Abnormal Strengths And Difficulties Questionnaire Research Articles

Emotional, hyperactivity and inattention problems in adolescents with immunocompromising chronic diseases during the COVID-19 pandemic

ObjectiveTo assess factors associated with emotional changes and Hyperactivity/Inattention (HI) motivated by COVID-19 quarantine in adolescents with immunocompromising diseases. MethodsA cross-sectional study included 343 adolescents with immunocompromising diseases and 108 healthy adolescents. Online questionnaires were answered including socio-demographic data and self-rated healthcare routine during COVID-19 quarantine and validated surveys: Strengths and Difficulties Questionnaire (SDQ), Pittsburgh Sleep Quality Index (PSQI), Pediatric Quality of Life Inventory 4.0 (PedsQL4.0). ResultsThe frequencies of abnormal emotional SDQ scores from adolescents with chronic diseases were similar to those of healthy subjects (110/343 [32%] vs. 38/108 [35%], p = 0.548), as well as abnormal hyperactivity/inattention SDQ scores (79/343 [23%] vs. 29/108 [27%], p = 0.417). Logistic regression analysis of independent variables associated with abnormal emotional scores from adolescents with chronic diseases showed: female sex (Odds Ratio [OR = 3.76]; 95% Confidence Interval (95% CI) 2.00‒7.05; p < 0.001), poor sleep quality (OR = 2.05; 95% CI 1.08‒3.88; p = 0.028) and intrafamilial violence during pandemic (OR = 2.17; 95% CI 1.12‒4.19; p = 0.021) as independently associated with abnormal emotional scores, whereas total PedsQL score was inversely associated with abnormal emotional scores (OR = 0.95; 95% CI 0.93‒0.96; p < 0.0001). Logistic regression analysis associated with abnormal HI scores from patients evidenced that total PedsQL score (OR = 0.97; 95% CI 0.95‒0.99; p = 0.010], changes in medical appointments during the pandemic (OR = 0.39; 95% CI 0.19-0.79; p = 0.021), and reliable COVID-19 information (OR = 0.35; 95% CI 0.16‒0.77; p = 0.026) remained inversely associated with abnormal HI scores. ConclusionThe present study showed emotional and HI disturbances in adolescents with chronic immunosuppressive diseases during the COVID-19 pandemic. It reinforces the need to promptly implement a longitudinal program to protect the mental health of adolescents with and without chronic illnesses during future pandemics.

Prevalence Of Behavioural Disorders and Its Correlates Among Adolescents in Uttara Kannada, Karnataka –A Cross Sectional Study

Background: Childhood and adolescence are critical stages of life for mental health. This is a time when rapid growth and development takes place. Half of all mental health conditions start by 14 years of age but most cases are undetected and untreated. Behavioural patterns of adolescents are not much explored in India. In this study, we aim to assess the behavioural pattern and its correlates among adolescents in Karwar of Uttara kannada district, Karnataka. Methodology: It is a cross-sectional questionnaire-based study conducted on adolescents studying in Government Pre-University college of Karwar in the month of June and July 2019.The Strengths and Difficulties Questionnaire (SDQ) was used to assess the mental health status of adolescents. The total difficulties score is used to categorize adolescents as normal (0-15) and high [borderline (16-19) and abnormal (20-40)]. Results: Although majority of adolescents were in the normal range, a significant number of adolescents were in borderline (18.4%) and abnormal (14.1%) SDQ scores. Binary logistic regression analysis shows that use of social media, abnormal emotional grade, conduct grade, hyperactivity grade, peer grade and impact grade were found statistically significant. Conclusion: Significant numbers of adolescents were in high range of SDQ scores and suffered from emotional, conduct, prosocial behaviour and hyperactivity problems.

Association between community noise and children's cognitive and behavioral development: A prospective cohort study.

