Mental health of internally displaced preschool children: a cross-sectional study conducted in Bogotá, Colombia

Purpose

Ongoing armed conflicts, like the one in Colombia, have forcibly displaced millions of people including many young children. This study aimed to assess the mental health of internally displaced preschoolers in Bogotá Colombia and to identify correlates of mental health in these children.

Methods

Cross-sectional study conducted among 279 children attending four kindergartens in a deprived neighbourhood in Bogotá. Child mental health was assessed with the Child Behaviour Checklist (CBCL) 1.5–5 years, a parent-report. Univariate analyses and multivariate logistic regressions were performed to assess the association between displacement and child mental health and to identify correlates of mental health in displaced children.

Results

Displaced children (n = 90) more often met borderline cut-off scores for the CBCL scales than non-displaced children (n = 189) (e.g. total problems 46.7 vs. 22.8 %; p < 0.001). The association between displacement and presence of CBCL total problems remained after adjustment for socio-demographic factors (Adjusted OR 3.3, 95 % CI 1.5; 6.9). Caretaker’s mental health partly explained the association. In displaced children, caretaker’s mental health (p < 0.01) and family functioning (p < 0.01) were independently associated with child mental health. Exposure to traumatic events and social support was also associated with child mental health; however, associations were not independent.

Conclusion

In this deprived neighbourhood in Bogotá, preschool children registered as internally displaced presented worse mental health than non-displaced peers. Family functioning and caretaker’s mental health were strongly and independently associated with displaced children’s mental health.     

Children’s behavioural/emotional problems: a comparison of parents’ and teachers’ reports for elementary school-aged children

This study assessed the agreement between parents and teachers concerning behavioural/emotional symptoms of children. 5671 children born in 1981 (mean age 8.5 years at the time of study) were studied using the Rutter Parent Questionnaire (RA2) and the Rutter Teacher Questionnaire (RB2). Boys had more behavioural symptoms on both scales, 3.6% of the boys and 2.3% of the girls were deviant on both scales. Agreement between parents and teachers on single behaviours was better for deviant girls than for deviant boys. The factors constructed from the Rutter scale items (separately of each scale) represented externalising, internalising and hyperactivity behaviours. For all children, moderate correlations between parents’ and teachers’ ratings were found in externalising behaviour and hyperactivity. Correlations of the factors were clearly higher for deviant girls than for deviant boys. Scoring high on one of the scales increased the probability of scoring high on the second scale. The discussion focuses on factors that may affect agreement between parents and teachers when behavioural symptoms are assessed.     

Fear of falling is independently associated with recurrent falls in patients with Parkinson’s disease: a 1-year prospective study

The present study aimed to examine whether fear of falling (FoF) could independently predict recurrent falls in people with Parkinson’s disease (PD). Seventy patients with PD completed the study. Thirty-two patients had fallen at least once in the previous 12 months. Most of patients with PD had moderate disease severity (Hoehn and Yahr stage III). FoF was assessed by the activities-specific balance confidence (ABC) scale. PD specific motor and balance impairment was determined by Unified PD rating scale (UPDRS). Functional mobility was measured by timed-up-and-go (TUG) test. All patients were followed for 12 months by phone interview to register monthly fall incidence. Results of stepwise discriminant analysis showed that after adjusting for the fall history (F = 32.57, P < 0.001) and UPDRS motor score (F = 25.23, P < 0.001), ABC score (F = 18.84, P < 0.001) remained as a significant predictor of recurrent falls. We further established that a cut-off ABC score of 69 (i.e. 0–100, 0 indicates no confidence and 100 indicates full confidence) demonstrated the best sensitivity (93%) in predicting future falls in PD patients. The results indicate that those with an ABC score <69 at baseline had significantly higher risk of sustaining recurrent falls in the next 12 months. Findings of the present study highlight the importance of considering FoF during fall risk assessment in patients with PD.     

