Association between parent mental health and paediatric TBI: epidemiological observations from the 1987 Finnish Birth Cohort

BackgroundThis study examined whether parental mental illness has implications for child risk for traumatic brain injuries (TBI).MethodData on 60 069 Finnish children born in 1987 and their parents were examined for demographic and mental health-related variables in relationship with paediatric TBI. Altogether, 15 variables were derived from the cohort data with ICD-10 F-codes being available for mental health diagnoses for all parents. Bivariate and multivariate analyses were carried out using inpatient and outpatient diagnoses of child TBI.ResultsPaternal disorders due to psychoactive substance use (F10–F19) was associated with an increased inpatient TBI (OR=1.51; CI=1.07 to 2.14). Mood disorders (F30–F39) were associated with higher rates of outpatient TBI (OR=1.42; CI=1.06 to 1.90). Paternal personality and behavioural disorders (F60–F69) were linked with a twofold increase in risk across both categories of child TBI (OR=2.35; CI=1.41 to 3.90) and (OR=2.29; CI=1.45 to 3.61), respectively. Among the maternal mental health factors associated with child TBI, schizophrenia and other non-mood psychotic disorders (F20–F29) were associated with an increase in inpatient traumatic brain injuries (iTBI) (OR=1.78; 1.22 to 2.59). Mothers having mood disorders (F30–F39) were more likely to have had a child who experienced an iTBI (OR=1.64; CI=1.20 to 2.22). Mothers with personality and behavioural disorders (F60–F69) were also found to have had children with an increased risk for iTBI (OR=2.30; CI=1.14 to 3.65).ConclusionTaken together, these data should call attention to methods and strategies designed to augment and support caregiving environments with modalities that can foster mutually supportive households in cooperation with parents who have been diagnosed with a mental disorder.

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Adolescent cannabis use, baseline prodromal symptoms and the risk of psychosis

The British Journal of Psychiatry ◽

10.1192/bjp.2017.52 ◽

2018 ◽

Vol 212 (4) ◽

pp. 227-233 ◽

Cited By ~ 21

Author(s):

Antti Mustonen ◽

Solja Niemelä ◽

Tanja Nordström ◽

Graham K. Murray ◽

Pirjo Mäki ◽

...

Keyword(s):

Substance Use ◽

General Population ◽

Birth Cohort ◽

Psychotic Disorders ◽

Temporal Order ◽

Population Based ◽

Cannabis Use ◽

Prodromal Symptoms ◽

Increased Risk ◽

Icd 10

BackgroundThe association between cannabis use and the risk of psychosis has been studied extensively but the temporal order still remains controversial.AimsTo examine the association between cannabis use in adolescence and the risk of psychosis after adjustment for prodromal symptoms and other potential confounders.MethodThe sample (n = 6534) was composed of the prospective general population-based Northern Finland Birth Cohort of 1986. Information on prodromal symptoms of psychosis and cannabis use was collected using questionnaires at age 15–16 years. Participants were followed up for ICD-10 psychotic disorders until age 30 years using nationwide registers.ResultsThe risk of psychosis was elevated in individuals who had tried cannabis five times or more (hazard ratio, (HR) = 6.5, 95% CI 3.0–13.9). The association remained statistically significant even when adjusted for prodromal symptoms, other substance use and parental psychosis (HR = 3.0, 95% CI 1.1–8.0).ConclusionsAdolescent cannabis use is associated with increased risk of psychosis even after adjustment for baseline prodromal symptoms, parental psychosis and other substance use.Declaration of interestNone.

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Indirect costs of sickness absence caused by mental and behavioural disorders (ICD-10: F00-F99) in Poland in the years 2012-2018

Wiedza Medyczna ◽

10.36553/wm.17 ◽

2020 ◽

Vol 2 (1) ◽

pp. 30-38

Author(s):

Bartosz Kobuszewski

Keyword(s):

