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Children born preterm with very low birthweight (VLBW) face long-lasting neurodevelopmental challenges, where multidisciplinary assessments are warranted. The International Classification of Functioning, Disability and Health (ICF) provides a framework for understanding and conceptualising these outcomes.We aimed to review clinical and neuroimaging findings from birth to adulthood in a Norwegian cohort of individuals born preterm with VLBW (gestational age 37 weeks, birthweight ≤1500 g) within the framework of ICF.We searched PubMed and Embase for articles reporting results of the Norwegian University of Science and Technology (NTNU) Low Birth Weight in a Lifetime Perspective study.We included original articles reporting proportions of adverse outcomes, mean group differences, risk factors or associations between outcomes. Data were extracted according to ICF's two-level classification. Body functions and structures comprised outcomes of brain structures, cognition, mental health, vision, pain and physical health. Activities and participation comprised motor skills, general and social functioning, education, employment, and health-related quality of life.We performed a qualitative synthesis of included articles. Where mean (SD) was reported, we calculated group differences in SD units.Fifty-eight publications were included. Within body functions and structures, increased prevalence of brain structure pathology, lower cognitive performance, mental health problems, visual and physical health impairments through childhood, adolescence and young adulthood were reported among preterm VLBW participants compared with controls. Within activities and participation, motor problems, lower general and social functioning, and lower academic attainment were found. Perinatal factors were associated with several outcomes, and longitudinal findings suggested persistent consequences of being born preterm with VLBW.Being born preterm with VLBW has long-term influences on body functions and structures, activities and participation. The ICF is appropriate for assessing general domains of functioning and guiding the management of individuals born preterm with VLBW.

CONTEXT There is a lack of research on individual perceptions of social experiences and social relationships among very preterm (VP) adults compared with term-born peers. OBJECTIVE To investigate self-perceived social functioning in adults born VP ( DATA SOURCES Two international consortia: Research on European Children and Adults born Preterm and Adults Born Preterm International Collaboration. STUDY SELECTION Cohorts with outcomes assessed by using the Adult Self-Report Adaptive Functioning scales (friends, spouse/partner, family, job, and education) in both groups. DATA EXTRACTION IPD from 5 eligible cohorts were collected. Raw-sum scores for each scale were standardized as z scores by using mean and SD of controls for each cohort. Pooled effect size was measured by difference (Δ) in means between groups. RESULTS One-stage analyses (1285 participants) revealed significantly lower scores for relationships with friends in VP/VLBW adults compared with controls (Δ −0.37, 95% confidence interval [CI]: −0.61 to −0.13). Differences were similar after adjusting for sex, age, and socioeconomic status (Δ −0.39, 95% CI: −0.63 to −0.15) and after excluding participants with neurosensory impairment (Δ −0.34, 95% CI: −0.61 to −0.07). No significant differences were found in other domains. LIMITATIONS Generalizability of research findings to VP survivors born in recent decades. CONCLUSIONS VP/VLBW adults scored their relationship with friends lower but perceived their family and partner relationships, as well as work and educational experiences, as comparable to those of controls.

Development of the cerebral cortex may be affected by aberrant white matter development. Preterm birth with very low birth weight (VLBW) has been associated with reduced fractional anisotropy of white matter and changes in cortical thickness and surface area. We use a new methodological approach to combine white and gray matter data and test the hypothesis that white matter injury is primary, and acts as a mediating factor for concomitant gray matter aberrations, in the developing VLBW brain. T1 and dMRI data were obtained from 47 young adults born preterm with VLBW and 73 term-born peers (mean age = 26). Cortical thickness was measured across the cortical mantle and compared between the groups, using the FreeSurfer software suite. White matter pathways were reconstructed with the TRACULA software and projected to their cortical end regions, where cortical thickness was averaged. In the VLBW group, cortical thickness was increased in anteromedial frontal, orbitofrontal, and occipital regions, and fractional anisotropy (FA) was reduced in frontal lobe pathways, indicating compromised white matter integrity. Statistical mediation analyses demonstrated that increased cortical thickness in the frontal regions was mediated by reduced FA in the corpus callosum forceps minor, consistent with the notion that white matter injury can disrupt frontal lobe cortical development. Combining statistical mediation analysis with pathway projection onto the cortical surface offers a powerful novel tool to investigate how cortical regions are differentially affected by white matter injury. © 2018 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ).

Importance: Birth before 32 weeks’ gestation (very preterm [VPT]) and birth weight below 1500 g (very low birth weight [VLBW]) have been associated with lower cognitive performance in childhood. However, there are few investigations of the association of neonatal morbidities and maternal educational levels with the adult cognitive performance of individuals born VPT or VLBW (VPT/VLBW). Objective: To assess differences in adult IQ between VPT/VLBW and term-born individuals and to examine the association of adult IQ with cohort factors, neonatal morbidities, and maternal educational level among VPT/VLBW participants. Data Sources: Systematic review of published data from PubMed and meta-analysis of individual participant data (IPD) of cohorts from 2 consortia (Research on European Children and Adults Born Preterm [RECAP] and Adults Born Preterm International Collaboration [APIC]). Study Selection: The meta-analysis included prospective longitudinal cohort studies that assessed the full-scale IQ of adults born VPT or VLBW and respective control groups comprising term-born adults. Data Extraction And Synthesis: The study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline for analyses of individual participant data and identified 8 studies that provided data from 2135 adults (1068 VPT/VLBW and 1067 term-born participants) born between 1978 and 1995. Meta-analyses of IPD were performed using a 1-stage approach, treating VPT birth or VLBW and cohort as random effects. Main Outcomes And Measures: Full-scale IQ scores were converted to z scores within each cohort using the combined SD of VPT/VLBW participants and a control group of term-born participants, with scores centered on the mean of the control group. Results: A total of 426 records were identified and screened. After exclusions, 13 studies were included in the aggregate meta-analysis. The IPD meta-analysis included 8 of the 9 RECAP and APIC cohorts with adult IQ data. The mean (SD) age among the 8 IPD cohorts was 24.6 (4.3) years, and 1163 participants (54.5%) were women. In unadjusted analyses, VPT/VLBW participants had mean adult IQ scores that were 0.78 SD (95% CI, −0.90 to −0.66 SD) lower than term-born participants, equivalent to a difference of 12 IQ points. Among VPT/VLBW participants, lower gestational age (score difference per week of gestation, 0.11; 95% CI, 0.07-0.14), lower birth weight z scores (score difference per 1.0 SD, 0.21; 95% CI, 0.14-0.28), the presence of neonatal bronchopulmonary dysplasia (score difference, −0.16; 95% CI, −0.30 to −0.02) or any grade of intraventricular hemorrhage (score difference, −0.19; 95% CI, −0.33 to −0.05), and lower maternal educational level (score difference, 0.26; 95% CI, 0.17-0.35) were all significantly associated with lower IQ scores in adulthood. Conclusions And Relevance: In this IPD meta-analysis, lower gestational age, lower weight for gestational age, neonatal morbidities, and lower maternal educational levels were all important risk factors associated with lower IQ among young adults born VPT or VLBW.

