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Child mental health and maternal depression history in Pakistan

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Abstract

Purpose

We address the significant gaps in knowledge of prevalence and correlates of child mental health (CMH) problems outside of high income countries. We describe the prevalence of CMH problems and their correlates with a focus on the association with maternal depression in a sample of seven-year-old children in rural Pakistan.

Methods

This study was nested in a long-term follow-up of a perinatal depression intervention together with a reference group of non-depressed women, yielding a population representative sample. The Total Difficulties (TD) and component scores of the Strength and Difficulties Questionnaire (SDQ) were used to measure emotional and behavioral difficulties.

Results

The mean SDQ TD score was 10.6 (standard deviation = 8.3), with 12.5 % of children categorized as “abnormal” using standard cutoffs. Boys had a roughly 1 point higher (worse) SDQ TD score than girls (p value = 0.04). Children of mothers who were depressed prenatally as well as currently had SDQ TD scores 2.87 points higher than children whose mothers were not depressed at either time point (p value < 0.01). This association was stronger for boys. There was no evidence of elevated SDQ TD score among children whose mothers were depressed only prenatally or only currently. Some deviations from this pattern were observed with specific components of the SDQ.

Conclusions

In this low resource, South Asian setting, we found evidence of elevated levels of emotional and behavioral problems, highlighting the need for effective interventions. Given the strong association of CMH with maternal depression, any intervention efforts should give strong consideration to maternal mental health.

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References

  1. Prince M, Patel V, Saxena S, Maj M, Maselko J, Phillips MR, Rahman A (2007) Global mental health 1—no health without mental health. Lancet 370(9590):859–877

    Article  PubMed  Google Scholar 

  2. Kieling C, Baker-Henningham H, Belfer M, Conti G, Ertem I, Omigbodun O, Rohde LA, Srinath S, Ulkuer N, Rahman A (2011) Global Mental Health 2 Child and adolescent mental health worldwide: evidence for action. Lancet 378(9801):1515–1525. doi:10.1016/s0140-6736(11)60827-1

    Article  PubMed  Google Scholar 

  3. Srinath S, Kandasamy P, Golhar TS (2010) Epidemiology of child and adolescent mental health disorders in Asia. Current Opinion in Psychiatry 23(4):330–336. doi:10.1097/YCO.0b013e32833aa0c1

    Article  PubMed  Google Scholar 

  4. Srinath S, Girimaji SC, Gururaj G, Seshadri S, Subbakrishna DK, Bhola P, Kumar N (2005) Epidemiological study of child & adolescent psychiatric disorders in urban & rural areas of Bangalore, India. Indian J Med Res 122(1):67–79

    PubMed  Google Scholar 

  5. Patel V, Flisher AJ, Hetrick S, McGorry P (2007) Mental health of young people: a global public-health challenge. Lancet 369(9569):1302–1313

    Article  PubMed  Google Scholar 

  6. Ban L, Gibson JE, West J, Tata LJ (2010) Association between perinatal depression in mothers and the risk of childhood infections in offspring: a population-based cohort study. Bmc Public Health. doi:10.1186/1471-2458-10-799

    PubMed Central  PubMed  Google Scholar 

  7. UNICEF (2012) South Asia. http://www.unicef.org/infobycountry/southasia.html. Accessed September 19, 2014 2014

  8. Patel V, Flisher AJ, Nikapota A, Malhotra S (2008) Promoting child and adolescent mental health in low and middle income countries. J Child Psychol Psychiatry 49(3):313–334. doi:10.1111/j.1469-7610.2007.01824.x

    Article  PubMed  Google Scholar 

  9. Baxter AJ, Patton G, Scott KM, Degenhardt L, Whiteford HA (2013) Global epidemiology of mental disorders: what are we missing? PLoS One. doi:10.1371/journal.pone.0065514

    Google Scholar 

  10. Sarkar S, Sinha VK, Praharaj SK (2012) Depressive disorders in school children of suburban India: an epidemiological study. Soc Psychiatry Psychiatr Epidemiol 47(5):783–788. doi:10.1007/s00127-011-0383-7

    Article  PubMed  Google Scholar 

  11. Malhotra S, Kohli A, Arun P (2002) Prevalence of psychiatric disorders in school children in Chandigarh, India. Indian J Med Res 116:21–28

