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Kieling C, Buchweitz C, Caye A, Silvani J, Ameis SH, Brunoni AR, Cost KT, Courtney DB, Georgiades K, Merikangas KR, Henderson JL, Polanczyk GV, Rohde LA, Salum GA, Szatmari P. Worldwide Prevalence and Disability From Mental Disorders Across Childhood and Adolescence: Evidence From the Global Burden of Disease Study. JAMA Psychiatry 2024; 81:347-356. [PMID: 38294785 PMCID: PMC10831630 DOI: 10.1001/jamapsychiatry.2023.5051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 11/03/2023] [Indexed: 02/01/2024]
Abstract
Importance The period from childhood to early adulthood involves increased susceptibility to the onset of mental disorders, with implications for policy making that may be better appreciated by disaggregated analyses of narrow age groups. Objective To estimate the global prevalence and years lived with disability (YLDs) associated with mental disorders and substance use disorders (SUDs) across 4 age groups using data from the 2019 Global Burden of Disease (GBD) study. Design, Setting, and Participants Data from the 2019 GBD study were used for analysis of mental disorders and SUDs. Results were stratified by age group (age 5 to 9, 10 to 14, 15 to 19, and 20 to 24 years) and sex. Data for the 2019 GBD study were collected up to 2018, and data were analyzed for this article from April 2022 to September 2023. Exposure Age 5 to 9 years, 10 to 14 years, 15 to 19 years, and 20 to 24 years. Main Outcomes and Measures Prevalence rates with 95% uncertainty intervals (95% UIs) and number of YLDs. Results Globally in 2019, 293 million of 2516 million individuals aged 5 to 24 years had at least 1 mental disorder, and 31 million had an SUD. The mean prevalence was 11.63% for mental disorders and 1.22% for SUDs. For the narrower age groups, the prevalence of mental disorders was 6.80% (95% UI, 5.58-8.03) for those aged 5 to 9 years, 12.40% (95% UI, 10.62-14.59) for those aged 10 to 14 years, 13.96% (95% UI, 12.36-15.78) for those aged 15 to 19 years, and 13.63% (95% UI, 11.90-15.53) for those aged 20 to 24 years. The prevalence of each individual disorder also varied by age groups; sex-specific patterns varied to some extent by age. Mental disorders accounted for 31.14 million of 153.59 million YLDs (20.27% of YLDs from all causes). SUDs accounted for 4.30 million YLDs (2.80% of YLDs from all causes). Over the entire life course, 24.85% of all YLDs attributable to mental disorders were recorded before age 25 years. Conclusions and Relevance An analytical framework that relies on stratified age groups should be adopted for examination of mental disorders and SUDs from childhood to early adulthood. Given the implications of the early onset and lifetime burden of mental disorders and SUDs, age-disaggregated data are essential for the understanding of vulnerability and effective prevention and intervention initiatives.
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Affiliation(s)
- Christian Kieling
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Child and Adolescent Psychiatry Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Claudia Buchweitz
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Arthur Caye
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- National Center for Research and Innovation in Mental Health (CISM), São Paulo, Brazil
| | - Juliana Silvani
- Graduate Program in Epidemiology, Department of Social Medicine, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Stephanie H. Ameis
- Campbell Family Mental Health Research Institute, Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - André R. Brunoni
- Department of Psychiatry, Faculdade de Medicina da Universidade de São Paulo, Universidade de São Paulo, São Paulo, Brazil
| | - Katherine T. Cost
- Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Darren B. Courtney
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Katholiki Georgiades
- Department of Psychiatry and Behavioural Neurosciences & Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
| | - Kathleen Ries Merikangas
- Section on Developmental Genetic Epidemiology, Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland
| | - Joanna L. Henderson
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Guilherme V. Polanczyk
- Department of Psychiatry, Faculdade de Medicina da Universidade de São Paulo, Universidade de São Paulo, São Paulo, Brazil
| | - Luis Augusto Rohde
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Child and Adolescent Psychiatry Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- National Center for Research and Innovation in Mental Health (CISM), São Paulo, Brazil
| | - Giovanni A. Salum
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Child Mind Institute, New York, New York
| | - Peter Szatmari
- Cundill Centre for Child and Youth Depression, Division of Child and Youth Mental Health, Centre for Addiction and Mental Health & University of Toronto, University of Toronto, Toronto, Ontario, Canada
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Koumoula A, Marchionatti LE, Karagiorga VE, Schafer JL, Simioni A, Caye A, Serdari A, Kotsis K, Basta M, Athanasopoulou L, Dafoulis V, Tatsiopoulou P, Zilikis N, Vergouli E, Balikou P, Kapsimalli E, Mitropoulou A, Tzotzi A, Klavdianou N, Zeleni D, Mitroulaki S, Botzaki A, Gerostergios G, Samiotakis G, Moschos G, Giannopoulou I, Papanikolaou K, Angeli K, Scarmeas N, Emanuele J, Schuster K, Karyotaki E, Kalikow L, Pronoiti K, Merikangas KR, Szatmari P, Cuijpers P, Georgiades K, Milham MP, Corcoran M, Burke S, Koplewicz H, Salum GA. Understanding priorities and needs for child and adolescent mental health in Greece from multiple informants: an open resource dataset. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02400-2. [PMID: 38558204 DOI: 10.1007/s00787-024-02400-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 02/15/2024] [Indexed: 04/04/2024]
Abstract
The Child and Adolescent Mental Health Initiative (CAMHI) aims to enhance mental health care capacity for children and adolescents across Greece. Considering the need for evidence-based policy, the program developed an open-resource dataset for researching the field within the country. A comprehensive, mixed-method, community-based research was conducted in 2022/2023 assessing the current state, needs, barriers, and opportunities according to multiple viewpoints. We surveyed geographically distributed samples of 1,756 caregivers, 1,201 children/adolescents, 404 schoolteachers, and 475 health professionals using validated instruments to assess mental health symptoms, mental health needs, literacy and stigma, service use and access, professional practices, training background, and training needs and preferences. Fourteen focus groups were conducted with informants from diverse populations (including underrepresented minorities) to reach an in-depth understanding of those topics. A dataset with quantitative and qualitative findings is now available for researchers, policymakers, and society [ https://osf.io/crz6h/ and https://rpubs.com/camhi/sdashboard ]. This resource offers valuable data for assessing the needs and priorities for child and adolescent mental health care in Greece. It is now freely available to consult, and is expected to inform upcoming research and evidence-based professional training. This initiative may inspire similar ones in other countries, informing methodological strategies for researching mental health needs.
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Affiliation(s)
- Anastasia Koumoula
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
| | - Lauro Estivalete Marchionatti
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
- Child Mind Institute, 101 E 56th St, New York, USA
- Department of Psychiatry, Universidade Federal Do Rio Grande Do Sul (UFRGS), Porto Alegre, Brazil
| | - Vasiliki Eirini Karagiorga
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
- Child Mind Institute, 101 E 56th St, New York, USA
| | - Julia Luiza Schafer
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
- Child Mind Institute, 101 E 56th St, New York, USA
- Department of Psychiatry, Universidade Federal Do Rio Grande Do Sul (UFRGS), Porto Alegre, Brazil
| | - André Simioni
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
- Child Mind Institute, 101 E 56th St, New York, USA
| | - Arthur Caye
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
- Child Mind Institute, 101 E 56th St, New York, USA
- Department of Psychiatry, Universidade Federal Do Rio Grande Do Sul (UFRGS), Porto Alegre, Brazil
| | - Aspasia Serdari
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
- Department of Child and Adolescent Psychiatry, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Konstantinos Kotsis
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Maria Basta
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
- Department of Psychiatry, University Hospital of Heraklion, Crete, Greece
- Department of Child and Adolescent Psychiatry, University Hospital of Heraklion, Crete, Greece
| | - Lilian Athanasopoulou
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
| | - Vaios Dafoulis
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
| | - Paraskevi Tatsiopoulou
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
| | - Nikos Zilikis
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
| | - Evangelia Vergouli
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
| | - Panagiota Balikou
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
| | - Efstathia Kapsimalli
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
| | - Andromachi Mitropoulou
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
| | - Alexandra Tzotzi
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
| | - Nikanthi Klavdianou
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
| | - Domna Zeleni
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
| | - Sotiria Mitroulaki
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
| | - Anna Botzaki
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
| | - Giorgos Gerostergios
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
| | - Giorgos Samiotakis
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
| | - Giorgos Moschos
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
| | - Ioanna Giannopoulou
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
- 2nd Department of Psychiatry, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Katerina Papanikolaou
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
- Department of Child Psychiatry, Agia Sophia Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Katerina Angeli
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
| | - Nikolaos Scarmeas
- National and Kapodistrian University of Athens (NKUA), Athens, Greece
- Columbia University, New York, NY, USA
| | - Jill Emanuele
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
- Child Mind Institute, 101 E 56th St, New York, USA
| | - Kenneth Schuster
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
- Child Mind Institute, 101 E 56th St, New York, USA
| | - Eirini Karyotaki
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
- Department of Clinical Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Lily Kalikow
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
| | - Katerina Pronoiti
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
| | - Kathleen R Merikangas
- Genetic Epidemiology Research Branch, National Institute of Mental Health, Bathesda, USA
| | - Peter Szatmari
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Pim Cuijpers
- Department of Clinical Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Katholiki Georgiades
- Department of Psychiatry and Behavioural Neurosciences & Offord Centre for Child Studies, McMaster University, Hamilton, Canada
| | - Michael P Milham
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
- Child Mind Institute, 101 E 56th St, New York, USA
| | - Mimi Corcoran
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
- Child Mind Institute, 101 E 56th St, New York, USA
| | - Sarah Burke
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
- Child Mind Institute, 101 E 56th St, New York, USA
| | - Harold Koplewicz
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA
- Child Mind Institute, 101 E 56th St, New York, USA
| | - Giovanni Abrahão Salum
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, 101 E 56th St, New York, NY, 10022, USA.
- Child Mind Institute, 101 E 56th St, New York, USA.
- Department of Psychiatry, Universidade Federal Do Rio Grande Do Sul (UFRGS), Porto Alegre, Brazil.
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Halladay J, Georgiades K, MacKillop J, Lipman E, Pires P, Duncan L. Identifying patterns of substance use and mental health concerns among adolescents in an outpatient mental health program using latent profile analysis. Eur Child Adolesc Psychiatry 2024; 33:739-747. [PMID: 36947251 PMCID: PMC10031175 DOI: 10.1007/s00787-023-02188-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 03/08/2023] [Indexed: 03/23/2023]
Abstract
Though mental health and substance use concerns often co-occur, few studies have characterized patterns of co-occurrence among adolescents in clinical settings. The current investigation identifies and characterizes these patterns among adolescents presenting to an outpatient mental health service in Ontario, Canada. Data come from cross-sectional standardized patient intake assessments from 916 adolescents attending an outpatient mental health program (January 2019-March 2021). Latent profile analysis identified patterns of substance use (alcohol, cannabis, (e-) cigarettes) and emotional and behavioral disorder symptoms. Sociodemographic and clinical correlates of these patterns were examined using multinomial regression. Three profiles were identified including: 1) low substance use and lower frequency and/or severity (relative to other patients in the sample) emotional and behavioral disorder symptoms (26.2%), 2) low substance use with higher emotional and behavioral disorder symptoms (48.2%), and 3) high in both (25.6%). Profiles differed in sociodemographic and clinical indicators related to age, gender, trauma, harm to self, harm to others, and service use. Experiences of trauma, suicide attempts, and thoughts of hurting others increased the odds of adolescents being in the profile high in both substance use and symptoms compared to other profiles. These findings further document the high rates of substance use in adolescents in mental health treatment and the profiles generally map onto three out of four quadrants in the adapted four-quadrant model of concurrent disorders, indicating the importance of assessing and addressing substance use in these settings.
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Affiliation(s)
- Jillian Halladay
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Australia Level 6, Jane Foss Russell Building, G02, Camperdown, NSW, 2006, Australia.
- The Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, 100 West 5Th St, Hamilton, ON, L8N 3K7, Canada.
| | - Katholiki Georgiades
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4S4, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, Canada
| | - James MacKillop
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4S4, Canada
- The Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, 100 West 5Th St, Hamilton, ON, L8N 3K7, Canada
| | - Ellen Lipman
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4S4, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, Canada
| | - Paulo Pires
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4S4, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, Canada
| | - Laura Duncan
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4S4, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, Canada
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Halladay J, MacKillop J, Acuff S, Amlung M, Munn C, Georgiades K. Early substance use and the school environment: A multilevel latent class analysis. J Can Acad Child Adolesc Psychiatry 2024; 33:33-56. [PMID: 38449719 PMCID: PMC10914148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
Background Early substance use is associated with increased risks for mental health and substance use problems which are compounded when using several substances (i.e., polysubstance use). A notable increase in substance use occurs when adolescents transition from elementary to secondary schooling. Objective This study seeks to characterize student and school classes of substance use. Methods A cross-sectional multilevel latent class analysis and regression was conducted on a representative sample of 19,130 grade 6-8 students from 180 elementary schools in Ontario, Canada to: 1) identify distinct classes of student substance use; 2) identify classes of schools based on student classes; and 3) explore correlates of these classes, including mental health, school climate, belonging, safety, and extracurricular participation. Results Two student and two school classes were identified. 4.1% of students were assigned to the high probability of early polysubstance use class while the remaining 95.9% were in the low probability class. Students experiencing depressive and externalizing symptoms had higher odds of being in the early polysubstance use class (Odds Ratio [OR]s=1.1-1.25). At the school level, 19% of schools had higher proportions of students endorsing polysubstance use. Perceptions of positive school climate, belonging, and safety increased the odds of students being in the low probability of early polysubstance use student-level class (ORs=0.85-0.93) and lower probability of early polysubstance use school-level class. Associations related to extracurricular participation were largely not statistically significant. Conclusions Student and school substance use classes may serve as targets for tailored prevention and early interventions. Results support examining school-based interventions targeting school climate, belonging, and safety.
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Affiliation(s)
- Jillian Halladay
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Camperdown NSW, Australia
- Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, Hamilton, Ontario
| | - James MacKillop
- Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, Hamilton, Ontario
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario
| | - Samuel Acuff
- Recovery Research Institute, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States
| | - Michael Amlung
- Cofrin Logan Center for Addiction Research and Treatment, The University of Kansas, Lawrence, Kansas, United States
| | - Catharine Munn
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario
| | - Katholiki Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario
- Offord Centre for Child Studies, McMaster University, Ron Joyce Children's Health Centre, Hamilton, Ontario
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Karagiorga VE, Schafer JL, Marchionatti LE, Caye A, Serdari A, Kotsis K, Basta M, Balikou P, Kapsimalli E, Mitropoulou A, Klavdianou N, Zeleni D, Mitroulaki S, Botzaki A, Gerostergios G, Samiotakis G, Simioni A, Georgiades K, Salum GA, Koumoula A. Translation and cross-cultural adaptation of seventeen widely-used assessment instruments for child and adolescent mental health in Greece. J Patient Rep Outcomes 2024; 8:18. [PMID: 38345660 PMCID: PMC10861406 DOI: 10.1186/s41687-024-00693-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 01/23/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND In the context of Greece, many instruments measuring constructs pertinent to child and adolescent mental health lacked a locally-validated, freely-available version. As part of a nationwide survey, we translated and cross-culturally adapted a collection of seventeen brief, largely-employed assessment tools that can be used at scale. METHODS This study is part of the Child and Adolescent Mental Health Initiative in Greece (CAMHI), a capacity-building program focusing on enhancing mental health care for children and adolescents living in Greece. We conducted a nationwide survey assessing mental health symptoms, parenting practices, service availability and quality, mental health literacy and stigma, and professional practices within the country. As part of this process, we selected outcomes and instruments after consulting the International Consortium for Health Outcomes Measurement (ICHOM) and the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). From our selection, we identified 17 instruments that did not have a Greek-validated version available for use. These instruments were translated and cross-culturally adapted following a structured procedure, including independent back-and-forth translations, synthesis of versions, expert revision, and pilot testing. Some instruments were slightly modified to meet CAMHI survey purposes. RESULTS A cross-culturally adapted version in Greek was made available for the following instruments: Pediatric Symptoms Checklist (PSC); Deliberate Self Harm Inventory (DSH) (modified); Child and Adolescent Trauma Screen-2 (CATS-2); ABCD Screen Use (modified); Swanson, Nolan, and Pelham-IV (SNAP-IV); Parent Behavior Inventory (PBI); Mental Health Literacy Scale (MHLS)-(modified); Australian Mental Health Vignettes; Reported and Intended Behavior Scale (RIBS); Barriers to Access to Care (BACE) (modified); Experience of Service Questionnaire (ESQ) (modified); and Multitheoretical List of Therapeutic Interventions (MULTI-30) (modified). CONCLUSION A collection of these widely-used assessment tools is now adapted for the local context and freely accessible at [ https://osf.io/crz6h/ ]. Researchers and health professionals in Greece can utilize this resource to screen, evaluate, and monitor various constructs related to mental health in accordance with the most effective practices.
