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Szabó B, Sharp C, Futó J, Boda M, Losonczy L, Miklósi M. The reflective function questionnaire for youth: Hungarian adaptation and evaluation of associations with quality of life and psychopathology. Clin Child Psychol Psychiatry 2024; 29:1497-1511. [PMID: 38724475 DOI: 10.1177/13591045241252205] [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] [Indexed: 10/14/2024]
Abstract
An important correlate of mental health problems is mentalizing capacity, which appears to be particularly influential during adolescence. However, quality of life has not been studied in relation to mentalizing capacity among adolescents. This study aimed to translate the Reflective Function Questionnaire for Youth (RFQY) into Hungarian, present its psychometric properties, and assess its relationship with demographic characteristics, psychopathology and quality of life. A community sample of 384 youths aged 12-18 years completed the RFQY, the Measure of Quality of Life for Children and Adolescents, and the Strengths and Difficulties Questionnaire. First, we conducted an exploratory factor analysis with direct oblimin rotation on the RFQY items. Next, we assessed the associations between the RFQY and demographics, quality of life, and psychopathology. The EFA resulted in four factors: Internal-self, Internal-other, Self-other, and Strong emotions. The Cronbach's alpha coefficients of the scales were .81, .82, .67, and .80, respectively. The subscales were uniquely associated with psychopathology and quality of life. Our study provides the first psychometric support for the Hungarian version of the RFQY and indicates that adolescents suffering from internalizing, externalizing symptoms or lower levels of quality of life could benefit from interventions aimed at enhancing mentalizing capacity.
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Affiliation(s)
- Brigitta Szabó
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Department of Developmental and Clinical Child Psychology, Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Department of Clinical Psychology, Semmelweis University Faculty of Medicine, Budapest, Hungary
| | - Carla Sharp
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Judit Futó
- Department of Developmental and Clinical Child Psychology, Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Márton Boda
- Child Psychiatric Outpatient Clinic, Fejér County Szent György University Teaching Hospital, Székesfehérvár, Hungary
| | - Laura Losonczy
- Department of Developmental and Clinical Child Psychology, Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Mónika Miklósi
- Department of Developmental and Clinical Child Psychology, Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Department of Clinical Psychology, Semmelweis University Faculty of Medicine, Budapest, Hungary
- Centre of Mental Health, Heim Pál Children's Hospital, Budapest, Hungary
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Lemmer D, Moessner M, Arnaud N, Baumeister H, Mutter A, Klemm SL, König E, Plener P, Rummel-Kluge C, Thomasius R, Kaess M, Bauer S. The Impact of Video-Based Microinterventions on Attitudes Toward Mental Health and Help Seeking in Youth: Web-Based Randomized Controlled Trial. J Med Internet Res 2024; 26:e54478. [PMID: 38656779 PMCID: PMC11079770 DOI: 10.2196/54478] [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: 11/13/2023] [Revised: 12/22/2023] [Accepted: 03/08/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Mental health (MH) problems in youth are prevalent, burdening, and frequently persistent. Despite the existence of effective treatment, the uptake of professional help is low, particularly due to attitudinal barriers. OBJECTIVE This study evaluated the effectiveness and acceptability of 2 video-based microinterventions aimed at reducing barriers to MH treatment and increasing the likelihood of seeking professional help in young people. METHODS This study was entirely web based and open access. The interventions addressed 5 MH problems: generalized anxiety disorder, depression, bulimia, nonsuicidal self-injury, and problematic alcohol use. Intervention 1 aimed to destigmatize and improve MH literacy, whereas intervention 2 aimed to induce positive outcome expectancies regarding professional help seeking. Of the 2435 participants who commenced the study, a final sample of 1394 (57.25%) participants aged 14 to 29 years with complete data and sufficient durations of stay on the video pages were randomized in a fully automated manner to 1 of the 5 MH problems and 1 of 3 conditions (control, intervention 1, and intervention 2) in a permuted block design. After the presentation of a video vignette, no further videos were shown to the control group, whereas a second, short intervention video was presented to the intervention 1 and 2 groups. Intervention effects on self-reported potential professional help seeking (primary outcome), stigma, and attitudes toward help seeking were examined using analyses of covariance across and within the 5 MH problems. Furthermore, we assessed video acceptability. RESULTS No significant group effects on potential professional help seeking were found in the total sample (F2,1385=0.99; P=.37). However, the groups differed significantly with regard to stigma outcomes and the likelihood of seeking informal help (F2,1385=3.75; P=.02). Furthermore, separate analyses indicated substantial differences in intervention effects among the 5 MH problems. CONCLUSIONS Interventions to promote help seeking for MH problems may require disorder-specific approaches. The study results can inform future research and public health campaigns addressing adolescents and young adults. TRIAL REGISTRATION German Clinical Trials Register DRKS00023110; https://drks.de/search/de/trial/DRKS00023110.
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Affiliation(s)
- Diana Lemmer
- Center for Psychotherapy Research, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
- Ruprecht-Karls University Heidelberg, Heidelberg, Germany
| | - Markus Moessner
- Center for Psychotherapy Research, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Nicolas Arnaud
- German Centre for Addiction Research in Childhood and Adolescence, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany
| | - Agnes Mutter
- Department of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany
| | - Sarah-Lena Klemm
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Elisa König
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm, Ulm, Germany
| | - Paul Plener
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm, Ulm, Germany
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Christine Rummel-Kluge
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Rainer Thomasius
- German Centre for Addiction Research in Childhood and Adolescence, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Clinic of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Stephanie Bauer
- Center for Psychotherapy Research, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
- Ruprecht-Karls University Heidelberg, Heidelberg, Germany
- German Center for Mental Health (DZPG), Partner site Mannheim/Heidelberg/Ulm, Heidelberg, Germany
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Lostelius PV, Gustavsson C, Adolfsson ET, Söderlund A, Revenäs Å, Zakrisson AB, Mattebo M. Identification of health-related problems in youth: a mixed methods feasibility study evaluating the Youth Health Report System. BMC Med Inform Decis Mak 2024; 24:64. [PMID: 38443898 PMCID: PMC10913260 DOI: 10.1186/s12911-024-02465-8] [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] [Received: 06/14/2023] [Accepted: 02/21/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Because poor health in youth risk affecting their entry in adulthood, improved methods for their early identification are needed. Health and welfare technology is widely accepted by youth populations, presenting a potential method for identifying their health problems. However, healthcare technology must be evidence-based. Specifically, feasibility studies contribute valuable information prior to more complex effects-based research. The current study assessed the process, resource, management, and scientific feasibility of the Youth Health Report System prototype, developed within a youth health clinic context in advance of an intervention study. METHODS This mixed-methods feasibility study was conducted in a clinical setting. The process, resource, management, and scientific feasibility of the Youth Health Report System were investigated, as recommended in the literature. Participants were youth aged 16-23 years old, attending a youth health clinic, and healthcare professionals from three clinics. The youth participants used their smart phones to respond to Youth Health Report System health questions and healthcare professionals used their computer to access the results and for registration system entries. Qualitative data were collected from interviews with healthcare professionals, which were described with thematic analysis. Youth participants' quantitative Youth Health Report System data were analyzed for descriptive statistics. RESULTS Feasibility analysis of qualitative data from interviews with 11 healthcare professionals resulted in three themes: We expected it could be hard; Information and routines helped but time was an issue; and The electronic case report form was valuable in the health assessment. Qualitative data were collected from the Youth Health Report System. A total of 54 youth participants completed the evaluation questionnaire, and healthcare professionals retrieved information from, and made post-appointment system entries. Quantitative results revealed few missing items and acceptable data variability. An assessment template of merged qualitative and quantitative data guided a consensus discussion among the researchers, resulting in acceptable feasibility. CONCLUSIONS The process-, resource-, management-, and scientific feasibility aspects were acceptable, with some modifications, strengthening the potential for a successful Youth Health Report System intervention study.
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Affiliation(s)
- Petra V Lostelius
- Centre for Innovation, Research and Education, Region Västmanland, Västmanland Hospital Västerås, Västerås, Sweden.
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.
- Clinic for Pain Rehabilitation Västmanland, Region Västmanland, Västerås, Sweden.
