Skip to main content
Top
Published in: Child and Adolescent Psychiatry and Mental Health 1/2018

Open Access 01-12-2018 | Research article

Psychopathology and impairment of quality of life in offspring of psychiatric inpatients in southern Brazil: a preliminary study

Authors: Ana Luiza Ache, Paula Fernandes Moretti, Gibsi Possapp Rocha, Rogéria Recondo, Marco Antônio Pacheco, Lucas Spanemberg

Published in: Child and Adolescent Psychiatry and Mental Health | Issue 1/2018

Login to get access

Abstract

Objective

To evaluate the quality of life and risk of psychopathology in the infant and adolescent offspring of psychiatric inpatients from a general hospital unit.

Methods

Offspring (4–17 years old) of psychiatric inpatients were interviewed face-to-face and assessed with the Strengths and Difficulties Questionnaire (SDQ). Interviews with caregivers and the hospitalized parents were also performed. The quality of life of the offspring, psychopathology of their hospitalized parents, and their current caregivers were investigated in order to evaluate any associations between these aspects and psychopathology in the offspring.

Results

Thirty-four children of 25 patients were evaluated, 38.2% of which presented high risk for some type of psychopathology including hyperactivity or attention deficit disorder (38.2%), behavioral disorders (20.6%), and emotional disorders (17.6%). While only the minority of these children (17.6%) were already receiving mental health treatment, another 41.2% of them exhibited some degree of symptoms and were only referred for specialized assessment. Additionally, 61.8% of the children were reported to be suffering from some impairment in their quality of life.

