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Hen M, Shenaar-Golan V, Atia S, Yatzkar U. Child-parent agreement on the SDQ: The role of child-parent attachment and parental feelings. J Clin Psychol 2024. [PMID: 38809521 DOI: 10.1002/jclp.23707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 04/16/2024] [Accepted: 05/11/2024] [Indexed: 05/30/2024]
Abstract
OBJECTIVES Children and their parents often provide divergent reports regarding their mental health on the Strengths and Difficulties Questionnaire (SDQ). These discrepancies may impede the diagnostic processes. The present study aimed to explore how a child's attachment to the parent and parental feelings may explain some of the variability between parent's and children's reports on the SDQ. METHODS Data were collected using self-report questionnaires from 277 children and their parents (n = 421) who were referred to a public mental health clinic. This information was classified into clinical categories (normal and abnormal) and analyzed using multinomial logistic regression. RESULTS The agreement rates between children and parents on the normality of children were high in general and across gender and age. Insecure attachment to parents positively and significantly predicted the agreement of child and parent reporting abnormality and disagreement when parents reported normality and children reported abnormality. Parental anger positively and significantly predicted disagreement in reports in which parents reported abnormal anger and children reported normal anger. CONCLUSIONS These findings highlight the importance of assessing informant variability in association with emotional and relationship variables as clinically meaningful information for a clinical diagnosis.
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Affiliation(s)
- Meirav Hen
- Department of Psychology, Tel-Hai Academic College, Upper Galilee, Israel
| | | | - Stav Atia
- Department of Psychology, Tel-Hai Academic College, Upper Galilee, Israel
| | - Uri Yatzkar
- Child and Adolescent Mental Health Clinic, Ziv Medical Center, Safed, Israel
- Department of Psychiatry, Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
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2
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Hysaj M, Crone MR, Kiefte-de Jong JC, Vermeiren RRJM. Do parental attachment and prosocial behavior moderate the impairment from depression symptoms in adolescents who seek mental health care? Child Adolesc Psychiatry Ment Health 2023; 17:133. [PMID: 38017555 PMCID: PMC10685577 DOI: 10.1186/s13034-023-00680-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 11/20/2023] [Indexed: 11/30/2023] Open
Abstract
We investigated parental attachment and prosocial behavior as social protective indicators in adolescents (age 11-17) with symptoms of depression in a clinical setting. Specifically, we tested the moderating effect of these factors on the relation between symptoms of depression and their impairment on daily life. The Development and Well-Being Assessment, as completed by children, mothers, and fathers, was used, and hierarchical multiple regression analyses were conducted for these three perspectives. From the adolescents' reports we only found a significant effect of symptoms on impairment indicating that a higher number of symptoms were related to higher impairment. For the mothers and fathers, a higher score on the adolescents' prosocial behavior was related to a lower impairment from depression symptoms on the daily life of the adolescent and the family. Only for the mothers did a higher score on prosocial behavior buffered the effect of symptoms on impairment, while a higher parental attachment score was associated with a lower impairment. Further, when examining maternal and paternal attachment separately, we found that, only the mothers, reported less impairment from the symptoms when they perceived that the adolescent was attached to the father, and paternal attachment even buffered the effect of symptoms on impairment. To conclude, our results indicate that social protective factors, from the parent's perspective, are likely to have a beneficial effect in clinical practice and should be taken into account when examining impairment scores. Future studies should investigate whether additional protective indicators from the adolescents' perspective, such as quality of parental attachment or family climate, may have a positive impact on their daily functioning.
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Affiliation(s)
- Marsida Hysaj
- Department of Child and Adolescent Psychiatry, Leiden University Medical Center, Leiden, The Netherlands.
| | - Mathilde R Crone
- Department of Public Health and Primary Care / LUMC-Campus The Hague, Leiden University Medical Centre, The Hague, The Netherlands
| | - Jessica C Kiefte-de Jong
- Department of Public Health and Primary Care / LUMC-Campus The Hague, Leiden University Medical Centre, The Hague, The Netherlands
| | - Robert R J M Vermeiren
- Department of Child and Adolescent Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
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3
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Plishty S, Terehovsky BE, Solan M, Cohen-Yeruchimovich T, Paldi R, Doron Y, Apter A, Brunstein-Klomek A. Revisiting the intake policy at the mental child and adolescent clinics. J Psychiatr Res 2023; 162:214-219. [PMID: 37178518 DOI: 10.1016/j.jpsychires.2023.05.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 03/30/2023] [Accepted: 05/01/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND The psychiatric intake interview is crucial for the delivery of quality care. Currently, the interview in most public clinics varies in nature. It often consists of a clinical face-to-face interview (structured/unstructured) with or without self-report questionnaires (systematic/non-systematic). By integrating structured computerized self-report questionnaires into the intake, the assessment process could be shortened, and diagnostic accuracy increased. OBJECTIVES The study aims to assess whether adding structured computerized questionnaires will increase the efficacy of the intake process, as indicates by shortened intakes and a higher level of diagnostic accuracy, for children and adolescents in mental health clinics in Israel. METHODOLOGY Patients (Mage = 8.62, SDage = 1.86; 33.8% females) referred to the youth mental health clinic of Maccabi HaSharon district, were included in either the CIA group (Comprehensive Intake Assessment - with questionnaires) or IAU group (Intake as Usual - without questionnaires). RESULTS In terms of accuracy and time measurements, the CIA group had higher diagnostic accuracy and a shorter intake duration of 6.63 min, almost 15% of an intake meeting, compared to the IAU group. No differences were found in satisfaction and therapeutic alliance between the groups. CONCLUSIONS AND IMPLICATIONS More accurate diagnosis is essential to tailor the appropriate treatment for the child's needs. Moreover, reducing intake time by a few minutes contributes significantly to the ongoing activities of mental health clinics. With this reduction, more intakes can be scheduled at a given time, optimizing the intake process, and reducing long wait times, which are increasing due to the growing demand for psychotherapeutic and psychiatric care.