- Centre for Clinical Research, Region Västmanland- Uppsala University, Västerås, Sweden.
| | - Catharina Gustavsson
- Centre for Clinical Research Dalarna, Uppsala University, Falun, Sweden
- School of Health and Welfare, Dalarna University, Falun, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Eva Thors Adolfsson
- Centre for Clinical Research, Region Västmanland- Uppsala University, Västerås, Sweden
| | - Anne Söderlund
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - Åsa Revenäs
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
- Centre for Clinical Research, Region Västmanland- Uppsala University, Västerås, Sweden
- Orthopedic Clinic, Västerås Hospital Region Västmanland, Västerås, Sweden
| | - Ann-Britt Zakrisson
- University Health Care Research Center, Faculty of Medicine, and Health, Örebro University, Örebro, Sweden
| | - Magdalena Mattebo
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
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Hammud G, Avital-Magen A, Schusheim G, Barzuza I, Engel-Yeger B. How Self-Regulation and Executive Functions Deficits Affect Quality of Life of Children/Adolescents with Emotional Regulation Disorders. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1622. [PMID: 37892283 PMCID: PMC10605933 DOI: 10.3390/children10101622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 09/23/2023] [Accepted: 09/25/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Deficits in self-regulation and executive functions (EFs) frequently characterize children/adolescents with emotional regulation disorders and restrict their daily function and quality of life (QOL). These deficits are mainly manifested by neuropsychological measures in laboratory settings. This study aimed to compare self-regulation and EFs by ecological measures to reflect the implications in daily life between children with emotional regulation disorders and healthy controls and examine the relations between self-regulation, EFs and QOL in the study group. METHODS the participants were 49 children aged 8-18: 25 children/adolescents with emotional regulation disorders and 24 healthy children. The parents completed a socio-demographic questionnaire, the Child Behavior Checklist (CBCL), the Behavior Rating Inventory of Executive Functions (BRIEF) and the Pediatric Quality of Life Inventory (Peds-QL). RESULTS The study group had greater self-regulation difficulties (internalization and externalization problems), executive dysfunctions (EFdys) (including metacognition difficulties) and a lower QOL. Their internalization and externalization problems correlated with reduced EFs and QOL. Internalization predicted the physical and emotional QOLs, while metacognition predicted social and school-related QOLs. CONCLUSIONS Deficits in self-regulation and EFs are prevalent in children/adolescents with emotional disorders and restrict their daily function and QOL. Therefore, they should be routinely evaluated by ecological instruments to reflect daily restrictions.
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Affiliation(s)
- Ginan Hammud
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa 3498838, Israel;
| | - Ayelet Avital-Magen
- Child and Adolescent Mental Health Clinic, Haemeq Medical Center, Afula 1834111, Israel
| | - Guy Schusheim
- Child and Adolescent Mental Health Clinic, Haemeq Medical Center, Afula 1834111, Israel
| | - Inbar Barzuza
- Child and Adolescent Mental Health Clinic, Haemeq Medical Center, Afula 1834111, Israel
| | - Batya Engel-Yeger
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa 3498838, Israel;
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Baldiotti ALP, Amaral-Freitas G, Barbosa MCF, Moreira PR, Machado RA, Coletta RD, Meger MN, Paiva SM, Scariot R, Ferreira FDM. Associations between Anxiety, Depression, Chronic Pain and Oral Health-Related Quality of Life, Happiness, and Polymorphisms in Adolescents' Genes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3321. [PMID: 36834016 PMCID: PMC9967116 DOI: 10.3390/ijerph20043321] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 02/09/2023] [Indexed: 06/18/2023]
Abstract
Adolescence is marked by changes and vulnerability to the emergence of psychological problems. This study aimed to investigate associations between anxiety/depression/chronic pain and oral health-related quality of life (OHRQoL)/happiness/polymorphisms in the COMT, HTR2A and FKBP5 genes in Brazilian adolescents. A cross-sectional study was conducted with ninety adolescents 13 to 18 years. Anxiety, depression and chronic pain were evaluated using the RDC/TMD. The Oral Health Impact Profile was used to assess oral OHRQoL. The Subjective Happiness Scale was used to assess happiness. Single-nucleotide polymorphisms in COMT (rs165656, rs174675), HTR2A (rs6313, rs4941573) and FKBP5 (rs1360780, rs3800373) were genotyped using the Taqman® method. Bivariate and multivariate logistic regression analyses were performed (p < 0.05). Chronic pain and depression were associated with feelings of happiness (p < 0.05). A significant inverse association was found between anxiety and OHRQoL (p = 0.004). The presence of minor allele C of COMT rs174675 was significantly associated with depression (p = 0.040). Brazilian adolescents with depression and chronic pain considers themselves to be less happy than others and those with anxiety are more likely to have a negative impact on OHRQoL. Moreover, the rs174675 variant allele in the COMT gene was associated with depressive symptoms in Brazilian adolescents.
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Affiliation(s)
- Ana Luiza Peres Baldiotti
- Department of Pediatric Dentistry, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Gabrielle Amaral-Freitas
- Department of Pediatric Dentistry, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | | | - Paula Rocha Moreira
- Department of Morphology, Institute of Biological Sciences (ICB), Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Renato Assis Machado
- Department of Oral Diagnosis and Graduate Program in Oral Biology, School of Dentistry, University of Campinas, Piracicaba 13414-903, SP, Brazil
| | - Ricardo Della Coletta
- Department of Oral Diagnosis and Graduate Program in Oral Biology, School of Dentistry, University of Campinas, Piracicaba 13414-903, SP, Brazil
| | | | - Saul Martins Paiva
- Department of Pediatric Dentistry, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Rafaela Scariot
- Departament of Oral Surgery and Maxilofacial, Federal University of Paraná, Curitiba 81530-000, PR, Brazil
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Thapa Bajgain K, Amarbayan M, Wittevrongel K, McCabe E, Naqvi SF, Tang K, Aghajafari F, Zwicker JD, Santana M. Patient-reported outcome measures used to improve youth mental health services: a systematic review. J Patient Rep Outcomes 2023; 7:14. [PMID: 36788182 PMCID: PMC9928989 DOI: 10.1186/s41687-023-00556-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 01/31/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND Patient-reported outcome measures (PROMs) are standardized and validated self-administered questionnaires that assess whether healthcare interventions and practices improve patients' health and quality of life. PROMs are commonly implemented in children and youth mental health services, as they increasingly emphasize patient-centered care. The objective of this study was to identify and describe the PROMs that are currently in use with children and youth living with mental health conditions (MHCs). METHODS Three databases (MEDLINE, EMBASE, and PsycINFO) were systematically searched that used PROMs with children and youth < 18 years of age living with at least one diagnosed MHC. All methods were noted according to Preferred Reporting Items for Systematic reviews and Meta-Analysis. Four independent reviewers extracted data, which included study characteristics (country, year), setting, the type of MHC under investigation, how the PROMs were used, type of respondent, number of items, domain descriptors, and the psychometric properties. RESULTS Of the 5004 articles returned by the electronic search, 34 full-texts were included in this review. This review identified both generic and disease-specific PROMs, and of the 28 measures identified, 13 were generic, two were generic preference-based, and 13 were disease-specific. CONCLUSION This review shows there is a diverse array of PROMs used in children and youth living with MHCs. Integrating PROMs into the routine clinical care of youth living with MHCs could improve the mental health of youth. Further research on how relevant these PROMs are children and youth with mental health conditions will help establish more uniformity in the use of PROMs for this population.
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Affiliation(s)
- Kalpana Thapa Bajgain
- grid.22072.350000 0004 1936 7697Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB Canada
| | - Mungunzul Amarbayan
- grid.22072.350000 0004 1936 7697School of Public Policy, University of Calgary, Calgary, AB Canada
| | - Krystle Wittevrongel
- grid.22072.350000 0004 1936 7697School of Public Policy, University of Calgary, Calgary, AB Canada
| | - Erin McCabe
- grid.22072.350000 0004 1936 7697School of Public Policy, University of Calgary, Calgary, AB Canada ,grid.22072.350000 0004 1936 7697Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB Canada
| | - Syeda Farwa Naqvi
- grid.22072.350000 0004 1936 7697Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB Canada
| | - Karen Tang
- grid.22072.350000 0004 1936 7697Department of Medicine and Community Health Sciences, University of Calgary, Calgary, AB Canada
| | - Fariba Aghajafari
- grid.22072.350000 0004 1936 7697Department of Medicine and Community Health Sciences, University of Calgary, Calgary, AB Canada
| | - Jennifer D. Zwicker
- grid.22072.350000 0004 1936 7697School of Public Policy, University of Calgary, Calgary, AB Canada ,grid.22072.350000 0004 1936 7697Faculty of Kinesiology, University of Calgary, Calgary, AB Canada
| | - Maria Santana
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. .,Alberta Children's Hospital, 2888 Shaganappi Trail NW, Calgary, Canada.