Background We aimed to examine psychosocial function, suicidality and school dropout in a clinical psychiatric population over a 3-year period from adolescence to young adulthood and explore associations with negative life events. Methods This study is part of the Health Survey in Department of Children and Youth, St. Olavs hospital, Norway. In the first study visit (T1), 717 (43.5% of eligible) participated, aged 13–18 years (2009–2011), and 3 years later (T2), 570 answered a questionnaire (school functioning and negative life events), and 549 completed Kiddie SADS as telephone interview assessing DSM-IV diagnoses, psychosocial functioning and suicidality. Results Suicidal ideation was more frequent among girls (17.9%) than among boys (5.4%) (risk difference; RD = 12.5%, CI (7.2 to 17.7), p p p p = 0.006). For those with a psychiatric disorder, 24.8% of girls had suicidal ideation and 30.0% suicidal behavior, which was larger than for boys (RD = 18.0%, CI (10.8 to 24.7), p p p p p p p = 0.011). Conclusions The high frequency of suicidality and school dropout confirms the severity of adolescent psychiatric disorders, especially among girls. Specific life events were associated risk factors and should be target points for prevention and intervention.

Background:\ud Data on psychiatric disorders in survivors born very preterm (VP; 2499 g and/or gestational age ≥37 weeks), and 3) structured measure of psychiatric diagnoses using DSM or ICD criteria. Diagnoses of interest were Attention Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD), Anxiety Disorder, Mood Disorder, Disruptive Behaviour Disorder (DBD), Eating Disorder, and Psychotic Disorder. A systematic search for eligible studies was conducted (PROSPERO Registration Number 47555).\ud \ud Findings:\ud Data were obtained from 10 studies (1385 VP/VLBW participants, 1780 controls), using a range of instruments and approaches to assigning diagnoses. Those born VP/VLBW had ten times higher odds of meeting criteria for ASD (odds ratio [OR] 10·6, 95% confidence interval [CI] 2·50, 44·7), five times higher odds of meeting criteria for ADHD (OR 5·42, 95% CI 3·10, 9·46), twice the odds of meeting criteria for Anxiety Disorder (OR 1·91, 95% CI 1·36, 2·69), and 1·5 times the odds of meeting criteria for Mood Disorder (OR 1·51, 95% CI 1·08, 2·12) than controls. This pattern of findings was consistent within age (

Supplemental Digital Content is available in the text., Objective: To investigate self-reported pain in young adults with a low birth weight. Materials and Methods: This study was a part of a long-term follow-up study of preterm very low birth weight (VLBW; birth weight ≤1500 g), term small for gestational age (SGA; birth weight 6 months and being moderate, severe, or very severe during the past 4 weeks. Results: The prevalence of chronic pain at 26 years was 16% in the VLBW group, 21% in the term SGA group, and 7% in the control group. The VLBW and the term SGA groups had higher odds ratios for chronic pain (crude OR, 2.6; 95% CI, 0.9-7.6 for the VLBW group and crude OR, 3.6; 95% CI, 1.3-9.9 for the term SGA group vs. controls). The main results remained after adjusting for potential confounding factors. Some attenuation was observed when adjusting for anxiety and depressive problems. Moderate to very severe pain increased from 16% to 41% in the term SGA group from 19 to 26 years, whereas less changes were seen in the VLBW and the control groups. Discussion: Results of our study imply that pain should be in focus when conducting long-term follow-up programs of individuals with a low birth weight.

Backgrounds: In 2009, the prevention service “Familieambulatoriet” (FA) was established in three pilot hospital areas offering psychosocial support and health monitoring to parents in high risk regarding mental health and substance use, for the purpose of preventing child mental health and developmental problems through preschool years. This study selected new-born health as a preliminary endpoint for evaluation of population effects in three pilot areas, utilizing national statistics for birth cohorts from 2005 to 2013. The aim of the study is to evaluate changes in population new born health incidences associated with the establishment of new supportive and preventive FA-services at three pilot sites from 2009 in contrast to previous years and the remaining country. This quasi-experimental design evaluated changes in populations with new services available not those receiving the services, and controlled for national historical changes, variation between hospital districts, and random variation across the years before or years after the pilot services were introduced. Our hypothesis was to expect reduced frequencies of preterm births, SGA births, low APGAR scores, pediatric transfer, and new born abstinence symptoms in the pilot areas. Methods: The baseline was established through 4 years preceding 2009, contrasting changes at pilot sites the following 4 years 2009–2013 using the remaining hospital area populations in Norway 2005–2008 and 2009–2013 as contrasts. Results: Related to the introduction of FA services, we found three significant improvements in new born health using mixed effects logistic regression. 1) In the population rate of babies born prematurely with small for gestational age (SGA), using the 10th percentile criteria as the definition; odds ratio (OR) = 0.73 (95% Cl: 0.60 to 0.88). 2) A similar reduction using the 2.5th percentile criteria, although with wider confidence limits; OR = 0.73 (95% Cl: 0.54 to 0.99). 3) A decrease in the frequency of low APGAR scores (0–6) 5 min. after birth; OR = 0.80 (95% Cl: 0.68 to 0.95). Thus, the FA-areas remained significantly lowered on SGA rates or Low APGAR rates across the years after FA establishment, despite considerable variation, in contrast to the baseline years and to the remaining country. No significant effect was found for the outcomes frequency of premature births (unrelated to SGA), SGA among full-term babies, child abstinence symptoms or pediatric transfer of the baby. False negative findings may result from low-rate outcomes or studying the population rather than users. Conclusions: Population rates suggest that introducing FA services offering support and monitoring in high-risk families may contribute to improving aspects of new born infant health. Intervention components and strategies should be studied more closely using individual data. © The Author(s). 2019Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, andreproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link tothe Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Low birthweight (LBW) has emerged as a risk factor of metabolic syndrome (MetS). Whether adults with very low birthweight (VLBW) born preterm are at higher risk than individuals who were term-born small for gestational age (tb-SGA) is not established. We assessed metabolic outcomes, including relation with skeletal parameters, in these two LBW categories.This follow-up cohort study included 189 individuals (females 51%), aged 25 to 28 years; 55 were preterm VLBW (≤1500 g), 59 were tb-SGA (10th percentile), and 75 were controls (≥10th percentile). Outcomes were indices of MetS: blood pressure (BP), waist circumference, fasting glucose, lipid profile, and association between calculated MetS score and bone mineral density (BMD) and trabecular bone score (TBS), a measure of bone quality.Compared with controls, individuals with VLBW displayed higher systolic [mean (SD), 126 (13.3) vs 119 (12.3) mm Hg; 95% CI, 1.27 to 11.48 mm Hg] and diastolic [71.9 (7.6) vs 68.6 (7.1) mm Hg; 95% CI, 0.3 to 6.2 mm Hg] BP, higher glycated hemoglobin, higher C-peptide, increased insulin resistance (Homeostatic Model Assessment 2), and lower high-density lipoprotein cholesterol [1.34 (0.3) vs 1.50 (0.4); 95% CI, 0.32 to 0.01]. Substantial differences were mainly seen between control females and females with VLBW. The adults who were tb-SGA had higher waist circumference and higher total and low-density lipoprotein cholesterol compared with controls. In males, MetS score correlated positively with BMD and inversely with TBS.The LBW groups and preferentially females in the VLBW group displayed a less favorable metabolic profile than did controls. The inverse association between MetS score and bone quality suggests enhanced future fracture risk.