Noise exposure has been associated with adverse cognitive and behavioral outcomes in children, but evidence on longitudinal associations between community noise and child development in low- and middle-income countries is rare. We investigated associations between community noise and behavioral and cognitive development in preschool children in São Paulo. We linked child development data from the São Paulo Western Region Birth Cohort with average (Lden) and night-time (Lnight) community noise exposure at children's home, estimated by means of a land use regression model using various predictors (roads, schools, greenness, residential and informal settlements). Outcomes were the Strengths and Difficulties Questionnaire (SDQ) and Regional Project on Child Development Indicators (PRIDI) at 3years of age and the Child Behavior Checklist (CBCL) and International Development and Early Learning Assessment (IDELA) at 6years of age. We investigated the relationship between noise exposure and development using cross-sectional and longitudinal regression models. Data from 3385 children at 3years of age and 1546 children at 6years of age were analysed. Mean Lden and Lnight levels were 70.3dB and 61.2dB, respectively. In cross-sectional analyses a 10dB increase of Lden above 70dB was associated with a 32% increase in the odds of borderline or abnormal SDQ total difficulties score (OR=1.32, 95% CI: 1.04; 1.68) and 0.72 standard deviation (SD) increase in the CBCL total problems z-score (95% CI: 0.55; 0.88). No cross-sectional association was found for cognitive development. In longitudinal analyses, each 10dB increase was associated with a 0.52 SD increase in behavioral problems (95% CI: 0.28; 0.77) and a 0.27 SD decrease in cognition (95%-CI: 0.55; 0.00). Results for Lnight above 60dB were similar. Our findings suggest that community noise exposure above Lden of 70dB and Lnight of 60dB may impair behavioral and cognitive development of preschool children.

Behavioral Symptoms May Correlate With the Load and Spatial Location of Tubers and With Radial Migration Lines in Tuberous Sclerosis Complex.

Objective: Tuberous sclerosis complex (TSC) is a multisystem neurocutaneous genetic disorder. The clinical manifestations are extensive and include neurological, dermatological, cardiac, ophthalmic, nephrological, and neuropsychiatric manifestations. The prediction and pathophysiology of neuropsychiatric disorders such as emotional symptoms, conduct problems, hyperactivity, and poor social behavior are poorly understood. The aim of the study was to diagnose neuropsychiatric symptoms in individuals with TSC, and to examine their possible correlations with quantity, magnitude, and spatial location of tubers and radial migration (RM) lines.Methods: The cohort comprised 16 individuals with TSC, aged 5–29 years, with normal or low normal intelligence. The participants or their parents were requested to fill Strengths and Difficulties Questionnaire (SDQ) and the TAND (TSC-associated neuropsychiatric disorders) Checklist for assessment of their neuropsychiatric symptoms. Correlations were examined between these symptoms and the magnitude, quantities, and locations of tubers and white matter RM lines, as identified in T2/FLAIR brain MRI scans.Results: The SDQ score for peer relationship problems showed correlation with the tuber load (r = 0.52, p < 0.05). Tuber load and learning difficulties correlated significantly in the temporal and parietal area. Mood swings correlated with tubers in the parietal area (r = 0.529, p < 0.05). RM lines in the temporal area correlated with abnormal total SDQ (r = 0.51, p < 0.05). Anxiety and extreme shyness were correlated with RM lines in the parietal area, r = 0.513, p < 0.05 and r = 0.593, p < 0.05, respectively. Hyperactive/inattention correlated negatively with RM lines in the parietal area (r = −707, p < 0.01).Conclusions: These observations may lead to future studies for precise localization of neuropsychiatric symptoms, thereby facilitating directed therapy.

Emotional and behavioural problems in children and adolescents: The role of constipation.

