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Singh SP, Tuomainen H, Bouliotis G, Canaway A, De Girolamo G, Dieleman GC, Franić T, Madan J, Maras A, McNicholas F, Paul M, Purper-Ouakil D, Santosh P, Schulze UME, Street C, Tremmery S, Verhulst FC, Wells P, Wolke D, Warwick J. Effect of managed transition on mental health outcomes for young people at the child-adult mental health service boundary: a randomised clinical trial. Psychol Med 2023; 53:2193-2204. [PMID: 37310306 PMCID: PMC10123823 DOI: 10.1017/s0033291721003901] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 09/03/2021] [Accepted: 09/03/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND Poor transition planning contributes to discontinuity of care at the child-adult mental health service boundary (SB), adversely affecting mental health outcomes in young people (YP). The aim of the study was to determine whether managed transition (MT) improves mental health outcomes of YP reaching the child/adolescent mental health service (CAMHS) boundary compared with usual care (UC). METHODS A two-arm cluster-randomised trial (ISRCTN83240263 and NCT03013595) with clusters allocated 1:2 between MT and UC. Recruitment took place in 40 CAMHS (eight European countries) between October 2015 and December 2016. Eligible participants were CAMHS service users who were receiving treatment or had a diagnosed mental disorder, had an IQ ⩾ 70 and were within 1 year of reaching the SB. MT was a multi-component intervention that included CAMHS training, systematic identification of YP approaching SB, a structured assessment (Transition Readiness and Appropriateness Measure) and sharing of information between CAMHS and adult mental health services. The primary outcome was HoNOSCA (Health of the Nation Outcome Scale for Children and Adolescents) score 15-months post-entry to the trial. RESULTS The mean difference in HoNOSCA scores between the MT and UC arms at 15 months was -1.11 points (95% confidence interval -2.07 to -0.14, p = 0.03). The cost of delivering the intervention was relatively modest (€17-€65 per service user). CONCLUSIONS MT led to improved mental health of YP after the SB but the magnitude of the effect was small. The intervention can be implemented at low cost and form part of planned and purposeful transitional care.
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Affiliation(s)
- S. P. Singh
- Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK
- Coventry and Warwickshire Partnership NHS Trust, Coventry, UK
| | - H. Tuomainen
- Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK
| | - G. Bouliotis
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - A. Canaway
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - G. De Girolamo
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - G. C. Dieleman
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - T. Franić
- Department of Psychiatry, Clinical Hospital Center Split, Split, Croatia
| | - J. Madan
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - A. Maras
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, Rotterdam, the Netherlands
- Yulius Academy, Rotterdam, the Netherlands
| | - F. McNicholas
- Department of Child and Adolescent Psychiatry, University College Dublin School of Medicine and Medical Science, Dublin, Republic of Ireland
- Geary Institute, University College Dublin, Dublin, Republic of Ireland
- Department of Child Psychiatry, Our Lady's Hospital for Sick Children, Dublin, Republic of Ireland
- Lucena Clinic SJOG, Dublin, Republic of Ireland
| | - M. Paul
- Coventry and Warwickshire Partnership NHS Trust, Coventry, UK
| | - D. Purper-Ouakil
- Centre Hospitalier Universitaire de Montpellier, Saint Eloi Hospital, Unit of Child and Adolescent Psychiatry (MPEA1), Montpellier, France
| | - P. Santosh
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Centre for Interventional Paediatric Psychopharmacology and Rare Diseases (CIPPRD), National and Specialist Child and Adolescent Mental Health Services, Maudsley Hospital, London, UK
- HealthTracker Ltd, Gillingham, UK
| | - U. M. E. Schulze
- Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
| | - C. Street
- Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK
| | - S. Tremmery
- Department of Neurosciences, Child & Adolescent Psychiatry, University of Leuven, Leuven, Belgium
| | - F. C. Verhulst
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, Rotterdam, the Netherlands
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - P. Wells
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - D. Wolke
- Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK
- Department of Psychology, University of Warwick, Coventry, UK
| | - J. Warwick
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
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2
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Gerritsen SE, van Bodegom LS, Dieleman GC, Overbeek MM, Verhulst FC, Wolke D, Rizopoulos D, Appleton R, van Amelsvoort TAMJ, Bodier Rethore C, Bonnet-Brilhault F, Charvin I, Da Fonseca D, Davidović N, Dodig-Ćurković K, Ferrari A, Fiori F, Franić T, Gatherer C, de Girolamo G, Heaney N, Hendrickx G, Jardri R, Kolozsvari A, Lida-Pulik H, Lievesley K, Madan J, Mastroianni M, Maurice V, McNicholas F, Nacinovich R, Parenti A, Paul M, Purper-Ouakil D, Rivolta L, de Roeck V, Russet F, Saam MC, Sagar-Ouriaghli I, Santosh PJ, Sartor A, Schulze UME, Scocco P, Signorini G, Singh SP, Singh J, Speranza M, Stagi P, Stagni P, Street C, Tah P, Tanase E, Tremmery S, Tuffrey A, Tuomainen H, Walker L, Wilson A, Maras A. Demographic, clinical, and service-use characteristics related to the clinician's recommendation to transition from child to adult mental health services. Soc Psychiatry Psychiatr Epidemiol 2022; 57:973-991. [PMID: 35146551 PMCID: PMC9042957 DOI: 10.1007/s00127-022-02238-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 01/22/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE The service configuration with distinct child and adolescent mental health services (CAMHS) and adult mental health services (AMHS) may be a barrier to continuity of care. Because of a lack of transition policy, CAMHS clinicians have to decide whether and when a young person should transition to AMHS. This study describes which characteristics are associated with the clinicians' advice to continue treatment at AMHS. METHODS Demographic, family, clinical, treatment, and service-use characteristics of the MILESTONE cohort of 763 young people from 39 CAMHS in Europe were assessed using multi-informant and standardized assessment tools. Logistic mixed models were fitted to assess the relationship between these characteristics and clinicians' transition recommendations. RESULTS Young people with higher clinician-rated severity of psychopathology scores, with self- and parent-reported need for ongoing treatment, with lower everyday functional skills and without self-reported psychotic experiences were more likely to be recommended to continue treatment. Among those who had been recommended to continue treatment, young people who used psychotropic medication, who had been in CAMHS for more than a year, and for whom appropriate AMHS were available were more likely to be recommended to continue treatment at AMHS. Young people whose parents indicated a need for ongoing treatment were more likely to be recommended to stay in CAMHS. CONCLUSION Although the decision regarding continuity of treatment was mostly determined by a small set of clinical characteristics, the recommendation to continue treatment at AMHS was mostly affected by service-use related characteristics, such as the availability of appropriate services.
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Affiliation(s)
- S E Gerritsen
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, P.O. Box 2060, 3000 CB, Rotterdam, The Netherlands
| | - L S van Bodegom
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, P.O. Box 2060, 3000 CB, Rotterdam, The Netherlands
- Yulius Academy, Yulius Mental Health Organization, Dordrecht, The Netherlands
| | - G C Dieleman
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, P.O. Box 2060, 3000 CB, Rotterdam, The Netherlands.
| | - M M Overbeek
- Yulius Academy, Yulius Mental Health Organization, Dordrecht, The Netherlands
- Clinical Child and Family Studies, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - F C Verhulst
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, P.O. Box 2060, 3000 CB, Rotterdam, The Netherlands
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - D Wolke
- Department of Psychology, University of Warwick, Coventry, UK
| | - D Rizopoulos
- Department of Biostatistics, Erasmus Medical Center, Rotterdam, The Netherlands
| | - R Appleton
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, UK
| | - T A M J van Amelsvoort
- Department of Psychiatry and Neuropsychology, University of Maastricht, Maastricht, The Netherlands
- Mondriaan Mental Health Care, Heerlen, The Netherlands
| | | | | | - I Charvin
- Centre Hospitalier Universitaire de Marseille, Marseille, France
| | - D Da Fonseca
- Centre Hospitalier Universitaire de Marseille, Marseille, France
| | - N Davidović
- University Hospital Split, Split, Croatia
- School of Medicine, University of Split, Split, Croatia
| | - K Dodig-Ćurković
- Faculty for Dental Care and Health, Osijek, Croatia
- University Health Center Osijek, Osijek, Croatia
- Unit for Child and Adolescent Psychiatry, Osijek, Croatia
| | - A Ferrari
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
- DISM, ULSS 16, SOPROXI Onlus, Padua, Italy
| | - F Fiori
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
- Centre for Interventional Paediatric Psychopharmacology and Rare Diseases, South London and Maudsley NHS Foundation Trust, London, UK
- HealthTracker Ltd, Kent, UK
| | - T Franić
- University Hospital Split, Split, Croatia
- School of Medicine, University of Split, Split, Croatia
| | - C Gatherer
- Warwick Medical School, University of Warwick, Coventry, UK
| | - G de Girolamo
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - N Heaney
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - G Hendrickx
- Department of Neurosciences, Centre for Clinical Psychiatry, KU Leuven, Leuven, Belgium
| | - R Jardri
- Lille Neurosciences and Cognitions, Plasticity and Subjectivity Team, CURE Platform, Université de Lille, INSERM (U-1172), Fontan Hospital, CHU Lille, Lille, France
| | | | | | - K Lievesley
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - J Madan
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - M Mastroianni
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
- Centre for Interventional Paediatric Psychopharmacology and Rare Diseases, South London and Maudsley NHS Foundation Trust, London, UK
| | - V Maurice
- Centre Hospitalier Universitaire de Montpellier, Saint Eloi Hospital, Montpellier, France
| | - F McNicholas
- School of Medicine & Medical Science, University College Dublin, Dublin, Republic of Ireland
- Lucena CAMHS, SJOG, Dublin, Republic of Ireland
| | - R Nacinovich
- Child and Adolescent Neuropsychiatry Unit, ASST Monza, Monza, Italy
- Università Degli Studi Milano Bicocca, Milan, Italy
| | - A Parenti
- Centre Hospitalier Universitaire de Lille, Lille, France
| | - M Paul
- Warwick Medical School, University of Warwick, Coventry, UK
- Coventry and Warwickshire Partnership NHS Trust, Coventry, UK
| | - D Purper-Ouakil
- Centre Hospitalier Universitaire de Montpellier, Saint Eloi Hospital, Montpellier, France
- INSERM, CESP U1018, PsyDev, University Paris Saclay, UVSQ, Versailles, France
| | - L Rivolta
- Psychiatric Epidemiology and Evaluation Unit, Saint John of God Clinical Research Center, Brescia, Italy
- Department of Mental Health, Psychiatry Unit, San Gerardo Hospital, Monza, Monza Brianza, Italy
| | - V de Roeck
- Department of Neurosciences, KU Leuven, Leuven, Belgium
- Child and Youth Studies, Campus Social School, University Colleges Leuven Limburg, Heverlee, Belgium
| | - F Russet
- Centre Hospitalier Universitaire de Montpellier, Saint Eloi Hospital, Montpellier, France
| | - M C Saam
- Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
| | - I Sagar-Ouriaghli
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - P J Santosh
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
- Centre for Interventional Paediatric Psychopharmacology and Rare Diseases, South London and Maudsley NHS Foundation Trust, London, UK
- HealthTracker Ltd, Kent, UK
| | - A Sartor
- Josefinum Augsburg, Klinik für Kinder- und Jugenspsychiatrie und Psychotherapie, Augsburg, Germany
| | - U M E Schulze
- Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
| | - P Scocco
- Department of Mental Health, ULSS 6 Euganea, Padua, Italy
- SOPROXI Onlus, Padua, Italy
| | - G Signorini
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - S P Singh
- Warwick Medical School, University of Warwick, Coventry, UK
| | - J Singh
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
- Centre for Interventional Paediatric Psychopharmacology and Rare Diseases, South London and Maudsley NHS Foundation Trust, London, UK
| | - M Speranza
- INSERM, CESP U1018, PsyDev, University Paris Saclay, UVSQ, Versailles, France
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Centre Hospitalier de Versailles, Versailles, France
| | - P Stagi
- Child and Adolescent Neuropsychiatry Unit, AUSL Modena, Modena, Italy
| | - P Stagni
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
- Child and Adolescent Neuropsychiatry, Department of Mental Health, Modena, Italy
| | - C Street
- Warwick Medical School, University of Warwick, Coventry, UK
| | - P Tah
- Warwick Medical School, University of Warwick, Coventry, UK
| | - E Tanase
- Abteilung für Psychiatrie und Psychotherapie des Kindes-und Jugendalters Weissenau, ZfP Südwürttemberg, Ravensburg, Germany
| | - S Tremmery
- Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - A Tuffrey
- Warwick Medical School, University of Warwick, Coventry, UK
| | - H Tuomainen
- Warwick Medical School, University of Warwick, Coventry, UK
| | - L Walker
- Warwick Medical School, University of Warwick, Coventry, UK
| | - A Wilson
- Warwick Medical School, University of Warwick, Coventry, UK
| | - A Maras
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, P.O. Box 2060, 3000 CB, Rotterdam, The Netherlands
- Yulius Academy, Yulius Mental Health Organization, Dordrecht, The Netherlands
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3
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Santosh P, Adams L, Fiori F, Davidović N, de Girolamo G, Dieleman GC, Franić T, Heaney N, Lievesley K, Madan J, Maras A, Mastroianni M, McNicholas F, Paul M, Purper-Ouakil D, Sagar-Ouriaghli I, Schulze U, Signorini G, Street C, Tah P, Tremmery S, Tuomainen H, Verhulst FC, Warwick J, Wolke D, Singh J, Singh SP. Protocol for the development and validation procedure of the managing the link and strengthening transition from child to adult mental health care (MILESTONE) suite of measures. BMC Pediatr 2020; 20:167. [PMID: 32299401 PMCID: PMC7161143 DOI: 10.1186/s12887-020-02079-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 04/13/2020] [Indexed: 02/06/2023] Open
Abstract
Background Mental health disorders in the child and adolescent population are a pressing public health concern. Despite the high prevalence of psychopathology in this vulnerable population, the transition from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS) has many obstacles such as deficiencies in planning, organisational readiness and policy gaps. All these factors contribute to an inadequate and suboptimal transition process. A suite of measures is required that would allow young people to be assessed in a structured and standardised way to determine the on-going need for care and to improve communication across clinicians at CAMHS and AMHS. This will have the potential to reduce the overall health economic burden and could also improve the quality of life for patients travelling across the transition boundary. The MILESTONE (Managing the Link and Strengthening Transition from Child to Adult Mental Health Care) project aims to address the significant socioeconomic and societal challenge related to the transition process. This protocol paper describes the development of two MILESTONE transition-related measures: The Transition Readiness and Appropriateness Measure (TRAM), designed to be a decision-making aide for clinicians, and the Transition Related Outcome Measure (TROM), for examining the outcome of transition. Methods The TRAM and TROM have been developed and were validated following the US FDA Guidance for Patient-reported Outcome Measures which follows an incremental stepwise framework. The study gathers information from service users, parents, families and mental health care professionals who have experience working with young people undergoing the transition process from eight European countries. Discussion There is an urgent need for comprehensive measures that can assess transition across the CAMHS/AMHS boundary. This study protocol describes the process of development of two new transition measures: the TRAM and TROM. The TRAM has the potential to nurture better transitions as the findings can be summarised and provided to clinicians as a clinician-decision making support tool for identifying cases who need to transition and the TROM can be used to examine the outcomes of the transition process. Trial registration MILESTONE study registration: ISRCTN83240263 Registered 23-July-2015 - ClinicalTrials.gov NCT03013595 Registered 6 January 2017.