OBJECTIVE: ADHD is a disorder associated with impairment and comorbid psychiatric problems in young adulthood; therefore, factors that may imply a more favorable outcome among adolescents with ADHD are of interest.METHOD: This study used a longitudinal design to assess whether adolescent personal resilience characteristics during adolescence protected against psychosocial impairment, depression, and anxiety 3 years later. Self-reported protective factors were used as baseline measures in the assessment of 190 clinically referred adolescents with ADHD. A semi-structured diagnostic interview was performed at the follow-up.RESULTS: In a group of youth with ADHD, personal resilience characteristics were associated with better psychosocial functioning in young adulthood, and less depression and anxiety.CONCLUSION: Although further research is needed, these results indicate that personal resilience characteristics may be protective factors in the transitional period from adolescence to early adulthood.

Objective The aims of this study were to examine the performance of eating disorder (ED) patients on the Rey Complex Figure Test and to investigate the validity of the Q-score as a new method for measuring central coherence (CC). Method Forty-one patients with anorexia nervosa, 40 patients with bulimia nervosa and 40 healthy controls completed the Rey Complex Figure Test, which was scored both quantitatively and qualitatively. Results Both ED groups scored lower than the healthy controls on copy, recall and the Q-score. For the anorexia nervosa group, performance on the Central Coherence Index was associated with the nadir body mass index. Performance on the recall measures was independently associated with the nadir body mass index and depressive symptoms for the bulimia nervosa group. There was a strong correlation between the Q-score and the Central Coherence Index (r = 0.77). Discussion The study reveals different levels of CC and suggests that the Q-score might be an applicable method for measuring CC in ED patients. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.

Background Self-esteem is fundamentally linked to mental health, but its’ role in trajectories of psychiatric problems is unclear. In particular, few studies have addressed the role of self-esteem in the development of attention problems. Hence, we examined the role of global self-esteem in the development of symptoms of anxiety/depression and attention problems, simultaneously, in a clinical sample of adolescents while accounting for gender, therapy, and medication. Methods Longitudinal data were obtained from a sample of 201 adolescents—aged 13–18—referred to the Department of Child and Adolescent Psychiatry in Trondheim, Norway. In the baseline study, self-esteem, and symptoms of anxiety/depression and attention problems were measured by means of self-report. Participants were reassessed 3 years later, with a participation rate of 77% in the clinical sample. Results Analyses showed that high self-esteem at baseline predicted fewer symptoms of both anxiety/depression and attention problems 3 years later after controlling for prior symptom levels, gender, therapy (or not), and medication. Conclusions Results highlight the relevance of global self-esteem in the clinical practice, not only with regard to emotional problems, but also to attention problems. Implications for clinicians, parents, and others are discussed. © The Author(s) 2017. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/)

Anxiety and depression are often co-occurring disorders, reflecting both homotypic and heterotypic continuity as possible developmental pathways. The present study aimed to examine homotypic and heterotypic continuities of anxiety and depression across 3 years in adolescence and young adulthood. Participants included patients presenting to psychiatric care with diagnoses of anxiety and/or depressive disorders aged 13-18 at T1 (N = 717, 44% initial participation rate) and aged 16-21 at T2 (N = 549, 80% follow-up participation rate). McNemar's mid-p test and ordinal proportional odds logistic regression analyses were used to assess changes in prevalence within and across diagnostic categories, respectively. More adolescents had an anxiety disorder (+ 11%), whereas fewer had a depressive disorder (- 11%), at T2 compared to T1. Of adolescents with anxiety and/or depression at T1, only 25% recovered or were non-symptomatic 3 years after referral to a psychiatric clinic. Homotypic continuity was observed for anxiety disorders in general (OR = 2.33), for phobic anxiety disorders (OR = 7.45), and for depressive disorders (OR = 2.15). For heterotypic continuity, depression predicted later anxiety (OR = 1.92), more specifically social anxiety (OR = 2.14) and phobic anxiety disorders (OR = 1.83). In addition, social anxiety predicted later generalized anxiety disorder (OR = 3.11). Heterotypic continuity was thus more common than homotypic continuity. For adolescents presenting with anxiety or depression, treatment should, therefore, target broad internalizing symptom clusters, rather than individual diagnoses. This may contribute to prevent future mental illness, particularly anxiety, in clinical samples.

Background:Being born preterm with very low birthweight (VLBW≤1500 g) poses a risk for cortical andsubcortical gray matter (GM) abnormalities, as well as for having more psychiatric problems during childhood andadolescence than term-born individuals. The aim of this study was to investigate the relationship between corticaland subcortical GM volumes and the course of psychiatric disorders during adolescence in VLBW individuals.Methods:We followed VLBW individuals and term-born controls (birth weight≥10th percentile) from 15 (VLBW;controlsn=40;56)to19(n= 44;60) years of age. Of these, 30;37 individuals were examined longitudinally. Cortical andsubcortical GM volumes were extracted from MRPRAGE images obtained with the same 1.5 T MRI scanner at both timepoints and analyzed at each time point with the longitudinal stream of the FreeSurfer software package 5.3.0. Allparticipants underwent clinical interviews and were assessed for psychiatric symptoms and diagnosis (Schedule forAffective Disorders and Schizophrenia for School-age Children, Children’s Global Assessment Scale, Attention-Deficit/Hyperactivity Disorder Rating Scale-IV). VLBW adolescents were divided into two groups according to diagnostic statusfrom 15 to 19 years of age: persisting/developing psychiatric diagnosis or healthy/becoming healthy.Results:Reduction in subcortical GM volume at 15 and 19 years, not including the thalamus, was limited to VLBWadolescents with persisting/developing diagnosis during adolescence, whereas VLBW adolescents in the healthy/becoming healthy group had similar subcortical GM volumes to controls. Moreover, across the entire VLBW group,poorer psychosocial functioning was predicted by smaller subcortical GM volumes at both time points and withreduced GM volume in the thalamus and the parietal and occipital cortex at 15 years. Inattention problems werepredicted by smaller GM volumes in the parietal and occipital cortex.Conclusions:GM volume reductions in the parietal and occipital cortex as well as smaller thalamic and subcortical GMvolumes were associated with the higher rates of psychiatric symptoms found across the entire VLBW group.Significantly smaller subcortical GM volumes in VLBW individuals compared with term-born peers might pose a risk fordeveloping and maintaining psychiatric diagnoses during adolescence. Future research should explore the possiblerole of reduced cortical and subcortical GM volumes in the pathogenesis of psychiatric illness in VLBW adolescents. © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, andreproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link tothe Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Botelleroet al. BMC Pediatrics (2017) 17:45 DOI 10.1186/s12887-017-0793-0

CONTEXT: Preterm birth increases the risk for mental disorders in adulthood, yet findings on self-reported or subclinical mental health problems are mixed. OBJECTIVE: To study self-reported mental health problems among adults born preterm at very low birth weight (VLBW; ≤1500 g) compared with term controls in an individual participant data meta-analysis. DATA SOURCES: Adults Born Preterm International Collaboration. STUDY SELECTION: Studies that compared self-reported mental health problems using the Achenbach Young Adult Self Report or Adult Self Report between adults born preterm at VLBW (n = 747) and at term (n = 1512). DATA EXTRACTION: We obtained individual participant data from 6 study cohorts and compared preterm and control groups by mixed random coefficient linear and Tobit regression. RESULTS: Adults born preterm reported more internalizing (pooled β = .06; 95% confidence interval .01 to .11) and avoidant personality problems (.11; .05 to .17), and less externalizing (–.10; –.15 to –.06), rule breaking (–.10; –.15 to –.05), intrusive behavior (–.14; –.19 to –.09), and antisocial personality problems (–.09; –.14 to –.04) than controls. Group differences did not systematically vary by sex, intrauterine growth pattern, neurosensory impairments, or study cohort. LIMITATIONS: Exclusively self-reported data are not confirmed by alternative data sources. CONCLUSIONS: Self-reports of adults born preterm at VLBW reveal a heightened risk for internalizing problems and socially avoidant personality traits together with a lowered risk for externalizing problem types. Our findings support the view that preterm birth constitutes an early vulnerability factor with long-term consequences on the individual into adulthood.