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Affiliation(s)
- Vasiliki Eirini Karagiorga
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation and Child Mind Institute, 101 East 56th Street, New York, New York, 10022, USA
- Child Mind Institute, New York, USA
| | - Julia Luiza Schafer
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation and Child Mind Institute, 101 East 56th Street, New York, New York, 10022, USA
- Child Mind Institute, New York, USA
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Lauro Estivalete Marchionatti
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation and Child Mind Institute, 101 East 56th Street, New York, New York, 10022, USA
- Child Mind Institute, New York, USA
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Arthur Caye
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation and Child Mind Institute, 101 East 56th Street, New York, New York, 10022, USA
- Child Mind Institute, New York, USA
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Aspasia Serdari
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation and Child Mind Institute, 101 East 56th Street, New York, New York, 10022, USA
- Department of Child and Adolescent Psychiatry, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Konstantinos Kotsis
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation and Child Mind Institute, 101 East 56th Street, New York, New York, 10022, USA
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Maria Basta
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation and Child Mind Institute, 101 East 56th Street, New York, New York, 10022, USA
- Department of Psychiatry, University Hospital of Heraklion, Crete, Greece
- Department of Child and Adolescent Psychiatry, University Hospital of Heraklion, Crete, Greece
| | - Panagiota Balikou
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation and Child Mind Institute, 101 East 56th Street, New York, New York, 10022, USA
| | - Efstathia Kapsimalli
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation and Child Mind Institute, 101 East 56th Street, New York, New York, 10022, USA
| | - Andromachi Mitropoulou
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation and Child Mind Institute, 101 East 56th Street, New York, New York, 10022, USA
| | - Nikanthi Klavdianou
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation and Child Mind Institute, 101 East 56th Street, New York, New York, 10022, USA
| | - Domna Zeleni
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation and Child Mind Institute, 101 East 56th Street, New York, New York, 10022, USA
| | - Sotiria Mitroulaki
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation and Child Mind Institute, 101 East 56th Street, New York, New York, 10022, USA
| | - Anna Botzaki
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation and Child Mind Institute, 101 East 56th Street, New York, New York, 10022, USA
| | - Giorgos Gerostergios
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation and Child Mind Institute, 101 East 56th Street, New York, New York, 10022, USA
| | - Giorgos Samiotakis
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation and Child Mind Institute, 101 East 56th Street, New York, New York, 10022, USA
| | - André Simioni
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation and Child Mind Institute, 101 East 56th Street, New York, New York, 10022, USA
- Child Mind Institute, New York, USA
| | - Katholiki Georgiades
- Department of Psychiatry and Behavioural Neurosciences and Offord Centre for Child Studies, McMaster University, Hamilton, Canada
| | - Giovanni Abrahão Salum
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation and Child Mind Institute, 101 East 56th Street, New York, New York, 10022, USA.
- Child Mind Institute, New York, USA.
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
| | - Anastasia Koumoula
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation and Child Mind Institute, 101 East 56th Street, New York, New York, 10022, USA.
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Halladay J, Sunderland M, Chapman C, Repchuck R, Georgiades K, Boak A, Hamilton HA, Slade T. Examining temporal trends in psychological distress and the co-occurrence of common substance use in a population-based sample of grade 7-12 students from 2013 to 2019. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02619-z. [PMID: 38311705 DOI: 10.1007/s00127-024-02619-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 01/01/2024] [Indexed: 02/06/2024]
Abstract
PURPOSE Characterizing trends and correlates of adolescent psychological distress is important due to observed global increases over the last 20 years. Substance use is a commonly discussed correlate, though we lack an understanding about how co-occurrence of these concerns has been changing over time. METHODS Data came from repeated, representative, cross-sectional surveys of grade 7-12 students across Ontario, Canada conducted biennially from 2013 to 2019. Poisson regression with robust standard errors was used to examine changes in the joint association between psychological distress (operationalized as Kessler-6 [K6] scores ≥ 13) and substance use over time. Weighted prevalence ratios (PR) and their 99% confidence intervals were estimated, where p < 0.01 denotes statistical significance. RESULTS The prevalence of psychological distress doubled between 2013 and 2019, with adjusted increases of about 1.2 times each survey year. This biennial increase did not differ based on sex, perceived social standing, school level, or any substance use. Students using substances consistently reported a higher prevalence of psychological distress (between 1.2 times and 2.7 times higher). There were similarly no differential temporal trends based on substance use for very high distress (K6 ≥ 19) or K6 items explored individually. CONCLUSION Psychological distress steeply increased among adolescents and substance use remains important to assess and address alongside distress. However, the magnitude of temporal increases appears to be similar for adolescents reporting and not reporting substance use.
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Affiliation(s)
- J Halladay
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Level 6, Jane Foss Russell Building, G02, Camperdown, NSW, 2006, Australia.
| | - M Sunderland
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Level 6, Jane Foss Russell Building, G02, Camperdown, NSW, 2006, Australia
| | - C Chapman
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Level 6, Jane Foss Russell Building, G02, Camperdown, NSW, 2006, Australia
| | - R Repchuck
- Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada
| | - K Georgiades
- Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada
| | - A Boak
- The Centre for Addiction and Mental Health (CAMH), University of Toronto, Toronto, Canada
| | - H A Hamilton
- The Centre for Addiction and Mental Health (CAMH), University of Toronto, Toronto, Canada
| | - T Slade
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Level 6, Jane Foss Russell Building, G02, Camperdown, NSW, 2006, Australia
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Hoffmann MS, Pine DS, Georgiades K, Szatmari P, Miguel EC, Pan PM, Gadelha A, Rohde LA, Merikangas KR, Milham MP, Satterthwaite TD, Salum GA. Comparing mental health semi-structured diagnostic interviews and symptom checklists to predict poor life outcomes: an 8-year cohort study from childhood to young adulthood in Brazil. Lancet Glob Health 2024; 12:e79-e89. [PMID: 37980914 PMCID: PMC10716620 DOI: 10.1016/s2214-109x(23)00462-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 09/13/2023] [Accepted: 09/28/2023] [Indexed: 11/21/2023]
Abstract
BACKGROUND Semi-structured diagnostic interviews and symptom checklists present similar internal reliability. We aim to investigate whether they differ in predicting poor life outcomes in the transition from childhood to young adulthood. METHODS For this longitudinal study, we used data from the Brazilian High Risk Cohort Study for Childhood Mental Health Conditions. Eligible participants were aged 6-14 years on the day of study enrolment (January to February, 2010) and were enrolled in public schools by a biological parent in Porto Alegre and São Paulo, Brazil. 2511 young people and their caregivers were assessed at baseline in 2010-11, and 1917 were assessed 8 years later (2018-19; 76·3% retention). Clinical thresholds were derived using semi-structured parent-report interview based on the Diagnostic and Statistical Manual of Mental Disorders, according to the Developmental and Well-being Assessment (DAWBA), and clinical scores as defined by the Child Behavior Checklist (CBCL; T-score ≥70 considered positive caseness). At 8 years, participants were assessed for a composite life-threatening outcome (a composite of death, suicide attempts, severe self-harm, psychiatric inpatient admission, or emergency department visits) and a composite poor life chances outcome (a composite of any criminal conviction, substance misuse, or school dropout). We evaluated the accuracy of DAWBA and CBCL to predict these outcomes. Logistic regression models were adjusted for age, sex, race or ethnicity, study site, and socioeconomic class. FINDINGS DAWBA and CBCL had similar sensitivity, specificity, predictive values, and test accuracy for both composite outcomes and their components. Any mental health problem, as classified by DAWBA and CBCL, was independently associated with the composite life-threatening outcome (DAWBA adjusted odds ratio 1·62, 95% CI 1·20-2·18; CBCL 1·66, 1·19-2·30), but only CBCL independently predicted poor life chances (1·56, 1·19-2·04). Participants classified by both approaches did not have higher odds of the life-threatening outcome when compared with participants classified by DAWBA or CBCL alone, nor for the poor life chances outcome when compared with those classified by CBCL alone. INTERPRETATION Classifying children and adolescents based on a semi-structured diagnostic interview was not statistically different to symptom checklist in terms of test accuracy and predictive validity for relevant life outcomes. Classification based on symptom checklist might be a valid alternative to costly and time-consuming methods to identify young people at risk for poor life outcomes. FUNDING Conselho Nacional de Desenvolvimento Científico e Tecnológico; Fundação de Amparo à Pesquisa do Estado de São Paulo; and Medical Research Council, European Research Council. TRANSLATION For the Portuguese translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Mauricio Scopel Hoffmann
- Department of Neuropsychiatry and Mental Health Epidemiology Group (MHEG), Universidade Federal de Santa Maria, Santa Maria, Brazil; Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK.
| | - Daniel S Pine
- Section on Developmental Affective Neuroscience, National Institute of Mental Health, Bethesda, MD, USA
| | - Katholiki Georgiades
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Peter Szatmari
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada; Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada; Department of Psychiatry, University of Toronto Faculty of Medicine, Toronto, ON, Canada
| | - Euripedes Constantino Miguel
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil; Universidade de São Paulo, São Paulo, Brazil
| | - Pedro Mario Pan
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil; Laboratório Interdisciplinar de Neurociências Clínicas, Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Ary Gadelha
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil; Departamento de Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Luis Augusto Rohde
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Department of Psychiatry and Legal Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil
| | - Kathleen Ries Merikangas
- Genetic Epidemiology Research Branch, National Institute of Mental Health Intramural Research Program, Bethesda, MD, USA
| | - Michael Peter Milham
- Nathan S Kline Institute for Psychiatric Research, Orangeburg, NY, USA; Child Mind Institute, New York, NY, USA
| | - Theodore Daniel Satterthwaite
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA; Lifespan Informatics and Neuroimaging Center, Philadelphia, PA, USA
| | - Giovanni Abrahão Salum
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Department of Psychiatry and Legal Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil; Child Mind Institute, New York, NY, USA
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8
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Halladay J, Ogrodnik M, Farag Alla J, Sunderland M, Gardner LA, Georgiades K. Playing for more than winning: Exploring sports participation, physical activity, and belongingness and their relationship with patterns of adolescent substance use and mental health. Drug Alcohol Depend 2024; 254:111039. [PMID: 38043225 DOI: 10.1016/j.drugalcdep.2023.111039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 11/18/2023] [Accepted: 11/20/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND Promoting adolescent sports participation and physical activity may be effective low-barrier prevention strategies for co-occurring adolescent substance use (SU) and mental health symptoms (MH). The objectives of this study were to: 1) explore associations between profiles of SU/MH and sports participation; and 2) determine whether physical activity and belongingness account for these associations. METHODS Data came from a representative sample of 11,994 grade 9-12 Ontarian students (ages ~14-18) previously grouped into five SU/MH profiles based on patterns of use and symptoms. A series of multinomial logistic regressions, adjusted for socio-demographics and school clustering, were used to predict the risks of students belonging to SU/MH profiles based on: 1) school sports participation (>=weekly), 2) sports and physical activity (>=60minutes; 0-7 days), and 3) sports, physical activity, and school belongingness. RESULTS Greater school sports participation, physical activity, and belongingness were each associated with reduced risks of belonging to most profiles with elevations in SU and/or MH symptoms relative to the low SU/MH profile (Relative Risk Ratios: sports=0.62-0.87, physical activity=0.78-0.98, belonging=0.75-0.83). Frequency of physical activity accounted for ~32-60% of the associations between sports and SU/MH profiles, while school belongingness accounted for the remaining associations. Physical activity and belongingness remained independently associated with SU/MH profiles. CONCLUSIONS Findings suggest possible indirect associations between school sports participation and SU/MH profiles through physical activity and school belongingness, which may be promising prevention targets that have independent associations over and above sports. School sports participation may be one of a number of ways to achieve these goals.
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Affiliation(s)
- J Halladay
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Australia.
| | - M Ogrodnik
- Department of Kinesiology and Health Sciences, University of Waterloo, Canada
| | - J Farag Alla
- Offord Centre for Child Studies, McMaster University, Canada
| | - M Sunderland
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Australia
| | - L A Gardner
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Australia
| | - K Georgiades
- Offord Centre for Child Studies, McMaster University, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Canada
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9
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Edwards J, Kurdyak P, Waddell C, Patten SB, Reid GJ, Campbell LA, Georgiades K. Surveillance of Child and Youth Mental Disorders and Associated Service Use in Canada. Can J Psychiatry 2023; 68:819-825. [PMID: 37357689 PMCID: PMC10590091 DOI: 10.1177/07067437231182059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Affiliation(s)
- Jordan Edwards
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
| | - Paul Kurdyak
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Institute of Mental Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada
| | - Charlotte Waddell
- Children's Health Policy Centre, Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada
| | - Scott B. Patten
- Cuthbertson & Fischer Chair in Pediatric Mental Health, Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Graham J. Reid
- Departments of Psychology & Family Medicine, The University of Western Ontario, London, Ontario, Canada
- Children's Health Research Institute, London, Ontario, Canada
| | - Leslie Anne Campbell
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Katholiki Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
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10
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Salami OO, Yaskina M, Georgiades K, Diaz E, Hegadoren K, Meherali S, Yohani S, Senthilselvan A. Mental Health of Immigrant Children and Adolescents (6-17 Years) in Canada: Evidence from the Canadian Health Measures Survey. Int J Environ Res Public Health 2023; 20:6997. [PMID: 37947555 PMCID: PMC10650002 DOI: 10.3390/ijerph20216997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 10/19/2023] [Accepted: 10/20/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Studies indicate a higher prevalence of mental health problems among immigrants, but findings on immigrant children and adolescents are mixed. We sought to understand the magnitude of differences in mental health indicators between immigrant and non-immigrant children and adolescents in Canada and the influence of age, sex, household income, and household education. METHODS We completed a secondary analysis of data from the Canadian Health Measures Survey, using a pooled estimate method to combine data from four survey cycles. A weighted logistic regression was used to estimate the unadjusted and adjusted odds ratios with 95% confidence intervals. RESULTS We found an association between the mental health of immigrant versus non-immigrant children and adolescents (6-17 years) as it relates to emotional problems and hyperactivity. Immigrant children and adolescents had better outcomes with respect to emotional problems and hyperactivity/inattention compared to non-immigrant children and adolescents. Lower household socioeconomic status was associated with poorer mental health in children and adolescents. CONCLUSION No significant differences in overall mental health status were evident between immigrant and non-immigrant children and adolescents in Canada but differences exist in emotional problems and hyperactivity. Sex has an influence on immigrant child mental health that varies depending on the specific mental health indicator.
