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Re: Psychiatric disorder and looked after status
- Murali K Sekar (24 April 2007)
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Murali K Sekar, Locum Consultant Psychiatrist
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drmurali98{at}yahoo.com Murali K Sekar
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Ford et al studied the possible explanation for increased prevalence of psychiatric disorder in children looked after by local authorities. This study identified the significant role of looked after status with higher levels of psychopathology, educational difficulties and neurodevelopmental disorders. The authors also suggested that the services should keep in mind that the change in the environment might be more appropriate in providing help at least in some cases. After carefully reading the article, I think the authors have missed an important aetiological factor whilst considering the reasons for increased prevalence for mental disorder in this high-risk group. The important factor is the role of biological factors in the form of genetics. When we try to find an explanation for increased prevalence, first of all, we must understand why the children came to ‘looked after’ status. Studies (e.g Howard et al) have identified that parents with mental disorder are likely to have broken family and their children to be looked after by another person or organisation. The biological factor, which caused mental illness in the parents of children currently looked after by services, might operate to cause the increased prevalence of psychiatric disorder in these children. Hence by neglecting the biological component in the biopsychosocial model of mental illnesses, the authors have failed to provide a comprehensive assessment of factors in the causation of psychiatric disorder in these children. The authors could have included psychiatric disorder in parents as one the variable in the analysis stage. The ‘looked after’ group could have been divided into children of parents with or without mental disorder and a finding of increased prevalence of mental illness in the group of children with parental mental illness, would have shed more light into the understanding of this complex issue. The authors themselves have identified that neuro developmental difficulties and learning difficulties are associated with increased prevalence of psychiatric disorder. We should note that both these factors are also associated with future development of mental illnesses like schizophrenia ( Lawrie et al, Done et al) in which genetics plays an important role in the aetiology (Cardno et al). Declaration of Interest: None References Alastair.G.Cardno, E.Jane Marshall,Bina Coid et al (1999) Heritability Estimates for Psychiatric Disorders : The Maudsley Twin Psychosis Services; Archives of General Psychiatry 56, 162-168 D.J.Done, T.J.Crow, E.C.Johnstone et al (1994) Childhood antecedents of Schizophrenia and Affective illnesses: Social adjustment at ages seven and eleven British Medical Journal 309 699-703 Louise.M.Howard, R.Kumar, Graham Thornicroft et al(2001) Psychosocial Characteristics and needs of mothers with psychotic disorders; British Journal of Psychiatry 178 427-432 Stephen.M.Lawrie, Majella Byrne, Patrick Miller et al (2001) Neurodevelopmental indices and the development of psychiatric symptoms in subjects at risk of schizophrenia; British Journal of Psychiatry 178 524- 530 Contact Details: Dr.M.K.Sekar 176,Soho Hill Handsworth Birmingham B19 1AG Phone:0121 685 6090 Fax :0121 685 6091 |
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