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.

Prevention of public health risks linked to bullying: a need for a whole community approach.

Bullying is a very toxic psychosocial stressor associated with serious health problems and death, affecting both the victims and the bullies. This form of abuse or maltreatment occurs around the world and along the lifespan. Health professionals have the unique responsibility of promoting the development of community initiatives for the prevention of bullying and related health problems. This effort must include ongoing programs with elements of primary, secondary, and tertiary prevention. These programs should be supported and monitored by a public health policy with a strategy aimed at developing a whole community awareness about bullying and the related health risks, prohibiting bullying, and developing emotionally and physically safe environments in schools and workplace settings. Public health policy should mandate the monitoring, detection, and reporting of bullying incidents; provide guidance for school intervention; and offer guidelines for medical consultation.

Mother-child interaction on video compared with infant observation: Is five minutes enough time for assessment?

In this small-scale preliminary study, we compared the correlation between assessments based on short videorecordings and infant observation. Five mother-infant dyads were assessed when the child was 1 year of age according to the Parent-Child Early Relational Assessment method (PCERA, 65 items) developed by Roseanne Clark (1985), using both observations covering 1 year and a 5-min videorecording. The agreement between two video raters was sufficient (κ = 0.41-1.00 or proportion of agreement: 4/5-5/5) in 54 items. In 42 (78%) of these items, there was at least moderate agreement (κ = 0.41-1.00 or proportion of agreement 4/5-5/5), and in another 7 (13%) items fair (κ = 0.21-0.40 or proportion of agreement 3/5) agreement between the video and observation ratings, and both methods revealed the areas of strength and areas of concern of the dyads. Only a few items describing negative interactive style were assessed as identifying concern, but such items identified the dyad which was assessed to have the most constant problems. Most items describing positive interactive style and identifying the areas of concern in the interactive style according to both observation and video assessment were connected with the parental and dyadic engagement in the interaction. Five items with slight or poor (κ ≤ 0.20 or proportion of agreement 1/5-2/5) agreement between video rater and observer gave rise to questions about how the videorecording situation affected the behavior of the dyads, and about the limits of assessment methods and assessment of dyads with children of different ages and dyads from different cultures. ©2005 Michigan Association for Infant Mental Health.