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Affiliation(s)
- Sarit Plishty
- Child and Adolescence Mental Health Clinic of Maccabi Health Services, HaSharon District, Netanya, Israel
| | - Bat-El Terehovsky
- Child and Adolescence Mental Health Clinic of Maccabi Health Services, HaSharon District, Netanya, Israel; The School of Psychology, Reichman University, Herzliya, Israel
| | - Maly Solan
- Child and Adolescence Mental Health Clinic of Maccabi Health Services, HaSharon District, Netanya, Israel
| | - Tali Cohen-Yeruchimovich
- Child and Adolescence Mental Health Clinic of Maccabi Health Services, HaSharon District, Netanya, Israel
| | - Romi Paldi
- The School of Psychology, Reichman University, Herzliya, Israel
| | - Yonit Doron
- The School of Psychology, Reichman University, Herzliya, Israel
| | - Alan Apter
- The School of Psychology, Reichman University, Herzliya, Israel
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Aydin S, Crone MR, Siebelink BM, Numans ME, Vermeiren RRJM, Westenberg PM. Informative value of referral letters from general practice for child and adolescent mental healthcare. Eur Child Adolesc Psychiatry 2023; 32:303-315. [PMID: 34417876 PMCID: PMC9970945 DOI: 10.1007/s00787-021-01859-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 08/08/2021] [Indexed: 11/29/2022]
Abstract
Although referral letters (RLs) form a nodal point in a patient's care journey, little is known about their informative value in child and adolescent mental healthcare. To determine the informative value of RLs to child and adolescent psychiatry, we conducted a chart review in medical records of minors registered at specialized mental healthcare between January 2015 and December 2017 (The Netherlands). Symptoms indicated in RLs originating from general practice (N = 723) were coded and cross-tabulated with the best estimate clinical classifications made in psychiatry. Results revealed that over half of the minors in the sample were classified in concordance with at least one reason for referral. We found fair to excellent discriminative ability for indications made in RLs concerning the most common psychiatric classifications (95% CI AUC: 60.9-70.6 for anxiety disorders to 90.5-100.0 for eating disorders). Logistic regression analyses suggested no statistically significant effects of gender, age, severity or mental healthcare history, with the exception of age and attention deficit hyperactivity disorders (ADHD), as RLs better predicted ADHD with increasing age (OR = 1.14, 95% CI 1.03-1.27). Contextual problems, such as difficulties studying, problems with parents or being bullied were indicated frequently and associated with classifications in various disorder groups. To conclude, general practitioners' RLs showed informative value, contrary to common beliefs. Replication studies are needed to reliably incorporate RLs into the diagnostic work-up.
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Affiliation(s)
- S Aydin
- Department of Developmental and Educational Psychology, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands.
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, The Netherlands.
- Department of Child and Adolescent Psychiatry, LUMC Curium, Leiden University Medical Centre, Oegstgeest, The Netherlands.
| | - M R Crone
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, The Netherlands
| | - B M Siebelink
- Department of Child and Adolescent Psychiatry, LUMC Curium, Leiden University Medical Centre, Oegstgeest, The Netherlands
| | - M E Numans
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, The Netherlands
| | - R R J M Vermeiren
- Department of Child and Adolescent Psychiatry, LUMC Curium, Leiden University Medical Centre, Oegstgeest, The Netherlands
- Youz, Parnassia Group, Rotterdam, The Netherlands
| | - P M Westenberg
- Department of Developmental and Educational Psychology, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands
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Riemersma I, Van Santvoort F, Van Doesum K, Hosman C, Janssens J, Weeland M, Otten R. Social-emotional problems of children with mild intellectual disabilities having parents with mental health concerns: A quantitative comparison study. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2022; 26:811-823. [PMID: 34402337 DOI: 10.1177/17446295211030092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Children of parents with mental health concerns are at-risk for social-emotional problems. In this study, we assessed whether children with a mild intellectual disability and parents with mental health concerns are particularly at-risk. METHOD Strengths and Difficulties Questionnaire (SDQ) reports of children with a mild intellectual disability (N = 55) and their parents with mental health concerns (N = 45) were compared to two comparison groups. The first group included children with average intelligence (N = 13) and their parents with mental health concerns (N = 56), the second group included children with mild intellectual disability (N = 44) and their parents (N = 36). RESULTS Children with a mild intellectual disability and a parent with mental health concerns show higher total SDQ problem scores and more internalizing and externalizing problems as compared to children in the two other groups. DISCUSSION Children having mild intellectual disability and parents with mental health concerns are particularly at risk for developing social-emotional problems.
