ADHD with co-occurring depression/anxiety in children: the relationship with somatic complaints and socio-economic position

The need for continued research of the development of child mental health problems is considerable, as child mental health often precedes the development of mental disorders later in life. Attention-Deficit/Hyperactivity Disorder (ADHD) is the most frequently diagnosed and impairing neurobehavioral disorder in children. The consequences of ADHD are more detrimental in lower socio-economic levels, and the diagnosis is often co-current comorbid with other mental disorders. The aim of the present study was to indentify the prevalence of ADHD with or without co-occurring depression/anxiety, and examine whether ADHD can be associated with somatic complaints. We also wanted to examine whether a low parental Socio-Economic Position (SEP) was related to ADHD alone, or when co-occurring with depression/anxiety. Data for this study is collected from the Akershus health profile, a survey conducted in 2002. ADHD and depression/anxiety were measured with the Strengths and Difficulties Questionnaire filled in by the children’s parents. Somatic complaints was measured by frequency of the child reporting headache, abdominal pain and neck pain, and SEP was measured by the household income and education level of the parents. Analyses showed that somatic complaints in children with ADHD, may be a symptom of co-current comorbidity of depression or anxiety. We also found an inverse relationship between low parental SEP and prevalence of both ADHD and depression/anxiety in children. The results from the present study may improve strategies to detect ADHD, with or without depression/anxiety, at an early stage and thus possibly intervene in a more appropriate way. Behovet for forskning innen psykiske helseproblemer hos barn er betydelig. Den psykiske helsetilstanden hos barn, legger i stor grad grunnlaget for utviklingen av psykiske lidelser senere i livet. Attention-Deficit/Hyperactivity Disorder (ADHD), er den hyppigste diagnostiserte atferdslidelsen hos barn. Konsekvensene av å ha ADHD, og prevalensen, viser seg å være større i for de i lav sosioøkonomisk posisjon, og lidelsen er ofte komorbid med andre psykiske lidelser. Målet med denne studien var å identifisere prevalensen av ADHD med eller uten sammenfallende depresjon/angst, og se om ADHD kan være assosiert med somatiske plager. Vi ønsket også å se om lav sosioøkonomisk posisjon hos barnets foreldre var assosiert med ADHD alene, eller i en komorbid tilstand med depresjon/angst. Datamaterialet for denne studien er hentet fra helseprofil for barn og unge i Akershus, en kartleggingsstudie som ble gjennomført i 2002. ADHD og depresjon/angst ble målt ved hjelp av Strengths and Difficulties Questionnaire, som ble fylt ut av barnets foreldre. Somatiske plager ble målt ved hjelp av rapportert hyppighet av hodepine, magesmerter og nakkesmerter, og sosioøkonomisk posisjon ble målt ved hjelp av inntekt i husholdningen og utdanningsnivå til foreldrene. Analysene viste at somatiske plager hos barn med ADHD, kan være et symptom på komorbiditet med depresjon eller angst. Vi fant også en sammenheng mellom lav sosioøkonomisk posisjon hos foreldre og økt forekomst av ADHD og depresjon/angst hos barna. Disse resultatene kan bidra til å forbedre strategier, slik at det er mulig å tidligere oppdage ADHD, med eller uten depresjon/angst, hos barn og sette i gang tiltak for å fremme, forebygge og behandle mental helse hos barn på en mer hensiktsmessig måte

Formative research in the development of a salutogenic early intervention home visiting program integrated in public child health service in a multiethnic population in Norway

Background Few early intervention programs aimed at maternal and child health have been developed to be integrated in the existing Child Health Service in a country where the service is free, voluntary and used by the majority of the eligible population. This study presents the process and the critical steps in developing the “New Mothers” program. Methods Formative research uses a mixed method, allowing us to obtain data from multiple sources. A scoping review provided information on early intervention programs and studies, clarifying key elements when framing a new program. Key informant and focus group interviews offered insight of existing challenges, perceptions, identified power structures and offered reflections germane to the identified framework, securing user involvement at all stages. Monthly meetings with the project group enabled feedback loops for the data, securing program advancement. Results The “New Mothers” program was formed based on a salutogenic theory, emphasizing resistance and strengths. Public health nurses in the existing Child Health Service were to offer universally all first-time mothers and children home visits from gestational week 28 until the child reached 2 years, with motivational interviewing and empathic communication as methods to mentor the mothers, help them identify their strengths and resources, and provide support and information. Conclusions Using formative research as mixed method ensures incorporation of detailed information from multiple resources when an early intervention program is developed. This method secured program appropriateness, both culturally and at system level, when integrating new elements in the existing service

A controlled weight loss intervention study among women of Somali background in Norway

Background: Women of Somali background in Norway have a high prevalence of overweight and obesity, compared with women in the general Norwegian population. For lifestyle interventions to be applicable for immigrants to Norway, it is important to culturally tailor interventions in collaboration with relevant communities. The primary outcome was a difference in weight change between the intervention and control groups. Methods: In this interventional study, Somali women living in one borough of Oslo Municipality in Norway with body mass index (BMI) ≥27.0 kg.m-2 received a co-created, culturally tailored 12-month weight loss intervention consisting of 24 interactive sessions during the first three months, and monthly sessions for the next nine months, compared to a control group. Both groups were measured at baseline and 12 months. Results: A total of 169 participants were recruited, and 101 participants completed the follow-up. After multiple imputation, the mean difference in weight change adjusted for baseline weight, age, education, employment, marital status, number of children in the household and length of Norwegian residency was -1.6 kg (95 % CI -3.57, 0.43, p = 0.12) in the intervention compared to the control group. Conclusion: This culturally tailored intervention study demonstrated a modest non-significant effect on weight change after 12 months, possibly due to the short intervention duration and COVID-19. Further studies of a longer duration and considering the provision of childcare are needed to understand whether this approach can be transferred to other immigrant groups and genders.Trial registration: The study was registered at clinicaltrials.gov NCT04578067, 2020-09-29

Risk factors for non-communicable diseases among overweight and obese women of Somali background in Oslo, Norway

Background: Non-communicable diseases (NCDs) are the most common causes of morbidity and mortality globally. Somalis are a relatively new immigrant group in Norway and knowledge about their health status and risk factors for NCDs is limited. This study aimed to determine the prevalence of selected risk factors for NCDs among overweight and obese women of Somali background in Oslo, Norway. Methods: Baseline data of an exercise intervention study among women of Somali background (n = 168, recruited between September 2020 and September 2022). Body mass index (BMI) (kg/m2), waist-hip-ratio (WHR), blood pressure, glycated hemoglobin (HbA1c), non-fasting glucose, and blood lipids were measured. Results: Mean (SD) age was 46.8 years (10.4) and BMI was 33.9 kg/m2 (5.1). Mean total cholesterol (TC), low-density lipoprotein (LDL), HbA1c, non-fasting glucose, and blood pressure were within the normal range on average. Per one unit increase in BMI systolic blood pressure (SBP) increased by 0.89 mm/Hg (95%CI: 0.35−1.44, P = 0.002) and diastolic blood pressure (DBP) increased by 0.46 mm/Hg (95%CI: 0.17−0.75 P = 0.002). No relation between BMI and HbA1c, blood lipids, age, education level, number of children in the household, or length of residence in Norway was found. Conclusion: Despite the high BMI, most of the selected risk factors for NCDs had mean values within the normal range. The participants had a low prevalence of diabetes type 2 and hyperlipidemia, although there was a moderate association between BMI and blood pressure. This indicates that it is possible to be obese and be of relatively good health in this population. Trial registration: The study was registered at clinicaltrials.gov NCT04578067