Abstract
Children exposed to parental psychiatric disorders have an increased risk of several psychiatric disorders, impaired development, behavioural problems, injuries, physical illness and mortality. Even though this high-risk group has been shown to benefit from health promotion and preventive interventions, estimates of the size of the population at risk are not available. Estimating the number of exposed children using adult survey data will likely generate valuable information for health policy, planning, and advocacy. In this paper, the authors present a method to indirectly estimate the size of this population using secondary data. A Canadian adult health survey and the Census were combined to estimate the prevalence of exposure of children less than 12 years to parental and non-parental psychiatric disorders. A method to combine census and survey data is presented and tested under varying degrees of data availability. Results are compared to the actual number of children exposed to parental psychiatric disorders and discussed. The most accurate estimates were obtained when the most complete survey was combined with relatively detailed census information. Incomplete survey simulations produced substantial underestimates of the prevalence of exposure even when combined with detailed census information.
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References
Anonymous (1999) Chronicity of maternal depressive symptoms, maternal sensitivity, and child functioning at 36 months. NICHD Early Child Care Research Network. Dev Psychol 35:1297–1310
Anonymous (2001) Children of parents affected by a mental illness scoping project report. In: Haygarth S, Bierbaum N (eds) Children of parents affected by a mental illness scoping project report. Australian Infant, Child, Adolescent and Family Mental Health Association, Stepney
Anonymous (2004) Canadian community health survey mental health and well-being cycle 1.2—master file documentation. CCHS 12. Statistics Canada, Ottawa
American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders DSM-IV-TR, 4th edn. American Psychiatric Association, Washington, DC
Beardslee W, Bemporad J, Keller M, Klerman G (1983) Children of parents with major affective disorder: a review. Am J Psychiatry 140:825–832
Beardslee W, Versage E, Gladstone T (1998) Children of affectively ill parents: a review of the past 10 years. J Am Acad Child Adolesc Psychiatry 37:1134–1141
Bearman PS, Jones J, Udry JR (1997). The National Longitudinal Study of Adolescent Health: Research Design. Retrieved February 12, 2001, from University of North Carolina at Chapel Hill, Carolina Population Center Web site: http://www.cpc.unc.edu/addhealth
Bijl RV, Cuijpers P, Smit F (2002) Psychiatric disorders in adult children of parents with a history of psychopathology. Soc Psychiatry Psychiatr Epidemiol 37:7–12
Brotman LM, Gouley KK, Chesir-Teran D, Dennis T, Klein RG, Shrout P (2005) Prevention for preschoolers at high risk for conduct problems: immediate outcomes on parenting practices and child social competence. J Clin Child Adolesc Psychol 34:724–734
Costello EJ, Egger H, Angold A (2005) 10-Year research update review: the epidemiology of child and adolescent psychiatric disorders: I. Methods and public health burden. J Am Acad Child Adolesc Psychiatry 44:972–986
Costello EJ, Foley DL, Angold A (2006) 10-year research update review: the epidemiology of child and adolescent psychiatric disorders: II. Developmental epidemiology. J Am Acad Child Adolesc Psychiatry 45:8–25
Cowling V (1999) Children of parents with mental illness, 1st edn. Australian Council for Educational Research, Melbourne
Craig T, Bromet EJ (2004) Parents with psychosis. Ann Clin Psychiatry 16:35–39
Cuijpers P (2003) Examining the effects of prevention programs on the incidence of new cases of mental disorders: the lack of statistical power. Am J Psychiatry 160:1385–1391
Cuijpers P, Van Straten A, Smit F (2005) Preventing the incidence of new cases of mental disorders: a meta-analytic review. J Nerv Ment Dis 193:119–125
Diaz R, Gual A, Garcia M, Arnau J, Pascual F, Canuelo B, Rubio G, de Dios Y, Fernandez-Eire MC, Valdes R, Garbayo I (2008) Children of alcoholics in Spain: from risk to pathology. Results from the ALFIL program. Soc Psychiatry Psychiatr Epidemiol 43:1–10