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Affiliation(s)
| | - Maryna Yaskina
- Women and Children’s Health Research Institute, University of Alberta, Edmonton, AB T6G 1C9, Canada
| | - Katholiki Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8N 3K7, Canada;
| | - Esperanza Diaz
- Department of Global Public Health and Primary Care, University of Bergen, 5009 Bergen, Norway
| | - Kathleen Hegadoren
- Faculty of Nursing, University of Alberta, Edmonton, AB T6G 1C9, Canada; (K.H.); (S.M.)
| | - Salima Meherali
- Faculty of Nursing, University of Alberta, Edmonton, AB T6G 1C9, Canada; (K.H.); (S.M.)
| | - Sophie Yohani
- Department of Educational Psychology, University of Alberta, Edmonton, AB T6G 1C9, Canada
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Wahi G, Kandasamy S, Bangdiwala SI, Baumann A, Crea-Arsenio M, Desai D, DiLiberto D, Georgiades K, Jackson-Best F, Kwan M, Montague P, Newbold KB, Sherifali D, Sim A, de Souza RJ, Anand SS. Strengthening Community Roots: Anchoring Newcomers in Wellness and Sustainability (SCORE!): A protocol for the co-design and evaluation of a healthy active living program among a newcomer community in Canada. PLoS One 2023; 18:e0288851. [PMID: 37768908 PMCID: PMC10538726 DOI: 10.1371/journal.pone.0288851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 07/11/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND The burden of childhood obesity and cardiometabolic risk factors affecting newcomer Canadians living in lower socioeconomic circumstances is a concerning public health issue. This paper describes Strengthening Community Roots: Anchoring Newcomers in Wellness and Sustainability (SCORE!), an academic-community research partnership to co-design interventions that nurture and optimize healthy activity living (HAL) among a community of children and families new to Canada in Hamilton, Ontario, Canada. METHODS/DESIGN Our overarching program is informed by a socio-ecological model, and will co-create HAL interventions for children and families new to Canada rooted in outdoor, nature-based physical activity. We will proceed in three phases: Phase 1) synthesis of existing evidence regarding nature based HAL interventions among children and families; Phase 2) program development through four data collection activities including: i) community engagement activities to build trustful relationships and understand barriers and facilitators, including establishing a community advisory and action board, qualitative studies including a photovoice study, and co-design workshops to develop programs; ii) characterizing the demographics of the community through a household survey; iii) characterizing the built environment and HAL programs/services available in the community by developing an accessible real-time systems map; and iv) reviewing municipal policies relevant to HAL and sustainability; leading to Phase 3) implementation and evaluation of the feasibility of co-designed HAL programs. CONCLUSION The etiology of childhood obesity and related chronic diseases is complex and multifactorial, as are intervention strategies. The SCORE! program of research brings together partners including community members, service providers, academic researchers, and organizational leaders to build a multi-component intervention that promotes the health and wellness of newcomer children and families.
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Affiliation(s)
- Gita Wahi
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Chanchlani Research Centre, McMaster University, Hamilton, Ontario, Canada
| | - Sujane Kandasamy
- Chanchlani Research Centre, McMaster University, Hamilton, Ontario, Canada
- Child and Youth Studies, Brock University, St Catherines, Ontario, Canada
| | - Shrikant I. Bangdiwala
- Population Health Research Institute, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Andrea Baumann
- School of Nursing, McMaster University, Hamilton, Ontario, Canada
- Global Health Office, McMaster University, Hamilton, Ontario, Canada
| | - Mary Crea-Arsenio
- Global Health Office, McMaster University, Hamilton, Ontario, Canada
| | - Dipika Desai
- Chanchlani Research Centre, McMaster University, Hamilton, Ontario, Canada
- Population Health Research Institute, Hamilton, Ontario, Canada
| | - Deborah DiLiberto
- Global Health Office, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Katholiki Georgiades
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, Ron Joyce Children’s Health Centre, Hamilton, Ontario, Canada
| | - Fatimah Jackson-Best
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Matthew Kwan
- Child and Youth Studies, Brock University, St Catherines, Ontario, Canada
| | - Patricia Montague
- Chanchlani Research Centre, McMaster University, Hamilton, Ontario, Canada
| | - K. Bruce Newbold
- School of Earth, Environment & Society, McMaster University, Hamilton, Ontario, Canada
| | - Diana Sherifali
- School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Amanda Sim
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Russell J. de Souza
- Chanchlani Research Centre, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Sonia S. Anand
- Chanchlani Research Centre, McMaster University, Hamilton, Ontario, Canada
- Population Health Research Institute, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
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12
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Bogdan T, Xie W, Talaat H, Mir H, Venkataraman B, Banfield LE, Georgiades K, Duncan L. Longitudinal studies of child mental disorders in the general population: A systematic review of study characteristics. JCPP Adv 2023; 3:e12186. [PMID: 37720586 PMCID: PMC10501698 DOI: 10.1002/jcv2.12186] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 07/01/2023] [Indexed: 09/19/2023] Open
Abstract
Introduction Longitudinal studies of child mental disorders in the general population (herein study) investigate trends in prevalence, incidence, risk/protective factors, and sequelae for disorders. They are time and resource intensive but offer life-course perspectives and examination of causal mechanisms. Comprehensive syntheses of the methods of existing studies will provide an understanding of studies conducted to date, inventory studies, and inform the planning of new longitudinal studies. Methods A systematic review of the research literature in MEDLINE, EMBASE, and PsycINFO was conducted in December 2022 for longitudinal studies of child mental disorders in the general population. Records were grouped by study and assessed for eligibility. Data were extracted from one of four sources: a record reporting study methodology, a record documenting child mental disorder prevalence, study websites, or user guides. Narrative and tabular syntheses of the scope and design features of studies were generated. Results There were 18,133 unique records for 487 studies-159 of these were eligible for inclusion. Studies occurred from 1934 to 2019 worldwide, with data collection across 1 to 68 time points, with 70% of studies ongoing. Baseline sample sizes ranged from n = 151 to 64,136. Studies were most frequently conducted in the United States and at the city/town level. Internalizing disorders and disruptive, impulse control, and conduct disorders were the most frequently assessed mental disorders. Of studies reporting methods of disorder assessment, almost all used measurement scales. Individual, familial and environmental risk and protective factors and sequelae were examined. Conclusions These results summarize characteristics of existing longitudinal studies of child mental disorders in the general population, provide an understanding of studies conducted to date, encourage comprehensive and consistent reporting of study methodology to facilitate meta-analytic syntheses of longitudinal evidence, and offer recommendations and suggestions for the design of future studies. Registration DOI: 10.17605/OSF.IO/73HSW.
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Affiliation(s)
- Theodora Bogdan
- Department of Psychiatry and Behavioural NeurosciencesOfford Centre for Child StudiesMcMaster UniversityHamiltonOntarioCanada
| | - Weiyi Xie
- Department of Psychiatry and Behavioural NeurosciencesOfford Centre for Child StudiesMcMaster UniversityHamiltonOntarioCanada
| | - Habeba Talaat
- Department of Psychiatry and Behavioural NeurosciencesOfford Centre for Child StudiesMcMaster UniversityHamiltonOntarioCanada
| | - Hafsa Mir
- Department of Psychiatry and Behavioural NeurosciencesOfford Centre for Child StudiesMcMaster UniversityHamiltonOntarioCanada
| | - Bhargavi Venkataraman
- Department of Psychiatry and Behavioural NeurosciencesOfford Centre for Child StudiesMcMaster UniversityHamiltonOntarioCanada
| | | | - Katholiki Georgiades
- Department of Psychiatry and Behavioural NeurosciencesOfford Centre for Child StudiesMcMaster UniversityHamiltonOntarioCanada
| | - Laura Duncan
- Department of Psychiatry and Behavioural NeurosciencesOfford Centre for Child StudiesMcMaster UniversityHamiltonOntarioCanada
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13
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Comeau J, Wang L, Duncan L, Edwards J, Georgiades K, Anderson KK, Wilk P, Lau T. Correlates of child mental health and substance use related emergency department visits in Ontario: A linked population survey and administrative health data study. Int J Popul Data Sci 2023; 8:2152. [PMID: 37670954 PMCID: PMC10476702 DOI: 10.23889/ijpds.v8i1.2152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2023] Open
Abstract
Introduction Knowledge of the sociodemographic, behavioural, and clinical characteristics of children visiting emergency departments (EDs) for mental health or substance use concerns in Ontario, Canada is lacking. Objectives Using data from a population-based survey linked at the individual level to administrative health data, this study leverages a provincially representative sample and quasi-experimental design to strengthen inferences regarding the extent to which children's sociodemographic, behavioural, and clinical characteristics are associated with the risk of a mental health or substance use related ED visit. Methods 9,301 children aged 4-17 years participating in the 2014 Ontario Child Health Study were linked retrospectively (6 months) and prospectively (12 months) with administrative health data on ED visits from the National Ambulatory Care Reporting System. Modified Poisson regression was used to examine correlates of mental health and substance use related ED visits among children aged 4-17 years over a 12-month period following their survey completion date, adjusting for ED visits in the 6 months prior to their survey completion date. Subgroup analyses of youths aged 14-17 years who independently completed survey content related to peer victimisation, substance use, and suicidality were also conducted. Results Among children aged 4-17 years, older age, parental immigrant status, internalising problems, and perceived need for professional help were statistically significant correlates that increased the risk of a mental health or substance use related ED visit; low-income and suicidal ideation with attempt were statistically significant only among youths aged 14-17 years. Conclusions Knowledge of the sociodemographic, behavioural, and clinical characteristics of children visiting EDs for mental health and substance use related concerns is required to better understand patient needs to coordinate effective emergency mental health care that optimises child outcomes, and to inform the development and targeting of upstream interventions that have the potential to prevent avoidable ED visits. Highlights Growing rates of child mental health and substance use related ED visits have been observed internationally.A population-based survey linked at the individual level to administrative health data was used to examine the extent to which children's sociodemographic, behavioural, and clinical characteristics are associated with the risk of a mental health or substance use related ED visit in Ontario, Canada.Older age, low-income, parental immigrant status, perceived need for professional help, internalising problems, and suicidality increase the risk of an ED visit.Knowledge of the characteristics of children visiting EDs can be used to coordinate effective emergency mental health care that optimises child outcomes, and to inform the development and targeting of upstream interventions that have the potential to prevent avoidable ED visits.
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Affiliation(s)
- Jinette Comeau
- King’s University College at Western University
- Children’s Health Research Institute, Division of Children’s Health and Therapeutics, Lawson Health Research Institute, Western University, London, ON, Canada
| | - Li Wang
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Laura Duncan
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Jordan Edwards
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Katholiki Georgiades
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Kelly K. Anderson
- Children’s Health Research Institute, Division of Children’s Health and Therapeutics, Lawson Health Research Institute, Western University, London, ON, Canada
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Canada
- Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Piotr Wilk
- Children’s Health Research Institute, Division of Children’s Health and Therapeutics, Lawson Health Research Institute, Western University, London, ON, Canada
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Canada
- Department of Paediatrics, Schulich School of Medicine and Dentistry, Western University, London, Canada
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Tammy Lau
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Canada
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Kamali M, Edwards J, Anderson LN, Duku E, Georgiades K. Social Disparities in Mental Health Service Use Among Children and Youth in Ontario: Evidence From a General, Population-Based Survey. Can J Psychiatry 2023; 68:596-604. [PMID: 36503305 PMCID: PMC10411367 DOI: 10.1177/07067437221144630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To examine differences in mental health-related service contacts between immigrant, refugee, racial and ethnic minoritized children and youth, and the extent to which social, and economic characteristics account for group differences. METHODS The sample for analyses includes 10,441 children and youth aged 4-17 years participating in the 2014 Ontario Child Health Study. The primary caregiver completed assessments of their child's mental health symptoms, perceptions of need for professional help, mental health-related service contacts, experiences of discrimination and sociodemographic and economic characteristics. RESULTS Adjusting for mental health symptoms and perceptions of need for professional help, children and youth from immigrant, refugee and racial and ethnic minoritized backgrounds were less likely to have mental health-related service contacts (adjusted odds ratios ranged from 0.54 to 0.79), compared to their non-immigrant peers and those who identified as White. Group differences generally remained the same or widened after adjusting for social and economic characteristics. Large differences in levels of perceived need were evident across non-migrant and migrant children and youth. CONCLUSION Lower estimates of mental health-related service contacts among immigrant, refugee and racial and ethnic minoritized children and youth underscore the importance and urgency of addressing barriers to recognition and treatment of mental ill-health among children and youth from minoritized backgrounds.
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Affiliation(s)
- Mahdis Kamali
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, Ron Joyce Children's Health Centre, Hamilton, ON, Canada
| | - Jordan Edwards
- Offord Centre for Child Studies, Ron Joyce Children's Health Centre, Hamilton, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Laura N. Anderson
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Eric Duku
- Offord Centre for Child Studies, Ron Joyce Children's Health Centre, Hamilton, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Katholiki Georgiades
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, Ron Joyce Children's Health Centre, Hamilton, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
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15
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Sim A, Ahmad A, Hammad L, Shalaby Y, Georgiades K. Reimagining mental health care for newcomer children and families: a qualitative framework analysis of service provider perspectives. BMC Health Serv Res 2023; 23:699. [PMID: 37370152 PMCID: PMC10303766 DOI: 10.1186/s12913-023-09682-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 06/10/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Persistent disparities in access to mental health care for refugee and immigrant children and their families pose unique challenges to policy and practice. This study examined service provider perspectives on the barriers and opportunities for improving mental health supports for newcomer children and families in Canada. METHODS Semi-structured individual and group interviews were conducted with 33 leadership and frontline staff from 14 organizations in the health, education, settlement, and social service sectors in Hamilton, Ontario. Interview data were analyzed using the framework method. RESULTS Participants described barriers at the systems, provider, and individual and family levels that prevented newcomer families from accessing and benefiting from mental health supports. Structural barriers included inadequate services and funding, complexity of systems, cultural tensions, and, lack of prevention and early identification. Provider-level barriers included lack of representation, mental health knowledge and cultural competency, and staff shortages and burnout. Individual and family-level barriers included lack of mental health literacy, primacy of settlement needs, stigma, fear, and the high threshold for help-seeking. Participants' recommendations for "reimagining care" related to newcomer engagement, person- and family-centered care, cultural responsiveness, mental health promotion and prevention, workforce diversity and development, collaborative and integrated care, and knowledge generation and uptake. CONCLUSIONS The intersection of structural, provider, and individual/family-level barriers reduce newcomer families' access to and effectiveness of mental health supports. Reducing disparities in mental health and access to care will require a paradigm shift in the way that mental health care is conceptualized and delivered to newcomer children and families.
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Affiliation(s)
- Amanda Sim
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
| | - Afreen Ahmad
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Lina Hammad
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Yasmine Shalaby
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Katholiki Georgiades
- Department of Psychiatry and Behavioural Neurosciences, The Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada
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Koumoula A, Marchionatti LE, Caye A, Karagiorga VE, Balikou P, Lontou K, Arkoulaki V, Simioni A, Serdari A, Kotsis K, Basta M, Kapsimali E, Mitropoulou A, Klavdianou N, Zeleni D, Mitroulaki S, Botzaki A, Gerostergios G, Samiotakis G, Moschos G, Giannopoulou I, Papanikolaou K, Aggeli K, Scarmeas N, Koulouvaris P, Emanuele J, Schuster K, Karyotaki E, Kalikow L, Pronoiti K, Gosmann NP, Schafer JL, Merikangas KR, Szatmari P, Cuijpers P, Georgiades K, Milham MP, Corcoran M, Burke S, Koplewicz H, Salum GA. The science of child and adolescent mental health in Greece: a nationwide systematic review. Eur Child Adolesc Psychiatry 2023:10.1007/s00787-023-02213-9. [PMID: 37179505 DOI: 10.1007/s00787-023-02213-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 04/11/2023] [Indexed: 05/15/2023]
Abstract
Evidence-based information is essential for effective mental health care, yet the extent and accessibility of the scientific literature are critical barriers for professionals and policymakers. To map the necessities and make validated resources accessible, we undertook a systematic review of scientific evidence on child and adolescent mental health in Greece encompassing three research topics: prevalence estimates, assessment instruments, and interventions. We searched Pubmed, Web of Science, PsycINFO, Google Scholar, and IATPOTEK from inception to December 16th, 2021. We included studies assessing the prevalence of conditions, reporting data on assessment tools, and experimental interventions. For each area, manuals informed data extraction and the methodological quality were ascertained using validated tools. This review was registered in protocols.io [68583]. We included 104 studies reporting 533 prevalence estimates, 223 studies informing data on 261 assessment instruments, and 34 intervention studies. We report the prevalence of conditions according to regions within the country. A repository of locally validated instruments and their psychometrics was compiled. An overview of interventions provided data on their effectiveness. The outcomes are made available in an interactive resource online [ https://rpubs.com/camhi/sysrev_table ]. Scientific evidence on child and adolescent mental health in Greece has now been cataloged and appraised. This timely and accessible compendium of up-to-date evidence offers valuable resources for clinical practice and policymaking in Greece and may encourage similar assessments in other countries.
