A two-year cohort of children of parapartum mentally ill mothers born in Stockholm during the mid-70s was studied with regard to mental development, somatic growth and social outcome. The observation period covered the pre-school-age period and the study was based on Well-Baby-Clinic (WBC) data. The findings were compared with those of matched controls. Nearly 40% of the children of the mentally ill mothers, compared to 3% of the controls, did not live with their biological mothers during the pre-school ages. No difference was found in somatic growth between the index and control children. However, more index children--especially those of addicts and neurotic or temporarily insufficient mothers--than controls suffered from developmental (p less than 0.05) and behavioural (p less than 0.001) disturbances. Fifteen per cent of the index children compared to 5% of the controls were judged by the staff of the WBC to be in need of treatment for psychological problems (p less than 0.01). The results of the present study emphasize the fact that children of mentally ill mothers constitute a high-risk group regarding mental and behavioural development. The study supports earlier research reports claiming that, while parental mental illness constitutes an important indicator of psychiatric risk for the children, the main risk stems from associated psychosocial disturbances in the family.
A two-year cohort of children of parapartum mentally ill mothers, born in Stockholm during the mid-1970s, was studied with regard to mortality, hospitalization rate and Well Baby Clinic (WBC) care consumption during the pre-school-age period. The findings were compared with those of matched controls. The index children-especially those of addicts and neurotic or temporarily insufficient mothers-had a higher admission rate and had spent more days in hospital than the controls. The index children tended to have a higher mortality rate than the controls. No significant difference was found in the WBC attendance rates of the index children and the controls. Socially disadvantaged families tended, however, to pay more visits to the WBC than those who were better off. Home visits by the WBC nurse were made more frequently to the index families than to the controls. Failure to appear for regular health checks of the child correlated better with social dysfunction than with mental illness per se in the mother. An adverse social environment, including addiction, seemed to be a separate factor of significant importance, apart from mental illness per se in the mothers, for the morbidity of the children.
Children of mothers who satisfied the Research Diagnostic Criteria of (1) Schizophrenia, (2) Alcoholism or Drug Use Disorder, (3) Major Depressive Disorder including Mania, (4) Unspecified Functional Psychosis, and (5) Other Psychiatric Disorder and children of obstetric controls were studied with regard to subsequent mental and behavioural development and social conditions. 72 index children and 17 children from the comparison group were examined at an approximate age of six years by a child psychologist. More index children than those from the comparison group showed impaired mental and behavioural development. The children of abusing mothers in particular tended to have a worse outcome. One-half of the index children were not living with their mothers at the time of follow-up.
A 2-year cohort of children (n = 75) of hospitalised first-episode parapartum mentally ill mothers in the mid-1970s in Stockholm were studied. The children were followed up during the school-age period from 1982 through 1992, and they were studied with regard to health development, academic achievement and family situation. Comparisons were made with matched controls. Data were collected from hospital case notes, the local tax authorities and school reports. No significant differences were found between the index children and the controls regarding the number of inpatient care episodes or days of inpatient care during the follow-up period. Nor was any significant difference found between the index and the control children regarding academic achievement as measured by the mean of all marks. Four index children and 2 controls were studying in schools for the mentally retarded. Seventy-four percent of the children of the patients were living with their mother, compared to 95% of the controls (p
The study is based on two series of patients with post partum mental illness, one consisting of 71 women in Gothenburg 1952-56 and another of 68 women in Stockholm 1976-77. The total number of births in the two cities during the periods in question were used as reference. A strategy of chi-squared test and the Edwards' criteria of seasonality was applied for statistical analyses of the results. A yearly double periodic trend in month of conception could be observed.
OBJECTIVE--To clarify the association between treatment of affective psychiatric disorders with lithium, and the development of secondary hyperparathyroidism. DESIGN--Retrospective review of medical records, 1973-89. SUBJECTS--17 patients with affective psychiatric disorders who were treated with lithium (n = 6) or with tricyclic antidepressant, or neuroleptic, drugs (n = 11) all of whom were operated on for hyperparathyroidism. MAIN OUTCOME MEASURE--Duration of lithium therapy and parathyroid histology. RESULTS--Parathyroid hyperplasia was present in 5 patients who had taken lithium during a median period of 13 years. A parathyroid adenoma was found in one patient treated with lithium for three years. Ten of the 11 patients who had been treated with tricyclic antidepressant, or neuroleptic drugs had a parathyroid adenoma and the remaining one had an adenoma as an underlying cause of hyperparathyroidism. CONCLUSION--Hyperparathyroidism in patients who have undergone long term treatment with lithium is associated with parathyroid hyperplasia. This indicates that lithium may exert a chronic stimulus that results in secondary hyperparathyroidism.
Antenatal care consumption, obstetric conditions, and neonatal health, were studied retrospectively in all women in the county of Stockholm who had a baby during 1976-77 and also had been admitted to a psychiatric department after the 20th week of pregnancy or within the first postpartum year, and the findings were compared in matched obstetric controls. Fewer index women had had uncomplicated pregnancies than the controls. A positive relationship was found between acute mental illness and pregnancy complications. Delivery complications tended to to be more common in the index group than in controls, but, only in patients with prepartum onset of mental illness. More index women had a history of several previous abortions than the controls. The index women, and especially the addicts, attended the antenatal care clinics significantly less frequently than the controls. The neonatal health of the index children seemed to be more closely correlated with alcohol or drug dependency per se in the mothers than with mental illness.
The aim of this study was to map the psychological/psychiatric, odontological and medical aspects of patients with symptoms allegedly related to the side-effects of mercury in dental fillings. A total of 67 consecutive patients and 64 controls matched for age, sex and residential area were included in the study. The most striking result was the high prevalence of psychiatric disorders in the patients (89%) compared to the controls (6%), predominantly somatoform disorders. The personality traits differentiating the patients according to the Karolinska Scales of Personality (KSP) were somatic anxiety, muscular tension, psychasthenia and low socialization. More patients than controls showed alexithymic traits. The prevalence of diagnosed somatic diseases was higher, but not sufficiently so to explain the large difference in perceived health. The multiple symptoms and signs of distress displayed by the patients could not be explained either by the odontological data or by the medical examination. Our data indicate that the patients show sociodemographic and clinical patterns similar to those of somatizing patients. The medicalization of the suffering of these patients and the neglect of psychiatric problems prevent the use of appropriate psychotherapeutic approaches.
All mothers (n = 79) in the county of Stockholm who gave birth to a child during 1976-77 and were also hospitalised for the first time in a psychiatric clinic were followed up after a mean interval of 15 years. The sample was classified according to the Research Diagnostic Criteria. Comparisons were made with matched obstetric controls. Five patients had died. The recurrence rate was 51% and 7. 3% relapsed after a subsequent childbirth. No difference was found between psychotic and non-psychotic mothers regarding mean sick-leave days per year. The majority of the women with a depressive disorder at index admission suffered from a minor depressive disorder. The women in the group with an unspecified functional psychosis showed a less severe course of illness than the women in the schizophrenia group.