Search

Supplemental material, sj-docx-1-anp-10.1177_00048674231179652 for Self-harm and suicidal ideation among young people is more often recorded by child protection than health services in an Australian population cohort by Kirstie O’Hare, Oliver Watkeys, Kimberlie Dean, Stacy Tzoumakis, Tyson Whitten, Felicity Harris, Kristin R Laurens, Vaughan J Carr and Melissa J Green in Australian & New Zealand Journal of Psychiatry

Objective: Detecting the early emergence of childhood risk for adult mental disorders may lead to interventions for reducing subsequent burden of these disorders. We set out to determine classes of children who may be at risk for later mental disorder on the basis of early patterns of development in a population cohort, and associated exposures gleaned from linked administrative records obtained within the New South Wales Child Development Study. Methods: Intergenerational records from government departments of health, education, justice and child protection were linked with the Australian Early Development Census for a state population cohort of 67,353 children approximately 5 years of age. We used binary data from 16 subdomains of the Australian Early Development Census to determine classes of children with shared patterns of Australian Early Development Census–defined vulnerability using latent class analysis. Covariates, which included demographic features (sex, socioeconomic status) and exposure to child maltreatment, parental mental illness, parental criminal offending and perinatal adversities (i.e. birth complications, smoking during pregnancy, low birth weight), were examined hierarchically within latent class analysis models. Results: Four classes were identified, reflecting putative risk states for mental disorders: (1) disrespectful and aggressive/hyperactive behaviour, labelled ‘misconduct risk’ ( N = 4368; 6.5%); (2) ‘pervasive risk’ ( N = 2668; 4.0%); (3) ‘mild generalised risk’ ( N = 7822; 11.6%); and (4) ‘no risk’ ( N = 52,495; 77.9%). The odds of membership in putative risk groups (relative to the no risk group) were greater among children from backgrounds of child maltreatment, parental history of mental illness, parental history of criminal offending, socioeconomic disadvantage and perinatal adversities, with distinguishable patterns of association for some covariates. Conclusion: Patterns of early childhood developmental vulnerabilities may provide useful indicators for particular mental disorder outcomes in later life, although their predictive utility in this respect remains to be established in longitudinal follow-up of the cohort.

Objective: We examined associations between developmental vulnerability profiles determined at the age of 5 years and subsequent childhood mental illness between ages 6 and 13 years in an Australian population cohort. Methods: Intergenerational records from New South Wales (NSW) Government Departments of Health and Child Protection spanning pre-birth to 13 years of age were linked with the 2009 Australian Early Development Census records for 86,668 children. Mental illness indices for children were extracted from health records between 2009 and 2016 (child’s age of 6–13 years). Associations between mental disorder diagnoses and membership of early childhood risk groups, including those with established ‘special needs’ (3777, 4.3%) at school entry, or putative risk classes delineated via latent class analysis of Australian Early Development Census subdomains – referred to as ‘pervasive risk’ ( N = 3479; 4.0%), ‘misconduct risk’ ( N = 5773; 6.7%) or ‘mild generalised risk’ ( N = 9542; 11%) – were estimated using multinomial logistic regression, relative to children showing ‘no risk’ ( N = 64,097; 74%). Poisson regression models estimated the relative risk of a greater number of days recorded with mental health service contacts among children in each Australian Early Development Census risk group. Adjusted models included child’s sex, socioeconomic disadvantage, child protection contacts and parental mental illness as covariates. Results: The crude odds of any mental disorder among children aged 6–13 years was increased approximately threefold in children showing pervasive risk or misconduct risk profiles at the age of 5 years, and approximately sevenfold in children with special needs, relative to children showing no risk; patterns of association largely remained after adjusting for covariates. Children with special needs and the misconduct risk class used mental health services over a greater number of days than the no risk class. Conclusion: Patterns of early childhood developmental vulnerability are associated with subsequent onset of mental disorders and have the potential to inform interventions to mitigate the risk for mental disorders in later childhood and adolescence.

The New South Wales Child Development Study (NSW-CDS) was established to enable a life course epidemiological approach to identifying risk and protective factors for childhood and adolescent-onset mental health problems, and other adverse outcomes (e.g. educational underachievement, welfare dependence, criminality). The study methodology entails repeated waves of record linkage for a population of Australian children in the state of NSW, funded by competitive funding awards (see Funding), and conducted in partnership with multiple NSW government departments. Table 1 summarizes the study phases (waves of record linkage) and measurements...