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Affiliation(s)
- Anastasia Koumoula
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Lauro Estivalete Marchionatti
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Arthur Caye
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Vasiliki Eirini Karagiorga
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
| | - Panagiota Balikou
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Katerina Lontou
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Vicky Arkoulaki
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - André Simioni
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
| | - Aspasia Serdari
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Department of Child and Adolescent Psychiatry, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Konstantinos Kotsis
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Maria Basta
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Department of Psychiatry, University Hospital of Heraklion, Crete, Greece
- Department of Child and Adolescent Psychiatry, University Hospital of Heraklion, Crete, Greece
| | - Efi Kapsimali
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Andromachi Mitropoulou
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Nikanthi Klavdianou
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Domna Zeleni
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Sotiria Mitroulaki
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Anna Botzaki
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Giorgos Gerostergios
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Giorgos Samiotakis
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Giorgos Moschos
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Ioanna Giannopoulou
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- 2nd Department of Psychiatry, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Katerina Papanikolaou
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Department of Child Psychiatry, Agia Sophia Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Katerina Aggeli
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Nikolaos Scarmeas
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Department of Neurology, National and Kapodistrian University of Athens, Athens, Greece
- Department of Neurology, Columbia University, New York, USA
| | - Panagiotis Koulouvaris
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Jill Emanuele
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
| | - Kenneth Schuster
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
| | - Eirini Karyotaki
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Department of Clinical Neuro and Developmental Psychology, Vrije University Amsterdam, Amsterdam, The Netherlands
| | - Lily Kalikow
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Katerina Pronoiti
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Natan Pereira Gosmann
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Julia Luiza Schafer
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Kathleen R Merikangas
- Genetic Epidemiology Research Branch, National Institute of Mental Health, Bethesda, USA
| | - Peter Szatmari
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Pim Cuijpers
- Department of Clinical Neuro and Developmental Psychology, Vrije University Amsterdam, Amsterdam, The Netherlands
| | - Katholiki Georgiades
- Department of Psychiatry and Behavioural Neurosciences & Offord Centre for Child Studies, McMaster University, Hamilton, Canada
| | - Michael P Milham
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
| | - Mimi Corcoran
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
| | - Sarah Burke
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
| | - Harold Koplewicz
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
| | - Giovanni Abrahão Salum
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA.
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA.
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
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Aitken M, Perquier F, Haltigan JD, Wang L, Andrade BF, Battaglia M, Szatmari P, Georgiades K. Individual- and family-level associations between child psychopathology and parenting. Dev Psychopathol 2023:1-9. [PMID: 37017128 DOI: 10.1017/s0954579423000202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
Parenting can protect against the development of, or increase risk for, child psychopathology; however, it is unclear if parenting is related to psychopathology symptoms in a specific domain, or to broad liability for psychopathology. Parenting differs between and within families, and both overall family-level parenting and the child-specific parenting a child receives may be important in estimating transdiagnostic associations with psychopathology. Data come from a cross-sectional epidemiological sample (N = 10,605 children ages 4-17, 6434 households). Parents rated child internalizing and externalizing symptoms and their parenting toward each child. General and specific (internalizing, externalizing) psychopathology factors, derived with bifactor modeling, were regressed on parenting using multilevel modeling. Less warmth and more aversive/inconsistent parenting in the family, and toward an individual child relative to family average, were associated with higher general psychopathology and specific externalizing problems. Unexpectedly, more warmth in the family, and toward an individual child relative to family average, was associated with higher specific internalizing problems in 4-11 (not 12-17) year-olds. Less warmth and more aversive/inconsistent parenting are broad correlates of child psychopathology. Aversive/inconsistent parenting, is also related to specific externalizing problems. Parents may behave more warmly when their younger children have specific internalizing problems, net of overall psychopathology.
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Affiliation(s)
- Madison Aitken
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Canada
| | - Florence Perquier
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, Canada
| | - John D Haltigan
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Canada
- Hospital for Sick Children, Toronto, Canada
| | - Li Wang
- Department of Psychiatry and Behavioural Neurosciences & Offord Centre for Child Studies, McMaster University, Hamilton, Canada
| | - Brendan F Andrade
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Canada
| | - Marco Battaglia
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Canada
| | - Peter Szatmari
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Canada
- Hospital for Sick Children, Toronto, Canada
| | - Katholiki Georgiades
- Department of Psychiatry and Behavioural Neurosciences & Offord Centre for Child Studies, McMaster University, Hamilton, Canada
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Sim A, Puffer E, Ahmad A, Hammad L, Georgiades K. Resettlement, mental health, and coping: a mixed methods survey with recently resettled refugee parents in Canada. BMC Public Health 2023; 23:386. [PMID: 36823525 PMCID: PMC9948768 DOI: 10.1186/s12889-023-15300-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 02/21/2023] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND Resettlement experiences of refugee parents are under-researched despite evidence indicating higher risk of poor mental health. The current study integrates family systems and social determinants of refugee mental health frameworks to examine: (1) Refugee parents' experiences of resettlement stressors and mental health; (2) Perceived impacts of resettlement stressors on individual and family indicators of well-being; and (3) Refugee parents' coping strategies and resources. METHODS The study draws on data from a mixed methods survey conducted with 40 Government-Assisted Refugee parents who had resettled to Hamilton, Canada within the past 4 years. Quantitative and qualitative data were analyzed separately and then integrated at the results stage using a weaving approach. RESULTS Results indicate significant exposure to economic and social stressors across multiple domains of daily life, as well as high levels of parental psychological distress. Parents drew linkages between resettlement stressors and negative mental health impacts that were compounded by intersecting risk factors of ill health, caregiving burden, single parenthood, and low levels of education and literacy. Most parents rated themselves as coping well or very well and described various coping strategies such as positive reframing, problem solving, planning, and turning to religion. Quantitative and qualitative findings indicate high frequency of positive parent-child interaction and low frequency of family conflict, and highlight the importance of family as a protective resource for coping with adversity. Exploratory regression analyses suggest that longer stay in Canada, poorer self-rated health, higher levels of resettlement stressors, and more conflict between adults in the household may be associated with greater psychological distress. CONCLUSION Study findings highlight both the resilience of refugee parents and the psychological toll of navigating their families through a new and challenging environment. Policies and programs to provide comprehensive social and economic supports to refugees beyond the first one to two years after arrival are necessary to mitigate the mental health impacts of displacement over time and strengthen individual and family resilience. Such programs should include culturally responsive and family-based models of mental health care that acknowledge collective experiences and impacts of adversity, as well as harness family resources to overcome past and present challenges.
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Affiliation(s)
- Amanda Sim
- Department of Psychiatry and Behavioural Neurosciences, The Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada.
| | - Eve Puffer
- grid.26009.3d0000 0004 1936 7961Department of Psychology and Neuroscience, Duke Global Health Institute, Duke University, Durham, NC USA
| | - Afreen Ahmad
- grid.25073.330000 0004 1936 8227Department of Psychiatry and Behavioural Neurosciences, The Offord Centre for Child Studies, McMaster University, Hamilton, ON Canada
| | - Lina Hammad
- grid.25073.330000 0004 1936 8227Department of Psychiatry and Behavioural Neurosciences, The Offord Centre for Child Studies, McMaster University, Hamilton, ON Canada
| | - Katholiki Georgiades
- grid.25073.330000 0004 1936 8227Department of Psychiatry and Behavioural Neurosciences, The Offord Centre for Child Studies, McMaster University, Hamilton, ON Canada
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Boyle MH, Duncan L, Wang L, Georgiades K. Problem checklists and standardized diagnostic interviews: evidence of psychometric equivalence for classifying psychiatric disorder among children and youth in epidemiological studies. J Child Psychol Psychiatry 2022; 64:779-786. [PMID: 36504296 DOI: 10.1111/jcpp.13735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/25/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND The standard approach for classifying child/youth psychiatric disorder as present or absent in epidemiological studies is lay-administered structured, standardized diagnostic interviews (interviews) based on categorical taxonomies such as the DSM and ICD. Converting problem checklist scale scores (checklists) to binary classifications provides a simple, inexpensive alternative. METHODS Using assessments obtained from 737 parents, we determine if child/youth behavioral, attentional, and emotional disorder classifications based on checklists are equivalent psychometrically to interview classifications. We test this hypothesis by (1) comparing their test-retest reliabilities based on kappa (κ), (2) estimating their observed agreement at times 1 and 2, and (3) in structural equation models, comparing their strength of association with clinical status and reported use of prescription medication to treat disorder. A confidence interval approach is used to determine if parameter differences lie within the smallest effect size of interest set at ±0.125. RESULTS The test-retest reliabilities (κ) for interviews compared with checklists met criteria for statistical equivalence: behavioral, .67 and .70; attentional, .64 and .66; and emotional, .61 and .65. Observed agreement between the checklist and interviews on classifications of disorder at times 1 and 2 was, on average, κ = .61. On average, the β coefficients estimating associations with clinical status were .59 (interviews) and .63 (checklists); and with prescription medication use, .69 (interviews) and .71 (checklists). Behavioral and attentional disorders met criteria for statistical equivalence. Emotional disorder did not, although the coefficients were stronger numerically for the checklist. CONCLUSIONS Classifications of child/youth psychiatric disorder from parent-reported checklists and interviews are equivalent psychometrically. The practical advantages of checklists over interviews for classifying disorder (lower administration cost and respondent burden) are enhanced by their ability to measure disorder dimensionally. Checklists provide an option to interviews in epidemiological studies of common child/youth psychiatric disorders.
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Affiliation(s)
- Michael H Boyle
- Department of Psychiatry and Behavioural Neurosciences, Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada
| | - Laura Duncan
- Department of Psychiatry and Behavioural Neurosciences, Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada
| | - Li Wang
- Department of Psychiatry and Behavioural Neurosciences, Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada
| | - Katholiki Georgiades
- Department of Psychiatry and Behavioural Neurosciences, Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada
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Albanese CM, Oberle E, Sutherland JM, Janus M, Schonert-Reichl KA, Georgiades K, Guhn M, Gagné Petteni M, Gadermann A. A cross-sectional study of organized activity participation and emotional wellbeing among non-immigrant and immigrant-origin children in British Columbia, Canada. Prev Med Rep 2022; 31:102052. [PMID: 36820384 PMCID: PMC9938338 DOI: 10.1016/j.pmedr.2022.102052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 11/07/2022] [Accepted: 11/13/2022] [Indexed: 11/16/2022] Open
Abstract
Organized activity participation has been linked to children's emotional wellbeing. However, a scarcity of literature considers the role of immigrant background. This study's primary objective was to measure the association between organized activity participation and emotional wellbeing among a population-based sample of Grade 7 children in British Columbia, Canada. We also examined whether this relationship depended on immigration background. Our sample included 14,406 children (47.8% female; mean age = 12.0 years). 9,393 (65.2%) children were of non-immigrant origin (48.9% female; mean age = 12.1 years). 5,013 children (34.8%) were of immigrant origin (45.8% female; mean age = 12.0 years; 40.8% first-generation). Participants completed the Middle Years Development Instrument, a self-report survey measuring children's wellbeing and assets. We used odds ratios and the χ2 test to compare the organized activity participation of non-immigrant and immigrant-origin children. We used multiple linear regression to measure associations between participation and indicators of emotional wellbeing and assessed whether associations varied based on immigrant background, controlling for demographic factors and peer belonging. Participation in any activity was similar among non-immigrant and immigrant-origin children (OR1st-gen=1.06, p=0.37; OR2nd-gen=0.97, p=0.62). Immigrant generation status modified the relationship between participation and emotional wellbeing (χSWL 2=3.69, p=0.03; χDep 2=12.31, p<0.01). Beneficial associations between participation and both life satisfaction and depressive symptoms were observed among non-immigrant children only, although associations were small. We conclude that immigrant background modestly modified the association between organized activity participation and emotional wellbeing.
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Key Words
- BC, British Columbia
- Depressive symptoms
- ICC, Intraclass correlation coefficient
- Immigration
- LRT, Likelihood ratio test
- MDI, Middle Years Development Instrument
- MLR, Multiple linear regression
- MOH, Ministry of Health
- MSP, Medical Services Plan
- Middle Years Development Instrument
- Middle childhood
- OR, Odds ratio
- Organized activities
- SES, Socioeconomic status
- SWL, Satisfaction with life
- Satisfaction with life
- US, United States
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Affiliation(s)
- Carmela Melina Albanese
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario M5T 3M7, Canada,Corresponding author.
| | - Eva Oberle
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada
| | - Jason M. Sutherland
- Centre for Health Services and Policy Research, School of Population and Public Health, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada,Centre for Health Evaluation and Outcome Sciences, Providence Health Care Research Institute, Vancouver, British Columbia V6Z 1Y6, Canada
| | - Magdalena Janus
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada,Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario L8S 4K1, Canada
| | | | - Katholiki Georgiades
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario L8S 4K1, Canada
| | - Martin Guhn
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada
| | - Monique Gagné Petteni
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada,Centre for Health Evaluation and Outcome Sciences, Providence Health Care Research Institute, Vancouver, British Columbia V6Z 1Y6, Canada
| | - Anne Gadermann
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada,Centre for Health Evaluation and Outcome Sciences, Providence Health Care Research Institute, Vancouver, British Columbia V6Z 1Y6, Canada
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21
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Edwards J, Kamali M, Georgiades S, Waddell C, Georgiades K. Provincial and Territorial Variation in Barriers in Accessing Healthcare for Children and Youth With Mental and Neurodevelopmental Health Concerns in Canada. Can J Psychiatry 2022; 67:867-869. [PMID: 35938630 PMCID: PMC9561698 DOI: 10.1177/07067437221114005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Jordan Edwards
- Department of Psychiatry and Behavioural Neurosciences, 3710McMaster University, Hamilton, Ontario, Canada.,Offord Centre for Child Studies, 3710McMaster University, Hamilton, Ontario, Canada
| | - Mahdis Kamali
- Department of Psychiatry and Behavioural Neurosciences, 3710McMaster University, Hamilton, Ontario, Canada.,Offord Centre for Child Studies, 3710McMaster University, Hamilton, Ontario, Canada
| | - Stelios Georgiades
- Department of Psychiatry and Behavioural Neurosciences, 3710McMaster University, Hamilton, Ontario, Canada.,Offord Centre for Child Studies, 3710McMaster University, Hamilton, Ontario, Canada
| | - Charlotte Waddell
- Children's Health Policy Centre, Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada
| | - Katholiki Georgiades
- Department of Psychiatry and Behavioural Neurosciences, 3710McMaster University, Hamilton, Ontario, Canada.,Offord Centre for Child Studies, 3710McMaster University, Hamilton, Ontario, Canada
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22
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Halladay J, MacKillop J, Munn C, Amlung M, Georgiades K. Individual- and school-level patterns of substance use and mental health symptoms in a population-based sample of secondary students: A multilevel latent profile analysis. Drug Alcohol Depend 2022; 240:109647. [PMID: 36244138 DOI: 10.1016/j.drugalcdep.2022.109647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND While substance use and mental health symptoms commonly co-occur among adolescents, few population-level studies have examined profiles of co-occurrence to inform tailored prevention and early interventions. METHODS A multilevel latent profile analysis was conducted on a representative sample of 11,994 students in 68 secondary schools to: 1) identify distinct profiles of co-occurring substance use and mental health symptoms; 2) identify types of schools based on student profiles; and 3) explore school correlates of student profiles and school types, including school climate, belonging, and safety. RESULTS Five student profiles and three school types were identified. Among students, 57.6 % were in a low substance use and mental health profile, 22.5 % were in a high mental health but low substance use profile, 9.7 % were in a heavy drinking and cannabis use profile, 3.7 % were in a heavy drinking and smoking profile, and 6.5 % were in a high substance use and mental health profile. Positive school climate, belonging, and safety increased the odds of students being in the low profile, with belonging yielding larger effects among females. Among schools, 28 % had low, 57 % had moderate, and 15 % had high levels of student substance use and comorbid mental health symptoms. Rural schools were disproportionately represented in higher risk school types. CONCLUSIONS The identified student substance use and mental health symptom profiles can serve as targets for tailored prevention and early interventions. Results support examining school-based interventions targeting school climate, belonging, and safety with potential benefits to both substance use and mental health.