The aim of this study was to assess the prevalence of chronic multisite pain with high disability in relation to emotional or behavioral problems and resilience factors in adolescence. A second aim was to investigate if resilience factors could attenuate the associations between psychiatric symptoms and chronic multisite pain. The study was based on a large cross-sectional study carried out in Norway between 2006 and 2008 and included 7,070 adolescents aged 13–19 years. Chronic multisite pain was defined as pain at least once a week during the last 3 months, scoring high on a disability index, and occurring in three or more locations. Chronic multisite pain was prevalent among adolescents with high scores (>85 %) for anxiety/depression, social anxiety, conduct or attention problems (22.8–31.0 % for girls, 8.8–19.0 % for boys). Several coexistent psychiatric symptoms increased the prevalence of chronic multisite pain for both girls and boys. Resilience factors, including high self-esteem, seldom feeling lonely, and high scores for family cohesion or social competence, were associated with a lower prevalence and markedly attenuated the association between psychiatric symptoms and chronic multisite pain. Psychiatrists should be careful to assess and treat comorbid chronic pain in adolescents with emotional or behavioral problems.

Objective This study explored the neuropsychological performance of patients diagnosed with anorexia nervosa (AN) or bulimia nervosa (BN) compared with healthy controls (HCs). An additional aim was to investigate the effect of several possible mediators on the association between eating disorders (EDs) and cognitive function. Method Forty patients with AN, 39 patients with BN, and 40 HCs who were comparable in age and education were consecutively recruited to complete a standardized neuropsychological test battery covering the following cognitive domains: verbal learning and memory, visual learning and memory, speed of information processing, visuospatial ability, working memory, executive function, verbal fluency, attention/vigilance, and motor function. Results The AN group scored significantly below the HCs on eight of the nine measured cognitive domains. The BN group also showed inferior performance on six cognitive domains. After adjusting for possible mediators, the nadir body mass index (lowest lifetime BMI) and depressive symptoms explained all findings in the BN group. Although this adjustment reduced the difference between the AN and HC groups, the AN group still performed worse than the HCs regarding verbal learning and memory, visual learning and memory, visuospatial ability, working memory, and executive functioning. Discussion Patients with EDs scored below the HCs on several cognitive function measures, this difference being most pronounced for the AN group. The nadir BMI and depressive symptoms had strong mediating effects. Longitudinal studies are needed to identify the importance of weight restoration and treatment of depressive symptoms in the prevention of a possible cognitive decline. © 2014 Wiley Periodicals, Inc. (Int J Eat Disord 2015; 48:397–405)

Few studies have focused the association between bullying and psychiatric disorders in clinical samples. The aim of this study was to examine if bullying behaviour was associated with psychiatric disorders and school well-being.The cross-sectional study was part of a health survey at St. Olav's University Hospital. The sample consisted of 685 adolescent patients aged 13-18 years who completed an electronic questionnaire. Clinical diagnoses were collected from clinical records.In this clinical psychiatric sample, 19% reported being bullied often or very often, and 51% reported being bullied from time to time. Logistic regression analyses showed associations between being a victim and having a mood disorder, and between being involved in bullying behaviour and reporting lower scores on school well-being. No difference was found in bullying behaviour on gender, age and SES.The risk of being a victim was high among adolescents in this clinical sample, especially among patients with mood disorders. Any involvement in bullying behaviour was associated with reduced school well-being.

To assess cognitive function at 12 months after moderate and severe traumatic brain injury (TBI) separately, as well as improvement from 3 to 12 months and relationship to global outcome.Cognitive function among patients with moderate (n = 30, Glasgow Coma Scale score (GCS) 9-3) and severe traumatic brain injury (n = 20, GCS score ≤ 8), recruited from an unselected neurosurgical cohort, all with MRI performed in the early phase were assessed with a neuropsychological test battery and Glasgow Outcome Scale Extended. Healthy volunteers (n = 47) matched for age, gender and years of education served as controls.Executive function was reduced at 12-months post-injury in patients with both moderate and severe TBI. However, motor function, processing speed and memory were reduced only among patients with severe TBI. Both patients with moderate and severe TBI improved their processing speed and visual memory. Patients with moderate TBI also improved motor function, while patients with severe TBI also improved executive function.Differentiating between patients with moderate and severe TBI yields a more accurate description of cognitive deficits and their improvement over time. Further, executive dysfunction and attention problems affected the ability to resume independent living and employment regardless of injury severity and age.

Objective This study aimed to examine cognitive function in individuals with anorexia nervosa (AN) and bulimia nervosa (BN) on the basis of IQ measures, indexes and subtests of the Wechsler Adult Intelligence Scale – Third Edition (WAIS-III). Methods A total of 41 patients with AN, 40 patients with BN and 40 healthy controls (HC), matched for sex, age and education, were recruited consecutively to complete the WAIS-III. Results The AN group showed a significantly lower performance than the HC group on most global measures and on eight of the 13 administered subtests. Minor differences in verbal function were detected between the BN group and the HC group. Conclusion The patients with eating disorders showed normal intellectual functions compared with the normative population. However, the AN group displayed a consistently lower performance than the matched HC group, which performed above normative means. The BN group performed at a level between that of the AN and HC groups. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.

Context and objectives Peak bone mass (PBM) is regarded as the most important determinant of osteoporosis. Growing evidence suggests a role of intrauterine programming in skeletal development. We examined PBM and trabecular bone score (TBS) in adults born preterm with very low birth weight (VLBW) or small for gestational age (SGA) at term compared with term-born controls. Design, setting, participants, and outcomes This follow-up cohort study included 186 men and women (25 to 28 years); 52 preterm VLBW (≤1500 g), 59 term-born SGA ( 10th percentile). Main outcome was bone mineral density (BMD) by dual x-ray absorptiometry. Secondary outcomes were bone mineral content (BMC), TBS, and serum bone markers. Results VLBW adults had lower BMC and BMD vs controls, also when adjusted for height, weight, and potential confounders, with the following BMD Z-score differences: femoral neck, 0.6 standard deviation (SD) (P = 0.003); total hip, 0.4 SD (P = 0.01); whole body, 0.5 SD (P = 0.007); and lumbar spine, 0.3 SD (P = 0.213). The SGA group displayed lower spine BMC and whole-body BMD Z-scores, but not after adjustment. Adjusted odds ratios for osteopenia/osteoporosis were 2.4 and 2.0 in VLBW and SGA adults, respectively. TBS did not differ between groups, but it was lower in men than in women. Serum Dickkopf-1 was higher in VLBW subjects vs controls; however, it was not significant after adjustment for multiple comparisons. Conclusions Both low-birth-weight groups displayed lower PBM and higher frequency of osteopenia/osteoporosis, implying increased future fracture risk. The most pronounced bone deficit was seen in VLBW adults.

