after the diagnosis of a physical illness should be prioritized in pediatric settings.
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Affiliation(s)
- Shannon V Reaume
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Mark A Ferro
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
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Mediterranean Diet Adherence is Associated with Lower Prevalence of Functional Gastrointestinal Disorders in Children and Adolescents. Nutrients 2019; 11:nu11061283. [PMID: 31174310 PMCID: PMC6628326 DOI: 10.3390/nu11061283] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 05/29/2019] [Accepted: 06/04/2019] [Indexed: 12/12/2022] Open
Abstract
Dietary patterns may have a role in the prevention of functional gastrointestinal disorders (FGIDs). The current study aimed at examining the association between FGIDs and adherence to the Mediterranean diet (MD) among elementary school children (ESC), as well as high school students (HSS). In a prospective cohort study, data from 1116 subjects (387 ESC and 448 HSS) aged 6–18 years were collected. FGID identification was based on the Questionnaire on Pediatric Gastrointestinal Symptoms-Rome III (QPGS-RIII). Adherence to the MD was assessed using the KIDMED Index. Full data were available on 835/1116 questionnaires. Based on Rome III criteria, 184/835 participants (22%) were identified with FGID (122 (66%) with functional constipation (FC)). The prevalence of FGIDs (p = 0.001) was significantly higher in HSS (13–18 years). The KIDMED score in the cohort was 5.7 ± 2.5. Subjects with FGIDs demonstrated a lower KIDMED score compared to the non-FGID group, both in the cohort, as well as in the ESC and HSS subgroups (FGID vs. non-FGID: p = 0.001, p = 0.007, and p = 0.032, respectively). Multivariate analysis highlighted the KIDMED score as a significant predictor of FGIDs and FC after controlling for the age subgroups. We conclude that good adherence to the MD is associated to lower prevalence of FGIDs, while adolescents display a significantly higher prevalence of FGIDs compared to children.
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Boyle MH, Duncan L, Georgiades K, Wang L, Comeau J, Ferro MA, Van Lieshout RJ, Szatmari P, MacMillan HL, Bennett K, Janus M, Lipman EL, Kata A. The 2014 Ontario Child Health Study Emotional Behavioural Scales (OCHS-EBS) Part II: Psychometric Adequacy for Categorical Measurement of Selected DSM-5 Disorders. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2019; 64:434-442. [PMID: 30376363 PMCID: PMC6591756 DOI: 10.1177/0706743718808251] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVES To compare the reliability and convergent validity of parent assessments from the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID-a structured diagnostic interview) and the Ontario Child Health Study Emotional Behavioural Scales (OCHS-EBS) symptom checklist for classifying conduct disorder (CD), conduct disorder or oppositional defiant disorder (CD-ODD), attention-deficit hyperactivity disorder (ADHD), major depressive disorder (MDD), generalized anxiety disorder (GAD), and separation anxiety disorder (SAD) based on DSM-5 criteria. METHODS Data came from 283 parent-youth dyads aged 9 to 18 years. Parents and youth completed the assessments separately on 2 different occasions 7 to 14 days apart. After converting the OCHS-EBS scale scores to binary disorder classifications, we compare test-retest reliability estimates and use structural equation modelling (SEM) to compare estimates of convergent validity for the same disorders assessed by each instrument. RESULTS Average test-retest reliabilities based on κ were 0.71 (MINI-KID) and 0.67 (OCHS-EBS). The average β coefficients for 3 latent measures comprising the following indicators-parent perceptions of youth mental health need and impairment, diagnosis of specific disorders based on health professional communications and youth taking prescribed medication, and youth classifications of disorder based on the MINI-KID-were 0.67 (MINI-KID) and 0.69 (OCHS-EBS). CONCLUSION The OCHS-EBS and MINI-KID achieve comparable levels of reliability and convergent validity for classifying child psychiatric disorder. The flexibility, low cost, and minimal respondent burden of checklists for classifying disorder make them well suited for studying disorder in the general population and screening in clinical settings.
