3 results
The impact of child psychiatric conditions on future educational outcomes among a community cohort in Brazil
- Mauricio Scopel Hoffmann, David McDaid, Giovanni Abrahão Salum, Wagner Silva-Ribeiro, Carolina Ziebold, Derek King, Ary Gadelha, Eurípedes Constantino Miguel, Jair de Jesus Mari, Luis Augusto Rohde, Pedro Mario Pan, Rodrigo Affonseca Bressan, Ramin Mojtabai, Sara Evans-Lacko
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- Journal:
- Epidemiology and Psychiatric Sciences / Volume 30 / 2021
- Published online by Cambridge University Press:
- 28 October 2021, e69
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Aims
Mental health problems early in life can negatively impact educational attainment, which in turn have negative long-term effects on health, social and economic opportunities. Our aims were to: (i) estimate the impacts of different types of psychiatric conditions on educational outcomes and (ii) to estimate the proportion of adverse educational outcomes which can be attributed to psychiatric conditions.
MethodsParticipants (N = 2511) were from a school-based community cohort of Brazilian children and adolescents aged 6–14 years enriched for high family risk of psychiatric conditions. We examined the impact of fear- (panic, separation and social anxiety disorder, specific phobia, agoraphobia and anxiety conditions not otherwise specified), distress- (generalised anxiety disorder, major depressive disorder and depressive disorder not otherwise specified, bipolar, obsessive-compulsive, tic, eating and post-traumatic stress disorder) and externalising-related conditions (attention deficit and hyperactivity disorder, conduct and oppositional-defiant conditions) on grade repetition, dropout, age-grade distortion, literacy performance and bullying perpetration, 3 years later. Psychiatric conditions were ascertained by psychiatrists, using the Development and Well-Being Behaviour Assessment. Propensity score and inverse probability weighting were used to adjust for potential confounders, including comorbidity, and sample attrition. We calculated the population attributable risk percentages to estimate the proportion of adverse educational outcomes in the population which could be attributed to psychiatric conditions. Analyses were conducted separately for males and females.
ResultsFear and distress conditions in males were associated with school dropout (odds ratio (OR) = 2.76; 95% confidence interval (CI) = 1.06, 7.22; p < 0.05) and grade repetition (OR = 2.76; 95% CI = 1.32, 5.78; p < 0.01), respectively. Externalising conditions were associated with grade repetition in males (OR = 1.66; 95% CI = 1.05, 2.64; p < 0.05) and females (OR = 2.03; 95% CI = 1.15, 3.58; p < 0.05), as well as age-grade distortion in males (OR = 1.66; 95% CI = 1.05, 2.62; p < 0.05) and females (OR = 2.88; 95% CI = 1.61, 5.14; p < 0.001). Externalising conditions were also associated with lower literacy levels (β = −0.23; 95% CI = −0.34, −0.12; p < 0.001) and bullying perpetration (OR = 3.12; 95% CI = 1.50, 6.51; p < 0.001) in females. If all externalising conditions were prevented or treated, we estimate that 5.0 and 4.8% of grade repetition would not have occurred in females and males, respectively, as well as 10.2 (females) and 5.3% (males) of age-grade distortion cases and 11.4% of female bullying perpetration.
ConclusionsThe study provides evidence of the negative impact of psychiatric conditions on educational outcomes in a large Brazilian cohort. Externalising conditions had the broadest and most robust negative impacts on education and these were particularly harmful to females which are likely to limit future socio-economic opportunities.
The association between psychotic experiences and traumatic life events: the role of the intention to harm
- Tais Silveira Moriyama, Marjan Drukker, Ary Gadelha, Pedro Mario Pan, Giovanni Abrahão Salum, Gisele Gus Manfro, Jair de Jesus Mari, Eurípedes Constantino Miguel, Luis Augusto Rohde, Guilherme Vanoni Polanczyk, Jim van Os, Rodrigo Affonseca Bressan
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- Journal:
- Psychological Medicine / Volume 48 / Issue 13 / October 2018
- Published online by Cambridge University Press:
- 14 January 2018, pp. 2235-2246
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Background
Previous work showed traumatic life events (TLE) with intention to harm, like bullying and abuse, to be more strongly associated with psychotic experiences (PE) than other types of trauma, like accidents. However, this association is subject to reporting bias and can be confounded by demographic characteristics and by differences in dose of exposure across different trauma categories. We studied the association between TLE with and without intention to harm and PE, taking into account potential confounders and biases.
MethodsA total of 2245 children and adolescents aged 6–14 years were interviewed by psychologists. The interview included the presence of 20 PE (both self-report and psychologist evaluation). In addition, parents provided information on child exposure to trauma, mental health and PE.
ResultsResults showed no significant association between TLE without intention to harm only and PE for the three methods of assessment of PE (self-report, parent report and psychologist rating). On the other hand, there was a positive association between PE and TLE in groups exposed to traumatic experiences with intention to harm (with intention to harm only and with and without intention to harm). Results remained significant after controlling for demographic and clinical confounders, but this positive association was no longer significant after adjusting for the number of TLE.
ConclusionsTLE with intention to harm display a stronger association with PE than TLE without intention to harm, and this difference is likely reducible to a greater level of traumatic exposure associated with TLE with intention to harm.
Is there an association between cortical thickness, age of onset, and duration of illness in schizophrenia?
- Idaiane Batista Assunção Leme, Ary Gadelha, João Ricardo Sato, Vanessa Kiyomi Ota, Jair de Jesus Mari, Maria Isabel Melaragno, Marilia de Arruda Cardoso Smith, Sintia Iole Nogueira Belangero, Rodrigo Affonseca Bressan, Andrea Parolin Jackowski
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- Journal:
- CNS Spectrums / Volume 18 / Issue 6 / December 2013
- Published online by Cambridge University Press:
- 06 June 2013, pp. 315-321
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Objective
Several studies have shown cortical volume loss in frontotemporal regions in schizophrenia patients, and it is known that these reductions may be associated with disease symptoms and cognitive deficits. The aim of this study was to investigate possible cortical thickness correlations in frontotemporal regions in relation to age at onset and duration of illness.
MethodsOne hundred forty-eight schizophrenia patients (97 males; age and SD 36.30 ± 10.06) and 87 (57 males; age and SD 36.48 ± 10.10) age-matched healthy subjects underwent a brain MRI scan. Cortical segmentation and surface statistical analysis were performed using the FreeSurfer software package. Results were corrected for multiple comparisons using the Monte Carlo method considering a cluster-corrected Type I Error of 5%.
ResultsCompared to controls, schizophrenia patients presented significant cortical thinning in the frontotemporal, parietal, and occipital cortices. No correlation between prefrontal cortex thickness and duration of illness in patients with schizophrenia or between frontotemporal cortical thickness and age at onset was found. However, a significant interaction between age and diagnosis was observed on frontal cortical thickness with patients presenting a thinner cortex than expected for age.
ConclusionAlthough there was no correlation between age of onset and duration of illness with brain volume, our findings suggest that there is an accelerated cortical loss in schizophrenia, thus reinforcing the progressive processes of the disease.