Familial and neighborhood effects on psychiatric disorders in childhood and adolescence

Jan Sundquist¹, Xinjun Li², Henrik Ohlsson³, Maria Råstam⁴, Marilyn Winkleby⁵, Kristina Sundquist⁶, Kenneth S Kendler⁷, Casey Crump⁸

Affiliations

¹ Center for Primary Health Care Research, Lund University, Malmö, Sweden; Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA. Electronic address: jan.sundquist@med.lu.se.
² Center for Primary Health Care Research, Lund University, Malmö, Sweden. Electronic address: xinjun.li@med.lu.se.
³ Center for Primary Health Care Research, Lund University, Malmö, Sweden. Electronic address: henrik.ohlsson@med.lu.se.
⁴ Child and Adolescent Psychiatry, Department of Clinical Sciences in Lund, Lund University, Lund, Sweden. Electronic address: maria.rastam@med.lu.se.
⁵ Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA. Electronic address: winkleby@stanford.edu.
⁶ Center for Primary Health Care Research, Lund University, Malmö, Sweden; Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA. Electronic address: kristina.sundquist@med.lu.se.
⁷ Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA; Department of Psychiatry, Virginia Commonwealth University, Richmond VA, USA; Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA, USA. Electronic address: kendler@vcu.edu.
⁸ Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA. Electronic address: kccrump@stanford.edu.

PMID: 25953099
PMCID: PMC4458148
DOI: 10.1016/j.jpsychires.2015.03.019

Familial and neighborhood effects on psychiatric disorders in childhood and adolescence

Jan Sundquist et al. J Psychiatr Res. 2015 Jul-Aug.

. 2015 Jul-Aug:66-67:7-15.

doi: 10.1016/j.jpsychires.2015.03.019. Epub 2015 Apr 25.

Authors

Jan Sundquist¹, Xinjun Li², Henrik Ohlsson³, Maria Råstam⁴, Marilyn Winkleby⁵, Kristina Sundquist⁶, Kenneth S Kendler⁷, Casey Crump⁸

Affiliations

¹ Center for Primary Health Care Research, Lund University, Malmö, Sweden; Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA. Electronic address: jan.sundquist@med.lu.se.
² Center for Primary Health Care Research, Lund University, Malmö, Sweden. Electronic address: xinjun.li@med.lu.se.
³ Center for Primary Health Care Research, Lund University, Malmö, Sweden. Electronic address: henrik.ohlsson@med.lu.se.
⁴ Child and Adolescent Psychiatry, Department of Clinical Sciences in Lund, Lund University, Lund, Sweden. Electronic address: maria.rastam@med.lu.se.
⁵ Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA. Electronic address: winkleby@stanford.edu.
⁶ Center for Primary Health Care Research, Lund University, Malmö, Sweden; Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA. Electronic address: kristina.sundquist@med.lu.se.
⁷ Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA; Department of Psychiatry, Virginia Commonwealth University, Richmond VA, USA; Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA, USA. Electronic address: kendler@vcu.edu.
⁸ Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA. Electronic address: kccrump@stanford.edu.

PMID: 25953099
PMCID: PMC4458148
DOI: 10.1016/j.jpsychires.2015.03.019

Abstract

Background: More knowledge is needed on potential associations between individual-, family-, and neighborhood-level factors and psychiatric disorders in children and adolescents.

Aims: To examine associations between, individual-, family-, and neighborhood-level factors and incident internalizing (anxiety and mood) disorders and externalizing (ADHD and conduct) disorders in children and adolescents, and to estimate the relative contributions of family and neighborhood to individual variation in these disorders.

Method: We performed a three-level logistic regression on all 542,195 children born in Sweden in 1992-1996, nested in 427,954 families, which in turn were nested in 8475 neighborhoods. The children were followed from 2000 to 2010 for incident internalizing and externalizing psychiatric disorders, assessed from medical records.

Results: 26,514 children (4.8%) were diagnosed with internalizing or externalizing psychiatric disorders. Approximately 29% of the total individual variance in internalizing disorders could be attributed to the family level, which includes both genetic and family environmental effects, and 5% to the neighborhood level. The corresponding figures for externalizing disorders were 43.5% and 5.5%, respectively. After adjustment for individual-level sociodemographic factors, high neighborhood deprivation was associated with increased risks of externalizing and internalizing psychiatric disorders (odds ratio [OR] = 1.37, 95% credible interval [CI] = 1.25-1.50 and OR = 1.34, 95% CI = 1.25-1.45, respectively), including conduct disorder (OR = 2.01, 95% CI = 1.58-2.55), anxiety disorders (OR = 1.40, 95% CI = 1.29-1.52), and mood disorders (OR = 1.21, 95% CI, 1.09-1.35). The strongest association between neighborhood deprivation and ADHD was observed in moderately deprived neighborhoods (OR = 1.31, 95% CI = 1.19-1.44).

Conclusions: These findings call for policies to promote mental health that consider potential influences from children's family and neighborhood environments.conclusion

Trial registration: Not applicable.

Keywords: Cohort study; Internalizing and externalizing psychiatric disorders; Neighborhood SES.

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Conflict of interest statement

Conflict of Interest Disclosures: None reported.

All authors declare no conflicts of interest.

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Familial and neighborhood effects on psychiatric disorders in childhood and adolescence

Affiliations

Familial and neighborhood effects on psychiatric disorders in childhood and adolescence

Authors

Affiliations

Abstract

Conflict of interest statement

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical

Miscellaneous