Ajay Risal, Hema Tharoor Dept. of Psychiatry, KMC, Manipal KANCIPS-08 BIRTH ORDER AND...
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Transcript of Ajay Risal, Hema Tharoor Dept. of Psychiatry, KMC, Manipal KANCIPS-08 BIRTH ORDER AND...
Ajay Risal , Hema TharoorDept. of Psychiatry , KMC , Manipal
KANCIPS-08
BIRTH ORDER AND PSYCHOPATHOLOGY
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)
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)
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”
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
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
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
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
RESULTS:
Table 1:Age of onset of mental illnessGroups Age of onset (Mean +/-SD)
Group I (N=527) 33.01 (+/- 15.073)
Group II (N=47) 11.68 (+/- 4.764)
Group III (N=110) 26.74 (+/- 7.529)
RESULTS:GROUP I (N=527)Table 2: Distribution of birth order & diagnosis
Birth order 1 2 3 4 5 6 6+ Last
Diagnosis n (%) n (%) n (%) n (%) n (%) n (%) n (%) n (%)
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)
SomatoformDisorder
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)
RESULTS:
Table 3: Distribution of birth order and diagnosisGROUP II (N=47) GROUP III (N=110)
Birth order
Diagnosis n (%) Birth order
Diagnosis n (%)
1 Dissociation 8 (36.4) 2 Alcohol dependence
12 (66.7)
Last ADHD 4 (26.7) Last Comorbid mental illness
9 (28.1)
RESULTS: Table 4: Distribution of diagnosis and birth order
between gendersGroup Male (n=402) Female (n=282)
Birth order
Diagnosis (%) Birth order
Diagnosis (%)
I 4 Depression (53.3) 6 Depression (72.7)
II 1 Dissociative Disorder (26.7)
1 Dissociative Disorder (57.1)
III 2 Alcohol Dependence (70.6)
2 Cannabis Dependence (100)
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 1 0.452 0.505
III(N=110)
17.547 1 1.509 0.222
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
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
FUTURE DIRECTIONSTrans-generational study ?
Nuclear family VS single child ?
A population based prospective study to examine birth order and development of temperament/ personality ?
THANK YOU!