The functional constipation (FC) is a source of an expressive suffering in children, negatively affecting their emotional, social, and physical well-being. The objective of this study is to describe the clinical and behavioural characteristics of children/adolescents with FC. A cross-sectional, observational, analytical study was conducted in public places by interviewing parents of children/adolescents about their child's bowel habits and psychological profile. Bowel symptoms were investigated using the Rome IV criteria. The Strengths and Difficulties Questionnaire (SDQ) was used to evaluate the emotional and behavioural problems. Of 799 children/adolescents included, 424 (53.1%) were female. Mean age was 9.1± 2.7 years. FC prevalence was 20.4%. The most common symptoms in Rome IV criteria were 'painful or hard bowel movements' (n= 110; 67.5%; 95% confidence interval: 60.0-74.3) and 'retentive posturing or excessive volitional stool retention' (n= 89; 54.6%; 95% confidence interval: 46.9-62.1). Median scores for internalising symptoms (7; interquartile range (IQR): 4-9 vs. 5; IQR: 2-7; P< 0.001) and externalising symptoms (7; IQR 4-11 vs. 6; IQR 3-9; P< 0.001) were higher in constipated children compared to non-constipated participants, respectively. The SDQ domains that were associated with FC were emotional symptoms (median 4, P< 0.001) and conduct problems (median 3, P< 0.001). No association was found between faecal incontinence and median scores for the internalising/externalising symptoms. All Rome IV criteria were associated with abnormal overall SDQ scores. Children and adolescents with FC had more emotional and behavioural problems irrespective of whether faecal incontinence was present or not, with higher scores for internalising and externalising symptoms compared to non-constipated children.

Impacts of international labor migration on the mental health and well-being of left-behind children

Abstract Background Labor migration is a challenge for the globalised world due to its long-term effects such as the formation of transnational families with the particularly vulnerable groups of left-behind children (LBC). These families, where family members of migrant workers are 'left-behind' are becoming common practice in many developing countries. In this systematic literature review, we aimed to investigate the impacts of parental labor migration on the mental health and well-being of their LBC. Methods Following the PRISMA guidelines, we performed a systematic literature search in English using PubMed, PsychINFO, Web of Science, Cochrane Library and Google Scholar for studies, investigating mental health and well-being among LBC who live in transnational families. Case-reports, qualitative studies as well as opinion papers were excluded. We summarized the evidence and additionally compared quantitative results. Results 25 studies were selected for the final analysis. We found that mental health and well-being outcomes of LBC differ across regions and sometimes even within regions. Only studies conducted in South America and South Asia observed purely negative effects. Overall, LBC show abnormal SDQ (Strengths and Difficulties Questionnaire) scores and report higher levels of depression and loneliness, than children who do not live in transnational families. Evidence suggests that gender of migrant parent, culture and other transnational family characteristics such as family arrangement, the role of the mother and the role of the father contribute to the well-being and psychological health of LBC. Conclusions International migration of parents has more negative than positive effects (e.g. through remittances) on the mental health and well-being of LBC. However, the effects strongly depend on family arrangements and care giving practices in migrants' sending countries. Key messages Further research utilizing longitudinal data is needed to better explore the complex and long-term effects of parental migration on LBC. Multidimensional family characteristics are crucial and should be better explored when examining the impacts of migratory separation on left-behind children.

The Association Between Preeclampsia and Childhood Development and Behavioural Outcomes.

To examine the associations between preeclampsia and longitudinal child developmental and behavioural outcomes using data from a nationally representative study of children living in Ireland. We used maternal-reported data from the Growing Up in Ireland longitudinal study of children. Data on preeclampsia and preeclampsia + small for gestational age (SGA) were collected when children were 9-months old. Data on child development and behavioural outcomes were collected at 9-months using the Ages and Stages Questionnaire (ASQ), and at 3years, 5years and 7-8years using the Strengths and Difficulties Questionnaire (SDQ). Multivariate logistic regression analysis was used to examine the association between preeclampsia exposure and failure of ASQ domains, and abnormal SDQ domains. Linear spline multilevel models were used to examine the association between preeclampsia and preeclampsia + SGA and repeated measures of SDQ. All models controlled for several perinatal and sociodemographic factors. A total of 10,692 children were included in the study at baseline, representing a weighted total of 70,791. Multivariate logistic regression suggested that preeclampsia was not associated with failing any ASQ domain. Preeclampsia was associated with abnormal SDQ cut-off of emotional (≥ 5) and hyperactivity (≥ 7) domains at age 5years only. In the linear spline model, mean SDQ score was higher at each time point in exposed groups. While we did not find strong evidence of associations between preeclampsia and child developmental and behavioural outcomes overall, some associations between preeclampsia-exposure and subtle behavioural issues did persist. Further research is needed to replicate these findings, and determine the clinical significance of changes in SDQ scores.