Conclusion

This preliminary study found a high rate of psychopathology in children of psychiatric inpatients. These results corroborate previous evidence that children and adolescents with parents with severe psychopathology are at high risk for developing mental disorders. Public policies and standard protocols of action directed to this population are urgently needed, especially for offspring of parents that are hospitalized in psychiatric in-patient units of general hospitals.
Literature
1.
go back to reference Vigo D, Thornicroft G, Atun R. Estimating the true global burden of mental illness. Lancet Psychiatry. 2016;3(2):171–8.CrossRef Vigo D, Thornicroft G, Atun R. Estimating the true global burden of mental illness. Lancet Psychiatry. 2016;3(2):171–8.CrossRef
2.
go back to reference Kessler RC, et al. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62(6):593–602.CrossRef Kessler RC, et al. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62(6):593–602.CrossRef
3.
go back to reference Kieling C, et al. Child and adolescent mental health worldwide: evidence for action. Lancet. 2011;378(9801):1515–25.CrossRef Kieling C, et al. Child and adolescent mental health worldwide: evidence for action. Lancet. 2011;378(9801):1515–25.CrossRef
4.
go back to reference Polanczyk GV, et al. Annual research review: a meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. J Child Psychol Psychiatry. 2015;56(3):345–65.CrossRef Polanczyk GV, et al. Annual research review: a meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. J Child Psychol Psychiatry. 2015;56(3):345–65.CrossRef
5.
go back to reference Bronsard G, et al. The prevalence of mental disorders among children and adolescents in the child welfare system: a systematic review and meta-analysis. Medicine. 2016;95(7):e2622.CrossRef Bronsard G, et al. The prevalence of mental disorders among children and adolescents in the child welfare system: a systematic review and meta-analysis. Medicine. 2016;95(7):e2622.CrossRef
6.
go back to reference Williams NJ, Scott L, Aarons GA. Prevalence of serious emotional disturbance among U.S. children: a meta-analysis. Psychiatr Serv. 2017;69(1):32–40.CrossRef Williams NJ, Scott L, Aarons GA. Prevalence of serious emotional disturbance among U.S. children: a meta-analysis. Psychiatr Serv. 2017;69(1):32–40.CrossRef
7.
go back to reference Lopes CS, et al. ERICA: prevalence of common mental disorders in Brazilian adolescents. Rev Saude Publica. 2016;50(Suppl 1):14s.CrossRef Lopes CS, et al. ERICA: prevalence of common mental disorders in Brazilian adolescents. Rev Saude Publica. 2016;50(Suppl 1):14s.CrossRef
8.
go back to reference Viana MC, Andrade LH. Lifetime prevalence, age and gender distribution and age-of-onset of psychiatric disorders in the Sao Paulo Metropolitan Area, Brazil: results from the Sao Paulo Megacity Mental Health Survey. Rev Bras Psiquiatr. 2012;34(3):249–60.CrossRef Viana MC, Andrade LH. Lifetime prevalence, age and gender distribution and age-of-onset of psychiatric disorders in the Sao Paulo Metropolitan Area, Brazil: results from the Sao Paulo Megacity Mental Health Survey. Rev Bras Psiquiatr. 2012;34(3):249–60.CrossRef
9.
go back to reference Petresco S, et al. Prevalence and comorbidity of psychiatric disorders among 6-year-old children: 2004 Pelotas Birth Cohort. Soc Psychiatry Psychiatr Epidemiol. 2014;49(6):975–83.CrossRef Petresco S, et al. Prevalence and comorbidity of psychiatric disorders among 6-year-old children: 2004 Pelotas Birth Cohort. Soc Psychiatry Psychiatr Epidemiol. 2014;49(6):975–83.CrossRef
10.
go back to reference Dean K, et al. Full spectrum of psychiatric outcomes among offspring with parental history of mental disorder. Arch Gen Psychiatry. 2010;67(8):822–9.CrossRef Dean K, et al. Full spectrum of psychiatric outcomes among offspring with parental history of mental disorder. Arch Gen Psychiatry. 2010;67(8):822–9.CrossRef
11.
go back to reference Gottesman II, et al. Severe mental disorders in offspring with 2 psychiatrically ill parents. Arch Gen Psychiatry. 2010;67(3):252–7.CrossRef Gottesman II, et al. Severe mental disorders in offspring with 2 psychiatrically ill parents. Arch Gen Psychiatry. 2010;67(3):252–7.CrossRef
12.
go back to reference Weissman MM, et al. Remissions in maternal depression and child psychopathology: a STAR*D-child report. JAMA. 2006;295(12):1389–98.CrossRef Weissman MM, et al. Remissions in maternal depression and child psychopathology: a STAR*D-child report. JAMA. 2006;295(12):1389–98.CrossRef
