Kevin Kelleher

Children's depression, gender and age norms for an Irish national (primary) school population

OBJECTIVES To provide normative data for older national (primary) school children, broken down by age and gender, for the Childrens Depression Inventory-Short version (CDI-S) and revised norms for the Childrens Depression Inventory-Parent version (CDI-P) and its subscales. METHOD Forty-three randomly selected national schools took part in this study. Participants were 1,255, fifth and sixth class, Irish national school children who completed the Childrens Depression Inventory Short Form (CDI-S). In total 1,018 parents completed the corresponding parent form, the Childrens Depression Inventory-Parent version (CDI-P). RESULTS Norms for the CDI-S and the CDI-P subscales were produced. Revised norms for the CDI-P are proposed. Results revealed no significant age or gender difference in depressive symptomatology as measured by respondents CDI-S and total CDI-P scores. Parents ratings of their childrens depression levels (CDI-P) and childrens self-reported depression levels (CDI-S) were significantly correlated. The CDI-S and CDI-P displayed good internal reliability. CONCLUSION Results indicate the utility of both the CDI-S and the CDI-P for assessing depressive symptoms in national school children in Ireland. This study confirms that national school children do display symptoms of depression. School based policies, materials and services supporting and promoting positive mental health should be developed, implemented and resourced.

Gender and the children's depression inventory's (CDI) ‘crying’ question

Objectives : Following disruption from students, particularly boys, during the administration of item 10, the ‘feel like crying’ question, of the Childrens Depression Inventory (CDI), this study sought to explore the issue of non-response to this question. It was decided that particular attention should be given to gender differences in responses and non-responses, based on the experiences of researchers administering this measure. Method : Chi-square analysis of non-responses was conducted on CDI items collected from a total sample of 2,297 second year and pre-leaving certificate students from 23 randomly selected schools in the Mid-West region of Ireland. Results : Analysis identified item 10 as being significantly less likely to be completed than any other item. Further analysis revealed that boys were significantly less likely to respond to this question than girls. Conclusion: A modification of the wording to item 10 is suggested to ameliorate this difficulty.

The Children’s Depression Inventory (CDI) in Ireland: Revision & Subscale Analysis

Abstract Houghton, O’Connell & O’Flaherty (1998) produced the first set of Irish norms for the Children’s Depression Inventory (CDI). However, since this research was conducted in 1996, Ireland has undergone profound social, economic and political changes. This study sought to replicate elements of the original Irish normative study to determine if these norms were still valid. Additionally, this study sought to produce Irish norms for the CDI’s five subscales (negative mood, interpersonal problems, ineffectiveness, anhedonia and negative self-esteem), an area of examination overlooked to date in Ireland. Results from a multistage, stratified random-sampling survey conducted in 2002, involving 2,297 post-primary school students from the mid-west region of Ireland, identified significantly lower levels of depressive symptoms among girls compared to results from 1996. As expected, depressive symptoms among girls were significantly higher than among boys. Similarly depressive symptoms among older adolescents...

The exposure fallacy: Migration, mobility and ecological analysis of health status in Ireland

The problem of differential rates of exposure within areas resulting from spatially inconsistent rates of migration and mobility is largely ignored in ecological health analysis. This error may be termed the ‘exposure fallacy’. This paper quantifies population mobility and migration in Ireland using a variety of census measures. The results indicate that there is not only substantial residential mobility in Ireland, but that the nature and extent of this mobility differs significantly across areas. For example in 1996 more 250,000 people were not living in the same residence they had occupied twelve months previously. The viability of ecological analysis is therefore questioned. As anticipated the most mobile groups were young adults aged 20-35 years, and most residential moves were of a local nature. The error associated with the exposure fallacy may be partially reduced if analysis is conducted at county level and if young adults are excluded. The development of an area based mobility index for Ireland is also proposed for use in weighted least squares regression analysis. However significant problems remain despite these precautions. The adoption of a Finnish style centralised population and housing register is proposed, as is the introduction of a unique identifier for all individuals within the State.

The Askeaton Investigation and the failure of Irish health information systems

Sporadic concerns over animal health problems have been voiced in north county Limerick since the late 1980s. This issue came to the fore in late 1994 when local concerns developed to encompass human health in the area. The MidWestern Health Board responded by attempting to investigate the health status of the local population in an effort to identify possible pollution related illnesses. Fourteen studies were initiated but several of the studies proved unfeasible given the limitations of the computerised health information systems, or had to completed by hand or interview. This investigation highlighted the almost total failure of Irish health information systems to respond to any form of in-depth analysis of population health status. This proved costly both financially and in terms of the delay that ensued, which allowed fear and concern to spread. As alarm escalated the number of conditions residents felt should be investigated increased. The geographical coding of all health information below county level, at least to DED level and ideally to point location is the most basic reform necessary for population health surveillance and investigation.

The Short Four-Item Center for Epidemiological Studies Depression Scale for Children (CES-DC) in Ireland

Abstract This study provides normative data for an Irish primary school population aged 10–13 years on the short four-item Center for Epidemiological Studies Depression Scale for Children (CES-DC). As part of a wider study examining alcohol, tobacco and drug use, data from 1,255 children were collected via 43 primary schools in the Mid-West region in 2005. A response rate of 76.2% was achieved. Internal reliability for this short measure was adequate (Cronbach’s Alpha = .583). Construct and convergent validity of this measure was supported through its correlation (ρ = .497) with the Short Form of the Children’s Depression Inventory (CDI-S). As suggested by the literature, the analyses revealed no significant age or gender differences in depressive symptomatology as measured by the short four-item CES-DC among this relatively young sample. Although further research on this measure is required, it may prove to be a useful measure for busy clinicians seeking to assess and prioritise patients for treatment.

Diagnostic criteria used to assess ADHD/hyperkinetic disorder

Sir -1 wish to commend Dr Louise Conlon and Prof Thomas Fahy in relation to their editorial Debriefing for Acute Trauma a Welcomed Demised As the major psychiatric advisor to the Military, Irish Marine Emergency Service and the Gardai in relation to when and where critical incident stress debriefing (CISD) should occur, I would like to make the following observations. CISD is only of use when a major incident has occurred, usually when there is a significant loss of life. It is very important that the critical incident stress debriefing only occurs after the operational debrief. The debriefers need to be highly trained particularly in relation to group dynamics. My major fear is the risk of scape goating. I am well aware of the negative findings of the Cochrane Review by Wesley Bedell and more recent findings by Shalev in relation to the poor outcome from CISD. I would consider that CISD is an inappropriate intervention in relation to road traffic accidents even when there is major trauma. It is best kept for major incidents in which a number of personnel were involved and carried out by their own peers who are respected.