Hospitalization in the first years of life and development of psychiatric disorders at age 6 and 11: a birth cohort study in Brazil

Abstract

This study aimed to evaluate the medium-term effects that hospitalization in the first 48 months of life has on the development of psychiatric disorders at 6 and 11 years of age among individuals in a birth cohort in a middle-income country. We analyzed data from a 2004 birth cohort (N = 4,231) in the city of Pelotas, Rio Grande do Sul State, Brazil. The frequency of hospitalization was investigated at 12, 24 and 48 months of life. When the children were 6 and 11 years old, psychiatric disorders were investigated with the Development and Well-Being Assessment. We used logistic regression to adjust for potential confounders. The overall frequency of hospitalization during the first 48 months of life was 33.1% (95%CI: 31.4; 34.7). Among the hospitalized children 25.6% (95%CI: 24.1; 27.1), 4.7% (95%CI: 4.0; 5.5) and 2.8% (95%CI: 2.3; 3.5) were hospitalized 1, 2 or ≥ 3 times during this period, respectively. After adjustment for potential confounders, the chance of presenting any psychiatric disorder at 6 and 11 years of age was higher for the children who had been hospitalized during the first 48 months of life than for those who had not, with OR of 1.50 (95%CI: 1.19; 1.88) and 1.63 (95%CI: 1.28; 2.07), respectively. Our results support the hypothesis that hospitalization in the early stages of life has an effect on the subsequent mental health of children. Preventive measures are needed in order to minimize the negative experiences of children who are hospitalized during infancy.

Perception of family members and health professionals about institutional violence against hospitalized children

“…Thus, when considering the condition of vulnerability of the child, due to the immaturity of their neurocognitive and motor systems, the experience of IV in this age group can have even more serious consequences, affecting child development. Corroborating this statement, research confirms that hospitalized children are more likely to develop psychiatric disorders in the medium and long term, such as anxiety, depression, obesity and other chronic diseases (7)(8) .…”

“…The lack of information and the loss of the child's autonomy are also strongly related to the behavior of prejudice and discrimination, which can constitute psychological violence. Psychological violence against children, despite being much tolerated by society, includes any action and omission that results in damage to the self-esteem, identity and development of the individual, since its victims remain subject to the power of adults who coerce them to exercise their interests (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16) .…”

“…For the contemporary philosopher Michel Foucault, the hospital, since its origin, has been a disciplinary place, established by the medical order, evolving towards the depersonalization of the hospitalized patient (9) . In this space, the body of individuals is considered both a target of care and an object of power (1)(2)(3)(4)(5)(6)(7)(8)(9) . The professional controls, prescribes and monitors behaviors, often through punishment, threats, screams and anger.…”

Population neuroscience: challenges and opportunities for psychiatric research in low- and middle-income countries

“…Eight studies from the 1993 Pelotas Birth Cohort were included from our search, including the following topics: genes associated with ADHD symptoms in adolescents, 39 , 40 gene-environment interaction on externalizing problems in adolescents, 41 the effects of socioeconomic changes on psychopathology in adolescents, 25 the prevalence of psychopathology in 11-year-olds, 42 the continuity of behavioral and emotional problems from childhood into pre-adolescence, 43 adverse childhood experiences and alcohol, tobacco, and drug use, 44 and determinants of attention and hyperactivity problems in adolescents. 26 Thirteen studies from the 2004 Pelotas Birth Cohort were included from our search, including the following topics: the effects of early hospitalization on psychiatric disorders in children and pre-adolescents, 45 the prevalence of psychiatric disorders in children/pre-adolescents, 28 , 29 risk factors for disruptive mood dysregulation disorder, 46 ADHD associations, 47 - 49 maternal mood disorders/symptoms and child psychopathology, 50 , 51 intrauterine exposure and emotional/hyperactivity problems, 30 breastfeeding and mental health in children, 52 gestational age at birth and behavioral problems, 53 and bed-sharing and psychiatric disorders in children. 54 …”

Percepção de familiares e profissionais de saúde sobre a violência institucional à criança hospitalizada

“…Dessa forma, ao considerar a condição de vulnerabilidade da criança, pela imaturidade dos seus sistemas neurocognitivo e motor, a vivência da VI nesta faixa etária pode acarretar consequências ainda mais graves, afetando o desenvolvimento infantil. Corroborando com esta afirmação, pesquisas confirmam que crianças hospitalizadas apresentam maior disposição para desenvolver distúrbios psiquiátricos a médio e longo prazo, como ansiedade, depressão, obesidade e outras doenças crônicas (7)(8) .…”