Surviving social assistance: 12-month prevalence of depression in sole-support parents receiving social assistance

BACKGROUND: Although it is generally recognized that poverty and depression can coexist among single parents receiving social assistance, there is insufficient research on this topic. The goals of this study therefore were to investigate the prevalence, correlates and health care expenditures associated with depression among sole-support parents receiving social assistance. METHODS: Sole-support parents who had applied for social assistance in 2 regions of southwestern Ontario were included in the study. Depression was diagnosed with the 1994 University of Michigan Composite International Diagnostic Interview short forms. RESULTS: The 12-month prevalence rate of depressive disorder among the parents interviewed was 45.4% (345/760). A total of 247 (32.5%) had major depressive disorder alone, 19 (2.5%) had dysthymia, and 79 (10.4%) had both major depressive disorder and dysthymia ("double depression"). Those with major depressive disorder, particularly double depression, had significantly higher rates of coexisting psychiatric disorder than those without depressive disorders. Parents with depression reported higher rates of developmental delay and behaviour problems in their children than parents without depression. Expenditures for health care services were higher for parents with depression and for their children than for parents without depressive disorder and their children. INTERPRETATION: Single parents receiving social assistance have high rates of depression. Such parents with depression also have higher rates of other psychiatric disorders and higher expenditures for health care services, and their children have higher rates of developmental delay and behaviour problems.     

Prevalence of type 1 diabetes mellitus in Saudi Arabian children and adolescents

OBJECTIVE: To determine the prevalence of type 1 diabetes mellitus among 0-19 years old Saudi children and adolescents. METHODS: A nationwide Saudi Arabian project was conducted in the years 2001-2007 with the objective of establishing national growth charts, and defining the prevalence of some chronic childhood diseases such as diabetes mellitus. The 14,000 households were randomly selected based on a recent population statistic. The questionnaire used included demographic data and evidence of diabetes mellitus. The prevalence was estimated and expressed per 100,000. Breakdown of this figure per age and region was carried out. RESULTS: In the 11,874 out of the 14,000 84.9% selected households, 45,682 children and adolescents were surveyed. Fifty children and adolescents were identified to have type 1 diabetes mellitus with a prevalence rate of 109.5 per 100,000. The male to female ratio was almost equal (26 males and 24 females). The distribution of prevalence of type 1 diabetes mellitus by region shows that the highest was 162 in the central region, and the lowest was 48 in the eastern region. Children and adolescents were also grouped by age into 5-6 (prevalence 100), 7-12 (prevalence 109), 13-16 (prevalence 243), and 17-18 (prevalence 150). CONCLUSION: We conclude that the prevalence of type 1 diabetes mellitus in Saudi Arabian children and adolescents is 109.5 per 100,000.     

Health-related quality of life of severely obese children and adolescents

CONTEXT: One in 7 US children and adolescents is obese, yet little is known about their health-related quality of life (QOL). OBJECTIVE: To examine the health-related QOL of obese children and adolescents compared with children and adolescents who are healthy or those diagnosed as having cancer. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional study of 106 children and adolescents (57 males) between the ages of 5 and 18 years (mean [SD], 12.1 [3] years), who had been referred to an academic children's hospital for evaluation of obesity between January and June 2002. Children and adolescents had a mean (SD) body mass index (BMI) of 34.7 (9.3) and BMI z score of 2.6 (0.5). MAIN OUTCOME MEASURES: Child self-report and parent proxy report using a pediatric QOL inventory generic core scale (range, 0-100). The inventory was administered by an interviewer for children aged 5 through 7 years. Scores were compared with previously published scores for healthy children and adolescents and children and adolescents diagnosed as having cancer. RESULTS: Compared with healthy children and adolescents, obese children and adolescents reported significantly (P<.001) lower health-related QOL in all domains (mean [SD] total score, 67 [16.3] for obese children and adolescents; 83 [14.8] for healthy children and adolescents). Obese children and adolescents were more likely to have impaired health-related QOL than healthy children and adolescents (odds ratio [OR], 5.5; 95% confidence interval [CI], 3.4-8.7) and were similar to children and adolescents diagnosed as having cancer (OR, 1.3; 95% CI, 0.8-2.3). Children and adolescents with obstructive sleep apnea reported a significantly lower health-related QOL total score (mean [SD], 53.8 [13.3]) than obese children and adolescents without obstructive sleep apnea (mean [SD], 67.9 [16.2]). For parent proxy report, the child or adolescent's BMI z score was significantly inversely correlated with total score (r = -0.246; P =.01), physical functioning (r = -0.263; P<.01), social functioning (r = -0.347; P<.001), and psychosocial functioning (r = -0.209; P =.03). CONCLUSIONS: Severely obese children and adolescents have lower health-related QOL than children and adolescents who are healthy and similar QOL as those diagnosed as having cancer. Physicians, parents, and teachers need to be informed of the risk for impaired health-related QOL among obese children and adolescents to target interventions that could enhance health outcomes.     