Developmental outcomes at age four following maternal antiepileptic drug use

We investigated whether prenatal antiepileptic drug (AED) exposure was associated with adverse outcomes in the Before School Check (B4SC) assessments, particularly the assessments measuring neurodevelopment. Children exposed to AEDs were identified by linking women dispensed AEDs in the Pharmaceutical Collection to births recorded on the National Minimum Dataset (NMDS). Multinomial logistic regression was used to estimate adjusted risk ratios (aRRs) and 95% confidence intervals (CIs) for outcomes of the parent-completed Parental Evaluation of Developmental Status (PEDS) questionnaire and Strengths and Difficulties Questionnaire (SDQ), after adjusting for gender, ethnicity, and socioeconomic deprivation. Between 2012 and 2016, 606 children with a mother who had been dispensed one or more AEDs during pregnancy had taken part in the B4SC. Prenatal exposure to sodium valproate (n = 161) or lamotrigine (n = 149) monotherapy was associated with an increased risk of having an abnormal SDQ — parent-completed (SDQP) score, ≥17 — indicating emotional or behavioral concerns (9.32% of children exposed to sodium valproate monotherapy had an abnormal score; aRR: 2.11; 1.23–3.63; lamotrigine 8.05%; aRR: 2.21; 1.21–4.02). Prenatal exposure to carbamazepine monotherapy (n = 201) was not associated with an increased risk of having an abnormal total SDQP score but was associated with increased risks in the individual domains of the SDQP. Prenatal exposure to AED polytherapy (n = 57) was associated with the highest risk of abnormal SDQP scores (17.54% of children exposed to polytherapy had abnormal scores; aRR: 2.75; 1.25–6.02). Prenatal exposure to sodium valproate and lamotrigine is associated with an increased risk of concerns about emotional and behavioral development being reported by parents in a neurodevelopmental screening program. Additional investigation is required into why significant differences between AEDs were not seen in this study.

Are School-going Adolescents Mentally Healthy? Case Study from Sabarkantha, Gujarat, India.

Background:Mental health issues becoming the global public health challenge, especially among the youth (12–24 years of age), although they are often detected later in life. In India, the adolescent population constitutes a quarter of the country's population and burden of disease varies from 9.5 to 102/1000 population. Most of the mental health disorders remain unidentified due to negligence and ignorance of multiple factors. Keeping this in mind and lack of population-based studies with good quality for guiding the mental health policies, this study aims to document the prevalence of emotional and behavioral difficulties among adolescents in Sabarkantha district of Gujarat, India.Methods:This is a school-based cross-sectional study conducted among 11–19 years of school-going adolescents during August–September 2016. About 477 adolescents who gave consent to participate were selected from 20 randomly primary and secondary schools. A prevalidated questionnaire for sociodemographic information including global validated standard questionnaire for mental health scoring known as Strengths and Difficulties Questionnaire (SDQ) were administered and self-reported responses were documented. Statistical analysis was conducted through SPSS version 20.Results:Mean age of the study population was 14.2 ± 1.4 years. About 14.6% boys and 12.6% of girls had abnormal total SDQ score, while 15.3% boys and 21.9% of girls had borderline SDQ score. Thus, 70.1% of boys compared to 65.6% girls had normal SDQ score. The difference between mean (higher mean score among girls) of total SDQ score of boys and girls was statically significant at the level of P < 0.05. Major risk factors for self-reported mental health issues were illiterate mother, occupation of parents, which make them away from family during daytime, nuclear family, severe addiction to alcohol in the family, financial problem in the family, and adolescent getting daily physical punishment. One-seventh adolescents are vulnerable for mental health problems found in this study. About one-fifth adolescents have internalizing (emotional) and about one-sixth have externalizing (conduct) manifestations.Conclusion:There is an urgent need to address the emotional and conduct manifestation among school-going adolescents. Rashtriya Kishor Swasthya Karyakram framework needs to address these issues on priority.

Childhood emotional and behavior problems and their associations with cesarean delivery.