    PubMed  Google Scholar 

  12. Catani C, Jacob N, Schauer E, Kohila M, Neuner F (2008) Family violence, war, and natural disasters: a study of the effect of extreme stress on children’s mental health in Sri Lanka. BMC Psychiatry 8:33. doi:10.1186/1471-244x-8-33

    Article  PubMed Central  PubMed  Google Scholar 

  13. John PB, Russell S, Russell PS (2007) The prevalence of posttraumatic stress disorder among children and adolescents affected by tsunami disaster in Tamil Nadu. Disaster management & response: DMR: an official publication of the Emergency Nurses Association 5(1):3–7. doi:10.1016/j.dmr.2006.11.001

    Google Scholar 

  14. Bele SD, Bodhare TN, Valsangkar S, Saraf A (2013) An epidemiological study of emotional and behavioral disorders among children in an urban slum. Psychol Health Med 18(2):223–232. doi:10.1080/13548506.2012.701751

    Article  PubMed  Google Scholar 

  15. Chiu YN, Gau SS, Tsai WC, Soong WT, Shang CY (2009) Demographic and perinatal factors for behavioral problems among children aged 4-9 in Taiwan. Psychiatry Clin Neurosci 63(4):569–576. doi:10.1111/j.1440-1819.2009.01979.x

    Article  PubMed  Google Scholar 

  16. Parsons CE, Young KS, Rochat TJ, Kringelbach ML, Stein A (2012) Postnatal depression and its effects on child development: a review of evidence from low- and middle-income countries. Br Med Bull 101(1):57–79. doi:10.1093/bmb/ldr047

    Article  PubMed  Google Scholar 

  17. Stein A, Pearson RM, Goodman SH, Rapa E, Rahman A, McCallum M, Howard LM, Pariante CM (2014) Effects of perinatal mental disorders on the fetus and child. Lancet 384(9956):1800–1819

    Article  PubMed  Google Scholar 

  18. Walker SP, Wachs TD, Gardner JM, Lozoff B, Wasserman GA, Pollitt E, Carter JA, Int Child Dev Steering G (2007) Child development in developing countries 2—Child development: risk factors for adverse outcomes in developing countries. Lancet 369 (9556):145–157

  19. Patel V, Rodrigues M, DeSouza N (2002) Gender, poverty, and postnatal depression: a study of mothers in Goa, India. vol 159. First published. doi:10.1176/appi.ajp.159.1.43

  20. Murray L, Cooper PJ (1997) Effects of postnatal depression on infant development. Arch Dis Child 77(2):99–101

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  21. Hussain MFA, Nauman F Maternal mental distress: a risk factor for infant under nutrition in developing countries. J Pak Med Assoc 60 (4):329–329

  22. Affonso DD, De AK, Horowitz JA, Mayberry LJ (2000) An international study exploring levels of postpartum depressive symptomatology. J Psychosomat Res 49(3):207–216

    Article  CAS  Google Scholar 

  23. Goodman SH, Rouse MH, Connell AM, Broth MR, Hall CM, Heyward D (2011) Maternal depression and child psychopathology: a meta-analytic review. Clin Child Fam Psychol Rev 14(1):1–27. doi:10.1007/s10567-010-0080-1

    Article  PubMed  Google Scholar 

  24. Campbell SB, Morgan-Lopez AA, Cox MJ, McLoyd VC, Natl Inst Child Hlth Human Dev E (2009) A latent class analysis of maternal depressive symptoms over 12 years and offspring adjustment in adolescence. J Abnorm Psychol 118 (3):479–493. doi:10.1037/a0015923

  25. Dawson G, Ashman SB, Panagiotides H, Hessl D, Self J, Yamada E, Embry L (2003) Preschool outcomes of children of depressed mothers: role of maternal behavior, contextual risk, and children’s brain activity. Child Dev 74(4):1158–1175

    Article  PubMed  Google Scholar 

  26. Almond P (2009) Postnatal depression: a global public health perspective. Perspect Public Health 129(5):221–227

    Article  PubMed  Google Scholar 

  27. Rahman A, Patel V, Maselko J, Kirkwood B (2008) The neglected ‘m’ in MCH programmes—why mental health of mothers is important for child nutrition. Trop Med Int Health 13(4):579–583. doi:10.1111/j.1365-3156.2008.02036.x