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Affiliation(s)
- I Riemersma
- Pluryn Research & Development, The Netherlands
| | | | - Ktm Van Doesum
- Radboud University Nijmegen, The Netherlands; Dimence groep, The Netherlands
| | - Cmh Hosman
- Radboud University Nijmegen, The Netherlands
| | | | | | - R Otten
- Pluryn Research & Development, The Netherlands; Radboud University Nijmegen, The Netherlands; Arizona State University, USA
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Grasso M, Lazzaro G, Demaria F, Menghini D, Vicari S. The Strengths and Difficulties Questionnaire as a Valuable Screening Tool for Identifying Core Symptoms and Behavioural and Emotional Problems in Children with Neuropsychiatric Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137731. [PMID: 35805390 PMCID: PMC9265541 DOI: 10.3390/ijerph19137731] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 06/17/2022] [Accepted: 06/21/2022] [Indexed: 02/05/2023]
Abstract
The Strengths and Difficulties Questionnaire (SDQ) is a worldwide questionnaire used for the early identification of behavioural/emotional symptoms in children and adolescents with neuropsychiatric disorders. Although its prognostic power has been studied, it has not yet been tested whether SDQ: (i) can identify pathognomonic symptoms across a variety of neurodevelopmental and neuropsychiatric disorders, (ii) can capture emotional and behavioural problems associated with the main diagnosis, as well as shared transdiagnostic dimensions, and (iii) can detect changes in symptomatology with age. The present study evaluated nearly 1000 children and adolescents overall with Global Developmental Delay (GDD), Intellectual Disability (ID), Language Disorder (LD), Specific Learning Disorder (SLD), Autism Spectrum Disorder (ASD), Attention Deficit/Hyperactivity Disorder (ADHD), Mood Disorder (MD), Anxiety Disorder (AD), and Eating Disorders (ED). We found that SDQ: (i) can identify the core symptoms in children with ASD, ADHD, MD, and AD via specific subscales; (ii) can capture the associated emotional and behavioural symptoms in children with LD, GDD, ID, SLD, and ED; and (iii) can detect changes in the symptomatology, especially for GDD, LD, ASD, ADHD, and AD. SDQ is also able to recognise the transdiagnostic dimensions across disorders. Our results underscore the potential of SDQ to specifically differentiate and identify behavioural/emotional profiles associated with clinical diagnosis.
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Affiliation(s)
- Melissa Grasso
- Neurological and Neurosurgical Diseases Research Unit, Bambino Gesù Children's Hospital IRCCS, 00146 Rome, Italy
| | - Giulia Lazzaro
- Child and Adolescent Neuropsychiatry Unit, Department of Neurosciences, Bambino Gesù Children's Hospital IRCCS, 00146 Rome, Italy
| | - Francesco Demaria
- Child and Adolescent Neuropsychiatry Unit, Department of Neurosciences, Bambino Gesù Children's Hospital IRCCS, 00146 Rome, Italy
| | - Deny Menghini
- Child and Adolescent Neuropsychiatry Unit, Department of Neurosciences, Bambino Gesù Children's Hospital IRCCS, 00146 Rome, Italy
| | - Stefano Vicari
- Child and Adolescent Neuropsychiatry Unit, Department of Neurosciences, Bambino Gesù Children's Hospital IRCCS, 00146 Rome, Italy
- Department of Life Sciences and Public Health, Catholic University, 00168 Rome, Italy
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Theunissen MHC, de Wolff MS, Eekhout I, Mieloo CL, Stone LL, Reijneveld SA. The Strengths and Difficulties Questionnaire Parent Form: Dutch norms and validity. BMC Pediatr 2022; 22:202. [PMID: 35413892 PMCID: PMC9004049 DOI: 10.1186/s12887-022-03274-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 03/30/2022] [Indexed: 11/16/2022] Open
Abstract
Objective This study provides Dutch national norms for the parent-reported Strengths and Difficulties Questionnaire (SDQ) for children aged 3-14 years, and assesses the test performance of the SDQ Total Difficulties Scale (TDS) and impairment Scale. We further compared Dutch SDQ norms with those of the United Kingdom (UK), to determine potential variation in country-specific norms. Study design We analyzed data of 3384 children aged 3 to 14 years. The data were obtained in schools, and in the context of Preventive Child Healthcare. Parents completed the SDQ parent form and the Child Behavior Checklist (CBCL). We determined clinical (10% elevated scores) and borderline (20% elevated scores) SDQ TDS norms. We assessed the test performance (validity) of the SDQ TDS and Impairment Score using the CBCL as criterion. Results The clinical SDQ TDS norms varied between > 10 and > 14 depending on the age group. The SDQ TDS discriminated between children with and without problems, as measured by the CBCL, for all age groups (AUCs varied from 0.92 to 0.96). The SDQ Impairment Score had added value (beyond the SDQ TDS) only for the age group 12-14 years. For the Netherlands we found lower clinical SDQ TDS norms than those previously reported for the UK (i.e. > 16). Conclusion The clinical SDQ TDS norms varied between > 10 and > 14 depending on the age groups. We found good test performance at these proposed norms. Dutch norms differed somewhat from UK norms. In the Netherlands, the SDQ performed better with Dutch-specific norms than with UK-specific norms.
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Affiliation(s)
| | | | - Iris Eekhout
- TNO Child Health, P. O. Box 3005, Leiden, 2301 DA, the Netherlands
| | | | - Lisanne L Stone
- Karakter, Child and Adolescent Psychiatry University Center Nijmegen, Nijmegen, The Netherlands
| | - Sijmen A Reijneveld
- TNO Child Health, P. O. Box 3005, Leiden, 2301 DA, the Netherlands.,Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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8
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Aydin S, Siebelink BM, Crone MR, van Ginkel JR, Numans ME, Vermeiren RRJM, Michiel Westenberg P. The diagnostic process from primary care to child and adolescent mental healthcare services: the incremental value of information conveyed through referral letters, screening questionnaires and structured multi-informant assessment. BJPsych Open 2022; 8:e81. [PMID: 35388780 PMCID: PMC9059622 DOI: 10.1192/bjo.2022.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 02/08/2022] [Accepted: 03/16/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND A variety of information sources are used in the best-evidence diagnostic procedure in child and adolescent mental healthcare, including evaluation by referrers and structured assessment questionnaires for parents. However, the incremental value of these information sources is still poorly examined. AIMS To quantify the added and unique predictive value of referral letters, screening, multi-informant assessment and clinicians' remote evaluations in predicting mental health disorders. METHOD Routine medical record data on 1259 referred children and adolescents were retrospectively extracted. Their referral letters, responses to the Strengths and Difficulties Questionnaire (SDQ), results on closed-ended questions from the Development and Well-Being Assessment (DAWBA) and its clinician-rated version were linked to classifications made after face-to-face intake in psychiatry. Following multiple imputations of missing data, logistic regression analyses were performed with the above four nodes of assessment as predictors and the five childhood disorders common in mental healthcare (anxiety, depression, autism spectrum disorders, attention-deficit hyperactivity disorder, behavioural disorders) as outcomes. Likelihood ratio tests and diagnostic odds ratios were computed. RESULTS Each assessment tool significantly predicted the classified outcome. Successive addition of the assessment instruments improved the prediction models, with the exception of behavioural disorder prediction by the clinician-rated DAWBA. With the exception of the SDQ for depressive and behavioural disorders, all instruments showed unique predictive value. CONCLUSIONS Structured acquisition and integrated use of diverse sources of information supports evidence-based diagnosis in clinical practice. The clinical value of structured assessment at the primary-secondary care interface should now be quantified in prospective studies.