Objective:To determine the prevalence of childhood emotional and behavioral problems and examine their associations with cesarean delivery.Methods:Our sample consisted of 8,900 preschoolers from 35 kindergartens in four cities in East China. Parents completed the Strengths and Difficulties Questionnaire (SDQ) and provided other information. Children’s emotional and behavioral problems were assessed using five subscales of the SDQ. Mode of delivery was classified as vaginal or cesarean section (CS); in sub-analyses, we divided CS into elective or emergency delivery. Logistic regression was used to examine associations.Results:A total of 1,209 (13.6%) children had a total SDQ score within abnormal range; 25.5% had peer problems within abnormal range, 9.0% had abnormal emotional symptoms, 13.9% had abnormal conduct problems, 18.9% had abnormal hyperactivity problems, and 16.2% were rated abnormal in pro-social behavior. Overall, 67.3% of the children who participated were delivered by CS. In fully adjusted analysis, CS was significantly associated with abnormal total SDQ score (OR = 1.27; 95%CI 1.10-1.46; p < 0.05) and pro-social behavior (OR = 1.27; 95%CI 1.12-1.45; p < 0.0001). No significant association was found between CS and risk of having conduct problems (OR 1.13; 95%CI 0.98-1.29), peer problems (OR 1.11; 95%CI 0.99-1.24), hyperactivity (OR 1.02; 95%CI 0.91-1.15), or emotional problems (OR 1.06; 95%CI 0.90-1.24).Conclusion:In this sample, CS was associated with risk of behavioral problems, but not with emotional problems. Further research is needed to better understand these associations.

Emotional and behavioral functioning among 10–14-year-old children who were very low birth weight at birth

ObjectiveThis study examined the emotional and behavioral functioning among 10–14 year-old children who were born with very low birth weight (VLBW, &lt;1500).MethodProspective and cross-sectional study of 90 VLBW (&lt;1500 g) survivors born at the Hospital Universitario la Paz in Madrid, Spain, from 2000 to 2005 who were assessed by interviewers using the Strengths and Difficulties Questionnaire (SDQ). Parents also reported on their children's functioning. Children who showed an abnormal SDQ score on the total difficulties subscale or who had psychiatric history were also assessed using the K-SADS-PL.ResultsThe proportion of children with abnormal-self-rated-SDQ scores was as follows: almost 25% of children showed an abnormal score on hyperactivity, nearly 15% on emotional problems, 15% on conduct problems and 10% on peer problems. Overall, 15% of children showed an abnormal score on the total difficulties subscale. Most children (99%) showed a normal score on the prosocial subscale. These proportions were higher when the questionnaire was rated by parents. Thirty-eight percent of children were assessed using the K-SADS and very few of them meet the criteria for at least one psychiatric disorder. Biomedical variables were associated in the expected direction to children's SDQ scores such as birth weight, head circumference and Apgar scores.ConclusionTo conclude, being born with very low birth weight seems to be related to the emotional and behavioral functioning that these children appear to show between 10 and 15 years later.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Relationships between students’ mental health and their perspectives of life at school

Purpose – The purpose of this paper is to explore relationships between students’ self-reported mental health and their perspectives about life at school in metropolitan Adelaide, South Australia. Design/methodology/approach – The Strengths and Difficulties Questionnaire (SDQ) and a purpose designed Living and Learning at School Questionnaire (LLSQ) were administered to 1,715 early adolescents in school Years 7-9. Correspondence analysis, which is a perceptual mapping technique available in SPSS, was used to examine relationships between students’ SDQ subscale scores (Emotional Symptoms, Hyperactivity, Conduct Problems, Pro-social Skills) and the LLSQ subscale scores (Motivation, Learning Strategies, Coping with Schoolwork, Bullying, Numbers of Friends, Safety at School and Teacher Intervention in Bullying Events). Findings – The correspondence analysis produced a two-dimensional visual display (a perceptual map) showing that students’ abnormal, borderline and normal SDQ subscale scores were closely related to their low, medium and high LLSQ subscale scores, respectively. A clear Dimension (factor) emerged, showing a progression from mental health difficulties to strengths, in close association with students’ reports about their school experiences. Research limitations/implications – Caution should be exercised when using the results to interpret events in other contexts. The limitations of self-report methods must be considered. Practical implications – The two-dimensional visual display provides a powerful tool for dissemination of the findings of this study about students’ perspectives to system-level and school-based personnel. This can inform the selection of intervention programs, such as strategies for self-regulation of emotions and learning behaviours, fostering friendships, and supporting academic achievement, that are related to positive mental health. Social implications – This paper can inform school-level policies and practices, such as those relating to professional development to support teachers’ and students’ capabilities (e.g. to manage and prevent bullying) and thus influence the nature of the school experiences that shape students’ perceptions. Originality/value – This paper adds students’ perspectives to the emerging field concerned with designing programs for mental health promotion in schools.

