Bould, H. et al. International Journal of Epidemiology. Published online: April 20 2016
Background: Clinical anecdote suggests that rates of eating disorders (ED) vary between schools. Given their high prevalence and mortality, understanding risk factors is important. We hypothesised that rates of ED would vary between schools, and that school proportion of female students and proportion of parents with post-high school education would be associated with ED, after accounting for individual characteristics.
Method: Multilevel analysis of register-based, record-linkage data on 55 059 females born in Stockholm County, Sweden, from 1983, finishing high school in 2002-10. Outcome was clinical diagnosis of an ED, or attendance at a specialist ED clinic, aged 16-20 years.
Results: The 5-year cumulative incidence of ED diagnosis aged 16-20 years was 2.4%. Accounting for individual risk factors, with each 10% increase in the proportion of girls at a school, the odds ratio for ED was 1.07 (1.01 to 1.13), P = 0.018. With each 10% increase in the proportion of children with at least one parent with post-high school education, the odds ratio for ED was 1.14 (1.09 to 1.19), P < 0.0001. Predicted probability of an average girl developing an ED was 1.3% at a school with 25% girls where 25% of parents have post-high school education, and 3.3% at a school with 75% girls where 75% of parents have post-high school education.
Conclusions: Rates of ED vary between schools; this is not explained by individual characteristics. Girls at schools with high proportions of female students, and students with highly educated parents, have higher odds of ED regardless of individual risk factors.
Families affected by poor mental health collaborate with an expert Consortium including YoungMinds to launch new online portal.
Developed with families, and aimed at families, MindEd for Families is a new site hoping to transform mental health support for relatives in difficulty and crisis.
MindEd for Families offers a large range of e-learning resources, developed to give anyone in regular contact with children and young people the skills to identify and support those they suspect to be affected by mental health issues
MindEd for Families:
provides information, advice and guidance about children’s mental health and wellbeing to parents and carers in England
improves parents and carers’ knowledge and awareness of children and young people’s emotional health and wellbeing
improves parents and carers’ ability to intervene early in mental health issues, working closely with teachers and other professionals to support their child
helps reduce stigma around mental health and demystify mental health and psychology
supports and enhance national mental health awareness and resilience
Children and young people struggling with personal issues are turning to bullying to help them cope according to a new survey.
A survey by anti-bullying charity Ditch the Label gathered responses from 8,850 12 to 20 year olds on the subject of bullying. Of those surveyed half said they had been bullied, while a quarter of those who were bullied had resorted to bullying themselves.
Korsgaard, H.O. et al. Child and Adolescent Psychiatry and Mental Health. 2016. 10:8
Background: Substance use disorders (SUDs) constitute a major health problem and are associated with an extensive psychiatric comorbidity. Personality disorders (PDs) and SUDs commonly co-occur. Comorbid PD is characterized by more severe addiction problems and by an unfavorable clinical outcome. The present study investigated the prevalence of SUDs, PDs and common Axis I disorders in a sample of adolescent outpatients. We also investigated the association between PDs and SUDs, and how this association was influenced by adjustment for other Axis I disorders, age and gender.
Methods: The sample consisted of 153 adolescents, aged 14–17 years, who were referred to a non-specialized mental health outpatient clinic with a defined catchment area. SUDs and other Axis I conditions were assessed using the mini international neuropsychiatric interview. PDs were assessed using the structured interview for DSM-IV personality.
Results: 18.3 % of the adolescents screened positive for a SUD, with no significant gender difference. There was a highly significant association between number of PD symptoms and having one or more SUDs; this relationship was practically unchanged by adjustment for gender, age and presence of Axis I disorders. For boys, no significant associations between SUDs and specific PDs, conduct disorder (CD) or attention deficit hyperactivity disorder (ADHD) were found. For girls, there were significant associations between SUD and BPD, negativistic PD, more than one PD, CD and ADHD.
Conclusions: We found no significant gender difference in the prevalence of SUD in a sample of adolescents referred to a general mental health outpatient clinic. The association between number of PD symptoms and having one or more SUDs was practically unchanged by adjustment for gender, age and presence of one or more Axis I disorders, which suggested that having an increased number of PD symptoms in itself may constitute a risk factor for developing SUDs in adolescence. The association in girls between SUDs and PDs, CD and ADHD raises the question if adolescent girls suffering from these conditions may be especially at risk for developing SUDs. In clinical settings, they should therefore be monitored with particular diligence with regard to their use of psychoactive substances.
Trachtenberg, M. LSE Health & Social Care Blog. Published online: 18 April 2016
by Marija Trachtenberg
Common challenges for young people transitioning from children’s to adult services
First, an issue that is most common is that young people may not be adequately prepared to handle new responsibilities that come with using adult services. Adult services, compared to children’s services take a different approach in interacting with young people. Adult services tend to assume that these young people will take full responsibility and act appropriately in handling appointments, adhering to their medications, and restrain from risk-taking activity that may harm their health. Children’s services on the other hand may be over-involved and may take more responsibility than they should as the young person reaches thirteen or fourteen years old. These problems with preparation by children’s services and reception by adult services may mean that young people’s health may deteriorate when they transition if it is the case that they don’t know how to manage their health with this new responsibility.
Second, young people’s brains are still developing and likewise they are developing ‘socially’ i.e. they are very conscious of their peers. They also like to experiment and seek novelty. Such behaviours are true for everyone but the adolescent brain has a period when the regulation and inhibition of certain behaviours by the front part of the brain tends to be overridden by a rapidly developing part of the brain called the limbic system which determines emotions and reward seeking. This isn’t necessarily a problem but it may be a problem if a young person attends a party and wants to drink or smoke to the extent it interacts with their medical condition and affects their health. Or, they may avoid taking medications so that they can party and this could harm their health. Allan Colver highlights the need for practitioners to recognize this as potentially inevitable rather than pretend this won’t occur at all. Rather than telling them ‘not to do it’, practitioners should have honest dialogue and help the young person “do both” (i.e. party and take care of their health).
Perraudin, F. The Guardian. Published online: 11th April 2016.
A report from the liberal thinktank CentreForum shows that mental healthcare providers refuse to treat an average of 23% of the under-18s referred to them by concerned parents, GPs, teachers and others.
The analysis also reveals that the longest waiting times endured by users of child and adolescent mental health services have doubled in the last two years, with waiting times of up to two and a half years reported.
Among the reasons reported for turning under-18s away included services feeling they lacked the capacity to deal with the problem, the child or young person not having being unwell for a long enough period of time or their condition not yet being serious enough.
Researchers found some services denied support to children and young people with anorexia if their body mass index (BMI) was not under a certain threshold. Other services referred people to more generic support unless they had “enduring suicidal ideation”, meaning they had to have expressed a desire to kill themselves on more than one occasion to access more specialist services.