Breastfeeding and cognitive development in children.
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Breast Feeding↗
Biomedical subjects
S Silburn
Publications and source records attributed to S Silburn.
Breast feeding and cognitive development in childhood: a prospective birth cohort study.
The aim of this study was to examine prospectively the relation between duration of breast feeding and cognitive outcomes. A cohort study of 2860 children enrolled before birth provided data from 2393 term infants of English-speaking mothers. Of these, complete infant feeding data in the first year of life and verbal cognitive IQ (Peabody Picture Vocabulary Test - PPVT-R) were available for 1450 children at 6 years, and a performance subtest (Perceptual organisation WISC - Block Design) for 1375 children at 8 years. Full breast feeding was categorised as none,> 0 to < 4 months, 4-6 months and> 6 months. Associations between breast-feeding duration and PPVT-R at 6 years and Block Design at 8 years were estimated before and after adjustment for gender, gestational age, maternal age, maternal education, parental smoking and the presence of older siblings. The early cessation of full breast feeding was associated with reduced verbal IQ and the performance subtest. In unadjusted analysis, mean standardised PPVT-R scores were 6.44 points greater (P < 0.0001) in children fully breast fed for> 6 months compared with those never breast fed. After adjustment, mean PPVT-R scores were 3.56 points higher in children fully breast fed for> 6 months compared with those children never breast fed (P = 0.003). Similarly, Block Design scores were higher in those fully breast fed for> 6 months compared with those never breast fed in unadjusted (P = 0.001) but not adjusted analyses (P = 0.223). Interactions between maternal education (four levels) and breast feeding demonstrated a positive association of maternal education on verbal IQ (F = 2.64; P = 0.005) in children breast fed for longer but not on performance (F = 0.74; P = 0.67). The early introduction of milk other than breast milk was associated with reduced verbal IQ after adjustment for social and perinatal confounders. Although these effects were interacting with maternal education, they may act through undefined mechanisms in human milk.
Breast Feeding↗
Psychological and social characteristics and precipitants of vomiting in children with cyclic vomiting syndrome.
A psychological etiology or predisposition for cyclic vomiting syndrome (CVS) has long been suspected. Much of the psychiatric literature to date has blamed patients or their families for the problem or focused on psychoanalytic interpretation to account for the syndrome. Thirty-two patients with CVS were compared with 64 age- and sex-matched controls. The patients had a higher incidence of psychological symptoms and migraine. On the Achenbach Child Behavior Checklist patients had higher internalizing, somatic complaints, and anxiety/depression scores. CVS is a migraine variant, with attacks usually precipitated by stress and intercurrent infections. The psychological characteristics of patients with CVS probably contribute to their vulnerability.
Adolescent↗
Blood alcohol levels in suicide cases.
STUDY OBJECTIVE: The aim was to investigate the relationship between alcohol consumption prior to suicide and the act of suicide. DESIGN: This was a retrospective total ascertainment survey of a three year cohort of suicides in Western Australia. SETTING: Coroner's records of suicide in Western Australia between 1986 and 1988 inclusive. PARTICIPANTS: The study involved 515 consecutive suicides: 414 males and 101 females. MAIN RESULTS: Information on blood alcohol levels at time of death, presence of other drugs at time of death, drug and alcohol abuse history, psychiatric history, life events prior to death and method of suicide were collected. It was found that 35.8% of cases had a positive blood alcohol reading. Those who had been drinking alcohol prior to suicide were younger, more likely to be male, more likely to have chosen carbon monoxide as the method of suicide, more likely to have experienced a break up of a relationship and less likely to have sought professional help than those who had not been drinking. CONCLUSIONS: Data from the present study do not provide evidence for a causal relationship between alcohol consumption and suicide. Differences between those who had consumed alcohol and those who had not are suggestive of a contributory role of alcohol to a decision to commit suicide in a subset of suicide cases.
Alcohol Drinking↗
Are children and adolescents who have suicidal thoughts different from those who attempt suicide?
In this study we inquire whether children and adolescents with suicidal ideation can be differentiated from children who attempt suicide on the basis of clinical symptoms or social grounds. From a total of 2181 consecutive outpatient referrals to a child and adolescent psychiatry service, 258 young persons who exhibited suicidal ideation are compared with 82 who had actually attempted suicide. We were unable to differentiate children with suicidal thoughts from those who attempted suicide on the basis of clinical symptoms alone. Both groups had similar high levels of symptoms of depression, anxiety, sleep disorder, and irritability. Conduct disorders were less common in both groups but 22% of the attempters abused illicit drugs or alcohol. Suicide attempts were more likely to be associated with chronic family discord and substance abuse. For boys, the odds of suicidal attempts were substantially increased if the subject had experienced loss. Results are discussed with reference to antecedents that may increase the odds of suicidal attempt and suggestions for future research are outlined.
Adolescent↗
Is suicidal ideation associated with puberty?
Chronological age, rather than puberty, was associated with suicidal ideation in both sexes in a sample of 1,060 children and adolescents aged nine to fourteen years who were referred to a child psychiatry service in Perth, Western Australia.
Adolescent↗
Symptomatic depression and suicidal ideation. A comparative study with 628 children.
A comparison was made of demographic and clinical variables between 481 children aged 15 or less who exhibited symptomatic depression and 147 children who had this symptom and who also had suicidal ideas. Suicidal ideation was associated with disturbed, hostile intrafamilial relationships. It was also associated with age in girls. Significantly, experiences of loss were associated with symptomatic depression rather than with suicidal ideation per se. No specific psychiatric, emotional, or conduct disorder symptoms were found to differentiate between the two groups. Similarly, extrafamilial and social characteristics were not differentiating features. The children with suicidal ideation had no more disturbance of peer relationships or social withdrawal than did their nonsuicidal depressed counterparts and may not, therefore, be readily identifiable by teachers or other responsible adults. Clinical management of potentially suicidal children needs to encompass symptomatic treatment of depression and amelioration of adverse family interactions.
Affective Symptoms↗
A survey of child psychiatry outpatients. 1. Clinical and demographic characteristics.
This paper describes clinical and demographic characteristics of 664 children who attended outpatient child psychiatry clinics in Perth, Western Australia, over a one-year period. All social classes were represented; parents were the most common source of referral and typically the child had been assessed or treated for emotional or behavioural problems by other agencies previously. Referrals from the juvenile justice system were uncommon. The accessibility of clinics to the child population was found to have a significant effect on the rate of referral. Only 10% of the sample received conduct disorder diagnoses, whereas 16.5% had mixed disorders of conduct and emotion, and 42% had emotional disorders. Environmental circumstances, particularly recent marital break-up, family discord and recent experience of loss, were contributing factors to the child's clinical presentation in a large proportion of cases.
Adolescent↗
Children who light fires: a comparison between firesetters and non-firesetters referred to a child psychiatric outpatient service.
This study compares firesetting children with an age- and sex-matched group of non-firesetting children referred to a child psychiatric outpatient service. Firesetting was associated with male sex, separated parents and with previous contact with welfare agencies. It was not associated with socioeconomic status. Firesetters were distinguished from the contrast group by higher levels of conduct disordered behaviour, particularly in children above the age of 11 years. Both groups had similar high levels of emotional disorder at all ages. These clinical features emphasise that firesetters have a mixed clinical picture with widespread psychopathology.
Adolescent↗