OBJECTIVE: To examine psychiatric morbidity and overall functioning in adults born with low birth weight compared with normal birth weight controls at age 26 years and to study longitudinal trajectories of psychiatric morbidity from early adolescence to adulthood. METHODS: Prospective cohort study wherein 44 preterm very low birth weight (≤1500 g), 64 term small for gestational age (SGA; RESULTS: From adolescence to adulthood, the term SGA group had a marked increase in the estimated probability of psychiatric disorders from 9% (95% confidence interval, 4–19) to 39% (95% confidence interval, 28–51). At 26 years, psychiatric diagnoses were significantly more prevalent in the preterm very low birth weight group (n = 16, 36%; P = .003) and the term SGA group (n = 24, 38%; P = .019) compared with the control group (n = 11, 14%). Both low birth weight groups had lower educational level and functioning scores than controls and a higher frequency of unemployment and disability benefit. CONCLUSIONS: Low birth weight was a substantial risk factor for adult psychiatric morbidity and lowered overall functioning. The results underscore the need for long-term follow-up of low birth weight survivors through adolescence and adulthood, focusing on mental health. The longitudinal increase in psychiatric morbidity in the term SGA group calls for additional investigation.

Background: Preterm birth at very low birth weight (VLBW) poses a risk for cerebellar abnormalities and increased psychiatric morbidity compared with reference populations. We aimed to study cerebellar volumes (grey and white matter; GM, WM) and mental health in VLBW individuals and controls at 15 and 19 years of age, as well as changes between the two time points. Methods: Forty VLBW (≤1500 g) and 56 control adolescents were included in the study at 15 years of age, and 44 VLBW and 60 control adolescents at 19 years of age. We had longitudinal data for 30 VLBW participants and for 37 controls. Clinical diagnoses were assessed following the schedule for affective disorders and schizophrenia for school-age children (KSADS). Psychiatric symptoms and function were further investigated with the Achenbach System of Empirically Based Assessment (ASEBA), ADHD Rating Scale-IV and the children’s global assessment scale (CGAS). An automatic segmentation of cerebellar GM and WM volumes was performed in FreeSurfer. The MRI scans were obtained on the same 1.5T scanner at both ages. Results: The VLBW group had higher rates of psychiatric disorders at both ages. Cerebellar growth trajectories did not differ between VLBW adolescents and controls, regardless of psychiatric status. However, VLBW adolescents who had a psychiatric diagnosis at both ages or developed a psychiatric disorder from 15 to 19 years had maintained smaller cerebellar WM and GM volumes than controls and also smaller volumes than VLWB adolescents who were or became healthy in this period. Moreover, there were no differences in cerebellar WM and GM volumes between controls and those VLBW who were healthy or became healthy. In the VLBW group, cerebellar WM and GM volumes correlated positively with psycho-social function at both 15 and 19 years of age, and smaller GM volumes were associated with inattention at 15 years. Conclusions: Smaller cerebellar volume in adolescents born very preterm and with VLBW may be a biomarker of increased risk of psychiatric problems in young adulthood. © Botellero et al. 2016. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

This study investigated the symptoms of anxiety and depression in adolescence, their associations with lifestyle and resilience and the possibility that resilience factors can attenuate the associations between unhealthy lifestyle and symptoms of anxiety and depression. Adolescents (n = 7,639) aged 13–18 years completed a questionnaire regarding lifestyle and health. Symptoms of anxiety and depression were measured by the SCL-5, a five-item shortened version of the Hopkins Symptom Checklist. Resilience factors included questions on friends and family relations and two sub-scales of the Resilience Scale for Adolescents; Family cohesion and Social competence. Of the total population, 13 % reported symptoms of anxiety and depression. Resilience characteristics were associated with lower symptom levels (ORs ranging from 0.2 to 0.6), and substance use and infrequent physical activity with higher symptom levels (ORs ranging from 2.1 to 4.0). The associations with substance use were strengthened by social competence, but attenuated by family cohesion. The association with physical activity was attenuated by both social competence and family cohesion. Symptoms of anxiety and depression were frequent in adolescents and were associated with unhealthy lifestyle factors as substance use and low physical activity. Resilience characteristics seemed to protect against symptoms and markedly influenced the associations between lifestyle factors and symptoms of anxiety and depression. The importance of family and other supportive relationships should be emphasized in treatment and prevention of anxiety and depression in adolescence.

Background Being born with low birth weight is a risk factor for psychiatric morbidity. Few longitudinal studies have included diagnostic assessment and followed subjects into adulthood. Aim To assess stability and change in psychiatric morbidity between adolescence and young adulthood in low birth weight subjects, and explore whether screening in adolescence can predict subsequent psychopathology in these groups. Study design Prospective geographically based follow-up study of two low birth weight groups and a control group born between 1986 and 1988, assessed at 14 (T1) and 20 (T2) years of age. Subjects Thirty eight subjects born preterm with very low birth weight (VLBW: ≤ 1500 g), 43 born at term but small for gestational age (SGA: Outcome measures Mental health was assessed using diagnostic psychiatric interview at both study points supplemented with the Achenbach System of Empirically Based Assessment and Children's Global Assessment Scale at T1. Results There was a trend towards increasing morbidity from T1 among VLBW (p = 0.086) and a significant increase among SGA (p = 0.003) participants. Supplementary assessment at T1 discriminated satisfactory between persons with and without psychiatric disorders at T2 (area under ROC curve: 0.66 to 0.89), but was most effective in the VLBW group. Conclusion High psychiatric morbidity continued into young adulthood in the VLBW group and increased significantly in the SGA group. Screening in adolescence can be used to detect individuals at risk especially among those born at very low birth weight.

To explore longitudinally gender differences in the associations between psychosocial functioning, subjective well-being and self-esteem among adolescents with and without symptoms of anxiety and depression. Data were obtained from a major population-based Norwegian study, the Nord-Trondelag Health Study, in which 1,092 boys and 1,262 girls (86% of all invited) completed an extensive self-report questionnaire at baseline (mean age 14.4 years) and at follow-up (mean age 18.4 years). Gender was a moderator variable in the associations between symptoms of anxiety and depression and impairment, meaning that boys’ functioning was impaired to a larger extent than girls’ functioning. A statistically significant interaction effect between gender and symptoms of anxiety and depression was found at follow-up in terms of subjective well-being (p

Background The entorhinal cortex serves as an important gateway between the cerebral cortex and the hippocampus by receiving afferent information from limbic, modality sensory-specific, and multimodal association fibers from all the brain lobes. Aim To investigate whether thinning of entorhinal cortex is associated with reduced perceptual, cognitive and executive skills in very low birth weight (VLBW) adolescents. Study design Prospective, geographically based follow-up study of three year cohorts of preterm born VLBW children. Subjects Forty-nine VLBW (birth weight ≤ 1500 g) and 58 term-born control adolescents were examined at the age of 14–15 years. Outcome measures Perceptual and cognitive functions were assessed with Visual motor integration test, Grooved Pegboard test, Wechsler Intelligence Scale for Children-III and different executive function tests (Wisconsin card sorting test, Trail Making test, Knox cube test). An automated MRI technique at 1.5 T for morphometric analyses of cortical thickness was performed. Areas with cortical thinning in left and right entorhinal cortex in the VLBW group were chosen as regions of interest to look for associations between cortical thickness and clinical findings. Results Thinning of the entorhinal cortex was correlated with low performance on perceptual and cognitive scores in the VLBW adolescents, but not in controls. In addition, thinning of the entorhinal cortices correlated with reduced performance on several executive tests, including perceptual speed and aspects of working memory. Conclusions Entorhinal cortical thinning is related with low IQ and reduced perceptual and executive functions in VLBW adolescents.