Prevalence of Mental Health Problems in Children and Its Associated Socio-Familial Factors in Urban Population of Semnan, Iran (2012).

Background:The World Health Organization (WHO) defines mental health as “a state of well-being in which every individual realizes own potential, can cope with the normal pressures of life, is able to work effectively, and can make a contribution to community”.Objectives:Mental Health Problems (MHP) is a great concern for all societies in terms of its burden and impact. This survey screened MHP and its impact in an Iranian urban population aged 6 - 12 years old, and explored its associated socio-familial factors.Patients and Methods:The survey was conducted in the elementary schools of Semnan, using random cluster sampling. Collection and analysis of data was performed using the parent version of the “Strengths and Difficulties Questionnaire (SDQ)” and survey commands of Stata-nine, taking into account cluster effect and population weights. Associations were assessed by fitting simple and multiple logistic regression models. P < 0.05 was considered significant.Results:With regard to the SDQ total score, 19.3% (95% CI: 8.6, 30.1) scored above the normal threshold (9.6% abnormal, 9.7% borderline). The frequency of problems ranged between 16.1% (peer problems) and 8.4% (emotional symptoms), and in all subscales boys were affected more than girls. The impact score was abnormal in 68.4% of all children, and was greater in girls than in boys. “A previously diagnosed mental health disorder” (OR = 11.11, 95% CI: 5.55, 25.00), “male gender” (OR = 1.43, 95% CI: 1.10, 1.87 and “less time spent with the child by father” (OR = 1.61, 95% CI: 1.20, 2.17) were significantly associated with an abnormal SDQ.Conclusions:The high rate of MHP in 6 - 12 year-old children and the lack of any significant correlation with their age, underpins the importance of early screening for MHP in schools, with particular focus on high risk groups.

PS-252 Infantile Colic, Hyperkinetic Disorder, And Emotional And Behavioural Problems In Childhood - The Danish National Birthcohort

<h3>Background</h3> Infantile colic is considered a transient problem, but children with infantile colic may have persistent behavioural problems. We studied the association between history of infantile colic, and attention deficit, hyperactivity, emotional and behavioural problems. <h3>Method</h3> Data on crying symptoms in infacy and Strengths and Difficulties Questionnaire (SDQ) scores at the age of 7 were available for 39,000 singletons from the Danish National Birth Cohort (DNBC). SDQ scores above the 90th percentile of community samples were characterised as abnormal. We compared the odds for abnormal SDQ scores of children with and without infantile colic using logistic regression. Complete follow-up with hospital admissions and discharge diagnoses from the National Patients’ Register were available for 63,773 children from the DNBC with data on crying symptoms. Hazard ratios (HR) for diagnosis of hyperkinetic disorder (HKD, ICD-10 F90.0-F90.9) were estimated using Cox regression. <h3>Results</h3> Children with a history of infantile colic had an increased risk of abnormal scores in all SDQ difficulties subscales (OR [95% confidence intervals]: emotional symptoms: 1.6 [1.4–1.8], conduct problems: 1.5 [1.3–1.7], attention deficit/hyperactivity: 1.5 [1.3–1.8], relation with peers:1.4 [1.2–1.6]), as well as in the Total Difficulties score (1.6 [1.4–1.9]. We moreover observed an increased risk of HKD diagnosis (HR: 1.4 [1.1–1.9] among children with a history of infantile colic. Results were similar after adjustment for gestational age, birth weight, several intrauterine exposures, and maternal SDQ symptoms. <h3>Conclusion</h3> Children with a history of infantile colic had higher risk of emotional, behavioural, attention deficit/hyperactivity problems, and for being diagnosed with HKD.

