scholarly journals Explaining ethnic variations in adolescent mental health: a secondary analysis of the Millennium Cohort Study

Author(s):  
Gargie Ahmad ◽  
Sally McManus ◽  
Laia Bécares ◽  
Stephani L. Hatch ◽  
Jayati Das-Munshi

Abstract Purpose The relationship between ethnicity and adolescent mental health was investigated using cross-sectional data from the nationally representative UK Millennium Cohort Study. Methods Parental Strengths and Difficulties Questionnaire reports identified mental health problems in 10,357 young people aged 14 (n = 2042 from ethnic minority backgrounds: Mixed n = 492, Indian n = 275, Pakistani n = 496, Bangladeshi n = 221, Black Caribbean n = 102, Black African n = 187, Other Ethnic Group n = 269). Univariable logistic regression models investigated associations between each factor and outcome; a bivariable model investigated whether household income explained differences by ethnicity, and a multivariable model additionally adjusted for factors of social support (self-assessed support, parental relationship), participation (socialising, organised activities, religious attendance), and adversity (bullying, victimisation, substance use). Results were stratified by sex as evidence of a sex/ethnicity interaction was found (P = 0.0002). Results There were lower unadjusted odds for mental health problems in boys from Black African (OR 0.15, 95% CI 0.04–0.61) and Indian backgrounds (OR 0.42, 95% CI 0.21–0.86) compared to White peers. After adjustment for income, odds were lower in boys from Black African (OR 0.10, 95% CI 0.02–0.38), Indian (OR 0.40, 95% CI 0.21–0.77), and Pakistani (OR 0.49, 95% CI 0.27–0.89) backgrounds, and girls from Bangladeshi (OR 0.18, 95% CI 0.05–0.65) and Pakistani (OR 0.63, 95% CI 0.41–0.99) backgrounds. After further adjustment for social support, participation, and adversity factors, only boys from a Black African background had lower odds (OR 0.16, 95% CI 0.03–0.71) of mental health problems. Conclusions Household income confounded lower prevalence of mental health problems in some young people from Pakistani and Bangladeshi backgrounds; findings suggest ethnic differences are partly but not fully accounted for by income, social support, participation, and adversity. Addressing income inequalities and socially focused interventions may protect against mental health problems irrespective of ethnicity.

2018 ◽  
Vol 41 (3) ◽  
pp. 456-461 ◽  
Author(s):  
Robert J Noonan

Abstract Background The study aims were to: (i) examine associations between deprivation at age 7 and health outcomes at age 7 and 14, (ii) determine whether a deprivation gradient to health outcomes exists at age 7 and 14, and (iii) assess the extent to which health outcomes at age 7 are associated with health outcomes at age 14. Methods Data were from wave four and six of the Millennium Cohort Study. Health outcome measures were weight status, and Strengths and Difficulties Questionnaire measured mental health problems. Deprivation was determined using the 2004 English Indices of Multiple Deprivation. Adjusted logistic and multinomial logistic regressions were conducted. Results A total of 6109 children (1890 girls) had complete data. Overweight, obesity and mental health problems were greatest among children in the highest deprivation decile at age 7 and 14 (P < 0.001). Health outcomes at age 7 were significantly associated with health outcomes at age 14 (P < 0.001). Conclusions A marked social gradient to weight status and mental health was evident at age 7 and 14, and no evidence of equalization was found. Weight status and mental health in childhood is strongly associated with weight status and mental health in adolescence.


2018 ◽  
Vol 104 (3) ◽  
pp. 268-274 ◽  
Author(s):  
Steven Hope ◽  
Jessica Deighton ◽  
Nadia Micali ◽  
Catherine Law

