Seventy-five patients were admitted to the ward of the Lund Suicide Research Center following a suicide attempt. After 5 years, the patients were followed up by a personal semistructured interview covering sociodemographic, psychosocial and psychiatric areas. Ten patients (13%) had committed suicide during the follow-up period, the majority within 2 years. They tended to be older at the index attempt admission, and most of them had a mood disorder in comparison with the others. Two patients had died from somatic diseases. Forty-two patients were interviewed, of whom 17 (40%) had reattempted during the follow-up period, most of them within 3 years. Predictors for reattempt were young age, personality disorder, parents having received treatment for psychiatric disorder, and a poor social network. At the index attempt, none of the reattempters had diagnoses of adjustment disorders or anxiety disorders. At follow-up, reattempters had more psychiatric symptoms (SCL-90), and their overall functioning (GAF) was poor compared to those who did not reattempt. All of the reattempters had long-lasting treatment ( > 3 years) as compared to 56% of the others. It is of great clinical importance to focus on treatment strategies for the vulnerable subgroup of self-destructive reattempters.
This study explored the possible links between family risk factors (i.e., parent gambling and parenting practices) and adolescent gambling. A community sample of 938 adolescents (496 females and 442 males) completed the South Oaks Gambling Screen Revised for Adolescents (SOGS-RA; K. C. Winters, R. Stinchfield, & J. Fulkerson, 1993b) along with a questionnaire assessing parenting practices. Both parents completed the SOGS (H. R. Lesieur & S. B. Blume, 1987). Results showed that adolescent gambling frequency was related to both parents' gambling frequency and problems. However, adolescent gambling problems were linked only to fathers' severity of gambling problems. Low levels of parental monitoring enhanced adolescents' risk of getting involved in gambling activities and developing related problems. A higher level of inadequate disciplinary practices was also related to greater gambling problems in youth. These links were significant after controlling for socioeconomic status, gender, and impulsivity-hyperactivity problems.
AIMS: In 1936 the Finnish Anti-Tuberculosis Association founded the first nursery, "Joulumerkkikoti", into which infants born into tuberculous families were admitted and given BCG vaccination to reduce the risk of tuberculosis. This prophylactic regimen was effective in reducing infant mortality and morbidity of tuberculosis. We investigated the mortality of these children later in childhood and adulthood. METHODS: The index cohort consisted of 3,020 subjects born between 1945 and 1965 in Finland and isolated from their family immediately after birth. The average separation time was 218 days. The subjects alive on 1 January 1971 were identified. For every index subject two reference subjects were chosen, the matching criteria being sex, year, and place of birth. Data on causes of deaths were obtained from the Finnish Cause of Death Registry by the end of 1998. RESULTS: The relative mortality rate (RR) was higher in the index cohort than in the reference cohort for all causes of death (RR 1.4; 95% CI 1.2-1.7), and particularly for unnatural deaths: RR 1.5 (1.1-1.9) for men and RR 1.9 (1.0-3.7) for women. CONCLUSIONS: The mortality in the index subjects later in childhood and adulthood was somewhat elevated. This may be explained by a variety of risks experienced during pregnancy, delivery, and childhood. The fall in the socioeconomic status of the family of origin due to tuberculosis may partially explain the result. Another interpretation is that the very early separation from the mother had unfavourable effects on later psychological developments in some children.
OBJECTIVE: The aim of this study was to investigate the predictors of the timing of alcohol consumption debut and to analyze possible associations between the timing of debut and later alcohol consumption and possible alcohol-related problems. METHOD: A population sample of 465 adolescents (249 girls) from the greater Oslo area was followed up through five data collections over a 6-year span. By means of generalized structural equation modeling--accommodating survival variables--parental and friends' influences on debut age were estimated. Further, the consequences of the age of debut on subsequent alcohol consumption and alcohol problems were studied, taking other influences into consideration. In particular, possible gender differences were investigated. RESULTS: The mean age for alcohol consumption debut was 14.8 years. The age of alcohol debut had an independent effect on both future alcohol consumption and the development of alcohol-related problems, and the effects were invariant across sex. According to the estimated model, a 10% delay in debut age will lead to a 35% decrease in subsequent expected alcohol consumption. CONCLUSIONS: Alcohol debut was an excellent predictor of subsequent alcohol consumption and alcohol problems. The strong preventive implication is that interventions should be implemented in order to postpone alcohol debut age. A weak implication is that preventive measures should be implemented for the early onset drinkers. Further, it seems to be important to give high priority to more thorough studies on the exact nature of the relationships we have investigated here.
The study explored a set of potential risk and protective factors in relation to criminal activity and adjustment with a group of delinquent youths. The results indicated, first, that risk variables reflecting family relationship and parenting problems were associated with heightened rates of re-offending and lower overall adjustment. Second, the presence of protective factors relating to positive peer relations, good school achievement, positive response to authority and effective use of leisure time was associated with more positive outcomes with controls for the risk variables. Third, there was no evidence of interaction between risk and protective factors; the latter operated similarly at low and high levels of risk. These results are discussed in terms of their theoretical and applied significance.