Depression among Australian adolescents

OBJECTIVES: To examine the prevalence and factors associated with depression in Australian adolescents. DESIGN: A representative, multistage probability sample of Australian households conducted in 1998 (part of the National Survey of Mental Health and Well-being). Adolescents completed self-report questionnaires and parents were interviewed using a lay-administered, structured psychiatric interview and several questionnaires. PARTICIPANTS: 1,490 adolescents aged 13-17 years and their parent or main caregiver. MAIN OUTCOME MEASURES: Prevalence of depression in adolescents, as reported by parents and by adolescents themselves; demographic factors; health-risk behaviours; and rate of use of support services. RESULTS: Of the 1,490 adolescents originally sampled, 150 (10%) did not complete responses to questions on depression and were excluded from the analysis. Seventy of the remaining 1340 adolescents (5.2%; 95% CI, 4.0%-6.4%) met criteria for self-reported depression. Agreement between parent- and adolescent-reported depression was poor (kappa=0.27). Adolescent-reported depression was associated with increased suicide plans (odds ratio [OR], 2.83; 95% CI, 1.19-6.70) and attempts (OR, 9.05; 95% CI, 3.49-23.50) in the previous year, use of marijuana 10 or more times in the previous month (OR, 2.88; 95% CI, 1.25-6.64), having conduct disorder (OR, 4.09; 95% CI, 1.23-13.63) and use of school support services (OR, 4.71; 95% CI, 1.82-12.22). Those who used any kind of support service (24/70; 34%) used a mean of 2.9 services (mode, 2; range, 1-5). Three per cent (2/70) of depressed adolescents had been treated with antidepressants. CONCLUSIONS: Depressed adolescents exhibit higher rates of health-risk behaviours and psychosocial impairment than non-depressed adolescents, but only a small number receive appropriate treatment. Staff working in school-based services should be trained to identify adolescents with depression and facilitate referral for treatment.     

芜湖地区儿童行为问题与家庭环境的相关研究

目的:了解芜湖地区儿童行为问题的发生与家庭心理环境之间的相关性。方法:采用分层随机整群抽样法,由父母填写Conners儿童行为问卷(父母版)、家庭环境量表中文版(FES-CV),对芜湖地区6 381名3～16岁儿童进行测查。结果:芜湖地区儿童行为问题的检出率为25.25%,三县儿童的行为问题显著高于市区;市区儿童家庭的亲密度等八项因子分显著高于三县,而矛盾性显著低于三县;较家庭环境中的其他因素相比,家庭的矛盾性与儿童行为问题的发生有较为密切的联系,其余较为密切的有知识性、组织性、亲密度。结论:精神环境良好的家庭,其子女行为问题较少,家庭成员之间矛盾冲突越多,其子女的行为问题亦越多。     