Mental Health ◽

Health Care ◽

Gross Domestic Product ◽

Sickness Absence ◽

Indirect Costs ◽

Gdp Per Capita ◽

Domestic Product ◽

Behavioural Disorders ◽

Icd 10 ◽

Per Capita

Introduction: Mental health is necessary for achieving the complete health by individuals. According to WHO, it is "a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community" (2). Unfortunately, there is an increasing number of people suffering from mental disorders that can deteriorate their life quality, lead to problems with the standard functioning in the society, a drop in productivity, and can cause disabilities. Purpose of the article: The purpose of this article was to attempt the estimation of indirect costs of sickness absence caused by mental and behavioural disorders (ICD-10: F00-F99) in Poland in the years 2012-2018. Materials and methods: Indirect costs were estimated with the human capital approach using data on sickness absence provided by the Polish Social Insurance Institution (ZUS) and macroeconomic indicators published by the Central Statistical Office in Poland (GUS). The individual productivity loss was introduced by means of three indicators: Gross Domestic Product (GDP) per capita, Gross Domestic Product per person employed, corrected Gross Domestic Product. Results: Estimated indirect costs of sickness absence caused by mental and behavioural disorders (ICD-10: F00-F99) in Poland in 2012 were: 1.62 billion PLN measured in terms of GDP per capita, 2.86 billion PLN measured in terms of corrected GDP per person employed, and 4.40 billion PL measured in terms of GDP per person employed. And those costs in 2018 were 2.93 billion PLN, 4.57 billion PLN, and 7.03 billion PLN respectively, and they were higher by ca. 60-80% than in 2012. Conclusions: The described estimation of indirect costs can lead to conclusions that mental health care in Poland is quite poor - indirect costs can reach twice the level of National Health Fund (NFZ) expenses on the mental health care.

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Risk of hospital-treated injury in children with cerebral palsy: a population-based cohort study

Injury Prevention ◽

10.1136/injuryprev-2019-043209 ◽

2019 ◽

Vol 26 (4) ◽

pp. 310-314

Author(s):

Laura Määttänen ◽

Liisi Ripatti ◽

Päivi Rautava ◽

Mari Koivisto ◽

Leena Haataja

Keyword(s):

Traumatic Brain Injury ◽

Cerebral Palsy ◽

Brain Injuries ◽

Traumatic Brain Injuries ◽

Population Based ◽

Finnish Population ◽

Risk Of Injury ◽

Increased Risk ◽

Children With Cerebral Palsy ◽

Type Of Injury

AimTo study whether cerebral palsy (CP) increases the risk of hospital-treated injuries in children up to 13 years of age.MethodsA Finnish population-based cohort (n=328 903) of children born during 2001 to 2006 was followed up for hospital-treated injuries until the end of 2014 via linkage of nation-wide registers. The rate of first injury was compared in children with and without CP. The effect of CP type, gender, severe comorbidities (intellectual disability, epilepsy, hearing or visual impairment), and the type of injury was evaluated.ResultsChildren with CP had an increased risk of injury compared with children without CP (unadjusted HR: 1.2, 95% CI: 1.0 – 1.4, p=0.40). Girls with CP (n = 191) had a higher risk of injury compared with girls without CP (29% vs 22%, HR: 1.4, 95% CI: 1.1 to 1.8, p = 0.01). Any comorbidity increased the risk of injury (HR: 1.5, 95% CI: 1.1 to 2.2, p = 0.015) among children with CP. Children with CP had a higher risk of traumatic brain injury (HR: 1.7, 95% CI 1.2 to 2.4, p = 0.002) than children without CP.ConclusionGirls with CP had the highest risk of hospital-treated injury. Children with CP are particularly prone to traumatic brain injuries.

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Relative impact of maternal depression and associated risk factors on offspring psychopathology

The British Journal of Psychiatry ◽

10.1192/bjp.bp.111.092346 ◽

2012 ◽

Vol 200 (2) ◽

pp. 124-129 ◽

Cited By ~ 89

Author(s):

Edward D. Barker ◽

William Copeland ◽

Barbara Maughan ◽

Sara R. Jaffee ◽

Rudolf Uher

Keyword(s):

Mental Health ◽

Risk Factors ◽

Risk Factor ◽

Maternal Depression ◽

Maternal Mental Health ◽

Factors Associated ◽

Increased Risk ◽

Clinically Depressed ◽

Internalising Disorders ◽

Depressed Mothers

BackgroundIn general, mothers with depression experience more environmental and family risk factors, and lead riskier lifestyles, than mothers who are not depressed.AimsTo test whether the exposure of a child to risk factors associated with mental health adds to the prediction of child psychopathology beyond exposure to maternal depression.MethodIn 7429 mother–offspring pairs participating in the Avon Longitudinal Study of Parents and Children in the UK, maternal depression was assessed when the children were aged 1.5 years; multiple risk factor exposures were examined between birth and 2 years of age; and DSM-IV-based externalising and internalising diagnoses were evaluated when the children were 7.5 years of age.ResultsChildren of clinically depressed mothers were exposed to more risk factors associated with maternal mental health. Maternal depression increased diagnoses of externalising and internalising disorders, but a substantial portion of these associations was explained by increased risk factor exposure (41% for externalising and 37% for internalising disorders). At the same time, these risk exposures significantly increased the odds of both externalising and internalising diagnoses, over and above the influence of maternal depression.ConclusionsChildren of clinically depressed mothers are exposed to both maternal psychopathology and risks that are associated with maternal mental health. These results may explain why treating mothers with depression shows beneficial effects for children, but does not completely neutralise the increased risk of psychopathology and impairment.