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Roos LE, Kaminski L, Stienwandt S, Hunter S, Giuliano R, Mota N, Katz LY, Zalewski M. The Building Regulation in Dual-Generations Program (BRIDGE): A Mixed-Methods Feasibility Pilot of a Parenting Program for Depressed Mothers of Preschoolers, Matched with Dialectical Behavior Therapy Skills. Child Psychiatry Hum Dev 2023; 54:34-50. [PMID: 34347227 PMCID: PMC8335713 DOI: 10.1007/s10578-021-01219-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/16/2021] [Indexed: 01/27/2023]
Abstract
Early exposure to maternal depression is a key risk factor for child mental illness (MI), but there are limited programs that interrupt intergenerational transmission. The BRIDGE "Building Regulation in Dual Generations" Program treats maternal MI using Dialectical Behavior Therapy Skills with a paired curriculum that promotes non-reactive and emotionally validating parenting designed to improve child mental health and ultimately prevent MI. The pilot feasibility trial (n = 28 dyads) included mothers and their preschool-aged children. The 20-week program was completed in a group-based format using mixed methods questionnaires and interviews. Results indicate high feasibility and acceptability (86% retention). Consistent improvements were seen across program targets and outcomes including maternal depression (d = 1.02) and child mental health (d = 1.08), with clinically significant symptom reductions for 85% of clients. Mothers with higher adversity exhibited greater reductions in parenting stress. Qualitative results highlighted efficacy in promoting positive parent-child relationships, rewarding parenting experiences, competence, and child development. Evidence suggests high feasibility and accessibility for BRIDGE in addressing intergenerational mental health needs. There was strong satisfaction with the program material and efficacy across key outcomes. BRIDGE holds promise for offering a transdiagnostic approach to preventing child MI in families of at-risk preschool aged children.
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Affiliation(s)
- Leslie E Roos
- Department of Psychology, University of Manitoba, 190 Dysart Road, Winnipeg, MB, R3T 2N2, Canada.
- Department of Pediatrics, University of Manitoba, Winnipeg, MB, Canada.
| | - Lauren Kaminski
- Department of Psychology, University of Manitoba, 190 Dysart Road, Winnipeg, MB, R3T 2N2, Canada
| | - Shaelyn Stienwandt
- Department of Psychology, University of Manitoba, 190 Dysart Road, Winnipeg, MB, R3T 2N2, Canada
| | - Sandra Hunter
- Department of Psychology, University of Manitoba, 190 Dysart Road, Winnipeg, MB, R3T 2N2, Canada
| | - Ryan Giuliano
- Department of Psychology, University of Manitoba, 190 Dysart Road, Winnipeg, MB, R3T 2N2, Canada
| | - Natalie Mota
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Laurence Y Katz
- Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
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Wood BJ, Ellis F. Universal Mental Health Screening Practices in Midwestern Schools: A Window of Opportunity for School Psychologist Leadership and Role Expansion? CONTEMPORARY SCHOOL PSYCHOLOGY 2022:1-11. [PMID: 36217533 PMCID: PMC9534464 DOI: 10.1007/s40688-022-00430-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 09/22/2022] [Indexed: 11/20/2022]
Abstract
The conducting of universal mental health screening is one widely endorsed practice suitable for use within P-12 school settings to more proactively identify children and young people experiencing or displaying characteristics of a mental health disorder. Absent routine screening, many school-age youth with mental health concerns, especially those of an internalizing nature, may go unidentified and left without timely treatment, support, and services. The current study, which employed survey methodology with principal respondents from four Midwestern states, primarily sought to contribute to and update the literature on the universal mental health screening practice habits of P-12 schools. Most principal respondents reported that their school does not currently conduct universal mental health screening and cited barriers (e.g., money, time, lack of support system in place) to screening commonly documented in prior studies. Many principals reported at least a moderate degree of interest in their school beginning to conduct universal screening in their buildings; however, a similar majority reported little to no knowledge about this important practice. Fortunately, principal respondents were generally interested in and receptive to support from their school psychologist in exploring and eventually implementing the conducting of universal mental health screening in their building. Implications for practice and future research, along with the potential for school psychologist leadership and role expansion, are discussed.
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Affiliation(s)
- Brandon J. Wood
- School of Intervention and Wellness, University of Toledo, 2801 W. Bancroft St, Toledo, OH 43606 USA
| | - Faith Ellis
- School of Intervention and Wellness, University of Toledo, 2801 W. Bancroft St, Toledo, OH 43606 USA
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Heterogeneity of quality of life in young people attending primary mental health services. Epidemiol Psychiatr Sci 2022; 31:e55. [PMID: 35856272 PMCID: PMC9305730 DOI: 10.1017/s2045796022000427] [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] [Indexed: 11/16/2022] Open
Abstract
AIMS The utility of quality of life (QoL) as an outcome measure in youth-specific primary mental health care settings has yet to be determined. We aimed to determine: (i) whether heterogeneity on individual items of a QoL measure could be used to identify distinct groups of help-seeking young people; and (ii) the validity of these groups based on having clinically meaningful differences in demographic and clinical characteristics. METHODS Young people, at their first presentation to one of five primary mental health services, completed a range of questionnaires, including the Assessment of Quality of Life-6 dimensions adolescent version (AQoL-6D). Latent class analysis (LCA) and multivariate multinomial logistic regression were used to define classes based on AQoL-6D and determine demographic and clinical characteristics associated with class membership. RESULTS 1107 young people (12-25 years) participated. Four groups were identified: (i) no-to-mild impairment in QoL; (ii) moderate impairment across dimensions but especially mental health and coping; (iii) moderate impairment across dimensions but especially on the pain dimension; and (iv) poor QoL across all dimensions along with a greater likelihood of complex and severe clinical presentations. Differences between groups were observed with respect to demographic and clinical features. CONCLUSIONS Adding multi-attribute utility instruments such as the AQoL-6D to routine data collection in mental health services might generate insights into the care needs of young people beyond reducing psychological distress and promoting symptom recovery. In young people with impairments across all QoL dimensions, the need for a holistic and personalised approach to treatment and recovery is heightened.
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Effect of antidepressants on functioning and quality of life outcomes in children and adolescents with major depressive disorder: a systematic review and meta-analysis. Transl Psychiatry 2022; 12:183. [PMID: 35508443 PMCID: PMC9068747 DOI: 10.1038/s41398-022-01951-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 04/17/2022] [Accepted: 04/21/2022] [Indexed: 01/21/2023] Open
Abstract
Functioning and quality of life (QOL) are typical outcomes assessed in children and adolescents with major depressive disorder (MDD); however, meta-analytical evidence remains scarce. The aim of this meta-analysis was to assess functioning and QOL antidepressant outcomes in this population. Eight electronic databases (PubMed, Cochrane Library, Web of Science, Embase, CINAHL, PsycINFO, LILACS, and ProQuest Dissertation Abstracts) were searched for double-blind randomized controlled trials (RCTs) up to July 31, 2020. RCTs that compared antidepressants with placebo for treating functioning and QOL in children and adolescents with MDD were included. Primary outcomes were mean change scores of functioning and QOL scales from baseline to post-treatment. Subgroup and sensitivity analyses were conducted to examine whether results were affected by moderator variables (e.g., medication type, age, sample size, and treatment duration). From 7284 publications, we included 17 RCTs (all 17 assessed functioning and 4 assessed QOL outcomes) including 2537 participants. Antidepressants showed significant positive effects on functioning (standardized mean difference [SMD] = 0.17, 95% confidence interval [CI] = 0.09-0.25, p < 0.0001) but not on QOL (SMD = 0.11, 95% CI = -0.02 to 0.24, p = 0.093), with no significant heterogeneity. The subgroup analysis showed that second-generation antidepressants (especially fluoxetine, escitalopram, and nefazodone), but not first-generation antidepressants, led to significant improvements in functioning. Antidepressants (especially second generation) improve functioning but not QOL in children and adolescents with MDD. However, well-designed clinical studies using large samples are needed to confirm these findings.
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O'Loughlin R, Hiscock H, Pan T, Devlin N, Dalziel K. The relationship between physical and mental health multimorbidity and children's health-related quality of life. Qual Life Res 2022; 31:2119-2131. [PMID: 35094215 PMCID: PMC9188523 DOI: 10.1007/s11136-022-03095-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2022] [Indexed: 12/04/2022]
Abstract
Purpose To examine the relationships between physical health problems, and borderline or clinical levels of mental health symptoms and children’s health-related quality of life (HRQoL). Methods Data were from the Longitudinal Study of Australian Children (2004–2018). Parents reported on their child’s HRQoL (PedsQL), physical health problems and mental health symptoms (Strengths and Difficulties Questionnaire, SDQ). A pooled cross-sectional analysis using linear regressions examined the relationships between physical health and clinical/borderline mental health symptoms, individually and when multi-morbid, and children’s HRQoL, and whether these relationships vary by a range of child, family and social factors. Results The sample comprised 47,567 observations of children aged 4–17 years. Borderline and clinical levels of mental health symptoms were associated with significantly lower HRQoL, equal to more than two-times (10.5 points) and more than three-times (16.8 points) the clinically meaningful difference, respectively. This was a larger difference than that associated with physical health problems (4.4 points). We found a significant interaction effect between physical health problems and clinical mental health symptoms which was associated with even poorer HRQoL after accounting for the individual relationships of both problems. Mental health problems were associated with poorer HRQoL for older versus younger children; and the interaction effect was significant for boys but not girls. Conclusion Findings highlight the importance of identifying and addressing mental health symptoms in children of all ages, even if these problems do not meet formal clinical criteria. Particular attention should be paid to the mental health and HRQoL of children with physical–mental multimorbidity, who are at risk of disproportionately poorer HRQoL. Supplementary Information The online version contains supplementary material available at 10.1007/s11136-022-03095-1. Ongoing physical and mental health problems are common in children and adolescents and, often, children can experience both problems together. Mental and physical health problems can have wide impacts for the child, including their health-related quality of life (HRQoL), which is a measure of the way the child’s health impacts their emotional, social and physical functioning during their day-to-day life. Our study shows that children with high levels of mental health symptoms have much poorer HRQoL than their peers, and we provide new evidence that even milder mental health symptoms are associated with poorer HRQoL than in children with physical health problems. When children have both physical and mental health problems, they are at even greater risk of poorer HRQoL than would be expected. Based on our findings, we recommend that clinicians should monitor and address mental health symptoms in children as young as 4–7 years old, even if these symptoms are milder, and particular attention should be given to children with physical and mental health problems, who are at greater risk of poor HRQoL.