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Affiliation(s)
- Semiha Aydin
- Department of Developmental and Educational Psychology, Leiden University, The Netherlands; Department of Child and Adolescent Psychiatry, Leiden University Medical Centre, The Netherlands; and Department of Public Health and Primary Care, Leiden University Medical Centre, The Netherlands
| | - Bart M. Siebelink
- Department of Child and Adolescent Psychiatry, Leiden University Medical Centre, The Netherlands
| | - Matty R. Crone
- Department of Public Health and Primary Care, Leiden University Medical Centre, The Netherlands
| | - Joost R. van Ginkel
- Methodology and Statistics Unit, Institute of Psychology, Leiden University, The Netherlands
| | - Mattijs E. Numans
- Department of Public Health and Primary Care, Leiden University Medical Centre, The Netherlands
| | - Robert R. J. M. Vermeiren
- Department of Child and Adolescent Psychiatry, Leiden University Medical Centre, The Netherlands; and Youz, Parnassia Group, The Netherlands
| | - P. Michiel Westenberg
- Department of Developmental and Educational Psychology, Leiden University, The Netherlands
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9
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The impact of psychopathology on academic performance in school-age children and adolescents. Sci Rep 2022; 12:4291. [PMID: 35277563 PMCID: PMC8917234 DOI: 10.1038/s41598-022-08242-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 03/02/2022] [Indexed: 11/09/2022] Open
Abstract
Psychiatric symptoms have consistently been associated with negative educational outcomes. However, possible confounding variables, such as comorbid mental and environmental conditions, have not been well addressed. This study examined whether mental health problems were significantly linked to academic performance in a Spanish school-based sample, after adjustment for co-occurring psychiatric symptoms and multiple contextual factors. Parents completed a questionnaire regarding child's sociodemographic characteristics (i.e., gender, age, type of school, socioeconomic status, ethnicity), stressful events (i.e., adoption, parental divorce/separation, grade retention) and lifestyle (i.e., diet, sleep, screen time), along with the Child Behavior Checklist (CBCL). Academic performance was obtained from school records. The sample comprised 7036 students aged 5-17 with full data on the CBCL. Mixed-effects ordinal logistic regression analyses were conducted to investigate the association between psychopathology and academic achievement, controlling for potential confounders. When examined separately, higher scores on the CBCL scales were related to lower grades, regardless of sociodemographic factors. However, after controlling for the presence of other psychiatric symptoms, we found that students who reported more anxious/depressed and thought problems were less likely to perform poorly, while those with increased levels of attention problems and delinquent behavior had higher risk for academic underachievement. These associations remained mainly the same once stressful events and lifestyle were taken into account. This investigation demonstrates that anxious/depressed symptoms, thought problems, attention problems, and delinquent behavior are independently associated with academic performance, which emphasize the need for preventive and treatment interventions targeted at students' mental health to improve their psychological well-being and functioning at school.
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Chuang YC, Wang CY, Huang WL, Wang LJ, Kuo HC, Chen YC, Huang YJ. Two meta-analyses of the association between atopic diseases and core symptoms of attention deficit hyperactivity disorder. Sci Rep 2022; 12:3377. [PMID: 35232975 PMCID: PMC8888762 DOI: 10.1038/s41598-022-07232-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 02/09/2022] [Indexed: 02/06/2023] Open
Abstract
Studies in the field of neuroscience and psychology have hypothesized that a causal association exists between atopic diseases and attention-deficit/hyperactivity disorder (ADHD). Previous systematic reviews and meta-analyses have reported a higher risk of ADHD in children with atopic diseases; however, the relationship between ADHD symptoms and atopic diseases remains unclear. We systematically reviewed observational cross-sectional and longitudinal studies to investigate the relationship between atopic diseases and ADHD symptom severity (hyperactivity/impulsivity and inattention). The majority of studies showed a statistically significant association between atopic diseases and both ADHD symptoms, with substantial heterogeneity in the outcome of hyperactivity/impulsivity. Remarkably decreased heterogeneity and statistical significance were observed in the second meta-analysis of ADHD-related behavior symptoms in atopic patients without ADHD. Our study indicated that atopic diseases not only associated with ADHD but also ADHD symptoms severity. This association was even observed in children with subthreshold ADHD, indicating that atopic diseases may play a role in the spectrum of ADHD symptom severity. Trial registration: This study was registered on PROSPERO (registration ID: CRD42020213219).