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Transition to schizophrenia in acute and transient psychotic disorders

The British Journal of Psychiatry ◽

10.1192/bjp.bp.113.127340 ◽

2014 ◽

Vol 204 (4) ◽

pp. 299-305 ◽

Cited By ~ 23

Author(s):

Filippo Queirazza ◽

David M. Semple ◽

Stephen M. Lawrie

Keyword(s):

Psychotic Disorders ◽

Age At Onset ◽

Diagnostic Category ◽

Male Gender ◽

Validity And Reliability ◽

Routinely Collected Data ◽

Younger Age ◽

Increased Risk ◽

Icd 10 ◽

Using Data

BackgroundThe diagnostic category of acute and transient psychotic disorders (ATPD) was introduced in ICD-10. Subsequent studies have called into question its validity and reliability.AimsTo determine the pattern of diagnostic revision to schizophrenia in first-ever diagnosed ATPD.MethodUsing data drawn from the Scottish Morbidity Record, we estimated incidence and diagnostic change in first-ever diagnosed ATPD in Scottish hospitals between January 1997 and December 2010 (n= 2923).ResultsThe average incidence of ATPD was 4.1 per 100 000 population per year. Diagnostic stability was estimated at 53.9% over an average of approximately 4 years of observation. The most common diagnostic shift was to schizophrenia (12.6%), over an average of 1.7 years. Estimates of the transition risks for schizophrenia were 80% at 2.8 years and 90% at 4.6 years. Longer first admission to hospital, younger age at onset and male gender were associated with increased risk and earlier development of schizophrenia.ConclusionsRoutinely collected data suggest that approximately one in eight individuals with first-ever diagnosed ATPD will develop schizophrenia within 3–5 years. Those at high risk of transition may benefit from monitoring for possible diagnostic change.

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Complementary and alternative medicine contacts by persons with mental disorders in 25 countries: results from the World Mental Health Surveys

Epidemiology and Psychiatric Sciences ◽

10.1017/s2045796017000774 ◽

2017 ◽

Vol 27 (6) ◽

pp. 552-567 ◽

Cited By ~ 20

Author(s):

P. de Jonge ◽

K. J. Wardenaar ◽

H. R. Hoenders ◽

S. Evans-Lacko ◽

V. Kovess-Masfety ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Disorders ◽

Mental Disorder ◽

Mood Disorders ◽

Standard Error ◽

Health Surveys ◽

Conventional Care ◽

Behavioural Disorders ◽

The World

Aims.A substantial proportion of persons with mental disorders seek treatment from complementary and alternative medicine (CAM) professionals. However, data on how CAM contacts vary across countries, mental disorders and their severity, and health care settings is largely lacking. The aim was therefore to investigate the prevalence of contacts with CAM providers in a large cross-national sample of persons with 12-month mental disorders.Methods.In the World Mental Health Surveys, the Composite International Diagnostic Interview was administered to determine the presence of past 12 month mental disorders in 138 801 participants aged 18–100 derived from representative general population samples. Participants were recruited between 2001 and 2012. Rates of self-reported CAM contacts for each of the 28 surveys across 25 countries and 12 mental disorder groups were calculated for all persons with past 12-month mental disorders. Mental disorders were grouped into mood disorders, anxiety disorders or behavioural disorders, and further divided by severity levels. Satisfaction with conventional care was also compared with CAM contact satisfaction.Results.An estimated 3.6% (standard error 0.2%) of persons with a past 12-month mental disorder reported a CAM contact, which was two times higher in high-income countries (4.6%; standard error 0.3%) than in low- and middle-income countries (2.3%; standard error 0.2%). CAM contacts were largely comparable for different disorder types, but particularly high in persons receiving conventional care (8.6–17.8%). CAM contacts increased with increasing mental disorder severity. Among persons receiving specialist mental health care, CAM contacts were reported by 14.0% for severe mood disorders, 16.2% for severe anxiety disorders and 22.5% for severe behavioural disorders. Satisfaction with care was comparable with respect to CAM contacts (78.3%) and conventional care (75.6%) in persons that received both.Conclusions.CAM contacts are common in persons with severe mental disorders, in high-income countries, and in persons receiving conventional care. Our findings support the notion of CAM as largely complementary but are in contrast to suggestions that this concerns person with only mild, transient complaints. There was no indication that persons were less satisfied by CAM visits than by receiving conventional care. We encourage health care professionals in conventional settings to openly discuss the care patients are receiving, whether conventional or not, and their reasons for doing so.