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Affiliation(s)
- P Santosh
- Department of Child and Adolescent Psychiatry, King's College London, London, UK. .,Centre for Interventional Paediatric Psychopharmacology and Rare Diseases, South London and Maudsley NHS Foundation Trust, London, UK. .,HealthTracker Ltd, Gillingham, Kent, UK.
| | - L Adams
- School of Psychology, Plymouth University, Plymouth, UK
| | - F Fiori
- Department of Child and Adolescent Psychiatry, King's College London, London, UK.,Centre for Interventional Paediatric Psychopharmacology and Rare Diseases, South London and Maudsley NHS Foundation Trust, London, UK.,HealthTracker Ltd, Gillingham, Kent, UK
| | - N Davidović
- Department of Psychiatry, Clinical Hospital Center Split, Split, Croatia
| | - G de Girolamo
- Unità di Psichiatria Epidemiologica e Valutativa, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - G C Dieleman
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - T Franić
- Department of Psychiatry, Clinical Hospital Center Split, Split, Croatia
| | - N Heaney
- Department of Child and Adolescent Psychiatry, King's College London, London, UK
| | - K Lievesley
- Department of Child and Adolescent Psychiatry, King's College London, London, UK
| | - J Madan
- Warwick Clinical Trials Unit, Warwick Medical School, Warwick Medical School, Coventry, UK
| | - A Maras
- Yulius Academy, Rotterdam, The Netherlands.,Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - M Mastroianni
- Department of Child and Adolescent Psychiatry, King's College London, London, UK
| | - F McNicholas
- Department of Child and Adolescent Psychiatry, University College Dublin School of Medicine and Medical Science, Dublin, Republic of Ireland.,Geary Institute, University College Dublin, Dublin, Republic of Ireland.,Department of Child Psychiatry, Our Lady's Hospital for Sick Children, Dublin, Republic of Ireland.,Lucena Clinic, SJOG, Dublin, Republic of Ireland
| | - M Paul
- Centre for Mental Health and Wellbeing Research, Warwick Medical School, University of Warwick, Coventry, UK.,Coventry and Warwickshire Partnership NHS Trust, Coventry, UK
| | - D Purper-Ouakil
- CHU Montpellier / University of Montpellier; Saint Eloi Hospital, Médecine Psychlogique de l'enfant et de adolescent (MPEA1), Montpellier, France
| | - I Sagar-Ouriaghli
- Department of Child and Adolescent Psychiatry, King's College London, London, UK
| | - U Schulze
- Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
| | - G Signorini
- Unità di Psichiatria Epidemiologica e Valutativa, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - C Street
- Centre for Mental Health and Wellbeing Research, Warwick Medical School, University of Warwick, Coventry, UK
| | - P Tah
- Centre for Mental Health and Wellbeing Research, Warwick Medical School, University of Warwick, Coventry, UK
| | - S Tremmery
- Department of Neurosciences, Child & Adolescent Psychiatry, University of Leuven, Leuven, Belgium.,Department of Child & Adolescent Psychiatry, University Hospitals Leuven, Leuven, Belgium
| | - H Tuomainen
- Centre for Mental Health and Wellbeing Research, Warwick Medical School, University of Warwick, Coventry, UK
| | - F C Verhulst
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, Rotterdam, The Netherlands.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - J Warwick
- Warwick Clinical Trials Unit, Warwick Medical School, Warwick Medical School, Coventry, UK
| | - D Wolke
- Centre for Mental Health and Wellbeing Research, Warwick Medical School, University of Warwick, Coventry, UK.,Department of Psychology, University of Warwick, Coventry, UK
| | - J Singh
- Department of Child and Adolescent Psychiatry, King's College London, London, UK.,Centre for Interventional Paediatric Psychopharmacology and Rare Diseases, South London and Maudsley NHS Foundation Trust, London, UK
| | - S P Singh
- Centre for Mental Health and Wellbeing Research, Warwick Medical School, University of Warwick, Coventry, UK.,Coventry and Warwickshire Partnership NHS Trust, Coventry, UK
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Richards JS, Hartman CA, Jeronimus BF, Ormel J, Reijneveld SA, Veenstra R, Verhulst FC, Vollebergh WAM, Oldehinkel AJ. Beyond not bad or just okay: social predictors of young adults' wellbeing and functioning (a TRAILS study). Psychol Med 2019; 49:1459-1469. [PMID: 30229710 PMCID: PMC6541871 DOI: 10.1017/s0033291718001976] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 05/23/2018] [Accepted: 07/12/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND Various childhood social experiences have been reported to predict adult outcomes. However, it is unclear how different social contexts may influence each other's effects in the long run. This study examined the joint contribution of adolescent family and peer experiences to young adult wellbeing and functioning. METHODS Participants came from the TRacking Adolescents' Individual Lives Survey (TRAILS) study (n = 2230). We measured family and peer relations at ages 11 and 16 (i.e. family functioning, perceived parenting, peer status, peer relationship quality), and functioning as the combination of subjective wellbeing, physical and mental health, and socio-academic functioning at age 22. Using structural equation modelling, overall functioning was indicated by two latent variables for positive and negative functioning. Positive, negative and overall functioning at young adulthood were regressed on adolescent family experiences, peer experiences and interactions between the two. RESULTS Family experiences during early and mid-adolescence were most predictive for later functioning; peer experiences did not independently predict functioning. Interactions between family and peer experiences showed that both protective and risk factors can have context-dependent effects, being exacerbated or overshadowed by negative experiences or buffered by positive experiences in other contexts. Overall the effect sizes were modest at best. CONCLUSIONS Adolescent family relations as well as the interplay with peer experiences predict young adult functioning. This emphasizes the importance of considering the relative effects of one context in relation to the other.
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Affiliation(s)
- J. S. Richards
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands
| | - C. A. Hartman
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands
| | - B. F. Jeronimus
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands
- University of Groningen, Department of Developmental Psychology, Faculty of Social and Behavioural Sciences, Groningen, The Netherlands
| | - J. Ormel
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands
| | - S. A. Reijneveld
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Groningen, The Netherlands
| | - R. Veenstra
- University of Groningen, Department of Sociology, Interuniversity Center for Social Science Theory and Methodology (ICS), Groningen, The Netherlands
| | - F. C. Verhulst
- Erasmus University Medical Center Rotterdam, Department of Child Psychiatry/Psychology, Rotterdam, The Netherlands
- Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
- University of Copenhagen, Department of Clinical Medicine, Faculty of Health and Medical Sciences, Copenhagen, Denmark
| | - W. A. M. Vollebergh
- Utrecht University, Department of Interdisciplinary Social Sciences, Utrecht, The Netherlands
| | - A. J. Oldehinkel
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands
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5
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Dremmen MHG, Bouhuis RH, Blanken LME, Muetzel RL, Vernooij MW, Marroun HE, Jaddoe VWV, Verhulst FC, Tiemeier H, White T. Cavum Septum Pellucidum in the General Pediatric Population and Its Relation to Surrounding Brain Structure Volumes, Cognitive Function, and Emotional or Behavioral Problems. AJNR Am J Neuroradiol 2019; 40:340-346. [PMID: 30679220 DOI: 10.3174/ajnr.a5939] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 12/01/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The cavum septum pellucidum, a cavity filled with CSF, is localized between the 2 lateral ventricles of the brain. The cavum is present in all neonates, but it typically closes within 5 months after birth. In some cases, this closure does not occur and a persistent or enlarged cavum septum pellucidum has been linked, in some studies, to psychiatric disorders. However, the clinical relevance in the general population is unknown. In this study, we examined the relationship between the cavum septum pellucidum and volumes of brain structures, cognitive function, and emotional and behavioral problems in children. MATERIALS AND METHODS This study was embedded in the Generation R Study, a prospective cohort in Rotterdam, the Netherlands. MR imaging studies of 1070 children, 6-10 years of age, were systematically evaluated for the presence and length of a persistent cavum septum pellucidum. An enlarged cavum septum pellucidum was defined as a cavum length of ≥6 mm. Groups without, with persistent, and with enlarged cavum septi pellucidi were compared for brain structure volumes, nonverbal intelligence, and emotional and behavioral problems. RESULTS The prevalence of cavum septi pellucidi in our sample was 4.6%. Children with an enlarged cavum septum pellucidum had a larger corpus callosum, greater thalamic and total white matter-to-total brain volume ratio, and smaller lateral ventricle volumes. We did not find a relationship between cavum septi pellucidi and cognitive function or emotional and behavioral problems. CONCLUSIONS The cavum septum pellucidum is a normal structural brain variation without clinical implications in this population-based sample of school-aged children.
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Affiliation(s)
- M H G Dremmen
- From the Departments of Radiology (M.H.G.D., R.H.B., M.W.V., T.W.)
| | - R H Bouhuis
- From the Departments of Radiology (M.H.G.D., R.H.B., M.W.V., T.W.)
| | - L M E Blanken
- Department of Child and Adolescent Psychiatry (L.M.E.B., R.L.M., H.E.M., F.C.V., H.T., T.W.)
- Generation R Study Group (L.M.E.B., R.L.M., H.E.M.), Erasmus Medical Center-Sophia, Rotterdam, the Netherlands
| | - R L Muetzel
- Epidemiology (R.L.M., M.W.V., V.W.V.J.)
- Department of Child and Adolescent Psychiatry (L.M.E.B., R.L.M., H.E.M., F.C.V., H.T., T.W.)
- Generation R Study Group (L.M.E.B., R.L.M., H.E.M.), Erasmus Medical Center-Sophia, Rotterdam, the Netherlands
| | - M W Vernooij
- From the Departments of Radiology (M.H.G.D., R.H.B., M.W.V., T.W.)
- Epidemiology (R.L.M., M.W.V., V.W.V.J.)
| | - H E Marroun
- Department of Child and Adolescent Psychiatry (L.M.E.B., R.L.M., H.E.M., F.C.V., H.T., T.W.)
- Generation R Study Group (L.M.E.B., R.L.M., H.E.M.), Erasmus Medical Center-Sophia, Rotterdam, the Netherlands
| | - V W V Jaddoe
- Epidemiology (R.L.M., M.W.V., V.W.V.J.)
- Pediatrics (V.W.V.J.), Erasmus Medical Center, Rotterdam, the Netherlands
| | - F C Verhulst
- Department of Child and Adolescent Psychiatry (L.M.E.B., R.L.M., H.E.M., F.C.V., H.T., T.W.)
- Department of Clinical Medicine (F.C.V.), University of Copenhagen, Copenhagen, Denmark
| | - H Tiemeier
- Department of Child and Adolescent Psychiatry (L.M.E.B., R.L.M., H.E.M., F.C.V., H.T., T.W.)
- Harvard School of Public Health (H.T.), Boston, Massachusetts
| | - T White
- From the Departments of Radiology (M.H.G.D., R.H.B., M.W.V., T.W.)
- Department of Child and Adolescent Psychiatry (L.M.E.B., R.L.M., H.E.M., F.C.V., H.T., T.W.)
