The importance of family to health, development and welfare of children.

OBJECTIVES: Recent investigations have shown that a number of families in Greenland have problems related to parents' use of alcohol. One of the consequences is that children get more difficult conditions during childhood. Children suffer when their parents have alcohol-related problems. An alcoholic parent is generally not able to meet the needs of his or her child. Many children are very lonely and do not discuss their thoughts, their situation or their problems with anyone. Some children get serious psychosocial problems as grown-ups. RESULTS AND CONCLUSIONS: Professionals who work with children in health services, social services or within the school system are generally not adequately aware of the importance of family to the children's reactions. This means that the children are at risk of being treated only for symptoms when the unity of child and family is not adequately taken into account. Prevention has to focus on the first steps. Children must be allowed to talk about their problems. The whole family should be included in the treatment.

Mental disorders in the Greenlandic population. A register study.

In a register study of all psychiatric first hospitalizations (1974-93) of persons born and resident in Greenland rates for all admissions as well as for the separate diagnostic groups, hierarchically organized, were compared with corresponding figures for the population in Denmark. Relative mortality rates for the psychiatric patients compared with the general population were computed for the Greenlandic and Danish populations respectively. No significant differences in the total pattern of hospitalization was found, but Greenlandic men 15-24 years old and Greenlandic women 25-34 years old had significantly higher and older age groups lower first admission rates than Danish men and women, respectively. The rates for affective psychoses were low especially among men in Greenland, whereas the rates for schizophrenia among men were comparatively high. The relative mortality risk compared to the general population was much higher among Danish than Greenlandic psychiatric patients, especially regarding suicide. A probable explanation for that is that the suicide rate in the Green-landic general population is very high.

Affective disorders among Greenlandic psychiatric patients.

OBJECTIVE: The aim of this study was to determine the treatment incidence, diagnostic stability and clinical and social outcome of affective disorders in the Greenlandic population. METHODS: A cohort of Greenlanders first hospitalized in 1980-1983 and diagnosed with an affective disorder at least once during the period 7 to 12 years after first admission formed the study population. The manic-depressive patients who were still alive at follow-up were invited for a Present State Examination, and information about clinical and social condition was obtained for the total cohort. RESULTS: The rates of manic-depressive psychoses diagnosed at first admission or later were 6.6 for men and 20.4 for women per 100,000 individuals of over 15 years of age. The unipolar:bipolar ratio was very low, namely 1:3 for men and 1:2 for women. Outcome was relatively poor. CONCLUSION: Manic-depression is a recognizable diagnostic category in Greenland. Extremely low rates of unipolar disorders in both sexes and high rates of bipolar disorders among women were the most marked findings.

Common mental disorders among patients in primary health care in Greenland.

Studies from all over the world have shown that well defined mental disorders are common in all general health care settings and that marked disability is associated with common mental disorders, more so than with chronic physical disorders without psychological disturbances. A majority of mental disorders are unrecognized and do not get appropriate treatment. No such study has been made in Greenland, but there are many indications that mental health is threatened and needs more attention. A two-stage study of common mental disorders among patients in the primary health service in Greenland is planned to take place from September 1996 to 1998. The research plan is presented as an invitation to replicate the study in other circumpolar areas.

Schizophrenia in Greenland: a follow-up study.

A total of 289 Greenlanders admitted for the first time to a mental hospital from 1980 to 1983, were followed for 7 years. Thirty-seven patients, 24 men and 13 women, were diagnosed with schizophrenia at least once during the follow-up period. The annual first admission rate per 100,000 was 41 for men and 23 for women. The schizophrenics were compared with a group of non-schizophrenics at the same age admitted in the same period. The main results were young age at first admittance, high male-female ratio and poor clinical and social outcome. The results were compared with WHO's cross-cultural studies. Young age and a high male-female ratio are in accordance with the developing countries, whereas poor outcome is in accordance with the industrialized countries.

Mental disorders and conditions of life in childhood in Greenlanders.

A cohort of Greenlandic psychiatric patients, domiciled in Greenland and admitted for the first time to a psychiatric institution in 1980-84, has been analyzed and followed until 1991. In this part of the study their conditions in childhood were analyzed in relation to diagnoses. Failing care, disharmony and possible violence in the early home were associated with great risk of later personality disorders, whereas they were not associated with a neurotic development. No direct association was found with the structure of the early home, whether or not spending the whole childhood with both or one of the biological parents. It was the quality of the home(s) that mattered. For other diagnoses there was no clear association between conditions in childhood and occurrence of the diagnosis. But there was an astonishingly high prevalence of poor conditions in childhood in the total study population, especially among those younger than 35 years at first admission.