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Clinical Profiles, Scope and General Findings of the Western Sydney First Episode Psychosis Project

Australian & New Zealand Journal of Psychiatry ◽

10.1080/j.1440-1614.2005.01517.x ◽

2005 ◽

Vol 39 (1-2) ◽

pp. 36-43 ◽

Cited By ~ 26

Author(s):

Anthony Harris ◽

John Brennan ◽

Josephine Anderson ◽

Anne Taylor ◽

Mark Sanbrook ◽

...

Keyword(s):

Mental Health ◽

Young People ◽

Health Services ◽

Social Functioning ◽

Mood Disorders ◽

Negative Symptoms ◽

Psychotic Disorders ◽

The Other ◽

First Episode ◽

Schizophrenia Group

Objective: To examine the clinical profile, treatment and social functioning of a communitybased sample of young people presenting with their first episode of psychosis. Methods: Over a 2-year period, young people with their first episode of psychosis referred to early intervention services in two area mental health services in western Sydney were assessed with a battery of clinical, neuropsychological, psychophysiological and neuroanatomical measures. This paper reports the clinical results of the baseline section of the study. Results: Of the 224 referrals to the project, 94 subjects meet inclusion criteria and agreed to take part. Subjects were divided into three diagnostic groups – ‘Schizophrenia’, ‘Mood Disorders’ and ‘Mixed Psychosis’, the latter principally comprised of substance induced psychotic disorders. Subjects from the ‘Schizophrenia’ group differed significantly from the other two groups in that they had higher levels of negative symptoms and general psychopathology, and were less likely to be employed or engaged in study. They had poorer overall social functioning. Subjects with ‘Mixed Psychosis’ were similar to those from the ‘Schizophrenia’ group in that they were older and male, but they did not have the same burden of negative symptoms as the ‘Schizophrenia’ group. The ‘Mood Disorders’ group was younger, female and had overall a higher level of psychosocial functioning than the other two groups. Subjects from the ‘Mood Disorders’ group were more likely to be managed with mood stabilisers and multiple drug therapies. The use of atypical antipsychotic medication was almost universal. Conclusions: Even shortly after the time of presentation to mental health services young people with a schizophrenia spectrum diagnosis have a heavier burden of symptoms and are significantly more impaired by them than young people with other psychotic illnesses. This and their symptom profile differentiated them from young people with other psychotic disorders.

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Child and adolescent service and community mental health center: HoNOS findings in a joint take in charge model in Trieste

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.437 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S438-S438

Author(s):

A. Bignotto ◽

D. Celona ◽

E. Pascolo Fabrici ◽

D. Garino

Keyword(s):

Mental Health ◽

Community Mental Health ◽

Psychotic Disorders ◽

Daily Life ◽

Mental Health Center ◽

Cognitive Disorders ◽

Child And Adolescent ◽

Icd 10 ◽

Competing Interest ◽

The Impact

IntroductionA collaboration between the Child and Adolescent Unit 2 (Badof-2) and Community Mental Health 2 (CMHC-2) started several years ago in order to have a joint take in charge of under 25 people presenting needs to either one of the services. A major focus has been put, in this period, on early psychotic onset.ObjectivesThe impact of schizophrenia and other psychotic disorders on daily life has been very well studied in clinical populations and in general ones, leaving some gaps on which are more heavily involved in the resulting disability. In this study, we have used the HoNOS scale, in the Italian validated version, in order to evaluate the single items.MethodsWe have enrolled all the under-30 people taken in charge by the two aforementioned services in the period 2013–2016 with a ICD-10 F20–F29 diagnosis, dividing them in two subgroups (′13–′14 and ′15–′16) in order to find if there was an impact of the prolonged time of take in charge. A HoNOS evaluation has been submitted to all the 21 people found.ResultsHoNOS scores of the first subgroup are generally lower than the ones of the second subgroup (median: 6 vs. 16.5). Self-harmness, cognitive disorders and post-psychotic depression have a heavier impact in daily life than the classic positive and negative symptomatology. Focusing on psychosocial recovery programs, this area has been partly marginally affected.ConclusionsThe two subgroups show different HoNOS scores, with lower ones in the ′13–′14 group. More studies on general population and covariates should be conducted.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Role of pre-existing adversity and child maltreatment on mental health outcomes for children involved in child protection: population-based data linkage study

BMJ Open ◽

10.1136/bmjopen-2019-029675 ◽

2019 ◽

Vol 9 (7) ◽

pp. e029675

Author(s):

