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.
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.
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
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.
Some previous studies indicate that parental hearing loss may have negative consequences in the parent-child relationship. However, most of these studies are qualitative or have apparent methodological shortcomings.
This study is the first of its kind conducted in a large population-based sample with audiometrically measured hearing loss aimed at investigating the extent to which parental hearing loss affects adolescents' mental health.
Questionnaires were administered to the adult (>19 years) and adolescent (age 13-19 years) population of Nord-Trøndelag county, Norway (1995-97), which collected information on mental and somatic health, including hearing loss. For adults participating in the study, pure tone audiometry tests were also administered. In total, 4047 fathers and 4785 mothers with self-reported hearing loss data were identified. The corresponding numbers with measured hearing loss data included 4079 fathers and 4861 mothers. The associations between the degrees of self-reported or measured parental hearing loss and the mental health of their adolescent, measured by Hopkins Symptom Check List (SCL) 5, were estimated using generalized estimating equations. After adjusting for several covariates, the mental health symptoms of adolescents were compared by parental hearing loss (i.e., with versus without hearing loss).
Adolescents whose mothers had severe measured or self-reported hearing loss had significantly worse mental health than their counterparts whose mothers did not have a hearing loss. No corresponding effects were found in the adolescents whose mothers had only a slight/moderate hearing loss, neither measured nor self-reported. Paternal slight/moderate self-reported hearing loss was associated with a small significant reduction of mental health in the adolescents, although attenuated when adjusting for paternal distress. No significant effects were detected in the adolescents whose fathers had measured hearing loss.
Severe maternal hearing loss is associated with significantly increased adolescent distress.
Few population-based studies have examined the association between parental psychopathology and bipolar disorder (BPD) in offspring. One limitation is lack of control for potential confounding by indicators of parental socio-economic status or maternal smoking during pregnancy. Furthermore, none of them included analyses restricted to parental diagnoses received prior to the birth of the offspring. Associations could not be affected by child-related factors affecting the parent in such analyses. This study explores associations between those parental psychiatric disorders diagnosed at any point of time as well as those diagnosed before offspring birth, and BPD in offspring.
In this nested case-control study, we identified 1,861 cases, age up to 25 years, 3,643 matched controls, and their parents from Finnish national registers. The associations were examined using conditional logistic regression, calculating odds ratios (OR) and adjusting for region of birth, parental age and education and mother's smoking during pregnancy.
Anytime diagnosed parental disorders associating with BPD in offspring (95% confidence interval) were BPD [OR (maternal) 5.2 (2.52-10.62); OR (paternal) 8.1 (3.77-17.26)], schizophrenia and related psychoses [OR (maternal) 3.1 (1.69-5.84); OR (paternal) 4.5 (1.97-10.27)], other affective disorders [OR (maternal) 3.0 (2.08-4.21); OR (paternal) 3.0 (1.97-4.47)] and maternal anxiety disorders OR 2.6 (1.08-6.42). Statistically significant associations were also found for parental schizophrenia and related psychoses, and other affective disorders, diagnosed before offspring birth.
BPD is associated with many parental psychiatric disorders, particularly BPD and schizophrenia and related psychoses. The associations must be partially due to child-independent factors. Covariate adjustments had only a minor impact on the associations.
The objective is to examine the factors associated with family functioning in families with children where a parent has cancer in comparison to families without cancer.
Eighty-five families including 85 cancer patients, 61 healthy spouses and 68 children between 11 and 17 years of age, and a control group of 59 families including 105 adults and 65 children were given a set of questionnaires including a background variable questionnaire, the Family Assessment Device, the Beck Depression Inventory and the Sense of Coherence (SOC). A statistical multilevel model allowing the use of data from several informants belonging to the same family was constructed for the analysis of associations between variables.
Maternal depression and SOC of family members were associated with family functioning; maternal depression impaired family functioning and family members' SOC improved it. No difference was found between the clinical group and the control group.
In clinical work with cancer families with children, maternal depression and SOC should be focused on.
A 22 year old female-to-male half-Aboriginal transsexual had been exposed to gross neglect and violence, separation and inconsistent cultural supports during childhood. Her mother had also been convicted of homicide in a context of alcohol and violence. Transsexual identification, antisocial behaviours, self mutilation, substance abuse and unmet dependency needs were evident from childhood or early adolescence. The killing was a confrontational peer group stabbing in a brawl under influence of alcohol--the male mode of homicide. This is the first known case in world literature of a female-to-male transsexual guilty of homicide.
This study examined differences in children's behavior and expenditures for health and social services used when their parents with dysthymia did or did not respond to antidepressant therapy.
Children ages 4 to 16 years of consenting parents enrolled in a treatment trial for dysthymia who did and did not respond to treatment were compared at baseline and 24 months. The responder was a parent with at least a 40% reduction in his or her baseline depressive symptoms using the Montgomery Asberg Depression Rating Scale. Children's behavior was measured using the Child Behavior Checklist, and expenditures for health and social services use was measured in Canadian dollars using the Health and Social Service Utilization Questionnaire.
Children of parents with dysthymia who responded to treatment had significantly greater reductions in emotional symptoms at 2-year follow-up than children of nonresponders, along with an economically important (not statistically significant) reduction in expenditures for health and social services use.
Reductions in parental symptoms of dysthymia may be associated with reductions in childhood behavioral problems and in expenditures for the child's use of services.
This study is based on interviews with 53 male alcoholics. Its purpose was to study the relationship between childhood conditions, history of alcohol and drug misuse and assaultive and suicidal behaviour. Fifty-seven per cent of the alcoholics reported a history of violent behaviour. Hidden violence, often towards women, was common. One-third of the violent patients had a history of attempted suicide compared to 17% in the non-violent group. The assaultive alcoholics also had a more violent childhood, a higher proportion of fathers with alcohol problems and had started drinking earlier in life. Drug addiction was much more common in this group too. We find support for our hypothesis that there is a positive correlation between violence in the parental home and assaultive and suicidal behaviour and drug misuse later in life. When violent and non-violent alcoholics are compared many of the same characteristics appear as when suicidal and non-suicidal and type 2 and type 1 alcoholics are compared. This study raises the question of adding attempted suicide as a characteristic of the type 2 alcoholic.