Suicidal ideation and behavior in children's homes.

The aim of this cross-sectional study is to report the self-destructive and suicidal behavior of 98 children and adolescents in child welfare institutions. The children were evaluated using the Child Behavior Checklist (CBCL), the Children's Global Assessment Scale (CGAS) and questionnaires about suicidal and violent behavior, filled in by the child's key worker. Thirty-two per cent of the sample had presented suicidal thoughts, threats or suicide attempts during the previous 6 months. Suicidality was associated with low general functioning level (CGAS<61), self-mutilating behavior and violence. Furthermore, suicidal children had significantly higher CBCL total, externalizing, internalizing, anxious-depressive and aggressive scores. Children with suicide attempts (8% of the sample) had a significantly higher number of different types of traumatic experiences before the placement and higher somatization syndrome scores compared to children with suicidal ideation or non-suicidal children.

A follow-up study of patients suffering from sudden sensorineural hearing loss.

Sudden sensorineural hearing loss (S-SNHL) is a common problem with a high recovery rate. However, little is known of the long-term prognosis of affected patients. The purpose of this follow-up study was to evaluate the long-term hearing results of S-SNHL patients. The sample consisted of 168 patients with S-SNHL treated with carbogen inhalation and/or anticoagulant therapy during the period 1982-89. A questionnaire was sent to these patients, and audiological investigations were carried out in a selection of these patients in 1997. Comparison of the different treatment methods showed that the difference observed in improvement of hearing was statistically significant between the carbogen inhalation and anticoagulant treatment groups. The hearing improvement achieved was stable for, on average, 8 years of follow-up. During the follow-up period, Ménière's disease was diagnosed in only 1 of the 116 patients who answered the questionnaire and no cases of acoustic neurinoma were diagnosed, indicating that establishment of a careful patient history and clinical and audiological investigations are sufficient for the diagnosis of S-SNHL. In general, the hearing improvement achieved in S-SNHL patients is stable during long-term follow-up.

Suicidal thoughts and attempts among adolescents: a longitudinal 8-year follow-up study.

BACKGROUND: To study the prevalence of and factors associated with suicidal behaviour among 580 adolescents. METHODS: An 8-year longitudinal study included questions about suicidal attempts and thoughts at age 16. Children were evaluated with parent and teacher Rutter scales and self-reported Child Depression Inventory at age 8. At age 16, parents filled in the Child Behaviour Check List and adolescents the Youth Self Report. RESULTS: 14% of girls and 7% of boys reported suicidal thoughts or preoccupations at age 16. Emotional and behavioural problems at age 8, especially antisocial symptoms, reported by parents and teachers and depressive symptoms reported by the child were correlated with suicidal thoughts and behaviour 8 years later. At age 16, internalizing and externalizing problems and low social competence were associated with suicidal features. Only about 20% of those who reported suicidal features had been referred to child mental health services. CONCLUSIONS: Many adolescents with suicidal thoughts and behaviour had a high rate of behavioural and emotional problems already at age 8. CLINICAL IMPLICATIONS: The early school years represent an opportunity for interventions which may prevent self-destructive behaviours in adolescence.

Parent-reported competence and emotional and behavioral problems in Finnish adolescents.

This study was part of an 8-year follow-up study of the Epidemiological Multicenter Child Psychiatric Study in Finland. The Child Behavior Checklists (CBCLs) were analyzed for 598 15- to 16-year-old adolescents living in the southwestern area of Finland in 1997. The internal consistency of the CBCL syndrome scales was adequate (the alpha coefficient ranged from 0.66 to 0.89). The CBCL scores differentiated between non-referred adolescents and adolescents who had been referred to the mental health service or had severe problems according to the parents. Boys had more externalizing problems than girls in the maladjustment group. Girls had more somatic symptoms in the maladjustment group than boys.

Psychosocial factors and adequacy of services for children in children's homes.

Risk and protective factors of psychosocial development in children in different residential care settings need to be further studied internationally, in order to develop working methods for social and health care services. Standardized methods of the CBCL, TRF, and CGAS, were used to evaluate psychosocial functioning of children in children's homes in Finland. Further, data on sociodemographic situations and traumatic events in their lives were assembled. The percentage of behavioural and emotional problems within clinical or borderline range in the different ratings was 55-80%. Combined traumatization, sexual abuse, school difficulties, male sex, older age (> 11 years) and older age at first and on-going placement (> 7 years), as well as difficulties in relationships with parents are likely to be associated with more severe behaviour problems and lower general functioning. The results of this study show that children and adolescents in social service residential settings are a highly vulnerable group and that these children have extensive mental health needs.

Predictors of outcome of short-term child psychiatric inpatient treatment.

In this study, 85 children were prospectively followed after discharge from short-term inpatient treatment. Outcome was defined as functioning within normal range at the follow-up or as improvement in the child's behavior problems. Rutter Parent's Questionnaire was used as a measure on admission and at the 5-month follow-up after discharge. The child's more frequent individual behavior problems, antisocial behavior and disengaged family interaction on admission predicted both functioning outside normal range and less improvement at follow-up. Previous treatment because of developmental or behavioral problems and hyperkinetic symptoms on admission predicted functioning outside normal range. Parent's previous psychiatric hospital treatment was negatively associated with improvement. Pure emotional disorder predicted normal range functioning at follow-up. The child's age, gender, place of treatment and length of short-term treatment were not related to outcome. The results also stress the importance of taking into account both parents' and teachers' evaluations on admission.