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

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Presentation on theme: "Ajay Risal, Hema Tharoor Dept. of Psychiatry, KMC, Manipal KANCIPS-08 BIRTH ORDER AND PSYCHOPATHOLOGY."— Presentation transcript:

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

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 1 st Jan07-31 st June07 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 GroupsAge of onset (Mean +/-SD) Group I (N=527)33.01 (+/ ) Group II (N=47)11.68 (+/ ) Group III (N=110)26.74 (+/ )

10 RESULTS:GROUP I (N=527) Table 2: Distribution of birth order & diagnosis Birth order Last Diagnosisn (%) Depression * 33 (24) 24 (27.6) 18 (27.3) 14 (37.8) 9 (39.1) 9 (60) 5 (27.8) 32 (26) Anxiety Disorder 24 (17.5) 9 (10.3) 11 (16.7) 5 (13.5) 3 (13) 2 (13.3) 2 (11.1) 17 (13.8) Somatoform Disorder 16 (11.7) -11 (16.7) 5 (13.5) 5 (21.7) 1 (6.7) 2 (11.1) 14 (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 Diagnosisn (%)Birth order Diagnosisn (%) 1Dissociation8 (36.4)2Alcohol dependence 12 (66.7) LastADHD4 (26.7)LastComorbid mental illness 9 (28.1)

12 RESULTS: Table 4: Distribution of diagnosis and birth order between genders GroupMale (n=402)Female (n=282) Birth order Diagnosis (%) Birth order Diagnosis (%) I 4Depression (53.3)6Depression (72.7) II 1 Dissociative Disorder (26.7) 1 Dissociative Disorder (57.1) III2Alcohol Dependence (70.6) 2Cannabis Dependence (100)

13 RESULTS: Table 5: Effect of Birth Order on Psychopathology GroupsMean squaredfFSignificance I(N=527) O.212 II(N=47) III(N=110)

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 ?


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