Brain imaging findings and social/emotional problems in Israeli children with neurofibromatosis type 1.

A potential association between brain MRI findings and social/emotional difficulties in children with neurofibromatosis type 1 (NF1) was examined. Twenty-eight children with NF1 filled in the Strengths and Difficulties Questionnaire (SDQ), and possible associations between their responses and findings in their brain MRI were sought. T2 bright foci were identified in MRI scans of 24 patients (85 %). There were no associations between the presence of the bright foci in any specific brain region and any of the SDQ scores for the emotional/behavioral measures. Male patients had significantly abnormal SDQ scores and peer problems. Patients with abnormal SDQ scores were younger than those with normal SDQ scores (mean 13.2 years vs 14.3 years, respectively; p = 0.23). A comparison of the scores obtained in ours and in another group of 11 children with NF1 yielded a significant difference between the groups. We believe that the lack of correlation between the MRI findings and the social/emotional parameters of the SDQ is another demonstration of the marked clinical variability characteristic of NF1.

Adolescent behavior and PTSD 6-7years after the World Trade Center terrorist attacks of September 11, 2001.

Behavioral problems and psychopathologies were reported in children exposed to the World Trade Center (WTC) attacks in New York City within 2–3 y post-disaster. Little is known of subsequent 9/11 related behavioral and emotional problems. We assessed risk factors for behavioral difficulties and probable posttraumatic stress disorder (PTSD) in 489 adolescent enrollees ages 11–18 y of age in the World Trade Center Health Registry cohort using the Strengths and Difficulties Questionnaire (SDQ) and DISC Predictive Scales (DPS), respectively, as reported by the adolescents. Associations between parental PTSD and adolescent PTSD and behavioral problems were studied in a subset of 166 adolescent-parent pairs in which the parent was also a Registry enrollee. Nearly one-fifth (17.4%) of the adolescents, all of whom were 5–12 y old at the time of the attacks, scored in the abnormal (5.7%) or borderline (11.7%) range of total SDQ. Problems were more frequent in minority, low-income, and single-parent adolescents. Abnormal and borderline SDQ scores were significantly associated with direct WTC exposures and with WTC-related injury or death of a family member. Adolescent PTSD was significantly associated with WTC exposure and with fear of one's own injury or death, and with PTSD in the parent (OR = 5.6; 95% CI 1.1–28.4). This adolescent population should be monitored for persistence or worsening of these problems. Co-occurrence of parent and child mental health symptoms following a disaster may have implications for healthcare practitioners and for disaster response planners.

Mental Health Problems among Adolescents with Early-Onset and Long-Duration Type 1 Diabetes and Their Association with Quality of Life: A Population-Based Survey

ObjectiveTo evaluate mental health problems and associations between mental health problems and health-related quality of life in adolescents with type 1 diabetes in comparison with the general population.MethodA total of 629 11- to 17-year-olds with early-onset and long-lasting type 1 diabetes and their parents completed comprehensive questionnaires. Mental health was assessed using the parent- and self-report versions of the Strengths and Difficulties Questionnaire (SDQ). The Revised Children's Quality of Life Questionnaire (KINDL-R) was used to measure quality of life. The comparison group (n = 6,813) was a representative sample from the German KiGGS study.ResultsThe proportion of youths with mental health problems (defined as abnormal SDQ total difficulties score) was, based on self-reports, 4.4% in the patient group and 2.9% in the general population (adjusted OR = 1.61, p = 0.044); and based on proxy reports, 7.9% in the patient group and 7.2% in the general population (OR = 1.05, p = 0.788). Youths with type 1 diabetes and self-reported mental health problems scored worse in the KINDL-R subscales of physical well-being (adjusted average difference β = −16.74, p<0.001) and family (β = −11.09, p = 0.017), and in the KINDL-R total score (β = −8.09, p<0.001), than peers with self-reported mental health problems. The quality of life of diabetic adolescents and proxy-reported mental health problems did not differ from peers with proxy-reported mental health problems adjusted for confounders.ConclusionsCompared with the general population with mental health problems, the quality of life of adolescents with type 1 diabetes who report mental health problems is more severely impaired. This observation calls for early prevention and intervention as part of pediatric diabetes long-term care.

