AUTHOR=Pant Sofie Weber , Holstein Bjørn Evald , Ammitzbøll Janni , Skovgaard Anne Mette , Pedersen Trine Pagh 

TITLE=Community health nurses' concerns about infant regulatory problems are predictive of mental disorders diagnosed at hospital: a prospective cohort study

JOURNAL=Frontiers in Child and Adolescent Psychiatry

VOLUME=Volume 2 - 2023

YEAR=2024

URL=https://www.frontiersin.org/journals/child-and-adolescent-psychiatry/articles/10.3389/frcha.2023.1330277

DOI=10.3389/frcha.2023.1330277

ISSN=2813-4540

ABSTRACT=Introduction: Regulatory problems of eating, sleeping, and crying in infancy may index mental health vulnerability in older ages, and knowledge is needed to inform strategies to break the developmental trajectories of dysregulation in early childhood. In this study we examined the prospective associations between infant regulatory problems at age 8-10 months identified by community health nurses (CHN) and mental disorders diagnosed in hospital settings at child ages 1- 8 years. Methods: From a cohort of all newborn children in 15 municipalities in the Capital Region of Copenhagen (N=43,922) we included all children who have been examined by CHNs at the scheduled home visit at age 8-10 months (N=36,338). Outcome measures were ICD-10 mental disorders diagnosed at public hospitals and reported to the National Patient Register. Logistic regression included data on child and family co-variables obtained from population registers. Results: The CHNs reported concerns regarding sleep in 7.7 %, feeding and eating in 19.1 %, combined sleeping and eating problems in 3.6%, and incessant crying in 0.7 %. A total of 1,439 children (4 % of the study population) was diagnosed in hospital settings with an ICD-10 mental disorder between age 11 months and 8 years. Analyses adjusted for a range of perinatal and family adversities showed an increased risk of any neuro-developmental disorder among children with CHN concerns of feeding and eating, Odds Ratio, OR, 1.36 (1.14-1.63) and co-occurrent problems of feeding and eating and sleep, OR 1.60 (1.14-2.26). For autism-spectrum disorders, an increased risk was seen among children with co-occurrent problems of both feeding and eating and sleep, OR 1.73 (1.07-2.79). Concern about feeding and eating was also associated with an increased risk of behavioral and emotional disorders, OR 1.27 (1.03 -1.56). Concern about incessant crying at age 8-10 months was not associated with a diagnosed mental disorder, but findings may reflect low statistical power due to low frequency of concern. Discussion: CHN concerns mirror a group of developmentally vulnerable children. Further research is needed to explore the possibilities of preventive intervention within the general child health surveillance to address the developmental psychopathology of dysregulation in early ages.