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Affiliation(s)
- Jillian Halladay
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, L8S 4S4, ON, Canada.
| | - James MacKillop
- Department of Psychiatry & Behavioral Neurosciences, McMaster University, Canada; Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, 100 West 5th St, Hamilton, Ontario, Canada L8N 3K7; Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University, Canada.
| | - Catharine Munn
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, L8S 4S4, ON, Canada; Department of Psychiatry & Behavioral Neurosciences, McMaster University, Canada; Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, 100 West 5th St, Hamilton, Ontario, Canada L8N 3K7.
| | - Michael Amlung
- Department of Psychiatry & Behavioral Neurosciences, McMaster University, Canada; Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, 100 West 5th St, Hamilton, Ontario, Canada L8N 3K7; Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, 1000 Sunnyside Avenue, Lawrence, KS 66045, the United States of America.
| | - Katholiki Georgiades
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, L8S 4S4, ON, Canada; Department of Psychiatry & Behavioral Neurosciences, McMaster University, Canada; Offord Centre for Child Studies, McMaster University, Canada.
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23
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Sim A, Georgiades K. Neighbourhood and family correlates of immigrant children's mental health: a population-based cross-sectional study in Canada. BMC Psychiatry 2022; 22:447. [PMID: 35790945 PMCID: PMC9254422 DOI: 10.1186/s12888-022-04096-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 06/24/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Immigrant children exhibit significant variation in their mental health outcomes despite disproportionate exposure to socio-economic adversity compared to their non-immigrant peers. Identifying aspects of neighbourhood and family contexts that are most salient for immigrant children's mental health can help to inform and target interventions to prevent mental disorder and promote mental well-being among this population. METHODS The study analyzed multi-informant data from 943 first- and second-generation immigrant caregiver and child dyads from the Hamilton Youth Study, a representative sample of immigrant and non-immigrant families in Hamilton, Ontario. Multivariate multilevel regression models examined associations between neighbourhood and family characteristics and processes, and parent and child self reports of internalizing and externalizing problems. RESULTS Positive and negative parenting behaviours were significantly associated with internalizing and externalizing problems, with negative parenting demonstrating associations with externalizing problems across both parent and child reports (b = 0.26-1.27). Neighbourhood social disorder and parental trauma exposure were associated with greater internalizing and externalizing problems, and neighbourhood immigrant concentration was associated with fewer externalizing problems for parent reports only. Adding parental distress and parenting behaviour to the models reduced the coefficients for parental trauma exposure by 37.2% for internalizing problems and 32.5% for externalizing problems and rendered the association with neighbourhood social disorder non-significant. Besides the parenting variables, there were no other significant correlates of child-reported internalizing and externalizing problems. CONCLUSIONS Results highlight the importance of parenting behaviour and parental experiences of trauma and distress for immigrant children's mental health. While not unique to immigrants, the primacy of these processes for immigrant children and families warrants particular attention given the heightened risk of exposure to migration-related adverse experiences that threaten parental and family well-being. To prevent or mitigate downstream effects on child mental health, it is imperative to invest in developing and testing trauma-informed and culturally responsive mental health and parenting interventions for immigrant families.
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Affiliation(s)
- Amanda Sim
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, The Offord Centre for Child Studies, Hamilton, ON, Canada.
| | - Katholiki Georgiades
- grid.25073.330000 0004 1936 8227Department of Psychiatry and Behavioural Neurosciences, McMaster University, The Offord Centre for Child Studies, Hamilton, ON Canada
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24
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Vitoroulis I, Sim A, Ma S, Jenkins J, Georgiades K. Resilience in the Face of Adversity: Family Processes and the Immigrant Paradox in Youth Externalizing Problems. Can J Psychiatry 2022; 67:565-574. [PMID: 35083921 PMCID: PMC9234893 DOI: 10.1177/07067437211065722] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Despite increased exposure to social adversity, immigrant youth have fewer externalizing problems compared to non-immigrants. Explanations for this apparent advantage remain unclear. This study examined the extent to which socio-economic characteristics and family processes account for group differences in externalizing problems between immigrant and non-immigrant youth. METHODS Data come from a population-based cross-sectional study of 1,449 youth and their primary caregiver in Hamilton, Ontario. Computer-assisted structured interviews were administered separately to primary caregivers and youth, which included assessments of externalizing problems and measures of family obligation, parental monitoring, value of education and socio-economic characteristics. RESULTS First- and second-generation immigrant youth had lower levels of externalizing problems compared to non-immigrants. The magnitude of group differences was larger for parent (d = 0.37-0.55) versus youth reports of externalizing behaviours (d = 0.15-0.29). Family socio-economic and process characteristics partially accounted for group differences, which remained significant in the parent-reported model but rendered non-significant in the youth-reported model. CONCLUSION Results suggesting the potential protective effects of positive family processes for immigrant youth could be extended to non-immigrant youth to inform the development of parenting and family skills interventions. Promoting familial sources of resilience is a potential avenue for reversing downward trends in mental health seen across successive generations of immigrant youth, while also reducing risk of behavioural difficulties among non-immigrant youth.
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Affiliation(s)
| | - Amanda Sim
- Department of Psychiatry & Behavioural Neurosciences & Offord Centre for Child Studies, 3710McMaster University, Hamilton, Canada
| | - Steven Ma
- Department of Psychiatry & Behavioural Neurosciences & Offord Centre for Child Studies, 3710McMaster University, Hamilton, Canada
| | - Jennifer Jenkins
- Applied Psychology and Human Development, University of Toronto, 113749OISE, Toronto, Canada
| | - Katholiki Georgiades
- Department of Psychiatry & Behavioural Neurosciences & Offord Centre for Child Studies, 3710McMaster University, Hamilton, Canada
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25
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Edwards J, Wang L, Duncan L, Comeau J, Anderson KK, Georgiades K. Characterizing mental health related service contacts in children and youth: a linkage study of health survey and administrative data. Child Adolesc Psychiatry Ment Health 2022; 16:48. [PMID: 35729646 PMCID: PMC9215063 DOI: 10.1186/s13034-022-00483-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 06/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To inform the provision and organization of care, and to improve equitable access to mental health services for children and youth, we must first characterize the children and youth being served, taking into consideration factors related to mental health need. Our objective was to use a population-based survey linked with health administrative data to estimate mental health related contacts and determine socio-demographic correlates, after adjusting for factors related to mental health need. METHODS Data from the 2014 Ontario Child Health Study (OCHS) were linked at the individual level to health administrative databases from Ontario's Ministry of Health and Long-Term Care (MOHLTC). Mental health related service contacts were identified in the 6-months prior to the OCHS survey date. Service contacts with physicians were obtained from health administrative data, and non-physician service contacts from survey data (parent-report). RESULTS 21.7% of Ontarian children (4-11 years) and youth (12-17 years) had at least one mental health related contact in the 6-months prior to their OCHS survey date (18.8% non-physician, 8.0% physician, 5.2% both). Children and youth contacting both physician and non-physician services (ref. contact with physician or non-physician services alone) had higher mean symptom ratings of mental disorders across all classes of disorder. After adjusting for total symptom ratings, children and youth with immigrant parent(s) (ref. non-immigrant) (Prevalence Ratio: 0.65, 95% CI 0.55, 0.75) were less likely to have any mental health related service contact. CONCLUSIONS Results indicate that children and youth with the highest mental health symptom ratings are more likely to have contact with multiple providers across sectors. As such, the coordination of care across and within sectors are critical components of mental health related services for children and youth. Our results indicate that the greatest disparities in mental health related service contacts may exist for children and youth with immigrant parent(s) and that targeted outreach efforts are required to reduce barriers to care and improve equitable access to mental health related services for children and youth in Ontario.
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Affiliation(s)
- Jordan Edwards
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada. .,Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada.
| | - Li Wang
- grid.25073.330000 0004 1936 8227Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON Canada
| | - Laura Duncan
- grid.25073.330000 0004 1936 8227Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON Canada ,grid.25073.330000 0004 1936 8227Offord Centre for Child Studies, McMaster University, Hamilton, ON Canada
| | - Jinette Comeau
- grid.39381.300000 0004 1936 8884Department of Sociology, King’s University College, Western University, London, ON Canada
| | - Kelly K. Anderson
- grid.39381.300000 0004 1936 8884Department of Epidemiology & Biostatistics, Western University, London, ON Canada ,grid.39381.300000 0004 1936 8884Department of Psychiatry, Schulich School of Medicine, Western University, London, ON Canada ,grid.415847.b0000 0001 0556 2414Lawson Health Research Institute, London, ON Canada
| | - Katholiki Georgiades
- grid.25073.330000 0004 1936 8227Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON Canada ,grid.25073.330000 0004 1936 8227Offord Centre for Child Studies, McMaster University, Hamilton, ON Canada
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26
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Jack SM, Duku E, Whitty H, Van Lieshout RJ, Niccols A, Georgiades K, Lipman EL. Young mothers' use of and experiences with mental health care services in Ontario, Canada: a qualitative descriptive study. BMC Womens Health 2022; 22:214. [PMID: 35672725 PMCID: PMC9172978 DOI: 10.1186/s12905-022-01804-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 05/31/2022] [Indexed: 11/16/2022] Open
Abstract
Background Despite the high prevalence of mental health issues among young mothers, their subsequent needs for mental health care support does not correlate with their access and use of services. The purpose of this study, grounded in the experiences of young mothers living in Ontario, Canada, was to describe their experiences of using mental health services during the perinatal period, and to identify the attributes of services and professionals that influenced their decision to engage with mental health services.
Methods As the qualitative component of a sequential explanatory mixed methods study, the principles of qualitative description informed sampling, data collection, and analysis decisions. In-depth, semi-structured interviews were conducted with a purposeful sample of 29 young mothers (≤ 21 years) who met diagnostic criteria for at least one psychiatric disorder, and who were ≥ 2 months postpartum. Interview data were triangulated with data from ecomaps and a sub-set of demographic data for this purposeful sample from the survey conducted in the quantitative study component. Qualitative data were analyzed using both conventional content analysis and reflexive thematic analysis; the subset of survey data extracted for these 29 participants were analyzed using descriptive statistics. Results Young mothers identified the need to have at least one individual, either an informal social support or formal service provider who they could talk to about their mental health. Among participants deciding to seek professional mental health support, their hesitancy to access services was grounded in past negative experiences or fears of being judged, being medicated, not being seen as an active partner in care decisions or experiencing increased child protection involvement. Participants identified organizational and provider attributes of those delivering mental health care that they perceived influenced their use of or engagement with services. Conclusion Organizations or health/social care professionals providing mental health services to young pregnant or parenting mothers are recommended to implement trauma-and violence-informed care. This approach prioritizes the emotional and physical safety of individuals within the care environment. Applying this lens in service delivery also aligns with the needs of young mothers, including that they are actively listened to, treated with respect, and genuinely engaged as active partners in making decisions about their care and treatment.
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Affiliation(s)
- Susan M Jack
- School of Nursing, McMaster University, HSC 3H48B, 1280 Main St. West, Hamilton, ON, L8S 4L8, Canada.
| | - Eric Duku
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Heather Whitty
- Institute for Innovation and Implementation, School of Social Work, University of Maryland Baltimore, Baltimore, USA
| | - Ryan J Van Lieshout
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Alison Niccols
- Ron Joyce Children's Health Centre, Hamilton, ON, Canada
| | - Katholiki Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Ellen L Lipman
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
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27
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Boyle MH, Duncan L, Wang L, Georgiades K. The 25-Item Ontario Child Health Study Emotional Behavioural Scales-Brief Version (OCHS-EBS-B): Test-Retest Reliability and Construct Validity When Used as Categorical Measures. Can J Psychiatry 2022; 67:305-314. [PMID: 34424799 PMCID: PMC9014671 DOI: 10.1177/07067437211037125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Child and youth mental health problems are often assessed by parent self-completed checklists that produce dimensional scale scores. When converted to binary ratings of disorder, little is known about their psychometric properties in relation to classifications based on lay-administered structured diagnostic interviews. In addition to estimating agreement, our objective is to test for statistical equivalence in the test-retest reliability and construct validity of two instruments used to classify child emotional, behavioural, and attentional disorders: the 25-item, parent completed Ontario Child Health Study Emotional Behavioural Scales-Brief Version (OCHS-EBS-B) and the Mini International Neuropsychiatric Interview for Children and Adolescents-parent version (MINI-KID-P). METHODS This study draws on independent samples (n = 452) and uses the confidence interval approach to test for statistical equivalence. Reliability is based on kappa (κ). Construct validity is based on standardized beta coefficients (β) estimated in structural equation models. RESULTS The average differences between the MINI-KID-P and OCHS-EBS-B in κ and β were -0.022 and -0.020, respectively. However, in both instances, criteria for statistical equivalence were met in only 5 of 12 comparisons. Based on κ, between-instrument agreement on the classifications of disorder went from 0.481 (attentional disorder) to 0.721 (emotional disorder) but were substantially higher (0.731 to 0.895, respectively) when corrected for attenuation due to measurement error. CONCLUSIONS Although falling short of equivalence, the results suggest on balance that the reliability and validity of the two instruments for classifying child psychiatric disorder assessed by parents are highly comparable. This conclusion is supported by the high levels of agreement between the instruments after correcting for attenuation due to measurement error.
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Affiliation(s)
- Michael H Boyle
- 62703Offord Centre for Child Studies and Department of Psychiatry and Behavioural Neurosciences, 3710McMaster University, Hamilton, Ontario
| | - Laura Duncan
- 62703Offord Centre for Child Studies and Department of Psychiatry and Behavioural Neurosciences, 3710McMaster University, Hamilton, Ontario
| | - Li Wang
- 62703Offord Centre for Child Studies and Department of Psychiatry and Behavioural Neurosciences, 3710McMaster University, Hamilton, Ontario
| | - Katholiki Georgiades
- 62703Offord Centre for Child Studies and Department of Psychiatry and Behavioural Neurosciences, 3710McMaster University, Hamilton, Ontario
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28
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Emerson SD, Gagné Petteni M, Guhn M, Oberle E, Georgiades K, Milbrath C, Janus M, Schonert-Reichl KA, Gadermann AM. Social context factors and refugee children's emotional health. Soc Psychiatry Psychiatr Epidemiol 2022; 57:829-841. [PMID: 34562109 DOI: 10.1007/s00127-021-02173-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 09/06/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Refugee children face numerous challenges associated with pre-migration trauma and post-migration adaptation. Much research pertaining to refugee children's well-being focuses on psychiatric symptoms. Relatively few studies have examined how social context factors-such as perceptions of peer belonging, and support from adults at home and at school-contribute to the emotional health of refugee children. Informed by social-ecological theories emphasizing dynamic interactions between the contexts in which children develop, we examined associations between social context factors and emotional health in refugee children. METHODS Data were drawn from a population-based data linkage in British Columbia, Canada. The analytic sample included 682 grade 4 students (Mage 9.2 years; 46.3% female) with a refugee background who responded to the Middle Years Development Instrument (MDI) during the 2010/2011-2016/2017 school years. The MDI is a self-report survey of children's social and emotional competencies and social context factors completed at school. Regression analyses were used to examine associations of social context factors (school climate, supportive adults at school and at home, and peer belonging) with indicators of emotional health (life satisfaction, self-concept, optimism, and sadness). Refugee generation status (first/second) was considered through stratification and testing of interactions with social context factors. RESULTS Perceived supportive school climate, support from adults in school and at home, and peer belonging were each independently associated with better emotional health. Results were similar for first- and second-generation children. CONCLUSION Taken together, results suggest a unique role of the school context to refugee children's emotional health. School-based programming that promotes positive school climate can be considered as an important approach to support newcomer refugee children and their families.
