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The aim was to study the association between preschool behavioural problems and emotional symptoms in 10- to 12-year-old children. The study was based on the Aarhus Birth cohort, Denmark, and included 1,336 children. Based on the parent-administered preschool behaviour questionnaire (PBQ), we identified three not mutually exclusive preschool behavioural categories: anxious–fearful ( n = 146), hyperactive–distractible ( n = 98), and hostile–aggressive ( n = 170). Children without any known symptoms were considered well adjusted ( n = 1,000). Borderline emotional ( n = 105) and emotional difficulties ( n = 136) were measured at age 10–12 years with the parent-administered strength and difficulties questionnaire (SDQ). Multinomial logistic regression analyses were used to adjust for potential confounding factors. We found that anxious–fearful behaviour and hostile–aggressive preschool behaviour were associated with twice the risk of school-age emotional difficulties. Comorbidity or confounding failed to explain these results. Hyperactive–distractible preschool behaviour was not associated with school-age emotional difficulties. Preschool anxious–fearful behaviour was associated with school-age emotional difficulties, suggesting internalizing symptom stability in some children from early childhood. Preschool hostile–aggressive behaviour was also associated with school-age emotional difficulties, which suggests transformation of one behavioural dimension into another through childhood, and the need to focus on both early internalizing difficulties and hostile–aggressive behaviour as risk factors for later internalizing difficulties. [ABSTRACT FROM AUTHOR]

BACKGROUND: Standardised diagnostic interviews are used increasingly in child and adolescent psychiatry; yet little is known about the attitudes towards such interviews among parents, children and staff members. In this study, we have aimed to assess (1) the K-SADS-PL's acceptability to parents and children (2) the usefulness of the interview as perceived by the staff. METHODS: Following the implementation of a semi-structured diagnostic interview in the standard assessment, parents, children, and staff were asked to fill in, anonymously, a brief questionnaire enquiring about their impression of the interview. RESULTS: Parental satisfaction with the parent interview was very high. Parental satisfaction with the child interview was high as well, although a small group of children were reported to be more sad/hyperactive or difficult immediately after the interview. However, these were found among the younger children only, and mainly children with conduct problems. Most children found that the interview was a good or fairly good way to talk about how they felt, but more than half the children found the interview boring to some extent, and a few felt worse after the interview than they did before. The staff found the interview to be useful in most cases, primarily for diagnostic purposes. CONCLUSIONS: Semi-structured diagnostic interviews are well accepted by parents and children, and have good face validity among staff members. To young children with many conduct difficulties the interview may seem overwhelming, and future work should focus on ways of making diagnostic interviews more engaging for children. [ABSTRACT FROM AUTHOR]

BACKGROUND: Involving parents in the treatment of youth referred for mental health problems is an important agenda. Parent involvement is associated with treatment retention, greater family participation, and positive outcomes. The main goal of the present study was to examine the role of youth and parent report of the youth's psychopathology and interpersonal problems on parent involvement in outpatient treatment of the youth. METHODS: Data were gathered from 63 referred youth in treatment in an outpatient clinic. Subjects reported the youth's interpersonal problems and problem syndromes. The direct account of the youth and parents was examined for association with two indices of parent involvement, namely, the mothers' behavioral involvement (BI) and personal emotional involvement (PEI) in the treatment process. RESULTS: Results showed that while direct reports of the youth and parents were not significant predictors of parent involvement, discrepancy scores predicted parent involvement. Further, there were twice as many scales of interpersonal problems that were related to parent involvement as the syndrome scales. CONCLUSION: The ability of discrepancy scores in predicting parent involvement underscores that it is not only a risk factor for later development of adverse outcomes, but also related with essential treatment processes. Clinicians may be able to address these issues and aid in treatment processes leading to desired outcomes. [ABSTRACT FROM AUTHOR]

