Poor family relationships in adolescence as a risk factor of in-patient psychiatric care across the life course: A prospective cohort study

Intergenerational continuity of loneliness and potential mechanisms: Young Finns Multigenerational Study

Evidence on the intergenerational continuity of loneliness and on potential mechanisms that connect loneliness across successive generations is limited. We examined the association between loneliness of (G0) parents (859 mothers and 570 fathers, mean age 74 years) and their children (G1) (433 sons and 558 daughters, mean age 47 years) producing 991 parent-offspring pairs and tested whether these associations were mediated through subjective socioeconomic position, temperament characteristics, cognitive performance, and depressive symptoms. Mean loneliness across parents had an independent effect on their adult children's experienced loneliness (OR = 1.72, 95% CI 1.23-2.42). We also found a robust effect of mothers' (OR = 1.64, 95% CI 1.17-2.29), but not of fathers' loneliness (OR = 1.47, 95% CI 0.96-2.25) on offspring's experienced loneliness in adulthood. The associations were partly mediated by offspring depressive (41-54%) and anxiety (29-31%) symptoms. The current findings emphasize the high interdependence of loneliness within families mediated partly by offspring's mental health problems.

Sex-related differences in parental rearing patterns in young adults with bipolar disorder

The aim of this study was to examine the parenting characteristics of young patients with bipolar disorder (BD) and explore the sex differences. The parental rearing pattern of young patients with BD was measured and compared with the healthy control of young adults. The EMBU scale was used to assess parental rearing patterns. Patients with BD reported significantly higher scores in the punishment and severity index, as well as of the rejection and denial index, but lower scores in the warmth & affectionate index in the paternal rearing pattern, compared with healthy controls. In addition, patients scored higher on the punishment and severity index and rejection and patterns index in maternal rearing patterns. More importantly, we found significant sex differences in maternal rearing patterns (pBonferroni < 0.05). Specifically, in the maternal rearing patterns, male patients had higher scores on the favoring index than male controls, whereas female patients had lower scores on the warmth & affectionate index than female controls. This study shows significant differences in parental rearing patterns between patients and control subjects. Male patients were overprotective by their mothers and female patients were overlooked by their mothers during upbringing.

Trust Beliefs in Significant Others, Interpersonal Stress, and Internalizing Psychopathology of Adolescents with Psychiatric Disorders

This study examined relations between trust beliefs in significant others (TBSO), interpersonal stress, and internalizing psychopathology for adolescents with psychiatric disorders. Two hundred and thirty-four adolescents from an acute inpatient unit (154 females, M_age = 14.72 years, SD = 1.39 years) completed standardized scales/interviews that assessed TBSO (mother, father, teacher, peers and TBSO as a total score), interpersonal stress, and internalizing psychopathology. It was found that adolescents' TBSO and trust beliefs in each significant other were negatively associated with interpersonal stress and internalizing psychopathology. The findings confirmed that the relation between the adolescents' interpersonal stress and internalizing psychopathology was moderated by TBSO, trust beliefs in mother, and trust beliefs in peers. The findings supported the conclusion that holding elevated TBSO (particularly trust beliefs in mother and peers) by adolescents with psychiatric disorders promotes their psychosocial adjustment including their resilience to the effects of interpersonal stress on internalizing psychopathology.

The Contributing Role of Family, School, and Peer Supportive Relationships in Protecting the Mental Wellbeing of Children and Adolescents

Globally, mental disorders are the leading cause of disability in children and adolescents. Previous research has demonstrated that supportive relationships are a key protective factor against poor mental health in children, particularly amongst those who have experienced adversity. However, fewer studies have examined the relative impact of different types of supportive relationships. The current study examined the association between level of family adult support, school adult support, and school peer support and mental wellbeing in a sample of children (age 8–15 years, N = 2,074) from schools in the UK. All three sources of support were independently associated with mental wellbeing. Analyses demonstrated a graded relationship between the number of sources of support and the odds of low mental wellbeing (LMWB), reflecting a cumulative protective effect. While all three sources of support were best, it was not vital, and analyses demonstrated a protective effect of school sources of support on LMWB amongst children with low family support. Peer support was found to be particularly important, with prevalence of LMWB similar amongst children who had high peer support (but low family and school adult support), and those who had high family and school adult support, (but low peer support), indicating that high peer support has an equivalent impact of two other protective factors. Findings from the study highlight the crucial context schools provide in fostering positive peer relationships and supportive teacher–student relationships to promote mental health and resilience for all children, including both those with and without supportive home environments.

Mood Disorder Detection in Adolescents by Classification Trees, Random Forests and XGBoost in Presence of Missing Data

We apply tree-based classification algorithms, namely the classification trees, with the use of the rpart algorithm, random forests and XGBoost methods to detect mood disorder in a group of 2508 lower secondary school students. The dataset presents many challenges, the most important of which is many missing data as well as the being heavily unbalanced (there are few severe mood disorder cases). We find that all algorithms are specific, but only the rpart algorithm is sensitive; i.e., it is able to detect cases of real cases mood disorder. The conclusion of this paper is that this is caused by the fact that the rpart algorithm uses the surrogate variables to handle missing data. The most important social-studies-related result is that the adolescents’ relationships with their parents are the single most important factor in developing mood disorders—far more important than other factors, such as the socio-economic status or school success.