    Article  PubMed  Google Scholar 

  28. Khairkar P, Pathak C, Lakhkar B, Sarode R, Vagha J, Jagzape T, Damke S, Saoji N (2013) A 5-year hospital prevalence of child and adolescent psychiatric disorders from Central India. Indian J Pediatr 80(10):826–831. doi:10.1007/s12098-013-1120-x

    Article  PubMed  Google Scholar 

  29. Pillai A, Patel V, Cardozo P, Goodman R, Weiss HA, Andrew G (2008) Non-traditional lifestyles and prevalence of mental disorders in adolescents in Goa, India. Br J Psychiatry 192(1):45–51. doi:10.1192/bjp.bp.106.034223

    Article  PubMed  Google Scholar 

  30. Samarakkody D, Fernando D, McClure R, Perera H, De Silva H (2012) Prevalence of externalizing behavior problems in Sri Lankan preschool children: birth, childhood, and sociodemographic risk factors. Soc Psychiatry Psychiatr Epidemiol 47(5):757–762. doi:10.1007/s00127-011-0377-5

    Article  PubMed  Google Scholar 

  31. Khan NZ, Ferdous S, Islam R, Sultana A, Durkin M, McConachie H (2009) Behaviour problems in young children in rural Bangladesh. J Trop Pediatr 55(3):177–182. doi:10.1093/tropej/fmn108

    Article  PubMed  Google Scholar 

  32. Mullick MSI, Goodman R (2005) The prevalence of psychiatric disorders among 5–10 year olds in rural, urban and slum areas in Bangladesh. Soc Psychiatry Psychiatr Epidemiol 40(8):663–671. doi:10.1007/s00127-005-0939-5

    Article  PubMed  Google Scholar 

  33. Hossain MD, Ahmed HU, Chowdhury WA, Niessen LW, Alam DS (2014) Mental disorders in Bangladesh: a systematic review. BMC Psychiatry. doi:10.1186/s12888-014-0216-9

    PubMed Central  PubMed  Google Scholar 

  34. Syed EU, Hussein SA, Mahmud S (2007) Screening for emotional and behavioural problems amongst 5-11-year-old school children in Karachi, Pakistan. Soc Psychiatry Psychiatr Epidemiol 42(5):421–427. doi:10.1007/s00127-007-0188-x

    Article  PubMed  Google Scholar 

  35. Syed EU, Hussein SA, Haidry SEZ (2009) Prevalence of emotional and behavioural problems among primary school children in Karachi, Pakistan—multi informant survey. Indian J Pediatr 76(6):623–627. doi:10.1007/s12098-009-0072-7

    Article  PubMed  Google Scholar 

  36. Lassi ZS, Mahmud S, Syed EU, Janjua NZ (2011) Behavioral problems among children living in orphanage facilities of Karachi, Pakistan: comparison of children in an SOS Village with those in conventional orphanages. Soc Psychiatry Psychiatr Epidemiol 46(8):787–796. doi:10.1007/s00127-010-0248-5

    Article  PubMed  Google Scholar 

  37. Imran N, Sattar A, Amjad N, Bhatti MR (2009) Psychological problems in children of parents with mental illness: a comparative study from Lahore, Pakistan. Pak J Med Sci 25(6):895–900

    Google Scholar 

  38. Rahman A, Malik A, Sikander S, Roberts C, Creed F (2008) Cognitive behaviour therapy-based intervention by community health workers for mothers with depression and their infants in rural Pakistan: a cluster-randomised controlled trial. Lancet 372(9642):902–909

    Article  PubMed Central  PubMed  Google Scholar 

  39. Maselko J, Sikander S, Bhalotra S, Bangash O, Ganga N, Mukherjee S, Egger H, Franz L, Bibi A, Liaqat R, Kanwal M, Abbasi T, Noor M, Ameen N, Rahman A (2015) Impact of an early perinatal depression intervention on longer-term child development outcomes. Lancet Psychiatry (in press)

  40. Lakes KD, Vargas D, Riggs M, Schmidt J, Baird M (2011) Parenting intervention to reduce attention and behavior difficulties in preschoolers: a CUIDAR evaluation study. J Child Fam Stud 20(5):648–659. doi:10.1007/s10826-010-9440-1

    Article  PubMed Central  PubMed  Google Scholar 

  41. Vostanis P (2006) Strengths and difficulties questionnaire: research and clinical applications. Curr Opin Psychiatry 19(4):367–372. doi:10.1097/01.yco.0000228755.72366.05