ObjectiveWe assessed whether maternal mental health problems increased rates for child injury during the preschool years and mid-childhood, and the extent to which associations could be accounted for by a range of potential explanatory factors.DesignWe analysed the UK Millennium Cohort Study, a nationally representative sample with data collected throughout childhood. Multinomial regression was used to investigate whether two measures of maternal mental health (diagnosed depression/anxiety and psychological distress) were associated with subsequent childhood injury. Models adjusted for sociodemographics, parenting and child externalising behaviours.Main outcome measureMaternal report of unintentional injuries (none, 1, 2+) recorded at three data collection periods (3–5 years; 5–7 years; 7–11 years).ResultsThe analytic sample comprised n=9240 families who participated 3–11 years with complete data on exposures and outcomes (multiply imputing missing covariates). Exposure to maternal mental health problems was associated with increased rates of subsequent childhood injuries. Associations attenuated after adjustment for potential explanatory factors, although they remained elevated. For example, high maternal distress was associated with injuries 3–5 years (adjusted relative risk ratio (aRRR): 1 injury=1.18, 95% CI 0.86 to 1.61; 2+ injuries=2.22, 95% CI 1.22 to 4.02); injuries 5–7 years (aRRR: 1 injury=1.31, 95% CI 0.97 to 1.76; 2+ injuries=1.84, 95% CI 1.09 to 3.09); and injuries 7–11 years (aRRR: 1 injury=1.03, 95% CI 0.81 to 1.31; 2+ injuries=1.33, 95% CI 0.97 to 1.81).ConclusionsChildren exposed to mothers with mental health problems had higher rates of childhood injury than those not exposed. If further investigation of this association suggests causality then it will be important to test measures that address mothers’ mental health issues with a view to reducing injuries among their children.


F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 1907 ◽  
Author(s):  
Alice Welch ◽  
Roz Shafran ◽  
Isobel Heyman ◽  
Anna Coughtrey ◽  
Sophie Bennett

Background: Epilepsy is one of the most common chronic paediatric conditions. Children and young people with epilepsy are at a significantly higher risk of developing mental health problems relative to the general population, yet the majority of these problems are unrecognised and under-treated in clinical practice. Although there is little epilepsy-specific guidance as to what interventions to use, researchers suggest there is no reason why clinicians should not be using the evidence base. Given the poor prognosis of untreated mental health difficulties, this cohort study sought to identify what psychological treatment young people with epilepsy with mental health needs receive in routine practice. Methods: Participants were children and young people aged 3 to 18 attending paediatric neurology clinics. The parents of those children who met threshold for impairing symptoms on the Strengths and Difficulties questionnaire were asked to complete the Development and Well-being Assessment (DAWBA), an online clinical assessment designed to generate psychiatric diagnoses. Participants who met clinical threshold for a disorder according to the DAWBA were provided with a bespoke measure asking questions regarding their experience with treatment for mental health support. Results: 16 of the 46 parents who completed the DAWBA reported that they had experienced previous or current support for their child’s mental health difficulties. The mental health support offered to families was highly variable, inadequate and often not clearly compliant with existing UK National Institute for Health and Clinical Excellence (NICE) guidelines for mental health treatment in children and young people. Conclusions: The present study demonstrates the inconsistency and inadequacy of mental health provision for children and young people with epilepsy. Future work should explore reasons for the treatments offered failing to adhere to existing guidance for mental health difficulties in children, as well as possible solutions to this.


2021 ◽  
Vol 12 ◽  
Author(s):  
Eva Rens ◽  
Pierre Smith ◽  
Pablo Nicaise ◽  
Vincent Lorant ◽  
Kris Van den Broeck

Background: The outbreak of the COVID-19 pandemic in 2020 and its associated measures led to high levels of mental distress in the general population. Previous research indicated that young people are especially vulnerable for a wide range of mental health problems during the pandemic, but little is known about the mechanisms. This study examined mental distress and its contributing factors among young Belgian people.Methods: An online survey was widely distributed in Belgium during the first wave of COVID-19 in March, and 16–25-year-olds were selected as a subsample. Mental distress was assessed using the 12-item General Health Questionnaire (GHQ-12), and a threshold of ≥4 was used to discriminate mental distress cases from non-cases. Bivariate and multivariable logistic regression analyses were performed to evaluate possible predictors of mental distress, including demographics, chronic condition, history of mental health problems, social support, exposure to COVID-19, and several changes in everyday activities.Results: A total of 2,008 respondents were included, of which the majority was female (78.09%) and student (66.82%). The results indicate that about two thirds (65.49%) experienced mental distress. In the multivariable regression model, significant (p &lt; 0.01) predictors of mental distress were female gender (OR = 1.78), low social support (OR = 2.17), loneliness (OR = 5.17), a small (OR = 1.63), or large (OR = 3.08) increase in social media use, a small (OR = 1.63) or large (OR = 2.17) decrease in going out for drinks or food, and a decrease in doing home activities (OR = 2.72).Conclusion: Young people experience high levels of mental distress during the COVID-19 pandemic. Our findings indicate that mental distress was highest among women, those experiencing loneliness or low social support and those whose usual everyday life is most affected. The psychological needs of young people, such as the need for peer interaction, should be more recognized and supported.