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Affiliation(s)
- Yu-Chieh Chuang
- Department of General Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Ching-Yun Wang
- Department of Pediatrics, Taipei Medical University Hospital, Taipei, Taiwan
| | - Wei-Lieh Huang
- Department of Psychiatry, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan.,Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Liang-Jen Wang
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ho-Chang Kuo
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Yang-Ching Chen
- Department of Family Medicine, Taipei Medical University Hospital, Taipei, Taiwan.,Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yu-Jui Huang
- Department of Psychiatry and Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan.
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11
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Vugteveen J, de Bildt A, Timmerman ME. Normative data for the self-reported and parent-reported Strengths and Difficulties Questionnaire (SDQ) for ages 12-17. Child Adolesc Psychiatry Ment Health 2022; 16:5. [PMID: 35042556 PMCID: PMC8764849 DOI: 10.1186/s13034-021-00437-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 12/27/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The Strengths and Difficulties Questionnaire (SDQ) is widely used to screen for psychosocial problems among adolescents. As the severity of such problems is known to be related to age and gender, screening could be improved by interpreting SDQ scale scores with age-specific and perhaps gender-specific norms. Up to now, such norms are lacking. The aim of the current study is to present gender-specific and joint normative data per year of age for the Dutch self-reported and parent-reported SDQ versions for use among 12- to 17-year-old adolescents. METHODS The norm groups for the self-reported and parent-reported SDQ versions consisted of 993 adolescents and 736 parents, respectively, from the general Dutch population. Per SDQ version, both gender-specific norms and joint norms (percentiles and cutoffs) per year of age were calculated through regression-based norming (Rigby in J Roy Stat Soc Ser C 54:507, 2005). Additionally, these norms were compared to the widely used British norms that are neither age-specific nor gender-specific. RESULTS By design, gender-specific 'abnormal' cutoffs (i.e., cutoffs aimed at identifying max. 10% of the most extremely scoring males and max. 10% of the most extremely scoring females) resulted in about equal percentages of 'abnormal' scoring male and female adolescents per SDQ scale. In contrast, joint 'abnormal' cutoffs (i.e., cutoffs aimed at identifying max. 10% of the most extremely scoring adolescents) resulted in relatively more male (7.6 to 13.6%, depending on age) than female (3.3 to 8.9%, depending on age) adolescents as scoring 'abnormal' on scales measuring externalizing behavior (self-reported and parent-reported SDQ versions), and relatively more female (3.9 to 14.3%, depending on age) than male (1.8 to 6.9%, depending on age) adolescents as scoring 'abnormal' on scales measuring internalizing behavior (self-reported SDQ version). In both types of norms, minor age effects were present. Among Dutch adolescents, the British norms yielded detection rates much lower than the expected 10%. CONCLUSIONS Our findings indicate that detection rates depend on the reference group that is used (British or Dutch general adolescent population; specific gender group or not). The normative data in this paper facilitate the comparison of an adolescent's scores to different reference groups, and allow for cross-country/cultural comparisons of adolescents' psychosocial behavior.
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Affiliation(s)
- Jorien Vugteveen
- Heymans Institute for Psychological Research, University of Groningen, Groningen, The Netherlands. .,Hanze University of Applied Sciences, Groningen, The Netherlands.
| | - Annelies de Bildt
- grid.4830.f0000 0004 0407 1981Department of Psychiatry, Child and Adolescent Psychiatry, University Medical Center Groningen (UMCG), University of Groningen, Groningen, The Netherlands ,grid.459337.f0000 0004 0447 2187Accare Child and Adolescent Psychiatry, Groningen, The Netherlands
| | - Marieke E. Timmerman
- grid.4830.f0000 0004 0407 1981Heymans Institute for Psychological Research, University of Groningen, Groningen, The Netherlands
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Sociodemographic and clinical characteristics in child and youth mental health; comparison of routine outcome measurements of an Australian and Dutch outpatient cohort. Epidemiol Psychiatr Sci 2021; 30:e74. [PMID: 34809732 PMCID: PMC8611930 DOI: 10.1017/s2045796021000652] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
AIMS Although of great value to understand the treatment results for mental health problems obtained in clinical practice, studies using naturalistic data from children and adolescents seeking clinical care because of complex mental health problems are limited. Cross-national comparison of naturalistic outcomes in this population is seldomly done. Although careful consideration is needed, such comparisons are likely to contribute to an open dialogue about cross-national differences and may stimulate service improvement. The aim of this observational study is to investigate clinical characteristics and outcomes in naturalistic cohorts of specialized child and adolescent mental health outpatient care in two different countries. METHODS Routinely collected data from 2013 to 2018 of 2715 outpatients in the Greater Area of Brisbane, Australia (CYMHS) and 1158 outpatients in Leiden, the Netherlands (LUMC-Curium) were analysed. Demographics, clinical characteristics and severity of problems at start and end of treatment were described, using Children's Global Assessment Scale (CGAS), Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) and the parental Strength and Difficulties Questionnaire (SDQ-P). RESULTS Routine outcome measures (CGAS, HoNOSCA, SDQ-P) showed moderate to severe mental health problems at start of treatment, which improved significantly over time in both cohorts. Effect sizes ranged between 0.73-0.90 (CYMHS) and 0.57-0.76 (LUMC-Curium). While internalizing problems (mood disorder, anxiety disorder and stress-related disorder) were more prevalent at CYMHS, externalizing developmental problems (ADHD, autism) prevailed at LUMC-Curium. Comorbidity (>1 diagnosis on ICD10/DSM-IV) was relatively similar: 45% at CYMHS and 39 % at LUMC-Curium. In both countries, improvement of functioning was lowest for conduct disorder and highest for somatoform/conversion disorders and obsessive-compulsive disorders (OCD). Overall, 20-40% showed clinically significant improvement (shift from clinical-range at start to a non-clinical-range at the end of treatment), but nearly half of patients still experienced significant symptoms at discharge. CONCLUSIONS This large-scale outcome study showed both cohorts from Australia and the Netherlands improve during the course of treatment on clinician- and parent-reported measures. Although samples were situated within different contexts and differed in patient profiles, they showed similar trends in improvement per diagnostic group. While 20-40% showed clinically significant change, many patients experienced residual symptoms reflecting increased risk for negative outcome into adulthood. We emphasize cross-national comparison of naturalistic outcomes faces challenges, although it can similarly reveal trends in treatment outcome providing direction for future research: what factors determine discharge from specialized services; and how to improve current treatments in this severely affected population.
