title: Is a large family a protective factor against behavioural and emotional problems at the age of 8 years?
abstract: OBJECTIVE
  To study the prevalence of behavioural and emotional problems among children from different family types, sibship size and birth order.
  
  
  METHODS
  A prospective birth cohort (n = 9357) study where parents filled in two questionnaires and teachers assessed children's behaviour using the Rutter scale (RB2).
  
  
  RESULTS
  14.3% scored above the cut-off point (RB2 > or = 9) indicating probable psychiatric disturbance, boys more often than girls (OR 2.6, 95% CI 2.3-3.0). Behavioural problems (9.2%) were more common than emotional ones (4.1%). Boys living in families other than two-parent families were at risk for probable psychiatric disturbance, and a corresponding risk was observed for girls living in single-parent or always one-parent families. Other than two-parent family was also a risk for behavioural problems; for boys adjusted odds ratios ranged significantly from 1.8 to 2.4 and for girls from 2.0 to 3.7. "Only children" had the highest prevalence of behavioural problems, while children in very large families had the lowest. Living in a very large family was a protective factor against behavioural problems among boys but not among girls. Eldest children were at lower risk of behavioural problems than the other children. The single-parent and always one-parent family was associated with higher risk of emotional problems among girls.
  
  
  CONCLUSIONS
  Children's psychiatric problems are manifested at school mostly as behavioural problems. A two-parent family and being the oldest in the sibling series seem to be protective factors. Very large family size, if not connected to social disadvantages, does not seem to be a risk factor for children's behaviour.
authors.affiliation: Department of Public Health Science and General Practice, University of Oulu, Finland. ataanila@c-c.oulu.fi
authors.forename: A
authors.initials: A
authors.lastname: Taanila
authors.forename: H
authors.initials: H
authors.lastname: Ebeling
authors.forename: A
authors.initials: A
authors.lastname: Kotimaa
authors.forename: I
authors.initials: I
authors.lastname: Moilanen
authors.forename: M R
authors.initials: MR
authors.lastname: Järvelin
mesh_terms: D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D015331:Cohort Studies; D005190:Family; D005191:Family Characteristics; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D010290:Parents; D011446:Prospective Studies; D012574:Schools; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires