Changes in Psychiatric Problems and Service Use Among 8-Year-Old Children: A 16-Year Population-Based Time-Trend Study

doi:10.1097/CHI.0b013e318160b98f

Journal of the American Academy of Child & Adolescent Psychiatry

Volume 47, Issue 3, March 2008, Pages 317-327

https://doi.org/10.1097/CHI.0b013e318160b98f Get rights and content

ABSTRACT

Objective:

To study differences in children's psychiatric symptoms and child mental health service use at three time points: 1989, 1999, and 2005.

Method:

Three cross-sectional representative samples of 8-year-old children were compared from southern Finland. The sampling, procedure, and methods were similar at all three time points. Information was gathered from parents and teachers using Rutter questionnaires and other related determinants of service use and from children using the Children's Depression Inventory. The participation rate at the three time points was 96% in 1989, 86% in 1999, and 84% in 2005.

Results:

Overall, parent and teacher reports of children's problems did not show a significant increase during the 16-year period. Parent reports of boys' conduct symptoms decreased from 1989 to 1999. However, self-reported depressive symptoms among girls increased from 1989 to 2005. Low parental education level, broken family, and negative life events were associated with depressive symptoms among girls. Although 4% of boys and 1% of girls had used child mental health services in 1989, the respective figures in 2005 were 12% and 4%. The majority of children who were screen positive on either parent or teacher ratings of emotional and behavioral problems using Rutter scales had received some educational support from school in 2005.

Conclusions:

Reports of depressive symptoms increased among girls, and this finding merits further studies. Use of services has continuously increased. School services play an important role in providing support and early detection of children who need to be referred to child mental health services.

Section snippets

Subjects

As reported previously,^12,¹⁵ the target population was Finnish-speaking children born in 1981 and living in one of the five university hospital catchment areas of Finland (Turku University Hospital, southwest Finland). A sample of 13% of the age cohort (n = 1,038 children) was drawn by selecting a representative sample of communities according to their degree of urbanization: urban, suburban, and rural. A child registered in the selected school district or community belonged to the sample even

Family, Parent, and Life Event Variables

Fewer children were living with two biological parents in 2005 and 1999 than in 1989 (77%, 77%, 85%, respectively, p < .001). The proportion of children living in single-parent households was rather similar at the three time points (11%-14%), whereas there was an increase in the number of children living in remarried families from 1989 (4%) to 1999 and 2005 (8%-9%; p < .001). Both mothers' and fathers' education level rose during the 16 years (proportion of mothers with upper secondary level

DISCUSSION

Our results have five main findings that are of major public health significance. First, parent and teacher reports of children's problems showed overall rather limited changes during the 16-year period except for a decrease in parent-reported conduct symptoms among boys. Second, there was a consistent increase in self-reported depressive symptoms among girls. Third, family structure, parental education level, and life events were associated with self-reported depressive problems more strongly

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Accepted August 21, 2007, under the Editorship of Mina K. Dulcan, M.D.

This study was supported by the Finnish Pediatric Research Foundation (Lastentautien Kummisäätio). The authors thank Anne Kaljonen for assisting in statistical analysis and Larri Toivonen for assisting in data collection.

Disclosure: The authors report no conflicts of interest.

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NEW RESEARCHChanges in Psychiatric Problems and Service Use Among 8-Year-Old Children: A 16-Year Population-Based Time-Trend Study

ABSTRACT

Objective:

Method:

Results:

Conclusions:

Section snippets

Subjects

Family, Parent, and Life Event Variables

DISCUSSION

Biol Psychiatry

J Am Acad Child Adolesc Psychiatry

J Affect Disord

J Am Acad Child Adolesc Psychiatry

Neurosci Biobehav Rev

Time trends in child and adolescent mental disorders

Curr Opin Psychiatry

Increased rates of psychosocial disorders in youth

Eur Arch Psychiatry Clin Neurosci

Age-cohort changes in the lifetime occurrence of depression and other mental disorders

J Abnorm Psychol

Rising prevalence of antidepressants among US youths

Pediatrics

Is there an epidemic of child and adolescent depression?

J Child Psychol Psychiatry

National trends in the treatment of attention deficit hyperactivity disorder

Am J Psychiatry

Is attention deficit hyperactivity disorder increasing among girls in the US? Trends in diagnosis and the prescribing of stimulants

CNS Drugs

Use of psychostimulants in Finland [in Finnish]

J Finnish Med Assoc

Are American children's problems still getting worse? A 23-year comparison

J Abnorm Child Psychol

Time trends in adolescent mental health

J Child Psychol Psychiatry

Ten-year comparisons of problems and competencies for national samples of youth: self, parent and teacher reports

J Emot Behav Disord

Ten-year time trends of psychopathology in Dutch children and adolescents: no evidence for strong trends

Acta Psychiatr Scand

NEW RESEARCH
Changes in Psychiatric Problems and Service Use Among 8-Year-Old Children: A 16-Year Population-Based Time-Trend Study