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Biomedical subjects

M H Boyle

Publications and source records attributed to M H Boyle.

At least 73 records · Page 4Linked to original sources
PubMed1989

Ontario Child Health Study: correlates of disorder.

Data from the Ontario Child Health Study were used to examine the prevalence and selected correlates of conduct disorder, hyperactivity, emotional disorder, and somatization in children 4 to 16 years of age by informant (parent and teacher for children 4 to 11, and parent and youth for children 12 to 16). The results indicate that the prevalence and pattern of correlates of the individual disorders differ in important ways by informant. This suggests that we need to understand the factors that influence assessments provided by informants from different contexts (e.g., parents and teachers) before combining information from them to arrive at singular classifications.

Adolescent↗
PubMed1989

The prevalence of emotional disorder in children.

This report presents data from the Ontario Child Health Study on the prevalence of individual emotional symptoms, the variation of prevalence rates of emotional disorders as a function of demographic factors, and the rates of service utilization for children with these disorders. To survey Ontario children from 4 to 16 years of age, a stratified random sample of 3,294 children was drawn from all household dwellings listed in the 1981 Census. The prevalence rates for emotional disorders in male and female children aged 4 to 11 years were 10.1% and 10.7%, respectively. For adolescents aged 12 to 16 years, the prevalence rate rose to 13.7% for females and fell to 5.0% for males. Children with emotional disorders were frequently found to meet criteria for more than one disorder. Only one in five children with emotional disorders had received mental health or social services in the 6 months prior to the survey.

Adolescent↗
PubMed1989

Correlates, associated impairments and patterns of service utilization of children with attention deficit disorder: findings from the Ontario Child Health Study.

The objective of this paper is to report on the correlates of attention deficit disorder with hyperactivity (ADDH), the associated impairments of ADDH children, and to describe briefly their utilization of services. Our results suggest that household, family, parental, and developmental variables are associated with this disorder. However, child-centered, rather than psychosocial, variables emerge as important if one controls for the presence of other disorders. Compared to children without any disorder, ADDH children are also impaired in their relationships with others, their school performance, and competence in extra-curricular activities. ADDH children utilized mental health, social, and special education services more than non-ADDH children. Nevertheless, it was found that only a minority of ADDH children had received specialized mental health or social services in the past 6 months.

Achievement↗
PubMed1989

Ontario Child Health Study: prevalence of attention deficit disorder with hyperactivity.

The objective of this paper is to present data from the Ontario Child Health Study on the prevalence of attention deficit disorder with hyperactivity (ADDH). The overall prevalence of ADDH was 9.0% in boys and 3.3% in girls. There were no significant differences in the prevalence of ADDH by age or urban-rural status, but the disorder was significantly more common in boys than in girls. The prevalence of various subtypes of ADDH was also explored: attention deficit with and without hyperactivity, situational vs pervasive ADDH, and ADDH with and without other disorders. The clinical implications of these findings are discussed.

Adolescent↗
PubMed1989

Methodologic note for child epidemiological surveys: the effects of instructions on estimates of behavior prevalence.

This paper examines the effects of a change in the wording of the Child Behavior Checklist (CBCL) instructions for the 0 category on the reported prevalence of behaviors among normal children by their parents. Convenience samples of parents were randomly allocated to complete CBCL items using either the standard instructions "not true" or "never or not true" to describe the 0 category. Adding the word "never" to describe the 0 category decreased parents' use of that category and increased their use of the adjacent, 1, category. Implications of these findings are discussed.

Adolescent↗
PubMed1989

Immigrant children: psychiatric disorder, school performance, and service utilization.

Data from the Ontario Child Health Study were used to examine the strength of association between child immigrant status and child psychiatric disorder, poor school performance, and use of mental health/social services. Bivariate results indicate that immigrant children are not at increased risk for psychiatric disorder or poor school performance and that they use mental health and social services significantly less often than do their nonimmigrant peers. Implications of the findings are explored.

Acculturation↗
PubMed1989

Ontario Child Health Study. Summary of selected results.

Selected results from the Ontario Child Health Study (OCHS), a cross-sectional community survey of Ontario children four to 16 years of age, are presented in the areas of prevalence, risk indicators and service utilization. The six month prevalence of one or more of four psychiatric disorders (conduct disorder, hyperactivity, emotional disorder, and somatization), in children four to 16 years of age, in Ontario was 18.1%. The highest rate was in 12 to 16 year old girls, and the lowest rate in four to 11 year old girls. Co-morbidity among these four disorders was high while the proportion of disorders identified by more than one respondent was low. Psychiatric disorders co-occurred significantly with other morbidities in children, including poor school performance, chronic health problems, substance use and suicidal behaviour. Chronic medical illness in the child as well as single parent status, living in a family on social assistance and residing in subsidized housing, were all strong indicators of increased rates of psychiatric disorders in children. Specialized mental health/social services, over a six month period, reached fewer than one of five children with psychiatric disorders, as measured in the study. In contrast, ambulatory medical care (primarily visits to family doctors and pediatricians) served almost 60% of Ontario children four to 16 years old, over the same six month period. The results are compared with those in the literature.