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Affiliation(s)
- Rachel O'Loughlin
- Health Economics Unit, Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, 3010, Australia.
| | - Harriet Hiscock
- Department of Paediatrics, Melbourne Medical School, University of Melbourne, Melbourne, VIC, 3010, Australia
- Health Services Research Unit, The Royal Children's Hospital, Parkville, VIC, 3052, Australia
- Health Services, Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia
| | - Tianxin Pan
- Health Economics Unit, Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Nancy Devlin
- Health Economics Unit, Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Kim Dalziel
- Health Economics Unit, Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, 3010, Australia
- Health Services Research Unit, The Royal Children's Hospital, Parkville, VIC, 3052, Australia
- Health Services, Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia
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12
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Gyori D, Farkas BF, Horvath LO, Komaromy D, Meszaros G, Szentivanyi D, Balazs J. The Association of Nonsuicidal Self-Injury with Quality of Life and Mental Disorders in Clinical Adolescents-A Network Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1840. [PMID: 33672808 PMCID: PMC7918829 DOI: 10.3390/ijerph18041840] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 02/08/2021] [Accepted: 02/10/2021] [Indexed: 11/17/2022]
Abstract
Although earlier research has highlighted that psychiatric disorders significantly impair patients' quality of life (QoL), few studies have examined the relationship between nonsuicidal self-injury (NSSI) and QoL. Our aim was to investigate whether QoL mediates the mental disorder-NSSI relationship, and to study the QoL ratings agreement of self and parents in a clinical population of adolescents. We involved 202 adolescents from Vadaskert Child Psychiatric Hospital and Outpatient Clinic, Budapest, aged 13-18 years. All participants completed the Deliberate Self-Harm Inventory, Inventar zur Erfassung der Lebensqualität bei Kindern und Jugendlichen, and the Mini International Neuropsychiatric Interview Kid. To map the interrelationship between the NSSI, mental disorders, and QoL dimensions, Mixed Graphical Models were estimated. Adolescents with a history of NSSI rated their QoL to be significantly lower than adolescents without NSSI. Self and parents' QoL ratings are closer in the NSSI sample than in the no-NSSI sample. Among all QoL dimensions, only family problems had a direct significant association with NSSI engagement. Our results highlight that, contrary to our hypothesis, the presence of mental disorders mediates the relationship between most QoL dimensions and the occurrence of NSSI. Our results draw attention to the potential causal effect of environmental factors (e.g., peer problems) on mental disorders that, in turn, result in NSSI. The present paper highlights the importance of network modelling in clinical research.
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Affiliation(s)
- Dora Gyori
- Doctoral School of Psychology, Eotvos Lorand University, 1075 Budapest, Hungary; (L.O.H.); (D.S.)
- Institute of Psychology, Eotvos Lorand University, 1075 Budapest, Hungary; (D.K.); (J.B.)
| | - Bernadett Frida Farkas
- Mental Health Sciences Doctoral School, Semmelweis University, 1083 Budapest, Hungary; (B.F.F.); (G.M.)
| | - Lili Olga Horvath
- Doctoral School of Psychology, Eotvos Lorand University, 1075 Budapest, Hungary; (L.O.H.); (D.S.)
- Institute of Psychology, Eotvos Lorand University, 1075 Budapest, Hungary; (D.K.); (J.B.)
| | - Daniel Komaromy
- Institute of Psychology, Eotvos Lorand University, 1075 Budapest, Hungary; (D.K.); (J.B.)
- Faculty of Social and Behavioural Sciences, University of Amsterdam, 1018 WV Amsterdam, The Netherlands
- Department of Behavioural and Movement Sciences, Vrije Universiteit, 1081 HV Amsterdam, The Netherlands
| | - Gergely Meszaros
- Mental Health Sciences Doctoral School, Semmelweis University, 1083 Budapest, Hungary; (B.F.F.); (G.M.)
- Faculty of Medicine, Department of Psychiatry and Psychotherapy, Semmelweis University, 1083 Budapest, Hungary
| | - Dora Szentivanyi
- Doctoral School of Psychology, Eotvos Lorand University, 1075 Budapest, Hungary; (L.O.H.); (D.S.)
- Institute of Psychology, Eotvos Lorand University, 1075 Budapest, Hungary; (D.K.); (J.B.)
- Pedagogical Assistance Services, 1067 Budapest, Hungary
| | - Judit Balazs
- Institute of Psychology, Eotvos Lorand University, 1075 Budapest, Hungary; (D.K.); (J.B.)
- Department of Psychology, Bjørknes University College, 0456 Oslo, Norway
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13
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Celebre A, Stewart SL, Theall L, Lapshina N. An Examination of Correlates of Quality of Life in Children and Youth With Mental Health Issues. Front Psychiatry 2021; 12:709516. [PMID: 34539463 PMCID: PMC8440870 DOI: 10.3389/fpsyt.2021.709516] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 08/10/2021] [Indexed: 11/13/2022] Open
Abstract
Quality of life (QoL) is significantly lower in children with mental health issues compared to those who are typically developing or have physical health problems. However, little research has examined factors associated with QoL in this particularly vulnerable population. To address this limitation, 347 clinically referred children and adolescents were assessed using the interRAI Child and Youth Mental Health (ChYMH) Assessment and Self-reported Quality of Life- Child and Youth Mental Health (QoL-ChYMH). Hierarchical multiple linear regression analyses were conducted to examine QoL at the domain-specific level. Children and adolescents who experienced heightened anhedonia and depressive symptoms reported lower social QoL (e.g., family, friends and activities; p = 0.024, 0.046, respectively). Additionally, children and youth who experienced heightened depressive symptoms reported lower QoL at the individual level (e.g., autonomy, health; p = 0.000), and level of basic needs (e.g., food, safety; p = 0.013). In contrast, no mental state indicators were associated with QoL related to services (e.g., school, treatment). Due to the paucity of research examining predictors of QoL in children and youth with mental health challenges, this study contributes to the field in assisting service providers with care planning and further providing implications for practice.
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Affiliation(s)
- Angela Celebre
- Faculty of Education, Western University, London, ON, Canada
| | | | - Laura Theall
- Child and Parent Resource Institute, London, ON, Canada
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14
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Abstract
Health-related quality of life (HRQOL) is central to how clinicians and parents make choices about medical care for pediatric neurology patients. To provide parents with the information they need to make these decisions and plan for the future, it is necessary for parents and clinicians to understand how HRQOL is defined and measured in the setting of pediatric neurodevelopmental impairment. We review challenges that exist in measuring HRQOL in pediatric neurology, examine existing measures, and outline key principles to guide selection and interpretation of HRQOL measures in children with neurologic conditions.
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Affiliation(s)
- Monica E. Lemmon
- Department of Pediatrics, Duke University Medical Center, Durham, NC,Department of Neurology, The Johns Hopkins Hospital, Baltimore, MD,Margolis Center for Health Policy, Duke University, Durham, NC
| | | | - Bryce B. Reeve
- Department of Pediatrics, Duke University Medical Center, Durham, NC,Department of Population Health Sciences, Duke University School of Medicine, Durham, NC,Center for Health Measurement, Duke University School of Medicine, Durham, NC
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15
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Tamplain P, Miller HL. What Can We Do to Promote Mental Health Among Individuals With Developmental Coordination Disorder? CURRENT DEVELOPMENTAL DISORDERS REPORTS 2020; 8:24-31. [PMID: 34306965 DOI: 10.1007/s40474-020-00209-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Purpose of the Review It is well-documented that individuals with DCD experience mental health problems, in both psychosocial and psychiatric domains. In this review, we propose a series of diverse options to improve mental health among individuals with DCD. Recent Findings Despite recognition of mental health problems in DCD, relatively little work has been done to develop effective interventions. There is an urgent need for action in this matter. We present and discuss options based on a societal perspective (awareness and understanding), parental perspective (access to services and resources), and child perspective (participation). Summary In order to improve mental health, interventions must take into account multiple levels in a complex framework that includes community, family, and the individual. While more research on intervention effectiveness is necessary, researchers, practitioners, and community advocates can use existing initiatives as a starting point to address the urgent need for improving mental health in DCD.
