Changes in psychiatric problems and service use among 8-year-old children: a 16-year population-based time-trend study.
OBJECTIVE
To study differences in children's psychiatric symptoms and child mental health service use at three time points: 1989, 1999, and 2005.


METHODS
Three cross-sectional representative samples of 8-year-old children were compared from southern Finland. The sampling, procedure, and methods were similar at all three time points. Information was gathered from parents and teachers using Rutter questionnaires and other related determinants of service use and from children using the Children's Depression Inventory. The participation rate at the three time points was 96% in 1989, 86% in 1999, and 84% in 2005.


RESULTS
Overall, parent and teacher reports of children's problems did not show a significant increase during the 16-year period. Parent reports of boys' conduct symptoms decreased from 1989 to 1999. However, self-reported depressive symptoms among girls increased from 1989 to 2005. Low parental education level, broken family, and negative life events were associated with depressive symptoms among girls. Although 4% of boys and 1% of girls had used child mental health services in 1989, the respective figures in 2005 were 12% and 4%. The majority of children who were screen positive on either parent or teacher ratings of emotional and behavioral problems using Rutter scales had received some educational support from school in 2005.


CONCLUSIONS
Reports of depressive symptoms increased among girls, and this finding merits further studies. Use of services has continuously increased. School services play an important role in providing support and early detection of children who need to be referred to child mental health services.
Sourander
Andre
A
Drs. Sourander, Niemelä, Santalahti, and Piha are with the Department of Child Psychiatry, Turku University Hospital, and Mr. Helenius is with the Department of Biostatistics, Turku University.. Electronic address: andre.sourander@utu.fi.
Niemelä
Solja
S
Drs. Sourander, Niemelä, Santalahti, and Piha are with the Department of Child Psychiatry, Turku University Hospital, and Mr. Helenius is with the Department of Biostatistics, Turku University.
Santalahti
Päivi
P
Drs. Sourander, Niemelä, Santalahti, and Piha are with the Department of Child Psychiatry, Turku University Hospital, and Mr. Helenius is with the Department of Biostatistics, Turku University.
Helenius
Hans
H
Drs. Sourander, Niemelä, Santalahti, and Piha are with the Department of Child Psychiatry, Turku University Hospital, and Mr. Helenius is with the Department of Biostatistics, Turku University.
Piha
Jorma
J
Drs. Sourander, Niemelä, Santalahti, and Piha are with the Department of Child Psychiatry, Turku University Hospital, and Mr. Helenius is with the Department of Biostatistics, Turku University.
D019958:Attention Deficit and Disruptive Behavior Disorders / Q000453:epidemiology / Q000266:history / Q000517:prevention & control; D002648:Child; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology / Q000266:history / Q000517:prevention & control; D005260:Female; D005387:Finland / Q000453:epidemiology; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening; D001523:Mental Disorders / Q000453:epidemiology* / Q000266:history / Q000517:prevention & control; D008605:Mental Health Services / Q000706:statistics & numerical data*; D015999:Multivariate Analysis; D012017:Referral and Consultation / Q000639:trends; D017678:Sex Distribution; D013997:Time Factors