Adolescent↗
PubMed1989

Prevalence of childhood and adolescent depression in the community. Ontario Child Health Study.

Data from a cross-sectional community survey of 2852 children were used to provide estimates of the prevalence of a 'DSM-III-like' major depressive syndrome in children aged 6 to 16. The severity of symptoms required to define a 'case' was varied to generate three levels of diagnostic certainty (DC). The overall estimates of prevalence made with high DC were 0.6% for pre-adolescents and 1.8% for adolescents. Corresponding rates determined with medium DC were 2.7% and 7.8%, whereas the figures for low DC were 17.5% and 43.9%. Utilisation of mental health and social services, comorbidity (combined disorders), poor school performance, problems in getting along with others and need for professional help all increased as diagnostic certainty increased. There was wide disagreement in data supplied by the different groups of respondents, i.e. parents, teachers and adolescents.

Adolescent↗
PubMed1988

Ontario Child Health Study: reliability and validity of the general functioning subscale of the McMaster Family Assessment Device.

The reliability and validity of the 12-item General Functioning (GF) subscale of the McMaster Family Assessment Device (FAD) is reported here. Psychometric properties of the FAD have been previously determined, but no independent assessment has been made of the GF subscale, which was used to measure family functioning in the Ontario Child Health Study (OCHS). Reliability was measured by Chronbach's alpha and split-half correlation. Validity was assessed by hypothesizing the relationships expected between the GF scores and other family variables included in the OCHS data set. The results indicate good reliability, and all hypotheses of validity were supported. The brevity and ease of administering the GF subscale recommend it for further use in survey research in which a global assessment of family functioning is required.

Adolescent↗
PubMed1988

Ontario Child Health Study: suicidal behavior in youth age 12-16 years.

The authors report on the prevalence and correlates of suicidal behavior in youth age 12-16 years. The data, from a community prevalence survey, show that 5%-10% of the male and 10%-20% of the female youth reported suicidal behavior within a 6-month period. Suicidal behavior in youth appeared to be related to psychiatric disorder in general as well as to family dysfunction and parental arrest.

Adolescent↗
PubMed1988

Ontario Child Health Study: patterns of ambulatory medical care utilization and their correlates.

Data from a large epidemiologic survey of Ontario children 4 to 16 years of age are presented concerning the frequency and correlates the use of ambulatory medical care services during a 6-month period in which a universal, first-dollar health insurance plan was used. Patterns of use of ambulatory medical care are described for three settings: doctor's offices, emergency rooms, and hospital outpatient departments. A group of children who are frequent users of ambulatory medical care (defined as using three or more services in 6 months) consumed nearly two thirds of all services. Two regression equations are presented--one predicting use/nonuse of ambulatory medical care and the other predicting the total number of visits for medical care. Although only a small proportion of the variance in use/nonuse and amount of use was explained, the major determinant of both ambulatory medical care use and frequency of use was the child's physical health status as perceived by the parent. Younger child, urban area of residence, the number of chronic medical problems of the child, and higher level of maternal education also contributed to the explanation of use v nonuse. Among ambulatory medical care users, high users were more likely to be described as having mental health problems and have parents who had been treated for "nerves." Family size and socioeconomic variables were not important factors in use, suggesting that universal health insurance reduces some barriers to ambulatory medical care for children.

Adolescent↗
PubMed1987

Ontario Child Health Study. I. Methodology.

We developed the methodology for a community survey to determine the prevalence of emotional and behavioral disorders among children 4 to 16 years of age in Ontario, Canada. Our discussion includes the objectives of the survey, the measurement of disorder, sampling methods and survey design, and a description of the data collected and instrumentation. Among 2052 households with eligible children, 1869 (91%) participated in the survey. The results can be used to help plan the future allocation of mental health resources in Ontario.

Adolescent↗
PubMed1987

Ontario Child Health Study. II. Six-month prevalence of disorder and rates of service utilization.

