Bo Vinnerljung

School performance and alcohol-related disorders in early adulthood: a Swedish national cohort study

Background Alcohol misuse is an important global health determinant and a major contributor to health inequalities. We aimed to investigate the association between school performance and alcohol-related disorders in early adulthood in a longitudinal register-based national cohort study. Methods We followed a register-based national cohort of Swedish citizens born 1973–1984 (Nu2009=u2009948u2009440) from compulsory school graduation at age 15–16 to 2009. We divided the population into five groups: high school marks (> meanu2009+u20091 SD); high average (between mean and meanu2009+u20091 SD); low average (between mean and mean − 1 SD); low (< mean – 1SD); and missing. Cox proportional hazard models were used to investigate the relation between school marks at time of graduation and hospital care for alcohol-related disorders in early adulthood. Results There was a steep gradient in the risk of alcohol-related disorders related to school performance. In comparison with peers in the top category of school marks, students with low marks had adjusted hazard ratios of 8.02 [95% confidence interval (CI) 7.20 to 8.91], low average 3.02 (2.72 to 3.35) and high average 1.55 (1.39 to 1.73). The risk associated with low school marks was stronger in the male population and in the group from high socioeconomic background. Conclusions The study demonstrated a strong graded relation between low school performance and alcohol-related disorders in young adulthood. School performance should be taken into account when developing prevention programmes/policies targeting alcohol misuse among teenagers and young adults, especially if the aim is to reach high-risk groups.

Teenage childbirth among female international adoptees: a national cohort study

1.Department of Woman and Child Health, Karolinska Institute, Stockholm, Sweden 2.Centre for Health Equity Studies (CHESS), Karolinska Institute, Stockholm, Sweden 3.Centre for Epidemiology, National Board of Health and Welfare, Stockholm, Sweden 4.Department of Neuroscience, Child and Adolescent Psychiatry, University Hospital of Uppsala, Uppsala, Sweden 5.Stress Research Institute, Stockholm University, Sockholm, Sweden 6.Institute for Evidence-based Social Work Practice, National Board of Health and Welfare, Stockholm, Sweden

Impact of childhood adversities on depression in early adulthood: A longitudinal cohort study of 478,141 individuals in Sweden

OBJECTIVEnAlthough the relationship between childhood adversity (CA) and depression is widely accepted, there is little information on what proportion of depression is attributable to CA.nnnMETHODnWe used a Swedish cohort of 478,141 individuals born in 1984-1988 in Sweden. Register-based CA indicators included parental death, parental substance abuse and psychiatric morbidity, parental criminality, parental separation, public assistance recipiency, child welfare intervention, and residential instability. Estimates of risk of depression, measured as retrieval of prescribed antidepressants and/or psychiatric care with a clinical diagnosis of depression, between 2006 and 2012 were calculated as Hazard Ratios (HR) with 95% confidence intervals (CI), using a Cox regression analysis.nnnRESULTSnAll CAs predicted depression in early adulthood. Furthermore, the predictive association between the CA indicators and depression was graded, with highest HRs observed for 4+ CAs (HR: 3.05 (95% CI 2.83-3.29)) for a clinical diagnosis for depression and HR: 1.32 (95% CI 1.25-1.41) for antidepressant medication after adjustments were made for important confounding factors. Of the studied CAs, child welfare intervention entailed highest HR for depression.nnnCONCLUSIONnRegardless of causality issues, children and youth with a history of multiple CA should be regarded as a high-risk group for depression by professionals in social, and health services that come into contact with this group.

Dental healthcare utilisation among young adults who were in societal out-of-home care as children: A Swedish National Cohort Study: Dental care utilisation among young adults from out-of-home care

We used Swedish national registers to analyse dental health care among young adults with childhood experience of out-of-home care (OHC), in Cox regression analyses. All 1.7 million Swedish resident ...

Gender aspects of health-related quality of life of youth in secure residential care in Sweden: Quality of life of youth in secure residential care

This study examined health-related quality of life of youth in secure residential care employing a gender perspective. The KIDSCREEN-52 questionnaire was administered to 91 youths (46 boys and 45 girls) aged 13–17, admitted to four secure residential units in southern Sweden, in connection with a medical examination. Results were compared with a national Swedish survey from 2009 of 86,000 youths aged 15–16 years old. In age-adjusted analyses, youth in secure residential care units reported lower levels of wellbeing for all but one KIDSCREEN measure, compared with the national survey, with moderate to large differences in effect size. In the residential care sample, female gender was associated will lower psychological wellbeing, poorer parental relations and less school satisfaction, while male gender was associated with lower self-perception and peer relations. (Less)

Health problems and healthcare needs among youth in Swedish secure residential care: Health problems among youth in secure residential care

International research has consistently reported that youth in secure residential care have high rates of somatic/dental health problems. Here, we report results from the first such study in a Nordic country. An experienced paediatrician performed systematic somatic and rudimentary dental health assessments of 91 youths, age 13–17, recently admitted to four secure residential units in Sweden. Girls were oversampled. Participants were tested for sexually transmitted diseases (STD). We found large unmet needs of health/dental care, similar to reports from other countries: 75% of the girls and 53% of the boys had at least one previously known health problem that was poorly followed up or was unknown before the assessment. Over 40% of the girls had severe dental decay. Only two cases of STD were identified (Chlamydia). Some 91% of the girls and 64% of the boys were referred to a health or a dental care clinic. (Less)

Intergenerational transmission of out-of-home care in Sweden: A population-based cohort study

The objective of this study is to examine the intergenerational transmission of out-of-home care. This population-based study used data from the Swedish National Registers and included all children born in Sweden between 1990 and 2012 (followed for up to 13 years), whose parents were both born in Sweden between 1973 and 1980 (278 327 children; 145 935 mothers; 146 896 fathers). Cox regression models are used to obtain crude and adjusted hazard ratios (HR) of OHC placement among children based on parents history of OHC. Compared with children whose parents both did not have a history of OHC, the risk of being placed in OHC was greater when both parents spent time in OHC (crude HRu202f=u202f48.70, 95% CI 41.46-57.21; adjusted HRu202f=u202f3.04, 95% CIu202f=u202f2.54-3.64), however, children who had only one parent who spent time in care were also at higher risk (mothers only adjusted HRu202f=u202f2.37, 95% CIu202f=u202f2.08-2.70; fathers only adjusted HRu202f=u202f1.33, 95% CIu202f=u202f1.13-1.55). The crude rate of placement in OHC was highest for children whose parents were placed in care during adolescence, but after adjusting for social and behavioral covariates, children whose parents were in care in early childhood were at greater risk of OHC than children whose parents were in care in adolescence. To reduce this intergenerational transmission of OHC, more supports should be provided to parents who spent time in OHC to ensure a successful transition to parenthood.