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Affiliation(s)
- Priscila Tamplain
- Department of Kinesiology, University of Texas at Arlington, 500 W Nedderman Dr, Arlington, TX 76019, USA
| | - Haylie L Miller
- Department of Physical Therapy, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX 76109, USA
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16
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Gil-Lacruz M, Gil-Lacruz AI, Gracia-Pérez ML. Health-related quality of life in young people: the importance of education. Health Qual Life Outcomes 2020; 18:187. [PMID: 32546249 PMCID: PMC7298764 DOI: 10.1186/s12955-020-01446-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 06/09/2020] [Indexed: 11/10/2022] Open
Abstract
Background The concept of health-related quality of life and education integrates the bio-psychosocial perspective of health and the multidimensional potentialities of education for wellbeing. This present work is especially relevant to young people because understanding the interaction between health and education can facilitate the design of preventive policies. The research examines the way in which the educational level of young people from an urban district in the city of Zaragoza (Casablanca) has an influence on their health-related quality of life (HRQOL). Methods A cross sectional survey was undertaken in the Casablanca district of Zaragoza (Spain). Participants were not randomly selected; their numbers reflected the areas where they lived with respect to age and sex distribution. It comprised 122 boys and 122 girls, aged between16 and 29, living in the neighbourhood are: Viñedo Viejo, Las Nieves and Fuentes Claras. These three residence zones are markedly different in terms of socioeconomic composition. The questionnaire included the following information: socioeconomic characteristics (sex, age, educational level, employment status, residence zone), an assessment of health (health problems, diagnosis and medication in the last 2 weeks) and HRQOL (WHOQOL-BREF dimensions: mental health; physical health; social relations; and environment). ANOVA and four regression models were used to assess the role, direction and intensity of educational level on HRQOL. Results The results show that the higher the level of education, the better the level of HRQOL. The biggest impact of education was on the mental health dimension, but this influence was modulated by sex and residence zone. The value of the interaction of education and residence zone was more significant than educational level alone. HRQOL of girls is more sensitive to education, being a student and residence zone than the HRQOL of boys. Conclusions The dimensions of HRQOL are influenced by educational level. The influence is greatest among girls and the youngest members of the poorest area of the district. Public authorities should contemplate the development of an equitable education system from the beginning of the life cycle as a public health strategy.
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Affiliation(s)
- Marta Gil-Lacruz
- Department of Psychology and Sociology, Health Science Faculty, Domingo Miral s/n, 50009, Zaragoza, Spain.
| | - Ana Isabel Gil-Lacruz
- Department of Management, School of Engineering and Architecture, C. María de Luna, 3, Edificio Betancourt, Campus Río Ebro, 50018, Zaragoza, Spain
| | - María Luisa Gracia-Pérez
- Department of Psychology and Sociology, Social and Work Science Faculty, Violante de Hungria 23, 50009, Zaragoza, Spain
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17
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Bastiaansen D, Ferdinand RF, Koot HM. Predictors of Quality of Life in Children and Adolescents with Psychiatric Disorders. Child Psychiatry Hum Dev 2020; 51:104-113. [PMID: 31338645 PMCID: PMC6965339 DOI: 10.1007/s10578-019-00914-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This study aimed to identify factors that predict quality of life (QoL), over and above potential improvements in QoL related to a decrease in psychopathology, in children and adolescents with psychiatric problems. Two hundred and thirty one referred children and adolescents, aged 7-19 years, were followed up across a 1-year period. QoL and psychopathology were assessed, as were a broad range of child, parent, and family/social network factors. Time 1 QoL scores and change in level of psychopathology from Time 1 to Time 2 were important predictors of Time 2 QoL scores. Lower than expected Time 2 QoL was also predicted by the presence at Time 1 of a chronic physical disease, low self-esteem, poor social skills, and stressful life events. Findings can be useful to identify children who are at risk for lower than expected levels of QoL, even after receiving help from mental health agencies.
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Affiliation(s)
- Dennis Bastiaansen
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.,Yulius Center for Child and Adolescent Psychiatry, Dordrecht, The Netherlands
| | - Robert F Ferdinand
- Department of Child and Adolescent Psychiatry, GGZ Delfland, Delft, The Netherlands
| | - Hans M Koot
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
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18
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Fong CY, Ng K, Kong AN, Ong LC, Rithauddin MA, Thong MK, Ganesan V, Heng HS, Teh CM, Yahya N. Quality of life of children with tuberous sclerosis complex. Arch Dis Child 2019; 104:972-978. [PMID: 31122923 DOI: 10.1136/archdischild-2018-316394] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 04/18/2019] [Accepted: 04/23/2019] [Indexed: 11/03/2022]
Abstract
AIM Evaluation of impaired quality of life (QOL) of Malaysian children with tuberous sclerosis complex (TSC) and its possible risk factors. METHOD Cross-sectional study on 68 parents of Malaysian children aged 2-18 years with TSC. QOL was assessed using proxy-report Paediatric Quality of Life Inventory (PedsQL) V.4.0, and scores compared with those from a previous cohort of healthy children. Parents also completed questionnaires on child behaviour (child behaviour checklist (CBCL)) and parenting stress (parenting stress index-short form). Multiple regression analysis was used to determine sociodemographic, medical, parenting stress and behavioural factors that impacted on QOL. RESULTS The mean proxy-report PedsQL V.4.0 total scale score, physical health summary score and psychosocial health summary score of the patients were 60.6 (SD 20.11), 65.9 (SD 28.05) and 57.8 (SD 19.48), respectively. Compared with healthy children, TSC patients had significantly lower mean PedsQL V.4.0 total scale, physical health and psychosocial health summary scores (mean difference (95% CI): 24 (18-29), 20 (12-27) and 26 (21-31) respectively). Lower total scale scores were associated with clinically significant CBCL internalising behaviour scores, age 8-18 years and Chinese ethnicity. Lower psychosocial health summary scale scores were associated with clinically significant CBCL internalising behaviour scores, Chinese ethnicity or >1 antiepileptic drug (AED). CONCLUSION Parents of children with TSC reported lower PedsQL V.4.0 QOL scores in all domains, with psychosocial health most affected. Older children, those with internalising behaviour problems, of Chinese ethnicity or on >1 AED was at higher risk of lower QOL. Clinicians need to be vigilant of QOL needs among children with TSC particularly with these additional risk factors.
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Affiliation(s)
- Choong Yi Fong
- Division of Paediatric Neurology, Department of Paediatrics, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Kexin Ng
- Division of Paediatric Neurology, Department of Paediatrics, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Ann Nie Kong
- Division of Paediatric Neurology, Department of Paediatrics, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Lai Choo Ong
- Division of Paediatric Neurology, Department of Paediatrics, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Meow Keong Thong
- Genetics Medicine Unit, Department of Paediatrics, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Hock Sin Heng
- Paediatric Department, Sabah Women and Children Hospital, Sabah, Malaysia
| | - Chee Ming Teh
- Paediatric Department, Penang General Hospital, Penang, Malaysia
| | - Norazni Yahya
- Paediatric Department, Hospital Raja Perempuan Zainab II, Kelantan, Malaysia
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19
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Jozefiak T, Greger HK, Koot HM, Klöckner CA, Wallander JL. The role of family functioning and self-esteem in the quality of life of adolescents referred for psychiatric services: a 3-year follow-up. Qual Life Res 2019; 28:2443-2452. [PMID: 31077032 DOI: 10.1007/s11136-019-02197-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE To investigate, in adolescents referred for psychiatric services, the associations of initial self-esteem and family functioning with level and change of quality of life (QoL) over a 3-year period, over and above the effect of their emotional problems. METHODS Of 1648 eligible 13-18 years old patients attending the child and adolescent psychiatric clinic (CAP) at least once, 717 (54.8% females) were enrolled at baseline (a response rate of 43.5%). Self- and parent reports on the McMaster Family Assessment Device were obtained. Adolescents reported self-esteem on the Rosenberg Scale, and emotional problems on the Symptom Check List-5. Adolescents completed the Inventory of Life Quality in Children and Adolescents (ILC). After 3 years, 570 adolescents again completed the ILC, and for 418 adolescents parent information was available. The longitudinal analysis sample of 418 adolescents was representative of the baseline sample for age, gender, emotional problems, and QoL. We used modified growth-model analysis, adjusted for SES, age, gender and time of contact with CAP, where residual variances for ILC at baseline and follow-up were fixed to 0. RESULTS A poorer family functioning at baseline, reported by parents, was significantly associated with worsening QoL during the 3 years follow-up period (p = 0.001). CONCLUSIONS Parents have important knowledge about their families that may reflect long-term influences on QoL development in adolescent psychiatric patients. Health care providers and policy makers should optimize treatment outcomes by addressing family functioning in adolescents with emotional problems.