13.
go back to reference Olfson M, et al. Parental depression, child mental health problems, and health care utilization. Med Care. 2003;41(6):716–21.PubMed Olfson M, et al. Parental depression, child mental health problems, and health care utilization. Med Care. 2003;41(6):716–21.PubMed
14.
go back to reference Mowbray CT, et al. Children of mothers diagnosed with serious mental illness: patterns and predictors of service use. Ment Health Serv Res. 2004;6(3):167–83.CrossRef Mowbray CT, et al. Children of mothers diagnosed with serious mental illness: patterns and predictors of service use. Ment Health Serv Res. 2004;6(3):167–83.CrossRef
15.
go back to reference Dean K, et al. Criminal conviction among offspring with parental history of mental disorder. Psychol Med. 2012;42(3):571–81.CrossRef Dean K, et al. Criminal conviction among offspring with parental history of mental disorder. Psychol Med. 2012;42(3):571–81.CrossRef
16.
go back to reference Simioni AR, Pan PM, Gadelha A, et al. Prevalence, clinical correlates and maternal psychopathology of deliberate self-harm in children and early adolescents: results from a large community study. Rev Bras Psiquiatr. 2018;40(1):48–55.CrossRef Simioni AR, Pan PM, Gadelha A, et al. Prevalence, clinical correlates and maternal psychopathology of deliberate self-harm in children and early adolescents: results from a large community study. Rev Bras Psiquiatr. 2018;40(1):48–55.CrossRef
17.
go back to reference Mok PL, et al. Parental psychiatric disease and risks of attempted suicide and violent criminal offending in offspring: a population-based cohort study. JAMA Psychiatry. 2016;73(10):1015–22.CrossRef Mok PL, et al. Parental psychiatric disease and risks of attempted suicide and violent criminal offending in offspring: a population-based cohort study. JAMA Psychiatry. 2016;73(10):1015–22.CrossRef
18.
go back to reference Gureje O, et al. Parental psychopathology and the risk of suicidal behavior in their offspring: results from the World Mental Health surveys. Mol Psychiatry. 2011;16(12):1221–33.CrossRef Gureje O, et al. Parental psychopathology and the risk of suicidal behavior in their offspring: results from the World Mental Health surveys. Mol Psychiatry. 2011;16(12):1221–33.CrossRef
19.
go back to reference McLaughlin KA, et al. Parent psychopathology and offspring mental disorders: results from the WHO World Mental Health Surveys. Br J Psychiatry. 2012;200(4):290–9.CrossRef McLaughlin KA, et al. Parent psychopathology and offspring mental disorders: results from the WHO World Mental Health Surveys. Br J Psychiatry. 2012;200(4):290–9.CrossRef
20.
go back to reference Bassani DG, Padoin CV, Veldhuizen S. Counting children at risk: exploring a method to estimate the number of children exposed to parental mental illness using adult health survey data. Soc Psychiatry Psychiatr Epidemiol. 2008;43(11):927–35.CrossRef Bassani DG, Padoin CV, Veldhuizen S. Counting children at risk: exploring a method to estimate the number of children exposed to parental mental illness using adult health survey data. Soc Psychiatry Psychiatr Epidemiol. 2008;43(11):927–35.CrossRef
21.
go back to reference Maybery DJ, et al. Prevalence of parental mental illness in Australian families. Psychiatr Bull. 2009;33(1):22–6.CrossRef Maybery DJ, et al. Prevalence of parental mental illness in Australian families. Psychiatr Bull. 2009;33(1):22–6.CrossRef
22.
go back to reference Reupert AE, Maybery JD, Kowalenko NM. Children whose parents have a mental illness: prevalence, need and treatment. Med J Aust. 2013;199(3 Suppl):S7–9.CrossRef Reupert AE, Maybery JD, Kowalenko NM. Children whose parents have a mental illness: prevalence, need and treatment. Med J Aust. 2013;199(3 Suppl):S7–9.CrossRef
23.
go back to reference Stambaugh LF, et al. Prevalence of serious mental illness among parents in the United States: results from the National Survey of Drug Use and Health, 2008-2014. Ann Epidemiol. 2017;27(3):222–4.CrossRef Stambaugh LF, et al. Prevalence of serious mental illness among parents in the United States: results from the National Survey of Drug Use and Health, 2008-2014. Ann Epidemiol. 2017;27(3):222–4.CrossRef
24.