Scand J Caring Sci; 2011; 25; 725–734 Psychosocial health in children and adolescents surviving cancer Aim: To explore psychosocial health in children and adolescents surviving cancer three years after diagnosis compared with healthy controls, as assessed by adolescents themselves, their parents and teacher. Material and methods: Case–control study included 50 children and adolescents diagnosed with cancer between 1 January 1993 and 1 January 2003 and treated at the Paediatric Department St. Olav’s University Hospital, Trondheim, Norway. Data were collected using the Strengths and Difficulties Questionnaire (self-report, parent report and teacher report), as well as the Achenbach System of Empirically Based Assessment questionnaire (teacher report). Results: Children surviving cancer had more emotional symptoms, higher total problem scores and poorer academic performance than their peers. Emotional problems were consistently reported by parents, teachers and adolescents themselves, in particular in children with brain tumours and among survivors with late effects. Conclusion: Our study shows that children surviving cancer are at higher risk for emotional problems when compared with their friends, even after several years following diagnosis and treatment. We conclude that when planning long-term follow-up care, rehabilitation of children and adolescents with cancer, especially for survivors with brain tumours and late effects, should particularly take into account their psychological problems and psychosocial functioning.

Gender differences in the prevalence of symptoms of anxiety and depression during adolescence are well documented. However, little attention has been given to differences in subjective well-being, self-esteem and psychosocial functioning between boys and girls with symptoms of anxiety and depression. The aim of this study was to investigate gender differences in the associations between such symptoms and subjective well-being, self-esteem, school functioning and social relations in adolescents. Data were taken from a major population-based Norwegian study, the Nord-Trondelag Health study (HUNT), in which 8984 (91% of all invited) adolescents, aged 13-19 years, completed an extensive self-report questionnaire. Although prevalence rates of symptoms of anxiety and depression were higher in girls than in boys, a significant interaction between gender and symptoms of anxiety and depression was found in respect of each of the following outcome variables: subjective well-being, self-esteem, academic problems, frequency of meeting friends and the feeling of not having enough friends. These interactions indicate that the associations between symptoms of anxiety and depression and lower subjective well-being and self-esteem, more academic problems in school and lower social functioning were stronger for boys than for girls. Our findings may contribute to an earlier assessment and more efficient treatment of male adolescent anxiety and depression.

Aim: To study the prevalence and characteristics of psychiatric symptoms and disorders in young adults born with low birth weight. Methods: At 20 years of age 44 very low birth weight (VLBW: birth weight ≤1500 g), 55 term born small for gestational age (SGA: birth weight

Aim To describe behavioural and emotional symptoms among Icelandic preschool children with cerebral palsy (CP). Method Children with congenital CP, assessed with the Child Behavior Checklist/1½–5 (CBCL/1½–5) and Caregiver-Teacher Report Form (C-TRF), were enrolled in the study. A comparison group was recruited from the general population. Thirty-six children (53% males) with CP were assessed at a mean age of 4 years 11 months (SD 5mo, range 4–6y); 26 (72%) had bilateral distribution of symptoms and 32 (89%) had spastic CP. Thirty (83%) were at Gross Motor Function Classification System levels I or II and six at levels III or IV. For comparison, 110 (43% males) and 120 (48% males) children were assessed with the CBCL/1½–5 and the C-TRF respectively, at a mean age of 4 years 6 months (SD 6mo, range 4–6y). Results Sixteen children (48%) with CP had high scores on total problems scale of the CBCL/1½–5 and 20 (65%) on the C-TRF compared with 18% of the comparison group, both on the CBCL/1½–5 and the C-TRF (p

The aim of this study was to investigate any structural-functional relationship between changes in white matter microstructure seen on diffusion tensor imaging and results of an executive function test in adolescents with very low birth weight (VLBW). Thirty-four VLBW adolescents were examined at 15 years of age. Executive function was assessed by the Wisconsin Card Sorting Test. Diffusion tensor imaging scans were performed at 1.5 T for calculation of individual fractional anisotropy maps. Through a voxel-wise regression analysis, correlations were found between the results on Wisconsin Card Sorting Test and fractional anisotropy values in the left cingulum and both inferior fronto-occipital fascicles. We speculate that impairments in executive function in VLBW children may be influenced by disturbed connectivity between posterior brain regions and the prefrontal cortex.

Increased prevalence of motor and visual problems has been reported in low birth weight populations, but the association between them is less studied.To examine how visual impairments may be associated with the increased risk of motor problems in low birth weight adolescents.Fifty-one very low birth weight adolescents (VLBW), 56 term small for gestational age (SGA) and 75 term control adolescents, without cerebral palsy, were examined at the age of 14. Motor skills were examined by the Movement Assessment Battery for Children. Visual functions included visual acuity, contrast sensitivity, nystagmus, strabismus, stereoacuity, accommodation, convergence and visual perception (Visual-Motor Integration test). An abnormality score was calculated as the sum of visual impairments. We used odds ratio as an estimate of the relative risk of having motor problems.The odds of having motor problems were 10.4 (95% CI: 2.2-49.4) in the VLBW group and 5.1 (95% CI: 1.0-25.8) in the SGA group compared with the control group. The odds of having motor problems in the VLBW group were influenced by all visual variables, and most by visual acuity, when we adjusted for these separately. The greatest reduction in OR was found when adjusting for the abnormality score (adjusted OR: 6.8; 95% CI: 1.3-34.5). In the SGA group the odds of having motor problems were relatively unaffected by the visual variables and the abnormality score.Visual impairments influence motor problems in VLBW adolescents, whereas motor problems in SGA adolescents seem to be unaffected by visual impairments.

