Childhood predictors of later psychiatric hospital treatment: findings from the Finnish 1981 birth cohort study

Psychiatric hospital treatment (PHT) is expensive and indicates a severe disorder. Investigation of the early identification of this small patient group has though been hindered by small samples or unsatisfactory assessment in childhood. The present study aims to study the predictive association between psychopathology at age 8 using multi-informant assessment and later PHT. A nationwide birth cohort of Finnish children (n = 5,346) was assessed at age 8 to obtain information about psychopathology using the Rutter parent and teacher reports and self-reports of depressive symptoms. The main outcome was admission to any hospital with a primary diagnosis of any psychiatric disorder according to the Finnish National Hospital Discharge Register between age 13 and 24. Between age 13 and 24, 6.2% of the males and 4.1% of the females had been admitted for PHT. Among males, PHT was independently predicted by non-intact family and adult reports of conduct and of emotional symptoms, while among females by self-reported depressive symptoms. However, the combination of conduct and emotional problems was the strongest predictor for PHT in both sexes. Admission due to psychosis among males was associated with childhood conduct, attention, and emotional problems, but with emotional problems among females. Psychopathology at age 8 can be seen as a long-lasting increased risk of severe psychiatric disorders requiring hospital treatment in adolescence or early adulthood. Attention should be paid to self-reports among females and of comorbid conduct and emotional problems in both sexes in the early identification of this patient group

Psykoterapeuttikoulutusten järjestämisvelvollisuus puuttuu

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Psychosocial functioning and psychiatric comorbidity among substance-abusing Icelandic adolescents

To access publisher full text version of this article. Please click on the hyperlink in Additional Links fieldOur objectives were to compare behaviour problem scores (BPS) for Icelandic adolescents admitted for detoxification treatment for alcohol and narcotic abuse as compared with the general population, in accordance with the Youth Self Report (YSR), and to describe psychosocial functioning and psychiatric comorbidity for the treated adolescents. The case series consisted of 103 adolescents, ages 12-18 years, who completed the YSR at the end of a 10-day stay at the National Hospital of Addiction Medicine. The total BPS tallied from the YSR items was compared with scores for the general population. The psychiatric comorbidity and psychosocial functioning of the case series were assessed through diagnostic interviews in accordance with DSM-IV and ICD-10 criteria. The BPS for the 36 treated girls was significantly higher than for the general population (104 versus 36) and higher than for the 56 treated boys (82 versus 56) with 2 standard deviations above the norm for the population. Three-quarters of the adolescents had psychiatric comorbidity: conduct disorder (44%), depression (28%), or posttraumatic stress disorder (11%). The findings support the discriminative validity of the YSR as part of a structured global assessment of substance-abusing adolescents, in particular to identify the frequently present psychiatric comorbidities

Parents' psychological well-being and parental self-efficacy in relation to the family's triadic interaction.

The aim of the study was to assess whether a parent's psychological well-being and/or self-efficacy relate to interaction within the family. This study is part of a Finnish follow-up study called Steps to the Healthy Development and Well-Being of Children (STEPS;). The study group included 120 families. Mother's and father's social anxiety and depression were assessed during pregnancy and at 18 months of the child's age using self-report questionnaires; the mother's and father's self-efficacy were assessed at 18 months using a parental self-efficacy scale validated within the STEPS study. Mother-father-child triadic interaction was studied at 18 months within a Lausanne Triadic Play setting. Results showed that maternal symptoms of depression during pregnancy and maternal social anxiety at 18 months were related to triadic interaction within the family. There was no relation between father's psychological well-being and triadic interaction within the family. Father's self-efficacy in teaching tasks and the Mother's self-efficacy in emotional support were associated with family interaction. The findings suggest that maternal psychological well-being and self-efficacy in emotional support may be important components of family triadic interaction whereas paternal self-efficacy in teaching tasks seems to support family coordination in triadic interaction