go back to reference Biebel K, et al. The responsiveness of State Mental Health Authorities to parents with mental illness. Adm Policy Ment Health. 2004;32(1):31–48.CrossRef Biebel K, et al. The responsiveness of State Mental Health Authorities to parents with mental illness. Adm Policy Ment Health. 2004;32(1):31–48.CrossRef
25.
go back to reference Potter R, et al. Missed opportunities: mental disorder in children of parents with depression. Br J Gen Pract. 2012;62(600):e487–93.CrossRef Potter R, et al. Missed opportunities: mental disorder in children of parents with depression. Br J Gen Pract. 2012;62(600):e487–93.CrossRef
26.
go back to reference Paula CS, et al. The mental health care gap among children and adolescents: data from an epidemiological survey from four Brazilian regions. PLoS ONE. 2014;9(2):e88241.CrossRef Paula CS, et al. The mental health care gap among children and adolescents: data from an epidemiological survey from four Brazilian regions. PLoS ONE. 2014;9(2):e88241.CrossRef
27.
go back to reference Webb RT, et al. Mortality risk among offspring of psychiatric inpatients: a population-based follow-up to early adulthood. Am J Psychiatry. 2006;163(12):2170–7.CrossRef Webb RT, et al. Mortality risk among offspring of psychiatric inpatients: a population-based follow-up to early adulthood. Am J Psychiatry. 2006;163(12):2170–7.CrossRef
28.
go back to reference Nicholson J. Parenting and recovery for mothers with mental disorders. In: Levin BL, Becker MA, editors. A public health perspective of women’s mental health. New York: Springer; 2010. p. 415. Nicholson J. Parenting and recovery for mothers with mental disorders. In: Levin BL, Becker MA, editors. A public health perspective of women’s mental health. New York: Springer; 2010. p. 415.
29.
go back to reference Ramchandani P, Stein A. The impact of parental psychiatric disorder on children. BMJ. 2003;327(7409):242–3.CrossRef Ramchandani P, Stein A. The impact of parental psychiatric disorder on children. BMJ. 2003;327(7409):242–3.CrossRef
30.
go back to reference Howard LM, et al. Predictors of parenting outcome in women with psychotic disorders discharged from mother and baby units. Acta Psychiatr Scand. 2004;110(5):347–55.CrossRef Howard LM, et al. Predictors of parenting outcome in women with psychotic disorders discharged from mother and baby units. Acta Psychiatr Scand. 2004;110(5):347–55.CrossRef
31.
go back to reference Lauritzen C, et al. Factors that may facilitate or hinder a family-focus in the treatment of parents with a mental illness. J Child Fam Stud. 2015;24(4):864–71.CrossRef Lauritzen C, et al. Factors that may facilitate or hinder a family-focus in the treatment of parents with a mental illness. J Child Fam Stud. 2015;24(4):864–71.CrossRef
32.
go back to reference Saur AM, Loureiro SR. Psychometric properties of the Strengths and Difficulties Questionnaire: a literature review. Estudos de Psicologia. 2012;29:609–29.CrossRef Saur AM, Loureiro SR. Psychometric properties of the Strengths and Difficulties Questionnaire: a literature review. Estudos de Psicologia. 2012;29:609–29.CrossRef
33.
go back to reference DAWBA. SDQ Information for researchers and professionals about the Strengths & Difficulties Questionnaires. DAWBA family of mental heath measures. 2012. http://www.sdqinfo.com. Accessed 25th Nov 2017. DAWBA. SDQ Information for researchers and professionals about the Strengths & Difficulties Questionnaires. DAWBA family of mental heath measures. 2012. http://​www.​sdqinfo.​com. Accessed 25th Nov 2017.
35.
go back to reference Kroenke K, Spitzer RL, Williams JBW, et al. An ultra-brief screening scale for anxiety and depression: the PHQ–4. Psychosomatics. 2009;50(6):613–21.PubMed Kroenke K, Spitzer RL, Williams JBW, et al. An ultra-brief screening scale for anxiety and depression: the PHQ–4. Psychosomatics. 2009;50(6):613–21.PubMed
36.
go back to reference Hirschfeld RM, Williams JB, Spitzer RL, et al. Development and validation of a screening instrument for bipolar spectrum disorder: the Mood Disorder Questionnaire. Am J Psychiatry. 2000;157(11):1873–5.CrossRef Hirschfeld RM, Williams JB, Spitzer RL, et al. Development and validation of a screening instrument for bipolar spectrum disorder: the Mood Disorder Questionnaire. Am J Psychiatry. 2000;157(11):1873–5.CrossRef
37.