Caregivers’ knowledge of autism in a local peri-urban community of Nepal: A cross-sectional study in Kirtipur,Kathmandu

Early markers of autism emerge during the first two years of life with a reliable diagnosis possible by 24 months of age. Caregivers’ knowledge about autism is crucial to facilitate the early identification of autism. However, research on caregivers’ knowledge of autism in low- and middle-income countries (LMICs) is scarce. The current study examined Nepalese caregivers’ knowledge about autism and potential differences in knowledge as a consequence of demographic characteristics. A population-based cross-sectional survey was conducted with 1895 caregivers (Mean age = 28 years, SD = 5.2) with children between 11–30 months of age in Kirtipur Municipality in Kathmandu, Nepal. Although Nepalese caregivers showed strong knowledge on early social attention and communication behaviours in infants/toddlers, only one-fourth reported any knowledge about autism. Moreover, knowledge on autism differed significantly by caregivers’ age, education and caste/ethnicity. Caregivers over 25 years of age, with more than secondary education and belonging to the upper caste and advantaged groups, had more knowledge about autism. The significant lack of knowledge regarding autism amongst Nepalese caregivers indicates the need to raise awareness, targeting caregivers from all ages, educational levels and caste/ethnic groups, to facilitate early recognition of autism.     

Complex gene–gene interactions in multiple sclerosis: a multifactorial approach reveals associations with inflammatory genes

The complex inheritance involved in multiple sclerosis (MS) risk has been extensively investigated, but our understanding of MS genetics remains rudimentary. In this study, we explore 51 single nucleotide polymorphisms (SNPs) in 36 candidate genes from the inflammatory pathway and test for gene–gene interactions using complementary case–control, discordant sibling pair, and trio family study designs. We used a sample of 421 carefully diagnosed MS cases and 96 unrelated, healthy controls; discordant sibling pairs from 146 multiplex families; and 275 trio families. We used multifactor dimensionality reduction to explore gene–gene interactions. Based on our analyses, we have identified several statistically significant models including both main effect models and two-locus, three-locus, and four-locus epistasis models that predict MS disease risk with between ∼61% and 85% accuracy. These results suggest that significant epistasis, or gene–gene interactions, may exist even in the absence of statistically significant individual main effects.Alison A. Motsinger and David Brassat contributed equally to this work.     

A pre–post intervention study investigating the confidence and knowledge of health professionals communicating with people with aphasia in a metropolitan hospital

Background: Communication partner training (CPT) is a social intervention approach that can be used to educate and train volunteers, family members, significant others and professionals, in addition to providing skills and strategies for people with aphasia (PWA). This body of CPT research extends the current research in the area by implementing CPT with health professionals (HPs) in using PWA as trainers in a sub-acute care setting, but some previous research in acute care setting has primarily focused on caregivers and volunteers in a community setting.

Aims: The aim of this study was to investigate implementing a CPT programme in an Australian metropolitan hospital by training professionals and utilising PWA as a key component of the training to facilitate “real-time” practical skill acquisition.

Method & Procedures: Fifty-two HPs from multidisciplinary teams (allied health assistants, audiology, dietetics, occupational therapy, pharmacy, physiotherapy, social work and nursing staff in a rehabilitation unit) participated in a pre–post intervention study. HPs completed a questionnaire to collect demographic information, identify current knowledge of aphasia-related communication strategies and ascertain their confidence levels (using a 100-mm visual analogue scale) related to interacting with people with communication impairments and list any strategies/resources that could be used as an adjunct to facilitate exchanges with PWA. These open-ended responses were categorised into four main groups using content analysis. The CPT component, adapted from two programmes run by “Connect—Communication Disability Network” in the United Kingdom, consisted of an educational lecture on communicating with PWA given by a speech-language pathologist and a practical conversation with a person with aphasia. The PWA provided “expert” practical feedback to the professionals participating in the training.

Outcomes & Results: HPs reported mean confidence levels of 46.56 mm (SD = 15.71) prior to training and 75.81 mm (SD = 12.16) post-training, t(51) = 12.479 (p < .001). More HPs were able to identify relevant strategies to assist with communication following the training (median total responses = 52, interquartile range [IQR] = 50–52), than prior to the training (median total responses = 15, IQR = 9–38).

Conclusions: The results provide preliminary evidence to suggest that a CPT programme may be an effective method to increase the confidence and knowledge of communication strategies of HPs, in an acute care setting, when interacting with PWA.     

Psychosocial risk factors associated with fathers’ mental health in the postnatal period: results from a population-based study

Purpose

Fathers’ psychological distress in the postnatal period can have adverse effects on their children’s wellbeing and development, yet little is known about the factors associated with fathers’ distress. This paper examines a broad range of socio-demographic, individual, infant and contextual factors to identify those associated with fathers’ psychological distress in the first year postpartum.