Use of medication by young people with attention-deficit/hyperactivity disorder

OBJECTIVES: To examine the prevalence of psychotropic medication use by children with attention-deficit/hyperactivity disorder (ADHD) and children without ADHD. To identify factors associated with stimulant use by children in the community. DESIGN: A representative, multistage probability sample of Australian households was conducted in 1998. Parents completed questionnaires assessing children's mental health problems and health-related quality of life. They also completed a structured interview to identify children's psychiatric disorders and their use of medications during the previous six months. PARTICIPANTS: Parent or main caregiver of 3597 children aged 6-17 years. MAIN OUTCOME MEASURES: Rates of use of stimulants (dexamphetamine and methylphenidate), antidepressants and clonidine by children. RESULTS: Overall, 1.8% of children (95% CI, 1.5%-2.3%) were receiving stimulant medication. Of those with ADHD, 12.6% (95% CI, 9.8%-16.1%) were being treated with stimulants, 2.3% (95% CI, 1.3%-4.3%) with antidepressants, and 1.9% (95% CI, 1.0%-3.7%) with clonidine. Among children without ADHD, 0.5% (95% CI, 0.3%-0.8%) were receiving stimulant medication. This represented 22.9% (95% CI, 14.6%-34.0%) of all the children who were receiving stimulants. Variables significantly associated with stimulant use were being male, having ADHD, attending a paediatrician, and having higher scores on the Aggressive Behaviour and Attention Problems scales on the Child Behaviour Checklist. CONCLUSIONS: About 13% of Australian children with ADHD, and a substantial number of children without ADHD, are taking stimulants. The question of whether Australian children are being undertreated or overtreated with stimulant medication depends on the criteria used to assess the appropriateness of stimulant use. Additional information is needed to clarify when stimulants should be used to treat ADHD.     

Asthma morbidity in Australia: an epidemiological study.

OBJECTIVE: To examine the prevalence and management of asthma in adults and children in a population sample in eastern Australia. SETTING: A random sample of children from 33 primary schools in Sydney, Melbourne, Brisbane, and the Upper Hunter Valley (New South Wales), and their parents. DESIGN: A cross-sectional analytic survey of 8753 primary school children aged between 5 and 12 years, and their parents (n = 13,945 adults). Asthma prevalence and management practices were determined by parental responses to a questionnaire, and spirometry was performed in children with "probable asthma". RESULTS: Of 8753 children whose parents responded, the prevalence of current wheeze was 19.5% and diagnosed asthma was 17.1%. Of the children with "probable asthma", 30% had their lung function measured in the previous year, and 6% possessed both a peak flow meter and an action plan for their asthma. Undertreatment was likely, as preventive asthma medications (inhaled corticosteroids or sodium cromoglycate) were used regularly by only 25.5% of these children and by 44.3% of children who had asthma symptoms more than twice per week. Children with the diagnosis of asthma reported higher rates of preventive medication use and ventilatory function measurement than children with frequent symptoms without the diagnosis. In the 13,945 adults, the reported prevalence of asthma was 7%, of whom 39% were using preventive medications, 34% had their ventilatory function assessed in the previous year, and 7% had both a peak flow meter and an asthma action plan. CONCLUSIONS: The study illustrated the gap between the current level of asthma management in the community and the standards set by the Thoracic Society of Australia and New Zealand. Undertreatment and suboptimal management of asthma remain important problems in Australia.     

The mental health and wellbeing of children and adolescents in home-based foster care

OBJECTIVE: To identify the prevalence of mental health problems, rates of suicidal ideation and behaviour, and use of professional mental health services among children and adolescents residing in home-based foster care, and to compare these rates with those reported for children and adolescents in the general Australian community. DESIGN: Cross-sectional survey. PARTICIPANTS AND SETTING: 326 children and adolescents (aged 6-17 years) residing in home-based foster care in the Adelaide metropolitan region between August 2004 and January 2006. MAIN OUTCOME MEASURES: Prevalence of emotional and behavioural problems, suicidal ideation and behaviour, and use of professional services to obtain help for emotional and behavioural problems. RESULTS: 61.0% of children and adolescents living in home-based foster care scored above the recommended cut-off for behaviour problems on the Child Behavior Checklist and 35.2% of adolescents scored above the cut-off on the Youth Self Report. 6.7% of 13-17- year olds in home-based foster care reported a suicide attempt that required medical treatment during the previous year. Caregivers reported that 53.4% of children needed professional help for their mental health problems but only 26.9% had obtained help during the previous 6 months. CONCLUSION: Children in home-based foster care experience high rates of mental health problems but only a minority receive professional help for their problems.     