Essex MJ, Kraemer HC, Armstrong JM, Boyce WT, Goldsmith HH, Klein MH, Woodward H, Kupfer DJ (2006) Exploring risk factors for the emergence of children’s mental health problems. Arch Gen Psychiatry 63:1246–1256
Farrell G, Handley C, Hanke A, Hazelton M, Josephs A (1999) The Tasmanian children’s project report: the needs of children and adolescents with a parent/carer with mental illness. University of Tasmania, Launceston
Fombonne E, Wostear G, Cooper V, Harrington R, Rutter M (2001) The Maudsley long-term follow-up of child and adolescent depression. 1. Psychiatric outcomes in adulthood. Br J Psychiatry 179:210–217
Fombonne E, Wostear G, Cooper V, Harrington R, Rutter M (2001) The Maudsley long-term follow-up of child and adolescent depression. 2. Suicidality, criminality and social dysfunction in adulthood. Br J Psychiatry 179:218–223
Ford T, Collishaw S, Meltzer H, Goodman R (2007) A prospective study of childhood psychopathology: independent predictors of change over three years. Soc Psychiatry Psychiatr Epidemiol 42:953–961
Fowler FJ Jr (1996) The redesign of the National Health Interview Survey. Public Health Rep 111:508–511
Grant B (2000) Estimates of US children exposed to alcohol abuse and dependence in the family. Am J Public Health 90:112–115
Gravel R, Beland Y (2005) The Canadian Community Health Survey: mental health and well-being. Can J Psychiatry 50:573–579
Handley C, Farrell GA, Josephs A, Hanke A, Hazelton M (2001) The Tasmanian children’s project: the needs of children with a parent/carer with a mental illness. Aust N Z J Ment Health Nurs 10:221–228
Hansson H, Rundberg J, Zetterlind U, Johnsson KO, Berglund M (2006) An intervention program for university students who have parents with alcohol problems: a randomized controlled trial. Alcohol Alcohol 41:655–663
Izzo CV, Eckenrode JJ, Smith EG, Henderson CR, Cole R, Kitzman H, Olds DL (2005) Reducing the impact of uncontrollable stressful life events through a program of nurse home visitation for new parents. Prev Sci 6:269–274
Kessler RC, Berglund P, Chiu WT, Demler O, Heeringa S, Hiripi E, Jin R, Pennell BE, Walters EE, Zaslavsky A, Zheng H (2004) The US National Comorbidity Survey Replication (NCS-R): design and field procedures. Int J Methods Psychiatr Res 13:69–92
Kessler RC, Haro JM, Heeringa SG, Pennell BE, Ustun TB (2006) The World Health Organization world mental health survey initiative. Epidemiol Psichiatr Soc 15:161–166
Kessler RC, McGonagle KA, Zhao S, Nelson CB, Hughes M, Eshleman S, Wittchen HU, Kendler KS (1994) Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Arch Gen Psychiatry 51:8–19
Lilenfeld LR, Kaye WH, Greeno CG, Merikangas KR, Plotnicov K, Pollice C, Rao R, Strober M, Bulik CM, Nagy L (1998) A controlled family study of anorexia nervosa and bulimia nervosa: psychiatric disorders in first-degree relatives and effects of proband comorbidity. Arch Gen Psychiatry 55:603–610
Maybery D, Reupert A (2006) Workforce capacity to respond to children whose parents have a mental illness. Aust N Z J Psychiatry 40:657–664
McLennan JD, Kotelchuck M (2000) Parental prevention practices for young children in the context of maternal depression. Pediatrics 105:1090–1095
Merikangas KR, Dierker LC, Szatmari P (1998) Psychopathology among offspring of parents with substance abuse and/or anxiety disorders: a high-risk study. J Child Psychol Psychiatry 39:711–720
Merikangas KR, Stolar M, Stevens DE, Goulet J, Preisig MA, Fenton B, Zhang H, O’Malley SS, Rounsaville BJ (1998) Familial transmission of substance use disorders. Arch Gen Psychiatry 55:973–979
Mittendorfer-Rutz E, Rasmussen F, Wasserman D (2008) Familial clustering of suicidal behaviour and psychopathology in young suicide attempters. A register-based nested case control study. Soc Psychiatry Psychiatr Epidemiol 43:28–36
Montigny G (1993) The National Longitudinal Survey of Children (NLSC). Health Rep 5:317–320
Mowbray CT, Lewandowski L, Bybee D, Oyserman D (2004) Children of mothers diagnosed with serious mental illness: patterns and predictors of service use. Ment Health Serv Res 6:167–183
Olds D, Henderson CR Jr, Cole R, Eckenrode J, Kitzman H, Luckey D, Pettitt L, Sidora K, Morris P, Powers J (1998) Long-term effects of nurse home visitation on children’s criminal and antisocial behavior: 15-year follow-up of a randomized controlled trial. JAMA 280:1238–1244