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Affiliation(s)
- Scott D Emerson
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, Canada.
| | - Monique Gagné Petteni
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Martin Guhn
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Eva Oberle
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Katholiki Georgiades
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Constance Milbrath
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Magdalena Janus
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, Canada.,Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Kimberly A Schonert-Reichl
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, Canada.,Department of Psychology, University of Illinois at Chicago, Chicago, USA
| | - Anne M Gadermann
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, Canada.,Centre for Health Evaluation and Outcome Sciences, Providence Health Care Research Institute, Vancouver, Canada
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29
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Khoury JE, Tanaka M, Kimber M, MacMillan HL, Afifi TO, Boyle M, Duncan L, Joshi D, Georgiades K, Gonzalez A. Examining the unique contributions of parental and youth maltreatment in association with youth mental health problems. Child Abuse Negl 2022; 124:105451. [PMID: 34991012 DOI: 10.1016/j.chiabu.2021.105451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 12/08/2021] [Accepted: 12/15/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Extensive research seeks to understand the intergenerational impact of child maltreatment. However, it remains unclear how parent's history of child maltreatment (PCM) is associated with child mental health, after accounting for children's experiences of maltreatment and other proximal risk factors. OBJECTIVE This study examines the associations between PCM and youth internalizing and externalizing problems, while accounting for youth experiences of maltreatment (YM), and parent mental health and positive parenting. PARTICIPANTS AND SETTING Youth aged 14 to 17 years (N = 2266) participated in the 2014 Ontario Child Heath Study. METHODS Parents and youth reported their experiences of child maltreatment. Parent-report and self-reports of youth internalizing and externalizing problems were also collected. Number of subtypes of maltreatment and specific subtypes of maltreatment were examined. Parents reported their own mental health problems and positive parenting practices. RESULTS Regarding number of maltreatment subtypes, initially PCM was associated with parent-reported, but not self-reported, youth internalizing and externalizing problems. After accounting for YM, parent mental health problems and positive parenting, only YM remained significant. Regarding specific subtypes of maltreatment, both parent and youth emotional abuse were related to parent- and youth-reported internalizing and externalizing problems, after controlling for other maltreatment subtypes. However, the effects of parent emotional abuse became nonsignificant after accounting for YM and proximal risk factors. CONCLUSIONS Findings indicate: 1) the unique associations between specific PCM and YM subtypes and youth mental health problems; 2) the role of proximal risk factors in explaining the association between PCM and youth mental health; and 3) the importance of multiple informants of youth mental health problems.
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Affiliation(s)
- Jennifer E Khoury
- Department of Psychology, Mount Saint Vincent University, Halifax, NS B3M 2J6, Canada
| | - Masako Tanaka
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8S 4K1, Canada; Offord Centre for Child Studies, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Melissa Kimber
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8S 4K1, Canada; Offord Centre for Child Studies, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Harriet L MacMillan
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8S 4K1, Canada; Offord Centre for Child Studies, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Tracie O Afifi
- University of Manitoba, Department of Community Health Sciences at the University of Manitoba, Winnipeg, MB R3E 0W3, Canada
| | - Michael Boyle
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8S 4K1, Canada; Offord Centre for Child Studies, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Laura Duncan
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8S 4K1, Canada; Offord Centre for Child Studies, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Divya Joshi
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Katholiki Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8S 4K1, Canada; Offord Centre for Child Studies, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Andrea Gonzalez
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8S 4K1, Canada; Offord Centre for Child Studies, McMaster University, Hamilton, ON L8S 4K1, Canada.
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Gadermann AM, Gagné Petteni M, Janus M, Puyat JH, Guhn M, Georgiades K. Prevalence of Mental Health Disorders Among Immigrant, Refugee, and Nonimmigrant Children and Youth in British Columbia, Canada. JAMA Netw Open 2022; 5:e2144934. [PMID: 35166784 PMCID: PMC8848209 DOI: 10.1001/jamanetworkopen.2021.44934] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 11/29/2021] [Indexed: 11/26/2022] Open
Abstract
Importance There remains limited understanding of population-level patterns of mental disorder prevalence for first- and second-generation immigrant and refugee children and youth and how such patterns may vary across mental disorders. Objective To examine the diagnostic prevalence of conduct, attention-deficit/hyperactivity disorder (ADHD), and mood/anxiety disorders in immigrant, refugee, and nonimmigrant children and youth in British Columbia, Canada. Design, Setting, and Participants This retrospective, population-level cohort study examined linked health administrative records of children and youth in British Columbia (birth to age 19 years) spanning 2 decades (1996-2016). Physician billings, hospitalizations, and drug dispensations were linked to immigration records to estimate time-in-British Columbia-adjusted prevalence of mental disorder diagnosis among children and youth from immigrant or refugee backgrounds compared with those from nonimmigrant backgrounds. Analyses were conducted from August 2020 to November 2021. Main Outcomes and Measures The diagnostic prevalence of conduct, ADHD, and mood/anxiety disorders were the main outcomes. Results were stratified by migration category (immigrant, refugee, nonimmigrant), generation status (first- and second-generation), age, and sex. Results A total of 470 464 children and youth in British Columbia were included in the study (227 217 [48.3%] female). Nonimmigrant children and youth represented 65.5% of the total study population (307 902 individuals). Among those who migrated, 142 011 (87.8%) were first- or second-generation immigrants, and 19 686 (12.2%) were first- or second-generation refugees. Diagnostic prevalence of mental disorders varied by migration category, generation status, age, and sex. Children and youth from immigrant and refugee backgrounds (both first- and second-generation), compared with nonimmigrant youth, generally had a lower prevalence of conduct disorder (eg, age 6-12 years: first-generation immigrant, 2.72% [95% CI, 2.56%-2.90%] vs nonimmigrant, 7.03% [95% CI, 6.93%-7.13%]), ADHD (eg, age 6-12 years: first-generation immigrant, 4.30% [95% CI, 4.10%-4.51%] vs nonimmigrant, 9.20% [95% CI, 9.08%-9.31%]), and mood/anxiety disorders (eg, age 13-19 years: first-generation immigrant, 11.07% [95% CI, 10.80%-11.36%] vs nonimmigrant, 24.54% [95% CI, 24.34%-24.76%]). Among immigrant children and youth, second-generation children and youth generally showed higher prevalence of conduct, ADHD, and mood/anxiety disorders than first-generation children and youth (eg, ADHD among second-generation immigrants aged 6-12 years, 5.94% [95% CI, 5.75%-6.14%]; among first-generation immigrants aged 6-12 years, 4.30% [95% CI, 4.10%-4.51%]). Second-generation refugee children had the highest diagnostic prevalence estimates for mood/anxiety in the 3-to-5-year age range relative to first- and second-generation immigrant and nonimmigrant children (eg, second-generation refugee, 2.58% [95% CI, 2.27%-2.94%] vs second-generation immigrant, 1.78% [95% CI, 1.67%-1.89%]). Mental disorder diagnoses also varied by age and sex within immigrant, refugee, and nonimmigrant groups. Conclusions and Relevance These findings show differences in diagnostic mental disorder prevalence among first- and second-generation immigrant and refugee children and youth relative to nonimmigrant children and youth. Further investigation is required into how cultural differences and barriers in accessing health services may be contributing to these differences.
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Affiliation(s)
- Anne M. Gadermann
- Human Early Learning Partnership, School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Health Evaluation and Outcome Sciences, Providence Health Care Research Institute, Vancouver, British Columbia, Canada
| | - Monique Gagné Petteni
- Human Early Learning Partnership, School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Health Evaluation and Outcome Sciences, Providence Health Care Research Institute, Vancouver, British Columbia, Canada
| | - Magdalena Janus
- Human Early Learning Partnership, School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Joseph H. Puyat
- Centre for Health Evaluation and Outcome Sciences, Providence Health Care Research Institute, Vancouver, British Columbia, Canada
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Martin Guhn
- Human Early Learning Partnership, School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Katholiki Georgiades
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
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Edwards J, Georgiades K. Reading Between the Lines: A Pursuit of Estimating the Population Prevalence of Mental Illness Using Multiple Data Sources. Can J Psychiatry 2022; 67:101-103. [PMID: 33969716 PMCID: PMC8892056 DOI: 10.1177/07067437211016255] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Population-based prevalence estimates of mental illness are foundational to health service planning, strategic resource allocation, and the development and evaluation of public mental health policy. Generating valid, reliable, and context-specific population-level estimates is of utmost importance and can be achieved by combining various data sources. This pursuit benefits from the right combination of theory, applied statistics, and the conceptualization of available data sources as a collective rather than in isolation. We believe there is a need to read between the lines as theory, methodology, and context (i.e., strengths and limitations) are what determines the meaningfulness of a combined prevalence estimate. Currently lacking is a gold standard approach to combining estimates from multiple data sources. Here, we compare and contrast various approaches to combining data and introduce an idea that leverages the strengths of pre-existing individually linked population-based survey and health administrative data sources currently available in Canada.
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Affiliation(s)
- Jordan Edwards
- Offord Centre for Child Studies, 3710McMaster University, Hamilton, Ontario, Canada
| | - Katholiki Georgiades
- Offord Centre for Child Studies, 3710McMaster University, Hamilton, Ontario, Canada
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Koziarz F, Roncadin C, Kata A, Duku E, Cauwenbergs A, Mahoney W, Di Rezze B, Anderson C, Drmic I, Eerkes J, Dekker K, Georgiades K, Hoult L, Kraus de Camargo O, Ng O, Rosenbaum P, Mesterman R, Gentles SJ, Robertson S, Bennett T, Georgiades S. Investigating the Associations Between Child Autistic Symptoms, Socioeconomic Context, and Family Life: A Pilot Study. Front Rehabilit Sci 2021; 2:748346. [PMID: 36188822 PMCID: PMC9397991 DOI: 10.3389/fresc.2021.748346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 10/21/2021] [Indexed: 11/13/2022]
Abstract
Objective: The day-to-day experience of families with an Autistic child may be shaped by both, child characteristics and available resources, which often are influenced by the socioeconomic context of the family. Using a socioecological approach, this study explored the quantitative associations between child autistic symptoms, family socioeconomic status, and family life. Methods: Data came from the Pediatric Autism Research Cohort—PARC Study (pilot). Parents of children with a recent diagnosis of autism completed a set of assessments, including the Autism Family Experience Questionnaire, Autism Impact Measure, and a Sociodemographic Questionnaire. A series of multiple, iterative linear regression models were constructed to ascertain quantitative associations between child autistic symptoms, socioeconomic context, and family life. Results: A total of 50 children (mean age: 76 months; SD: 9.5 months; and 84% male) with data on the variables of interest were included in the analysis. The frequency of child autistic symptoms was associated with family life outcomes (p = 0.02 and R2 = 24%). Once autistic symptom frequency, symptom impact, and sociodemographic variables were considered, parents of higher educational attainment reported worse family life outcomes compared to their lesser-educated counterparts. This cumulative regression model had considerable explanatory capability (p = 0.01, R2 = 40%). Conclusion: This study demonstrates the utility of using a socioecological approach to examine the dynamic interplay between child characteristics and family circumstances. Our findings suggest that family life for parents (of an autistic child) who have obtained higher education is reported (by the parents themselves) as less satisfactory compared to that of parents without higher education, once adjusted for the autistic symptom frequency of child, symptom impact, and income. These findings can inform the design and delivery of more family-centered care pathways during the years following a diagnosis of autism.
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Affiliation(s)
- Frank Koziarz
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- *Correspondence: Frank Koziarz
| | - Caroline Roncadin
- Autism Program, McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, ON, Canada
| | - Anna Kata
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Eric Duku
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Amber Cauwenbergs
- Autism Program, McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, ON, Canada
| | - William Mahoney
- Autism Program, McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, ON, Canada
| | - Briano Di Rezze
- Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - Colleen Anderson
- Autism Program, McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, ON, Canada
| | - Irene Drmic
- Autism Program, McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, ON, Canada
| | - Judy Eerkes
- Autism Program, McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, ON, Canada
| | - Kathleen Dekker
- Autism Program, McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, ON, Canada
| | - Katholiki Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Lorraine Hoult
- Autism Program, McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, ON, Canada
| | - Olaf Kraus de Camargo
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Olivia Ng
- Autism Program, McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, ON, Canada
| | - Peter Rosenbaum
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Ronit Mesterman
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Stephen J. Gentles
- Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
- Department of Community Health, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Sue Robertson
- Autism Program, McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, ON, Canada
| | - Teresa Bennett
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Stelios Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
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Georgiades K. Expanding the evidence for population mental health in Canada: a call to action for evidence-informed policy and practice. Health Promot Chronic Dis Prev Can 2021; 41:321-324. [PMID: 34569769 PMCID: PMC8639175 DOI: 10.24095/hpcdp.41.11.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Katholiki Georgiades
- Department of Psychiatry and Behavioural Neurosciences & Offord Centre for Child Studies, McMaster University, Hamilton, Ontario
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Gagné M, Guhn M, Janus M, Georgiades K, Emerson SD, Milbrath C, Duku E, Magee C, Schonert-Reichl KA, Gadermann AM. Thriving, catching up, falling behind: Immigrant and refugee children’s kindergarten competencies and later academic achievement. Journal of Educational Psychology 2021. [DOI: 10.1037/edu0000634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Halladay J, Horricks L, Amlung M, MacKillop J, Munn C, Nasir Z, Woock R, Georgiades K. The CAMP study: feasibility and clinical correlates of standardized assessments of substance use in a youth psychiatric inpatient sample. Child Adolesc Psychiatry Ment Health 2021; 15:48. [PMID: 34517903 PMCID: PMC8439003 DOI: 10.1186/s13034-021-00403-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 09/03/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND To determine: (a) the feasibility and acceptability of administering a standardized electronic assessment of substance use and other mental health concerns to youth admitted to an inpatient psychiatric unit, and (b) the prevalence and clinical correlates of substance use in this sample. METHODS The sample included 100 youth between the ages of 13 to 17 years admitted to an inpatient psychiatric unit in Ontario, Canada between September and November 2019 (78% response rate). Youth data were comprised of electronic self-reported assessments (during hospitalization and 6-months following) and chart reviews (99% consented; historical and prospective). Frontline staff completed a self-report survey assessing their perceptions of the need for standardized substance use assessments, training, and interventions on the unit (n = 38 Registered Nurses and Child and Youth Workers; 86% response rate). Analyses included descriptive statistics, correlations, regression, and qualitative content analysis. RESULTS Feasibility of standardized youth self-reported mental health and substance use assessments was evident by high response rates, little missing data, and variability in responses. 79% of youth had used at least one substance in their lifetime; 69% reported use in the last 3 months. Substance use was positively correlated with severity of psychiatric symptoms (τb 0.17 to 0.45) and number of psychiatric diagnoses (τb 0.17 to 0.54) at index. Based on prospective and retrospective data, substance use was also positively related to mental health symptom severity at follow-up and repeat mental health related hospital visits. Frontline staff reported a need for standardized assessment, training, and interventions on the unit, indicative of acceptability. CONCLUSIONS This study demonstrated the feasibility, acceptability and clinical importance of administering a standardized mental health and substance use assessment among youth experiencing psychiatric hospitalization.