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Affiliation(s)
- Michael H Boyle
- 1 Offord Centre for Child Studies, McMaster University, Hamilton, Ontario.,2 Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario
| | - Laura Duncan
- 1 Offord Centre for Child Studies, McMaster University, Hamilton, Ontario.,2 Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario.,3 Department of Health Research Methods, Evidence and Impact (formerly Clinical Epidemiology and Biostatistics), McMaster University, Hamilton, Ontario
| | - Katholiki Georgiades
- 1 Offord Centre for Child Studies, McMaster University, Hamilton, Ontario.,2 Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario
| | - Li Wang
- 1 Offord Centre for Child Studies, McMaster University, Hamilton, Ontario.,2 Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario.,3 Department of Health Research Methods, Evidence and Impact (formerly Clinical Epidemiology and Biostatistics), McMaster University, Hamilton, Ontario
| | - Jinette Comeau
- 4 Department of Sociology, King's University College at Western University, London, Ontario
| | - Mark A Ferro
- 5 School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario
| | - Ryan J Van Lieshout
- 1 Offord Centre for Child Studies, McMaster University, Hamilton, Ontario.,2 Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario
| | - Peter Szatmari
- 1 Offord Centre for Child Studies, McMaster University, Hamilton, Ontario.,6 Department of Psychiatry, Centre for Addiction and Mental Health, Hospital for Sick Children, University of Toronto, Toronto, Ontario
| | - Harriet L MacMillan
- 1 Offord Centre for Child Studies, McMaster University, Hamilton, Ontario.,2 Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario.,7 Department of Paediatrics, McMaster University, Hamilton, Ontario
| | - Kathryn Bennett
- 1 Offord Centre for Child Studies, McMaster University, Hamilton, Ontario.,3 Department of Health Research Methods, Evidence and Impact (formerly Clinical Epidemiology and Biostatistics), McMaster University, Hamilton, Ontario
| | - Magdalena Janus
- 1 Offord Centre for Child Studies, McMaster University, Hamilton, Ontario.,2 Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario
| | - Ellen L Lipman
- 1 Offord Centre for Child Studies, McMaster University, Hamilton, Ontario.,2 Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario
| | - Anna Kata
- 1 Offord Centre for Child Studies, McMaster University, Hamilton, Ontario.,2 Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario
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Boyle MH, Duncan L, Georgiades K, Comeau J, Reid GJ, O’Briain W, Lampard R, Waddell C. Tracking Children's Mental Health in the 21st Century: Lessons from the 2014 OCHS. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2019; 64:232-236. [PMID: 30978140 PMCID: PMC6463360 DOI: 10.1177/0706743719830025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Affiliation(s)
- Michael H. Boyle
- Offord Centre for Child Studies & Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario
| | - Laura Duncan
- Offord Centre for Child Studies & Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada
| | - Katholiki Georgiades
- Offord Centre for Child Studies & Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario
| | - Jinette Comeau
- Department of Sociology, King’s University College at Western University, London, Ontario, Canada
- Children’s Health Research Institute, Children’s Health and Therapeutics, Western University, London, Ontario, Canada
| | - Graham J. Reid
- Children’s Health Research Institute, Children’s Health and Therapeutics, Western University, London, Ontario, Canada
- Departments of Psychology, Family Medicine, and Paediatrics, Western University, London, Ontario, Canada
| | - Warren O’Briain
- British Columbia Centre on Substance Use, Vancouver, British Columbia, Canada
| | - Robert Lampard
- Child and Youth Mental Health Policy Branch, British Columbia Ministry of Children and Family Development, Victoria, British Columbia, Canada
| | - Charlotte Waddell
- Children’s Health Policy Centre Faculty of Health Sciences Simon Fraser University, Vancouver, British Columbia, Canada
