Mila Kingsbury

Time trends in symptoms of mental illness in children and adolescents in Canada

Background: Existing research and media reports convey conflicting impressions of trends in the prevalence of mental illness. We sought to investigate trends in the prevalence of symptoms of mental illness in a large population-based cohort of Canadian children and adolescents. Methods: We obtained population-based data from the National Longitudinal Survey of Children and Youth. Every 2 years, participants completed self-reported measures of mental illness indicators, including conduct disorder, hyperactivity, indirect aggression, suicidal behaviour, and depression and anxiety. We analyzed trends in mean scores over time using linear regression. Results: We evaluated 11 725 participants aged 10–11 years from cycles 1 (1994/95) through 6 (2004/05), 10 574 aged 12–13 years from cycles 2 (1996/97) through 7 (2006/07), and 9835 aged 14–15 years from cycles 3 (1998/99) through 8 (2008/09). The distribution of scores on depression and anxiety, conduct and indirect aggression scales remained stable or showed small decreases over time for participants of all ages. The mean hyperactivity score increased over time in participants aged 10–11 years (change per 2-year cycle: 0.16, 95% CI 0.02 to 0.12) and those aged 12–13 years (0.13, 95% CI 0.09 to 0.18). Over time, fewer participants aged 12–13 years (0.40% per cycle, 95% CI −0.78 to −0.07) and aged 14–15 years (0.56% per cycle, 95% CI −0.91 to −0.23) reported attempting suicide in the previous 12 months. Interpretation: With the exception of hyperactivity, the prevalence of symptoms of mental illness in Canadian children and adolescents has remained relatively stable from 1994/95 to 2008/09. Conflicting reports of escalating rates of mental illness in Canada may be explained by differing methodologies between studies, an increase in treatment-seeking behaviour, or changes in diagnostic criteria or practices.

Associations between fruit and vegetable consumption and depressive symptoms: evidence from a national Canadian longitudinal survey

Background Several cross-sectional studies have demonstrated associations between diet quality, including fruit and vegetable consumption, and mental health. However, research examining these associations longitudinally, while accounting for related lifestyle factors (eg, smoking, physical activity) is scarce. Methods This study used data from the National Population Health Survey (NPHS), a large, national longitudinal survey of Canadians. The sample included 8353 participants aged 18 and older. Every 2 years from 2002/2003 to 2010/2011, participants completed self-reports of daily fruit and vegetable consumption, physical activity, smoking and symptoms of depression and psychological distress. Using generalised estimating equations, we modelled the associations between fruit and vegetable consumption at each timepoint and depression at the next timepoint, adjusting for relevant covariates. Results Fruit and vegetable consumption at each cycle was inversely associated with next-cycle depression (β=−0.03, 95% CI −0.05 to −0.01, p<0.01) and psychological distress (β=−0.03, 95% CI −0.05 to −0.02, p<0.0001). However, once models were adjusted for other health-related factors, these associations were attenuated (β=−0.01, 95% CI −0.04 to 0.02, p=0.55; β=−0.00, 95% CI −0.03 to 0.02, p=0.78 for models predicting depression and distress, respectively). Conclusions These findings suggest that relations between fruit and vegetable intake, other health-related behaviours and depression are complex. Behaviours such as smoking and physical activity may have a more important impact on depression than fruit and vegetable intake. Randomised control trials of diet are necessary to disentangle the effects of multiple health behaviours on mental health.

Air Pollution and Emergency Department Visits for Depression: A Multicity Case-Crossover Study

Background The aim of this study was to investigate the associations between ambient air pollution and emergency department (ED) visits for depression. Methods Health data were retrieved from the National Ambulatory Care Reporting System. ED visits for depression were retrieved from the National Ambulatory Care Reporting System using the International Classification of Diseases (ICD-10), Tenth revision codes; ICD-10: F32 (mild depressive episode) and ICD-10: F33 (recurrent depressive disorder). A case-crossover design was employed for this study. Conditional logistic regression models were used to estimate odds ratios. Results For females, exposure to ozone was associated with increased risk of an ED visit for depression between 1 and 7 days after exposure, for males, between 1 and 5, and 8 days after exposure, with odds ratios ranging between 1.02 and 1.03. Conclusions These findings suggest that, as hypothesized, there is a positive association between exposure to air pollution and ED visits for depression.