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Affiliation(s)
- Jillian Halladay
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, ON, L8S 4S4, Hamilton, Canada. .,Child and Youth Mental Health Program, McMaster Children's Hospital, 1200 Main St W, ON, L8N 3Z5, Hamilton, Canada.
| | - Laurie Horricks
- grid.422356.40000 0004 0634 5667Child and Youth Mental Health Program, McMaster Children’s Hospital, 1200 Main St W, ON L8N 3Z5 Hamilton, Canada
| | - Michael Amlung
- grid.266515.30000 0001 2106 0692Department of Applied Behavioral Science, Cofrin Logan Center for Addiction Research and Treatment, Addictions Lab at The University of Kansas, 1000 Sunnyside Avenue, KS 66045 Lawrence, United States ,grid.25073.330000 0004 1936 8227Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - James MacKillop
- grid.25073.330000 0004 1936 8227Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada ,grid.25073.330000 0004 1936 8227Peter Boris Centre for Addictions Research, McMaster University/St. Joseph’s Healthcare Hamilton, 100 West 5th St, ON L8N 3K7 Hamilton, Canada ,grid.25073.330000 0004 1936 8227Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University, Hamilton, Canada
| | - Catharine Munn
- grid.25073.330000 0004 1936 8227Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, ON L8S 4S4 Hamilton, Canada ,grid.25073.330000 0004 1936 8227Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada ,grid.25073.330000 0004 1936 8227Peter Boris Centre for Addictions Research, McMaster University/St. Joseph’s Healthcare Hamilton, 100 West 5th St, ON L8N 3K7 Hamilton, Canada ,grid.25073.330000 0004 1936 8227Resident Affairs, Postgraduate Medical Education (PGME), McMaster University, 1280 Main Street West, ON L8S 4S4 Hamilton, Canada
| | - Zil Nasir
- grid.25073.330000 0004 1936 8227Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, ON L8S 4S4 Hamilton, Canada ,grid.413615.40000 0004 0408 1354Hamilton Health Sciences, 1200 Main St W, ON L8N 3Z5 Hamilton, Canada
| | - Rachel Woock
- grid.413615.40000 0004 0408 1354Hamilton Health Sciences, 1200 Main St W, ON L8N 3Z5 Hamilton, Canada
| | - Katholiki Georgiades
- grid.25073.330000 0004 1936 8227Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, ON L8S 4S4 Hamilton, Canada ,grid.25073.330000 0004 1936 8227Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada ,grid.25073.330000 0004 1936 8227Offord Centre for Child Studies, McMaster University, McMaster Innovation Park, Suite 201A, 1280 Main Street West, ON L8S 4K1 Hamilton, Canada
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Barican JL, Yung D, Schwartz C, Zheng Y, Georgiades K, Waddell C. Prevalence of childhood mental disorders in high-income countries: a systematic review and meta-analysis to inform policymaking. Evid Based Ment Health 2021; 25:36-44. [PMID: 34281985 PMCID: PMC8788041 DOI: 10.1136/ebmental-2021-300277] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 06/17/2021] [Indexed: 12/13/2022]
Abstract
QUESTION Mental disorders typically start in childhood and persist, causing high individual and collective burdens. To inform policymaking to address children's mental health in high-income countries we aimed to identify updated data on disorder prevalence. METHODS We identified epidemiological studies reporting mental disorder prevalence in representative samples of children aged 18 years or younger-including a range of disorders and ages and assessing impairment (searching January 1990 through February 2021). We extracted associated service-use data where studies assessed this. We conducted meta-analyses using a random effects logistic model (using R metafor package). FINDINGS Fourteen studies in 11 countries met inclusion criteria, published from 2003 to 2020 with a pooled sample of 61 545 children aged 4-18 years, including eight reporting service use. (All data were collected pre-COVID-19.) Overall prevalence of any childhood mental disorder was 12.7% (95% CI 10.1% to 15.9%; I2=99.1%). Significant heterogeneity pertained to diagnostic measurement and study location. Anxiety (5.2%), attention-deficit/hyperactivity (3.7%), oppositional defiant (3.3%), substance use (2.3%), conduct (1.3%) and depressive (1.3%) disorders were the most common. Among children with mental disorders, only 44.2% (95% CI 37.6% to 50.9%) received any services for these conditions. CONCLUSIONS An estimated one in eight children have mental disorders at any given time, causing symptoms and impairment, therefore requiring treatment. Yet even in high-income countries, most children with mental disorders are not receiving services for these conditions. We discuss the implications, particularly the need to substantially increase public investments in effective interventions. We also discuss the policy urgency, given the emerging increases in childhood mental health problems since the onset of the COVID-19 pandemic (PROSPERO CRD42020157262).
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Affiliation(s)
- Jenny Lou Barican
- Children's Health Policy Centre, Simon Fraser University, Vancouver, British Columbia, Canada
| | - Donna Yung
- Children's Health Policy Centre, Simon Fraser University, Vancouver, British Columbia, Canada
| | - Christine Schwartz
- Children's Health Policy Centre, Simon Fraser University, Vancouver, British Columbia, Canada
| | - Yufei Zheng
- Children's Health Policy Centre, Simon Fraser University, Vancouver, British Columbia, Canada
| | | | - Charlotte Waddell
- Children's Health Policy Centre, Simon Fraser University, Vancouver, British Columbia, Canada
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Patel H, Siegel M, Hatchard T, Veltman A, McKinnon MC, Syan SK, Merrifield C, Roth SL, Georgiades K, Archie S, Wolf J, Nicholson AA. The influence of minority stress on the neurobiological correlates of executive functioning. Quant Imaging Med Surg 2021; 12:4013-4015. [DOI: 10.21037/qims-22-206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 04/02/2022] [Indexed: 11/06/2022]
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Abstract
Children and youth flourish in environments that are predictable, safe, and structured. The COVID-19 pandemic has disrupted these protective factors making it difficult for children and youth to adapt and thrive. Pandemic-related school closures, family stress, and trauma have led to increases in mental health problems in some children and youth, an area of health that was already in crisis well before COVID-19 was declared a global pandemic. Because mental health problems early in life are associated with significant impairment across family, social, and academic domains, immediate measures are needed to mitigate the potential for long-term sequalae. Now more than ever, Canada needs a national mental health strategy that is delivered in the context in which children and youth are most easily accessible—schools. This strategy should provide coordinated care across sectors in a stepped care framework and across a full continuum of mental health supports spanning promotion, prevention, early intervention, and treatment. In parallel, we must invest in a comprehensive population-based follow-up of Statistics Canada’s Canadian Health Survey on Children and Youth so that accurate information about how the pandemic is affecting all Canadian children and youth can be obtained. It is time the Canadian government prioritizes the mental health of children and youth in its management of the pandemic and beyond.
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Affiliation(s)
- Tracy Vaillancourt
- University of Ottawa, Ottawa, Ontario, Canada
- Royal Society of Canada, Working Group on Children and Schools
| | - Peter Szatmari
- Royal Society of Canada, Working Group on Children and Schools
- Cundill Centre for Child and Youth Depression at Centre for Addiction and Mental Health, Hospital for Sick Children, Toronto, Ontario
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Kim S, Favotto L, Halladay J, Wang L, Boyle MH, Georgiades K. Differential associations between passive and active forms of screen time and adolescent mood and anxiety disorders. Soc Psychiatry Psychiatr Epidemiol 2020; 55:1469-1478. [PMID: 32055896 DOI: 10.1007/s00127-020-01833-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Accepted: 02/03/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To quantify the strength of association between passive and active forms of screen time and adolescent major depressive episode and anxiety disorders. METHODS Data from the 2014 Ontario Child Health Study, a representative sample of 2,320 adolescents aged 12-17 years in Ontario (mean age = 14.58, male = 50.7%) were used. Screen time was measured using adolescent self-report on time spent on screen-based activities. Past 6-month occurrence of DSM-IV-TR defined major depressive episode, social phobia, generalized anxiety disorder, and specific phobia which were assessed using the Mini International Neuropsychiatric Interview for Children and Adolescents. RESULT Adolescents reporting 4 or more hours of passive screen time per day, compared to those reporting less than 2 h, were three times more likely to meet the DSM-IV-TR criteria for major depressive episode [OR = 3.28(95% CI = 1.71-6.28)], social phobia [OR = 3.15 (95% CI = 1.57-6.30)] and generalized anxiety disorder [OR = 2.92 (95% CI = 1.64-5.20)]. Passive screen time continued to be significantly associated with increased odds of disorders, after adjusting for age, sex, low income, active screen time use, sleep and physical activity. A small-to-moderate attenuation of the estimated ORs was observed in the fully adjusted model. In contrast, associations between active screen time use and depression and anxiety disorders were smaller in magnitude and failed to reach statistical significance. CONCLUSIONS Passive screen time use was associated with mood and anxiety disorders, whereas active screen time was not. Further research is needed to better understand the underlying processes contributing to differential risk associated with passive versus active screen time use and adolescent mood and anxiety disorders.
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Affiliation(s)
- Soyeon Kim
- Offord Centre for Child Studies and Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main Street West, McMaster Innovation Park, Hamilton Ontario, L8S 4K1, Canada.
| | - Lindsay Favotto
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton Ontario, L8S 4K1, Canada
| | - Jillian Halladay
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton Ontario, L8S 4K1, Canada
| | - Li Wang
- Offord Centre for Child Studies and Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main Street West, McMaster Innovation Park, Hamilton Ontario, L8S 4K1, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton Ontario, L8S 4K1, Canada
| | - Michael H Boyle
- Offord Centre for Child Studies and Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main Street West, McMaster Innovation Park, Hamilton Ontario, L8S 4K1, Canada
| | - Katholiki Georgiades
- Offord Centre for Child Studies and Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main Street West, McMaster Innovation Park, Hamilton Ontario, L8S 4K1, Canada
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Halladay J, Woock R, El-Khechen H, Munn C, MacKillop J, Amlung M, Ogrodnik M, Favotto L, Aryal K, Noori A, Kiflen M, Georgiades K. Patterns of substance use among adolescents: A systematic review. Drug Alcohol Depend 2020; 216:108222. [PMID: 32971420 DOI: 10.1016/j.drugalcdep.2020.108222] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 07/10/2020] [Accepted: 07/28/2020] [Indexed: 12/31/2022]
Abstract
PURPOSE This review characterizes empirically derived patterns of multiple (multi-) substance use among adolescents. A secondary objective was to examine the extent to which mental health symptomatology was included in the empirical analyses examining substance use patterns. METHODS Eligible studies included those that used cluster-based approaches, included the assessment of at least two different substances, and were based on study samples with mean ages between 11 and 18 years. 4665 records were screened including 461 studies for full-text screening. RESULTS 70 studies were included with common clusters being: low use, single or dual substance use, moderate general multi-use, and high multi-use. The most common patterns of single or multi-substance use were: alcohol only, alcohol with cannabis and/or tobacco, and use of alcohol, tobacco, and cannabis with and without other drugs. Lower socioeconomic status, older age, and male gender were consistent predictors of multi-use clusters. Only 37 % of studies compared differences in levels of mental health across clusters with symptoms consistently associated with a greater likelihood of multi-use. Only 29 % of studies included mental health indicators in cluster-based analyses, with over half identifying distinct mental health and substance use clusters. Fit indices in cluster analyses and measurement properties of substance use were heterogeneous and inconsistently reported across studies. CONCLUSIONS Distinct patterns of substance use were derived but methodological differences prevented direct comparison and reduced capacity to generalize across studies. There is a need to establish standardized methodological approaches to identify robust patterns of substance use to enhance etiological, prognostic, and intervention research.
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Affiliation(s)
- Jillian Halladay
- Department of Health Research, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton ON L8S 4S4, Canada.
| | - R Woock
- Department of Social Sciences, McMaster University, Canada.
| | - H El-Khechen
- Department of Health Research, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton ON L8S 4S4, Canada.
| | - C Munn
- Department of Health Research, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton ON L8S 4S4, Canada; Department of Psychiatry & Behavioral Neurosciences, McMaster University, Canada; Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University, Canada.
| | - J MacKillop
- Department of Psychiatry & Behavioral Neurosciences, McMaster University, Canada; Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada; Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University, Canada.
| | - M Amlung
- Department of Psychiatry & Behavioral Neurosciences, McMaster University, Canada; Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada; Michael G. DeGroote Centre for Medicinal Cannabis Research, McMaster University, Canada.
| | - M Ogrodnik
- NeuroFit Lab, Department of Kinesiology, McMaster University, Canada.
| | - L Favotto
- Department of Health Research, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton ON L8S 4S4, Canada.
| | - K Aryal
- Department of Health Research, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton ON L8S 4S4, Canada.
| | - A Noori
- Department of Health Research, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton ON L8S 4S4, Canada.
| | - M Kiflen
- Department of Health Research, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton ON L8S 4S4, Canada; Population Health Research Institute, Hamilton, ON, Canada.
| | - K Georgiades
- Department of Health Research, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton ON L8S 4S4, Canada; Department of Psychiatry & Behavioral Neurosciences, McMaster University, Canada; Offord Centre for Child Studies, McMaster University, Canada.
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Gardner W, Nicholls SG, Reid GJ, Hutton B, Hamel C, Sikora L, Salamatmanesh M, Duncan L, Georgiades K, Gilliland J. A protocol for a scoping review of equity measurement in mental health care for children and youth. Syst Rev 2020; 9:233. [PMID: 33028412 PMCID: PMC7542722 DOI: 10.1186/s13643-020-01495-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 09/27/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Mental health (MH) problems are among the most important causes of morbidity and mortality for children and youth. Problems of lack of equity in child and youth MH services (CYMHS)-including, but not limited to, problems in inaccessibility and quality of services-are widespread. Characterizing the nature of equity in CYMHS is an ongoing challenge because the field lacks a consistent approach to conceptualizing equity. We will conduct a scoping review of how equity in MH services for children and youth has been defined, operationalized, and measured. Our objectives are to discover: (1) What conceptual definitions of equity are used by observational studies of CYMHS?; (2) What service characteristics of CYMHS care do indices of equity cover?; (3) What population dimensions have been used to operationalize equity?; (4) What statistical constructs have been used in indices that measure CYMHS equity?; and (5) What were the numerical values of those indices? METHODS The following databases will be searched: Medline, Embase, PsycINFO, Cochrane Controlled Register of Trials, CINAHL, EconLit, and Sociological Abstracts. Searches will be conducted from the date of inception to the end of the last full calendar year (December 2019). Studies will be included if they include an evaluation of a mental health service for children or youth (defined as those under 19 years of age) and which quantify variation in some aspect of child or youth mental health services (e.g., accessibility, volume, duration, or quality) as a function of socio-demographic and/or geographic variables. Study selection will occur over two stages. Stage one will select articles based on title and abstract using the liberal-accelerated method. Stage two will review the full texts of selected titles. Two reviewers will work independently on full-text reviewing, with each study screened twice using pre-specified eligibility criteria. One reviewer will chart study characteristics and indices to be verified by a second reviewer. Reviewers will resolve full-text screening and data extraction disagreements through discussion. Synthesis of the collected data will focus on compiling and mapping the types and characteristics of the indices used to evaluate MH services equity. DISCUSSION The planned, systematic scoping review will survey the literature regarding how equity in MH services for children and youth has been operationalized and help inform future studies of equity in CYMHS. SYSTEMATIC REVIEW REGISTRATION Open Science Foundation ID SYSR-D-19-00371, https://osf.io/58srv/ .
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Affiliation(s)
- William Gardner
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada. .,CHEO Research Institute, 401 Smyth Rd, Ottawa, Ontario, Canada.
| | | | - Graham J Reid
- Departments of Psychology, Family Medicine & Paediatrics, Children's Health Research Institute, University of Western Ontario, London, Ontario, Canada
| | - Brian Hutton
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada.,Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Candyce Hamel
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Lindsey Sikora
- Library, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Laura Duncan
- Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
| | | | - Jason Gilliland
- Departments of Geography, Paediatrics, Health Studies, Epidemiology & Biostatistics, Children's Health Research Institute, University of Western Ontario, London, Ontario, Canada
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Halladay J, Bennett K, Weist M, Boyle M, Manion I, Campo M, Georgiades K. Teacher-student relationships and mental health help seeking behaviors among elementary and secondary students in Ontario Canada. J Sch Psychol 2020; 81:1-10. [PMID: 32711720 DOI: 10.1016/j.jsp.2020.05.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 02/04/2020] [Accepted: 05/29/2020] [Indexed: 12/18/2022]
Abstract
This study examined associations between teacher-student relationship quality at school and teachers' responsiveness to students' emotional concerns in a classroom and (a) students' intention to seek help at school for mental health concerns and (b) mental health-related service use. Data for analyses came from the School Mental Health Survey, a cross-sectional survey of 31,120 grade 6-12 students, in 1968 classrooms, attending 248 schools in Ontario, Canada. Three-level (student, classroom, school) binary logistic regression was used to address the study objectives. Student ratings of the quality of teacher-student relationships and teachers' responsiveness were included as predictors, both at the individual student level and aggregated to represent a contextual level characteristic at the school and classroom level, respectively. At the student level, both teacher-student relationship quality and teacher responsiveness were positively associated with intentions to seek help at school among both elementary and secondary students (ORs ranged from 1.14-1.19 for relationships and 1.06-1.08 for responsiveness). Aggregated to the school level, teacher-student relationship quality was positively associated with mental health service use for secondary students (OR = 1.36, 95% CI [1.10, 1.69]). Positive and responsive teacher-student relationships were associated with help-seeking behaviors among students. Longitudinal studies are warranted to disentangle the temporality of these associations.