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Affiliation(s)
- Thomas Jozefiak
- Regional Center for Child and Youth Mental Health and Child Welfare, Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, MTFS, Pb. 8905, 7491, Trondheim, Norway.
| | - Hanne K Greger
- Regional Center for Child and Youth Mental Health and Child Welfare, Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, MTFS, Pb. 8905, 7491, Trondheim, Norway.,Department of Child and Adolescent Psychiatry, St. Olavs Hospital, Elgeseter, Postboks 6810, 7433, Trondheim, Norway
| | - Hans M Koot
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - Christian A Klöckner
- Department of Psychology, University of Science and Technology, Trondheim, Norway
| | - Jan L Wallander
- Regional Center for Child and Youth Mental Health and Child Welfare, Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, MTFS, Pb. 8905, 7491, Trondheim, Norway.,Psychological Sciences and Health Sciences Research Institute, University of California, Merced, 5200, North Lake Rd, Merced, CA, 95343, USA
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20
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Self-rated health and health-related quality of life are related with adolescents' healthy lifestyle. Public Health 2019; 170:89-94. [PMID: 30978580 DOI: 10.1016/j.puhe.2019.02.022] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 01/13/2019] [Accepted: 02/22/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Self-rated health (SRH) and health-related quality of life (HRQoL) are related with health outcomes. It is expected that these constructs are also associated with healthy behaviours. Thus, the present study sought to analyse the associations between a healthy lifestyle composite score and SRH and HRQoL among adolescents. STUDY DESIGN This was an observational, cross-sectional study. METHODS Data were obtained from the cross-sectional health behaviour in school-aged children (HBSC) 2014 Portuguese survey. Participants were 5024 adolescents (2373 boys), aged 10-17 years. A composite score of healthy lifestyle was obtained using the combination of the following factors: daily physical activity, sleep at least 8-9 h/night, daily consumption of fruit and vegetables, spend <2 h daily in screen-based behaviours, never drink and never smoke. RESULTS Adolescents with a healthy lifestyle had significantly better SRH and higher HRQoL than those who were not engaged in all healthy behaviours. CONCLUSIONS Healthy lifestyle (composed of physical activity, sleep at least 8-9 h/night, daily consumption of fruit and vegetables, spend <2 h daily in screen-based behaviours, never drink and never smoke) is related to SRH and HRQoL. Promoting a comprehensive approach to these behaviours is a public health strategy to be considered when aiming to improve health, in general, and SRH and HRQoL, in particular.
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21
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Cademartori MG, Corrêa MB, Silva RA, Goettems ML. Childhood social, emotional, and behavioural problems and their association with behaviour in the dental setting. Int J Paediatr Dent 2019; 29:43-49. [PMID: 30381852 DOI: 10.1111/ipd.12436] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 08/10/2018] [Accepted: 09/26/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND Mental disorders are among the main causes of global disability in children, with negative impacts on their quality of life. It is possible that mental disorders could be associated with how children react in the dental setting. AIM To test the association between children's psychological attributes and behaviour presented during dental care. DESIGN A questionnaire was given to mothers of children attending a paediatric dental clinic. Psychological attributes were evaluated using the Strengths and Difficulties Questionnaire. For analysis, the Internalizing and Externalizing problems and the Prosocial behaviour subscales were considered. Children's behaviour was assessed using the Frankl Scale. For analysis, Poisson regression models were employed. A significant level of P ≤ 0.05 was adopted. RESULTS Overall, 128 children aged between four and 12 years were included. Total difficulties (PR 5.36; 95%CI 2.2-12.9), Internalizing problems (PR 4.04; 95%CI 1.6-10.0), and externalizing problems (PR 3.36; 1.5-7.7) were associated with uncooperative behaviour. In relation to the strength domain, the Prosocial behaviour subscale (PR 1.21; 95%CI 0.6-2.6) was not associated with child behaviour. CONCLUSIONS This study provides evidence that children aged between four and 12 years with internalizing and externalizing problems tend to have a higher prevalence of negative behaviour during dental treatment.
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Affiliation(s)
| | - Marcos B Corrêa
- Department of Dentistry and Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Ricardo A Silva
- Graduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil
| | - Marília L Goettems
- Department of Social and Preventive Dentistry and Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
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22
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Ranøyen I, Gulliksrud E, Indredavik MS, Stenseng F. Psychiatric problems and quality of life in a clinical sample of adolescents: The role of peer relations. Scand J Child Adolesc Psychiatr Psychol 2019; 6:183-192. [PMID: 33520763 PMCID: PMC7703841 DOI: 10.21307/sjcapp-2018-019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The quality of peer relations is linked to mental health in childhood and adolescence, but few studies have investigated its clinical relevance. In particular, the potential mediating role of peer functioning in the associations between different dimensions of symptoms and quality of life (QoL) has not been sufficiently examined. OBJECTIVE In a clinical sample of adolescents, we examined peer relations in light of psychiatric diagnoses, as well as QoL and symptoms of mental health problems, with particular focus on symptoms of anxiety, depression, and ADHD. We also examined the potential mediating role of peer problems in the relationship between such symptoms and QoL. METHODS The sample consisted of 603 adolescents (ages 13-18) referred to clinical assessment. Psychiatric diagnoses according to the criteria of the International Statistical Classification of Diseases and Related Health Problems, 10th revision, were collected from participants' clinical charts. Symptoms of disorders, QoL, and quality of peer relations were measured by self-report questionnaires. RESULTS Adolescents diagnosed with anxiety/depressive disorder reported more peer problems and lower QoL than adolescents with attention deficit/hyperactivity disorder. These findings were supported with symptom ratings. A path model with bootstrapping was used to assess the potential mediating role of peer problems in the association between symptoms and QoL, showing that peer problems partly mediated the relationship between emotional symptoms and QoL, but not the relationship between ADHD-symptoms and QoL. CONCLUSION Improvement of peer relations may be a fruitful path for enhancing QoL among adolescents with symptoms of anxiety and depression.
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Affiliation(s)
- Ingunn Ranøyen
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Faculty of Medicine, Norwegian University of Science and Technology (NTNU)
- Division of Mental Health Care, Department of Children and Youth, St. Olavs Hospital, Trondheim University Hospital, Norway
| | - Eva Gulliksrud
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Faculty of Medicine, Norwegian University of Science and Technology (NTNU)
| | - Marit S. Indredavik
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Faculty of Medicine, Norwegian University of Science and Technology (NTNU)
- Division of Mental Health Care, Department of Children and Youth, St. Olavs Hospital, Trondheim University Hospital, Norway
| | - Frode Stenseng
- Department of Education and Lifelong Learning, NTNU, Trondheim, Norway
- Queen Maud University College, Trondheim, Norway
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Öztürk Y, Özyurt G, Akay A. Family functioning and quality of life among children with anxiety disorder and healthy controls. A cross-sectional study. SAO PAULO MED J 2018; 136:346-353. [PMID: 30110079 PMCID: PMC9881690 DOI: 10.1590/1516-3180.2018.0145240418] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 04/17/2018] [Accepted: 04/24/2018] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Studies have shown that children with anxiety disorders (ADs) present impaired family functioning and quality of life. We aimed to evaluate family functioning and quality of life among children with AD and healthy controls. DESIGN AND SETTING Cross-sectional study (survey) at two centers in Turkey. METHODS The study group comprised 42 children diagnosed with AD and 55 controls. The Screen for Child Anxiety-Related Emotional Disorders (SCARED) questionnaire was filled out by their parents to measure the severity of anxiety symptoms. Family functioning among the children was assessed using the Family Assessment Device (FAD) and Parental Attitude Research Instrument (PARI). The children's quality of life was assessed through the Pediatric Quality of Life Inventory (PedsQL). RESULTS The children's average age was 10.00 ± 0.21 years in the AD group and 9.98 ± 1.53 years among the controls. There were higher scores on all FAD subscales in the AD group (2.15 ± 0.52; 2.29 ± 0.44; 2.44 ± 0.55; 2.10 ± 0.61; 2.56 ± 0.40; 2.32 ± 0.33; and 2.29 ± 0.47). On PARI subscales, there were significant differences favoring the AD group (p < 0.05), except for democratic attitude. All PedsQL subscales differed significantly between the groups, favoring the AD group. A statistically significant relationship was found between all PedsQL subscales and SCARED scores in the AD group. CONCLUSION We found that both family functioning and quality of life among children with AD were negatively affected. However, further studies with larger sample sizes are required to reach stronger conclusions.