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6
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Bolhuis K, Koopman-Verhoeff ME, Blanken LME, Cibrev D, Jaddoe VWV, Verhulst FC, Hillegers MHJ, Kushner SA, Tiemeier H. Psychotic-like experiences in pre-adolescence: what precedes the antecedent symptoms of severe mental illness? Acta Psychiatr Scand 2018; 138:15-25. [PMID: 29675994 DOI: 10.1111/acps.12891] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/26/2018] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Adolescent psychotic-like experiences predict the onset of psychosis, but also predict subsequent non-psychotic disorders. Therefore, it is crucial to better understand the aetiology of psychotic-like experiences. This study examined whether (a) child emotional and behavioural problems at 3 and 6 years, or (b) childhood adversities were associated with psychotic-like experiences at age 10 years. METHOD This prospective study was embedded in the Generation R Study; 3984 children (mean age 10 years) completed a psychotic-like experiences questionnaire. Mothers reported problems of their child at ages 3, 6 and 10 years. Additionally, mothers were interviewed about their child's adversities. RESULTS Psychotic-like experiences were endorsed by ~20% of children and predicted by both emotional and behavioural problems at 3 years (e.g. emotional-reactive problems: ORadjusted = 1.10, 95% CI: 1.06-1.15, aggressive behaviour: ORadjusted = 1.03, 95% CI: 1.02-1.05) and 6 years (e.g. anxious/depressed problems: ORadjusted = 1.11, 95% CI: 1.06-1.15, aggressive behaviour: ORadjusted = 1.04, 95% CI: 1.04-1.05). Childhood adversities were associated with psychotic-like experiences (>2 adversities: ORadjusted = 2.24, 95% CI: 1.72-2.92), which remained significant after adjustment for comorbid psychiatric problems. CONCLUSION This study demonstrated associations between early adversities, childhood emotional and behavioural problems and pre-adolescent psychotic-like experiences, which will improve the understanding of children at increased risk of severe mental illness.
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Affiliation(s)
- K Bolhuis
- Department of Child & Adolescent Psychiatry, Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands.,Generation R Study Group, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - M E Koopman-Verhoeff
- Department of Child & Adolescent Psychiatry, Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands.,Generation R Study Group, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - L M E Blanken
- Department of Child & Adolescent Psychiatry, Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - D Cibrev
- Department of Child & Adolescent Psychiatry, Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - V W V Jaddoe
- Department of Paediatrics, Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - F C Verhulst
- Department of Child & Adolescent Psychiatry, Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands.,Child and Adolescent Mental Health Centre, Mental Health Services Capital Region, Research Unit, Copenhagen University Hospital, Copenhagen, Denmark
| | - M H J Hillegers
- Department of Child & Adolescent Psychiatry, Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands.,Department of Psychiatry, Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - S A Kushner
- Department of Psychiatry, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - H Tiemeier
- Department of Child & Adolescent Psychiatry, Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands.,Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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7
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Ormel J, Oerlemans AM, Raven D, Laceulle OM, Hartman CA, Veenstra R, Verhulst FC, Vollebergh W, Rosmalen JGM, Reijneveld SA, Oldehinkel AJ. Functional outcomes of child and adolescent mental disorders. Current disorder most important but psychiatric history matters as well. Psychol Med 2017; 47:1271-1282. [PMID: 28065168 DOI: 10.1017/s0033291716003445] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Various sources indicate that mental disorders are the leading contributor to the burden of disease among youth. An important determinant of functioning is current mental health status. This study investigated whether psychiatric history has additional predictive power when predicting individual differences in functional outcomes. METHOD We used data from the Dutch TRAILS study in which 1778 youths were followed from pre-adolescence into young adulthood (retention 80%). Of those, 1584 youths were successfully interviewed, at age 19, using the World Health Organization Composite International Diagnostic Interview (CIDI 3.0) to assess current and past CIDI-DSM-IV mental disorders. Four outcome domains were assessed at the same time: economic (e.g. academic achievement, social benefits, financial difficulties), social (early motherhood, interpersonal conflicts, antisocial behavior), psychological (e.g. suicidality, subjective well-being, loneliness), and health behavior (e.g. smoking, problematic alcohol, cannabis use). RESULTS Out of the 19 outcomes, 14 were predicted by both current and past disorders, three only by past disorders (receiving social benefits, psychiatric hospitalization, adolescent motherhood), and two only by current disorder (absenteeism, obesity). Which type of disorders was most important depended on the outcome. Adjusted for current disorder, past internalizing disorders predicted in particular psychological outcomes while externalizing disorders predicted in particular health behavior outcomes. Economic and social outcomes were predicted by a history of co-morbidity of internalizing and externalizing disorder. The risk of problematic cannabis use and alcohol consumption dropped with a history of internalizing disorder. CONCLUSION To understand current functioning, it is necessary to examine both current and past psychiatric status.
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Affiliation(s)
- J Ormel
- Department of Psychiatry,University of Groningen,University Medical Center Groningen,Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE),Groningen,The Netherlands
| | - A M Oerlemans
- Department of Psychiatry,University of Groningen,University Medical Center Groningen,Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE),Groningen,The Netherlands
| | - D Raven
- Department of Psychiatry,University of Groningen,University Medical Center Groningen,Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE),Groningen,The Netherlands
| | - O M Laceulle
- Department of Psychiatry,University of Groningen,University Medical Center Groningen,Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE),Groningen,The Netherlands
| | - C A Hartman
- Department of Psychiatry,University of Groningen,University Medical Center Groningen,Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE),Groningen,The Netherlands
| | - R Veenstra
- Department of Sociology,University of Groningen,Groningen,The Netherlands
| | - F C Verhulst
- Department of Child and Adolescent Psychiatry & Psychology,Erasmus University Medical Center,Rotterdam,The Netherlands
| | - W Vollebergh
- Department of Interdisciplinary Social Science,University of Utrecht,Utrecht,The Netherlands
| | - J G M Rosmalen
- Department of Psychiatry,University of Groningen,University Medical Center Groningen,Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE),Groningen,The Netherlands
| | - S A Reijneveld
- Department of Health Sciences,University of Groningen,University Medical Center Groningen,Groningen,The Netherlands
| | - A J Oldehinkel
- Department of Psychiatry,University of Groningen,University Medical Center Groningen,Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE),Groningen,The Netherlands
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8
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Kocevska D, Meinderts S, Verhoeff ME, Luijk MP, Verhulst FC, Tiemeier H. 0940 PRENATAL AND EARLY INFANT BRAIN DEVELOPMENT IS RELATED TO CHILDHOOD SLEEP PATTERNS. THE GENERATION R STUDY. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.939] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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9
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Ringoot AP, Jansen PW, Rijlaarsdam J, So P, Jaddoe VWV, Verhulst FC, Tiemeier H. Self-reported problem behavior in young children with and without a DSM-disorder in the general population. Eur Psychiatry 2016; 40:110-115. [PMID: 27992835 DOI: 10.1016/j.eurpsy.2016.08.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 08/22/2016] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Problem behavior of young children is generally not assessed with structured child interviews. This paper examined how information about problem behavior, obtained by structured interviews with six-year-old children, relates to DSM-disorders obtained from parents and to treatment referral. METHODS In a population-based cohort, caregivers of 1084 young children (mean age 6.7 years) were interviewed with the DSM-based Diagnostic Interview Schedule-Young Child version (DISC-YC), and they scored the Child Behavior Checklist (CBCL). Children themselves were interviewed about problem behavior using the semi-structured Berkeley Puppet Interview (BPI). Information regarding treatment referral to mental health services was obtained by parent-reported questionnaire when children were on average eight years old. RESULTS DSM-disorders and CBCL problems in the clinical range were cross-sectionally associated with higher levels of child self-reported problems. Associations were strongest in the externalizing domain (e.g. DISC-YC externalizing disorders with BPI externalizing scores: F(1, 416)=19.39, P<0.001; DISC-YC internalizing disorders with BPI internalizing scores: F(1, 312)=3.75, P=0.054). Moreover, higher BPI internalizing and externalizing problem scores predicted treatment referral two years later. CONCLUSIONS We conclude that systematically interviewing preschool and young elementary school-aged children should be an integral part of child assessment. This approach may contribute to a better understanding of child development and may predict future problems.
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Affiliation(s)
- A P Ringoot
- The Generation R Study Group, Rotterdam, The Netherlands; Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Clinical Psychology, Open University of the Netherlands, Heerlen, The Netherlands
| | - P W Jansen
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Rotterdam, The Netherlands; Institute of Psychology, Erasmus University, Rotterdam, The Netherlands
| | - J Rijlaarsdam
- Faculty of Pedagogical Sciences, Leiden University, Leiden, The Netherlands
| | - P So
- Lucertis, Rotterdam, The Netherlands
| | - V W V Jaddoe
- The Generation R Study Group, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Pediatrics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - F C Verhulst
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - H Tiemeier
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Psychiatry, Erasmus University Medical Center, Rotterdam, The Netherlands.
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10
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Louwerse A, Eussen MLJM, Van der Ende J, de Nijs PFA, Van Gool AR, Dekker LP, Verheij C, Verheij F, Verhulst FC, Greaves-Lord K. ASD Symptom Severity in Adolescence of Individuals Diagnosed with PDD-NOS in Childhood: Stability and the Relation with Psychiatric Comorbidity and Societal Participation. J Autism Dev Disord 2016; 45:3908-18. [PMID: 26395112 PMCID: PMC4653230 DOI: 10.1007/s10803-015-2595-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The current 7-year follow-up study investigated: (1) the stability of ASD severity, and (2) associations of ASD severity in adolescence with (a) childhood and concurrent psychiatric comorbidity, and (b) concurrent societal functioning. The Autism Diagnostic Observation Schedule (ADOS) and the Diagnostic Interview Schedule for Children were administered in childhood (ages 6-12) and in adolescence (ages 12-20) to 72 individuals with a pervasive developmental disorder-not otherwise specified (PDD-NOS). ADOS calibrated severity scores showed a large stability (r = .51). Psychiatric comorbidity in childhood and adolescence were not associated with ASD severity in adolescence. Mental health care use (87 %) and special education needs were high (71 %). Reevaluation of ASD severity and psychiatric comorbidity later in life seem useful when PDD-NOS is diagnosed in childhood.
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Affiliation(s)
- A Louwerse
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Wytemaweg 8, 3015 CN, Rotterdam, The Netherlands. .,Yulius, Organisation for Mental Health, Yulius Academy, Hellingen 21, 3311 GZ, Dordrecht, The Netherlands.
| | - M L J M Eussen
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Wytemaweg 8, 3015 CN, Rotterdam, The Netherlands.,Yulius, Organisation for Mental Health, Yulius Academy, Hellingen 21, 3311 GZ, Dordrecht, The Netherlands
| | - J Van der Ende
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Wytemaweg 8, 3015 CN, Rotterdam, The Netherlands
| | - P F A de Nijs
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Wytemaweg 8, 3015 CN, Rotterdam, The Netherlands
| | - A R Van Gool
- Yulius, Organisation for Mental Health, Yulius Academy, Hellingen 21, 3311 GZ, Dordrecht, The Netherlands
| | - L P Dekker
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Wytemaweg 8, 3015 CN, Rotterdam, The Netherlands.,Yulius, Organisation for Mental Health, Yulius Academy, Hellingen 21, 3311 GZ, Dordrecht, The Netherlands
| | - C Verheij
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Wytemaweg 8, 3015 CN, Rotterdam, The Netherlands
| | - F Verheij
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Wytemaweg 8, 3015 CN, Rotterdam, The Netherlands
| | - F C Verhulst
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Wytemaweg 8, 3015 CN, Rotterdam, The Netherlands
| | - K Greaves-Lord
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC - Sophia Children's Hospital, Wytemaweg 8, 3015 CN, Rotterdam, The Netherlands.,Yulius, Organisation for Mental Health, Yulius Academy, Hellingen 21, 3311 GZ, Dordrecht, The Netherlands
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11
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Boer F, Verhulst FC, Vermeiren RRJM. [Mental health care for teenagers is falling apart before our very eyes]. Ned Tijdschr Geneeskd 2016; 160:D407. [PMID: 27581864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
With the introduction of the Youth Act in 2015, the Dutch Ministry of Health has taken a step back from child and adolescent mental health care (CAMHC). This act placed CAMHC under the responsibility of the municipalities, as part of a programme of integrated youth care. Care at municipal level offers unique possibilities for the timely identification of problems and disturbances in adolescence. However, the prevalence of severe mental disorder in adolescents (2%), is too low for specialised CAMHC to be offered in each of the 390 Dutch municipalities. CAMHC needs to be organised at a supraregional level. Since the introduction of the Youth Act there has been a disturbing lack of coherence and a time- and money-devouring new bureaucracy at this level that threatens the survival of CAMHC. The Ministry of Health should step forward to safeguard the efforts of the Association of Netherlands Municipalities and CAMHC professional organisations to maintain and foster supraregional services.
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Affiliation(s)
- F Boer
- AMC, afd. Kinder- en jeugdpsychiatrie, Amsterdam
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12
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Luijk MPCM, Linting M, Henrichs J, Herba CM, Verhage ML, Schenk JJ, Arends LR, Raat H, Jaddoe VWV, Hofman A, Verhulst FC, Tiemeier H, van IJzendoorn MH. Hours in non-parental child care are related to language development in a longitudinal cohort study. Child Care Health Dev 2015; 41:1188-98. [PMID: 25722078 DOI: 10.1111/cch.12238] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/21/2015] [Indexed: 01/22/2023]
Abstract
BACKGROUND The effects of child care services on several domains of child development have been extensively investigated, but evidence regarding the effects of child care on language development remains inconclusive. METHODS Within a large-scale population-based study, we examined the longitudinal associations between non-parental child care and language development from 1 to 6 years (n = 5375). RESULTS Results showed that more hours in non-parental child care were associated with better language abilities. However, more hours in care in the first year of life were associated with less language proficiency at ages 1 to 1.5. At later ages, this effect disappeared and language proficiency increased. Furthermore, children who spent more hours in centre-based care had better language scores than children in home-based care. Ethnicity, socio-economic status, gender or parity did not change these results. CONCLUSIONS This large, multi-ethnic study demonstrates beneficial effects of non-parental child care, particularly centre-based care, on language proficiency later in childhood.