We studied the six-month prevalence of four child psychiatric disorders (conduct disorder, hyperactivity, emotional disorder, and somatization) and patterns of service utilization for mental health and social services, ambulatory medical care and special education by different regions of Ontario, urban-rural residence, and age and sex groupings. Among children 4 to 16 years of age, the overall six-month prevalence rate of one or more of these disorders was 18.1%. The prevalences of hyperactivity and one or more disorders were significantly higher in urban areas than rural areas. The utilization data indicated that children with these psychiatric disorders, compared with children without these disorders, were almost four times more likely to have received mental health or social services in the six months preceding this study. However, five of six of these children had not received these specialized services in the previous six-month period. Over 50% of the children in the province had received ambulatory medical care in the last six months. Over 15% of the children in the province had received special education services at some time thus far in their school careers. Implications of these findings, especially for the provision of child mental health services, are discussed.

Adolescent↗
PubMed1987

Psychiatric disorder and poor school performance among welfare children in Ontario.

Parental welfare status was found to be a marker for identifying a group of children with an increased prevalence of psychiatric disorder and poor school performance. The marker was particularly strong for psychiatric disorder in young boys and for poor school performance in young girls. For instance, the prevalence rates of psychiatric disorder, in the 6 to 11 age group, for welfare and non-welfare boys, were 40.0% and 13.9%, respectively; and for poor school performance in welfare and non-welfare girls, 27.8% and 6.1%, respectively. The relationship between different measures of psychosocial disadvantage and these child deficits was examined. Multivariate analyses revealed, for example, that parental welfare status made an independent contribution to the prediction of psychiatric disorder and was a more powerful predictor of poor school performance in girls compared to boys. The implications of these and other results are discussed.

Adolescent↗
PubMed1986

Smoking, drinking and use of illicit drugs among adolescents in Ontario: prevalence, patterns of use and sociodemographic correlates.

Data from a cross-sectional survey of the health of Ontario children carried out in 1983 were used to provide estimates of the prevalence, patterns and sociodemographic correlates of the use of tobacco, alcohol and illicit drugs (substance use) among adolescents aged 12 to 16 years. Ninety-one percent of selected households participated. The prevalence rates of all categories of substance use, except use of inhalants, increased with increasing age. Among children aged 14 to 16 years the rates for girls were higher than those for boys for all categories of substance use except use of other, nondefined drugs. The prevalence rates of substance use tended to be higher in small urban areas except for use of marijuana (more prevalent in large urban areas) and use of inhalants (more prevalent in rural areas). The strongest evidence of clustering of substance use within families was found for smoking. Children who used less prevalent drugs (e.g., "hard" drugs) also tended to use the more prevalent ones (e.g., marijuana, tobacco and alcohol). Associations between substance use and low socioeconomic status suggested a positive relation with smoking and a negative relation with use of alcohol. The findings highlight the need for preventive programs aimed at specific subgroups in the adolescent population.

Adolescent↗
PubMed1986

Chronic illness and functional limitation in Ontario children: findings of the Ontario Child Health Study.

The Ontario Child Health Study (OCHS) was based on interviews of 1869 Ontario families who were selected by means of a stratified, multistaged sampling method from the 1981 census of Canada. Its primary purpose was to determine the prevalence and distribution of mental health problems in Ontario children aged 4 to 16 years and their families, but it also allowed an estimate of other significant medical conditions and provided an overview of these children's use of health care, education and social services. Our results are based on questionnaire responses concerning 3294 children. Limitation of function without a chronic illness or medical condition was reported in 1.9%, the converse in 14.0%, and a chronic illness or medical condition with limitation of function in 3.7%. When the three groups are considered together, 19.6% of Ontario children had a chronic health problem. Children of lower socioeconomic status were much more likely to have chronic health problems. Overall, children with chronic health problems were more likely to use physician, special education, social and mental health services. These findings have implications for those who provide services for children, plan community programs or train professionals in caring for children.

Activities of Daily Living↗
PubMed1986

Problems in setting up an executing large-scale psychiatric epidemiological studies.

This paper focuses on problems that can be encountered in conceptualizing, executing and writing up large-scale psychiatric epidemiological studies. It makes no attempt to cover fundamental issues of design and analysis, rather it centers on problems associated with projects of considerable size. In the conceptual area, it discusses the prerequisites to be considered before deciding to launch such a study. It notes the administrative and scientific uses of epidemiological studies and considers the strengths and weaknesses of large-scale studies to address those concerns. Issues in carrying out such studies are discussed including decisions about study design, sampling method and instrumentation. All are dependent on the central purpose of the study but trade-offs between feasibility and scientific rigor are always present. Data collection and analysis problems highlighted in large-scale studies are examined. They include the difficulty, in the former, of adequately motivating and supervising field personnel and, in the latter, of dealing with problems that accompany missing data and complicated sampling strategies. Potential problems in data access and use and writing up the results are seen as arising from the presence of a large investigative team with diverse interests. Lastly, the comparative worth of these studies is considered.

Data Collection↗