声言自杀儿童少年的家庭和临床特征及社交能力调查

目的分析声言自杀（TAKS）儿童少年的家庭和临床相关因素及其与社交能力的关系。方法多阶段分层随机整群抽取武汉地区12所学校（小学、初中和高中各4所）的1975名在校7—17岁学生自评完成自编一般情况问卷和儿童抑郁量表,学生家长自评完成Achenbach儿童行为（CBCL）量表;根据CBCL量表91条目（声言要自杀）判定TAKS行为,用多因素Logistic回归筛选儿童少年TAKS的相关因素。结果儿童少年父母报告的近半年TAKS行为的检出率（95％CI）为4．1％（3．2％,5．0％）;TAKS与父母婚姻状况不良（OR=2．29）、父亲无业（OR=2．07）、父母经常吵架（OR=2．23）、父母曾很厉害地打架（OR=2．00）、经常被同学欺负（OR=2．11）、内向性行为问题（OR=2．28）、外向性行为问题（OR=2．50）和有抑郁症状（OR=4．83）显著关联;TAKS儿童少年的社交能力总分显著低于非TAKS儿童少年[（18．8±7．6）分vs．（20．9±6．9）分,P=O．007]。结论伴有不良的家庭因素、行为问题和抑郁情绪的儿童少年TAKS检出率偏高,TAKS儿童少年的社交能力也较差,TAKS值得临床关注。     

克拉玛依市区儿童青少年肥胖与父母社会经济状况的关系

目的 掌握克拉玛依区儿童青少年超重及肥胖的发生率与其父母社会经济状况的关系.方法 测身高、体重,采用国内儿童青少年年龄-性别-BMI超重、肥胖判定标准,调查父母文化程度及职业.结果 超重和肥胖的检出率分别为13.6％、7.67％,男性高于女性,各民族间差异有统计学意义.超重和肥胖在父母文化程度和职业较高中检出率高.结论 克拉玛依市区儿童青少年超重及肥胖已达1/5,与家庭的社会经济状况呈正相关.     

绘画治疗对情绪障碍儿童亲子关系的作用

目的 探讨绘画治疗对情绪障碍儿童亲子关系的作用.方法 本研究采用自身对照研究,把58例符合<中国精神障碍分类与诊断标准>第三版中儿童情绪障碍诊断标准的儿童作为研究对象,进行为期6个月的绘画治疗.于治疗前及治疗后使用儿童焦虑性情绪障碍筛查量表(Screen for Child Anxiety Related Emotio...     

Out-of-pocket Costs of Disabilities and Their Association with Household Socioeconomic Status Among School-aged Children in Vietnam

Objective: The aim of this study was to assess the economic burden of disability of school-aged children and to evaluate the association between disabilities and household socioeconomic status, as well as the economic burden of disability and household socioeconomic status in Vietnam.Materials and Methods: Nationally representative data for 9,882 children aged 6 to 17 years from the Vietnam Household Living Standard Survey 2006 were used. Disabilities were measured in six basic functional domains, including vision, hearing, remembering or concentrating, mobility, self-care, and communication. We evaluated the association between area, household income, educational attainment, or occupation of household head, and each difficulty. The ratio of health-care expenditure to per capita household income was compared by presence of a disability as well as household socioeconomic status.Results: The prevalence of difficulty was 1.9% for vision and 2.3% for at least one of the other five domains. Difficulty in vision was more prevalent in the richer households (p=0.001), whereas difficulty in the other five domains was more prevalent in the poorer households (p=0.002). The ratio of health-care expenditure to per capita household income was greater than 0.05 in 4.6% of children. The adjusted odds ratio of children with difficulty in vision having a health-care expenditure share greater than 0.05 compared with children without difficulty was 4.78 (95% CI: 2.95, 7.73; p<0.001), and that for difficulty in the other five domains was 3.13 (95% CI: 2.04, 4.80; p<0.001). Among children with difficulty in at least one of the five domains other than vision, the proportion of children with a health-care expenditure share greater than 0.05 was higher among children from the poorer households (p=0.033).Conclusions: Children with a disability spent more on health care relative to their income than those without. Visual disability was more prevalent among children from the richer households, whereas other disabilities were more prevalent among children from the poorer households.     

