Objective: To determine the mean duration of fussing and crying and prevalence of colic using modified Wessel criteria in infants in the first 3 months of life. Is there a universal 6 week crying peak and what is the prevalence of colic according to age and country?Study Design: A systematic literature search was performed using the databases Medline, PsycINFO and Embase. The major outcome measure was mean total fuss/cry duration during 24 hours at 1-2 weeks (11 samples), 3-4 weeks (6 samples); 5-6 weeks (28 samples), 8-9 weeks (9 samples) and 10-12 weeks (12 samples). Results:Of 5687 articles reviewed, 28 diary studies (33 samples) were suitable for inclusion in meta-analysis. The studies included 8690 infants. No statistical evidence for a universal crying peak at 6 weeks across studies was found. Rather, the mean fuss/cry duration across studies was stable at around 117-133 minutes (SDs: 66-70) in the first 6 weeks and dropped to a mean of around 68 minutes (SD: 46.2) by 10-12 weeks. Colic was much more frequent in the first 6 weeks (17-25%) than thereafter (11% by 8-9 weeks and 0.6% by 10-12 weeks) according to modified Wessel criteria and lowest in Denmark and Japan.Conclusions: Fuss/cry duration drops significantly after 8-9 weeks of age with colic as defined by modified Wessel criteria being rare in infants older than 9 weeks. Colic or excessive fuss/cry may be more accurately identified by defining fuss/cry above the 90 th percentile in the chart provided based on the review.
BackgroundPersonality disorders are now internationally recognised as a mental health priority. Nevertheless, there are no systematic reviews examining the global prevalence of personality disorders.AimsTo calculate the worldwide prevalence of personality disorders and examine whether rates vary between high-income countries and low- and middle-income countries (LMICs).MethodWe systematically searched PsycINFO, MEDLINE, EMBASE and PubMed from January 1980 to May 2018 to identify articles reporting personality disorder prevalence rates in community populations (PROSPERO registration number: CRD42017065094).ResultsA total of 46 studies (from 21 different countries spanning 6 continents) satisfied inclusion criteria. The worldwide pooled prevalence of any personality disorder was 7.8% (95% CI 6.1–9.5). Rates were greater in high-income countries (9.6%, 95% CI 7.9–11.3%) compared with LMICs (4.3%, 95% CI 2.6–6.1%). In univariate meta-regressions, significant heterogeneity was partly attributable to study design (two-stage v. one-stage assessment), county income (high-income countries v. LMICs) and interview administration (clinician v. trained graduate). In multiple meta-regression analysis, study design remained a significant predictor of heterogeneity. Global rates of cluster A, B and C personality disorders were 3.8% (95% CI 3.2, 4.4%), 2.8% (1.6, 3.7%) and 5.0% (4.2, 5.9%).ConclusionsPersonality disorders are prevalent globally. Nevertheless, pooled prevalence rates should be interpreted with caution due to high levels of heterogeneity. More large-scale studies with standardised methodologies are now needed to increase our understanding of population needs and regional variations.
BACKGROUND AND OBJECTIVES: Preterm birth is a significant stressor for parents and may adversely impact maternal parenting behavior. However, findings have been inconsistent. The objective of this meta-analysis was to determine whether mothers of preterm children behave differently (eg, less responsive or sensitive) in their interactions with their children after they are discharged from the hospital than mothers of term children.
PT/LBW is associated with lower educational qualifications, decreased rate of employment, and an increased rate of receipt of social benefits in adulthood. Low educational qualifications were most prevalent in those born very preterm and consistent across geographic regions. However, the findings are less clear for independent living.
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