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Affiliation(s)
- M P C M Luijk
- School of Pedagogical and Educational Sciences, Erasmus University Rotterdam, Rotterdam, The Netherlands.,Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - M Linting
- Centre for Child and Family Studies, Leiden University, Leiden, The Netherlands
| | - J Henrichs
- Department of Developmental Psychology, Tilburg University, Tilburg, The Netherlands
| | - C M Herba
- Department of Psychology, Université du Québec à Montréal and Centre de Recherche du CHU Sainte-Justine, Montréal, QC, Canada
| | - M L Verhage
- Department of Clinical Child and Family Studies, VU University Amsterdam, Amsterdam, The Netherlands
| | - J J Schenk
- School of Pedagogical and Educational Sciences, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - L R Arends
- School of Pedagogical and Educational Sciences, Erasmus University Rotterdam, Rotterdam, The Netherlands.,Institute for Psychology, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - H Raat
- Department of Public Health, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - V W V Jaddoe
- The Generation R Study Group, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - A Hofman
- Department of Epidemiology, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - F C Verhulst
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - H Tiemeier
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands.,Department of Psychiatry, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - M H van IJzendoorn
- School of Pedagogical and Educational Sciences, Erasmus University Rotterdam, Rotterdam, The Netherlands.,Centre for Child and Family Studies, Leiden University, Leiden, The Netherlands
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13
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Grootendorst-van Mil NH, Verhulst FC, Tiemeier H. [The association of gestational duration and birth weight with child IQ: The Generation R Study]. Tijdschr Psychiatr 2015; 57:886-891. [PMID: 26727564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Several psychiatric disorders are considered to be neurodevelopmental in origin. Population-based research provides us with a unique opportunity to explore how prenatal factors influence neurodevelopment. AIM To analyse whether non-verbal child iq is linked to gestational duration and birth weight and to find out whether these birth factors can be seen as to reflect the intra-uterine environment. METHOD Participants were 5,893 (73.6%) children enrolled in the Generation R Study. The gestational duration was determined on the basis of foetal ultrasound scans. Birth weight was measured and transformed into standard deviation scores corrected for gestational duration and gender. The non-verbal iq was measured when the child reached the age of six. RESULTS Even during in the a-term period, gestational duration showed a linear association with non-verbal iq, whereas the association between birth weight and non-verbal iq was found to be curvilinear. CONCLUSION Independently and showing different patterns, both gestational duration and birth weight were found to have a predictive value for childhood non-verbal iq. This finding illustrates the various mechanisms that could lead to neurodevelopmental disorders.
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14
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Ormel J, Raven D, van Oort F, Hartman CA, Reijneveld SA, Veenstra R, Vollebergh WAM, Buitelaar J, Verhulst FC, Oldehinkel AJ. Mental health in Dutch adolescents: a TRAILS report on prevalence, severity, age of onset, continuity and co-morbidity of DSM disorders. Psychol Med 2015; 45:345-360. [PMID: 25066533 DOI: 10.1017/s0033291714001469] [Citation(s) in RCA: 152] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND With psychopathology rising during adolescence and evidence suggesting that adult mental health burden is often due to disorders beginning in youth, it is important to investigate the epidemiology of adolescent mental disorders. METHOD We analysed data gathered at ages 11 (baseline) and 19 years from the population-based Dutch TRacking Adolescents' Individual Lives Survey (TRAILS) study. At baseline we administered the Achenbach measures (Child Behavior Checklist, Youth Self-Report) and at age 19 years the World Health Organization's Composite International Diagnostic Interview version 3.0 (CIDI 3.0) to 1584 youths. RESULTS Lifetime, 12-month and 30-day prevalences of any CIDI-DSM-IV disorder were 45, 31 and 15%, respectively. Half were severe. Anxiety disorders were the most common but the least severe whereas mood and behaviour disorders were less prevalent but more severe. Disorders persisted, mostly by recurrence in mood disorders and chronicity in anxiety disorders. Median onset age varied substantially across disorders. Having one disorder increased subjects' risk of developing another disorder. We found substantial homotypic and heterotypic continuity. Baseline problems predicted the development of diagnosable disorders in adolescence. Non-intact families and low maternal education predicted externalizing disorders. Most morbidity concentrated in 5-10% of the sample, experiencing 34-55% of all severe lifetime disorders. CONCLUSIONS At late adolescence, 22% of youths have experienced a severe episode and 23% only mild episodes. This psychopathology is rather persistent, mostly due to recurrence, showing both monotypic and heterotypic continuity, with family context affecting particularly externalizing disorders. High problem levels at age 11 years are modest precursors of incident adolescent disorders. The burden of mental illness concentrates in 5-10% of the adolescent population.
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Affiliation(s)
- J Ormel
- University of Groningen, University Medical Center Groningen,Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen,The Netherlands
| | - D Raven
- University of Groningen, University Medical Center Groningen,Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen,The Netherlands
| | - F van Oort
- Department of Child and Adolescent Psychiatry and Psychology,Erasmus Medical Center,Rotterdam,The Netherlands
| | - C A Hartman
- University of Groningen, University Medical Center Groningen,Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen,The Netherlands
| | - S A Reijneveld
- Department of Health Sciences,University of Groningen,University Medical Center Groningen, Groningen,The Netherlands
| | - R Veenstra
- Department of Sociology,University of Groningen,Groningen,The Netherlands
| | - W A M Vollebergh
- Department of Youth and Family,University of Utrecht,Utrecht,The Netherlands
| | - J Buitelaar
- Department of Psychiatry,Radboud University Nijmegen,Nijmegen,The Netherlands
| | - F C Verhulst
- Department of Child and Adolescent Psychiatry and Psychology,Erasmus Medical Center,Rotterdam,The Netherlands
| | - A J Oldehinkel
- University of Groningen, University Medical Center Groningen,Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen,The Netherlands
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15
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Mous SE, Muetzel RL, El Marroun H, Polderman TJC, van der Lugt A, Jaddoe VW, Hofman A, Verhulst FC, Tiemeier H, Posthuma D, White T. Cortical thickness and inattention/hyperactivity symptoms in young children: a population-based study. Psychol Med 2014; 44:3203-3213. [PMID: 25065362 DOI: 10.1017/s0033291714000877] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND While many neuroimaging studies have investigated the neurobiological basis of attention deficit hyperactivity disorder (ADHD), few have studied the neurobiology of attention problems in the general population. The ability to pay attention falls along a continuum within the population, with children with ADHD at one extreme of the spectrum and, therefore, a dimensional perspective of evaluating attention problems has an added value to the existing literature. Our goal was to investigate the relationship between cortical thickness and inattention and hyperactivity symptoms in a large population of young children. METHOD This study is embedded within the Generation R Study and includes 6- to 8-year-old children (n = 444) with parent-reported attention and hyperactivity measures and high-resolution structural imaging data. We investigated the relationship between cortical thickness across the entire brain and the Child Behavior Checklist Attention Deficit Hyperactivity Problems score. RESULTS We found that greater attention problems and hyperactivity were associated with a thinner right and left postcentral gyrus. When correcting for potential confounding factors and multiple testing, these associations remained significant. CONCLUSIONS In a large, population-based sample we showed that young (6- to 8-year-old) children who show more attention problems and hyperactivity have a thinner cortex in the region of the right and left postcentral gyrus. The postcentral gyrus, being the primary somatosensory cortex, reaches its peak growth early in development. Therefore, the thinner cortex in this region may reflect either a deviation in cortical maturation or a failure to reach the same peak cortical thickness compared with children without attention or hyperactivity problems.
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Affiliation(s)
- S E Mous
- The Generation R Study Group,Erasmus Medical Center,Rotterdam,The Netherlands
| | - R L Muetzel
- The Generation R Study Group,Erasmus Medical Center,Rotterdam,The Netherlands
| | - H El Marroun
- The Generation R Study Group,Erasmus Medical Center,Rotterdam,The Netherlands
| | - T J C Polderman
- Complex Trait Genetics, Department of Functional Genomics, Center for Neurogenomics and Cognitive Research (CNCR), Neuroscience Campus Amsterdam (NCA),VU University,Amsterdam,The Netherlands
| | - A van der Lugt
- Department of Radiology,Erasmus Medical Center,Rotterdam,The Netherlands
| | - V W Jaddoe
- The Generation R Study Group,Erasmus Medical Center,Rotterdam,The Netherlands
| | - A Hofman
- Department of Epidemiology,Erasmus Medical Center,Rotterdam,The Netherlands
| | - F C Verhulst
- Department of Child and Adolescent Psychiatry/Psychology,Erasmus Medical Center - Sophia Children's Hospital,Rotterdam,The Netherlands
| | - H Tiemeier
- Department of Child and Adolescent Psychiatry/Psychology,Erasmus Medical Center - Sophia Children's Hospital,Rotterdam,The Netherlands
| | - D Posthuma
- Department of Child and Adolescent Psychiatry/Psychology,Erasmus Medical Center - Sophia Children's Hospital,Rotterdam,The Netherlands
| | - T White
- Department of Child and Adolescent Psychiatry/Psychology,Erasmus Medical Center - Sophia Children's Hospital,Rotterdam,The Netherlands
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16
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Breeman LD, van Lier PAC, Wubbels T, Verhulst FC, van der Ende J, Maras A, Hopman JAB, Tick NT. Developmental links between disobedient behavior and social classroom relationships in boys with psychiatric disorders in special education. J Abnorm Child Psychol 2014; 43:787-99. [PMID: 25212230 DOI: 10.1007/s10802-014-9935-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
In mainstream education, positive relationships with teachers and peers have been found to positively influence children's behavioral development. However, high levels of classroom behavior problems may hinder the formation of such positive relationships. Therefore, findings from mainstream education cannot be generalized to special education. The present study investigated the developmental links between disobedience and positive as well as negative relationships with teachers and peers among boys in restrictive special educational settings. At three assessment waves across one school year, teacher-reports of teacher-child closeness and conflict, and peer-reports of peer acceptance, rejection and disobedience were collected among 340 boys (mean age = 10.1 years, SD = 1.58, range = 5-13) with psychiatric disorders receiving special education. Autoregressive cross-lagged models were fitted to explore the nature of these developmental links. The impact of boys' age was examined using multiple group analyses. Findings supported the importance of teacher-child conflict, but not closeness, and positive and negative peer relationships for the development of boys' disobedience, with a stronger effect of negative than positive relationships. However, teacher-child and peer relationships were not longitudinally related and the effect of boys' age was minimal. This study extends prior research by suggesting that, despite differences in educational setting and severity of behavior problems between children in mainstream and special education, reducing negative classroom interactional patterns is most important in preventing the development of problematic classroom behavior in boys with severe social-emotional and behavioral difficulties.
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Affiliation(s)
- L D Breeman
- Yulius Mental Health, Yulius Academy, Mathenesserlaan 202, 3014HH, Rotterdam, The Netherlands,
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17
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van der Knaap LJ, Schaefer JM, Franken IHA, Verhulst FC, van Oort FVA, Riese H. Catechol-O-methyltransferase gene methylation and substance use in adolescents: the TRAILS study. Genes Brain Behav 2014; 13:618-25. [PMID: 24902721 DOI: 10.1111/gbb.12147] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Revised: 05/16/2014] [Accepted: 06/02/2014] [Indexed: 12/18/2022]
Abstract
Substance use often starts in adolescence and poses a major problem for society and individual health. The dopamine system plays a role in substance use, and catechol-O-methyltransferase (COMT) is an important enzyme that degrades dopamine. The Val(108/158) Met polymorphism modulates COMT activity and thus dopamine levels, and has been linked to substance use. COMT gene methylation, on the other hand, may affect expression and thus indirectly COMT activity. We investigated whether methylation of the COMT gene was associated with adolescents' substance use. Furthermore, we explored whether the COMT Val(108/158) Met polymorphism interacts with COMT gene methylation in association with substance use. In 463 adolescents (mean age=16, 50.8% girls), substance use (cigarette smoking, alcohol and cannabis use) was assessed with self-report questionnaires. From blood samples, COMT Val(108/158) Met genotype and methylation rates of membrane bound (MB) and soluble (S) COMT promoters were assessed. MB-COMT promoter methylation was associated with non-daily smoking [odds ratio (OR)=1.82, P=0.03], but not with daily smoking (OR=1.20, P=0.34), MB-COMT promoter methylation was not associated with alcohol use. Adolescents with the Met/Met genotype and high rates of MB-COMT promoter methylation were less likely to be high-frequent cannabis users than adolescents with the Val/Val or Val/Met genotype. S-COMT promoter methylation was not associated with substance use. These results indicate that there is an association between substance use and COMT gene methylation. Although this association is complex, combining genetic and epigenetic variation of the COMT gene may be helpful in further elucidating the influence of the dopamine system on substance use in adolescence.