石河子市学龄儿童睡眠障碍及影响因素调查分析

目的：了解石河子市学龄儿童的睡眠障碍状况及其影响因素。方法：2005年12月在石河子市各小学随机抽取1—6年级学龄儿童993名,由专人负责对其家长进行儿童家庭环境、社会环境与睡眠健康问卷调查。结果：学龄儿童睡眠障碍发生率为52．3％,其中睡眠不安、肢体有抽动者占36．5％,睡眠时磨牙4．2％,夜间频繁惊醒2．5％,梦呓2．4％,睡眠时频繁打鼾1．5％,遗尿1．3％,梦游1．3％,夜间憋气或呼吸困难0．7％,呼吸暂停0．2％,影响睡眠障碍发生的因素主要有常患感冒、家庭人均住房面积、卧房内有电视、与父母同睡、家族中有人有睡眠障碍及有学习困难史等。结论：石河子市学龄儿童睡眠障碍发生率高,引起睡眠障碍的因素较多,应引起社会和家长的重视。     

儿童焦虑障碍治疗现状及展望

焦虑障碍是儿童期患病率最高的心理障碍之一,且患病率有逐年增高的趋势。目前以心理疗法为主,药物治疗为辅,研究较多的是行为认知疗法,其有效率达到86%。本文综述了儿童焦虑障碍的药物及心理治疗的研究进展、存在的问题,并对未来研究的方向进行展望。     

Prevalence and correlates of common mental disorders among children and adolescents in Blantyre-Urban,Malawi

BackgroundThe high global prevalence of mental disorders justifies the need to quantify their burden in the sub-Saharan Africa where there is a dearth of information. These mental disorders are linked to different socio-demographic factors.ObjectiveTo determine the prevalence of, and factors associated with mental disorders among children and adolescents in Blantyre City, Malawi.MethodsChildren and adolescents aged 6 to 17 years were interviewed to determine their socio-demographic characteristics and assess their mental health status using the Strengths and Difficulties Questionnaire (SDQ) and Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS). Associations between mental disorders and socio-demographic characteristics were tested using Chi-square and logistic regression analysis.ResultsThe prevalence of symptoms of psychopathology on the SDQ was 7.3% (95%CI 4.8–10.5%) while for the K-SADS was 5.9% (95% CI 3.7%–8.9%). The prevalence of mental disorders across the age ranges of 6 to 12 years and 13 to 17 years was 5.4% and 7.9 % respectively. Males had a higher prevalence (7.1%) compared to females (4.7%). Conduct disorder was most prevalent (3.4%), followed by either type of ADHD-Attention Deficit Hyperactive Disorders (2.0%). Having a single parent (p<0.001), staying with a non-biological guardian (p<0.030), engaging in paid work (p<0.039), not attending school (p<0.019) and having teacher difficulties(p<0.028) were positively associated with a mental disorder.ConclusionThe socio-demographic factors associated with the risk of developing mental disorders may be important targets for mental health intervention programs.     