Social workers' perspectives on a medical home model for children and adolescents in out of home care - an interview study

Background

This study seeks to explore how social workers have perceived and experienced a medical home model for children and adolescents in out-of-home care in Uppsala County, Sweden.

Method

A qualitative explorative study was conducted, which involved ten semi-structured individual telephone interviews with social workers. The study sample included employees within the social service, working in a specialised case unit who had experience of referring children and/or adolescents to the medical home model called Hälsofam. Data were analysed inductively using thematic analysis.

Results

The findings of the current study indicated that working with Hälsofam has offered social workers a way into the health care sector and an active collaborative working situation, with focus on organised work across the ‘silos’ of care services. However, the findings raised the question of whether or not all children and adolescents have the same possibility to receive care from Hälsofam.

Conclusion

The findings indicated that the Hälsofam model had a positive impact on the interrelations between the social service and the health care sector. Yet, findings showed that personal views of the social worker and the societal situation in which they operate create limitations for providing care for every child and adolescent. This study adds to the extant literature for it addresses the limitations within the work of children and adolescents in out-of-home care.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-021-06737-1.

Poor family relationships in adolescence as a risk factor of in-patient somatic care across the life course: Findings from a 1953 cohort

Background

Prior research has shown that poor family relations during upbringing have long-term detrimental effects on mental health. Few previous studies have, however, focused on somatic health outcomes and studies rarely cover the life span until retirement age. The aims of the current study were, firstly, to examine the association between poor family relationships in adolescence and in-patient somatic care across the life course whilst adjusting for confounders at baseline and concurrent psychiatric in-patient care; and secondly, to compare the risks of somatic and psychiatric in-patient care across the life course.

Methods

Prospective data from the Stockholm Birth Cohort study were used, with 2636 participants born in 1953 who were followed up until 2016. Information on family relationships was collected from the participants’ mothers in 1968. Annual information on in-patient somatic and psychiatric care was retrieved from official register data from 1969 to 2016.

Results

Poisson regressions showed that poor family relationships in adolescence were associated with an increased risk of in-patient somatic care in mid- and especially in late adulthood (ages 44–53 and 54–63 years), even when controlling for the co-occurrence of psychiatric illness and a range of childhood conditions. No statistically significant association was observed in early adulthood (ages 16–43 years), when controlling for confounders. These findings are in sharp contrast to the analyses of inpatient psychiatric care, according to which the association with poor family relations was strongest in early adulthood and thereafter attenuated across the life course.

Conclusion

Poor family relationships in adolescence are associated with an increased risk of severe consequences for somatic health lasting to late adulthood even when controlling for confounders including in-patient psychiatric care, emphasising the potentially important role of early interventions.

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Using longitudinal data, the article investigates long term health consequences of poor family relationships in adolescence.

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We find an association between poor relations and increased risk of in-patient somatic care in mid- and in late adulthood.

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Conversely, the association between poor family relations and an in-patient psychiatric care is strongest in early adulthood.

Predictors of Intensive Treatment in Patients With Obsessive-Compulsive Disorder

Background: Few studies have investigated which patients with obsessive-compulsive disorder (OCD) do not recover through regular cognitive behavior therapy or pharmacotherapy and subsequently end up in intensive treatment like day treatment or inpatient treatment. Knowing the predictors of intensive treatment in these patients is significant because it could prevent intensive treatment. This study has identified predictors of intensive treatment in patients with OCD. Methods: Using 6-year longitudinal data of the Netherlands Obsessive Compulsive Disorder Association (NOCDA), potential predictors of intensive treatment were assessed in patients with OCD (n = 419). Intensive treatment was assessed using the Treatment Inventory Costs in Patients with Psychiatric Disorders (TIC-P). Examined potential predictors were: sociodemographics, and clinical and psychosocial characteristics. Logistic Generalized Estimating Equations was used to estimate to what extent the various characteristics (at baseline, 2- and 4-year assessment) predicted intensive treatment in the following 2 years, averaged over the three assessment periods. Results: Being single, more severe comorbid depression, use of psychotropic medication, and a low quality of life predicted intensive treatment in the following 2 years. Conclusions: Therapists should be aware that patients with OCD who are single, who have more severe comorbid depression, who use psychotropic medication, and who have a low quality of life or a drop in quality of life are at risk for intensive treatment. Intensive treatment might be prevented by focusing regular treatment not only on OCD symptoms but also on comorbid depression and on quality of life. Intensive treatment might be improved by providing extra support in treatment or by adjusting treatment to impairments due to comorbid depressive symptoms or a low quality of life.