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Affiliation(s)
- L J van der Knaap
- Department of Child and Adolescent Psychiatry & Psychology, Erasmus Medical Center, The Netherlands
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18
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van der Knaap LJ, Riese H, Hudziak JJ, Verbiest MMPJ, Verhulst FC, Oldehinkel AJ, van Oort FVA. Glucocorticoid receptor gene (NR3C1) methylation following stressful events between birth and adolescence. The TRAILS study. Transl Psychiatry 2014; 4:e381. [PMID: 24713862 PMCID: PMC4012286 DOI: 10.1038/tp.2014.22] [Citation(s) in RCA: 123] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 02/07/2014] [Accepted: 02/25/2014] [Indexed: 12/16/2022] Open
Abstract
Stress early in life is a known risk factor for the development of affective disorders later in life. Epigenetic mechanisms, such as DNA methylation, may have an important role in mediating that risk. Recent epigenetic research reported on the long-term relationship between traumatic stress in childhood and DNA methylation in adulthood. In this study, we examined the impact of various types of stress (perinatal stress, stressful life events (SLEs) and traumatic youth experiences) on methylation of the glucocorticoid receptor gene (NR3C1) in the blood of a population sample of 468 adolescents (50.4% female, mean age 16.1 years). Second, we determined whether stress at different ages was associated with higher NR3C1 methylation. NR3C1 methylation rates were higher after exposure to SLEs and after exposure to traumatic youth experiences. NR3C1 methylation in adolescence was not higher after exposure to perinatal stress. Experience of SLEs in adolescence was associated with a higher NR3C1 methylation, independently of childhood SLEs. We demonstrate that not only traumatic youth experiences but also (more common) SLEs are associated with higher NR3C1 methylation. In addition, our findings underline the relevance of adolescent stress for epigenetic changes in the NR3C1 gene.
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Affiliation(s)
- L J van der Knaap
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands
| | - H Riese
- Interdisciplinary Center Psychopathology and Emotion regulation, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands,Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - J J Hudziak
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands,Vermont Center for Children, Youth, and Families, The University of Vermont, Burlington, VT, USA
| | - M M P J Verbiest
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - F C Verhulst
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands
| | - A J Oldehinkel
- Interdisciplinary Center Psychopathology and Emotion regulation, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - F V A van Oort
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands,Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center, Sophia Children's Hospital, PO Box 2060, 3000 CB Rotterdam, The Netherlands. E-mail:
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19
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Benyamin B, Pourcain BS, Davis OS, Davies G, Hansell NK, Brion MJA, Kirkpatrick RM, Cents RAM, Franić S, Miller MB, Haworth CMA, Meaburn E, Price TS, Evans DM, Timpson N, Kemp J, Ring S, McArdle W, Medland SE, Yang J, Harris SE, Liewald DC, Scheet P, Xiao X, Hudziak JJ, de Geus EJC, Jaddoe VWV, Starr JM, Verhulst FC, Pennell C, Tiemeier H, Iacono WG, Palmer LJ, Montgomery GW, Martin NG, Boomsma DI, Posthuma D, McGue M, Wright MJ, Smith GD, Deary IJ, Plomin R, Visscher PM. Childhood intelligence is heritable, highly polygenic and associated with FNBP1L. Mol Psychiatry 2014; 19:253-8. [PMID: 23358156 PMCID: PMC3935975 DOI: 10.1038/mp.2012.184] [Citation(s) in RCA: 167] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2012] [Revised: 10/28/2012] [Accepted: 11/12/2012] [Indexed: 01/11/2023]
Abstract
Intelligence in childhood, as measured by psychometric cognitive tests, is a strong predictor of many important life outcomes, including educational attainment, income, health and lifespan. Results from twin, family and adoption studies are consistent with general intelligence being highly heritable and genetically stable throughout the life course. No robustly associated genetic loci or variants for childhood intelligence have been reported. Here, we report the first genome-wide association study (GWAS) on childhood intelligence (age range 6-18 years) from 17,989 individuals in six discovery and three replication samples. Although no individual single-nucleotide polymorphisms (SNPs) were detected with genome-wide significance, we show that the aggregate effects of common SNPs explain 22-46% of phenotypic variation in childhood intelligence in the three largest cohorts (P=3.9 × 10(-15), 0.014 and 0.028). FNBP1L, previously reported to be the most significantly associated gene for adult intelligence, was also significantly associated with childhood intelligence (P=0.003). Polygenic prediction analyses resulted in a significant correlation between predictor and outcome in all replication cohorts. The proportion of childhood intelligence explained by the predictor reached 1.2% (P=6 × 10(-5)), 3.5% (P=10(-3)) and 0.5% (P=6 × 10(-5)) in three independent validation cohorts. Given the sample sizes, these genetic prediction results are consistent with expectations if the genetic architecture of childhood intelligence is like that of body mass index or height. Our study provides molecular support for the heritability and polygenic nature of childhood intelligence. Larger sample sizes will be required to detect individual variants with genome-wide significance.
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Affiliation(s)
- B Benyamin
- The University of Queensland, Queensland Brain Institute, St Lucia, Queensland, Australia
- Queensland Institute of Medical Research, Brisbane, Queensland, Australia
| | - BSt Pourcain
- Medical Research Council Centre for Causal Analyses in Translational Epidemiology, University of Bristol, Bristol, UK
| | - OS Davis
- King's College London, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, London, UK
| | - G Davies
- Department of Psychology, University of Edinburgh, Edinburgh, Scotland, UK
| | - NK Hansell
- Queensland Institute of Medical Research, Brisbane, Queensland, Australia
| | - M-JA Brion
- Medical Research Council Centre for Causal Analyses in Translational Epidemiology, University of Bristol, Bristol, UK
- School of Women's and Infants' Health, The University of Western Australia, Perth, Western Australia, Australia
| | - RM Kirkpatrick
- Department of Psychology, University of Minnesota, St Paul, MN, USA
| | - RAM Cents
- The Generation R Study Group, Erasmus MC-University Medical Centre Rotterdam, Rotterdam, The Netherlands
- Department of Child and Adolescent Psychiatry, Erasmus MC-University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - S Franić
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - MB Miller
- Department of Psychology, University of Minnesota, St Paul, MN, USA
| | - CMA Haworth
- King's College London, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, London, UK
| | - E Meaburn
- Department of Psychology, Birkbeck University of London, London, UK
| | - TS Price
- King's College London, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, London, UK
| | - DM Evans
- Medical Research Council Centre for Causal Analyses in Translational Epidemiology, University of Bristol, Bristol, UK
| | - N Timpson
- Medical Research Council Centre for Causal Analyses in Translational Epidemiology, University of Bristol, Bristol, UK
| | - J Kemp
- Medical Research Council Centre for Causal Analyses in Translational Epidemiology, University of Bristol, Bristol, UK
| | - S Ring
- Medical Research Council Centre for Causal Analyses in Translational Epidemiology, University of Bristol, Bristol, UK
| | - W McArdle
- Medical Research Council Centre for Causal Analyses in Translational Epidemiology, University of Bristol, Bristol, UK
| | - SE Medland
- Queensland Institute of Medical Research, Brisbane, Queensland, Australia
| | - J Yang
- The University of Queensland Diamantina Institute, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - SE Harris
- Molecular Medicine Centre, Institute for Genetics and Molecular Medicine Centre, University of Edinburgh, Edinburgh, UK
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | - DC Liewald
- Department of Psychology, University of Edinburgh, Edinburgh, Scotland, UK
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | - P Scheet
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - X Xiao
- Department of Epidemiology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - JJ Hudziak
- Department of Psychiatry, College of Medicine, University of Vermont, Burlington, VT, USA
| | - EJC de Geus
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - VWV Jaddoe
- The Generation R Study Group, Erasmus MC-University Medical Centre Rotterdam, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC-University Medical Centre Rotterdam, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - JM Starr
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
- Alzheimer Scotland Dementia Research Centre, Department of Psychology, University of Edinburgh, Edinburgh, Scotland, UK
| | - FC Verhulst
- Department of Child and Adolescent Psychiatry, Erasmus MC-University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - C Pennell
- School of Women's and Infants' Health, The University of Western Australia, Perth, Western Australia, Australia
| | - H Tiemeier
- Department of Child and Adolescent Psychiatry, Erasmus MC-University Medical Centre Rotterdam, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC-University Medical Centre Rotterdam, Rotterdam, The Netherlands
- Department of Psychiatry, Erasmus MC-University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - WG Iacono
- Department of Psychology, University of Minnesota, St Paul, MN, USA
| | - LJ Palmer
- Genetic Epidemiology and Biostatistics Platform, Ontario Institute for Cancer Research, University of Toronto, Toronto, Ontario, Canada
- Samuel Lunenfeld Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - GW Montgomery
- Queensland Institute of Medical Research, Brisbane, Queensland, Australia
| | - NG Martin
- Queensland Institute of Medical Research, Brisbane, Queensland, Australia
| | - DI Boomsma
- Netherlands Twin Register, Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - D Posthuma
- Department of Child and Adolescent Psychiatry, Erasmus MC-University Medical Centre Rotterdam, Rotterdam, The Netherlands
- Department of Functional Genomics, Center for Neurogenomics and Cognitive Research (CNCR), Neuroscience Campus Amsterdam (NCA), VU University Amsterdam and VU Medical Centre, Amsterdam, The Netherlands
- Department of Clinical Genetics, Section Medical Genomics, VU Medical Centre, Amsterdam, The Netherlands
| | - M McGue
- Department of Psychology, University of Minnesota, St Paul, MN, USA
- Department of Epidemiology, University of Southern Denmark, Odense, Denmark
| | - MJ Wright
- Queensland Institute of Medical Research, Brisbane, Queensland, Australia
| | - G Davey Smith
- Medical Research Council Centre for Causal Analyses in Translational Epidemiology, University of Bristol, Bristol, UK
| | - IJ Deary
- Department of Psychology, University of Edinburgh, Edinburgh, Scotland, UK
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | - R Plomin
- King's College London, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, London, UK
| | - PM Visscher
- The University of Queensland, Queensland Brain Institute, St Lucia, Queensland, Australia
- Queensland Institute of Medical Research, Brisbane, Queensland, Australia
- The University of Queensland Diamantina Institute, Princess Alexandra Hospital, Brisbane, Queensland, Australia
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
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20
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Micali N, dos-Santos-Silva I, De Stavola B, Steenweg-de Graaff J, Steenweg-de Graaf J, Jaddoe V, Hofman A, Verhulst FC, Steegers E, Tiemeier H. Fertility treatment, twin births, and unplanned pregnancies in women with eating disorders: findings from a population-based birth cohort. BJOG 2013; 121:408-16. [PMID: 24206173 PMCID: PMC4155863 DOI: 10.1111/1471-0528.12503] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2013] [Indexed: 11/27/2022]
Abstract
Objective To investigate fertility treatment, twin births, and unplanned pregnancies in pregnant women with eating disorders in a population-based sample. Design A longitudinal population-based birth cohort (Generation R). Setting Rotterdam, the Netherlands. Sample Women from the Generation R study who reported a history of (recent or past) anorexia nervosa (n = 160), bulimia nervosa (n = 265), or both (n = 130), and a history of psychiatric disorders other than eating disorders (n = 1396) were compared with women without psychiatric disorders (n = 4367). Methods Women were compared on the studied outcomes using logistic regression. We performed crude and adjusted analyses (adjusting for relevant confounding factors). Main outcome measures Fertility treatment, twin births, unplanned pregnancies, and women's feelings towards unplanned pregnancies. Results Relative to women without psychiatric disorders, women with bulimia nervosa had increased odds (odds ratio, OR, 2.3; 95% confidence interval, 95% CI, 1.1–5.2) of having undergone fertility treatment. Women with all eating disorders had increased odds of twin births (anorexia nervosa, OR 2.7, 95% CI 1.0–7.7; bulimia nervosa, OR 2.7, 95% CI 1.1–6.6; anorexia and bulimia nervosa, OR 3.795% CI 1.3–10.7). Anorexia nervosa was associated with increased odds of unplanned pregnancies (OR 1.8, 95% CI 1.2–2.6) and mixed feelings about these pregnancies (adjusted OR 5.0, 95% CI 1.7–14.4). Pre-pregnancy body mass index did not explain the observed associations. Conclusions Eating disorders are associated with increased odds of receiving fertility treatment and twin births. Women with anorexia nervosa were more likely to have an unplanned pregnancy and have mixed feelings about the unplanned pregnancy. Fertility treatment specialists should be aware that both active and past eating disorders (both anorexia nervosa and bulimia nervosa) might underlie fertility problems.
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Affiliation(s)
- N Micali
- Behavioural and Brain Sciences Unit, UCL Institute of Child Health, London, UK
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21
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Van Batenburg-Eddes T, Brion MJ, Henrichs J, Jaddoe VWV, Hofman A, Verhulst FC, Lawlor DA, Davey Smith G, Tiemeier H. Parental depressive and anxiety symptoms during pregnancy and attention problems in children: a cross-cohort consistency study. J Child Psychol Psychiatry 2013; 54:591-600. [PMID: 23215861 PMCID: PMC3796855 DOI: 10.1111/jcpp.12023] [Citation(s) in RCA: 135] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Maternal depression and anxiety during pregnancy have been associated with offspring-attention deficit problems. AIM We explored possible intrauterine effects by comparing maternal and paternal symptoms during pregnancy, by investigating cross-cohort consistency, and by investigating whether parental symptoms in early childhood may explain any observed intrauterine effect. METHODS This study was conducted in two cohorts (Generation R, n = 2,280 and ALSPAC, n = 3,442). Pregnant women and their partners completed questionnaires to assess symptoms of depression and anxiety. Child attention problems were measured in Generation R at age 3 with the Child Behavior Checklist, and in ALSPAC at age 4 with the Strengths and Difficulties Questionnaire. RESULTS In both cohorts, antenatal maternal symptoms of depression (Generation R: OR 1.23, 95% CI 1.05-1.43; ALSPAC: OR 1.33, 95% CI 1.19-1.48) and anxiety (Generation R: OR 1.24, 95% CI 1.06-1.46; ALSPAC: OR 1.32, 95% CI 1.19-1.47) were associated with a higher risk of child attention problems. In ALSPAC, paternal depression was also associated with a higher risk of child attention problems (OR 1.11, 95% CI 1.00-1.24). After adjusting for maternal symptoms after giving birth, antenatal maternal depression and anxiety were no longer associated with child attention problems in Generation R. Moreover, there was little statistical evidence that antenatal maternal and paternal depression and anxiety had a substantially different effect on attention problems of the child. CONCLUSIONS The apparent intrauterine effect of maternal depression and anxiety on offspring-behavioural problems may be partly explained by residual confounding. There was little evidence of a difference between the strength of associations of maternal and paternal symptoms during pregnancy with offspring-attention problems. That maternal symptoms after childbirth were also associated with offspring-behavioural problems may indicate a contribution of genetic influences to the association.
