Russian child mental health A cross-sectional study of prevalence and risk factors

Abstract Background The fall of communism and subsequent economic crises have been followed by major social and health problems. High rates of child mental health problems are frequently cited by the Russian media, though there is little relevant evidence. Aims The aim of this study was to investigate the prevalence and associations of child mental health problems in Russia using internationally recognised measures and diagnostic systems. Method A two-stage, two-phase cross-sectional survey of the mental health of 7- to 14-year-olds involved random sampling of schools, followed by random sampling of pupils from school lists. A sample of 448 children was obtained, representing an 83% participation rate. In the first phase, screening measures of psychopathology and risk were administered to parents, teachers and 11- to 14-year-olds. In the second phase, more detailed psychiatric assessments were carried out for subgroups of screen-positive and screen-negative children (N=172). Results The prevalence of psychiatric disorder was about 70% higher than that recently found in Britain with comparable measures, but there were few differences between Britain and Russia in type of disorder or key risk factors. Conclusion There is a pressing need for evidence-based mental health treatments to be made widely available to Russian children and adolescents.     

Epidemiological study of children's mental health in Fuzhou]

This epidemiological survey of mental health's conditions among 1,428 children below the age of 14 in an urban and rural area with a population of 398,674 was carried out with the standardized methods and diagnostic criteria, the result shows that the total incidence of abnormal mental health's conditions is 70.03/1000. Through a statistical deal, the result shows that the weights of these infants are slight, that they can only recognize their parents slowly, that their parents are in low educated levels. That the emotion between their parents is always not so harmonious, and that their parents always treat their children with different attitudes. In short, all these factors are in close connection with the incidence of abnormal mental health of these children.     

Validation of the Autism Spectrum Screening Questionnaire in a Total Population Sample

There is a lack of instruments validated for screening of autism spectrum disorders (ASD) in general populations and primary care settings. The Autism Spectrum Screening Questionnaire (ASSQ) has previously been shown to have good screening properties in clinical settings. We used the ASSQ to screen a total population of 7–9 year-olds (N = 9430) for ASD in the Bergen Child Study. Parents and teachers filled in the ASSQ, and high-scorers were invited for clinical assessment, along with a large group of screen negative children. We found that the ASSQ was well suited as a general population screen. Combining parent and teacher ASSQ and using cut-off score of ≥17 provided the most efficient screen with sensitivity of 0.91 and specificity of 0.86.     

Managerial and environmental factors in the continuity of mental health care across institutions

OBJECTIVE: The authors examined the association of continuity of care with factors assumed to be under the control of health care administrators and environmental factors not under managerial control. METHODS: The authors used a facility-level administrative data set for 139 Department of Veterans Affairs medical centers over a six-year period and supplemental data on environmental factors to conduct two types of analysis. First, simple correlations were used to examine bivariate associations between eight continuity-of-care measures and nine measures of the institutional environment and the social context. Second, to control for potential autocorrelation, multivariate hierarchical linear models with all nine independent measures were created. RESULTS: The strongest predictors of continuity of care were per capita outpatient expenditure and the degree of emphasis on outpatient care as measured by the percentage of all mental health expenditures devoted to outpatient care. The former was significantly associated with greater continuity of care on six of eight measures and the latter on seven of eight measures. The environmental factor of social capital (the degree of civic involvement and trust at the state level) was associated with greater continuity of care on five measures. The degree to which non-VA mental health services were funded in a state was unexpectedly found to be positively associated with greater continuity of care. In multivariate analysis using hierarchical linear modeling, significant relationships with continuity of care remained for per capita outpatient expenditures, overall outpatient emphasis, and social capital, but not for non-VA mental health funding. A linear term representing the year was positively and significantly associated with six of the eight examined continuity-of-care measures, indicating improvement in continuity of care for the period under study, although the explanation for this trend over time is unclear. CONCLUSIONS: Several factors potentially under managerial control are associated with increased mental health continuity of care.     

军人中精神障碍流行病学研究现状

精神障碍严重影响部队的战斗力。在平时,官兵在面临调职使用、转业安排时,常因与个人愿望不符、产生心理冲突,而导致精神障碍。在抢险救灾、军事演习、大型军事比武、应付突发事件等急难险重任务时,官兵可因心理准备不足,心理负荷加大,而诱发精神障碍。战争环境下,军人要面对更多重大的心理应激,精神障碍的发生明显增加,本文针对国内外军人精神障碍的流行病学现状综述。     

Screening mental health problems during adolescence: Psychometric properties of the Spanish version of the Strengths and Difficulties Questionnaire

The main purpose of the present study was to test the psychometric properties of the Strength and Difficulties Questionnaire (SDQ), self-reported version, in Spanish adolescents, introducing a five-point Likert response scale. The sample consisted of 1474 adolescents with a mean age of 15.92 years (SD = 1.18). The level of internal consistency of the SDQ Total score was .75, ranging from .56 to .71 for the subscales. Results from exploratory factor analysis revealed a three-factor structure as the most satisfactory. Confirmatory factor analyses showed that the five-factor model (with modifications) displayed better goodness of-fit indices than the other hypothetical dimensional models tested. Furthermore, strong measurement invariance by age and partial measurement invariance by gender was supported. The study of the psychometric properties confirms that the Spanish version of the SDQ, self-reported form, is a useful tool for the screening of emotional and behavioural problems in adolescents.     

Cross-cultural issues in research on child mental health

This article describes and discusses the major challenges in cross-cultural research on child mental health. Based on a literature review, the article summarizes limitations of past research in this area. Possible conceptualization and operationalization of culture and approaches to derive cross-culturally equivalent methods are discussed.     

