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Paediatricians and other professionals in Sweden note that the amount of children with psychiatric and psychosomatic symptoms is growing in number. Suicide attempts among the young (15-24 y) increased by more than 30% from 1998-2003. The Swedish National Board for Health and Welfare's 2004 guidelines for school healthcare shed light on this increasing problem among schoolchildren. An article in this issue of Acta Paediatrica, "Living conditions and psychosomatic complaints in Swedish schoolchildren", analyses economic stress as a causative factor leading to psychosomatic symptoms such as headache, abdominal pain and difficulty in falling asleep. Living conditions, however, most likely include other factors related to our modern and ever-changing society that also have an impact on the growing child. CONCLUSION: Psychiatric health is changing for the worse among Swedish schoolchildren. The cause is multifactorial. Economic stress is one factor, but there are also other possible causes related to modern society that correlate to the increase of psychosomatic problems among schoolchildren. Three major problems are among those suspected: impaired education and deficient working environment in Swedish schools, a general lack of adult contact and guidance, and excessive computer and TV use. Language: en

BACKGROUND: Over a million children have been born from assisted conception worldwide. Newer techniques being introduced appear less and less ‘natural’, such as intracytoplasmic sperm injection (ICSI), but there is little information on these children beyond the neonatal period. METHODS: 540 ICSI conceived 5-year-old children from five European countries were comprehensively assessed, along with 538 matched naturally conceived children and 437 children conceived with standard IVF. RESULTS: Of the 540 ICSI children examined, 63 (4.2%) had experienced a major congenital malformation. Compared with naturally conceived children, the odds of a major malformation were 2.77 (95% CI 1.41– 5.46) for ICSI children and 1.80 (95% CI 0.85– 3.81) for IVF children; these estimates were little affected by adjustment for socio-demographic factors. The higher rate observed in the ICSI group was due partially to an excess of malformations in the (boys’) urogenital system. In addition, ICSI and IVF children were more likely than naturally conceived children to have had a significant childhood illness, to have had a surgical operation, to require medical therapy and to be admitted to hospital. A detailed physical examination revealed no further substantial differences between the groups, however. CONCLUSIONS: Singleton ICSI and IVF 5-year-olds are more likely to need health care resources than naturally conceived children. Assessment of singleton ICSI and IVF children at 5 years of age was generally reassuring, however, we found that ICSI children presented with more major congenital malformations and both ICSI and IVF children were more likely to need health care resources than naturally conceived children. Ongoing monitoring of these children is therefore required.