Childhood predictors of use and costs of antidepressant medication by age 24 years: findings from the Finnish Nationwide 1981 Birth Cohort Study.

OBJECTIVE: Prior studies on antidepressant use in late adolescence and young adulthood have been cross-sectional, and prospective associations with childhood psychiatric problems have not been examined. The objective was to study the association between childhood problems and lifetime prevalence and costs of antidepressant medication by age 24 years. METHOD: A total of 5,547 subjects from a nation-wide birth cohort were linked to the National Prescription Register. Information about parent- and teacher-reported conduct, hyperkinetic and emotional symptoms, and self-reported depressive symptoms was gathered at age 8 years. The main outcome measure was national register-based lifetime information about purchases of antidepressants between ages 8 and 24 years. In addition, antidepressant costs were analyzed using a Heckman maximum likelihood model. RESULTS: In all, 8.8% of males and 13.8% of females had used antidepressants between age 13 and 24 years. Among males, conduct problems independently predicted later antidepressant use. In both genders, self-reported depressive symptoms and living in other than a family with two biological parent at age 8 years independently predicted later antidepressant use. Significant gender interactions were found for conduct and hyperkinetic problems, indicating that more males who had these problems at age 8 have used antidepressants compared with females with the same problems. CONCLUSIONS: Childhood psychopathology predicts use of antidepressants, but the type of childhood psychopathology predicting antidepressant use is different among males and females.

Childhood bullying as a predictor for becoming a teenage mother in Finland.

The aim of this study is to examine the association between bullying behaviour at the age of 8 and becoming a mother under the age of 20. This birth cohort study included 2,867 Finnish girls at baseline in 1989. Register-based follow-up data on births was collected until the end of 2001. Information, both on the main exposure and outcome, was available for 2,507 girls. Both bullies and victims had an increased risk of becoming a teenage mother independent of family-related risk factors. When controlled for childhood psychopathology, however, the association remained significant for bullies (OR 2.2, 95% CI 1.2-4.1) and bully-victims (OR 1.8, 95% CI 1.05-3.2), but not for pure victims. Reports of bullying and victimisation from the girls themselves, their parents and their teachers were all associated with becoming a teenage mother independent of each other. There is a predictive association between being a bully in childhood and becoming a mother in adolescence. It may be useful to target bullies for teenage pregnancy prevention.

CBCL in the assessment of psychopathology in Finnish children with intellectual disability.

Structured checklists have been used to supplement psychiatric assessment of children with normal intelligence, but for children with intellectual disability, only a few checklists exist. We evaluated the Child Behavior Checklist (CBCL) in the assessment of psychopathology in Finnish children with intellectual disability. The CBCL was completed by parents or other carers of 90 children aged 6-13 years. Of the 118 CBCL problem items, the lowest scores were for 'Suicidal talks' and 'Alcohol, drugs', and the highest score for 'Acts too young'. Total Problem, Internalizing, and Externalizing scores were highest among children with moderate intellectual disability and lowest among those with profound intellectual disability. Externalizing scores were significantly higher among children with mild or moderate intellectual disability than among those with severe or profound intellectual disability. Compared with the original normative samples, Total Problem scores were higher in the present study. With a T-score cut-off point of 60, the rated frequency of psychiatric disorders was 43%. We conclude that, despite certain limitations, the CBCL can be used in the assessment of psychopathology among children with mild intellectual disability but is less reliable for those with moderate, severe, or profound intellectual disability.