Methods

Secondary analysis of data from 3,219 fathers participating in the infant cohort of the Longitudinal Study of Australian Children at wave 1 when children were 0–12 months of age.

Results

Approximately 10 % of fathers reported elevated symptoms of psychological distress. Logistic regression analyses revealed that the risk factors were poor job quality, poor relationship quality, maternal psychological distress, having a partner in a more prestigious occupation and low parental self-efficacy.

Conclusion

These findings provide new information to guide the assessment of fathers’ risk for psychological distress in postnatal period. There are also important social policy implications related to workplace entitlements and the provision of services for fathers.     

Lost in transition? Perceptions of health care among young people with mental health problems in Germany: a qualitative study

Background

The transitioning of young patients from child and adolescent to adult mental health services when indicated often results in the interruption or termination of service. The personal views of young service users on current clinical practice are a valuable contribution that can help to identify service gaps. The purpose of this qualitative study was to explore the perceptions of health care of young people with mental health problems in the transition age range (16–25 years), and to better understand health behaviour, care needs and the reasons for disengaging from care at this point in time.

Methods

Seven group discussions and three interviews were conducted with 29 young people in this age range. Discussions were audio-taped, transcribed verbatim and analysed following the reconstructive approach of R. Bohnsack’s documentary method.

Results

An overarching theme and nine subthemes emerged. Participants displayed a pessimistic and disillusioned general attitude towards professional mental health services. The discussions highlighted an overall concern of a lack of compassion and warmth in care. When they come into contact with the system they often experience a high degree of dependency which contradicts their pursuit of autonomy and self-determination in their current life stage. In the discussions, participants referred to a number of unmet needs regarding care provision and strongly emphasised relationship issues. As a response to their care needs not being met, they described their own health behaviour as predominantly passive, with both an internal and external withdrawal from the system.

Conclusions

Research and clinical practice should focus more on developing needs-oriented and autonomy-supporting care practice. This should include both a shift in staff training towards a focus on communicative skills, and the development of skills training for young patients to strengthen competences in health literacy.

     

Non-motor symptoms in Huntington’s disease: a comparative study with Parkinson’s disease

Journal of Neurology - The presence of non-motor symptoms in Huntington’s disease (HD) has not been systematically assessed so far. Our objective was to know their prevalence and to compare...     

Increasing cancer risk over calendar year in people with multiple sclerosis: a case–control study

Journal of Neurology - Data on cancer prevalence and incidence in multiple sclerosis (MS) patients are controversial. This study is aimed at estimating cancer risk in MS patients. Nested...     

Effective long-term treatment with incobotulinumtoxin (Xeomin®) without neutralizing antibody induction: a monocentric,cross-sectional study

Journal of Neurology - Among the spectrum of licensed botulinum neurotoxin preparations incobotulinumtoxin (incoBoNT/A; Xeomin®) is the only one which does not contain complex proteins....     

Association of high BMI with subclinical hypothyroidism in young,first-episode and drug-naïve patients with major depressive disorder: a large-scale cross-sectional study

European Archives of Psychiatry and Clinical Neuroscience - Thyroid dysfunction is known to be associated with obesity, but the reliability of this relationship is easily affected by drug...     

A cross-sectional study of clinical management,and provision of health services and their utilisation,by patients with Parkinson’s disease in urban and regional Victoria

Our objective was to evaluate and compare clinical management, utilisation of health services and quality of life (QoL) in patients with Parkinson’s disease (PD) attending clinics in urban and regional Victoria. A cross-sectional survey was conducted on 210 patients with PD attending specialist neurological clinics in a regional area (Ballarat) (n = 97), and an urban area (Melbourne) (n = 113), Victoria. Demographic characteristics of patients with PD, QoL, patterns of disease and management and utilisation of medical and allied health services were analysed. Compared to patients with PD from urban clinics, patients in the regional clinic were significantly older and were diagnosed at a later age with a shorter duration of treatment (all p < 0.05). Despite no significant difference in disease severity (measured by Unified Parkinson’s Disease Rating Scale scores) between the groups, patients in the urban clinic reported a lower QoL (p = 0.003). Patients in the regional clinic were more satisfied with their treatment, despite seeing their medical specialist less frequently (p < 0.001) and having a higher rate of early misdiagnosis (p = 0.015). Patients from regional clinics reported a poorer understanding of their illness than patients in the urban clinic (p = 0.049). Half of all respondents were interested in using telemedicine services. Two-thirds (71%) of all patients used allied health services, with patients in the urban clinic utilising more and desiring greater access to these services (p < 0.05). In conclusion, we found significant differences in the presentation, management and use of health services between patients accessing regional and urban PD clinics in Victoria. Telemedicine may be an effective, and even desirable, method for facilitating improved diagnosis and referral for appropriate therapies.     

