Ahinkorah Bright Opoku, Lam-Cassettari Christa, John James Rufus, Eapen Valsamma
School of Clinical Medicine, Discipline of Psychiatry & Mental Health, University of New South Wales, Sydney, NSW, Australia.
Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), Ingham Institute of Applied Medical Research, Liverpool, NSW, Australia.
Front Psychiatry. 2024 Sep 18;15:1356037. doi: 10.3389/fpsyt.2024.1356037. eCollection 2024.
Understanding associations between psychosocial development in early childhood and formal diagnosis of neurodevelopmental disorders (NDDs) in adolescence is critical for early identification and for tailoring interventions and support. This study investigated whether the Strengths and Difficulties Questionnaire (SDQ) scores in early childhood (4-5 years) predict mental health (MH) problems as evidenced by SDQ scores and formal diagnosis of NDDs in adolescence (16-17 years).
This study analysed data from a sample of 4968 children and adolescents using data from the Longitudinal Study of Australian Children. We used hierarchical regression models to determine the association between SDQ subscales and total scores at ages 4-5 years (primary exposure) and total SDQ scores and NDD diagnoses at ages 16-17 years (outcomes) whilst controlling for sociodemographic risk factors.
Each unit increase in SDQ score at age 4-5 led to a rise in SDQ scores at age 16-17. Autism and ADHD diagnoses, female gender, lower maternal education, and financial hardship were associated with higher SDQ scores at age 16-17. Furthermore, parent reported SDQ at age 4-5 was linked to higher likelihoods of formal diagnoses of ADHD, autism, and ADHD/autism at age 16-17. Additionally, social determinants of health such as female gender, culturally and linguistically diverse (CALD) backgrounds, and financial hardship were associated with increased odds of ADHD, autism, and ADHD/autism diagnoses at age 16-17.
Our findings highlight the opportunity for early identification of transdiagnostic developmental and MH issues in the preschool period. Findings also emphasise the critical role of social determinants of health in the longitudinal trajectory of MH and NDDs and highlight the need for implementing early supports for improving peer relations and behavioural support strategies. If coupled with wrap around social care, early support strategies can enhance MH and wellbeing in adolescence and beyond.
了解幼儿期心理社会发展与青少年神经发育障碍（NDDs）正式诊断之间的关联对于早期识别以及制定干预措施和提供支持至关重要。本研究调查了幼儿期（4至5岁）的优势与困难问卷（SDQ）得分是否能预测青少年期（16至17岁）SDQ得分及NDDs正式诊断所证明的心理健康（MH）问题。
本研究使用澳大利亚儿童纵向研究的数据，对4968名儿童和青少年的样本进行了分析。我们使用分层回归模型来确定4至5岁时SDQ子量表和总分（主要暴露因素）与16至17岁时SDQ总分及NDD诊断（结果）之间的关联，同时控制社会人口学风险因素。
4至5岁时SDQ得分每增加一个单位，会导致16至17岁时SDQ得分上升。自闭症和注意力缺陷多动障碍（ADHD）诊断、女性性别、母亲教育程度较低以及经济困难与16至17岁时较高的SDQ得分相关。此外，4至5岁时家长报告的SDQ与16至17岁时ADHD、自闭症以及ADHD/自闭症正式诊断的更高可能性相关。此外，健康的社会决定因素，如女性性别、文化和语言多样化（CALD）背景以及经济困难，与16至17岁时ADHD、自闭症以及ADHD/自闭症诊断几率的增加相关。
我们的研究结果凸显了在学龄前早期识别跨诊断发展和MH问题的机会。研究结果还强调了健康的社会决定因素在MH和NDDs纵向轨迹中的关键作用，并强调需要实施早期支持措施以改善同伴关系和行为支持策略。如果与全面的社会关怀相结合，早期支持策略可以提高青少年及以后的MH水平和幸福感。