| | - 2014 Ontario Child Health Study Team
- (in alphabetical order) Tracie O. Afifi (University of Manitoba), William R. Avison (Western University), Kathryn Bennett (McMaster University), Terry Bennett (McMaster University), Khrista Boylan (McMaster University), Michael H. Boyle (McMaster University), Michelle Butt (McMaster University), John Cairney (University of Toronto), Corine Carlisle (University of Toronto), Kristin Cleverley (Centre for Addiction and Mental Health, University of Toronto), Ian Colman (University of Ottawa), Jinette Comeau (King’s University College at Western University), Charles Cunningham (McMaster University), Scott Davies (University of Toronto), Claire de Oliveira (Centre for Addiction and Mental Health, University of Toronto), Melanie Dirks (McGill University), Eric Duku (McMaster University), Laura Duncan (McMaster University), Jim Dunn (McMaster University), Mark A. Ferro (University of Waterloo), Katholiki Georgiades (McMaster University), Stelios Georgiades (McMaster University), Andrea Gonzalez (McMaster University), Geoffrey Hall (McMaster University), Joanna Henderson (Centre for Addiction and Mental Health, University of Toronto), Magdalena Janus (McMaster University), Jennifer Jenkins (University of Toronto), Melissa Kimber (McMaster University), Ellen Lipman (McMaster University), Harriet MacMillan (McMaster University), Ian Manion (Royal’s Institute of Mental Health Research), John McLennan (University of Ottawa), Amelie Petitclerc (Northwestern University), Anne Rhodes (University of Toronto), Graham Reid (Western University), Peter Rosenbaum (McMaster University), Roberto Sassi (McMaster University), Louis Schmidt (McMaster University), Cody Shepherd (Simon Fraser University), Noam Soreni (McMaster University), Peter Szatmari (Centre for Addiction and Mental Health, Hospital for Sick Children, University of Toronto), Brian Timmons (McMaster University), Juliana Tobon (McMaster University), Ryan Van Lieshout (McMaster University), Charlotte Waddell (Simon Fraser University), Li Wang (McMaster University), Christine Wekerle (McMaster University)
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Boyle MH, Georgiades K, Duncan L, Comeau J, Wang L. The 2014 Ontario Child Health Study-Methodology. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2019; 64:237-245. [PMID: 30978137 PMCID: PMC6463362 DOI: 10.1177/0706743719833675] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To describe the methodology of the 2014 Ontario Child Health Study (OCHS): a province-wide, cross-sectional, epidemiologic study of child health and mental disorder among 4- to 17-year-olds living in household dwellings. METHOD Implemented by Statistics Canada, the 2014 OCHS was led by academic researchers at the Offord Centre for Child Studies (McMaster University). Eligible households included families with children aged 4 to 17 years, who were listed on the 2014 Canadian Child Tax Benefit File. The survey design included area and household stratification by income and 3-stage cluster sampling of areas and households to yield a probability sample of families. RESULTS The 2014 OCHS included 6,537 responding households (50.8%) with 10,802 children aged 4 to 17 years. Lower income families living in low-income neighbourhoods were less likely to participate. In addition to measures of childhood mental disorder assessed by the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID) and OCHS Emotional Behavioural Scales (OCHS-EBS), the survey contains measures of neighbourhoods, schools, families and children, and includes administrative data held by the Ministries of Education and Health and Long-Term Care. CONCLUSIONS The complex survey design and differential non-response of the 2014 OCHS required the use of sampling weights and adjustment for design effects. The study is available throughout Canada in the Statistics Canada Research Data Centres (RDCs). We urge external investigators to access the study through the RDCs or to contact us directly to collaborate on future secondary analysis studies based on the OCHS.
