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Biomedical subjects

D R Offord

Publications and source records attributed to D R Offord.

At least 91 records · Page 5Linked to original sources
PubMed1989

Immigrant children: psychiatric disorder, school performance, and service utilization.

Data from the Ontario Child Health Study were used to examine the strength of association between child immigrant status and child psychiatric disorder, poor school performance, and use of mental health/social services. Bivariate results indicate that immigrant children are not at increased risk for psychiatric disorder or poor school performance and that they use mental health and social services significantly less often than do their nonimmigrant peers. Implications of the findings are explored.

Acculturation↗
PubMed1989

Ontario Child Health Study. Summary of selected results.

Selected results from the Ontario Child Health Study (OCHS), a cross-sectional community survey of Ontario children four to 16 years of age, are presented in the areas of prevalence, risk indicators and service utilization. The six month prevalence of one or more of four psychiatric disorders (conduct disorder, hyperactivity, emotional disorder, and somatization), in children four to 16 years of age, in Ontario was 18.1%. The highest rate was in 12 to 16 year old girls, and the lowest rate in four to 11 year old girls. Co-morbidity among these four disorders was high while the proportion of disorders identified by more than one respondent was low. Psychiatric disorders co-occurred significantly with other morbidities in children, including poor school performance, chronic health problems, substance use and suicidal behaviour. Chronic medical illness in the child as well as single parent status, living in a family on social assistance and residing in subsidized housing, were all strong indicators of increased rates of psychiatric disorders in children. Specialized mental health/social services, over a six month period, reached fewer than one of five children with psychiatric disorders, as measured in the study. In contrast, ambulatory medical care (primarily visits to family doctors and pediatricians) served almost 60% of Ontario children four to 16 years old, over the same six month period. The results are compared with those in the literature.

Adolescent↗
PubMed1989

Ontario Child Health Study. Implications for clinical services, research and training.

The Ontario Child Health Study (OCHS) described in the companion paper (1) confirms the fact that psychiatric disorders among children and adolescents are prevalent, that comorbidity and associated impairements are common and that only a minority of children are seen by any definite mental health or social service. The current assessment and treatment methods and the present service system leave the majority of children unserved. Children and their families suffer a good deal before they are adequately diagnosed and treated, and treatment service delivered on a one-by-one basis are expensive. The OCHS data, has, it follows, important implications for clinical work, for mental health service planning, for further research and for training in child and adolescent psychiatry. This paper does not address all the implications of the OCHS in these areas but does attempt to address those which follow from the summary of the OCHS data described in (1).

Adolescent↗
PubMed1989

Prevalence of childhood and adolescent depression in the community. Ontario Child Health Study.

Data from a cross-sectional community survey of 2852 children were used to provide estimates of the prevalence of a 'DSM-III-like' major depressive syndrome in children aged 6 to 16. The severity of symptoms required to define a 'case' was varied to generate three levels of diagnostic certainty (DC). The overall estimates of prevalence made with high DC were 0.6% for pre-adolescents and 1.8% for adolescents. Corresponding rates determined with medium DC were 2.7% and 7.8%, whereas the figures for low DC were 17.5% and 43.9%. Utilisation of mental health and social services, comorbidity (combined disorders), poor school performance, problems in getting along with others and need for professional help all increased as diagnostic certainty increased. There was wide disagreement in data supplied by the different groups of respondents, i.e. parents, teachers and adolescents.

Adolescent↗
PubMed1988

Ontario Child Health Study: reliability and validity of the general functioning subscale of the McMaster Family Assessment Device.

The reliability and validity of the 12-item General Functioning (GF) subscale of the McMaster Family Assessment Device (FAD) is reported here. Psychometric properties of the FAD have been previously determined, but no independent assessment has been made of the GF subscale, which was used to measure family functioning in the Ontario Child Health Study (OCHS). Reliability was measured by Chronbach's alpha and split-half correlation. Validity was assessed by hypothesizing the relationships expected between the GF scores and other family variables included in the OCHS data set. The results indicate good reliability, and all hypotheses of validity were supported. The brevity and ease of administering the GF subscale recommend it for further use in survey research in which a global assessment of family functioning is required.

Adolescent↗
PubMed1988

Ontario Child Health Study: suicidal behavior in youth age 12-16 years.

The authors report on the prevalence and correlates of suicidal behavior in youth age 12-16 years. The data, from a community prevalence survey, show that 5%-10% of the male and 10%-20% of the female youth reported suicidal behavior within a 6-month period. Suicidal behavior in youth appeared to be related to psychiatric disorder in general as well as to family dysfunction and parental arrest.