Miriam Jennifer Maclean ◽

Scott Anthony Sims ◽

Melissa O'Donnell

Keyword(s):

Mental Health ◽

Health Outcomes ◽

Child Protection ◽

Maternal Mental Health ◽

Population Based ◽

Linkage Study ◽

Mental Health Outcomes ◽

Health Events ◽

Increased Risk ◽

Outcomes For Children

ObjectivesTo determine mental health outcomes for children with a history of child protection system involvement, accounting for pre-existing adversity, and to examine variation in risk across diagnostic groupings and child protection subgroups.DesignA longitudinal, population-based record-linkage study.ParticipantsAll children in Western Australia (WA) with birth records between 1990 and 2009.Outcome measuresMental health diagnoses, mental health contacts and any mental health event ascertained from International Classification of Diseases codes within WA’s Hospital Morbidity Data Collection and Mental Health Information System from birth until 2013.ResultsCompared with children without child protection contact, children with substantiated maltreatment had higher prevalence of mental health events (37.4% vs 5.9%) and diagnoses (20% vs 3.6%). After adjusting for background risks, all maltreatment types were associated with an almost twofold to almost threefold increased hazard for mental health events. Multivariate analysis also showed mental health events were elevated across all child protection groups, ranging from HR: 3.54 (95% CI 3.28 to 3.82) for children who had entered care to HR: 2.31 (95% CI 2.18 to 2.46) for unsubstantiated allegations. Maternal mental health, aboriginality, young maternal age and living in socially disadvantaged neighbourhoods were all associated with an increased likelihood of mental health events. The increase varied across diagnostic categories, with particularly increased risk for personality disorder, and frequent comorbidity of mental health and substance abuse disorders.ConclusionsYoung people who have been involved in the child protection system are at increased risk for mental health events and diagnoses. These findings emphasise the importance of services and supports to improve mental health outcomes in this vulnerable population. Adversities in childhood along with genetic or environmental vulnerabilities resulting from maternal mental health issues also contribute to young people’s mental health outcomes, suggesting a role for broader social supports and early intervention services in addition to targeted mental health programmes.

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Quetiapine: off-label prescribing in a community mental health team

BJPsych Open ◽

10.1192/bjo.2021.212 ◽

2021 ◽

Vol 7 (S1) ◽

pp. S63-S64

Author(s):

Ala Abdelgadir ◽

Richard Walsh ◽

Elizabeth Walsh ◽

Sonn Patel

Keyword(s):

Mental Health ◽

Psychotic Disorders ◽

Prescribing Patterns ◽

Low Doses ◽

Off Label Use ◽

Mental Health Team ◽

Off Label ◽

Health Team ◽

Icd 10 ◽

Label Use

AimsQuetiapine is an atypical anti-psychotic medication licensed for the treatment of schizophrenia, bipolar disorder and adjunctive use in major depressive disorder. It's off-label use in low doses is increasing, possibly due to its sedative qualities, tolerability, low risk of extrapyramidal symptoms and to limit the unnecessary use of benzodiazepines. However, previous research highlights the risk of metabolic consequences even in low doses. Our aim is to establish the prescribing patterns and off-label use of quetiapine within a complete comminity mental health team population (CMHT).MethodThe GR1 CMHT provides care to a population of 25,000 people in a mixed urban and rural area. Multi-disciplinary case notes for all registered patients were reviewed for a one-year period. A database was created to include sociodemographic details, diagnosis, and medication. The proportion of patients prescribed quetiapine was identified and the dosage divided into multiple increments. The team's consultant reviewed and verified all ICD-10 diagnoses. Quetiapine dose by diagnosis was examined using descriptive statistics.ResultOf 246 registered patients, 62 (25% of CMHT caseload) were prescribed Quetiapine. Quetiapine was prescribed across a range of disorders including psychotic 17 (27%), mood 18 (29%), anxiety 14 (22 %), personality disorders 11 (18%) and others 2 (3%). Doses spanned between 25 mg – 800 mg daily. 19 patients (31%) were prescribed less than 25 mg, 20 patients (32%) between 25 mg and 100 mg and 23 patients (37%) above 100 mg. In psychotic and mood disorders, dosage varied widely between the low and high range. Furthermore, of the psychotic disorders, 11 (65%) were prescribed a second antipsychotic medication. For diagnoses in which the prescribing indication was clearly off-label, the dosages were predominantly low (100 mg or less).ConclusionQuetiapine was commonly prescribed in our patient population. Its frequent off-label use in low doses suggests that its prescription was for its additional qualities. Our findings highlight the importance of assessing the risk-benefit profile for every patient given the potential side effects, involving patients in the consultation of its off-label use and appropriate monitoring.

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