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BIRTH ORDER AND PSYCHOPATHOLOGY

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Presentation on theme: "BIRTH ORDER AND PSYCHOPATHOLOGY"— Presentation transcript:

1 BIRTH ORDER AND PSYCHOPATHOLOGY
Ajay Risal , Hema Tharoor Dept. of Psychiatry , KMC , Manipal KANCIPS-08

2 BACKGROUND The ordinal position a child holds within the sibling ranking predicts intellectual functioning, personality & behaviour The subject of extensive research: Alcohol abuse (Conley,1980) Infantile Autism (Tsai & Stewart ,1983) Delinquency (Calhoun,1984)

3 COHORT STUDIES A cohort of New Zealand children: Significantly more girls, first borns &children from small families had DSM-III disorders (Michael Feehan et al, 1994) Northern Finland 1966 Birth Cohort: Specific birth order status is an independent risk factor for schizophrenia (Bender KG,2001)

4 AIM “To examine the association between birth order & development of psychopathology among the patients attending in-patient or out-patient psychiatry services in Kasturba Hospital, Manipal”

5 MATERIALS AND METHODS I. Methodology:
Institutional Ethics Committee clearance was taken Retrospective file review of patients admitted in psychiatry ward or evaluated in psychiatry OPD between 1st Jan’07-31st June’07 was done

6 II. Sample size: 684 patients, divided in three groups : Group I(Adult general psychiatry)- 527 Group II (Childhood mental illness)- 47 Group III (Substance use disorders)- 110

7 III. Procedure : Detailed review of patient related variables such as age of onset of illness, order of birth, family type, family history of mental illness and psychiatry diagnosis (ICD-10) generated were studied and compared

8 IV. Statistical analysis:
SPSS software package (Version 13, SPSS Inc., Chicago , USA) was used to analyze the data Descriptive statistics and One way ANOVA was used to evaluate the effect of birth order on psychopathology

9 RESULTS: Table 1:Age of onset of mental illness Groups
Age of onset (Mean +/-SD) Group I (N=527) 33.01 (+/ ) Group II (N=47) (+/ ) Group III (N=110) (+/ )

10 RESULTS:GROUP I (N=527) Table 2: Distribution of birth order & diagnosis Birth order 1 2 3 4 5 6 6+ Last Diagnosis n (%) Depression * 33 (24) 24 (27.6) 18 (27.3) 14 (37.8) 9 (39.1) (60) (27.8) 32 (26) Anxiety Disorder (17.5) (10.3) 11 (16.7) (13.5) (13) 2 (13.3) (11.1) 17 (13.8) Somatoform Disorder 16 (11.7) - 5 (21.7) (6.7) (11.4) *Birth order & depression (p-value<0.001)

11 RESULTS: Table 3: Distribution of birth order and diagnosis
GROUP II (N=47) GROUP III (N=110) Birth order Diagnosis n (%) 1 Dissociation 8 (36.4) 2 Alcohol dependence 12 (66.7) Last ADHD 4 (26.7) Comorbid mental illness 9 (28.1)

12 RESULTS: Table 4: Distribution of diagnosis and birth order between genders Group Male (n=402) Female (n=282) Birth order Diagnosis (%) Diagnosis (%) I 4 Depression (53.3) 6 Depression (72.7) II 1 Dissociative Disorder (26.7) Disorder (57.1) III 2 Alcohol Dependence (70.6) Cannabis Dependence (100)

13 RESULTS: Table 5: Effect of Birth Order on Psychopathology Groups
Mean square df F Significance I(N=527) 20.151 1 1.564 O.212 II(N=47) 8.167 0.452 0.505 III(N=110) 17.547 1.509 0.222

14 SUMMARY Adults: All birth orders had depression as the most common diagnosis A within group analysis of birth order and depression was statistically significant (p <0.001) Substance abuse: Comorbid mental illness was maximum among the last born

15 SUMMARY (CONTD….) Children: Dissociative disorder was more predominant in the first born Gender: Birth order (4) in males and (6) in females had a maximum risk for depression

16 FUTURE DIRECTIONS Trans-generational study ?
Nuclear family VS single child ? A population based prospective study to examine birth order and development of temperament/ personality ?

17 THANK YOU!


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