Browsing by Subject "out-of-home placement"

Objective. Based on previous studies, foster care adolescents placed due to behavioral problems have an elevated risk to psychosis. In this large register based longitudinal study we aimed to investigate the prevalence of psychosis among Finnish reform school adolescents compared to matched peers in general population. We also intended to assess the possible differences in psychosis liability among five cohorts of reform school adolescents and examined the possible correlation between instability of out-of-home placements or the age at the time of first out-of-home placement with later psychosis. It was hypothesized that reform school adolescents had greater risk for psychosis, the number of adolescents with psychosis in reform schools was increasing and that instability of placements and early age at the time of fist out-of-home placement would be associated with an elevated risk for psychosis. Methods. The subjects (N=1159, M/F=749/410) were chosen from the Finnish welfare registry by status "placement in reform school" the last day of the years 1991, 1996, 2001, 2006 or (/and?) 2011. A control group (N=5676) matched on age, gender and place of birth was obtained from the Population Register Centre, Finland. The information about child's involvement in child welfare services and out-of-home placements was collected from the Finnish welfare register, and the data from schizophrenia spectrum disorders was collected from the Finnish hospital discharge register. Results. Prevalence of psychosis among reform adolescents was 7.1%, which was significantly higher than among general population controls (0.8%) (χ² = 205.550, df =1, P<.000). After controlling for gender and cohort, reform school adolescents had a 9.44 fold risk for psychosis compared to controls (OR=9.440, p<.000). There was no difference in psychosis liability between the five study cohorts after controlling for the difference in cohorts' follow-up times. The instability of out-of-home placements and the age at the time of first out-of-home placement were not associated with an elevated risk to psychosis. Conclusions. Results of this study show clearly that psychosis is a common problem among reform school adolescents, and indicates that reform school adolescents are a population, where the identification of early psychosis should be readily and reliable accessible. Only by recognizing early psychotic symptoms it is possible to offer intervention procedures, which in turn might prevent psychosis from becoming a chronic illness, decrease other mental health and substance abuse problems and thus enhance the overall functioning and quality of life of reform school adolescents.