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Affiliation(s)
- Michael H Boyle
- 1 Offord Centre for Child Studies & Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario
| | - Katholiki Georgiades
- 1 Offord Centre for Child Studies & Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario
| | - Laura Duncan
- 1 Offord Centre for Child Studies & Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario.,2 Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada
| | - Jinette Comeau
- 3 Department of Sociology, King's University College at Western University, London, Ontario.,4 Children's Health Research Institute, Children's Health and Therapeutics, Western University, London, Ontario, Canada
| | - Li Wang
- 1 Offord Centre for Child Studies & Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario.,2 Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada
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- 5 (in alphabetical order) Tracie O. Afifi (University of Manitoba), William R. Avison (Western University), Kathryn Bennett (McMaster University), Terry Bennett (McMaster University), Khrista Boylan (McMaster University), Michael H. Boyle (McMaster University), Michelle Butt (McMaster University), John Cairney (University of Toronto), Corine Carlisle (University of Toronto), Kristin Cleverley (Centre for Addiction and Mental Health, University of Toronto), Ian Colman (University of Ottawa), Jinette Comeau (King's University College at Western University), Charles Cunningham (McMaster University), Scott Davies (University of Toronto), Claire de Oliveira (Centre for Addiction and Mental Health, University of Toronto), Melanie Dirks (McGill University), Eric Duku (McMaster University), Laura Duncan (McMaster University), Jim Dunn (McMaster University), Mark A. Ferro (University of Waterloo), Katholiki Georgiades (McMaster University), Stelios Georgiades (McMaster University), Andrea Gonzalez (McMaster University), Geoffrey Hall (McMaster University), Joanna Henderson (Centre for Addiction and Mental Health, University of Toronto), Magdalena Janus (McMaster University), Jennifer Jenkins (University of Toronto), Melissa Kimber (McMaster University), Ellen Lipman (McMaster University), Harriet MacMillan (McMaster University), Ian Manion (Royal's Institute of Mental Health Research), John McLennan (University of Ottawa), Amelie Petitclerc (Northwestern University), Anne Rhodes (University of Toronto), Graham Reid (Western University), Peter Rosenbaum (McMaster University), Roberto Sassi (McMaster University), Louis Schmidt (McMaster University), Cody Shepherd (Simon Fraser University), Noam Soreni (McMaster University), Peter Szatmari (Centre for Addiction and Mental Health, Hospital for Sick Children, University of Toronto), Brian Timmons (McMaster University), Juliana Tobon (McMaster University), Ryan Van Lieshout (McMaster University), Charlotte Waddell (Simon Fraser University), Li Wang (McMaster University), Christine Wekerle (McMaster University)
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Duncan L, Georgiades K, Birch S, Comeau J, Wang L, Boyle MH. Children's Mental Health Need and Expenditures in Ontario: Findings from the 2014 Ontario Child Health Study. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2019; 64:275-284. [PMID: 30978141 PMCID: PMC6463359 DOI: 10.1177/0706743719830036] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To estimate the alignment between the Ontario Ministry of Children and Youth Services (MCYS) expenditures for children's mental health services and population need, and to quantify the value of adjusting for need in addition to population size in formula-based expenditure allocations. Two need definitions are used: "assessed need," as the presence of a mental disorder, and "perceived need," as the subjective perception of a mental health problem. METHODS Children's mental health need and service contact estimates (from the 2014 Ontario Child Health Study), expenditure data (from government administrative data), and population counts (from the 2011 Canadian Census) were combined to generate formula-based expenditure allocations based on 1) population size and 2) need (population size adjusted for levels of need). Allocations were compared at the service area and region level and for the 2 need definitions (assessed and perceived). RESULTS Comparisons were made for 13 of 33 MCYS service areas and all 5 regions. The percentage of MCYS expenditure reallocation needed to achieve an allocation based on assessed need was 25.5% at the service area level and 25.6% at the region level. Based on perceived need, these amounts were 19.4% and 27.2%, respectively. The value of needs-adjustment ranged from 8.0% to 22.7% of total expenditures, depending on the definition of need. CONCLUSION Making needs adjustments to population counts using population estimates of children's mental health need (assessed or perceived) provides additional value for informing and evaluating allocation decisions. This study provides much-needed and current information about the match between expenditures and children's mental health need.
