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Familial and neighborhood effects on psychiatric disorders in childhood and adolescence

Sundquist, Jan LU ; Li, Xinjun LU ; Ohlsson, Henrik LU ; Råstam, Maria LU ; Winkleby, Marilyn; Sundquist, Kristina LU ; Kendler, Kenneth S and Crump, Casey (2015) In Journal of Psychiatric Research 66-67. p.7-15
Abstract
Background:

More knowledge is needed on potential associations between individual-, family-, and neighborhood-level factors and psychiatric disorders in children and adolescents.



Aims:

To examine associations between, individual-, family-, and neighborhood-level factors and incident internalizing (anxiety and mood) disorders and externalizing (ADHD and conduct) disorders in children and adolescents, and to estimate the relative contributions of family and neighborhood to individual variation in these disorders.



Method:

We performed a three-level logistic regression on all 542,195 children born in Sweden in 1992-1996, nested in 427,954 families, which in turn were nested in... (More)
Background:

More knowledge is needed on potential associations between individual-, family-, and neighborhood-level factors and psychiatric disorders in children and adolescents.



Aims:

To examine associations between, individual-, family-, and neighborhood-level factors and incident internalizing (anxiety and mood) disorders and externalizing (ADHD and conduct) disorders in children and adolescents, and to estimate the relative contributions of family and neighborhood to individual variation in these disorders.



Method:

We performed a three-level logistic regression on all 542,195 children born in Sweden in 1992-1996, nested in 427,954 families, which in turn were nested in 8475 neighborhoods. The children were followed from 2000 to 2010 for incident internalizing and externalizing psychiatric disorders, assessed from medical records.



Results:

26,514 children (4.8%) were diagnosed with internalizing or externalizing psychiatric disorders. Approximately 29% of the total individual variance in internalizing disorders could be attributed to the family level, which includes both genetic and family environmental effects, and 5% to the neighborhood level. The corresponding figures for externalizing disorders were 43.5% and 5.5%, respectively. After adjustment for individual-level sociodemographic factors, high neighborhood deprivationwas associated with increased risks of externalizing and internalizing psychiatric disorders (odds ratio [OR] = 1.37, 95% credible interval [CI] = 1.25-1.50 and OR = 1.34, 95% CI = 1.25-1.45, respectively), including conduct disorder (OR = 2.01, 95% CI = 1.58-2.55), anxiety disorders (OR = 1.40, 95% CI = 1.29-1.52), and mood disorders (OR = 1.21, 95% CI, 1.09-1.35). The strongest association between neighborhood deprivation and ADHD was observed in moderately deprived neighborhoods (OR = 1.31, 95% CI = 1.19-1.44).



Conclusions:

These findings call for policies to promote mental health that consider potential influences from children's family and neighborhood environments.



Trial registration: Not applicable. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cohort study, Neighborhood SES, Internalizing and externalizing psychiatric disorders
in
Journal of Psychiatric Research
volume
66-67
pages
7 - 15
publisher
Elsevier
external identifiers
  • wos:000356746700002
  • pmid:25953099
  • scopus:84930537405
ISSN
1879-1379
DOI
10.1016/j.jpsychires.2015.03.019
language
English
LU publication?
yes
id
c1a4212f-2f21-4c2b-9a9a-3f4dab9a996a (old id 5424191)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/25953099?dopt=Abstract
date added to LUP
2015-06-22 15:54:04
date last changed
2017-11-19 03:22:13
@article{c1a4212f-2f21-4c2b-9a9a-3f4dab9a996a,
  abstract     = {Background: <br/><br>
More knowledge is needed on potential associations between individual-, family-, and neighborhood-level factors and psychiatric disorders in children and adolescents.<br/><br>
<br/><br>
Aims: <br/><br>
To examine associations between, individual-, family-, and neighborhood-level factors and incident internalizing (anxiety and mood) disorders and externalizing (ADHD and conduct) disorders in children and adolescents, and to estimate the relative contributions of family and neighborhood to individual variation in these disorders.<br/><br>
<br/><br>
Method:<br/><br>
We performed a three-level logistic regression on all 542,195 children born in Sweden in 1992-1996, nested in 427,954 families, which in turn were nested in 8475 neighborhoods. The children were followed from 2000 to 2010 for incident internalizing and externalizing psychiatric disorders, assessed from medical records.<br/><br>
<br/><br>
Results: <br/><br>
26,514 children (4.8%) were diagnosed with internalizing or externalizing psychiatric disorders. Approximately 29% of the total individual variance in internalizing disorders could be attributed to the family level, which includes both genetic and family environmental effects, and 5% to the neighborhood level. The corresponding figures for externalizing disorders were 43.5% and 5.5%, respectively. After adjustment for individual-level sociodemographic factors, high neighborhood deprivationwas associated with increased risks of externalizing and internalizing psychiatric disorders (odds ratio [OR] = 1.37, 95% credible interval [CI] = 1.25-1.50 and OR = 1.34, 95% CI = 1.25-1.45, respectively), including conduct disorder (OR = 2.01, 95% CI = 1.58-2.55), anxiety disorders (OR = 1.40, 95% CI = 1.29-1.52), and mood disorders (OR = 1.21, 95% CI, 1.09-1.35). The strongest association between neighborhood deprivation and ADHD was observed in moderately deprived neighborhoods (OR = 1.31, 95% CI = 1.19-1.44).<br/><br>
<br/><br>
Conclusions: <br/><br>
These findings call for policies to promote mental health that consider potential influences from children's family and neighborhood environments.<br/><br>
<br/><br>
Trial registration: Not applicable.},
  author       = {Sundquist, Jan and Li, Xinjun and Ohlsson, Henrik and Råstam, Maria and Winkleby, Marilyn and Sundquist, Kristina and Kendler, Kenneth S and Crump, Casey},
  issn         = {1879-1379},
  keyword      = {Cohort study,Neighborhood SES,Internalizing and externalizing psychiatric disorders},
  language     = {eng},
  pages        = {7--15},
  publisher    = {Elsevier},
  series       = {Journal of Psychiatric Research},
  title        = {Familial and neighborhood effects on psychiatric disorders in childhood and adolescence},
  url          = {http://dx.doi.org/10.1016/j.jpsychires.2015.03.019},
  volume       = {66-67},
  year         = {2015},
}