Purpose: To assess eye movements and binocular function in 14-year-olds with very low birthweight (VLBW: birthweight

Very low birth weight (VLBW) children are at high risk of perinatal white matter injury, which, when subtle, may not be seen using conventional magnetic resonance imaging. The relationship between clinical findings and fractional anisotropy (FA) measurements in white matter of adolescents born prematurely with VLBW was studied in 34 subjects (age = 15 years, birth weight

VLBW adolescentsWe found that the VLBW adolescents had specific emotional and cognitive traits. Some of them fit with psychiatric concepts and others do not. They had an increased risk of developing psychiatric symptoms and disorders compared with controls, especially attention deficit, anxiety and relational problems affecting their social skills and overall functioning. Academic achievement was reduced. The attention problems were widespread, but only a minority fulfilled the diagnostic criteria of Attentiondeficit/ hyperactivity disorder. Increased prevalence of anxiety symptoms and disorders may be due to a number of factors, comprising both biological/neuroendocrine and psychosocial mechanisms. The peer problems and deficits in social skills may indicate specific difficulties in relating and adjusting to others, with deficits in comprehending the subtle cues of social relations. The implication of thought problems reported by teachers is unclear. Adolescents with birth weight ≤ 1000 g showed a tendency towards more psychiatric disorders than those with birth weight between 1000 and 1500 g. The lack of gender differences demonstrates that prematurity exceeds the usual effect of gender regarding vulnerability for developing psychiatric symptoms.We found that the VLBW adolescents perceived self-esteem and quality of life as others did at the age of 14. However, parents reported functional disadvantages and reduced quality of life measures for their adolescents. The parents worried more for their children’s functioning and well-being, especially if the child had a psychiatric disorder or cerebral palsy. Still, being born VLBW did not influence the warmth in the parent-child relationship, nor did the parents have more mental health problems.As the association between VLBW and psychiatric problems could not be explained by SES or the parents’ mental health, a biological cause-effect relationship seems plausible. The frequency of cerebral MRI abnormalities was higher in the VLBW group than in the control group. Furthermore, ADHD symptoms were associated with white matter reduction and thinning of the corpus callosum, while other psychiatric symptoms were not associated with MRI abnormalities. These results support the hypothesis of a specific (“pure”) type of ADHD with a dominant neurological aetiology, while interacting psychosocial experiences play a minor part. Our study indicates that being born VLBW involves a biological vulnerability with increased risk of psychiatric symptoms.SGA adolescentsAlthough every fifth SGA adolescent had psychiatric symptoms, assessed by interview, the prevalence of symptoms and disorders did not differ significantly from controls. Yet, screening questionnaires displayed more behavioural problems, lowered social competence and a tendency towards attention deficit/hyperactivity. Teachers reported withdrawal and thought problems, while academic performance did not differ from controls. Boys had more attention and externalizing problems than girls.Generally, on psychiatric measures, the term SGA group seemed to fall inbetween the VLBW and the control group, resembling the control group more than the VLBW group.The SGA adolescents and their parents reported self-esteem and quality of life as in the control group. Being born SGA at term did not influence the warmth in the parent-child relationship, and the parents did not have more mental health problems than others. The frequency of cerebral MRI abnormalities in the SGA group did not differ from the control group, and no associations were found between psychiatric symptoms and MRI abnormalities.

While cross-sectional neuroimaging studies on cortical development predict reductions in cortical volume (surface area and thickness) during adolescence, this is the first study to undertake a longitudinal assessment of cortical surface area changes across the continuous cortical surface during this period. We studied the developmental dynamics of cortical surface area and thickness in adolescents and young adults (aged 15-20) born with very low birth weight (VLBW

To explore associations between psychiatric symptoms and cerebral magnetic resonance imaging abnormalities in low-birth-weight adolescents, 55 very low-birth-weight (or=1500 gm), 54 term small for gestational age (birth weight10th centile) and 66 term control adolescents (birth weightor=10th centile) were assessed at 14-15 years of age. Outcome measures were Schedule for Affective Disorders and Schizophrenia for School-Age Children, Attention-Deficit/Hyperactivity Disorder Rating Scale IV, Autism Spectrum Screening Questionnaire, and qualitatively assessed cerebral magnetic resonance images. The very low-birth-weight group manifested increased prevalence of psychiatric symptoms and disorders compared with controls (P0.001), especially symptoms of attention-deficit/hyperactivity disorder, and high frequency of ventricular dilatation, white matter reduction, thinning of corpus callosum, and gliosis (P0.01 vs controls). The Attention-Deficit/Hyperactivity Disorder Rating Scale score was significantly associated with white matter reduction and thinning of corpus callosum in this group. The term small for gestational age group had increased prevalence of psychiatric symptoms compared with control subjects, but not more frequent abnormalities on cerebral magnetic resonance imaging. In conclusion, attention-deficit/hyperactivity disorder symptoms were significantly associated with white matter reduction and thinning of corpus callosum in very low-birth-weight adolescents. No associations were found for other psychiatric symptoms and brain abnormalities in any of the groups.

The aim of this study was to explore psychiatric symptoms in low birth weight adolescents, and the usefulness of questionnaires compared with psychiatric interview. DESIGN/STUDY GROUPS: A population-based follow-up study of 56 very low birth weight (VLBW), 60 term small for gestational age (SGA) and 83 control adolescents at 14 years of age was made.The Achenbach System of Empirically Based Assessment (ASEBA) and the Strengths and Difficulties Questionnaire (SDQ) were rated by adolescents, parents and teachers. The results were compared with diagnostic assessment based on the semi-structured interview, Schedule for Affective Disorders and Schizophrenia for School Aged Children (K-SADS).VLBW adolescents had more psychiatric symptoms than controls, especially attention deficit, emotional, behavioural, social and also academic problems. Although less consistent, the SGA group had more emotional, conduct and attention deficit symptoms than controls. Results remained essentially the same when adolescents with low estimated IQ were excluded, and persisted after controlling for possible confounders. The sensitivity and specificity of ASEBA and SDQ differed between informants and groups.VLBW adolescents are at risk of developing psychiatric symptoms, and reduced social and academic skills by the age of 14. Term SGA adolescents may have discrete emotional, behavioural and attention deficit symptoms. ASEBA and SDQ provide a useful supplement to psychiatric interview.

Background: A high prevalence of abnormal cerebral MRI findings has been reported in low-birth-weight children. Objective: To compare MRI findings in very-low-birth-weight (VLBW) and term small-for-gestational-age (SGA) children with controls in early adolescence. Materials and methods: Cerebral MRI was used to examine 55 VLBW, 54 SGA and 66 controls at 15 years of age. The MR images were qualitatively assessed, and size of ventricles, white-matter and grey-matter abnormalities were reported. Results: The VLBW teenagers had a higher prevalence of various MRI abnormalities than SGA children and controls. Dilation of the ventricular system, especially of the occipital horns, was found in 82% of the VLBW group, in 19% of the SGA group and in 21% of controls. White-matter reduction was found in 53% of the VLBW, in 6% of the SGA and in 2% of controls. Corpus callosum thinning was found in 47% of the VLBW, in 2% of the SGA and in 6% of controls. Periventricular gliosis was found in 29% of the VLBW, in 4% of the SGA and in 8% of controls. Conclusions: Cerebral MRI pathology in white matter is a common finding in VLBW teenagers. The findings may indicate minor perinatal PVL with resulting loss of white-matter tissue and ventricular dilation.