Adolescent↗
PubMed1988

Characteristics of borderline personality disorder: a Canadian study.

This study presents data on a Canadian sample of inpatients with the diagnosis of Borderline Personality Disorder (BPD). Inpatients with BPD were compared to inpatients with borderline traits. The results indicate that the BPD inpatients have a chronic severe disorder, which onsets in adolescence, and are likely to have suffered early deprivation or abuse.

Adult↗
PubMed1988

The Ontario Child Health Study: social adjustment and mental health of siblings of children with chronic health problems.

There has been controversy concerning the type and amount of psychosocial maladjustment among the siblings of children with chronic physical health problems and disabilities. Most previous studies have been conducted in clinical populations, often from tertiary care centers. This paper reports the risks of psychiatric disorders and social adjustment problems of the siblings of chronically ill children found in the Ontario Child Health Study (OCHS). The OCHS was a general population survey of 3,294 children, 4-16 years of age, living in 1,869 randomly selected families in the Province of Ontario, Canada. A 2-fold risk in emotional disorders, including depression, anxiety, and obsessive-compulsive disorder, and a 1.6-fold increase in risk in poor peer relationships were found. However, risks for conduct disorder, somatization disorder (measured only in 12- to 16-year olds), attention deficit disorder-hyperactivity, and one or more psychiatric disorders were not elevated. Moreover, no increased risks of adjustment problems, including social isolation, low participation in leisure activities, low competence in usual childhood recreational activities or school problems, were observed. Clinicians treating chronically ill children should assess the mental health and adjustment of their siblings without an expectation bias that problems will be found.

Adolescent↗
PubMed1988

Ontario Child Health Study: patterns of ambulatory medical care utilization and their correlates.

Data from a large epidemiologic survey of Ontario children 4 to 16 years of age are presented concerning the frequency and correlates the use of ambulatory medical care services during a 6-month period in which a universal, first-dollar health insurance plan was used. Patterns of use of ambulatory medical care are described for three settings: doctor's offices, emergency rooms, and hospital outpatient departments. A group of children who are frequent users of ambulatory medical care (defined as using three or more services in 6 months) consumed nearly two thirds of all services. Two regression equations are presented--one predicting use/nonuse of ambulatory medical care and the other predicting the total number of visits for medical care. Although only a small proportion of the variance in use/nonuse and amount of use was explained, the major determinant of both ambulatory medical care use and frequency of use was the child's physical health status as perceived by the parent. Younger child, urban area of residence, the number of chronic medical problems of the child, and higher level of maternal education also contributed to the explanation of use v nonuse. Among ambulatory medical care users, high users were more likely to be described as having mental health problems and have parents who had been treated for "nerves." Family size and socioeconomic variables were not important factors in use, suggesting that universal health insurance reduces some barriers to ambulatory medical care for children.

Adolescent↗
PubMed1987

Ontario Child Health Study. I. Methodology.

We developed the methodology for a community survey to determine the prevalence of emotional and behavioral disorders among children 4 to 16 years of age in Ontario, Canada. Our discussion includes the objectives of the survey, the measurement of disorder, sampling methods and survey design, and a description of the data collected and instrumentation. Among 2052 households with eligible children, 1869 (91%) participated in the survey. The results can be used to help plan the future allocation of mental health resources in Ontario.

Adolescent↗
PubMed1987

Ontario Child Health Study. II. Six-month prevalence of disorder and rates of service utilization.

We studied the six-month prevalence of four child psychiatric disorders (conduct disorder, hyperactivity, emotional disorder, and somatization) and patterns of service utilization for mental health and social services, ambulatory medical care and special education by different regions of Ontario, urban-rural residence, and age and sex groupings. Among children 4 to 16 years of age, the overall six-month prevalence rate of one or more of these disorders was 18.1%. The prevalences of hyperactivity and one or more disorders were significantly higher in urban areas than rural areas. The utilization data indicated that children with these psychiatric disorders, compared with children without these disorders, were almost four times more likely to have received mental health or social services in the six months preceding this study. However, five of six of these children had not received these specialized services in the previous six-month period. Over 50% of the children in the province had received ambulatory medical care in the last six months. Over 15% of the children in the province had received special education services at some time thus far in their school careers. Implications of these findings, especially for the provision of child mental health services, are discussed.

Adolescent↗
PubMed1987

Psychiatric disorder and poor school performance among welfare children in Ontario.