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Vugteveen J, de Bildt A, Theunissen M, Reijneveld M, Timmerman M. Validity Aspects of the Strengths and Difficulties Questionnaire (SDQ) Adolescent Self-Report and Parent-Report Versions Among Dutch Adolescents. Assessment 2021; 28:601-616. [PMID: 31257902 PMCID: PMC7883005 DOI: 10.1177/1073191119858416] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In this study, validity aspects of the Strengths and Difficulties Questionnaire (SDQ) self-report and parent-report versions were assessed among Dutch adolescents aged 12 to 17 years (community sample: n = 962, clinical sample: n = 4,053). The findings mostly support the continued use of both SDQ versions in screening for psychosocial problems as (a) exploratory structural equation analyses partially supported the grouping of items into five scales; (b) investigation of associations between scales of the SDQ and the Child Behavior Checklist, Youth Self-Report, and Intelligence Development Scales-2 provided evidence for the SDQ versions' convergent and divergent validity; and (c) receiver operating characteristics curves yielded evidence for both SDQ versions' criterion validity by showing that these questionnaires can be used to screen for psychosocial problems, except for the adolescent-reported version for males. Regardless of the adolescent's gender, the receiver operating characteristics curves showed both SDQ versions to be useful for screening for three specific types of problems: anxiety/mood disorder, conduct/oppositional deviant disorder, and attention-deficit/hyperactivity disorder. Additionally, parent-rated SDQ scores were found to be useful for screening for autism spectrum disorder.
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Affiliation(s)
- Jorien Vugteveen
- Heymans Institute for Psychological Research, University of Groningen, the Netherlands
| | - Annelies de Bildt
- Department of Psychiatry, University Medical Center Groningen (UMCG), University of Groningen, the Netherlands
- Accare Child and Adolescent Psychiatry Groningen, the Netherlands
| | - Meinou Theunissen
- Netherlands Organisation of Applied Scientific Research (TNO), Leiden, the Netherlands
| | - Menno Reijneveld
- Netherlands Organisation of Applied Scientific Research (TNO), Leiden, the Netherlands
- Department of Health Sciences, University Medical Center Groningen (UMCG), University of Groningen, the Netherlands
| | - Marieke Timmerman
- Heymans Institute for Psychological Research, University of Groningen, the Netherlands
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The combined self- and parent-rated SDQ score profile predicts care use and psychiatric diagnoses. Eur Child Adolesc Psychiatry 2021; 30:1983-1994. [PMID: 33125550 PMCID: PMC8563533 DOI: 10.1007/s00787-020-01667-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 10/18/2020] [Indexed: 11/08/2022]
Abstract
The Strengths and Difficulties Questionnaire (SDQ) is widely used, based on evidence of its value for screening. This evidence primarily regards the single informant total difficulties scale and separate difficulties subscales. We assessed to what degree adolescents' SDQ profiles that combined all self- and parent-rated subscales were associated with use of care and psychiatric diagnoses, and examined the added value thereof over using only a single informant and the total scale. Cluster analysis was used to identify common SDQ profiles based on self- and parent-reports among adolescents aged 12-17 in mental healthcare (n = 4282), social care (n = 124), and the general population (n = 1293). We investigated associations of the profiles with 'care use' and 'DSM-IV diagnoses', depending on gender. We identified six common SDQ profiles: five profiles with varying types and severities of reported difficulties, pertaining to 95% of adolescents in care, and one without difficulties, pertaining to 55% of adolescents not in care. The types of reported difficulties in the profiles matched DSM-IV diagnoses for 88% of the diagnosed adolescents. The SDQ profiles were found to be more useful for predicting care use and diagnoses than SDQ scores reported by the adolescent as single informant and the total difficulties scale. The latter indicated the presence of problems among 42-63% of the adolescents in care, missing a substantial number of adolescents with reported emotional difficulties and borderline problem severity. These findings advocate the use of combined self- and parent-rated SDQ score profiles for screening.
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Graybill E, Roach A, Barger B. Factor Structure of the Self-Report Strength and Difficulties Questionnaire in a Diverse U.S. Sample. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2020. [DOI: 10.1007/s10862-020-09833-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Imrie S, Zadeh S, Wylie K, Golombok S. Children with Trans Parents: Parent-Child Relationship Quality and Psychological Well-being. PARENTING, SCIENCE AND PRACTICE 2020; 21:185-215. [PMID: 34421395 PMCID: PMC8372299 DOI: 10.1080/15295192.2020.1792194] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Objective. Families with trans parents are an increasingly visible family form, yet little is known about parenting and child outcomes in these families. This exploratory study offers the first quantitative assessment of parent-child relationship quality and child socio-emotional and behavioral adjustment in families with a self-identified trans parent with school-aged children. Design. A sample of 35 families (37 trans parents, 13 partners, and 25 children aged 8-18 years) was recruited primarily through social media. Parents, children, and teachers were administered a range of standardized interview and questionnaire assessments of parent-child relationship quality, quality of parenting, psychological adjustment, and gender-related minority stress. Results. Parents and children had good quality relationships, as assessed by both parents and children, and children showed good psychological adjustment. Child age at the time the parent communicated their gender identity to the child was unrelated to child outcomes. Conclusions. Parents and children in trans parent families had good quality relationships and children showed good psychological adjustment. The findings of this exploratory study challenge commonly held concerns about the potentially negative effects on children of growing up with a trans parent.
