Child- and parent-related determinants for out-of-home care in a nationwide population with neurodevelopmental disorders: a register-based Finnish birth cohort 1997 study.

Autor: Penttilä S; Faculty of Medicine, Research Unit of Clinical Medicine, University of Oulu, Oulu, Finland. sanni.penttila@oulu.fi., Niemelä M; Faculty of Medicine, Research Unit of Population Health, University of Oulu, Oulu, Finland., Hakko H; Faculty of Medicine, Research Unit of Population Health, University of Oulu, Oulu, Finland.; Department of Psychiatry, Oulu University Hospital, Oulu, Finland., Keski-Säntti M; The Finnish Institute for Health and Welfare (THL), Helsinki, Finland., Ristikari T; ITLA Children's Foundation, Helsinki, Finland., Räsänen S; Faculty of Medicine, Research Unit of Clinical Medicine, University of Oulu, Oulu, Finland.; Department of Psychiatry, Oulu University Hospital, Oulu, Finland.
Jazyk: angličtina
Zdroj: European child & adolescent psychiatry [Eur Child Adolesc Psychiatry] 2024 Oct; Vol. 33 (10), pp. 3459-3470. Date of Electronic Publication: 2024 Mar 02.
DOI: 10.1007/s00787-024-02406-w
Abstrakt: Neurodevelopmental disorders (NDDs) are among the most common health issues in childhood and adolescence. Psychiatric disorders are known to be overrepresented among children using child welfare services and placed in out-of-home care (OHC). Child- and parent-related determinants for OHC among a national population with NDDs were evaluated utilising longitudinal register data from the national Finnish Birth Cohort 1997 (n = 58,802) from birth to 18 years (1997-2015). The cohort members with NDDs (n = 5,143, 9% of total cohort) formed our study population. Based on their history of OHC, cohort members with NDD were categorised to OHC (n = 903) and non-OHC groups (n = 4,240). Of all cohort members with NDDs, 17.6% had a history of OHC. Within NDDs, a significant excess of ADHD diagnosis was observed in the OHC group compared to the non-OHC group (49% vs. 26%). The OHC group with NDDs was significantly characterised by having comorbid psychiatric diagnosis for conduct and oppositional disorders (adj. RR 2.21), substance use disorders (adj. RR 1.61) and depression and anxiety disorders (adj. RR 1.60). Of all parent-related determinants, the most prevailing in the OHC group compared to the non-OHC group, was social assistance received by parent (88% vs. 44.5%). The longer the period (in years) for received social assistance, the greater the likelihood for OHC (adj. RRs range from 2.41 for one year to 5.24 for over 4 years). Further, significantly associating determinants for OHC were parental psychiatric disorders (adj. RR 1.42) and parental death (adj. RR 1.23). Our findings from the population-based cohort of children and adolescents with NDDs highlight the importance of screening and assessment of family situation. Also, effective prevention and treating of comorbid psychiatric disorders, especially conduct and oppositional disorders is essential.
Competing Interests: Declarations Competing interests The authors declare no competing interests.
(© 2024. The Author(s).)
Databáze: MEDLINE
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