Aim To describe behavioural and emotional symptoms among Icelandic preschool children with cerebral palsy (CP). Method Children with congenital CP, assessed with the Child Behavior Checklist/1(1/2)-5 (CBCL/1(1/2)-5) and Caregiver-Teacher Report Form (C-TRF), were enrolled in the study. A comparison group was recruited from the general population. Thirty-six children (53% males) with CP were assessed at a mean age of 4 years 11 months (SD 5mo, range 4-6y); 26 (72%) had bilateral distribution of symptoms and 32 (89%) had spastic CP. Thirty (83%) were at Gross Motor Function Classification System levels I or II and six at levels III or IV. For comparison, 110 (43% males) and 120 (48% males) children were assessed with the CBCL/1(1/2)-5 and the C-TRF respectively, at a mean age of 4 years 6 months (SD 6mo, range 4-6y). Results Sixteen children (48%) with CP had high scores on total problems scale of the CBCL/1(1/2)-5 and 20 (65%) on the C-TRF compared with 18% of the comparison group, both on the CBCL/1(1/2)-5 and the C-TRF (p
The aim of this study was to assess the prevalence of chronic multisite pain with high disability in relation to emotional or behavioral problems and resilience factors in adolescence. A second aim was to investigate if resilience factors could attenuate the associations between psychiatric symptoms and chronic multisite pain. The study was based on a large cross-sectional study carried out in Norway between 2006 and 2008 and included 7,070 adolescents aged 13-19 years. Chronic multisite pain was defined as pain at least once a week during the last 3 months, scoring high on a disability index, and occurring in three or more locations. Chronic multisite pain was prevalent among adolescents with high scores (>85%) for anxiety/depression, social anxiety, conduct or attention problems (22.8-31.0 for girls, 8.8-19.0% for boys). Several coexistent psychiatric symptoms increased the prevalence of chronic multisite pain for both girls and boys. Resilience factors, including high self-esteem, seldom feeling lonely, and high scores for family cohesion or social competence, were associated with a lower prevalence and markedly attenuated the association between psychiatric symptoms and chronic multisite pain. Psychiatrists should be careful to assess and treat comorbid chronic pain in adolescents with emotional or behavioral problems.
People who suffer from psychiatric disorders are burdened with a high prevalence of chronic illnesses and pain, but evidence on pain prevalence among adolescents with psychiatric disorders is scarce. The aim of this study was to investigate the frequency and location of self-reported chronic pain and pain-related disability in adolescent psychiatric patients.
This study was part of the larger Health Survey administered at the Department of Child and Adolescent Psychiatry (CAP) at St. Olav's University Hospital, in Trondheim, Norway. All patients aged 13-18 years who visited the CAP clinic at least once between February 15, 2009 and February 15, 2011 were invited to participate. A total of 717 (43.5% of eligible/invited patients) participated; of these, 566 were diagnosed with one or more psychiatric disorders. The adolescents completed a questionnaire, which included questions about pain and pain-related disability. Clinical diagnoses were classified by a clinician according to International Statistical Classification of Diseases and Related Health Problems, 10th revision criteria.
In adolescents with psychiatric disorders, 70.4% reported chronic pain, and 37.3% experienced chronic pain in three or more locations (multisite pain). Chronic musculoskeletal pain was the most prevalent type of pain (57.7%). Pain-related disability was found in 22.2% of the sample. The frequency of chronic pain and multisite pain increased with age, and girls reported a higher frequency of chronic pain, multisite pain and pain-related disability than boys did. There was an increased risk of chronic pain among adolescents with mood or anxiety disorders versus those with hyperkinetic disorders, yet this was not present after adjusting for sex. Comorbidity between hyperkinetic and mood or anxiety disorders involved an increased risk of pain-related disability.
In this study, seven out of 10 adolescents with psychiatric disorders reported chronic pain. These findings indicate the importance of early detection of chronic pain in adolescents with psychiatric disorders, to provide targeted treatment and reduce poor long-term outcomes.
Regional Centre for Child and Youth Mental Health and Child Welfare, Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway. ingunn.ranoyen@ntnu.no.
Anxiety and depression are often co-occurring disorders, reflecting both homotypic and heterotypic continuity as possible developmental pathways. The present study aimed to examine homotypic and heterotypic continuities of anxiety and depression across 3 years in adolescence and young adulthood. Participants included patients presenting to psychiatric care with diagnoses of anxiety and/or depressive disorders aged 13-18 at T1 (N = 717, 44% initial participation rate) and aged 16-21 at T2 (N = 549, 80% follow-up participation rate). McNemar's mid-p test and ordinal proportional odds logistic regression analyses were used to assess changes in prevalence within and across diagnostic categories, respectively. More adolescents had an anxiety disorder (+ 11%), whereas fewer had a depressive disorder (- 11%), at T2 compared to T1. Of adolescents with anxiety and/or depression at T1, only 25% recovered or were non-symptomatic 3 years after referral to a psychiatric clinic. Homotypic continuity was observed for anxiety disorders in general (OR = 2.33), for phobic anxiety disorders (OR = 7.45), and for depressive disorders (OR = 2.15). For heterotypic continuity, depression predicted later anxiety (OR = 1.92), more specifically social anxiety (OR = 2.14) and phobic anxiety disorders (OR = 1.83). In addition, social anxiety predicted later generalized anxiety disorder (OR = 3.11). Heterotypic continuity was thus more common than homotypic continuity. For adolescents presenting with anxiety or depression, treatment should, therefore, target broad internalizing symptom clusters, rather than individual diagnoses. This may contribute to prevent future mental illness, particularly anxiety, in clinical samples.