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Barzilay S, Apter A. Perspectives on cross-diagnostic trajectories and outcomes in children's mental health. Eur Child Adolesc Psychiatry 2020; 29:1031-1033. [PMID: 32613260 DOI: 10.1007/s00787-020-01584-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Shira Barzilay
- Fienberg Child Study Center, Schneider Children' Medical Center of Israel, Tel Aviv University, Tel Aviv, Israel
| | - Alan Apter
- Fienberg Child Study Center, Schneider Children' Medical Center of Israel, Tel Aviv University, Tel Aviv, Israel. .,Interdisciplinary Center Herzliya, Herzliya, Israel. .,Ruppin Academic Center, Emek Hefer, Israel.
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Broersen M, Creemers DHM, Frieswijk N, Vermulst AA, Kroon H. Investigating the critical elements and psychosocial outcomes of Youth Flexible Assertive Community Treatment: a study protocol for an observational prospective cohort study. BMJ Open 2020; 10:e035146. [PMID: 32265243 PMCID: PMC7245379 DOI: 10.1136/bmjopen-2019-035146] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION When adolescents experience complex psychiatric and social problems, numerous healthcare services usually become involved. In these cases, fragmentation of care services is a risk that often results in both ineffective care and in patients disengaging from care services. To address these issues, Youth Flexible Assertive Community Treatment (Youth Flexible ACT) was developed in the Netherlands. This client-centred service delivery model aims to tackle the fragmented care system by providing psychiatric treatment and support in a flexible and integrated manner. While Youth Flexible ACT is gaining in popularity, the effectiveness of the care model remains largely unexamined. METHODS AND ANALYSIS Here, we present an observational prospective cohort (2017-2021) in which a broad range of treatment outcomes will be monitored. The primary aim of the study is to examine change in treatment outcomes over the course of the Flexible ACT care. The secondary aim is to examine the association between (elements of) Youth Flexible ACT model fidelity and treatment outcomes. An estimated total number of 200 adolescents who receive care from one of the 16 participating Youth Flexible ACT teams will be included in the study. Participants will be asked to complete assessments at four time points in 6-month intervals, resulting in a study duration of 18 months. Latent growth curve analysis will be conducted to examine change in psychosocial functioning over time and its relation to model fidelity. ETHICS AND DISSEMINATION This study received ethical approval from Trimbos Ethics Committee (201607_75-FACT2). This approval applies for all participating institutions. The results of the study will be reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology statement. Results will be disseminated via peer-reviewed academic journals and presentations at conferences. In addition, results will be made available for participating sites, funders and researchers.
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Affiliation(s)
- Marieke Broersen
- GGZ Oost Brabant, Oss, The Netherlands
- Tranzo - Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | | | | | | | - Hans Kroon
- Tranzo - Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
- Trimbos Institute, Utrecht, The Netherlands
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Broersen M, Frieswijk N, Kroon H, Vermulst AA, Creemers DHM. Young Patients With Persistent and Complex Care Needs Require an Integrated Care Approach: Baseline Findings From the Multicenter Youth Flexible ACT Study. Front Psychiatry 2020; 11:609120. [PMID: 33324268 PMCID: PMC7724087 DOI: 10.3389/fpsyt.2020.609120] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 10/29/2020] [Indexed: 12/27/2022] Open
Abstract
Background: The Multicenter Youth Flexible ACT Study is an ongoing observational prospective cohort study that examines the effects of Youth Flexible ACT (Assertive Community Treatment) on young people with complex care needs who are difficult to engage in traditional (office-based) mental health services. However, a clear and detailed description of this patient group is lacking. In the current paper, we present baseline characteristics and psychosocial outcomes of the Youth Flexible ACT target group and explore the existence of underlying specific patient subgroups. Methods: Sixteen Youth Flexible ACT teams from seven mental healthcare institutes in the Netherlands participated in the study. Research participants were monitored for 18 months and administered questionnaires measuring psychiatric- and social functioning every 6 months, yielding four measurements. Baseline data were obtained from 199 adolescents, their mental health workers, and parents/carers. Latent Class Analysis based on HoNOSCA scores (measuring psychosocial and daily functioning) was conducted to identify underlying subgroups. Results: The target group of Youth Flexible ACT mainly consisted of patients older than 15 years of age with a history of (specialized) mental healthcare. They face many complex problems, including trauma; developmental, mood, and anxiety disorders; and problems with school attendance, family life, and peer relationships. Other frequently reported difficulties were substance misuse, the involvement of the legal system or police, problems with intellectual functioning, and personal finance. Patients were classified into four distinct classes: the "internalizing," "externalizing," "non-specific," and the "overly impulsive" subgroup. Each subgroup had its unique pattern of difficulties and focus, respectively, high levels of depression and anxiety, disruptive behavior, unspecific difficulties, and substance misuse. Conclusions: As expected, patients in Youth Flexible ACT experienced many severe problems, rendering them vulnerable to fragmented and, thus, ineffective care. Our findings underscore the need for an integrated care approach with a multidisciplinary team of skilled professionals that can bridge these wide-ranging psychosocial problems, as each class of participants experienced a different set of difficulties. Youth Flexible ACT teams need to adjust their care services accordingly.