High-resolution ultrasound in patients with Wartenberg’s migrant sensory neuritis,a case-control study

Objective

Wartenberg’s migrant sensory neuritis (WMSN) is a rare, patchy, pure sensory neuropathy of unknown etiology. High-resolution ultrasonography (HRUS) is an emerging diagnostic technique for neuropathies, but it has not been applied in WMSN. In this study we aimed to determine HRUS abnormalities in WMSN.

Increasing incidence of multiple sclerosis among women in Buenos Aires: a 22 year health maintenance organization based study

Studies in multiple sclerosis (MS) suggest a trend of increasing disease prevalence and incidence, and especially, a disproportional increase in the incidence of multiple sclerosis in women. The objective of this study was to evaluate the incidence of MS over 22 years and to determine the ratio in incidence of men to women in a health maintenance organization from Buenos Aires, Argentina. The population was made up of all members of a hospital-based HMO affiliated between January 1992 and December 2013. Each person was followed contributing time at risk. Cases with definite diagnosis of MS were included. Incidence density was calculated with 95 % confidence intervals and compared between women and men. 165,456 subjects were followed for a total of 1,488,575 person–years, of whom 42 developed MS. Incidence density was 3/100,000 person–years (95 % CI 2.1–3.5/100,000 person–years). During this period (1992–2013), the incidence rate in women increased from 1/100,000 (95 % CI 0.8–1.6) to 4.9/100,000 (95 % CI 4.1–5.4) (p < 0.001), while in men the incidence ranged from 1.4/100,000 (95 % CI 1–1.7) to 1.8 (1.3–2.1) (p = 0.16). Incidence density during the study period increased significantly in women but not in men. This is the first report of this phenomenon in Latin America region.     

Modifiable risk factors of COVID-19 in patients with multiple sclerosis: a single-centre case–control study

Journal of Neurology - Disease and treatment-associated immune system abnormalities may confer higher risk of Coronavirus disease 2019 (COVID-19) to people with multiple sclerosis (PwMS). We...     

Subjects at risk of Parkinson’s disease in health checkup examinees: cross-sectional analysis of baseline data of the NaT-PROBE study

Journal of Neurology - The present study aimed to survey the prevalence of prodromal symptoms of Parkinson’s disease (PD) in Japanese health checkup examinees, for identifying at-risk...     

Canadian Adolescents’ Internalized Symptoms in Pandemic Times: Association with Sociodemographic Characteristics,Confinement Habits,and Support

Psychiatric Quarterly - Adolescence is a time of increased risk for developing symptoms of anxiety and depression, especially for girls. The stress and social isolation experienced during...     

Familial aggregation in atypical Parkinson’s disease: a case control study in multiple system atrophy and progressive supranuclear palsy

Familial aggregation has been consistently found in PD, but it is unclear whether there is a familial aggregation in families of patients with multiple system atrophy (MSA) or progressive supranuclear palsy (PSP). MSA and PSP cases were recruited from a two-arm case control study. One control was matched to each case for age, gender and living area. Medical history of first-degree relatives was obtained through a face-to-face questionnaire. Age-specific cumulative incidence of Parkinsonism and dementia in first-degree relatives of cases and controls was compared for MSA and PSP separately. Seventy-one pairs for MSA and their controls and 79 pairs for PSP and their controls were included. No significant familial aggregation was found in PSP. MSA cases reported Parkinsonism more often, but not dementia in their first-degree relatives than controls. MSA patients, but not those with PSP, have Parkinsonism more often in their first-degree relatives than controls.