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Affiliation(s)
- Laura Duncan
- Offord Centre for Child Studies & Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada
| | - Katholiki Georgiades
- Offord Centre for Child Studies & Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario
| | - Stephen Birch
- Department of Economics, McMaster University, Hamilton Ontario, Canada
| | - Jinette Comeau
- Department of Sociology, King’s University College at Western University, London, Ontario, Canada
- Children’s Health and Therapeutics, Children’s Health Research Institute, Western University, London, Ontario, Canada
| | - Li Wang
- Offord Centre for Child Studies & Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada
| | - Michael H. Boyle
- Offord Centre for Child Studies & Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario
| | - 2014 Ontario Child Health Study Team
- (in alphabetical order) Tracie O. Afifi (University of Manitoba), William R. Avison (Western University), Kathryn Bennett (McMaster University), Terry Bennett (McMaster University), Khrista Boylan (McMaster University), Michael H. Boyle (McMaster University), Michelle Butt (McMaster University), John Cairney (University of Toronto), Corine Carlisle (University of Toronto), Kristin Cleverley (Centre for Addiction and Mental Health, University of Toronto), Ian Colman (University of Ottawa), Jinette Comeau (King’s University College at Western University), Charles Cunningham (McMaster University), Scott Davies (University of Toronto), Claire de Oliveira (Centre for Addiction and Mental Health, University of Toronto), Melanie Dirks (McGill University), Eric Duku (McMaster University), Laura Duncan (McMaster University), Jim Dunn (McMaster University), Mark A. Ferro (University of Waterloo), Katholiki Georgiades (McMaster University), Stelios Georgiades (McMaster University), Andrea Gonzalez (McMaster University), Geoffrey Hall (McMaster University), Joanna Henderson (Centre for Addiction and Mental Health, University of Toronto), Magdalena Janus (McMaster University), Jennifer Jenkins (University of Toronto), Melissa Kimber (McMaster University), Ellen Lipman (McMaster University), Harriet MacMillan (McMaster University), Ian Manion (Royal’s Institute of Mental Health Research), John McLennan (University of Ottawa), Amelie Petitclerc (Northwestern University), Anne Rhodes (University of Toronto), Graham Reid (Western University), Peter Rosenbaum (McMaster University), Roberto Sassi (McMaster University), Louis Schmidt (McMaster University), Cody Shepherd (Simon Fraser University), Noam Soreni (McMaster University), Peter Szatmari (Centre for Addiction and Mental Health, Hospital for Sick Children, University of Toronto), Brian Timmons (McMaster University), Juliana Tobon (McMaster University), Ryan Van Lieshout (McMaster University), Charlotte Waddell (Simon Fraser University), Li Wang (McMaster University), Christine Wekerle (McMaster University)
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Comeau J, Georgiades K, Duncan L, Wang L, Boyle MH. Changes in the Prevalence of Child and Youth Mental Disorders and Perceived Need for Professional Help between 1983 and 2014: Evidence from the Ontario Child Health Study. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2019; 64:256-264. [PMID: 30978139 PMCID: PMC6463358 DOI: 10.1177/0706743719830035] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To examine: 1) changes in the prevalence of mental disorders and perceived need for professional help among children (ages 4 to 11) and youth (ages 12 to 16) between 1983 and 2014 in Ontario and 2) whether these changes vary by age and sex, urban-rural residency, poverty, lone-parent status, and immigrant background. METHODS The 1983 ( n = 2836) and 2014 ( n = 5785) Ontario Child Health Studies are provincially representative cross-sectional surveys with identical self-report checklist measures of conduct disorder, hyperactivity, and emotional disorder, as well as perceived need for professional help, assessed by integrating parent and teacher responses (ages 4 to 11) and parent and youth responses (ages 12 to 16). RESULTS The overall prevalence of perceived need for professional help increased from 6.8% to 18.9% among 4- to 16-year-olds. An increase in any disorder among children (15.4% to 19.6%) was attributable to increases in hyperactivity among males (8.9% to 15.7%). Although the prevalence of any disorder did not change among youth, conduct disorder decreased (7.2% to 2.5%) while emotional disorder increased (9.2% to 13.2%). The prevalence of any disorder increased more in rural and small to medium urban areas versus large urban areas. The prevalence of any disorder decreased for children and youth in immigrant but not nonimmigrant families. CONCLUSIONS Although there have been decreases in the prevalence of conduct disorder, increases in other mental disorders and perceived need for professional help underscore the continued need for effective prevention and intervention programs.