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Affiliation(s)
- Marieke Broersen
- GGZ Oost Brabant, Oss, Netherlands.,Tranzo - Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
| | | | - Hans Kroon
- Tranzo - Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands.,Trimbos Institute, Utrecht, Netherlands
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Strengths and Difficulties Questionnaire Assessment of Long-Term Psychological Outcome in Children After Intensive Care Admission. Pediatr Crit Care Med 2019; 20:e496-e502. [PMID: 31274777 DOI: 10.1097/pcc.0000000000002078] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES We investigated the long-term psychologic symptoms of patients who survived pediatric intensive care admission. DESIGN Longitudinal follow-up study. SETTING Nationwide cohort study based on a national ICU register and a questionnaire survey. PATIENTS All pediatric patients (0-16 yr old) who were admitted to an ICU in Finland in 2009-2010. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Six years after ICU admission, all surviving patients were sent the Strengths and Difficulties Questionnaire, and questionnaires regarding chronic diseases and need for medication and therapy. At the end of the follow-up period, there were 3,674 surviving children who had been admitted to an ICU in 2009-2010. Of these children, 1,105 completed the Strengths and Difficulties Questionnaire 6 years after admission. Strengths and Difficulties Questionnaire scores were abnormal for 84 children (7.6%), borderline for 80 (7.2%), and normal for 941 (85.2%). Participants with abnormal scores were younger at admission to the ICU (3.06 vs 4.70 yr; p = 0.02), and more commonly had a chronic disease (79.5% vs 47.4%; p < 0.001), a need for continuous medication (49.4% vs 31.7%; p < 0.001), a need for therapy (58.5% vs 15.9%; p < 0.001), and a need for annual healthcare visits (91.4% vs 85.2%; p = 0.05). Abnormal Strengths and Difficulties Questionnaire scores were associated with higher rates of neurologic (32.1% vs 10.2%), gastrointestinal (7.1% vs 3.9%), psychiatric (3.6% vs 0.5%), and chromosomal disorders (9.5% vs 1.3%), as well as with long-term pain (1.2% vs 0.6%). CONCLUSIONS Participants with abnormal Strengths and Difficulties Questionnaire scores (poor psychologic outcome) at 6 years after childhood ICU admission more commonly suffered neurologic, chromosomal, or psychiatric diagnoses or long-term pain, and generally required higher levels of healthcare services, therapies, and medication.
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Vergunst F, Tremblay RE, Galera C, Nagin D, Vitaro F, Boivin M, Côté SM. Multi-rater developmental trajectories of hyperactivity-impulsivity and inattention symptoms from 1.5 to 17 years: a population-based birth cohort study. Eur Child Adolesc Psychiatry 2019; 28:973-983. [PMID: 30506420 PMCID: PMC6647515 DOI: 10.1007/s00787-018-1258-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 11/19/2018] [Indexed: 12/16/2022]
Abstract
The developmental course of hyperactivity-impulsivity and inattention symptoms from infancy to adolescence has not been documented in a population sample. The aim of this study was to describe the developmental course of hyperactivity-impulsivity and inattention symptoms from 1.5 to 17 years using multiple informants, and to identify perinatal risk factors associated with following elevated (high-risk) trajectories. Using a population-based birth cohort (n = 1374), symptom ratings from mothers (1.5-8 years), teachers (6-13 years) and participant self-reports (10-17 years) were combined using group-based multi-trajectory modeling to identify informants' convergence in identifying high-symptom trajectories of hyperactivity-impulsivity and inattention over time. Perinatal risk factors associated with high-symptom trajectories were identified using stepwise logistic regression. The study found that symptoms of hyperactivity-impulsivity broadly declined from 1.5 to 17 years while symptoms of inattention remained constant. 21.4% of participants followed elevated trajectories of hyperactivity-impulsivity and 20.2% followed elevated trajectories of inattention; 11.6% followed elevated trajectories of both types of symptoms concurrently. Risk factors for high-risk trajectories of hyperactivity-impulsivity were low maternal education, prenatal alcohol exposure, non-intact family, maternal depression, and low child IQ; for high-risk inattention they were prenatal street drug exposure, early motherhood, low maternal education, maternal depression and low child IQ. Risk factors for trajectories of high-risk hyperactivity-impulsivity and inattention concurrently were low maternal education, maternal depression, and low child IQ. The combination of longitudinal assessments from multiple informants (i.e., mother, teacher, participant-reports) provides a new way to characterize hyperactivity-impulsivity and inattention phenotypes over time.
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Affiliation(s)
- Francis Vergunst
- Sainte-Justine University Hospital, Université de Montréal, Montreal, Canada
| | - Richard E Tremblay
- Sainte-Justine University Hospital, Université de Montréal, Montreal, Canada
- Department of Pediatrics and Psychology, University of Montreal, Montreal, Canada
- School of Public Health, Physiotherapy and Population Science, University College Dublin, Dublin, Ireland
| | - Cédric Galera
- INSERM U1219, Université de Bordeaux, Bordeaux, France
| | | | - Frank Vitaro
- Sainte-Justine University Hospital, Université de Montréal, Montreal, Canada
- School of Psycho-Education, University of Montreal, Montreal, Canada
| | - Michel Boivin
- Sainte-Justine University Hospital, Université de Montréal, Montreal, Canada
- School of Psychology, Université Laval, Quebec, Canada
- Institute of Genetic, Neurobiological, and Social Foundations of Child Development, Tomsk State University, Tomsk, Russian Federation
| | - Sylvana M Côté
- Sainte-Justine University Hospital, Université de Montréal, Montreal, Canada.
- INSERM U1219, Université de Bordeaux, Bordeaux, France.
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