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Affiliation(s)
- T Van Batenburg-Eddes
- The Generation R Study Group, Erasmus Medical CenterRotterdam, the Netherlands,Department of Child and Adolescent Psychiatry, Erasmus Medical Center-Sophia Children’s HospitalRotterdam, the Netherlands,Department of Educational Neuroscience, Faculty of Psychology and Education, LEARN! Institute, VU University AmsterdamAmsterdam, the Netherlands
| | - MJ Brion
- Medical Research Council Centre for Causal Analyses in Translational Epidemiology, School of Social and Community Medicine, University of BristolBristol, UK
| | - J Henrichs
- The Generation R Study Group, Erasmus Medical CenterRotterdam, the Netherlands,Institute of Psychology, Erasmus University RotterdamRotterdam, the Netherlands,International Victimology Institute Tilburg, Tilburg UniversityTilburg, the Netherlands
| | - VWV Jaddoe
- The Generation R Study Group, Erasmus Medical CenterRotterdam, the Netherlands,Department of Epidemiology, Erasmus Medical CenterRotterdam, the Netherlands,Department of Pediatrics, Erasmus Medical Center-Sophia Children’s HospitalRotterdam, the Netherlands
| | - A Hofman
- Department of Epidemiology, Erasmus Medical CenterRotterdam, the Netherlands
| | - FC Verhulst
- Department of Child and Adolescent Psychiatry, Erasmus Medical Center-Sophia Children’s HospitalRotterdam, the Netherlands
| | - DA Lawlor
- Medical Research Council Centre for Causal Analyses in Translational Epidemiology, School of Social and Community Medicine, University of BristolBristol, UK
| | - G Davey Smith
- Medical Research Council Centre for Causal Analyses in Translational Epidemiology, School of Social and Community Medicine, University of BristolBristol, UK
| | - H Tiemeier
- Department of Child and Adolescent Psychiatry, Erasmus Medical Center-Sophia Children’s HospitalRotterdam, the Netherlands,Department of Epidemiology, Erasmus Medical CenterRotterdam, the Netherlands,Department of Psychiatry, Erasmus Medical CenterRotterdam, the Netherlands
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Kok R, van IJzendoorn MH, Linting M, Bakermans-Kranenburg MJ, Tharner A, Luijk MPCM, Székely E, Jaddoe VWV, Hofman A, Verhulst FC, Tiemeier H. Attachment insecurity predicts child active resistance to parental requests in a compliance task. Child Care Health Dev 2013; 39:277-87. [PMID: 22394322 DOI: 10.1111/j.1365-2214.2012.01374.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM We studied the effects of early mother-child relationship quality and child temperament on the development of child compliance and active resistance in a large population-based cohort study (n = 534). BACKGROUND Parenting and the quality of the parent-child relationship can either hamper or support the development of child compliance directly or in interplay with child temperament. METHODS Mother-infant dyads were observed at 14 and 36 months and maternal and child behaviours were independently coded. The quality of compliance was assessed at 36 months in a clean-up task. Child behaviour was coded using a system differentiating between two dimensions: Compliance and Active Resistance. RESULTS Controlling for concurrent maternal sensitivity, child temperament, and gender children with a more insecure attachment relationship showed higher levels of active resistance during Clean-Up than more securely attached children. The effect was stronger for boys than for girls and mainly driven by attachment avoidance. CONCLUSIONS Early attachment is an important contributor to child socialization of moral behaviour.
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Affiliation(s)
- R Kok
- Centre for Child and Family Studies, Leiden University, Leiden, The Netherlands
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23
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Cents RAM, Diamantopoulou S, Hudziak JJ, Jaddoe VWV, Hofman A, Verhulst FC, Lambregtse-van den Berg MP, Tiemeier H. Trajectories of maternal depressive symptoms predict child problem behaviour: the Generation R study. Psychol Med 2013; 43:13-25. [PMID: 22490169 DOI: 10.1017/s0033291712000657] [Citation(s) in RCA: 103] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND It is unclear how the course of maternal depressive symptoms affects child development. We modelled trajectories of maternal depressive symptoms from mid-pregnancy to 3 years after childbirth to better determine their associations with child problem behaviour. METHOD Mother-child dyads (n = 4167) participated in a population-based prospective cohort in The Netherlands. Depressive symptoms were assessed with the Brief Symptom Inventory during pregnancy and at 2, 6 and 36 months postnatally. When children were 3 years old, problem behaviour was assessed with the Child Behaviour Checklist completed by each parent. A group-based modelling technique was used to model trajectories of maternal depressive symptoms and to examine their association with child problem behaviour. The added value of trajectory modelling was determined with successive linear regressions. RESULTS We identified four trajectories of maternal depressive symptoms; 'no' (34%), 'low' (54%), 'moderate' (11%) and 'high' (1.5%). Child problem behaviour varied as a function of maternal trajectory membership. Whether rated by mother or father, children of mothers assigned to higher trajectories had significantly more problem behaviours than children of mothers assigned to lower trajectories. The model including trajectories had additive predictive value over a model relying only on a summed repeated measure of severity and a predefined chronicity variable. CONCLUSIONS Depending on their course, maternal depressive symptoms have different effects on child problem behaviour. More information is gained by studying trajectories of symptoms, than only predefined measures of severity and chronicity. Moreover, trajectories can help identifying clinically depressed mothers who are possible candidates for early interventions.
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Affiliation(s)
- R A M Cents
- The Generation R Study Group, Erasmus MC-University Medical Centre, Rotterdam, The Netherlands
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24
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Stavrakakis N, Oldehinkel AJ, Nederhof E, Oude Voshaar RC, Verhulst FC, Ormel J, de Jonge P. Plasticity genes do not modify associations between physical activity and depressive symptoms. Health Psychol 2013; 32:785-92. [DOI: 10.1037/a0030111] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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25
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Wigman JTW, van Winkel R, Ormel J, Verhulst FC, van Os J, Vollebergh WAM. Early trauma and familial risk in the development of the extended psychosis phenotype in adolescence. Acta Psychiatr Scand 2012; 126:266-73. [PMID: 22486536 DOI: 10.1111/j.1600-0447.2012.01857.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Both genetic and environmental factors are thought to play a role in the development of psychotic outcomes; however, their respective contributions over time, including possible developmental interactions, remain largely unknown. METHOD The contribution of parental general and psychotic psychopathology as proxies of genetic risk to the development of subthreshold psychosis and its hypothesized interaction with childhood trauma were studied in a general population sample of 2230 adolescents, followed from age 10-16 years. Outcome measures were: i) level of psychotic experiences at age 16 years and ii) persistence of such experiences over the total follow-up period. RESULTS General parental psychopathology was associated with CAPE score (OR = 1.08; P < 0.043 for highest quintile) and suggestively predicted psychosis persistence (OR, 1.16; P < 0.072). Psychotic parental psychopathology was suggestively associated with CAPE score (OR, 2.25; P < 0.063 for highest quintile), predicted membership of the Persistent group (OR, 3.72; P < 0.039) and suggestively predicted membership of the Decreasing group (OR 2.04; P < 0.051). Childhood trauma was associated with CAPE score and with all developmental trajectories of subclinical psychosis. No evidence was found for an interaction between trauma and parental psychopathology. CONCLUSION The development and persistence of subthreshold psychotic symptoms may be conditional on non-interacting proxy genetic and environmental influences.
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Affiliation(s)
- J T W Wigman
- Department of Interdisciplinary Social Science, University of Utrecht, the Netherlands.
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26
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Micali N, De Stavola B, dos-Santos-Silva I, Steenweg-de Graaff J, Jansen PW, Jaddoe VWV, Hofman A, Verhulst FC, Steegers EAP, Tiemeier H. Perinatal outcomes and gestational weight gain in women with eating disorders: a population-based cohort study. BJOG 2012; 119:1493-502. [DOI: 10.1111/j.1471-0528.2012.03467.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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27
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van der Valk JC, Verhulst FC, Stroet TM, Boomsma DI. Quantitative genetic analysis of Internalising and Externalising Problems in a large sample of 3-year-old twins. ACTA ACUST UNITED AC 2012. [DOI: 10.1375/twin.1.1.25] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractFor a quantitative genetic study of pre-school problem behaviours, we have collected data with the Child Behavior Checklist for 2 and 3-year-old children (CBCL 2/3). Questionnaires were completed by mothers of 3620 twin pairs: 633 monozygotic males, 581 dizygotic males, 695 monozygotic females, 519 dizygotic females and 1192 dizygotic opposite sex twin pairs. The genetic and environmental influences on the Externalising and Internalising Problem scales were estimated, simultaneously with sex differences and sibling interaction effects. Genetic factors explained most of the observed variance for both Externalising and Internalising Problems. Cooperative sibling interactions were found for Externalising Problems, indicating that twins reinforce each other's behaviour. Sex differences in genetic architecture were found for Externalising Problems. Genetic factors explained 75% of the variance in girls and 50% in boys. Shared environmental influences were only of importance in boys. For both problem scales, non-shared environmental factors accounted for 25 to 32% of the variance. The observed variances of Internalising Problems could be adequately explained by genetic and nonshared environmental factors, with genetic factors accounting for 68% of the variance.
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Wolff NJ, Darlington ASE, Hunfeld JAM, Jaddoe VWV, Hofman A, Raat H, Verhulst FC, Passchier J, Tiemeier H. Concurrent and Longitudinal Bidirectional Relationships Between Toddlers' Chronic Pain and Mental Health: The Generation R Study. J Pediatr Psychol 2012; 37:546-56. [DOI: 10.1093/jpepsy/jsr122] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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van Oort FVA, Ormel J, Verhulst FC. [Symptoms of anxiety in adolescents. Findings from the TRAILS-study]. Tijdschr Psychiatr 2012; 54:463-469. [PMID: 22588961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND The Dutch TRAILS-study focuses on development from early adolescence into adulthood. An important aspect of this development is the development of anxiety. Hitherto little has been known about typical development of symptoms of anxiety during adolescence. AIM To describe both the normative development of anxiety during adolescence, and the risk indicators for high levels of anxiety in adolescents. METHOD Studies were embedded in trails, a large cohort study that followed children from the age of 10 to adulthood. RESULTS Our results showed that, on average, levels of anxiety decrease in early adolescence and subsequently increase in middle or late adolescence, depending on the subtype of anxiety involved. Child-, parent- and peer-factors at age 10-12 years were related to higher subsequent anxiety levels. Some factors, such as the style of upbringing, were related to higher anxiety levels solely in early adolescence, whereas other factors such as being bullied by peers were related to continuing higher anxiety levels throughout adolescence, irrespective of later victimisation. CONCLUSION Our study should, we hope, lead to a better understanding of the normative development of anxiety in the general adolescent population.
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Wigman JTW, van Winkel R, Raaijmakers QAW, Ormel J, Verhulst FC, Reijneveld SA, van Os J, Vollebergh WAM. Evidence for a persistent, environment-dependent and deteriorating subtype of subclinical psychotic experiences: a 6-year longitudinal general population study. Psychol Med 2011; 41:2317-2329. [PMID: 21477418 DOI: 10.1017/s0033291711000304] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Research suggests that subclinical psychotic experiences during adolescence represent the behavioral expression of liability for psychosis. Little is known, however, about the longitudinal trajectory of liability in general population samples. METHOD Growth mixture modeling was used to examine longitudinal trajectories of self-reported positive psychotic experiences in the Youth Self Report (YSR), completed three times over a period of 6 years by a general population cohort of adolescents aged 10-11 years at baseline (n=2230). RESULTS Four groups with distinct developmental trajectories of low, decreasing, increasing and persistent levels of mild positive psychotic experiences were revealed. The persistent trajectory was associated strongly with cannabis use, childhood trauma, developmental problems and ethnic minority status, and consistently displayed strong associations with factors known to predict transition from subclinical psychotic experience to clinical psychotic disorder (severity of and secondary distress due to psychotic experiences, social and attentional problems and affective dysregulation) and also with high levels of parental-reported psychotic experiences and use of mental health care at the end of the follow-up period. Progressively weaker associations were found for the increasing, decreasing and low trajectories respectively. CONCLUSIONS The results suggest that the outcome of early developmental deviation associated with later expression of psychotic experiences is contingent on the degree of later interaction with environmental risks inducing, first, persistence of psychotic experiences and, second, progression to onset of need for care and service use. Insight into the longitudinal dynamics of risk states in representative samples may contribute to the development of targeted early intervention in psychosis.
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Affiliation(s)
- J T W Wigman
- Department of Interdisciplinary Social Science, University of Utrecht, The Netherlands.
