Psychiatric Outcomes, Functioning, and Participation in Extremely Low Gestational Age Newborns at Age 15 Years.

OBJECTIVE: To evaluate the prevalence, co-occurrence, sex differences, and functional correlates of DSM-5 psychiatric disorders in 15-year-old adolescents born extremely preterm. METHOD: The Extremely Low Gestational Age Newborns (ELGAN) Study is a longitudinal study of children born <28 weeks gestation. At age 15, 670 adolescents completed the Mini-International Neuropsychiatric Interview for Children and Adolescents (MINI-KID), the Youth Self-Report, a disability scale of participation in social roles, and cognitive testing. Parents completed a family psychiatric history questionnaire. RESULTS: The most prevalent psychiatric disorders were anxiety, attention-deficit/hyperactivity disorder, and major depression. More girls met criteria for anxiety than boys. Though 66% of participants did not meet criteria for a psychiatric disorder, 15% met criteria for 1, 9% for 2, and 8% for ≥3 psychiatric disorders. Participants with ≥2 psychiatric disorders were more likely to have repeated a grade, to have an individualized educational program, and to have a lower nonverbal IQ than those with no psychiatric disorders. Participants with any psychiatric disorder were more likely to use psychotropic medications; to have greater cognitive and functional impairment; and to have mothers who were single, were on public health insurance, and had less than a high school education. Finally, a positive family psychiatric history was identified more frequently among adolescents with ≥3 psychiatric disorders. CONCLUSION: Among adolescents born extremely preterm, anxiety, major depression, and attention-deficit/hyperactivity disorder were the most prevalent psychiatric disorders at age 15. Adolescents with >1 psychiatric disorder were at increased risk for multiple functional and participatory challenges.

Assessment of clinical performance without adequate analytical validation: A prescription for confusion.

OBJECTIVES: Lp-PLA2 is a biomarker with promise for predicting cardiac risk. The lack of reproducible results has limited its use. In evaluating a new reagent kit, we investigated conditions for optimal reproducibility. METHODS: The Auto-PLAC reagents were evaluated on the Cobas instrument. Performance characteristics, stability, and population ranges were determined. RESULTS: Analytical performance characteristics replicated manufacturer's claims. The stability profile of the analyte was unusual, with increasing results observed with storage at 4°C or -20°C. Only storage at -70°C gave acceptable stability. Population median values with properly preserved samples were much lower than the cut off previously validated for increased risk. CONCLUSIONS: It is postulated that variability in specimen handling was a major contributor to the lack of traceability of the current reagents to the earlier clinical studies demonstrating its utility. We are now unsure how to identify reliable criteria for result interpretation.

Maternal psychological distress: adult sons' and daughters' mental health and educational attainment.

BACKGROUND: Offspring of depressed women have high rates of depressive symptoms and other psychopathology. The authors examined the relationship of mothers' symptoms of depression and anxiety reported during their offspring's childhood and adolescence on depressive disorder and educational achievement of their adult children. METHOD: The data come from a longitudinal cohort study of first graders from Woodlawn, a neighborhood in Chicago, followed from age 6 to 32 years (N = 879). Adult children's depression and educational attainment are regressed on earlier self-reports of mothers' psychological distress. Using multiple logistic regression, the authors controlled for the relationships of poverty, mothers' education, mobility, family structure, mothers' illness, and children's first grade classroom behavior and psychological symptoms. RESULTS: Daughters of mothers with persistent maternal psychological distress had two and a half times the risk of lifetime depressive disorder, but no increased risk of high school dropout. For sons, mothers' psychological distress was not related to depression but was related to poorer educational attainment. CONCLUSIONS: Mothers' depressed feelings during the childrearing years relate to their children's depression and educational attainment as measured in adulthood. The patterns differ for sons and daughters.