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Daytime sleepiness and different symptoms are common problems affecting health and well-being of schoolchildren. This population-based cohort study included 568 children who were followed from ages 10 to 15 years. Daytime sleepiness, headache, abdominal pain, and psychological symptoms (depression, irritability or bad temper, nervousness, anxiety, and dejection) were assessed by self-administered questionnaires. The prevalence of frequent daytime sleepiness was 13% at the ages of 10 and 12 years and increased significantly up to 24% at the age of 15 (p < 0.0001). Daytime sleepiness as well as psychological symptoms were positively associated with headache and abdominal pain from ages 10 to 15 years. Headache in girls at the ages of 10 predicted the occurrence of headache at the age of 15. School nurses and other professionals need to understand the importance of a holistic evaluation of sleep and different symptoms in children. There is also a need for interventions targeting several co-occurring symptoms.

Background: The basis of self-perceived physical competence is built in childhood and school personnel have an important role in this developmental process. We investigated the association between initial self-perceived physical competence and reported leisure-time physical activity (LTPA) longitudinally in 10-, 12-, and 15-year-old children. Methods: This longitudinal follow-up study comprises pupils from an elementary school cohort (N = 1346) in the city of Turku, Finland (175,000 inhabitants). The self-perceived physical competence (fitness and appearance) and LTPA data were collected with questionnaires. The full longitudinal data were available from 571 pupils based on repeated studies at the ages of 10, 12, and 15 years in 2004, 2006, and 2010. We analyzed the association of self-perceived physical competence and LTPA using regression models. Results: Self-perceived physical competence was positively associated with LTPA at all ages (10 years p < 0.05, 12 years p < 0.0001, 15 years p < 0.0001). Increase in the self-perceived physical fitness scores was likely to associate with higher LTPA at each age point (10 years [odds ratio, OR] = 1.18, 95% confidence interval, CI: 1.09-1.27; 12 years [OR] = 1.27, 95% CI: 1.18-1.37; and 15 years [OR] = 1.28, 95% CI: 1.19-1.38). Conclusions: Self-perceived physical competence is associated with LTPA in children and adolescents, and the association is strengthened with age.

In a prospective population-based study, mothers and fathers of 1,247 children reported their physical and mental health during pregnancy, after delivery, within the child's first 18 months of life, and at 12 years. Additionally, maternal health clinic nurses rated parents' well-being and perceived need for support. At age 12, child outcomes were also measured using CBCL and YSR externalizing and internalizing scales. Results indicate that both ante- and postnatal maternal distress predicted future externalizing problems in offspring. Conversely, fathers' postnatal distress predicted subsequent internalizing problems. Furthermore, mother's depressed mood in the first trimester best predicted the child's externalizing problems at age 12. Nurses's ratings of mother's antenatal and perinatal need for support, perinatal distress, and family's need for support were associated with both internalizing and externalizing problems at age 12. Maternal antenatal distress increases the risk of offspring's externalizing problems in preadolescense, and postnatal distress in either parent increases the risk of internalizing problems. Parental self-reports and indirect ratings from health care providers during pregnancy and infancy may therefore reliably recognize offspring at risk for subsequent psychiatric symptomatology.

Objective: To determine the effect of child-, parent- and family-related factors on the use of and need for mental health services by 12 years of age. Method: A prospective population-based questionnaire study of 1,287 first-born children was launched in Finland in 1985. The Child Behavior Checklist (CBCL) was completed by 1,086 parents when the children were aged 3 years. At the age of 12, the CBCL, the Youth Self-Report, and other potential determinants of service need and use were obtained from 908 parents and 900 children (80% response rate). Results: Of the total sample, 7.2% had used professional services, and 3.3% had needed services without obtaining them. Elevated scores on the age 3 CBCL Total Problems and Externalizing scale predicted independently later service use but not perceived need of services. In cross-sectional data at age 12, parental ratings of the child's problem behavior were associated with both the need for and use of services. Poor social competence and parental distress were independently associated with use of services. Conclusions: Recognizing behavior problems in early childhood and evaluating family stress factors are important in social and health care systems designed for children. J. Am. Acad. Child Adolesc. Psychiatry, 2004;43(8):974-983. Key Words: epidemiology, mental health services, Child Behavior Checklist.

