ABSTRACT
Objectives:
In this study, it was aimed to evaluate both the diagnosis and psychosocial stressors of infants and young children who were assessed in the infant mental health unit according to Diagnostic Classification of Mental Health and Developmental Disorders (DC: 0-5) and the effects of those on parent-infant interaction.
Materials and Methods:
Children aged 0-5 years who were referred to Infant Mental Health Unit of our department, between June 1st, 2019 and June 1st, 2020, were included. Clinical data including psychiatric evaluations and diagnoses, developmental tests, sociodemographic forms investigating psychosocial difficulties existed in DC: 0-5, parent-infant relationship-global assessment scale (PIR-GAS) scores according to Crowell observation procedure, and psychiatric disorders and diagnoses through clinical interview based on DC: 0-5 were retrospectively analyzed.
Results:
Among 137 patients evaluated, 111 (81,0%) had psychiatric diagnoses. Fifty three (38.6%) patients were diagnosed with two comorbid psychiatric disorders and 6 patients (4.4%) were diagnosed with 3 comorbid disorders. Global developmental delay (47.4%) was the most common diagnosis among the patients. The most common psychosocial difficulties were hospitalization of the infant or young child (32.8%), non-physical quarrel or conflict between parents or caregivers (28.6%), and medical disease of the infant or young child (27.7%). While there was no significant relationship between PIR-GAS scores and the total number of psychosocial difficulties, the number of psychosocial difficulties related to education or child care was found to be negatively correlated with PIR-GAS scores after categorizing the difficulties reported (p=0.03).
Conclusion:
It is thought that the findings of the study may be useful for healthcare professionals and parents to develop interventions that will provide adequate support required for psychosocial stressors.
Keywords:
Infant, psychology, psychiatry, diagnosis, psychosocial factors
References
1Clinton J, Feller AF, Williams RC. The importance of infant mental health. Paediatr Child Health. 2016;21:239-241.
2Chinitz S, Guzman H, Amstutz E, Kohchi J, Alkon M. Improving outcomes for babies and toddlers in child welfare: A model for infant mental health intervention and collaboration. Child Abuse Negl. 2017;70:190-198.
3Friis RH, Sellers T. Epidemiology for public health practice: Jones & Bartlett Learning; 2020.
4Behrman RE, Butler AS. Preterm birth: causes, consequences, and prevention: National academies press Washington, DC; 2007.
5Evans GW, Fuller-Rowell TE. Childhood poverty, chronic stress, and young adult working memory: the protective role of self-regulatory capacity. Dev Sci. 2013;16:688-696.
6O’Connell ME, Boat T, Warner KE. Preventing mental, emotional, and behavioral disorders among young people: Progress and possibilities: Washington, DC: National Academies Press; 2009.
7Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. Am J Prev Med. 1998;14:245-258.
8Bagner DM, Rodriguez GM, Blake CA, Linares D, Carter AS. Assessment of behavioral and emotional problems in infancy: a systematic review. Clin Child Fam Psychol Rev. 2012;15:113-128.
9Zero to Three. DC: 0-5. Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood Washington, DC: Zero to Three Press c; 2016.
10Crowell JA, Feldman SS. Mothers’ internal models of relationships and children’s behavioral and developmental status: A study of mother-child interaction. Child Dev. 1988;59:1273-1285.
11Zeanah CH, Boris NW, Heller SS, Hinshaw‐Fuselier S, Larrieu JA, Lewis M, Palomino R, Roveris M, Valliere J. Relationship assessment in infant mental health. Infant Mental Health Journal. 1997;18:182-197.
12Gleason MM. Relationship assessment in clinical practice. Child Adolesc Psychiatr Clin N Am. 2009;18:581-591.
13Anders T. Clinical syndromes, relationship disturbances and their assessment. Relationship disturbances in early childhood. 1989.
14Cordeiro MJ, Da Silva PC, Goldschmidt T. Diagnostic classification: Results from a clinical experience of three years with DC: 0-3. Infant Mental Health Journal. 2003;24:349-364.
15Keren M, Feldman R, Tyano S. A five‐year Israeli experience with the DC: 0–3 classification system. Infant Mental Health Journal. 2003;24:337-348.
16Mothander PR, Grette Moe RG. Infant Mental Health Assessment: The use of DC 0‐3 in an outpatient child psychiatric clinic in Scandinavia. Scand J Psychol. 2008;49:259-267.
17Uslu R, Özalp O, Bilgiç A, Erdoğan G. Bebek Ruh Sağlığı Polikliniğine Başvuran Hastalarda TS:-3YB Tanı Dağılımı’na İlişkin Bir Ön-Çalışma. Türkiye Klinikleri Pediatrik Bilimler Özel Dergisi. 2007;3:8-13.
18Zeanah CH, Boris NW, Larrieu JA. Infant development and developmental risk: A review of the past 10 years. J Am Acad Child Adolesc Psychiatry. 1997;36:165-178.
19DelCarmen-Wiggins R, Carter AS. Introduction--Assessment of infant and toddler mental health: advances and challenges. J Am Acad Child Adolesc Psychiatry. 2001;40:8-10.
20Bosquet M, Egeland B. Associations among maternal depressive symptomatology, state of mind and parent and child behaviors: implications for attachment-based interventions. Attach Hum Dev. 2001;3:173-199.
21Şahin B, Karabekiroğlu K. Bebek Ruh Sağlığında Erken Müdahale Programları. Türkiye Klinikleri Çocuk Psikiyatrisi Özel Dergisi. 2018;4:69-76.
