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      Independent contributions of family and neighbourhood indicators of socioeconomic status and migrant status to risk of mental health problems in 4–12 year old children

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          Abstract

          Rationale

          A range of family and neighbourhood indicators of socioeconomic status and migrant status have been shown to be associated with risk of mental health l problems (MHP) in children. In this study we determined the independent contributions of these indicators.

          Objectives

          The main objective is to examine independent associations of family and neighbourhood socioeconomic status indicators and migrant status with risk of MHP in children.

          Methods

          We analyzed data from an anonymous public health survey among 5010 parents/caretakers of children aged 4–12 years living in Rotterdam, The Netherlands, gathered in 2018. Outcome of interest was risk of MHP measured using the total difficulties score of the Strengths and Difficulties Questionnaire. Associations of parent-reported perceived financial difficulties, material deprivation (not being able to provide certain goods, or leisure, educational or cultural activities or care use for children due to financial restrictions), parental educational level, child's migrant status and neighbourhood socioeconomic status with risk of MHP and with the total difficulties score were assessed using multilevel multivariable logistic and linear regression models.

          Results

          In total, 473 (9.5%) children had a high risk of MHP. We observed independent associations of perceived financial difficulties, material deprivation and parental educational level with risk of MHP and with an increase in total difficulties score (P < 0.05). Migrant status and neighbourhood socioeconomic status were not independently associated with risk of MHP or a change in total difficulties score.

          Conclusions

          Already in early life, perceived financial difficulties by parents, material deprivation reported by parents and lower parental education appeared to be independently associated with the risk of MHP in 4–12 year olds. Health professionals should be aware of the relatively higher risks in these subgroups and consider policies address this.

          Highlights

          • Uses multilevel models to examine associations with child mental health problems.

          • Mat erial deprivation increases risk of child mental health problems.

          • Lower parental education increases risk of child mental health problems.

          • Studies risk of SES indicators and migrant status on child mental health problems.

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          Most cited references39

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          Annual research review: A meta-analysis of the worldwide prevalence of mental disorders in children and adolescents.

          The literature on the prevalence of mental disorders affecting children and adolescents has expanded significantly over the last three decades around the world. Despite the field having matured significantly, there has been no meta-analysis to calculate a worldwide-pooled prevalence and to empirically assess the sources of heterogeneity of estimates.
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            Age of onset of mental disorders: a review of recent literature

            The aim of this article is to review recent epidemiological research on age-of-onset of mental disorders, focusing on the WHO World Mental Health surveys. Median and inter-quartile range (IQR; 25th-75th percentiles) of age-of-onset is much earlier for phobias (7-14, IQR 4-20) and impulse-control disorders (7-15; IQR 4-35) than other anxiety disorders (25-53, IQR 15-75), mood disorders (25-45, IQR 17-65), and substance disorders (18-29, IQR 16-43). Although less data exist for nonaffective psychosis, available evidence suggests that median age-of-onset is in the range late teens through early 20s. Roughly half of all lifetime mental disorders in most studies start by the mid-teens and three quarters by the mid-20s. Later onsets are mostly secondary conditions. Severe disorders are typically preceded by less severe disorders that are seldom brought to clinical attention. First onset of mental disorders usually occur in childhood or adolescence, although treatment typically does not occur until a number of years later. Although interventions with early incipient disorders might help reduce severity-persistence of primary disorders and prevent secondary disorders, additional research is needed on appropriate treatments for early incipient cases and on long-term evaluation of the effects of early intervention on secondary prevention.
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              Mental health of young people: a global public-health challenge.

              Mental disorders account for a large proportion of the disease burden in young people in all societies. Most mental disorders begin during youth (12-24 years of age), although they are often first detected later in life. Poor mental health is strongly related to other health and development concerns in young people, notably lower educational achievements, substance abuse, violence, and poor reproductive and sexual health. The effectiveness of some interventions for some mental disorders in this age-group have been established, although more research is urgently needed to improve the range of affordable and feasible interventions, since most mental-health needs in young people are unmet, even in high-income countries. Key challenges to addressing mental-health needs include the shortage of mental-health professionals, the fairly low capacity and motivation of non-specialist health workers to provide quality mental-health services to young people, and the stigma associated with mental disorder. We propose a population-based, youth focused model, explicitly integrating mental health with other youth health and welfare expertise. Addressing young people's mental-health needs is crucial if they are to fulfil their potential and contribute fully to the development of their communities.
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                Author and article information

                Contributors
                Journal
                SSM Popul Health
                SSM Popul Health
                SSM - Population Health
                Elsevier
                2352-8273
                30 September 2020
                December 2020
                30 September 2020
                : 12
                : 100675
                Affiliations
                [a ]Department of Public Health, Erasmus University Medical Center, PO Box 2040, 3000, CA, Rotterdam, the Netherlands
                [b ]Department of Research and Business Intelligence, Municipality of Rotterdam, P O Box 3001, Rotterdam, AH, the Netherlands
                [c ]Department of Social Development, Municipality of Rotterdam, PO Box 70032, LP, Rotterdam, the Netherlands
                Author notes
                []Corresponding author. Department of Public Health, Erasmus University Medical Center, PO box 2040, 3000, CA, Rotterdam, the Netherlands. w.jansen@ 123456rotterdam.nl
                Article
                S2352-8273(20)30312-8 100675
                10.1016/j.ssmph.2020.100675
                7548441
                33072844
                70c16494-f0f8-4252-a33b-172df567238b
                © 2020 The Authors

                This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

                History
                : 24 June 2020
                : 24 September 2020
                : 26 September 2020
                Categories
                Article

                socioeconomic status,children,mental health problems,neighbourhood,migrant status,material deprivation

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