Objective: To examine the association of psychiatric symptoms with migraine and tension-type headache in children. Method: A questionnaire completed by 1,135 Finnish children in the sixth grade identified 154 children with migraine, 138 with tension-type headache, and 407 children who were headache-free. Seventy children were randomly selected from each group and evaluated by a structured interview to confirm headache type, resulting in a sample of 59 children with migraine, 65 with tension-type headache, and 59 without headache. The children completed the Children's Depression Inventory, and the parents completed the Child Behavior Checklist and General Functioning scale of the McMaster Family Assessment Device. Results: Children with migraine had significantly higher levels of total, internalizing, and somatic symptoms, as well as social and family problems, than those without headache and had higher levels of somatic symptoms than children with tension-type headache. Children with tension-type headache had significantly higher levels of somatic symptoms and family problems than those without headache. Conclusions: The association between psychiatric symptoms and headaches shows differences between different headache types. However, a minority of children with migraine or tension-type headache have high levels of psychiatric symptoms. J. Am. Acad. Child Adolesc.

Objective. To examine the association of teacher- and parent-rated behavior with headache in a prospective follow-up study of adolescent Finnish twins. Methods. Questionnaire data were collected during 1995-2001 from a nationwide sample of Finnish families of U-year-old twins who were born 1983-1987 (n = 5393) and again at age of 14. Psychological factors were measured by using parents&apos; and teachers&apos; ratings of a 37-item multidimensional rating instrument at the ages of 11 and 14. Results. At age 11, headache frequency (5 categories) was associated with total scales of externalizing and internalizing problem behaviors and adaptive behaviors, assessed by parents, but only with externalizing problem behaviors assessed by teachers. Results were similar at age 14. The incidence of at least monthly headache between the ages of 11 and 14 years was predicted by externalizing problem behaviors and 2 subscales of adaptive behaviors: constructiveness and poor compliance. In twin pairs discordant for headache, externalizing and internalizing problem behaviors were more common among headache sufferers than among headache-nonsufferers. Headache-discordant monozygotic co-twins confirmed the association of externalizing problem behaviors with headache. Conclusions. The frequency of adolescents&apos; headache is predicted by psychological factors, especially by externalizing problem behaviors. This seems to be independent of genetic or familial influences on behavior and headache. Behavioral problems may be a sign of worsening of headache or vice versa., ABBREVIATIONS. MPNI, Multidimensional Peer Nomination Inventory; MZ, monozygotic; DZ, dizygotic; Tr-MPNI, Teacher Rating Form; Pr-MPNI, Parent Rating Form; OR, odds ratios; CI, confidence interval; CBCL, Child Behavior Checklist. Headache is [...]

Abstract Background Anxious parents have many concerns about the future health of their atopic infants. Paediatricians and primary care practitioners need to seek knowledge on long-term outcomes in order to cope with the increasing caseload of suspected allergy and the concerns of parents. The aim of the study was to assess suspected and diagnosed allergy in infancy as predictors of allergy and asthma in adolescence. Methods Families expecting their first baby and making their first visit to a maternity health care clinic in 1986 were selected as the study population in a random sample. There were 1278 eligible study families. The data were provided of the children at the ages of 9 and 18 months and 3, 5, 12, 15 and 18 years by health care professionals, parents, and adolescents (themselves). Results At the age of 9 months, the prevalence of allergy suspicions was distinctly higher than that of allergy diagnoses. At the age of five years suspected allergy approaches were nil, and the prevalence of diagnosed allergy was about 9%. During the adolescence, the prevalence of self-reported allergy increases steadily up to the age of 18 years, and that of asthma remains at approximately 5%. Suspected allergy at the age of 9 or 18 months and at the 5 years of age does not predict allergy at adolescence. Compared with non-allergic children, children with definite allergy at the age of 5 were over 8 times more likely to have allergy and nearly 7 times more likely to have asthma in adolescence. Conclusion An early ascertained diagnosis of allergy, but not suspicions of allergy, predicts prevailing allergy in adolescence. Efforts need to be focused on accurate diagnosis of early childhood allergies.