    Article  PubMed  Google Scholar 

  42. Goodman R (1997) The strengths and difficulties questionnaire: a research note. J Child Psychol Psychiatry 38(5):581–586

    Article  CAS  PubMed  Google Scholar 

  43. Syed EU (2007) Comparing the urdu version of strengths and difficulties questionnaire (SDQ) and the child behavior checklist (CBCL) in a sample of 5–11 year old school children in Karachi, Pakistan. J Pak Psychiatric Soc 4(1):15–18

    Google Scholar 

  44. Samad L, Hollis C, Prince M, Goodman R (2005) Child and adolescent psychopathology in a developing country: testing the validity of the Strengths and Difficulties Questionnaire (Urdu version). Int J Methods Psychiatric Res 14(3):158–166. doi:10.1002/mpr.3

    Article  Google Scholar 

  45. First MB, Spitzer RL, Gibbon M, Williams JB (2002) Structured clinical interview for DSM-IV-TR Axis I disorders, research version, non-patient edition. (SCID-I/NP) Biometrics Research, New York Psychiatric Institute, New York

  46. Gorman LL, O’Hara MW, Figueiredo B, Hayes S, Jacquemain F, Kammerer MH, Klier CM, Rosi S, Seneviratne G, Sutter-Dallay AL, Grp T-P (2004) Adaptation of the structured clinical interview for DSM-IV disorders for assessing depression in women during pregnancy and post-partum across countries and cultures. Br J Psychiatry 184:S17–S23. doi:10.1192/bjp.184.46.s17

    Article  Google Scholar 

  47. SDQ W (2012) SDQ Normative Data http://www.sdqinfo.org/g0.html. Youth in Mind. http://www.sdqinfo.org/g0.html. Accessed Nov 28, 2012 2012

  48. Bourdon KH, Goodman R, Rae DS, Simpson G, Koretz DS (2005) The strengths and difficulties questionnaire: US normative data and psychometric properties. J Am Acad Child Adolesc Psychiatry 44(6):557–564. doi:10.1097/01.chi.0000159157.57075.c8

    Article  PubMed  Google Scholar 

  49. Goodman A, Heiervang E, Fleitlich-Bilyk B, Alyahri A, Patel V, Mullick MSI, Slobodskaya H, dos Santos DN, Goodman R (2012) Cross-national differences in questionnaires do not necessarily reflect comparable differences in disorder prevalence. Soc Psychiatry Psychiatr Epidemiol 47(8):1321–1331. doi:10.1007/s00127-011-0440-2

    Article  PubMed Central  PubMed  Google Scholar 

  50. Niclasen J, Teasdale TW, Andersen AMN, Skovgaard AM, Elberling H, Obel C (2012) Psychometric properties of the danish strength and difficulties questionnaire: the SDQ assessed for more than 70,000 raters in four different cohorts. PLoS One. doi:10.1371/journal.pone.0032025

    PubMed Central  PubMed  Google Scholar 

  51. Shibata Y, Okada K, Fukumoto R, Nomura K (2015) Psychometric properties of the parent and teacher forms of the Japanese version of the strengths and difficulties questionnaire. Brain Dev 37(5):501–507. doi:10.1016/j.braindev.2014.08.001

    Article  PubMed  Google Scholar 

  52. Sagatun A, Lien L, Sogaard AJ, Bjertness E, Heyerdahl S (2008) Ethnic Norwegian and ethnic minority adolescents in Oslo, Norway. Soc Psychiatry Psychiatr Epidemiol 43(2):87–95. doi:10.1007/s00127-007-0275-z

    Article  PubMed  Google Scholar 

  53. Klein AM, Otto Y, Fuchs S, Reibiger I, von Klitzing K (2015) A prospective study of behavioral and emotional symptoms in preschoolers. Eur Child Adolesc Psych 24(3):291–299. doi:10.1007/s00787-014-0575-2

    Article  Google Scholar 

  54. Liu SK, Chien YL, Shang CY, Lin CH, Liu YC, Gau SSF (2013) Psychometric properties of the Chinese version of Strength and Difficulties Questionnaire. Compr Psychiat 54(6):720–730. doi:10.1016/j.comppsych.2013.01.002

    Article  PubMed  Google Scholar 

  55. Muris P, Meesters C, Eijkelenboom A, Vincken M (2004) The self-report version of the strengths and difficulties questionnaire: its psychometric properties in 8- to 13-year-old non-clinical children. Br J Clin Psychol 43:437–448. doi:10.1348/0144665042388982