To evaluate the prevalence of psychiatric symptoms and disorders associated with low birth weight.Design/study groups: A population based follow up study of 56 very low birthweight (VLBW: birth weightor = 1500 g), 60 term small for gestational age (SGA: birth weight10th centile), and 83 term control (birth weightor = 10th centile) children at 14 years of age.Schedule for affective disorders and schizophrenia for school aged children, attention deficit/hyperactivity disorder (ADHD) rating scale IV, autism spectrum screening questionnaire, and children's global assessment scale.VLBW adolescents had a higher prevalence of psychiatric symptoms (46%) than controls (13%) (odds ratio (OR) 5.7, 95% confidence interval (CI) 2.5 to 13.0) and more psychiatric disorders (25%) than controls (7%) (OR 4.3, 95%CI 1.5 to 12.0), especially anxiety disorders. Although 25% of the VLBW adolescents had attention problems, ADHD was diagnosed in only 7%. Four VLBW adolescents had symptoms of Asperger's disorder, and the VLBW group had a higher sum score than controls on the autism spectrum screening questionnaire. Although more SGA adolescents had psychiatric symptoms than controls (23% v 13%), the difference was not statistically significant. Results remained essentially the same when adolescents with low estimated intelligence quotient were excluded, and persisted after possible psychosocial confounders had been controlled for.VLBW, but not SGA adolescents, have a high risk of developing psychiatric symptoms and disorders by the age of 14, especially attention deficit, anxiety symptoms, and relational problems.

Aim The effects of resilience factors on associations between emotional symptoms and perceived pubertal timing or body mass in adolescence are unknown, and this study examined the moderating effects of social competence, family cohesion and loneliness. Methods Data were drawn from the Young-HUNT 3 study, including a self-report questionnaire and clinical measurements of weight and height from 7639 adolescents aged 13-18 years. Emotional symptoms were assessed by a five-item version of the Hopkins Symptom Checklist. Associations between pubertal timing or body mass and emotional symptoms were assessed by linear regression models. Interactions with social competence, family cohesion and loneliness were explored. Results A U-shaped relationship was found for both perceived pubertal timing and for perceived body mass and emotional symptoms. For girls, early perceived pubertal timing was more strongly associated with emotional symptoms among those who often felt lonely. For boys, late perceived pubertal timing and feeling they were fat were more strongly associated with emotional symptoms in those with low scores for social competence or family cohesion. Conclusion Emotional symptoms were more strongly associated with perceived pubertal timing and body mass than actual measures and the associations were stronger for adolescents with low scores for resilience factors.

Bullying is defined as a specific type of aggression in which (a) the behaviour is intended to harm or disturb, (b) the behaviour occurs repeatedly over time and (c) there is an imbalance of power, with a more powerful person or group attacking a less powerful one (1). The prevalence of bullying has been reported to vary between nine and 54 percent among school pupils (2). Being bullied can have large consequences for the individual child, which may persist into adulthood (2,3). Victims may show a pattern of internalizing symptoms like anxiousness and depression, negative thoughts about themselves, loneliness and low self-esteem (3). Moreover, victims can be socially marginalized, experiencing low social status and being avoided by classmates (4). Children with motor impairment are more likely to be victims (5). Children and adolescents with very low birth weight (VLBW: birth weight ≤1500 g) have increased risk of developing both severe (cerebral palsy, mental retardation) and minor neuroimpairments (poor fine motor function, perceptual problems) (6). Moreover, studies have reported increased risk of psychiatric problems among VLBW adolescents, especially attention deficit/hyperactivity (ADHD) symptoms, anxiety disorders and possibly depression, autistic spectrum symptoms and thought problems (7,8). They may also have lower self-esteem than their normal weight peers and problems with social rejection (9). Thus, as a group, VLBW adolescents have a high prevalence of risk factors associated with bullying. None the less, little research has been conducted on the association between being born with VLBW and being bullied. The objective of this study was to assess the prevalence of being bullied in a group of VLBW adolescents, and to describe associations between being bullied and physical and psychiatric functioning. Fifty-four VLBW and 86 control adolescents participated in the study at age 14. To assess bullying, we used appropriate questions from the strengths and difficulties questionnaire (SDQ), and in addition parental assessment of bullying was analyzed using one question from the autism spectrum screening questionnaire (ASSQ). Schedule for affective disorders and schizophrenia for school-age children (K-SADS) was used in the assessment of psychiatric symptoms and diagnoses. The mothers reported ADHD-symptoms on the ADHD-rating scale. As a measure of social cognition, we used a revised ASSQ sum score (ASSQ sumrev). Child health questionnaire (CHQ) – child form 87 (self-report) was used to measure self-esteem. An estimate of intelligence quotient (IQest) was calculated using four subscales of the Wechsler intelligence scales (WISC-III). Socioeconomic status (SES) was calculated according to Hollingshead’s two-factor index of social position. These instruments are previously described in detail (7). Anthropometrics were assessed by clinical examination. Motor function was evaluated with the Movement Assessment Battery for Children (Movement ABC) (10). Scores

Objective: The aim of this study was to assess the impact of self-reported emotional and conduct problems on family functioning and quality of life (QoL) among adolescents with ADHD. Method: The ADHD group ( N = 194) was divided into the following groups: without additional emotional or conduct problems, with emotional problems, with conduct problems, and with both problem types. The cross-sectional study included parent and adolescent reports. Results: Adolescents with ADHD and both problem types reported significantly lower QoL and family functioning than all other ADHD groups. Parents reported better QoL for the ADHD group without additional problems, but similar family functioning for all groups. Conclusion: A higher level of coexisting psychiatric problems had a significant impact on adolescents’ reports of family functioning and QoL. However, coexisting problems showed no association with parent reports of family functioning. Adolescents with ADHD might add important information in clinical assessment.

The frequencies of social anxiety symptoms in a mental health clinical and a community sample of adolescents are compared. Also, we explore if adolescents can be classified in subgroups based on social anxiety symptoms. Associations between social anxiety symptoms and coexisting problems and sociodemographic characteristics are examined. Adolescent participants, aged 13–18, in two large Norwegian studies, consisting of a clinical (n = 694, 42.1 % participation rate, 55 % girls, mean age = 15.6) and a community (n = 7,694, 73.1 % participation rate, 51 % girls, mean age = 15.8) sample completed identical self-report questionnaires measuring social anxiety and related variables. Median sum scores (interquartile range) of social anxiety symptoms were higher among girls than boys and in the clinical [girls = 16 (12–22); boys = 12 (9–16)] compared to the community sample [girls = 12 (9–15); boys = 10 (7–12)] (p

Being born small for gestational age (SGA) (birth weight10th percentile) is connected to decreased white matter (WM) integrity in newborns and increased prevalence of psychiatric symptoms in adulthood. The aims of this study were to investigate whether being born SGA at term affects WM integrity in young adulthood and to explore possible relationships between fractional anisotropy (FA) and pre- and perinatal factors and cognitive and psychiatric outcomes in adulthood in SGA and controls.Diffusion tensor imaging and tract-based spatial statistics were conducted to test for voxelwise differences in FA in SGAs (n = 46) and controls (n = 57) at 18-22 y.As compared with controls SGAs had reduced FA in ventral association tracts and internal/external capsules. In the SGAs, no relationship was found between FA and intrauterine head growth in the third trimester, although total intelligence quotient was negatively correlated to FA. In controls, a positive correlation was found between FA and brain growth in the third trimester and maternal smoking. No relationship was found between FA and psychiatric measures in SGAs or controls.These results demonstrate that being born SGA leads to reduced WM integrity in adulthood, and suggest that different factors modulate the development of WM in SGA and control groups.