University of Turku and Turku University Hospital, Turku, Finland.
University of Turku and Turku University Hospital, Turku, Finland.
J Am Acad Child Adolesc Psychiatry. 2016 Aug;55(8):717-725.e2. doi: 10.1016/j.jaac.2016.05.018. Epub 2016 Jun 4.
The aim of this study was to examine changes in the mental health problems, bullying, and service use of 8-year-old children at 4 different time points (1989, 1999, 2005, and 2013) using population-based, time-trend data.
Information from 4 cross-sectional samples was compared over a 24-year period. The target population was Finnish-speaking children born in 1981 (n = 1,038), 1991 (n = 1,035), 1997 (n = 1,030), and 2004 (n = 1,114) and living in selected school districts in the Turku University Hospital area in southwestern Finland. The participation rates varied from 84% (2005) to 95% (1989). Information about the children's psychiatric symptoms, bullying experience, and service use was obtained from parents and teachers using Rutter questionnaires. Child depression was measured using the Children's Depression Inventory (CDI).
Parental reports showed that emotional (p < .001) and conduct (p = .001) problems among boys and emotional (p = .002) problems among girls decreased over the 24-year period. In teacher reports, there were no significant changes in hyperactivity, emotional, and conduct problems between 1989 and 2013. Girls' self-reported depression scores increased between 1989 and 2005, but leveled off in 2013. There were no significant decreases in bullying behavior between 2005 and 2013 despite the introduction of a nationwide school-based anti-bullying program in 2009. Mental health service use increased constantly during the study period: in 1989, 4.2% of boys and 0.9% of girls were in contact with services, and by 2013 this had risen to 15.1% and 6.1% (p < .001).
No substantial increases in children's mental health problems were seen between 1989 and 2013. Service use increased constantly, indicating lower thresholds for seeking help. Bullying behavior is strongly related to mental health problems, and that is why school-based bullying interventions, including mental health perspectives, are needed.
本研究旨在使用基于人群的时间趋势数据，从心理健康问题、欺凌行为和服务利用的角度，在 4 个不同时间点（1989 年、1999 年、2005 年和 2013 年）研究 8 岁儿童的变化情况。
利用 24 年间的 4 个横断面样本进行比较。目标人群为芬兰语 1981 年出生（n=1038）、1991 年（n=1035）、1997 年（n=1030）和 2004 年（n=1114）出生且居住在芬兰西南部图尔库大学医院地区选定学区的儿童。参与率从 84%（2005 年）到 95%（1989 年）不等。父母和老师通过 Rutter 问卷获得有关儿童精神症状、欺凌经历和服务利用的信息。儿童抑郁使用儿童抑郁量表（CDI）进行测量。
父母报告显示，男孩的情绪（p<0.001）和行为（p=0.001）问题以及女孩的情绪（p=0.002）问题在 24 年间逐渐减少。在教师报告中，1989 年至 2013 年期间，多动、情绪和行为问题并没有明显变化。1989 年至 2005 年期间，女孩的自我报告抑郁评分有所增加，但在 2013 年趋于平稳。尽管 2009 年在全国范围内推出了一项学校反欺凌计划，但 2005 年至 2013 年期间，欺凌行为并没有明显减少。研究期间，心理健康服务的利用率持续上升：1989 年，4.2%的男孩和 0.9%的女孩接受服务，到 2013 年，这一比例上升至 15.1%和 6.1%（p<0.001）。
1989 年至 2013 年期间，儿童的心理健康问题没有明显增加。服务利用率持续上升，表明寻求帮助的门槛降低。欺凌行为与心理健康问题密切相关，因此需要进行基于学校的欺凌干预措施，包括心理健康方面的干预措施。