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van Oort FVA, Greaves-Lord K, Ormel J, Verhulst FC, Huizink AC. Risk indicators of anxiety throughout adolescence: the TRAILS study. Depress Anxiety 2011; 28:485-94. [PMID: 21509913 DOI: 10.1002/da.20818] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2010] [Revised: 03/14/2011] [Accepted: 03/15/2011] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The aim was to identify risk indicators from preadolescence (age period 10-12) that significantly predict unfavorable deviations from normal anxiety development throughout adolescence (age period 10-17 years). METHODS Anxiety symptoms were assessed in a community sample of 2,220 boys and girls at three time-points across a 5-year interval. Risk indicators were measured at baseline and include indicators from the child, family, and peer domain. Associations with anxiety were measured with multilevel growth curve analyses. RESULTS A stable difference in anxiety over adolescence was found between high and low levels of a range of child factors (frustration, effortful control), family factors (emotional warmth received from parents, lifetime parental internalizing problems), and peer factor (victims of bullying) (P <.001). In contrast, the difference in anxiety between high and low levels of factors, such as self-competence, unfavorable parenting styles, and bully victims, decreased over adolescence (P <.001). For other family factors, associations were weaker (.05 <P <.001). Associations with parental education and family composition were not significant. Adjustment for concurrent depressive symptoms attenuated the associations, but those that were significant at P <.001 remained to be so. Specificity for anxiety subtypes (generalized anxiety, separation anxiety, social phobia, panic, and obsessive-compulsive symptoms) was reported for each association. CONCLUSIONS Several child, family, and peer factors measured in preadolescence were risk indicators of high levels of anxiety symptoms throughout adolescence. Some factors (such as rejective parenting) were vulnerability indicators for anxiety in early adolescence only, whereas other factors (such as peer victimization) were indicators of long-term elevated anxiety levels.
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Affiliation(s)
- F V A van Oort
- Erasmus University Medical Centre Rotterdam/Sophia Children's Hospital, Department of Child and Adolescent Psychiatry, Rotterdam, The Netherlands.
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Polderman TJC, Bartels M, Verhulst FC, Huizink AC, van Beijsterveldt CEM, Boomsma DI. No effect of classroom sharing on educational achievement in twins: a prospective, longitudinal cohort study. J Epidemiol Community Health 2011; 64:36-40. [PMID: 20007633 DOI: 10.1136/jech.2009.091629] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND A returning dilemma for families with multiple births is whether twins should share the same, or a parallel classroom, or in other words, whether they should be separated at school or not. This study investigated the effects of sharing a classroom during primary school on cognitive achievement in twins. METHOD Subjects were 839 monozygotic and 1164 dizygotic twin pairs who were registered at birth at The Netherlands Twin Register. A prospective, longitudinal study design was used with educational achievement at age 12 years, measured with a standardised test (CITO test), as outcome measure. RESULTS Most twin pairs (72%) shared a classroom during their schooling, 19% were in separate, but parallel, classes, and 9% "partly" shared a classroom. Twins who were in parallel classrooms had higher CITO scores (mean 539.51; SD 8.12), compared to twins who shared a classroom (537.99; SD 8.52). When controlling for socioeconomic status, and externalising problems before starting primary school (age 3), there was no significant difference in educational achievement between separated and non-separated twin pairs (p = 0.138). In addition, there was no interaction with sex or zygosity of the twins (p = 0.798). CONCLUSION There is no difference in educational achievement between twins who share a classroom and twins who do not share a classroom during their primary school time. The choice of separation should be made by teachers, parents and their twin children, based on individual characteristics of a twin pair.
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Affiliation(s)
- T J C Polderman
- Department of Biological Psychology, VU University Amsterdam, Van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands.
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Geelhoed JJM, El Marroun H, Verburg BO, van Osch-Gevers L, Hofman A, Huizink AC, Moll HA, Verhulst FC, Helbing WA, Steegers EAP, Jaddoe VWV. Maternal smoking during pregnancy, fetal arterial resistance adaptations and cardiovascular function in childhood. BJOG 2011; 118:755-62. [PMID: 21385303 DOI: 10.1111/j.1471-0528.2011.02900.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To unravel the mechanisms underlying the previously demonstrated associations between low birthweight and cardiovascular disease in adulthood, we examined whether maternal smoking during pregnancy leads to fetal arterial resistance adaptations, and subsequently to fetal growth retardation and changes in postnatal blood pressure and cardiac development. DESIGN Prospective cohort study from early fetal life onwards. SETTING Academic hospital. POPULATION Analyses were based on 1120 children aged 2 years. METHODS Maternal smoking during pregnancy [non-smoking, first trimester smoking, continued smoking (< 5 and ≥ 5 cigarettes/day)] was assessed by questionnaire. MAIN OUTCOME MEASURES Third trimester placental and fetal arterial resistance indices and fetal growth were assessed by ultrasound and Doppler measurements. Postnatal blood pressure and cardiac structures (aortic root diameter, left atrial diameter, left ventricular mass) were measured at 2 years of age. RESULTS First trimester smoking was not associated with third trimester placental and fetal blood flow adaptations. Continued smoking of ≥ 5 cigarettes/day was associated with an increased resistance in uterine, umbilical and middle cerebral arteries, and with a decreased flow and diameter of the ascending aorta. Among mothers who continued to smoke, the third trimester estimated fetal weights and birthweights were most affected in children with the highest umbilical artery resistance. Fetal arterial resistance indices were also associated with aortic root diameter and left atrial diameter. CONCLUSIONS Fetal arterial resistance adaptations may be involved in the pathways leading from maternal smoking during pregnancy to low birthweight and cardiovascular developmental changes in childhood in the offspring.
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Affiliation(s)
- J J M Geelhoed
- The Generation R Study Group Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands.
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El Marroun H, Tiemeier H, Jaddoe VWV, Hofman A, Verhulst FC, van den Brink W, Huizink AC. Agreement between maternal cannabis use during pregnancy according to self-report and urinalysis in a population-based cohort: the Generation R Study. Eur Addict Res 2011; 17:37-43. [PMID: 20975275 DOI: 10.1159/000320550] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
AIM To verify self-reported information on prenatal drug use in urine because reporting in pregnancy is sensitive to stigma and might lead to misclassification. METHODS Using semiquantitative immunochemical analysis, the presence of the urinary metabolite (11-nor-Δ9-tetrahydrocannabinol- 9-carboxylic acid) was compared to self-reported prenatal cannabis use. Sensitivity and specificity for self-report and urinalysis outcomes were calculated and Yule's Y was used as an agreement measure. RESULTS Urine samples were available for 3,997 pregnant women. Of these women, 92 reported having used cannabis during pregnancy (2.3%) and 71 had positive urine screens (1.8%). In total 35% of the 92 women with self-reported cannabis use also had a positive urine screen. Positive urines were relatively frequent in women reporting cannabis use before pregnancy only (7.6%) and in women with missing information (2.6%). Sensitivity and specificity of urinalysis compared to self-report were 0.46 and 0.98. Sensitivity and specificity of self-report compared to urinalysis were 0.36 and 0.99. Yule's Y amounted to 0.77, indicating substantial agreement between the measures. CONCLUSIONS Our findings illustrate the difficulties in obtaining valid information on prenatal cannabis use. To improve the quality of cannabis use data, we suggest a 2-step approach starting with self-report.
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Affiliation(s)
- H El Marroun
- The Generation R Study Group, Erasmus Medical Centre Rotterdam, Rotterdam, The Netherlands.
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Vermunt LCAC, Buysse CMP, Aarsen FK, Catsman-Berrevoets CE, Duivenvoorden HJ, Joosten KFM, Hazelzet JA, Verhulst FC, Utens EMWJ. Long-term cognitive functioning in children and adolescents who survived septic shock caused by Neisseria meningitidis. British Journal of Clinical Psychology 2010; 48:195-208. [DOI: 10.1348/014466508x391094] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Vermunt LCAC, Buysse CMP, Joosten KFM, Hazelzet JA, Verhulst FC, Utens EMWJ. Behavioural, emotional, and post-traumatic stress problems in children and adolescents, long term after septic shock caused by Neisseria meningitidis. British Journal of Clinical Psychology 2010; 47:251-63. [DOI: 10.1348/014466507x258868] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Spijkerboer AW, Utens EMWJ, Bogers AJJC, Verhulst FC, Helbing WA. Long-term intellectual functioning and school-related behavioural outcomes in children and adolescents after invasive treatment for congenital heart disease. British Journal of Developmental Psychology 2010. [DOI: 10.1348/026151007x253323] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Blom EA, Jansen PW, Verhulst FC, Hofman A, Raat H, Jaddoe VWV, Coolman M, Steegers EAP, Tiemeier H. Perinatal complications increase the risk of postpartum depression. The Generation R Study. BJOG 2010; 117:1390-8. [PMID: 20682022 DOI: 10.1111/j.1471-0528.2010.02660.x] [Citation(s) in RCA: 142] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To examine whether specific pregnancy and delivery complications are risk factors for postpartum depression. DESIGN A prospective longitudinal study. SETTING Rotterdam, the Netherlands. POPULATION A cohort of 4941 pregnant women who enrolled in the Generation R Study. METHODS Information on perinatal complications was obtained from the midwife and hospital registries or by questionnaire. Logistic regression analyses were used to calculate the risk of postpartum depression for the separate perinatal complications. MAIN OUTCOME MEASURES Postpartum psychiatric symptoms were assessed 2 months after delivery using the Edinburgh postnatal depression scale. RESULTS Several perinatal complications were significantly associated with postpartum depression, namely: pre-eclampsia (adjusted OR, aOR 2.58, 95% CI 1.30-5.14), hospitalization during pregnancy (aOR 2.25, 95% CI 1.19-4.26), emergency caesarean section (aOR 1.53, 95% CI 1.02-2.31), suspicion of fetal distress (aOR 1.56, 95% CI 1.08-2.27), a medically indicated delivery provided by an obstetrician (aOR 2.43, 95% CI 1.56-3.78), and hospital admission of the baby (aOR 1.45, 95% CI 1.10-1.92). Unplanned pregnancy, thrombosis, meconium-stained amniotic fluid, and Apgar score were not associated with postpartum depression after adjustment for confounding factors, such as pre-existing psychopathological symptoms and sociodemographic characteristics. The risk of postpartum depression increased with the number of perinatal complications women experienced (P < 0.001). CONCLUSIONS We showed that several pregnancy and delivery complications present a risk for women's mental health in the postpartum period. Obstetricians, midwives, general practitioners, and staff at baby well clinics should be aware that women who experienced perinatal complications-especially those with a number of perinatal complications-are at risk for developing postpartum depression.
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Affiliation(s)
- E A Blom
- Division of Obstetrics and Perinatal Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
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Abstract
OBJECTIVE Our aim was to provide an overview of prospective studies that have addressed the association between attention problems (AP, i.e. symptoms of hyperactivity and inattentiveness) and academic achievement (AA). METHOD We conducted a systematic search in the literature. Normal population studies and clinical studies were included. The methodological quality of each study was evaluated by objective criteria. A best evidence synthesis was used to determine the strengths of the association. RESULTS Sixteen studies were included. We found convincing evidence for a negative association between AP and AA. After controlling for intelligence, comorbidity, and socioeconomic status (SES), the association between the hyperactive symptoms of AP and AA was non-significant in two studies. CONCLUSION Children with AP are at risk for lower AA and subsequent adverse outcomes later in life. Interventions in affected children should focus on their behavioural and educational development.
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Affiliation(s)
- Tinca J C Polderman
- Department of Biological Psychology, VU University Amsterdam, Amsterdam, the Netherlands.
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Henrichs J, Schenk JJ, Roza SJ, van den Berg MP, Schmidt HG, Steegers EAP, Hofman A, Jaddoe VWV, Verhulst FC, Tiemeier H. Maternal psychological distress and fetal growth trajectories: the Generation R Study. Psychol Med 2010; 40:633-643. [PMID: 19656431 DOI: 10.1017/s0033291709990894] [Citation(s) in RCA: 117] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Previous research suggests, though not consistently, that maternal psychological distress during pregnancy leads to adverse birth outcomes. We investigated whether maternal psychological distress affects fetal growth during the period of mid-pregnancy until birth. METHOD Pregnant women (n=6313) reported levels of psychological distress using the Brief Symptom Inventory (anxious and depressive symptoms) and the Family Assessment Device (family stress) at 20.6 weeks pregnancy and had fetal ultrasound measurements in mid- and late pregnancy. Estimated fetal weight was calculated using head circumference, abdominal circumference and femur length. RESULTS In mid-pregnancy, maternal distress was not linked to fetal size. In late pregnancy, however, anxious symptoms were related to fetal size after controlling for potential confounders. Anxious symptoms were also associated with a 37.73 g [95% confidence interval (CI) -69.22 to -6.25, p=0.019] lower birth weight. When we related maternal distress to fetal growth curves using multilevel models, more consistent results emerged. Maternal symptoms of anxiety or depression were associated with impaired fetal weight gain and impaired fetal head and abdominal growth. For example, depressive symptoms reduced fetal weight gain by 2.86 g (95% CI -4.48 to -1.23, p<0.001) per week. CONCLUSIONS The study suggests that, starting in mid-pregnancy, fetal growth can be affected by different aspects of maternal distress. In particular, children of prenatally anxious mothers seem to display impaired fetal growth patterns during pregnancy. Future work should address the biological mechanisms underlying the association of maternal distress with fetal development and focus on the effects of reducing psychological distress in pregnancy.
