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Psychiatric disorder among British children looked after by local authorities: Comparison with children living in private households

  • Tamsin Ford (a1), Panos Vostanis (a2), Howard Meltzer (a3) and Robert Goodman (a3)
Abstract
Background

Children looked after by local authorities are at higher risk of poor psychosocial outcomes than children living in private households, but nationally representative and random samples of the two groups of children have not previously been compared.

Aims

To find explanations for the increased prevalence of psychiatric disorder in children looked after by local authorities.

Method

We examined socio-demographic characteristics and psychopathology by type of placement among children looked after in Britain by local authorities (n = 1453), and compared these children with deprived and non-deprived children living in private households (n = 10 428).

Results

Children looked after by local authorities had higher levels of psychopathology, educational difficulties and neurodevelopmental disorders, and ‘looked after’ status was independently associated with nearly all types of psychiatric disorder after adjusting for these educational and physical factors. The prevalence of psychiatric disorder was particularly high among those living in residential care and with many recent changes of placement.

Conclusions

Our findings indicate a need for greater support of this vulnerable group of children.

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Copyright
Corresponding author
Dr Tamsin Ford, Box 085, Department of Child and Adolescent Psychiatry, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK. Email: t.ford@iop.kcl.ac.uk
Footnotes
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Declaration of interest

None.

Footnotes
References
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The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
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Psychiatric disorder among British children looked after by local authorities: Comparison with children living in private households

  • Tamsin Ford (a1), Panos Vostanis (a2), Howard Meltzer (a3) and Robert Goodman (a3)
Submit a response

eLetters

Re: Psychiatric disorder and looked after status

Murali K Sekar, Locum Consultant Psychiatrist
24 April 2007

Ford et al studied the possible explanation for increased prevalence of psychiatric disorder in children looked after by local authorities. This study identified the significant role of looked after status with higher levels of psychopathology, educational difficulties and neurodevelopmental disorders. The authors also suggested that the services should keep in mind that the change in the environment might be more appropriate in providing help at least in some cases.

After carefully reading the article, I think the authors have missed an important aetiological factor whilst considering the reasons for increased prevalence for mental disorder in this high-risk group. The important factor is the role of biological factors in the form of genetics. When we try to find an explanation for increased prevalence, first of all, we must understand why the children came to ‘looked after’ status. Studies (e.g Howard et al) have identified that parents with mental disorder are likely to have broken family and their children to be looked after by another person or organisation. The biological factor, which caused mental illness in the parents of children currently looked after by services, might operate to cause the increased prevalence of psychiatric disorder in these children. Hence by neglecting the biologicalcomponent in the biopsychosocial model of mental illnesses, the authors have failed to provide a comprehensive assessment of factors in the causation of psychiatric disorder in these children.

The authors could have included psychiatric disorder in parents as one the variable in the analysis stage. The ‘looked after’ group could have been divided into children of parents with or without mental disorderand a finding of increased prevalence of mental illness in the group of children with parental mental illness, would have shed more light into theunderstanding of this complex issue.

The authors themselves have identified that neuro developmental difficulties and learning difficulties are associated with increased prevalence of psychiatric disorder. We should note that both these factorsare also associated with future development of mental illnesses like schizophrenia ( Lawrie et al, Done et al) in which genetics plays an important role in the aetiology (Cardno et al).

Declaration of Interest: None

References

Alastair.G.Cardno, E.Jane Marshall,Bina Coid et al (1999) Heritability Estimates for Psychiatric Disorders : The Maudsley Twin Psychosis Services; Archives of General Psychiatry 56, 162-168

D.J.Done, T.J.Crow, E.C.Johnstone et al (1994) Childhood antecedents of Schizophrenia and Affective illnesses: Social adjustment at ages seven and eleven British Medical Journal 309 699-703

Louise.M.Howard, R.Kumar, Graham Thornicroft et al(2001) PsychosocialCharacteristics and needs of mothers with psychotic disorders; British Journal of Psychiatry 178 427-432

Stephen.M.Lawrie, Majella Byrne, Patrick Miller et al (2001) Neurodevelopmental indices and the development of psychiatric symptoms in subjects at risk of schizophrenia; British Journal of Psychiatry 178 524- 530

Contact Details: Dr.M.K.Sekar 176,Soho Hill Handsworth Birmingham B191AG Phone:0121 685 6090 Fax :0121 685 6091
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Conflict of interest: None Declared

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