Psychiatric disorders and behaviour problems were found to be commoner in children and adolescents with inflammatory bowel disease (IBD) than in matched comparison groups with tension headache and diabetes as well as in healthy children. Depression, anxiety and low self-esteem were common. Many children denied their problems. This may be due to the type of illness, its social consequences and the embarrassment experienced by the children. Discrepancies were found between the children's and their mothers' replies. These results are discussed in terms of their implication for paediatric practice.

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BackgroundSelf-report measures can guide clinical decisions and are useful when evaluating treatment outcomes. However, many clinicians do not use self-report measures systematically in their clinical practice. Internet-based questionnaires could facilitate administration, but the psychometric properties of the online version of an instrument should be explored before implementation. The recommendation from the International Test Commission is to test the psychometric properties of each questionnaire separately.ObjectiveOur objective was to compare the psychometric properties of paper-and-pencil versions and Internet versions of two questionnaires measuring depressive symptoms.MethodsThe 87 participating patients were recruited from primary care and psychiatric care within the public health care system in Sweden. Participants completed the Beck Depression Inventory (BDI-II) and the Montgomery-Åsberg Depression Rating Scale—Self-rated (MADRS-S), both on paper and on the Internet. The order was randomized to control for order effects. Symptom severity in the sample ranged from mild to severe depressive symptoms.ResultsPsychometric properties of the two administration formats were mostly equivalent. The internal consistency was similar for the Internet and paper versions, and significant correlations were found between the formats for both MADRS-S (r = .84) and the BDI-II (r = .89). Differences between paper and Internet total scores were not statistically significant for either questionnaire nor for the MADRS-S question dealing with suicidality (item 9) when analyzed separately. The score on the BDI-II question about suicidality (item 9) was significantly lower when administered via the Internet compared with the paper score, but the difference was small (effect size, Cohen’s [d] = 0.14). There were significant main effects for order of administration on both questionnaires and significant interaction effects between format and order. This should not, however, pose a problem in clinical use as long as the administration format is not changed when repeated measurements are made.ConclusionsThe MADRS-S can be transferred to online use without affecting the psychometric properties in a clinically meaningful way. The full BDI-II also seems to retain its properties when transferred; however, the item measuring suicidality in the Internet version needs further investigation since it was associated with a lower score in this study. The use of online questionnaires offers clinicians a more practical way of measuring depressive symptoms and has the potential to save resources.

According to the "ICP-growth model" (ICP = Infancy, Childhood and Puberty components), linear growth during the first three years of life can be represented mathematically by a combination of a sharply decelerating Infancy component and a slowly decelerating Childhood component. Growth as measured by supine length is analysed for 191 longitudinally followed healthy infants using this model. The main aim is to devise ICP-based methods for biological and clinical applications. The onset of the Childhood component, which occurs some time between 6 and 12 months of age and is typically abrupt, can be detected on an individual basis. Its starting point probably defines the as yet unknown age at which growth hormone begins to exert a significant influence. The analyses have also revealed some new facets of linear growth. Most infants are found to have a non-linear decelerating Infancy component, free from seasonal influence. Age at onset of the Childhood component is earlier for girls than for boys and is positively related to the magnitude of the Infancy component. During the second year of life the variation in growth rate of the cohort increases. This fluctuation is found to be seasonal and greater for those with late onset of the Childhood component. During the third year of life the growth pattern is stabilized.

This study shows that the well-being of a chronically ill child depends not only on the course of the physical disease but also on the psychological and social complications that often seem to accompany a disease of this kind. The importance of taking good care of the psychosocial aspects of inflammatory bowel disease within the comprehensive treatment program is discussed.

In a prospective study 101 children aged less than 2 years (median age 10 months), were examined the first time they were admitted to a paediatric ward for asthmatic symptoms. Two-thirds were boys and 58 had parents or siblings with allergic symptoms. During winter-spring, respiratory syncytial (RS) virus was verified in 50% of children. Other viral agents were adenovirus, parainfluenza 3, coxsackie B 2, ECHO 6 and rotavirus. At the acute stage, 54% of the children displayed changes on pulmonary X-ray. The total IgE value was greater than or equal to +2 SD score units in 14 children. At reinvestigation after 3-4.5 years, when the children were aged 3.3-6.3 years, 53% were free from asthmatic symptoms; the median age for the last episode was 2 years. A total of 33% had mild asthma, 8% moderate and 6% severe asthma. The factors which correlated significantly with persistent asthma were: (1) The need for daily medication for at least 6 months. (2) A young age in conjunction with the first wheezing episode and on the first admission to a paediatric ward because of asthmatic symptoms. (3) Other past or present atopic symptoms. Heredity, tobacco smoking at home, having a furry pet, RS virus infection, or high total IgE at the time of the first admission did not correlate significantly with the persistence of asthma 3-4.5 years later. The results emphasize the good overall prognosis of wheezing in early childhood, even when the wheezing is severe enough to lead to inpatient treatment.

Analysis of linear growth using a mathematical model. 11. From 3 to 21 years of age. Acta Paediatr Scand [Suppl] 337:12, 1987.

Internet-based CBT seems promising in preventing relapse in persons with partially remitted major depression after previous treatment.