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Affiliation(s)
- Yusuf Öztürk
- MD. Assistant Professor, Department of Children and Adolescents, Bolu Abant İzzet Baysal Üniversitesi, Bolu, Turkey.
| | - Gonca Özyurt
- MD. Assistant Professor, Department of Children and Adolescents, İzmir Katip Celebi Üniversitesi, İzmir, Turkey.
| | - Aynur Akay
- MD. Professor, Department of Children and Adolescents, Dokuz Eylül Üniversitesi, İzmir, Turkey.
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24
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Telman LGE, van Steensel FJA, Maric M, Bögels SM. Are Anxiety Disorders in Children and Adolescents Less Impairing Than ADHD and Autism Spectrum Disorders? Associations with Child Quality of Life and Parental Stress and Psychopathology. Child Psychiatry Hum Dev 2017; 48:891-902. [PMID: 28176178 PMCID: PMC5680363 DOI: 10.1007/s10578-017-0712-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
We compared clinically referred children with anxiety disorders (AD; n = 63) to children with autism spectrum disorder (ASD; n = 39), ADHD Combined (ADHD-C; n = 62), ADHD Predominantly Inattentive (ADHD-I; n = 64), and typically developing children (n = 42) on child quality of life (QOL), paternal and maternal psychopathology and parental stress. Diagnoses were based on DSM-IV-TR criteria. Multilevel analyses showed that QOL in AD was higher on school and social functioning, compared to respectively ADHD and ASD, and lower compared to normal controls on all five domains. Fathers reported their AD children higher QOL than mothers. Also, AD appeared to be associated with less parental stress and parental psychopathology than other child psychopathology. Therefore, parental factors may need to be considered more in treatment of children with ADHD/ASD than AD.
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Affiliation(s)
- Liesbeth G E Telman
- Research Priority Area Yield, Research Institute of Child Development and Education, University of Amsterdam, Postbus 15780, 1001 NG, Amsterdam, The Netherlands.
| | - Francisca J A van Steensel
- Research Priority Area Yield, Research Institute of Child Development and Education, University of Amsterdam, Postbus 15780, 1001 NG, Amsterdam, The Netherlands
- UvA minds, Academic Outpatient Child and Adolescent Treatment Center, Amsterdam, The Netherlands
| | - Marija Maric
- Department of Developmental Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Susan M Bögels
- Research Priority Area Yield, Research Institute of Child Development and Education, University of Amsterdam, Postbus 15780, 1001 NG, Amsterdam, The Netherlands
- UvA minds, Academic Outpatient Child and Adolescent Treatment Center, Amsterdam, The Netherlands
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25
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Magiera A, Sowa A, Jacek R, Pac A. The quality of life among middle-school adolescents in Krakow. DEVELOPMENTAL PERIOD MEDICINE 2017. [PMID: 28796983 PMCID: PMC8522968 DOI: 10.34763/devperiodmed.20172102.124130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
AIM The aim of the study was to describe the quality of life of Polish adolescents living in a big city and to investigate whether there are differences in this respect between girls and boys. Moreover, we would like to compare the results concerning the quality of life of the screened adolescents from Krakow with those of their European peers. MATERIAL AND METHODS The survey was carried out in 2013-2015 in 17 middle schools in Krakow based on anonymous auditorium questionnaires. The analysis included the responses of 1387 pupils - 686 girls and 701 boys. In order to assess the quality of life, the Polish version of the international KIDSCREEN-27 questionnaire was used. Five dimensions of the quality of life (Qol) were analyzed. The specific dimensions of Qol were analyzed using 0-100 point scales, as well as T-scores standardized for the European population. RESULTS The mean values for five dimensions of quality of life assessed by the KIDSCREEN-27 questionnaire ranged from 54 pts. to 65 pts. (maximum score 100 pts.). However, the results for the Polish adolescents were lower when compared to their European peers. The greatest differences in the level of Qol between Polish adolescents and their European peers involved the following dimensions: Psychological Well-being and School Environment. On average, girls scored their Qol lower than boys in three out of five dimensions (Physical Well-being, Psychological Well-being, Autonomy & Parents; p<0.001). Additionally, using the norm data for the Polish population (sex and age specific), more girls than boys were classified as having low Qol regarding the School Environment (23.5%vs 14.8%; p<0.001). CONCLUSIONS Polish adolescents scored their Qol lower than their European peers. The quality of life for girls was significantly lower than of boys, except for the relation with their friends and peers (Social Support & Peers).
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Affiliation(s)
- Agnieszka Magiera
- Katedra Epidemiologii i Medycyny Zapobiegawczej, Wydział Lekarski, Uniwersytet Jagielloński, Collegium Medicum, Kraków, Polska
| | - Agata Sowa
- Katedra Epidemiologii i Medycyny Zapobiegawczej, Wydział Lekarski, Uniwersytet Jagielloński, Collegium Medicum, Kraków, Polska
| | - Ryszard Jacek
- Katedra Epidemiologii i Medycyny Zapobiegawczej, Wydział Lekarski, Uniwersytet Jagielloński, Collegium Medicum, Kraków, Polska
| | - Agnieszka Pac
- Katedra Epidemiologii i Medycyny Zapobiegawczej, Wydział Lekarski, Uniwersytet Jagielloński, Collegium Medicum, Kraków, Polska,Agnieszka Pac Katedra Epidemiologii i Medycyny Zapobiegawczej UJ CM ul. Kopernika 7a, 31-034 Kraków tel. (12) 423-10-03
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26
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Herpers PCM, Klip H, Rommelse NNJ, Taylor MJ, Greven CU, Buitelaar JK. Taxometric analyses and predictive accuracy of callous-unemotional traits regarding quality of life and behavior problems in non-conduct disorder diagnoses. Psychiatry Res 2017; 253:351-359. [PMID: 28427034 DOI: 10.1016/j.psychres.2017.04.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 03/19/2017] [Accepted: 04/02/2017] [Indexed: 11/18/2022]
Abstract
Callous-unemotional (CU) traits have mainly been studied in relation to conduct disorder (CD), but can also occur in other disorder groups. However, it is unclear whether there is a clinically relevant cut-off value of levels of CU traits in predicting reduced quality of life (QoL) and clinical symptoms, and whether CU traits better fit a categorical (taxonic) or dimensional model. Parents of 979 youths referred to a child and adolescent psychiatric clinic rated their child's CU traits on the Inventory of Callous-Unemotional traits (ICU), QoL on the Kidscreen-27, and clinical symptoms on the Child Behavior Checklist. Experienced clinicians conferred DSM-IV-TR diagnoses of ADHD, ASD, anxiety/mood disorders and DBD-NOS/ODD. The ICU was also used to score the DSM-5 specifier 'with limited prosocial emotions' (LPE) of Conduct Disorder. Receiver operating characteristic (ROC) analyses revealed that the predictive accuracy of the ICU and LPE regarding QoL and clinical symptoms was poor to fair, and similar across diagnoses. A clinical cut-off point could not be defined. Taxometric analyses suggested that callous-unemotional traits on the ICU best reflect a dimension rather than taxon. More research is needed on the impact of CU traits on the functional adaptation, course, and response to treatment of non-CD conditions.
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Affiliation(s)
- Pierre C M Herpers
- Karakter, Child and Adolescent Psychiatry, University Center, Reinier Postlaan 12, 6525 GC Nijmegen, The Netherlands; Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Psychiatry, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands.
| | - Helen Klip
- Karakter, Child and Adolescent Psychiatry, University Center, Reinier Postlaan 12, 6525 GC Nijmegen, The Netherlands
| | - Nanda N J Rommelse
- Karakter, Child and Adolescent Psychiatry, University Center, Reinier Postlaan 12, 6525 GC Nijmegen, The Netherlands; Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Psychiatry, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands
| | - Mark J Taylor
- Karolinska Institutet, Department of Medical Epidemiology & Biostatistics, Nobels väg 12A, Stockholm 17177, Sweden
| | - Corina U Greven
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Cognitive Neuroscience, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands; King's College London, Medical Research Council Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London SE5 8AF, United Kingdom
| | - Jan K Buitelaar
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Cognitive Neuroscience, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands
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Tilahun D, Hanlon C, Araya M, Davey B, Hoekstra RA, Fekadu A. Training needs and perspectives of community health workers in relation to integrating child mental health care into primary health care in a rural setting in sub-Saharan Africa: a mixed methods study. Int J Ment Health Syst 2017; 11:15. [PMID: 28168004 PMCID: PMC5286789 DOI: 10.1186/s13033-017-0121-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 01/22/2017] [Indexed: 11/24/2022] Open
Abstract
Background Community health workers can help to address the substantial unmet need for child mental health care in low and middle income countries. However, little is known about their training needs for this potential role. The aim of this study was to examine training needs and perspectives of community health extension workers (HEWs) in relation to providing child mental health care in rural Ethiopia. Methods The study was conducted in the Southern Nations, Nationalities and Peoples’ Region of Ethiopia. A mixed methods approach was used. A total of 104 HEWs who had received training in child mental health using the Health Education and Training (HEAT) curriculum were interviewed using a structured survey. In-depth interviews were then conducted with 11 HEWs purposively selected on the basis of the administrative zone they had come from. A framework approach was used for qualitative data analysis. Results Most of the HEWs (88.5%; n = 93/104) reported that they were interested in the training provided and all respondents considered child mental health to be important. The perceived benefits of training included improved knowledge (n = 52), case identification (n = 14) and service provision (n = 22). While most of the participants had their training four months prior to the interview, over a third of them (35.6%; n = 37) had already organized mental health awareness-raising meetings. Participants in the qualitative interviews considered the problem of child mental disorders to be widespread and to cause a large burden to the family and the affected children. They reported that improving their competence and knowledge was important to address the problem and to tackle stigma and discrimination. Participants also listed some barriers for service provision, including lack of competence, stigma and institutional constraints. Opportunities mentioned included staff commitment, high levels of interest and a positive attitude towards providing the service. Conclusions Although the HEAT training on child mental health was brief, it appears to have had some impact in improving knowledge and care provision. If the key barriers to service provision are addressed and supported by policy guidance, community health workers may contribute substantially in addressing the treatment gap for children with mental health needs.
