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ObjectivesMethodologically, to assess the feasibility of participant recruitment and retention, as well as missing data in studying mental disorder among children newly diagnosed with chronic physical conditions (ie, multimorbidity). Substantively, to examine the prevalence of multimorbidity, identify sociodemographic correlates and model the influence of multimorbidity on changes in child quality of life and parental psychosocial outcomes over a 6-month follow-up.DesignProspective pilot study.SettingTwo children’s tertiary-care hospitals.ParticipantsChildren aged 6–16 years diagnosed in the past 6 months with one of the following: asthma, diabetes, epilepsy, food allergy or juvenile arthritis, and their parents.Outcome measuresResponse, participation and retention rates. Child mental disorder using the Mini International Neuropsychiatric Interview at baseline and 6 months. Child quality of life, parental symptoms of stress, anxiety and depression, and family functioning. All outcomes were parent reported.ResultsResponse, participation and retention rates were 90%, 83% and 88%, respectively. Of the 50 children enrolled in the study, the prevalence of multimorbidity was 58% at baseline and 42% at 6 months. No sociodemographic characteristics were associated with multimorbidity. Multimorbidity at baseline was associated with declines over 6 months in the following quality of life domains: physical well-being, β=−4.82 (–8.47, –1.17); psychological well-being, β=−4.10 (–7.62, –0.58) and school environment, β=−4.17 (–8.18, –0.16). There was no association with parental psychosocial outcomes over time.ConclusionsPreliminary evidence suggests that mental disorder in children with a physical condition is very common and has a negative impact on quality of life over time. Based on the strong response rate and minimal attrition, our approach to study child multimorbidity appears feasible and suggests that multimorbidity is an important concern for families. Methodological and substantive findings from this pilot study have been used to implement a larger, more definitive study of child multimorbidity, which should lead to important clinical implications.

Externalizing behavior symptoms (EBS) in childhood are a strong predictor of future conduct problems. This study evaluated their predictive accuracy using logistic regression and receiver operating characteristic curve techniques. EBS, alone and in combination with other child and familial risk factors, were used to predict conduct problems 30 months later in a nonclinic population of kindergartners and Grade 1 children. The sensitivity (Sn) and positive predictive value (PPV) of EBS alone were below preset criteria of > or = 50% for each (prevalence < or = 15%). Sn and PPV increased when other child and familial factors were combined with symptoms but did not exceed the preset criteria. From a developmental perspective, substantial stability of EBS exists over time. However, from the perspective of prevention science, significant levels of misclassification will occur when EBS are used to designate high-risk status under the low-prevalence conditions of normal populations.

This study demonstrates the use of multilevel modeling to examine influences on ratings of whole family functioning collected from multiple family members (N=26,614) living in 11,023 families with 1 or more dependent children aged 0 to 24 years. Results indicate that 45.7% of the variance in ratings of whole family functioning was shared among family members, whereas 54.3% was nonshared. Family-level characteristics, such as socioeconomic status (SES), family structure and composition, and family well-being, accounted for 30.6% of between-family variation (i.e., shared perceptions). Individual-level characteristics, such as sex, age, dependent child status, education, and well-being, accounted for 5.6% of within-family variance (i.e., unique perceptions). There was significant between-family variation in the relationship between dependent child status and ratings of family functioning, and increased rating discrepancies among members of the same family were linked with higher levels of family SES. The findings attest to the validity of measuring whole family functioning directly from self-report ratings provided from multiple family members. However, caution is warranted when assessments are available only from single respondents.

The goals of the study were to examine test-retest reliability, informant agreement and convergent and discriminant validity of nine DSM-IV-TR psychiatric disorders classified by parent and youth versions of the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID). Using samples drawn from the general population and child mental health outpatient clinics, 283 youth aged 9 to 18 years and their parents separately completed the MINI-KID with trained lay interviewers on two occasions 7 to 14 days apart. Test-retest reliability estimates based on kappa (κ) went from 0.33 to 0.79 across disorders, samples and informants. Parent-youth agreement on disorders was low (average κ = 0.20). Confirmatory factor analysis provided evidence supporting convergent and discriminant validity. The MINI-KID disorder classifications yielded estimates of test-retest reliability and validity comparable to other standardized diagnostic interviews in both general population and clinic samples. These findings, in addition to the brevity and low administration cost, make the MINI-KID a good candidate for use in epidemiological research and clinical practice. (PsycINFO Database Record

This study evaluated the influence of neighborhoods and socioeconomic disadvantage on behavioral problems rated by parents and teachers in a nationally representative sample of children ages 4 to 11 years living in Canada. Between-neighborhood variation accounted for 7.6% and 6.6% of parent and teacher ratings, respectively. About 25.0% of this neighborhood variation could be explained by socioeconomic variables evenly divided between neighborhood and family-level measures. Family socioeconomic status, lone-parent family status, and percentage of lone parents in neighborhoods were strong, reliable predictors of behavioral problems. Ratings were contextualized: Fewer behavioral problems were assessed in children from well-off families living in disadvantaged neighborhoods, whereas more problems were assessed in children from poor families living in advantaged neighborhoods.