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Should Mental-Health Screenings Be Routinely Done at School?

“The early detection of children who are showing psychiatric symptoms or are at the risk of a mental disorder is crucial, but introducing ‘mental health checkups’ as part of healthcare in schools is not altogether simple,” says David Gyllenberg, MD.

In Gyllenberg’s study (“Childhood Predictors of Later Psychotropic Medication Use and Psychiatric Hospital Treatment—Findings from the Finnish Nationwide 1981 Birth Cohort Study”), he charted the mental well-being of nearly 6,000, 8-year-old Finnish children through a survey carried out in 1989. He then followed up on the use of psychotropic medication and psychiatric hospital periods of the same children from the age of 12 to 25.

Both the use of psychotropic drugs and the need for psychiatric hospital treatment were linked with symptoms reported in the survey carried out at the age of 8. Symptoms of depression at this age were linked to later treatment of depression for both boys and girls, while a non-intact family background was linked with a range of psychiatric care required in the teens or early adulthood for both sexes.

However, the predictive value of many factors differs between girls and boys. While the strongest factor for girls to predict later use of psychotropic medication and need for psychiatric care were symptoms of depression and anxiety shown in childhood, for boys, the most salient predictors were behavioral problems such as acting out, aggression, and stealing.

Gyllenberg stresses that a systematic mental health screening at schools would have to be based strictly on solid scientific research and conducted in a way that would not lead to stigmatization or become a self-fulfilling prophecy.


Which Rules—Nature or Nurture? It May Depend on Where You Live

The extent to which our development is affected by nature or nurture—our genetic make-up or our environment—may differ depending on where we live, according to new research.

Our development, health, and behavior are determined by complex interactions between our genetic make-up and the environment in which we live. For example, we may carry genes that increase our risk of developing Type 2 diabetes, but if we eat a healthy diet and get sufficient exercise, we may not develop the disease. Similarly, someone may carry genes that reduce his or her risk of developing lung cancer, but heavy smoking may still lead to the disease.

Researchers from the Twins Early Development Study at King’s College London’s Institute of Psychiatry (IoP) studied data from more than 6,700 families relating to 45 childhood characteristics, from IQ and hyperactivity to height and weight. They found that genetic and environmental contributions to these characteristics vary geographically in the United Kingdom, and published their results online as a series of nature-nurture maps.

“Take a trait like classroom behavior problems,” says Dr. Oliver Davis, a Sir Henry Wellcome Fellow at King’s. “From our maps we can tell that in most of the UK, around 60 percent of the difference between people is explained by genes. However, in the South East, genes aren’t as important: they explain less than half of the variation. For classroom behavior, London is an ‘environmental hotspot.’”

The patterns in the maps give the researchers important clues about which environments to explore in more detail. For example, they found that when they compare maps of income inequality to the nature-nurture map for classroom behavior, “we find income inequality may account for some of the pattern,” Dr. Davis says.

In contrast, “genetic hotspots” are areas where the environment exposes the effects of genetic variation. For example, researchers searching for gene variants that increase the risk of hay fever may study populations from two regions. In the first region people live among fields of wind-pollinated crops, whereas the second region is miles away from those fields. In this second region, where no one is exposed to pollen, no one develops hay fever; hence any genetic differences between people living in this region would be invisible.

On the other hand, in the first region, where people live among the fields of crops, they will all be exposed to pollen and differences between the people with a genetic susceptibility to hay fever and the people without will stand out. That would make the region a genetic hotspot for hay fever.

“The message that these maps really drive home,” says Dr. Davis, “is that your genes aren’t your destiny.”
SourceThe research is also explained in a video, available through the TEDS website.