F1000Research ◽  
2020 ◽  
Vol 7 ◽  
pp. 1907
Author(s):  
Alice Welch ◽  
Roz Shafran ◽  
Isobel Heyman ◽  
Anna Coughtrey ◽  
Sophie Bennett

Background: Epilepsy is one of the most common chronic paediatric conditions. Children and young people with epilepsy are at a significantly higher risk of developing mental health problems relative to the general population, yet the majority of these problems are unrecognised and under-treated in clinical practice. Although there is little epilepsy-specific guidance as to what interventions to use, researchers suggest there is no reason why clinicians should not be using the evidence base. Given the poor prognosis of untreated mental health difficulties, this cohort study sought to identify what psychological treatment young people with epilepsy with mental health needs receive in routine practice. Methods: Participants were children and young people aged 3 to 18 attending paediatric neurology clinics. The parents of those children who met threshold for impairing symptoms on the Strengths and Difficulties questionnaire were asked to complete the Development and Well-being Assessment (DAWBA), an online clinical assessment designed to generate psychiatric diagnoses. Participants who met clinical threshold for a disorder according to the DAWBA were provided with a bespoke measure asking questions regarding their experience with treatment for mental health support. Results: 16 of the 46 parents who completed the DAWBA reported that they had experienced previous or current support for their child’s mental health difficulties. The mental health support offered to families was highly variable, inadequate and often not clearly compliant with existing UK National Institute for Health and Clinical Excellence (NICE) guidelines for mental health treatment in children and young people. Conclusions: The present study demonstrates the inconsistency and inadequacy of mental health provision for children and young people with epilepsy. Future work should explore reasons for the treatments offered failing to adhere to existing guidance for mental health difficulties in children, as well as possible solutions to this.


2022 ◽  
Author(s):  
Eoin McElroy ◽  
Marc Tibber ◽  
Pasco Fearon ◽  
Praveetha Patalay ◽  
George Ploubidis

BackgroundStudies using symptom-based screeners have suggested that mental health problems have increased in adolescents in recent decades, however, few studies have explicitly tested the equivalence of their instruments, which is critical for inferring changes in prevalence. In addition, few studies have explored whether changes in socioeconomic position (SEP) and sex inequalities across generations have impacted trends in adolescent mental health. MethodsUsing structural equation modelling, we explore sex differences in harmonised parent-reports of emotional and behavioural problems, using data from four UK birth cohorts: the 1958 National Child Development Study (NCDS’58; N= 11,398), the 1970 British Cohort Study (BCS’70; N= 8,161), the 1991-92 Avon Longitudinal Study of Parents and Children (ALSPAC’91; N= 5,304), and the 2001 Millennium Cohort Study (MCS’01; N= 10,384). We also delineate associations between four harmonised indicators of childhood SEP and adolescent mental health, and test whether changes in SEP account for increases in mental ill-health over time. Results We found an increase in the latent means of parent-reported emotional and behavioural problems across time in both males and females in more recent cohorts, with the exception of ALSPAC’91. Sex-inequalities did not change over time, with females having consistently higher emotional problems. The associations between the four indicators of SEP and emotional problems were strongest in the MCS’01, with housing tenure having the strongest association. All four SEP indicators were associated with behavioural problems in all of the cohorts, with housing tenure again more strongly associated with problems in the MCS’01. Inconsistent mediation (i.e. regression suppression) suggested that the increases in mental health problems occurred despite broadly improving average socio-economic conditions. ConclusionsOur findings suggest that parent-reported adolescent mental health problems have risen in recent generations and that this trend is not due solely to reporting styles. A failure to address widening inequalities may result in further increases in mental ill-health amongst disadvantaged young people.


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