Olds DL, Eckenrode J, Henderson CR Jr, Kitzman H, Powers J, Cole R, Sidora K, Morris P, Pettitt LM, Luckey D (1997) Long-term effects of home visitation on maternal life course and child abuse and neglect. Fifteen-year follow-up of a randomized trial. JAMA 278:637–643
Olds DL, Henderson CR Jr, Kitzman H (1994) Does prenatal and infancy nurse home visitation have enduring effects on qualities of parental caregiving and child health at 25 to 50 months of life? Pediatrics 93:89–98
Olds DL, Kitzman H, Cole R, Robinson J, Sidora K, Luckey DW, Henderson CR Jr, Hanks C, Bondy J, Holmberg J (2004) Effects of nurse home-visiting on maternal life course and child development: age 6 follow-up results of a randomized trial. Pediatrics 114:1550–1559
Olds DL, Robinson J, Pettitt L, Luckey DW, Holmberg J, Ng RK, Isacks K, Sheff K, Henderson CR Jr (2004) Effects of home visits by paraprofessionals and by nurses: age 4 follow-up results of a randomized trial. Pediatrics 114:1560–1568
Olfson M, Marcus SC, Druss B, Alan Pincus H, Weissman MM (2003) Parental depression, child mental health problems, and health care utilization. Med Care 41:716–721
Ramchandani P, Stein A (2003) The impact of parental psychiatric disorder on children. BMJ 327:242–243
Regier DA, Narrow WE, Rae DS, Manderscheid RW, Locke BZ, Goodwin FK (1993) The de Facto US Mental and Addictive Disorders Service System: epidemiologic catchment area prospective 1-year prevalence rates of disorders and services 1852. Arch Gen Psychiatry 50:85
Reid MJ, Webster-Stratton C, Baydar N (2004) Halting the development of conduct problems in head start children: the effects of parent training. J Clin Child Adolesc Psychol 33:279–291
Russell KM (1998) Preschool children at risk for repeat injuries. J Community Health Nurs 15:179–190
Scott S, Spender Q, Doolan M, Jacobs B, Aspland H (2001) Multicentre controlled trial of parenting groups for childhood antisocial behaviour in clinical practice. BMJ 323:194–198
Skre I, Onstad S, Edvardsen J, Torgersen S, Kringlen E (1994) A family study of anxiety disorders: familial transmission and relationship to mood disorder and psychoactive substance use disorder. Acta Psychiatr Scand 90:366–374
Spieker SJ, Larson NC, Lewis SM, Keller TE, Gilchrist L (1999) Developmental trajectories of disruptive behavior problems in preschool children of adolescent mothers. Child Dev 70:443–458
Stein A, Woolley H, Cooper S, Winterbottom J, Fairburn CG, Cortina-Borja M (2006) Eating habits and attitudes among 10-year-old children of mothers with eating disorders: longitudinal study. Br J Psychiatry 189:324–329
Stein A, Woolley H, Senior R, Hertzmann L, Lovel M, Lee J, Cooper S, Wheatcroft R, Challacombe F, Patel P, Nicol-Harper R, Menzes P, Schmidt A, Juszczak E, Fairburn CG (2006) Treating disturbances in the relationship between mothers with bulimic eating disorders and their infants: a randomized, controlled trial of video feedback. Am J Psychiatry 163:899–906
Talati A, Wickramaratne PJ, Pilowsky DJ, Alpert JE, Cerda G, Garber J, Hughes CW, King CA, Malloy E, Sood AB, Verdeli H, Trivedi MH, Rush AJ, Weissman MM (2007) Remission of maternal depression and child symptoms among single mothers: a STAR*D-Child report. Soc Psychiatry Psychiatr Epidemiol 42:962–971
Vostanis P, Graves A, Meltzer H, Goodman R, Jenkins R, Brugha T (2006) Relationship between parental psychopathology, parenting strategies and child mental health—findings from the GB national study. Soc Psychiatry Psychiatr Epidemiol 41:509–514
Webster-Stratton C, Reid MJ, Hammond M (2001) Preventing conduct problems, promoting social competence: a parent and teacher training partnership in head start. J Clin Child Psychol 30:283–302
Weil CM, Wade SL, Bauman LJ, Lynn H, Mitchell H, Lavigne J (1999) The relationship between psychosocial factors and asthma morbidity in inner-city children with asthma. Pediatrics 104:1274–1280
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Bassani, D.G., Padoin, C.V. & Veldhuizen, S. Counting children at risk. Soc Psychiat Epidemiol 43, 927–935 (2008). https://doi.org/10.1007/s00127-008-0376-3
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DOI: https://doi.org/10.1007/s00127-008-0376-3