Gender differences in psychosocial functioning of adolescents with symptoms of anxiety and depression: longitudinal findings from the Nord-Trøndelag Health Study.
Department of Neuroscience, Faculty of Medicine, The Regional Centre for Child and Adolescent Mental Health (RBUP), Norwegian University of Science and Technology, 7491, Trondheim, Norway. ruth.derdikman@ntnu.no
To explore longitudinally gender differences in the associations between psychosocial functioning, subjective well-being and self-esteem among adolescents with and without symptoms of anxiety and depression.
Data were obtained from a major population-based Norwegian study, the Nord-Trøndelag Health Study, in which 1,092 boys and 1,262 girls (86% of all invited) completed an extensive self-report questionnaire at baseline (mean age 14.4 years) and at follow-up (mean age 18.4 years).
Gender was a moderator variable in the associations between symptoms of anxiety and depression and impairment, meaning that boys' functioning was impaired to a larger extent than girls' functioning. A statistically significant interaction effect between gender and symptoms of anxiety and depression was found at follow-up in terms of subjective well-being (p
Gender differences in subjective well-being, self-esteem and psychosocial functioning in adolescents with symptoms of anxiety and depression: findings from the Nord-Trøndelag Health Study.
The Regional Centre for Child and Adolescent Mental Health, Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway. derdikman@ntnu.no
Gender differences in the prevalence of symptoms of anxiety and depression during adolescence are well documented. However, little attention has been given to differences in subjective well-being, self-esteem and psychosocial functioning between boys and girls with symptoms of anxiety and depression. The aim of this study was to investigate gender differences in the associations between such symptoms and subjective well-being, self-esteem, school functioning and social relations in adolescents. Data were taken from a major population-based Norwegian study, the Nord-Trøndelag Health study (HUNT), in which 8984 (91% of all invited) adolescents, aged 13-19 years, completed an extensive self-report questionnaire. Although prevalence rates of symptoms of anxiety and depression were higher in girls than in boys, a significant interaction between gender and symptoms of anxiety and depression was found in respect of each of the following outcome variables: subjective well-being, self-esteem, academic problems, frequency of meeting friends and the feeling of not having enough friends. These interactions indicate that the associations between symptoms of anxiety and depression and lower subjective well-being and self-esteem, more academic problems in school and lower social functioning were stronger for boys than for girls. Our findings may contribute to an earlier assessment and more efficient treatment of male adolescent anxiety and depression.
Intelligence is the aggregate or global capacity of the individual to act purposefully, to think rationally and to deal effectively with the environment. Previous studies have shown that individuals with intellectual disability, IQ?
Being born with low birth weight is a risk factor for psychiatric morbidity. Few longitudinal studies have included diagnostic assessment and followed subjects into adulthood.
To assess stability and change in psychiatric morbidity between adolescence and young adulthood in low birth weight subjects, and explore whether screening in adolescence can predict subsequent psychopathology in these groups.
Prospective geographically based follow-up study of two low birth weight groups and a control group born between 1986 and 1988, assessed at 14 (T1) and 20 (T2) years of age.
Thirty eight subjects born preterm with very low birth weight (VLBW: =1500g), 43 born at term but small for gestational age (SGA:
Being born with low birth weight may have an impact on different aspects of mental health, psychosocial functioning and well-being; however results from studies in young adulthood have so far yielded mixed findings. The aim of this study was to assess the long-term impact in young adulthood on self-reported mental health, health-related quality of life, self-esteem and social relations by investigating differences between two low birth weight groups and a control group.
In a follow-up at 20 years of age, 43 preterm VLBW (birth weight = 1500 g), 55 term SGA (birth weight
Notes
Cites: JAMA. 2000 Feb 2;283(5):625-3210665702
Cites: Arch Gen Psychiatry. 2012 Jun;69(6):E1-822660967
Cites: Early Hum Dev. 2001 Mar;61(2):97-11011223272
Cites: Lancet. 2001 May 26;357(9269):1641-311425366
Cites: Am J Psychiatry. 2001 Jul;158(7):1091-811431231
Cites: J Autism Dev Disord. 2001 Feb;31(1):5-1711439754
Professional collaboration - support for children with cancer and their families - focus group interview - a source of information and knowledge - professionals' perspectives.
In this study, our aims were to evaluate a professional collaborative model and to explore professionals' perceptions of collaboration generally. Focus group interviews were performed with 18 health and non-health professionals caring for children diagnosed and treated for cancer. Collaboration was considered significant for professionals themselves and the families they work with. Focus group participants support the importance of arranging collaborative meetings at an early stage of the child's illness and the family's crisis. Many professionals, working in the child's home community, were alone with the responsibility for follow-up care, but only a few of these professionals received supervision. More frequent contact with the paediatric clinic was desired, as well as a more active role for the general practitioner. Professionals perceived the model as being a valuable support system for longterm planning of follow-up care, allowing parents to collaborate with the care team. It is essential however, to emphasize the importance of having well-established routines, as well as the use of a coordinator. This can be important for enhancing communication between professionals and for obtaining a well-functioning collaboration.