The study examines the validity and reliability of the Danish version of the Children's Depression Inventory (CDI) in a child psychiatric population. Participants were 149 child psychiatric patients aged 8-13 and their parents. After diagnostic interview with the Kiddie-Schedule for Affective Disorders and Schizophrenia, the children completed the CDI. A subgroup of 44 children repeated the CDI after 2 weeks. The psychometric properties of the Danish CDI were similar to those reported for the English version. CDI is moderately correlated with other measures for depressive disorder, but the instrument is not sufficiently reliable or valid to be used as a single diagnostic or screening measure in a child psychiatric population. [ABSTRACT FROM AUTHOR]

The prescription of antidepressants for children and adolescents is a controversial subject, and it has been documented that the practice has increased in the past decade in Denmark, the UK, and the USA. The aim of this study was to survey the indications for and use of antidepressants in child and adolescent psychiatry. Questionnaires were sent to all Danish child and adolescent psychiatric hospitals, out-patient clinics and privately practising psychiatrists treating children and adolescents under the age of 19 years (31 units in all). A 93.5 % response rate for the total of 382 questionnaires in the survey. The antidepressant serotonin selective re-uptake inhibitors (SSRIs) were the most prominently used agents in treating children and adolescents. The extent of their use represents 8 % of the total sample of individuals under the age of 19 years receiving any kind of psychiatric treatment - 0.03 % of the reference population in Denmark. It is only a surprisingly minor group of children and adolescents that are being treated with antidepressants despite the fact that 10 % of youth under the age of 19 are afflicted with diseases like depression, OCD, anxiety disorder and eating disorders. [ABSTRACT FROM AUTHOR]

The purpose of the study was to assess the association of obstetric complications with risk for mental disorders resulting in hospitalization before the age of 15. Records from all births in Denmark from 1973 through 1993 were linked to records of all psychiatric hospitalizations. Diagnoses were grouped into seven broad categories. A reference population of 10% of births in Denmark from 1973 to 1990 was used for comparison. Obstetric complications were associated with the range of mental disorders occurring in childhood. The strongest predictors were a variable indicating the interaction of birth weight with speed of growth and the 5-minute Apgar score. There was no diagnostic group that stood out as different with respect to obstetric complications. These results are consistent with the hypothesis of the continuum of reproductive casualty. [ABSTRACT FROM AUTHOR]

The literature on treatment of childhood and adolescent obsessive-compulsive disorder is reviewed. Most studies concerning treatment of obsessive-compulsive disorder has been based on experience from adult patients. Only a few controlled trials using medication with obsessive-compulsive children have been produced. No controlled study has as yet documented the effect of behavioural therapy alone. The most effective treatment seems to be a combination of behavioural therapy and medication with a serotonin reuptake inhibitor. In the treatment of children with OCD, it is important to consider the child's personality and comorbid disorders. [ABSTRACT FROM AUTHOR]

The operational diagnostic criteria for ADHD or HKD were not at hand in Denmark before 1994, when WHO's International Classification of Diseases -10 (ICD-10) was introduced. The criteria for ADHD/HKD were well known at our clinic, but when treating children with stimulants the criteria used clinically prior to 1994 were less specific than today. The aims of this paper are to examine the prevalence of ADHD in a historical cohort of children treated with stimulants during the period 1969-1989 and to reassess a wide range of comorbid disorders and sociodemographic characteristics in order to compare aspects of the given treatment with the modern recommendations. At our clinic 208 children (183 boys) were given stimulants during the period 1969-1989. Case records on these probands were reassessed retrospectively for DSM-IV criteria regarding ADHD and comorbid disorders as well as for characteristics of stimulant treatment. Sixty-five percent met full criteria for an ADHD diagnosis. Including Subthreshold ADHD as many as 81 % of the cohort were re-diagnosed with ADHD. Prevalence rates of conduct problems and anxiety disorder were similar to previous prospective ADHD studies. The use of stimulants during the period 1969-1989 were in accord with modern guidelines. This cohort is comparable to other clinically based ADHD cohorts as regards inattentive, hyperactive/impulsive symptoms, comorbidity, impairment, gender differences, intelligence and socio-economic status (SES). [ABSTRACT FROM AUTHOR]