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Affiliation(s)
- Dejene Tilahun
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, PO 9086, Addis Ababa, Ethiopia.,Department of Health Education and Behavioural Sciences, College of Public Health and Medical Science, Jimma University, Jimma, Ethiopia
| | - Charlotte Hanlon
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, PO 9086, Addis Ababa, Ethiopia.,Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, Centre for Global Mental Health, King's College London, London, UK
| | - Mesfin Araya
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, PO 9086, Addis Ababa, Ethiopia
| | - Basiro Davey
- Department of Life, Health and Chemical Sciences, The Open University, Milton Keynes, UK
| | - Rosa A Hoekstra
- Department of Life, Health and Chemical Sciences, The Open University, Milton Keynes, UK.,Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Abebaw Fekadu
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, PO 9086, Addis Ababa, Ethiopia.,Centre for Innovative Drug Development and Therapeutic Trials for Africa, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.,Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Centre for Affective Disorders, King's College London, London, UK
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Nezu S, Iwasaka H, Saeki K, Obayashi K, Ishizuka R, Goma H, Furuichi Y, Kurumatani N. Reliability and validity of Japanese versions of KIDSCREEN-27 and KIDSCREEN-10 questionnaires. Environ Health Prev Med 2016; 21:154-63. [PMID: 26883049 DOI: 10.1007/s12199-016-0510-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 01/17/2016] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE This study aimed to assess the reliability and validity of Japanese versions of the KIDSCREEN-27 (J-KIDSCREEN-27) and KIDSCREEN-10 (J-KIDSCREEN-10) questionnaires, which are shorter versions of the KIDSCREEN-52 (J-KIDSCREEN-52). METHODS The present analyses are based on a pre-existing dataset of the J-KIDSCREEN-52 validation study, including 1564 children and adolescents aged 8-18 years and their 1326 parents. All were asked to complete the J-KIDSCREEN and Pediatric Quality of Life Inventory (PedsQL) questionnaires. Test-retest reliability was assessed with Intraclass Correlation Coefficients (ICCs) in a one-way random effects model, and internal consistency reliability was measured using Cronbach's alpha coefficients. Agreement between child and parent scores was evaluated using ICCs in a two-way mixed effects model. To assess concurrent validity, a sub-sample of 535 parents evaluated their child's mental health status using the Strengths and Difficulties Questionnaire (SDQ). RESULTS For children, test-retest ICCs were ≥0.60 and Cronbach's alpha ≥0.70 for every dimension of both instruments. Correlations of corresponding dimensions between the J-KIDSCREEN-27 or -10 and the PedsQL were acceptable. For parents, test-retest ICCs were ≥0.60, Cronbach's alpha ≥0.70, and ICCs between child and parent scores ≥0.41 in every dimension of both instruments. In multivariate logistic regression models, after adjusting for confounders, lower health-related QOL in every dimension of both instruments, except Physical Well-being, was significantly associated with higher odds ratios for borderline and clinical ranges of the SDQ. CONCLUSION The child/adolescent and parent/proxy versions of the J-KIDSCREEN-27 and J-KIDSCREEN-10 demonstrated acceptable levels of reliability and validity.
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Affiliation(s)
- Satoko Nezu
- Department of Community Health and Epidemiology, Nara Medical University School of Medicine, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan
| | - Hidemi Iwasaka
- Center for Special Needs Education, Nara University of Education, Nara, Japan
| | - Keigo Saeki
- Department of Community Health and Epidemiology, Nara Medical University School of Medicine, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan
| | - Kenji Obayashi
- Department of Community Health and Epidemiology, Nara Medical University School of Medicine, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan
| | - Rika Ishizuka
- Department of Food and Nutrition Faculty of Contemporary Human Life Science, Tezukayama University, Nara, Japan
| | - Hideyo Goma
- Department of Education for Children with Disabilities, Kyoto University of Education, Kyoto, Japan
| | - Yasuko Furuichi
- Pediatrics of Higashiosaka City General Hospital, Higashiosaka, Osaka, Japan
| | - Norio Kurumatani
- Department of Community Health and Epidemiology, Nara Medical University School of Medicine, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan.
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Associations between high callous-unemotional traits and quality of life across youths with non-conduct disorder diagnoses. Eur Child Adolesc Psychiatry 2016; 25:547-55. [PMID: 26362863 PMCID: PMC4854931 DOI: 10.1007/s00787-015-0766-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2015] [Accepted: 08/27/2015] [Indexed: 02/01/2023]
Abstract
Research regarding callous-unemotional (CU) traits in non-conduct disorder (CD) diagnoses is sparse. We investigated the presence of high CU traits and their associations with quality of life (QoL) in a clinically referred sample of youths with non-CD diagnoses. Parents of 1018 children referred to a child and adolescent psychiatric clinic and rated their child's CU traits and QoL. Experienced clinicians derived DSM-IV-TR diagnoses based on systematic clinical evaluations of these children. High CU traits compared to low CU traits were present in 38.5 % of the sample, and more often in boys than girls (69.4 vs. 30.6 %, p = .004), and were associated with more police contacts (12.2 vs. 3.5 %, p < .001). Logistic regression analyses revealed that those with diagnoses of autism spectrum disorder (odds ratio; OR = 1.61; 95 % CI 1.24-2.09; p < .001) and disruptive behavior disorder not otherwise specified/oppositional defiant disorder (OR = 4.98; 95 % CI 2.93-8.64; p < .001), but not attention-deficit/hyperactivity disorder (OR = 1.01; 95 % CI .79-1.31; p = .94), were more likely to have high than low CU traits. Those with anxiety/mood disorders were more likely to have low than high CU traits (OR = .59; 95 % CI .42-82; p = .002). In all diagnostic groups, high CU compared to low CU traits were associated with significantly lower QoL, while controlling for gender, age, and comorbidity. As such, high CU traits significantly modify QoL in non-CD disorders.
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30
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Girls' quality of life prior to detention in relation to psychiatric disorders, trauma exposure and socioeconomic status. Qual Life Res 2014; 24:1419-29. [PMID: 25429824 DOI: 10.1007/s11136-014-0878-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE Practice and research on detained girls has mainly been problem oriented, overlooking these minors' own perspective on and satisfaction with life. The aim of this study was to examine how girls evaluate multiple domains of quality of life (QoL) and how each domain is affected by psychiatric (co)morbidity, trauma, and socioeconomic status (SES). METHODS An abbreviated version of the World Health Organization (WHO) QoL Instrument was used to assess the girls' (N = 121; M(age) = 16.28) QoL prior to detention. This self-report questionnaire consists of two benchmark items referring to their overall QoL and health, and 24 remaining items measuring their QoL regarding four domains (physical health, psychological health, social relationships, and environment). The Diagnostic Interview Schedule for Children-IV was used to assess the past-year prevalence of psychiatric disorders and life-time trauma exposure. RESULTS Detained girls perceived their QoL almost as good as the 12- to 20-year-olds from the WHO's international field trial on all but one domain (i.e., psychological health). They were most satisfied with their social relationships and least satisfied with their psychological health. Psychiatric disorders, trauma, and low SES were distinctively and negatively related to various domains of QoL. The girls' psychological health was most adversely affected by psychosocial and socioeconomic problems, while these variables had an almost negligible impact on their satisfaction with their social relationships. CONCLUSIONS The particularity of each domain of QoL supports a multidimensional conceptualization of QoL. Regarding treatment, psychological health appears as a domain of major concern, while social relationships might serve as a source of resilience.
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Carona C, Silva N, Moreira H. Applying a developmental approach to quality of life assessment in children and adolescents with psychological disorders: challenges and guidelines. Expert Rev Pharmacoecon Outcomes Res 2014; 15:47-70. [DOI: 10.1586/14737167.2015.972377] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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