Is breastfeeding in infancy predictive of child mental well‐being and protective against obesity at 9 years of age?

Preventing child mental health problems and child obesity have been recognized as public health priorities. The aim of the present study was to examine whether being breastfed (at all or exclusively) in infancy was a predictor of mental well-being and protective against risk of obesity at age 9. Cross-sectional data from a large, nationally representative cohort study in the Republic of Ireland was used (n = 8357). Data on breastfeeding were retrospectively recalled. Child mental well-being was assessed using a parent-completed Strengths and Difficulties Questionnaire (SDQ). Child's height and weight were measured using scientifically calibrated instruments. Logistic regression analyses indicated that, after controlling for a wide range of potential confounding variables, being breastfed in infancy was associated with a 26% (P < 0.05) reduction in the risk of an abnormal SDQ score at 9 years. Being breastfed remained a significant predictor of child mental well-being when child obesity was controlled for, indicating that being breastfed, independent of child obesity, is a predictor of child mental well-being. The results of a second logistic regression indicated that, after controlling for a wide range of potential confounding variables, being breastfed for between 11 and 25 weeks was associated with a 36% (P < 0.05) reduction in the risk of obesity at 9 years, while being breastfed for 26 weeks or longer was associated with a 48% (P < 0.01) reduction in the risk of obesity at 9 years. Breastfeeding in infancy may protect against both poor mental well-being and obesity in childhood.

Preschool behavioral problems in children prenatally exposed to antiepileptic drugs — A follow-up study

We studied the association between maternal epilepsy, antiepileptic drug (AED) treatment, and behavioral problems in preschool children.In the Danish National Birth Cohort, we identified 4- to 5-year-old children whose mothers had epilepsy and received AED treatment (n=133) or not (n=304) during pregnancy and compared them with randomly selected children whose mothers did not have epilepsy (n=1193). The children's behavioral problems were assessed by the use of the Strengths and Difficulties Questionnaire (SDQ).Children prenatally exposed to AEDs more often had an abnormal total SDQ score as compared with children of women without epilepsy (odds ratio (OR)=4.8 (95% CI: 1.9–12.1)) and as compared with children of women with epilepsy who were not treated with AEDs during their pregnancy (OR=4.0 (95% CI: 1.3–12.8)).In conclusion, prenatal AED exposure may increase the risk of behavioral problems in preschool children even after adjustments for potential confounders and maternal epilepsy.

Prenatal antidepressant exposure and behavioral problems in early childhood – a cohort study

To estimate a potential association between in utero exposure to antidepressants and behavioral problems in childhood. Information on exposures was obtained from the Danish National Birth Cohort. We studied the children of 127 mothers who had used antidepressants during pregnancy and compared these to 98 children of mothers with a prenatal depression with no use of antidepressants during pregnancy and 723 children of mothers with no prenatal depression and no use of antidepressant during pregnancy (unexposed). Behavioral problems were assessed at 4 or 5 years of age by the parent-reported Strengths and Difficulties Questionnaire (SDQ). Prenatal antidepressant exposure was not associated with abnormal SDQ scores compared with prenatal exposure to untreated prenatal depression or to no exposure. Untreated prenatal depression was associated with abnormal SDQ scores in the subscales of conduct [adjusted odds ratio (aOR) 2.3 (95% CI, 1.2-4.5)] and prosocial problems [aOR 3.0 (95% CI, 1.2-7.8)] compared with unexposed children. Total SDQ score was higher in children of mothers with untreated prenatal depression. These associations attenuated after adjusting for postnatal maternal psychiatric disease. Prenatal antidepressant exposure was not associated with behavioral or emotional problems in early childhood.