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Affiliation(s)
- Jinette Comeau
- Department of Sociology, King’s University College at Western University, London, Ontario
- Children’s Health Research Institute, Children’s Health and Therapeutics, Western University, London, Ontario
| | - Katholiki Georgiades
- Offord Centre for Child Studies & Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario
| | - Laura Duncan
- Offord Centre for Child Studies & Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario
| | - Li Wang
- Offord Centre for Child Studies & Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario
| | - Michael H. Boyle
- Offord Centre for Child Studies & Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario
| | - 2014 Ontario Child Health Study Team
- (In alphabetical order) Tracie O. Afifi (University of Manitoba), William R. Avison (Western University), Kathryn Bennett (McMaster University), Terry Bennett (McMaster University), Khrista Boylan (McMaster University), Michael H. Boyle (McMaster University), Michelle Butt (McMaster University), John Cairney (University of Toronto), Corine Carlisle (University of Toronto), Kristin Cleverley (Centre for Addiction and Mental Health, University of Toronto), Ian Colman (University of Ottawa), Jinette Comeau (King’s University College at Western University), Charles Cunningham (McMaster University), Scott Davies (University of Toronto), Claire de Oliveira (Centre for Addiction and Mental Health, University of Toronto), Melanie Dirks (McGill University), Eric Duku (McMaster University), Laura Duncan (McMaster University), Jim Dunn (McMaster University), Mark A. Ferro (University of Waterloo), Katholiki Georgiades (McMaster University), Stelios Georgiades (McMaster University), Andrea Gonzalez (McMaster University), Geoffrey Hall (McMaster University), Joanna Henderson (Centre for Addiction and Mental Health, University of Toronto), Magdalena Janus (McMaster University), Jennifer Jenkins (University of Toronto), Melissa Kimber (McMaster University), Ellen Lipman (McMaster University), Harriet MacMillan (McMaster University), Ian Manion (Royal’s Institute of Mental Health Research), John McLennan (University of Ottawa), Amelie Petitclerc (Northwestern University), Anne Rhodes (University of Toronto), Graham Reid (Western University), Peter Rosenbaum (McMaster University), Roberto Sassi (McMaster University), Louis Schmidt (McMaster University), Cody Shepherd (Simon Fraser University), Noam Soreni (McMaster University), Peter Szatmari (Centre for Addiction and Mental Health, Hospital for Sick Children, University of Toronto), Brian Timmons (McMaster University), Juliana Tobon (McMaster University), Ryan Van Lieshout (McMaster University), Charlotte Waddell (Simon Fraser University), Li Wang (McMaster University), and Christine Wekerle (McMaster University)
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Boyle MH, Georgiades K, Duncan L, Wang L, Comeau J. Poverty, Neighbourhood Antisocial Behaviour, and Children's Mental Health Problems: Findings from the 2014 Ontario Child Health Study. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2019; 64:285-293. [PMID: 30978142 PMCID: PMC6463363 DOI: 10.1177/0706743719830027] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To determine if levels of neighbourhood poverty and neighbourhood antisocial behaviour modify associations between household poverty and child and youth mental health problems. METHODS Data come from the 2014 Ontario Child Health Study-a provincially representative survey of 6537 families with 10,802 four- to 17-year-olds. Multivariate multilevel modelling was used to test if neighbourhood poverty and antisocial behaviour interact with household poverty to modify associations with children's externalizing and internalizing problems based on parent assessments of children (4- to 17-year-olds) and self-assessments of youth (12- to 17-year-olds). RESULTS Based on parent assessments, neighbourhood poverty, and antisocial behaviour modified associations between household poverty and children's mental health problems. Among children living in households below the poverty line, levels of mental health problems were 1) lower when living in neighbourhoods with higher concentrations of poverty and 2) higher when living in neighbourhoods with more antisocial behaviour. These associations were stronger for externalizing versus internalizing problems when conditional on antisocial behaviour and generalized only to youth-assessed externalizing problems. CONCLUSION The lower levels of externalizing problems reported among children living in poor households in low-income neighbourhoods identify potential challenges with integrating poorer households into more affluent neighbourhoods. More important, children living in poor households located in neighbourhoods exhibiting more antisocial behaviour are at dramatically higher risk for mental health problems. Reducing levels of neighbourhood antisocial behaviour could have large mental health benefits, particularly among poor children.
