A new Finnish study suggests screening youth for mental health issues can identify 10-15 percent of teens or early adults who go on to develop mental health problems.
While early screening and intervention may improve or even prevent the need for future intervention, experts warn that the screening must be carefully designed and administered to avoid stigmatization or becoming a self-fulfilling prophecy.
“The early detection of children who are showing psychiatric symptoms or are at risk of a mental disorder is crucial, but introducing ‘mental health checkups’ as part of health care in schools is not altogether simple,” said author David Gyllenberg, M.D.
In Gyllenberg’s study, the mental well-being of nearly 6,000 Finnish children of the age of eight was charted through a survey carried out in 1989. After this, the use of psychotropic medication and psychiatric hospital periods of the same children from the age of 12 to 25 was followed up.
Both the use of psychotropic drugs and need for psychiatric hospital treatment was linked with symptoms reported in the survey carried out at the age of eight. Symptoms of depression at this age were linked to later treatment of depression both with boys and girls, while a non-intact family background was linked with a range of psychiatric care required in the teens or early adulthood for both sexes.
Nevertheless, the predictive value of the screens differed among girls and boys. In girls, symptoms of depression and anxiety in youth were associated with later use of psychotropic medication and need for psychiatric care.
Among boys, behaviors such as acting out, aggressive behavior and stealing were predictors of teen and young adult behavioral problems.
“Boys showed symptoms directed towards their environment while girls showed more introverted symptoms,” said Gyllenberg.
Gyllenberg’s study also showed that by the age of 25, 15 per cent of those participating in the survey had taken some kind of psychotropic drug, and 12 per cent had taken antidepressants.
The strong link between psychiatric symptoms displayed in childhood and later use of psychotropic drugs and psychiatric care backs up previous research. A new finding in this particular study was how predictive factors differ between boys and girls.
“If future research supports these findings and an element of mental health screening is made part of health checkups at school, employing sex-specific criteria should be considered,” Gyllenberg said.
The study involved approximately 10 percent of Finnish children who turned eight in 1989, a total 5,817 children. Parents and teachers completed questionnaires with items concerning family structure, parental education level, conduct problems, hyperactive problems, emotional symptoms, bullying, and victimization of bullying behavior.
The children themselves completed questions regarding depressive symptoms, bullying, and victimization of bullying behavior.
Finland’s comprehensive database of interventions allowed detailed followup using the personal identification numbers of 5,525 subjects who had participated in the survey at age eight. Subjects were linked to data in the nationwide Drug Prescription Register and the nationwide Finnish Hospital Discharge Register which gives information about medication use and psychiatric hospital treatment between age 12 and 25.
Source: University of Helsinki