Validation of the Finnish Autism Spectrum Screening Questionnaire (ASSQ) for Clinical Settings and Total Population Screening

We assessed the validity and determined cut-off scores for the Finnish Autism Spectrum Screening Questionnaire (ASSQ). A population sample of 8-year-old children (n?=?4,408) was rated via the ASSQ by parents and/or teachers, and a subgroup of 104 children was examined via structured interview, semi-structured observation, IQ measurement, school observation, and medical records. Autism spectrum disorders (ASDs) were diagnosed following DSM-IV-TR criteria. A search for hospital-registered ASDs was performed. For Finnish higher-functioning primary school-aged, 7- to 12-year-olds, the optimal cut-off score was 30 in clinical settings and 28 in total population screening using summed ASSQ scores of parents' and teachers' ratings. Determining appropriate cut-off scores in ASD screening in different languages and in different cultures is of utmost importance.     

Questionnaire screening for mental health problems in Bangladeshi children: a preliminary study

  Background: In the developing world, child psychiatric disorders are common but child mental health professionals are scarce. A cheap and effective method for detecting child psychiatric problems would be useful. The present study examined the potential suitability of the Strengths and Difficulties Questionnaire (SDQ) for this role. Methods: SDQs were administered to the parents and teachers of 261 Bangladeshi 4–16 year olds: 99 drawn from a psychiatric clinic and 162 drawn from the community. Self-report SDQs were completed by 11–16 year olds. Children from the clinic sample were assigned psychiatric diagnoses blind to their SDQ scores. Results: SDQ scores distinguished well between community and clinic samples, and also between children with different psychiatric diagnoses in the clinic sample. A simple algorithm based on SDQ scores was used to predict whether children had hyperkinesis, conduct disorders, emotional disorders or any psychiatric disorder – rates of predicted disorder varied markedly between clinic and community samples. Conclusions: Predictions based on multi-informant SDQs potentially provide a cheap and easy method for detecting children in the developing world with significant mental health problems. The potential effectiveness of any such screening programme should be evaluated on a broad range of children, using both international and culture-specific assessments. Accepted: 4 December 2000     

中学生心理健康水平与个性及防御方式的相关研究

目的 探讨中学生的心理健康水平及人格、防御方式对其心理健康的影响。方法采用整群抽样法抽取中学生463名，实施症状自评量表（SCL-90）、艾森克人格问卷（EPQ）、防御方式量表（DSQ）测量。结果中学生心理问题的检出率为26、78％，男女检出率分别为22．01％，和33．33％。两者比较差异显著（x^2=7．37，P〈0．01）；男女学生各因子分比较，女学生在躯体症状、焦虑、恐怖症状因子、不成熟防御方式、中间型防御方式、精神质、神经质得分均高于男性；对防御方式、人格各因子与SCL-90各因子进行相关分析，SCL-90各因子与防御方式各因子、EPQ神经质、精神质因子呈正相关。对中学生的心理健康水平与人格、防御方式的关系在0．10水平上进行逐步回归分析，不成熟防御方式、神经质因子依次进入回归方程。结论女学生心理健康状况较男学生差，主要表现为躯体症状、焦虑、恐怖症状，防御方式、个性类型与心理健康密切相关，不成熟防御方式、神经质个性是影响心理健康的重要因素。     

Review of child and adolescent refugee mental health

OBJECTIVE: To review stressful experiences and stress reactions among child and adolescent refugees, as well as interventions and ethical considerations in research and clinical work, within the framework of the chronological experiences of child refugees; namely, the phases of preflight, flight, and resettlement. Highlighted are special refugee populations such as unaccompanied minors, asylum seekers, and former child soldiers. Pertinent medical findings are summarized. METHOD: The authors reviewed articles from 1990 to 2003 addressing the topics above. Literature was gathered from databases including PsycINFO, Medline, and SocioFile. Pertinent earlier papers and those from other disciplines cited in database-identified articles were also included. RESULTS: Child and adolescent refugees suffer from significant conflict-related exposures. Reactions to stress may be mediated by coping strategies, belief systems, and social relations. CONCLUSIONS: More research is needed on interventions, specifically on efficacy and cultural relevance. Interventions that have an impact on multiple ecological levels need further development and evaluation.     

Risk factors for child mental health problems in Lithuania: The role of parental nationality

BackgroundWe compare the mental health status of children who reside in Lithuania with parents who are either Lithuanian nationals or non-Lithuanian nationals.MethodData were drawn from the School Child Mental Health Europe survey (SCMHE), a cross-sectional survey of school children aged 6–11 years. A total of 1152 Lithuanian children participated, among them 11.7% from a non-Lithuanian family. Child mental health was assessed using the Dominique Interactive (DI) and the parent- and teacher Strength and Difficulties Questionnaire (SDQ). Parental attitudes were evaluated, and socio-demographics were collected.ResultsOverall 26.7% of non-Lithuanian versus 17.2% of Lithuanian children reported having an internalizing disorder (p = 0.01) mainly due to separation anxiety (16.4% versus 10.2%, p = 0.04). Odds ratio (OR) for child-reported internalizing disorders was 1.86 (95% CI = 1.17–2.96) once adjusted for other factors including being a girl, to be younger, parental unemployment and low caring and low autonomy parental attitudes which were associated with greater odds of internalizing disorders. In addition, 31.9% of non-Lithuanian reported suicidal thoughts versus 22.0% of Lithuanian children p = .02); OR = 1.60 (95% CI = 1.04–2.46) once adjusted for single parent, parental unemployment, parental alcohol problems and overreactivity attitude.ConclusionsBeing a non-national minority in Lithuania is a risk factor for child mental health. These findings suggest that further studies are needed to inform local policy-makers on targeted prevention and intervention programs in these children.