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Affiliation(s)
- Michael H. Boyle
- Offord Centre for Child Studies & Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario
| | - Katholiki Georgiades
- Offord Centre for Child Studies & Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario
| | - Laura Duncan
- Offord Centre for Child Studies & Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario
| | - Li Wang
- Offord Centre for Child Studies & Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario
| | - Jinette Comeau
- Department of Sociology, King’s University College at Western University, London, Ontario
- Children’s Health and Therapeutics, Children’s Health Research Institute, Western University, London, Ontario
| | - 2014 Ontario Child Health Study Team
- (In alphabetical order) Tracie O. Afifi (University of Manitoba), William R. Avison (Western University), Kathryn Bennett (McMaster University), Terry Bennett (McMaster University), Khrista Boylan (McMaster University), Michael H. Boyle (McMaster University), Michelle Butt (McMaster University), John Cairney (University of Toronto), Corine Carlisle (University of Toronto), Kristin Cleverley (Centre for Addiction and Mental Health, University of Toronto), Ian Colman (University of Ottawa), Jinette Comeau (King’s University College at Western University), Charles Cunningham (McMaster University), Scott Davies (University of Toronto), Claire de Oliveira (Centre for Addiction and Mental Health, University of Toronto), Melanie Dirks (McGill University), Eric Duku (McMaster University), Laura Duncan (McMaster University), Jim Dunn (McMaster University), Mark A. Ferro (University of Waterloo), Katholiki Georgiades (McMaster University), Stelios Georgiades (McMaster University), Andrea Gonzalez (McMaster University), Geoffrey Hall (McMaster University), Joanna Henderson (Centre for Addiction and Mental Health, University of Toronto), Magdalena Janus (McMaster University), Jennifer Jenkins (University of Toronto), Melissa Kimber (McMaster University), Ellen Lipman (McMaster University), Harriet MacMillan (McMaster University), Ian Manion (Royal’s Institute of Mental Health Research), John McLennan (University of Ottawa), Amelie Petitclerc (Northwestern University), Anne Rhodes (University of Toronto), Graham Reid (Western University), Peter Rosenbaum (McMaster University), Roberto Sassi (McMaster University), Louis Schmidt (McMaster University), Cody Shepherd (Simon Fraser University), Noam Soreni (McMaster University), Peter Szatmari (Centre for Addiction and Mental Health, Hospital for Sick Children, University of Toronto), Brian Timmons (McMaster University), Juliana Tobon (McMaster University), Ryan Van Lieshout (McMaster University), Charlotte Waddell (Simon Fraser University), Li Wang (McMaster University), Christine Wekerle (McMaster University)
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Georgiades K, Boylan K, Duncan L, Wang L, Colman I, Rhodes AE, Bennett K, Comeau J, Manion I, Boyle MH. Prevalence and Correlates of Youth Suicidal Ideation and Attempts: Evidence from the 2014 Ontario Child Health Study. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2019; 64:265-274. [PMID: 30978144 PMCID: PMC6463356 DOI: 10.1177/0706743719830031] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To present the 12-month prevalence and correlates of suicidal ideation and attempts in a sample of youth in Ontario. METHODS Data come from the 2014 Ontario Child Health Study, a provincially representative survey of families with children in Ontario. Youth aged 14 to 17 y ( n = 2,396) completed a computer-assisted, self-administered questionnaire in their home to assess the occurrence of suicidal ideation, suicidal attempts, and associated correlates, including non-suicidal self-injury, mental disorders, substance use, peer victimization and exposure to child maltreatment. Socio-demographic information was collected from the parent. Logistic regression models were used to identify correlates that distinguished between youth reporting: 1) no suicidal ideation or attempts, 2) suicidal ideation but no attempts, and 3) suicidal ideation and attempts. RESULTS The 12-month prevalence of suicidal ideation and attempts was 8.1% and 4.3%, respectively. All clinical and behavioural correlates were significantly higher among youth reporting suicidal ideation or attempts, as compared with non-suicidal youth. In adjusted models, depression and non-suicidal self-injury were each independently associated with elevated odds of suicidal ideation (OR = 4.84 and 4.19, respectively) and suicidal attempt (OR = 7.84 and 22.72, respectively). Among youth who reported suicidal ideation, the only variable that differentiated youth who attempted suicide v. those who did not, in adjusted models, was non-suicidal self-injury (OR = 3.89). CONCLUSIONS Suicidal ideation and attempts are common among youth in Ontario, often co-occurring with mental disorders and high-risk behaviours. These findings underscore the need for effective prevention and intervention strategies, particularly for youth depression and non-suicidal self-injury.