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Affiliation(s)
- Jillian Halladay
- Department of Health Research, Methods, Evidence, and Impact at McMaster University, Canada
| | - Kathryn Bennett
- Department of Health Research Methods, Evidence, and Impact and Department of Psychiatry & Behavioral Neurosciences at McMaster University, Offord Centre for Child Studies, Canada
| | - Mark Weist
- Department of Psychology at the University of South Carolina, United States of America
| | - Michael Boyle
- Department of Health Research Methods, Evidence, and Impact and Department of Psychiatry & Behavioral Neurosciences at McMaster University, Offord Centre for Child Studies, Canada
| | - Ian Manion
- Youth Research Unit at The Royal's Institute of Mental Health Research and the School of Psychology at the University of Ottawa, Canada
| | | | - Katholiki Georgiades
- Department of Health Research Methods, Evidence, and Impact and Department of Psychiatry & Behavioral Neurosciences at McMaster University, Offord Centre for Child Studies, Canada.
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Kim S, Martin-Storey A, Drossos A, Barbosa S, Georgiades K. Prevalence and Correlates of Sexting Behaviors in a Provincially Representative Sample of Adolescents. Can J Psychiatry 2020; 65:401-408. [PMID: 31835912 PMCID: PMC7265605 DOI: 10.1177/0706743719895205] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To examine the prevalence and correlates of sending and receiving sexts (i.e., sexually explicit images) in a provincially representative sample of adolescents in Canada. METHODS Data from the 2014 Ontario Child Health Study, a provincial survey of households with children in Ontario, which includes a sample of 2,537 adolescents aged 14 to 17 years (mean age = 15.42, male = 51.6%) were used to address the research objectives. RESULTS The past 12 months prevalence of sending and receiving sexts was 14.4% and 27.0%, respectively. In unadjusted logistic regression analyses, non-White adolescents and those living in low-income households were less likely to send or receive sexts compared to White and non-low-income adolescents. Adolescents who disclosed their sexual and/or gender minority identities were 3 to 4 times more likely to send and receive sexts than youth who had not disclosed these identities. Higher levels of mental health problems generally observed among adolescents who sent or received sexts. In fully adjusted models, low income and ethnic minority status were associated with reduced odds of sending and receiving sexts, while sexual and/or gender minority disclosure status was associated with increased odds. Social anxiety was associated with reduced odds of sending and receiving sexts, while conduct disorder was associated with elevated odds. CONCLUSION The prevalence of sexting behavior was higher among adolescents who disclosed their sexual or gender minority identities. Sexting behaviors were associated with higher levels of mental health problems. Identifying vulnerable populations and the potential mental health ramifications associated with sexting behavior is vital to mitigating negative sequelae.
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Affiliation(s)
- Soyeon Kim
- Offord Centre for Child Studies and Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | | | - Alexander Drossos
- Child and Youth Mental Health Program and Department of Psychiatry and Behavioural Neurosciences, McMaster University, Ron Joyce Children’s Health Centre, Hamilton, Ontario, Canada
| | - Samantha Barbosa
- Offord Centre for Child Studies and Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Katholiki Georgiades
- Offord Centre for Child Studies and Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
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44
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Van Lieshout RJ, Savoy CD, Boyle MH, Georgiades K, Jack SM, Niccols A, Whitty H, Lipman EL. The Mental Health of Young Canadian Mothers. J Adolesc Health 2020; 66:464-469. [PMID: 32057608 DOI: 10.1016/j.jadohealth.2019.10.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 10/15/2019] [Accepted: 10/16/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Although many young mothers (aged <21 years) are exposed to multiple adversities that increase their risk for mental illness, prevalence data are largely limited self-report questionnaires estimating only the prevalence of postpartum depression. Gaining a greater understanding of the burden of a broader range of common mental illnesses affecting these young women has the potential to improve their health as well as the development and functioning of their children. METHODS The Young Mothers Health Study recruited 450 mothers aged <21 years and 100 comparison mothers (aged >20 years old at first delivery) living in urban and rural central-west Ontario. Age-matched young mothers were also compared with 15- to 17-year-old women without children (N = 630) from the 2014 Ontario Child Health Study. The prevalence of current mental disorders was assessed using the Mini-International Neuropsychiatric Interview for Children and Adolescents. RESULTS Nearly 2 of 3 young mothers reported at least one mental health problem, and almost 40% had more than one. Young mothers were 2 to 4 times as likely to have an anxiety disorder (generalized anxiety disorder, separation anxiety disorder, social phobia, and specific phobia), attention-deficit/hyperactivity disorder, oppositional defiant disorder, or conduct disorder and were 2 to 4 times more likely to have more than one psychiatric problem than older comparison mothers or women aged 15-17 years. CONCLUSIONS Given the high rates of mental health problems and complex needs of young mothers in Canada and the possible adverse effects of maternal psychopathology on their children, further efforts should be directed at engaging and treating this high-risk group.
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Affiliation(s)
- Ryan J Van Lieshout
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Calan D Savoy
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.
| | - Michael H Boyle
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Katholiki Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Susan M Jack
- School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Alison Niccols
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Heather Whitty
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Ellen L Lipman
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
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Comeau J, Duncan L, Georgiades K, Wang L, Boyle MH. Social assistance and trajectories of child mental health problems in Canada: evidence from the National Longitudinal Survey of Children and Youth. Can J Public Health 2020; 111:585-593. [PMID: 32124402 DOI: 10.17269/s41997-020-00299-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 02/04/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To examine the link between stability and change in social assistance (SA) use and children's mental health trajectories to better understand whether social policies targeted at low-income families might be an effective population-based mechanism for preventing mental health problems among children at risk. METHODS The National Longitudinal Survey of Children and Youth (N = 8981) is used to classify children into 5 categories based on their family's pattern of SA use from age 4-5 to 10-11: always or never on SA, a single transition on or off SA, or fluctuations on and off SA. Latent growth modelling is used to compare trajectories of emotional and behavioural problems among children with different patterns of SA exposure to their counterparts never on SA over this same time period. RESULTS Child emotional and behavioural problems are exacerbated over time in accordance with patterns of SA use: chronic SA use (behavioural) and moving onto SA (emotional and behavioural). These differential rates of change result in mental health disparities at age 10-11 that were not present at age 4-5. Children exposed to SA when they were age 4-5 but subsequently moved off continue to demonstrate elevated levels of emotional and behavioural problems at age 10-11. CONCLUSIONS Successful social policies and interventions will require understanding the specific mechanisms through which SA undermines child mental health and how programs can be modified to reduce its negative consequences.
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Affiliation(s)
- Jinette Comeau
- Department of Sociology, King's University College at Western University, London, ON, Canada. .,Children's Health Research Institute, Division of Children's Health and Therapeutics, Lawson Health Research Institute, Western University, London, ON, Canada.
| | - Laura Duncan
- Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.,Department of Health Research Methods, Evidence & Impact (formerly Clinical Epidemiology & Biostatistics), McMaster University, Hamilton, ON, Canada
| | - Katholiki Georgiades
- Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Li Wang
- Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Michael H Boyle
- Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
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Halladay JE, Munn C, Boyle M, Jack SM, Georgiades K. Temporal Changes in the Cross-Sectional Associations between Cannabis Use, Suicidal Ideation, and Depression in a Nationally Representative Sample of Canadian Adults in 2012 Compared to 2002. Can J Psychiatry 2020; 65:115-123. [PMID: 31177831 PMCID: PMC6997972 DOI: 10.1177/0706743719854071] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND With the recent legalization of nonmedical cannabis in Canada, it is important to document previous associations between cannabis use and major depressive episode and suicidal ideation, as well as the extent to which these associations have changed over time. METHODS This study uses pooled data from the 2002 and 2012 Canadian Community Health Survey's Mental Health Component, which are repeated cross-sectional surveys of nationally representative samples of Canadians 15 to 60 years of age (n = 43,466). Binary logistic regression was performed, applying weighting and bootstrapping, to examine the association between at least monthly use of cannabis and past 12-month suicidal ideation and major depressive episode (MDE). RESULTS At least monthly nonmedical cannabis use was associated with an increased odds of MDE and suicidal ideation, and both associations strengthened in 2012 compared to 2002. Canadians using cannabis at least once a month in 2012 had 1.59 (95% confidence interval [CI], 1.11 to 2.27) times the odds of experiencing suicidal ideation and 1.55 (95% CI, 1.12 to 2.13) times the odds of experiencing MDE compared to those who used cannabis at least once a month in 2002. This temporal change remained after controlling for other substance use. CONCLUSIONS Monthly cannabis use was consistently related to both suicidal ideation and MDE, and these associations were stronger in 2012 compared to 2002. The findings of this study provide a baseline for the association between cannabis use and suicide and depression in the Canadian population that should be reevaluated now that nonmedical cannabis has been legalized.
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Affiliation(s)
- Jillian E Halladay
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario
| | - Catharine Munn
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario.,Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton Ontario
| | - Michael Boyle
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario.,Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton Ontario.,Offord Centre for Child Studies, McMaster University, Hamilton, Ontario
| | - Susan M Jack
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario.,Offord Centre for Child Studies, McMaster University, Hamilton, Ontario.,School of Nursing, McMaster University, Hamilton, Ontario
| | - Katholiki Georgiades
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario.,Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton Ontario.,Offord Centre for Child Studies, McMaster University, Hamilton, Ontario
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Duncan L, Georgiades K, Reid GJ, Comeau J, Birch S, Wang L, Boyle MH. Area-Level Variation in Children’s Unmet Need for Community-Based Mental Health Services: Findings from the 2014 Ontario Child Health Study. Adm Policy Ment Health 2020; 47:665-679. [DOI: 10.1007/s10488-020-01016-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Turner S, Menzies C, Fortier J, Garces I, Struck S, Taillieu T, Georgiades K, Afifi TO. Child maltreatment and sleep problems among adolescents in Ontario: A cross sectional study. Child Abuse Negl 2020; 99:104309. [PMID: 31838226 DOI: 10.1016/j.chiabu.2019.104309] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 11/25/2019] [Accepted: 11/29/2019] [Indexed: 05/14/2023]
Abstract
INTRODUCTION Child maltreatment has a negative impact on health and well-being. Healthy sleep patterns are an important indicator of health and are particularly important for adolescent growth and development. Few studies examine the relationship between child maltreatment and sleep problems using a general population, adolescent sample. The objective of the current study was to examine the relationship between five different types of child maltreatment and four sleep outcomes among adolescents. METHODS Data were from a subset of the Ontario Child Health Study 2014, a representative sample of 14 to 17- year-olds in Ontario, Canada (n=2,910). Sexual abuse, physical abuse and exposure to intimate partner violence (EIPV) were measured using the Childhood Experiences of Violence Questionnaire (CEVQ). Emotional maltreatment and physical neglect were measured using items derived from survey questions designed for the National Longitudinal Study of Adolescent to Adult Health. Sleep outcomes included time it takes to fall asleep, waking during the night, and hours of sleep on weekdays and weekends. Models were adjusted for sociodemographic variables. RESULTS Findings indicate that all types of child maltreatment were associated with increased odds of taking more than 10 min to fall asleep (adjusted odds ratio [AOR]: 1.21-1.58), waking more often during the night (AOR: 1.62-5.73) and fewer hours slept on weekdays (adjusted beta [AB]: -0.39 to -0.15). Child sexual abuse, emotional maltreatment, and EIPV were associated with decreased hours of sleep on weekends (AB: -0.63 to -0.28). CONCLUSION Preventing child maltreatment may improve sleep outcomes among adolescents, thereby improving overall health and well- being.
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Affiliation(s)
- Sarah Turner
- Department of Community Health Sciences, Medical Services Building, S113 - 750 Bannatyne Avenue, University of Manitoba, Winnipeg, Manitoba, R3E 0W3, Canada.
| | - Caitlin Menzies
- Department of Psychology, P404 Duff Roblin Building, 190 Dysart Rd, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
| | - Janique Fortier
- Department of Community Health Sciences, Medical Services Building, S113 - 750 Bannatyne Avenue, University of Manitoba, Winnipeg, Manitoba, R3E 0W3, Canada
| | - Isabel Garces
- Department of Community Health Sciences, Medical Services Building, S113 - 750 Bannatyne Avenue, University of Manitoba, Winnipeg, Manitoba, R3E 0W3, Canada
| | - Shannon Struck
- Department of Community Health Sciences, Medical Services Building, S113 - 750 Bannatyne Avenue, University of Manitoba, Winnipeg, Manitoba, R3E 0W3, Canada
| | - Tamara Taillieu
- Department of Community Health Sciences, Medical Services Building, S113 - 750 Bannatyne Avenue, University of Manitoba, Winnipeg, Manitoba, R3E 0W3, Canada
| | - Katholiki Georgiades
- Department of Psychiatry and Behavioural Neurosciences, St. Joseph's Healthcare Hamilton, West 5th Campus Administration - B3 100 West 5th, Hamilton, ON, L8N 3K7, Canada
| | - Tracie O Afifi
- Departments of Community Health Sciences and Psychiatry, Medical Services Building, S113 - 750 Bannatyne Avenue, University of Manitoba, Winnipeg, Manitoba, R3E 0W3, Canada
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Filler T, Georgiades K, Khanlou N, Wahoush O. Understanding Mental Health and Identity from Syrian Refugee Adolescents’ Perspectives. Int J Ment Health Addict 2019. [DOI: 10.1007/s11469-019-00185-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Afifi TO, Fortier J, MacMillan HL, Gonzalez A, Kimber M, Georgiades K, Duncan L, Taillieu T, Davila IG, Struck S. Examining the relationships between parent experiences and youth self-reports of slapping/spanking: a population-based cross-sectional study. BMC Public Health 2019; 19:1345. [PMID: 31640664 PMCID: PMC6805493 DOI: 10.1186/s12889-019-7729-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 10/09/2019] [Indexed: 01/31/2023] Open
Abstract
Background Slapping/spanking is related to a number of poor health outcomes. Understanding what factors are related to the increased or decreased use of spanking/slapping is necessary to inform prevention. This study used a population-based sample to determine the prevalence of slapping/spanking reported by youth; the relationship between sociodemographic factors and slapping/spanking; and the extent to which parental exposures to victimization and maltreatment in childhood and current parental mental health, substance use and family circumstances, are associated with youth reports of slapping/spanking. Methods Data were from the 2014 Ontario Child Health Study, a provincially representative sample of households with children and youth aged 4–17 years. Self-reported lifetime slapping/spanking prevalence was determined using a sub-sample of youth aged 14–17 years (n = 1883). Parents/primary caregivers (i.e., person most knowledgeable (PMK) of the youth) self-reported their own childhood experiences including bullying victimization, slapping/spanking and child maltreatment, and current mental health, substance use and family circumstances including mental health functioning and emotional well-being, alcohol use, smoking, marital conflict and family functioning. Analyses were conducted in 2018. Results Living in urban compared to rural residence and family poverty were associated with decreased odds of slapping/spanking. PMK childhood experiences of physical and verbal bullying victimization, spanking, sexual abuse, emotional abuse, and exposure to physical intimate partner violence were associated with increased odds of youth reported slapping/spanking (adjusted odds ratio [AOR] ranged from 1.33–1.77). PMK experiences of physical abuse and exposure to emotional/verbal intimate partner violence in childhood was associated with decreased odds of youth reported slapping/spanking (AOR = 0.72 and 0.88, respectively). PMK’s higher levels of marital conflict, languishing to moderate mental health functioning and emotional well-being, and moderate or greater alcohol use were associated with increased odds of youth reported slapping/spanking (AOR ranged from 1.36–1.61). Conclusions It may be important to consider parent/primary caregiver’s childhood experiences with victimization and maltreatment along with their current parental mental health, substance use and family circumstances when developing and testing strategies to prevent slapping/spanking.
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Affiliation(s)
- Tracie O Afifi
- Departments of Community Health Sciences and Psychiatry, University of Manitoba, S113-750 Bannatyne Avenue, Winnipeg, Manitoba, R3E 0W5, Canada.
| | - Janique Fortier
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Harriet L MacMillan
- Departments of Psychiatry and Behavioural Neurosciences, and of Pediatrics, McMaster University, Hamilton, Canada
| | - Andrea Gonzalez
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Melissa Kimber
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Katholiki Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Laura Duncan
- Offord Centre for Child Studies, Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Tamara Taillieu
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Isabel Garces Davila
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Shannon Struck
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
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