Tourette综合征患儿脑电图遗传学特征研究

目的：探讨抽动秽语综合征（Tourette综合征，TS）患儿及其父母的脑电图（EEG）改变在生物遗传学上的意义。方法：对25例TS患儿及50例父母进行2h EEG监测研究。结果：TS患儿父母的EEG异常率（64％）明显高于其抽动障碍发生率（28％）（P＜0．01），EEG异常的TS患儿及其父母的EEG异常率显著高于EEG正常的TS患儿的父母（P＜0．05），TS患儿双亲EEG异常也有较高比率，不同性别TS患儿父母间比较EEG异常没有明显差异。结论：通过EEG检查，进一步论证了TS是一种有遗传倾向的疾病。     

学龄儿童气质与睡眠障碍关系的研究

目的了解学龄儿童气质与睡眠障碍的关系,为睡眠障碍的干预提供依据。方法应用自行编制的《儿童家庭社会环境与睡眠健康问卷》和《中国儿童8-12岁气质量表》对1 665名8-12岁儿童的家长进行儿童睡眠健康问卷调查和气质的测评。结果不同气质类型儿童睡眠障碍的发生率不一,依次为麻烦型21.3%、中间偏烦型18.22%、发动缓慢型13.8%、中间偏易型11.6%、平易型9.7%,经χ^2检验差异有统计学意义（χ^2=20.589,P=0.000）;睡眠障碍儿童的活动水平、节律性、适应性、心境及持久性得分均高于正常儿童,差异有统计学意义。结论学龄儿童气质与睡眠障碍相关。     

综合性医院儿科门诊就诊者心理行为问题调查

目的了解综合性医院儿科门诊就诊患者中有关心理行为问题,以及家长们对待儿童心理问题的态度及诊治需求。方法对2006年12月至2007年1月在本院儿科门诊就诊的4~15岁儿童的家长或监护人进行问卷调查,采用自行设计问卷及儿科症状检查表(PSC),对结果进行统计学分析。结果39.2%的家长认为患躯体疾病会使儿童产生心理行为方面的影响,如睡眠不好、易激惹发脾气等。16.6%的家长认为孩子平时有心理行为方面的问题,然而其中只有39.4%的家长与医师讨论过这些问题,与此相比78.8%的家长能与自己的亲友讨论这些问题。如果发现孩子有心理行为问题,55.8%的家长选择在心理门诊就诊,32.2%的家长选择在儿保门诊就诊,8.5%的家长选择在普通儿科门诊就诊,3.5%的家长选择在精神科门诊就诊。结论患躯体疾病会对孩子产生一些心理行为方面的影响,儿科门诊医师在诊治儿童的躯体疾病时不应忽略这些影响,应予早期的处理,问题严重时转诊到精神专科。虽然家长已经发现孩子平时存在心理行为方面的问题,真正与医师讨论过的家长还不到一半,这影响了儿童心理行为方面的问题的解决。与在精神专科就诊相比,家长们更愿意在心理门诊及儿保门诊就诊,但选择在普通儿科门诊就诊的家长不多,应该充分利用普通儿科门诊这个解决儿童心理行为问题的最便利的资源,改善我国儿童的精神健康服务。     

Childhood anxiety disorders prevalence in Saudi Arabia

Objectives:To investigate the prevalence of childhood anxiety disorders in Saudi Arabia.Methods:We conducted a cross-sectional study, between September and November 2019, in Saudi Arabia. The study group included the parents of 468 primary school children, aged 6-12 years. Parents completed the Screen for Child Anxiety Related Disorders (SCARED) screening instrument, translated to Arabic. The measured outcome was the prevalence of childhood anxiety disorders, determined from the scores on the SCARED instrument.Results:Childhood anxiety disorders prevalence were as follows: 32.7% had one anxiety, 18.4% had 2, 10.9% had 3, 8.1% had 4, and 7.7% had 5. Of note, 22.2% of children did not have an anxiety disorder.Conclusion:Our results reveal a high prevalence of childhood anxiety disorders among primary school age children in Saudi Arabia. Based on these findings, conducting awareness campaigns and providing educational programs on childhood anxiety disorders might be important to improve the health outcomes of children.