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Affiliation(s)
- Katholiki Georgiades
- Offord Centre for Child Studies & Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Khrista Boylan
- Offord Centre for Child Studies & Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Laura Duncan
- Offord Centre for Child Studies & Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence & Impact (Formerly Department of Clinical Epidemiology and Biostatistics), McMaster University, Hamilton, Ontario, Canada
| | - Li Wang
- Offord Centre for Child Studies & Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence & Impact (Formerly Department of Clinical Epidemiology and Biostatistics), McMaster University, Hamilton, Ontario, Canada
| | - Ian Colman
- School of Epidemiology & Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Anne E. Rhodes
- Offord Centre for Child Studies & Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Kathryn Bennett
- Offord Centre for Child Studies & Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence & Impact (Formerly Department of Clinical Epidemiology and Biostatistics), McMaster University, Hamilton, Ontario, Canada
| | - Jinette Comeau
- Department of Sociology, King’s University College at Western University, London, Ontario, Canada
- Children’s Health Research Institute, Children’s Health and Therapeutics, Western University, London, Ontario, Canada
| | - Ian Manion
- The Royal’s Institute of Mental Health Research, Ottawa, Ontario, Canada
| | - Michael H. Boyle
- Offord Centre for Child Studies & Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - 2014 Ontario Child Health Study Team
- (in alphabetical order) Tracie O. Afifi (University of Manitoba), William R. Avison (Western University), Kathryn Bennett (McMaster University), Terry Bennett (McMaster University), Khrista Boylan (McMaster University), Michael H. Boyle (McMaster University), Michelle Butt (McMaster University), John Cairney (University of Toronto), Corine Carlisle (University of Toronto), Kristin Cleverley (Centre for Addiction and Mental Health, University of Toronto), Ian Colman (University of Ottawa), Jinette Comeau (King’s University College at Western University), Charles Cunningham (McMaster University), Scott Davies (University of Toronto), Claire de Oliveira (Centre for Addiction and Mental Health, University of Toronto), Melanie Dirks (McGill University), Eric Duku (McMaster University), Laura Duncan (McMaster University), Jim Dunn (McMaster University), Mark A. Ferro (University of Waterloo), Katholiki Georgiades (McMaster University), Stelios Georgiades (McMaster University), Andrea Gonzalez (McMaster University), Geoffrey Hall (McMaster University), Joanna Henderson (Centre for Addiction and Mental Health, University of Toronto), Magdalena Janus (McMaster University), Jennifer Jenkins (University of Toronto), Melissa Kimber (McMaster University), Ellen Lipman (McMaster University), Harriet MacMillan (McMaster University), Ian Manion (Royal’s Institute of Mental Health Research), John McLennan (University of Ottawa), Amelie Petitclerc (Northwestern University), Anne Rhodes (University of Toronto), Graham Reid (Western University), Peter Rosenbaum (McMaster University), Roberto Sassi (McMaster University), Louis Schmidt (McMaster University), Cody Shepherd (Simon Fraser University), Noam Soreni (McMaster University), Peter Szatmari (Centre for Addiction and Mental Health, Hospital for Sick Children, University of Toronto), Brian Timmons (McMaster University), Juliana Tobon (McMaster University), Ryan Van Lieshout (McMaster University), Charlotte Waddell (Simon Fraser University), Li Wang (McMaster University), Christine Wekerle (McMaster University)
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