go back to reference Castelo MS, Carvalho ER, Gerhard ES, Costa CM, Ferreira ED, Carvalho AF. Validity of the Mood Disorder Questionnaire in a Brazilian psychiatric population. Rev Bras Psiquiatr. 2010;32:424–8.CrossRef Castelo MS, Carvalho ER, Gerhard ES, Costa CM, Ferreira ED, Carvalho AF. Validity of the Mood Disorder Questionnaire in a Brazilian psychiatric population. Rev Bras Psiquiatr. 2010;32:424–8.CrossRef
38.
go back to reference Assumpção FB, Kuczynski E, Sprovieri MH, Aranha EM. Quality of life evaluation scale (AUQEI): validity and reliability of a quality of life scale for children from 4 to 12 years-old. Arq Neuropsiquiatr. 2000;58:119–27.CrossRef Assumpção FB, Kuczynski E, Sprovieri MH, Aranha EM. Quality of life evaluation scale (AUQEI): validity and reliability of a quality of life scale for children from 4 to 12 years-old. Arq Neuropsiquiatr. 2000;58:119–27.CrossRef
39.
go back to reference Skevington SM, et al. The World Health Organization’s WHOQOL-BREF quality of life assessment: psychometric properties and results of the international field trial. A report from the WHOQOL group. Qual Life Res. 2004;13(2):299–310.CrossRef Skevington SM, et al. The World Health Organization’s WHOQOL-BREF quality of life assessment: psychometric properties and results of the international field trial. A report from the WHOQOL group. Qual Life Res. 2004;13(2):299–310.CrossRef
40.
go back to reference Fleck MP, et al. Application of the Portuguese version of the abbreviated instrument of quality life WHOQOL-bref. Rev Saude Publica. 2000;34(2):178–83.CrossRef Fleck MP, et al. Application of the Portuguese version of the abbreviated instrument of quality life WHOQOL-bref. Rev Saude Publica. 2000;34(2):178–83.CrossRef
41.
go back to reference Guy W. ECDEU assessment manual for psychopharmacology. Rockville: US Department of Health, Education, and Welfare Public Health Service Alcohol, Drug Abuse, and Mental Health Administration; 1976. p. 603. Guy W. ECDEU assessment manual for psychopharmacology. Rockville: US Department of Health, Education, and Welfare Public Health Service Alcohol, Drug Abuse, and Mental Health Administration; 1976. p. 603.
42.
go back to reference Evans JD. Straightforward statistics for the behavioral sciences. 12th ed. Pacific Grove: Brooks/Cole Pub. Co; 1996. p. 600. Evans JD. Straightforward statistics for the behavioral sciences. 12th ed. Pacific Grove: Brooks/Cole Pub. Co; 1996. p. 600.
43.
go back to reference Oladeji BD, Gureje O. Parental mental disorders and suicidal behavior in the Nigerian survey of mental health and well-being. Arch Suicide Res. 2011;15(4):372–83.CrossRef Oladeji BD, Gureje O. Parental mental disorders and suicidal behavior in the Nigerian survey of mental health and well-being. Arch Suicide Res. 2011;15(4):372–83.CrossRef
44.
go back to reference Santana GL, et al. The influence of parental psychopathology on offspring suicidal behavior across the lifespan. PLoS ONE. 2015;10(7):e0134970.CrossRef Santana GL, et al. The influence of parental psychopathology on offspring suicidal behavior across the lifespan. PLoS ONE. 2015;10(7):e0134970.CrossRef
45.
go back to reference Atwoli L, et al. Association between parental psychopathology and suicidal behavior among adult offspring: results from the cross-sectional South African Stress and Health survey. BMC Psychiatry. 2014;14:65.CrossRef Atwoli L, et al. Association between parental psychopathology and suicidal behavior among adult offspring: results from the cross-sectional South African Stress and Health survey. BMC Psychiatry. 2014;14:65.CrossRef
46.
go back to reference Salum GA, et al. High risk cohort study for psychiatric disorders in childhood: rationale, design, methods and preliminary results. Int J Methods Psychiatr Res. 2015;24(1):58–73.CrossRef Salum GA, et al. High risk cohort study for psychiatric disorders in childhood: rationale, design, methods and preliminary results. Int J Methods Psychiatr Res. 2015;24(1):58–73.CrossRef
47.
go back to reference Silke Wiegand-Grefe SH, Franz Petermann, Angela Plass. Psychopathology and quality of life in children of mentally ill parents, in mental illnesses—evaluation, treatments and implications. In: L’Abate L, editor. InTech; 2012. Silke Wiegand-Grefe SH, Franz Petermann, Angela Plass. Psychopathology and quality of life in children of mentally ill parents, in mental illnesses—evaluation, treatments and implications. In: L’Abate L, editor. InTech; 2012.
48.