Anticipation describes an inheritance pattern within a pedigree with an increase in disease severity and/or decrease in age at onset in successive generations. The phenomenon of anticipation has recently been shown to be correlated with the expansion of trinucleotide repeat sequences in a neuromuscular disease, various neurodegenerative disorders and mental retardation. We have studied parent-offspring differences in age at onset and disease severity in 31 pairs with unilineal inheritance of unipolar affective disorder (UPAD). Life-table analyses showed a significant decrease in survival to 1st episode of major depression in the offspring generation compared with the parental generation (P = 0.0007). There was also a significant difference in age at onset (P
Antisocial behaviour among adolescent suicide victims (44 males, 9 females) was investigated in a nationwide psychological autopsy study of suicides in Finland. The data were collected through interviews of the victims' relatives and attending health care personnel, and from official records. Antisocial behaviour was reported among 43% of the victims. Separation from parents, parental alcohol abuse and parental violence were common among male victims with antisocial behaviour. Their psychosocial adjustment was poor, and they had experienced severe stressors. Depressive disorders were common among all suicides, but male victims with antisocial behaviour had more often alcohol abuse and comorbid mental disorders compared with victims without antisocial behaviour. The results indicate a strong relatedness between adolescent suicide and antisocial behaviour. Recognition and treatment of manifest mental symptoms and evaluation of suicide risk among adolescents with antisocial behaviour and substance abuse is emphasized. Antisocial symptoms with relatively short duration and not severe enough to meet the criteria for actual antisocial disorders also need to be taken into account.
The associations of psychosocial characteristics with both gender and smoking behavior were explored in a sample of 1552 grade-six students from 107 schools in one Ontario, Canada, school district. Ever smokers were more likely to have spending money: a part-time job; to have missed school in previous 2 months; perceive themselves to be below average or average in school; to have a mother, a father, and a sibling who smoke; to have consumed low alcohol and alcoholic beverages; and agree with fewer positive statements concerning second-hand smoke and the addictive properties of smoking. Ever smokers had more close friends who tried smoking, spent more time with friends, scored higher on depression, rebelliousness, and social conformity scales, reported more life events in the past year, and had lower scores for social support. More boys than girls had ever smoked (18.9% vs. 14.7%). Gender differences were found for sociodemographic, attitudes, social bonding, and psychosocial factors.
Chercheure à l'Institut de recherche pour le développement social des jeunes (IRDS), Institut de recherche du Centre jeunesse de Montréal-Institut universitaire et au département de psychiatrie du Centre universitaire de santé McGill (CUSM).
An exploratory survey of 68 youth protection services' workers in Montréal, who followed 1,030 children reveals that 39 % of these children have at least one parent who suffer from mental health problems. Among these parents, 48 % of mothers and 30 % of fathers have a personality disorder, and for the majority, a borderline personality disorder. This mental health problem is preoccupying for youth protection workers because of its high prevalence, its impact on children and case workers and the difficulties brought forth by having to intervene in a context of authority and within an organization not adapted to the management of this mental health problem. Some intervention's guidelines to work with these parents are presented as well as some challenges and future perspectives.
Although there is evidence that adverse childhood experiences are associated with worse mental health in adulthood, scarce evidence is available regarding an emerging concern that the next generation might also be affected.
To compare the risk of psychiatric hospitalization in cousins whose parents were vs were not exposed to the Finnish evacuation policy that involved a mean 2-year stay with a Swedish foster family.
This multigenerational, population-based cohort study of Finnish individuals and their siblings born between January 1, 1933, and December 31, 1944, analyzed the association of evacuee status as a child during World War II in the first generation with the risk of psychiatric hospitalization among offspring in the second generation. Evacuee status during World War II was determined using the Finnish National Archive's registry of participants in the Finnish evacuation. Data on evacuee status were linked to the psychiatric diagnoses in the Finnish Hospital Discharge Register from January 1, 1971, through December 31, 2012, for offspring (n?=?93?391) born between January 1, 1950, and December 31, 2010. Sex-specific Cox proportional hazards regression models were used to estimate hazard ratios for risk of psychiatric hospitalization during the follow-up period. Because offspring of evacuees and their nonevacuated siblings are cousins, the Cox proportional hazards regression models included fixed effects to adjust for confounding factors in families. Data analysis was performed from June 15, 2016, to August 26, 2017.
Parental participation in the evacuation during World War II (coded 1 for parents who were evacuated and placed in foster care and 0 for those not evacuated).
Offspring's initial admission to the hospital for a psychiatric disorder, obtained from the Finnish Hospital Discharge Register from January 1, 1971, through December 31, 2012.
Of the 93?391 study persons, 45?955 (49.2%) were women and 47?436 (50.8) were men; mean (SD) age in 2012 among survivors was 45.4 (6.58) years. Female offspring of mothers evacuated to Sweden during childhood had an elevated risk of psychiatric hospitalization (hazard ratio for any type of psychiatric disorder: 2.04 [95% CI, 1.04-4.01]; hazard ratio for mood disorder: 4.68 [95% CI, 1.92-11.42]). There was no excess risk of being hospitalized for a psychiatric disorder among women whose fathers were exposed to the Finnish evacuation policy during World War II or among men whose mothers or fathers were exposed.
In a prior follow-up study of the Finnish evacuees, girls evacuated to Swedish foster families during World War II were more likely to be hospitalized for a psychiatric disorder-in particular, a mood disorder-in adulthood than their nonevacuated sisters. The present study found that the offspring of these individuals were also at risk for mental health problems that required hospitalization and suggests that early-life adversities, including war-related exposures, may be associated with mental health disorders that persist across generations.
CommentIn: JAMA Psychiatry. 2018 Jan 1;75(1):5-6 PMID 29188290