A comparison of health-related quality of life between children with versus without special health care needs, and children requiring versus not requiring psychiatric services

Purpose: The purpose of the present study was to compare health-related quality of life (HRQoL) between children with special health care needs (CSHCN) and those without. In particular, CSHCN who require psychiatric services and those who do not were compared. Methods: A representative community sample of 3,325 children (10-14years old) was recruited from the Canton of Zurich. Via either computer-assisted telephone interviews or a written questionnaire, special health care needs were assessed using the five-item parent-reported CSHCN Screener. Subsequent to screening, a written questionnaire was sent to a sub-sample of 974 children to acquire more detailed information, both from the children and their parents, about their health and health care utilization, and to assess HRQoL (KIDSCREEN-27) and emotional and behavioral problems (SDQ). A total of 626 children responded to the questionnaire. Multiple linear regression models were used to examine the association between HRQoL and subject group, controlling for other covariates. Results: Among 2,586 children whose parents participated in the screening stage, roughly 18% were identified as CSHCN, with 6.2% requiring psychiatric services. The subsequent survey revealed that those CSHCN who required psychiatric services had the lowest HRQoL scores and highest SDQ scores. CSHCN who utilized psychiatric services were particularly prone to low HRQoL, especially among lower income families. Conclusions: The influence of noticeable emotional and behavioral problems on HRQoL should be afforded more attention, both in clinical practice and empirical studies involving children with special health care need

Assessing parent-child agreement in health-related quality of life among three health status groups

Purpose: To examine parent-child agreement regarding a child's health-related quality of life (HRQOL) among three health status groups. Methods: Parent-child agreement was evaluated for three health status groups of a population-based sample: (1) children with mental health problems (N=461), (2) children with physical health problems (N=281), and (3) healthy controls (N=699). The KIDSCREEN-27 was used to assess HRQOL. The children were 9-14years of age. Results: Intraclass correlation coefficients were mostly good across all HRQOL scores and health status groups. This relatively high level of agreement was also reflected by the following findings: first, the AGREE group was the largest in three out of five HRQOL subscales in all health status groups; second, when disagreement occurred, it was often minor in magnitude. Despite this relatively high level of agreement, the means of self-ratings were significantly higher for all HRQOL scores and health status groups than the means of proxy ratings. These higher self-ratings were especially pronounced among children with mental health problems in certain HRQOL domains. Conclusions: Even though the level of parent-child agreement regarding a child's HRQOL is relatively high, it should be considered that children (especially those with mental health problems) often report better HRQOL than their parents. It is, therefore, highly recommended that both proxy- and self-ratings are used to evaluate a child's HRQOL comprehensivel

Health-related quality of life among children with mental disorders: a systematic review

Purpose: To systematically review studies about the quality of life (QOL) of children with various mental disorders relative to healthy controls and to describe limitations in these studies. Methods: Relevant articles were searched using different databases, by checking reference lists and contacting experts. We included articles that either compared children with mental disorders to healthy controls/norm values or made such a comparison possible. Results: Sixteen out of 4,560 articles met the pre-defined inclusion criteria. These studies revealed that the QOL of children with various mental disorders is compromised across multiple domains. The largest effect sizes were found for psychosocial and family-related domains and for the total QOL score, whereas physical domains generally were less affected. The most important limitations in the existing literature include the lack of study samples drawn from the general population, the failure to use self-ratings, not considering item overlap between measuring QOL and assessing for the presence of a particular mental disorder, and not determining whether the children were receiving medication for their mental disorder. Conclusions: Children with mental disorders experience a considerable reduction in QOL across various domains. Research studies that avoid previous limitations are crucial to fill existing knowledge gap

The Swiss Youth Mental Health Literacy and Stigma Survey: Study methodology, survey questions/vignettes, and lessons learned

Background and objectives Mental health literacy and stigma towards mentally ill people have hitherto mainly been studied in relation to depression and schizophrenia and in adult samples. The Swiss Youth Mental Health Literacy and Stigma Survey (SYMHLSS) was planned and carried out to address these gaps. The aims of this article are to (1) outline and reflect on the methodology of the SYMHLSS in order to build a sound methodological foundation for preparing and conducting similar future surveys; and (2) advance school-based survey methods more generally. Methods The Australian National Survey of Youth Mental Health Literacy and Stigma (telephone survey) served as basis for the Swiss survey. As in the Australian survey, vignettes describing a person with a mental disorder were the core element to which most subsequent survey questions referred. Five vignettes were used in the online-based Swiss survey that used a representative school-based sample of roughly 5000 students: (1) depression; (2) alcohol abuse; (3) depression and alcohol abuse combined; (4) schizophrenia, and (5) social anxiety disorder. Results and conclusions The current paper describes (1) the aims and research questions of the SYMHLSS against the backdrop of some essential research gaps in the field; (2) the rationale for selecting the particular vignettes mentioned above; (3) the adaption and development process of the SYMHLSS (including pilot testing); (4) the reasoning for using a school-based online survey with in situ guidance of research staff; (5) and methodological insights gained during data collection. The provided information might be used as guiding references for other researchers who aim to adapt and develop vignette-based surveys in the field of mental health literacy or stigmatizing attitudes or who are planning a school-based online survey with in situ presence of research staff

Teachers’ Experiences with and Helping Behaviour Towards Students with Mental Health Problems

The aim of the current study was to examine secondary school teachers’ experiences with and helping behaviour towards students with mental health problems. Data from 176 teachers were analysed. Altogether, 91.5% of participating teachers reported that they already had students with a mental health problem (particularly mood disorders) in their classes. About ¾ of teachers (74.7%) were also willing to help a student with a mental health problem, particularly by listening attentively or by recommending professional help. The self-rated mental health literacy of teachers was significantly and positively associated with help provision and with the assessment that ‘asking students about suicidal thoughts’ is helpful. In contrast, the perception of not having the necessary experience/training to help or that other people are better suited to help were seen as barriers to providing help. Based on the results, it is concluded that increasing teachers’ mental health literacy and the confidence in their ability to help (including asking students about suicidal thoughts) might increase their helping behaviour directed towards students with mental health problems

Beverage preferences and associated drinking patterns, consequences and other substance use behaviours

Background: Studies about beverage preferences in a country in which wine drinking is relatively widespread (like Switzerland) are scarce. Therefore, the main aims of the present study were to examine the associations between beverage preferences and drinking patterns, alcohol-related consequences and the use of other substances among Swiss young men. Methods: The analytical sample consisted of 5399 Swiss men who participated in the Cohort Study on Substance Use Risk Factors (C-SURF) and had been drinking alcohol over the preceding 12 months. Logistic regression analyses were conducted to study the associations between preference for a particular beverage and (i) drinking patterns, (ii) negative alcohol-related consequences and (iii) the (at-risk) use of cigarettes, cannabis and other illicit drugs. Results: Preference for beer was associated with risky drinking patterns and, comparable with a preference for strong alcohol, with the use of illicit substances (cannabis and other illicit drugs). In contrast, a preference for wine was associated with low-risk alcohol consumption and a reduced likelihood of experiencing at least four negative alcohol-related consequences or of daily cigarette smoking. Furthermore, the likelihood of negative outcomes (alcohol-related consequences; use of other substances) increased among people with risky drinking behaviours, independent of beverage preference. Conclusions: In our survey, beer preference was associated with risky drinking patterns and illicit drug use. Alcohol polices to prevent large quantities of alcohol consumption, especially of cheaper spirits like beer, should be considered to reduce total alcohol consumption and the negative consequences associated with these beverage type