go back to reference Bee P, Berzins K, Calam R, et al. Defining quality of life in the children of parents with severe mental illness: a preliminary stakeholder-led model. PLoS One. 2013;8(9):e73739.CrossRef Bee P, Berzins K, Calam R, et al. Defining quality of life in the children of parents with severe mental illness: a preliminary stakeholder-led model. PLoS One. 2013;8(9):e73739.CrossRef
49.
go back to reference Rutter M, Quinton D. Parental psychiatric disorder: effects on children. Psychol Med. 1984;14(4):853–80.CrossRef Rutter M, Quinton D. Parental psychiatric disorder: effects on children. Psychol Med. 1984;14(4):853–80.CrossRef
50.
go back to reference Biederman J, et al. Patterns of psychopathology and dysfunction in high-risk children of parents with panic disorder and major depression. Am J Psychiatry. 2001;158(1):49–57.CrossRef Biederman J, et al. Patterns of psychopathology and dysfunction in high-risk children of parents with panic disorder and major depression. Am J Psychiatry. 2001;158(1):49–57.CrossRef
51.
go back to reference Middeldorp CM, et al. Parents of children with psychopathology: psychiatric problems and the association with their child’s problems. Eur Child Adolesc Psychiatry. 2016;25(8):919–27.CrossRef Middeldorp CM, et al. Parents of children with psychopathology: psychiatric problems and the association with their child’s problems. Eur Child Adolesc Psychiatry. 2016;25(8):919–27.CrossRef
52.
go back to reference Larson RW. Toward a psychology of positive youth development. Am Psychol. 2000;55(1):170–83.CrossRef Larson RW. Toward a psychology of positive youth development. Am Psychol. 2000;55(1):170–83.CrossRef
53.
go back to reference Krumm S, Becker T, Wiegand-Grefe S. Mental health services for parents affected by mental illness. Curr Opin Psychiatry. 2013;26(4):362–8.CrossRef Krumm S, Becker T, Wiegand-Grefe S. Mental health services for parents affected by mental illness. Curr Opin Psychiatry. 2013;26(4):362–8.CrossRef
54.
go back to reference Ostman M, Hansson L. Children in families with a severely mentally ill member. Prevalence and needs for support. Soc Psychiatry Psychiatr Epidemiol. 2002;37(5):243–8.CrossRef Ostman M, Hansson L. Children in families with a severely mentally ill member. Prevalence and needs for support. Soc Psychiatry Psychiatr Epidemiol. 2002;37(5):243–8.CrossRef
55.
go back to reference Wansink HJ, Drost RMWA, Paulus ATG, et al. Cost-effectiveness of preventive case management for parents with a mental illness: a randomized controlled trial from three economic perspectives. BMC Health Serv Res. 2016;16:228.CrossRef Wansink HJ, Drost RMWA, Paulus ATG, et al. Cost-effectiveness of preventive case management for parents with a mental illness: a randomized controlled trial from three economic perspectives. BMC Health Serv Res. 2016;16:228.CrossRef
56.
go back to reference Hammen C. Depression runs in families—the social context of risk and resilience in children of depressed mothers. New York: Springer; 1991. p. 275. Hammen C. Depression runs in families—the social context of risk and resilience in children of depressed mothers. New York: Springer; 1991. p. 275.
57.
go back to reference Maybery D, Goodyear M, Reupert A, et al. Developing an Australian-first recovery model for parents in Victorian mental health and family services: a study protocol for a randomised controlled trial. BMC Psychiatry. 2017;17(1):198.CrossRef Maybery D, Goodyear M, Reupert A, et al. Developing an Australian-first recovery model for parents in Victorian mental health and family services: a study protocol for a randomised controlled trial. BMC Psychiatry. 2017;17(1):198.CrossRef
58.
go back to reference Patel V, et al. Improving access to care for children with mental disorders: a global perspective. Arch Dis Child. 2013;98(5):323–7.CrossRef Patel V, et al. Improving access to care for children with mental disorders: a global perspective. Arch Dis Child. 2013;98(5):323–7.CrossRef
Metadata
Title
Psychopathology and impairment of quality of life in offspring of psychiatric inpatients in southern Brazil: a preliminary study
Authors
Ana Luiza Ache
Paula Fernandes Moretti
Gibsi Possapp Rocha
Rogéria Recondo
Marco Antônio Pacheco
Lucas Spanemberg
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Child and Adolescent Psychiatry and Mental Health / Issue 1/2018
Electronic ISSN: 1753-2000
DOI
https://doi.org/10.1186/s13034-018-0251-2

Other articles of this Issue 1/2018

Child and Adolescent Psychiatry and Mental Health 1/2018 Go to the issue