Parental welfare status was found to be a marker for identifying a group of children with an increased prevalence of psychiatric disorder and poor school performance. The marker was particularly strong for psychiatric disorder in young boys and for poor school performance in young girls. For instance, the prevalence rates of psychiatric disorder, in the 6 to 11 age group, for welfare and non-welfare boys, were 40.0% and 13.9%, respectively; and for poor school performance in welfare and non-welfare girls, 27.8% and 6.1%, respectively. The relationship between different measures of psychosocial disadvantage and these child deficits was examined. Multivariate analyses revealed, for example, that parental welfare status made an independent contribution to the prediction of psychiatric disorder and was a more powerful predictor of poor school performance in girls compared to boys. The implications of these and other results are discussed.

Adolescent↗
PubMed1987

Chronic illness, disability, and mental and social well-being: findings of the Ontario Child Health Study.

Chronic childhood illness, disability, and psychosocial problems are receiving major attention in current pediatric care. Much of the evidence associating chronic physical problems and mental health and adjustment problems has come from clinic-based studies and is often inconsistent in its conclusions. This paper reports the findings of the Ontario Child Health Study, an epidemiologic survey of 3,294 children 4 to 16 years of age in the general community, concerning the relationship of psychiatric disorders and social adjustment problems among children with chronic illness, medical conditions, and long-term disability in contrast to children free of chronic physical health problems. Age- and sex-adjusted risks for psychiatric disorders and social problems, compared with those for healthy peers, were calculated: children with both chronic illness and associated disability were at greater than threefold risk for psychiatric disorders and considerable risk for social adjustment problems. Children with chronic medical conditions, but no disability, were at considerably less risk: about a twofold increase in psychiatric disorders but little increased risk for social adjustment problems was observed. A relative underuse of specialized mental health services by children who might benefit supports the opinion that all physicians in the community who care for children with chronic health problems should become skilled in the recognition of existing or incipient mental health and social problems and familiar with preventive and treatment approaches that may lessen the excessive burden of psychosocial problems among those with chronic ill-health.

Adaptation, Psychological↗
PubMed1986

Smoking, drinking and use of illicit drugs among adolescents in Ontario: prevalence, patterns of use and sociodemographic correlates.

Data from a cross-sectional survey of the health of Ontario children carried out in 1983 were used to provide estimates of the prevalence, patterns and sociodemographic correlates of the use of tobacco, alcohol and illicit drugs (substance use) among adolescents aged 12 to 16 years. Ninety-one percent of selected households participated. The prevalence rates of all categories of substance use, except use of inhalants, increased with increasing age. Among children aged 14 to 16 years the rates for girls were higher than those for boys for all categories of substance use except use of other, nondefined drugs. The prevalence rates of substance use tended to be higher in small urban areas except for use of marijuana (more prevalent in large urban areas) and use of inhalants (more prevalent in rural areas). The strongest evidence of clustering of substance use within families was found for smoking. Children who used less prevalent drugs (e.g., "hard" drugs) also tended to use the more prevalent ones (e.g., marijuana, tobacco and alcohol). Associations between substance use and low socioeconomic status suggested a positive relation with smoking and a negative relation with use of alcohol. The findings highlight the need for preventive programs aimed at specific subgroups in the adolescent population.

Adolescent↗
PubMed1986

Chronic illness and functional limitation in Ontario children: findings of the Ontario Child Health Study.

The Ontario Child Health Study (OCHS) was based on interviews of 1869 Ontario families who were selected by means of a stratified, multistaged sampling method from the 1981 census of Canada. Its primary purpose was to determine the prevalence and distribution of mental health problems in Ontario children aged 4 to 16 years and their families, but it also allowed an estimate of other significant medical conditions and provided an overview of these children's use of health care, education and social services. Our results are based on questionnaire responses concerning 3294 children. Limitation of function without a chronic illness or medical condition was reported in 1.9%, the converse in 14.0%, and a chronic illness or medical condition with limitation of function in 3.7%. When the three groups are considered together, 19.6% of Ontario children had a chronic health problem. Children of lower socioeconomic status were much more likely to have chronic health problems. Overall, children with chronic health problems were more likely to use physician, special education, social and mental health services. These findings have implications for those who provide services for children, plan community programs or train professionals in caring for children.

Activities of Daily Living↗
PubMed1986

Participation and sibship size in a skill-development program: a research note.

The behavior of interest in this study was participation or non-participation in a non-school skill-development program carried out in Ottawa, Ontario, for children living in a rent-to-income housing complex. Participant and non-participant children differed sharply only in sibship size; the larger the sibship from which a child came the greater the probability that he or she would participate. The basis for this relationship seems to have been a strong tendency for the probability of a child's participating to increase whenever a brother or sister in the same family participated.

Adolescent↗