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Affiliation(s)
- J Henrichs
- Institute of Psychology, Erasmus University Rotterdam, The Netherlands
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41
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Abstract
BACKGROUND Little is known about the development of anxiety symptoms from late childhood to late adolescence. The present study determined developmental trajectories of symptoms of separation anxiety disorder (SAD), social phobia (SoPh), generalized anxiety disorder (GAD), panic disorder (PD), and obsessive-compulsive disorder (OCD) in a large prospective community cohort. METHODS Anxiety symptoms were assessed in a community sample of 2220 boys and girls at three time-points across a 5-year interval. The Revised Child Anxiety and Depression Scale (RCADS) was used to assess anxiety symptoms, and multilevel growth-curve analyses were performed. RESULTS All subtypes of anxiety first showed a decrease in symptoms (beta for age ranged from -.05 to -.13, p < .0001), followed by a leveling off of the decrease, and a subsequent slight increase in symptoms (beta for age-squared ranged from .006 to .01, p < .0001) from middle adolescence (GAD, SoPh, SAD) or late adolescence (PD and OCD) onwards. This increase in anxiety symptoms could not be explained by a co-occurring increase in depression symptoms. Girls had more anxiety symptoms than boys, and this difference remained stable during adolescence (p < .0001). Gender differences were strongly attenuated by adjustment for symptoms of depression. CONCLUSIONS The current study shows that, in the general population, anxiety symptoms first decrease during early adolescence, and subsequently increase from middle to late adolescence. These findings extend our knowledge on the developmental course of anxiety symptoms during adolescence. This is the first study to separate the development of anxiety symptoms from that of symptoms of depression.
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Affiliation(s)
- F V A Van Oort
- Department of Child and Adolescent Psychiatry, Erasmus Medical Center, 3000 CB Rotterdam, The Netherlands.
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42
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van de Looij-Jansen PM, de Wilde EJ, Mieloo CL, Donker MCH, Verhulst FC. Seasonal variation in self-reported health and health-related behaviour in Dutch adolescents. Public Health 2009; 123:686-8. [PMID: 19783266 DOI: 10.1016/j.puhe.2009.07.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2008] [Revised: 05/30/2009] [Accepted: 07/30/2009] [Indexed: 11/25/2022]
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Greaves-Lord K, Huizink AC, Oldehinkel AJ, Ormel J, Verhulst FC, Ferdinand RF. Baseline cortisol measures and developmental pathways of anxiety in early adolescence. Acta Psychiatr Scand 2009; 120:178-86. [PMID: 19485962 DOI: 10.1111/j.1600-0447.2009.01402.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE This study investigated whether baseline cortisol measures predicted future anxiety, and compared cortisol values of groups with different developmental pathways of anxiety. METHOD Cortisol levels were assessed in 1768 individuals (10-12 years). Anxiety levels were assessed at the same age and 2 years later. RESULTS Cortisol measures did not predict future anxiety levels. Individuals with persistent anxiety problems did not show higher morning cortisol levels than those with persistently low, decreasing, or increasing anxiety levels. Instead, individuals with persistently high anxiety levels showed significantly lower evening cortisol levels than all other individuals. Further, participants with increasing anxiety levels showed higher morning cortisol levels (area under the curve; AUC) than individuals with persistently low anxiety levels. CONCLUSION The extent to which the HPA-axis - by itself - plays a role in the aetiology of anxiety is questionable. Interactions of the HPA-axis with other biological or environmental factors may be more important.
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Affiliation(s)
- K Greaves-Lord
- Department of Child and Adolescent Psychiatry, Erasmus Medical Center Rotterdam/Sophia Children's Hospital, 3015 GJ Rotterdam, the Netherlands.
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Jansen PW, Tiemeier H, Jaddoe VWV, Hofman A, Steegers EAP, Verhulst FC, Mackenbach JP, Raat H. Explaining educational inequalities in preterm birth: the generation r study. Arch Dis Child Fetal Neonatal Ed 2009; 94:F28-34. [PMID: 18562446 DOI: 10.1136/adc.2007.136945] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Although a low socioeconomic status has consistently been associated with an increased risk of preterm birth, little is known about the pathways through which socioeconomic disadvantage influences preterm birth. AIM To examine mechanisms that might underlie the association between the educational level of pregnant women as an indicator of socioeconomic status, and preterm birth. METHODS The study was nested in a population-based cohort study in the Netherlands. Information was available for 3830 pregnant women of Dutch origin. FINDINGS The lowest-educated pregnant women had a statistically significant higher risk of preterm birth (odds ratio (OR) = 1.89 (95% CI 1.28 to 2.80)) than the highest educated women. This increased OR was reduced by up to 22% after separate adjustment for age, height, preeclampsia, intrauterine growth restriction, financial concerns, long-lasting difficulties, psychopathology, smoking habits, alcohol consumption, and body mass index (BMI) of the pregnant women. Joint adjustment for these variables resulted in a reduction of 89% of the increased risk of preterm birth among low-educated pregnant women (fully adjusted OR = 1.10 (95% CI 0.66 to 1.84)). CONCLUSIONS Pregnant women with a low educational level have a nearly twofold higher risk of preterm birth than women with a high educational level. This elevated risk could largely be explained by pregnancy characteristics, indicators of psychosocial well-being, and lifestyle habits. Apparently, educational inequalities in preterm birth go together with an accumulation of multiple adverse circumstances among women with a low education. A number of explanatory mechanisms unravelled in the present study seem to be modifiable by intervention programmes.
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Affiliation(s)
- P W Jansen
- The Generation R Study Group, Erasmus MC-University Medical Center Rotterdam, Rotterdam, The Netherlands.
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45
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Greaves-Lord K, Verhulst FC, Oldehinkel AJ, Ormel J, Huizink AC. [Stress reactivity as an underlying mechanism of anxiety? Findings from the TRAILS study]. Tijdschr Psychiatr 2009; 51:401-406. [PMID: 19517370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
This short report provides an overview of the results of a recent Dutch study on the relation between anxiety and the reactivity of two important stress response systems: the autonomic nervous system and the hypothalamic-pituitary-adrenal axis. Future research will have to investigate the reactivity of both stress response systems in combination with several other important biological, psychological and social factors. In this way it should be possible to obtain more insight into the complex and interacting systems that underlie anxiety.
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46
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Vanheusden K, Mulder CL, van der Ende J, Selten JP, van Lenthe FJ, Verhulst FC, Mackenbach JP. Associations between ethnicity and self-reported hallucinations in a population sample of young adults in The Netherlands. Psychol Med 2008; 38:1095-1102. [PMID: 18070372 DOI: 10.1017/s0033291707002401] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Psychotic disorders are more common in people from ethnic minorities. If psychosis exists as a continuous phenotype, ethnic disparities in psychotic disorder will be accompanied by similar ethnic disparities in the rate of psychotic symptoms. This study examined ethnic disparities in self-reported hallucinations in a population sample of young adults. MethodA cross-sectional population survey (n=2258) was carried out in the south-west Netherlands. Seven ethnic groups were delineated: Dutch natives, Turks, Moroccans, Surinamese/Antilleans, Indonesians, other non-Western immigrants (mostly from Africa or Asia) and Western immigrants (mostly from Western Europe). Self-reported auditory and visual hallucinations were assessed with the Adult Self-Report (ASR). Indicators of social adversity included social difficulties and a significant drop in financial resources. RESULTS Compared to Dutch natives, Turkish females [odds ratio (OR) 13.48, 95% confidence interval (CI) 5.97-30.42], Moroccan males (OR 8.36, 95% CI 3.29-21.22), Surinamese/Antilleans (OR 2.19, 95% CI 1.05-4.58), Indonesians (OR 4.15, 95% CI 1.69-10.19) and other non-Western immigrants (OR 3.57, 95% CI 1.62-7.85) were more likely to report hallucinations, whereas Western immigrants, Turkish males and Moroccan females did not differ from their Dutch counterparts. When adjusting for social adversity, the ORs for self-reported hallucinations among the non-Western immigrant groups showed considerable reductions of 28% to 52%. CONCLUSIONS In a general population sample, several non-Western immigrant groups reported hallucinations more often than Dutch natives, which is consistent with the higher incidence of psychotic disorders in most of these groups. The associations between ethnicity and hallucinations diminished after adjustment for social adversity, which supports the view that adverse social experiences contribute to the higher rate of psychosis among migrants.
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Affiliation(s)
- K Vanheusden
- Department of Child and Adolescent Psychiatry, Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands
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Abstract
BACKGROUND The long-term consequences of child and adolescent externalizing problems often involve a wide spectrum of social maladaptation in adult life. The purpose of this study was to describe the predictive link of child and adolescent externalizing developmental trajectories to social functioning in adulthood. METHOD Social functioning was predicted from developmental trajectories of parent-reported aggression, opposition, property violations and status violations that were defined in a longitudinal multiple birth cohort study of 2,076 males and females aged 4-18 years. Social functioning was assessed using self-reports by young adults aged 18-30 years. Linear and logistic regression analyses were used to describe the extent to which developmental trajectories are prospectively related to social functioning. RESULTS Children with high-level trajectories of opposition and status violations reported more impaired social functioning as young adults than children with high-level trajectories of aggression and property violations. Young adults who showed onset of problems in adolescence reported overall less impaired social functioning than individuals with high-level externalizing problems starting in childhood. Overall, males reported more impaired social functioning in adulthood than females. However, females with persistent high-level externalizing behaviour reported more impairment in relationships than males with persistent high-level externalizing behaviour. CONCLUSION The long-term consequences of high levels of opposition and status violations in childhood to serious social problems during adulthood are much stronger than for individuals who show only high levels of aggressive antisocial behaviours.
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Affiliation(s)
- I L Bongers
- Department of Child and Adolescent Psychiatry, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands
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48
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Legerstee JS, Huizink AC, van Gastel W, Liber JM, Treffers PDA, Verhulst FC, Utens EMWJ. Maternal anxiety predicts favourable treatment outcomes in anxiety-disordered adolescents. Acta Psychiatr Scand 2008; 117:289-98. [PMID: 18321354 DOI: 10.1111/j.1600-0447.2008.01161.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To determine the differential impact of maternal and paternal internalizing psychopathology on cognitive-behavioural treatment (CBT) outcome of anxiety-disordered children and adolescents. METHOD Participants consisted of 127 children and 51 adolescents with a primary anxiety diagnosis. Children were randomly assigned to a standardized group CBT or individual CBT; adolescents received individual CBT. Parents received four training sessions. Participants were evaluated at pre- and post-treatment with a clinical interview and with self- and parent-reported questionnaires. Lifetime anxiety and mood disorders in parents were obtained with a clinical interview. RESULTS For children, no associations were found between maternal and paternal anxiety or mood disorders and treatment outcome. For adolescents, however, maternal lifetime anxiety disorders were positively associated with pre-post-treatment improvement in clinician severity ratings and with treatment success. CONCLUSION Lifetime maternal anxiety disorders were significantly associated with favourable treatment outcomes in adolescents. Paternal disorders were not associated with treatment response.
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Affiliation(s)
- J S Legerstee
- Department of Child and Adolescent Psychiatry, Erasmus Medical Centre Rotterdam/Sophia Children's Hospital, Rotterdam, The Netherlands
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Spijkerboer AW, Utens EMWJ, Bogers AJJC, Verhulst FC, Helbing WA. Long-term behavioural and emotional problems in four cardiac diagnostic groups of children and adolescents after invasive treatment for congenital heart disease. Int J Cardiol 2008; 125:66-73. [PMID: 17433472 DOI: 10.1016/j.ijcard.2007.02.025] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2006] [Revised: 02/08/2007] [Accepted: 02/17/2007] [Indexed: 11/20/2022]
Abstract
AIMS To assess the occurrence of a wide range of behavioural and emotional problems long-term after invasive treatment for congenital heart disease (ConHD) in infancy and childhood. METHODS Parents of 125 ConHD children, aged 7-17, completed the Child Behavior Checklist and 85, 11-17-year-old, ConHD children completed the Youth Self-Report. RESULTS According to parents' reports of problem behaviours a significant proportion of ConHD children scored in the deviant range (16.9%) compared to the reference group (10.2%). The proportion of ConHD boys scoring in the deviant range according to parents (21.4%) was significantly greater than that in the reference sample (10%). Parents reported significantly higher problems scores for the scales Somatic Complaints, Social Problems, Attention Problems, Internalising and Total Problems compared to the reference group. In contrast, reports of patients were comparable to those of reference peers. No differences were found on the self-reports between problem scores for different cardiac diagnostic groups. Discrepancies between self- and parent-reports were found, indicating that more problems were reported by ConHD patients themselves than by their parents. CONCLUSION Overall, parents of ConHD patients reported higher levels of behavioural and emotional problems compared to the reference group whereas patients themselves reported no long-term behavioural impairment compared to same-sex reference peers. Assessing behavioural and emotional problems in ConHD patients can be helpful to detect children at risk for developing psychopathology. Especially younger male ConHD patients deserve special attention.
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Affiliation(s)
- A W Spijkerboer
- Department of Child and Adolescent Psychiatry, Erasmus Medical Centre, Rotterdam, The Netherlands
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50
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Abstract
OBJECTIVE Research into changes in the prevalence of children's psychiatric diagnoses has indicated an increase in recent decades. However, methodological problems may have influenced results. This study compared children's emotional and behavioral problem levels across three population samples from different time points across 20 years, assessed with identical methodologies. METHOD We compared Child Behavior Checklists and Teacher's Report Forms across three population samples of 6- to 16-year olds, assessed in 1983, 1993, and 2003. RESULTS We found evidence for small increases in the mean population levels of parent-reported problems, and in the percentages of children with serious problems. These changes concerned mostly internalizing problems. Teacher reports showed less changes. Decreases in scores were found on several areas of competence. Changes were the strongest between 1993 and 2003. CONCLUSION We found evidence for small increases in Dutch children's problems. Further developments must be monitored, as this trend may continue and have serious societal consequences.
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Affiliation(s)
- N T Tick
- Department of Child and Adolescent Psychiatry, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands
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