Depression and mortality in a longitudinal study: 1952–2011

BACKGROUND: Many studies have shown that depression increases mortality risk. We aimed to investigate the duration of time over which depression is associated with increased risk of mortality, secular trends in the association between depression and mortality, and sex differences in the association between depression and mortality. METHODS: We conducted a cohort study of 3410 adults enrolled in 3 representative samples of a county in Atlantic Canada in 1952 (n = 1003), 1970 (n = 1203) or 1992 (n = 1402) (the Stirling County Study). Depression was measured using a diagnostic algorithm based on the presence of depressed mood and associated symptoms, duration of more than 1 month, and substantial impairment. Vital status of participants through 2011 was determined using probabilistic linkages to the Canadian Mortality Database. RESULTS: Depression was associated with a heightened risk of mortality among men during the 3 time periods of the study, with hazard ratios (HRs) of 2.90 (95% confidence interval [CI] 1.69–4.98) between 1952 and 1967, 1.97 (CI 1.34–2.89) between 1968 and 1990, and 1.52 (CI 1.09–2.13) between 1991 and 2011. Elevated risk of mortality was noted among women only between 1990 and 2011 (HR = 1.51; CI = 1.11–2.05). INTERPRETATION: The association between depression and mortality persists over long periods of time and has emerged among women in recent decades, despite contemporaneous improvements in the treatment of depression and reduction of stigma associated with depression. Further research is needed to better understand the mechanisms involved.

Migraine headache and risk of self-harm and suicide: a population-based study in Ontario, Canada

Migraine has been associated with mental illness, and may also be associated with increased risk of suicidal behavior.

Assessment and Implications of Coping Styles in Response to a Social Stressor among Early Adolescents in China.

The aims of the present study were to (a) examine the factor structure of the Self-Report Coping Scale in a sample of Chinese early adolescents and (b) explore associations between coping and socioemotional functioning in this sample. Participants were N= 569 elementary school students (307 boys) in Grades 4 to 6. Participants completed a measure of coping in response to an argument with a friend. Students’ functioning across multiple domains was assessed using self, peer, and teacher reports. Results suggested a five-factor model of coping in Chinese early adolescents (problem solving, seeking social support, internalizing, externalizing, distancing). In support of predictions, internalizing and distancing coping were positively related to adjustment indices, whereas seeking social support and problem-solving coping were negatively related to outcomes. Results are discussed in terms of the important role of coping for adolescents’ adjustment across multiple domains and in relation to recent shifts in traditional Chinese cultural values.

CARTOONS KILL: casualties in animated recreational theater in an objective observational new study of kids' introduction to loss of life.

Objectives To assess the risk of on-screen death of important characters in children’s animated films versus dramatic films for adults. Design Kaplan-Meier survival analysis with Cox regression comparing time to first on-screen death. Setting Authors’ television screens, with and without popcorn. Participants Important characters in 45 top grossing children’s animated films and a comparison group of 90 top grossing dramatic films for adults. Main outcome measures Time to first on-screen death. Results Important characters in children’s animated films were at an increased risk of death compared with characters in dramatic films for adults (hazard ratio 2.52, 95% confidence interval 1.30 to 4.90). Risk of on-screen murder of important characters was higher in children’s animated films than in comparison films (2.78, 1.02 to 7.58). Conclusions Rather than being the innocuous form of entertainment they are assumed to be, children’s animated films are rife with on-screen death and murder.

Depressive and anxious symptoms and 20-year mortality: Evidence from the Stirling County study

Depression and anxiety disorders are highly comorbid, and share significant symptom overlap. Whereas depression has been consistently associated with excess mortality, the association between anxiety and mortality is less clear. Our aim was to identify constellations of anxious and depressive symptoms and examine their associations with mortality.

Relationship between leisure time physical activity, sedentary behaviour and symptoms of depression and anxiety: evidence from a population-based sample of Canadian adolescents

Background Physical and sedentary activities have been identified as potentially modifiable risk factors for many diseases, including mental illness, and may be effective targets for public health policy and intervention. However, the relative contribution of physical activity versus sedentary behaviour to mental health is less clear. This study investigated the cross-sectional association between physical activity, sedentary activity and symptoms of depression and anxiety at age 14–15 in the National Longitudinal Survey of Children and Youth (NLSCY). Methods Respondents aged 14–15 years between 1996 and 2009 who reported on symptoms of depression in the NLSCY were included (n=9702). Multinomial logistic regression was used to assess the relationship between physical and sedentary activity and symptoms of depression and anxiety. Joint models including both physical and sedentary activity were also explored. Models were adjusted for sex, ethnicity, immigration status, family income, parental education, recent major stressful life events and chronic health conditions. Results The odds of having moderate and severe symptoms of depression and anxiety compared with no symptoms was 1.43 (1.11 to 1.84) and 1.88 (1.45 to 2.45) times higher, respectively, in physically inactive youth relative to physically active youth. The odds of having moderate and severe symptoms of depression and anxiety compared with no symptoms was 1.38 (1.13 to 1.69) and 1.31 (1.02 to 1.69) times higher, respectively, in sedentary youth relative to non-sedentary youth. In joint models including both physical and sedentary activity, sedentary activity was not consistently associated with symptoms of depression and anxiety. Conclusions Both physical inactivity and sedentary activity appear to be significantly related to symptoms of depression and anxiety. The importance of distinguishing these two behaviours has relevance for research as well as policies targeting physical activity and mental health in youth.