    Article  PubMed  Google Scholar 

  56. Piccinelli M, Wilkinson G (2000) Gender differences in depression—Critical review. Br J Psychiatry 177:486–492

    Article  CAS  PubMed  Google Scholar 

  57. Kendler KS, Gardner CO (2014) Sex differences in the pathways to major depression: a study of opposite-sex twin pairs. Am J Psychiatry 171(4):426–435. doi:10.1176/appi.ajp.2013.13101375

    Article  PubMed Central  PubMed  Google Scholar 

  58. Cents RAM, Diamantopoulou S, Hudziak JJ, Jaddoe VWV, Hofman A, Verhulst FC, Lambregtse-van den Berg MP, Tiemeier H (2013) Trajectories of maternal depressive symptoms predict child problem behaviour: the generation R study. Psychol Med 43(1):13–25. doi:10.1017/s0033291712000657

    Article  CAS  PubMed  Google Scholar 

  59. Niclasen J, Andersen AMN, Teasdale TW, Strandberg-Larsen K (2014) Prenatal exposure to alcohol, and gender differences on child mental health at age seven years. J Epidemiol Community Health 68(3):224–232. doi:10.1136/jech-2013-202956

    Article  PubMed  Google Scholar 

  60. Fujiwara T, Kato N, Sanders MR (2011) Effectiveness of group positive parenting program (Triple P) in changing child behavior, parenting style, and parental adjustment: an intervention study in Japan. J Child Fam Stud 20(6):804–813. doi:10.1007/s10826-011-9448-1

    Article  Google Scholar 

  61. Usami M, Iwadare Y, Watanabe K, Kodaira M, Ushijima H, Tanaka T, Harada M, Tanaka H, Sasaki Y, Okamoto S, Sekine K, Saito K (2014) Prosocial behaviors during school activities among child survivors after the 2011 earthquake and tsunami in Japan: a retrospective observational study. PLoS One. doi:10.1371/journal.pone.0113709

    Google Scholar 

  62. Ashman SB, Dawson G, Panagiotides H (2008) Trajectories of maternal depression over 7 years: relations with child psychophysiology and behavior and role of contextual risks. Dev Psychopathol 20(1):55–77. doi:10.1017/s0954579408000035

    Article  PubMed  Google Scholar 

  63. Bureau JF, Easterbrooks MA, Lyons-Ruth K (2009) Maternal depressive symptoms in infancy: unique contribution to children’s depressive symptoms in childhood and adolescence? Dev Psychopathol 21(2):519–537. doi:10.1017/s0954579409000285

    Article  PubMed Central  PubMed  Google Scholar 

  64. Waters CS, Hay DF, Simmonds JR, van Goozen SHM (2014) Antenatal depression and children’s developmental outcomes: potential mechanisms and treatment options. Eur Child Adolesc Psych 23(10):957–971. doi:10.1007/s00787-014-0582-3

    Article  Google Scholar 

  65. Betts KS, Williams GM, Najman JM, Alati R (2015) The relationship between maternal depressive, anxious, and stress symptoms during pregnancy and adult offspring behavioral and emotional problems. Depress Anxiety 32(2):82–90. doi:10.1002/da.22272

    Article  PubMed  Google Scholar 

  66. Korhonen M, Luoma I, Salmelin R, Tamminen T (2014) Maternal depressive symptoms: associations with adolescents’ internalizing and externalizing problems and social competence. Nord J Psychiatr 68(5):323–332. doi:10.3109/08039488.2013.838804

    Article  Google Scholar 

  67. Rutter M (2012) Resilience as a dynamic concept. Dev Psychopathol 24(2):335–344. doi:10.1017/s0954579412000028

    Article  PubMed  Google Scholar 

  68. Van den Bergh BRH, Mulder EJH, Mennes M, Glover V (2005) Antenatal maternal anxiety and stress and the neurobehavioural development of the fetus and child: links and possible mechanisms. A review. Neurosci Biobehav Rev 29(2):237–258. doi:10.1016/j.neubiorev.2004.10.007

    Article  PubMed  Google Scholar 

  69. Van den Bergh BRH, Marcoen A (2004) High antenatal maternal anxiety is related to ADHD symptoms, externalizing problems, and anxiety in 8-and 9-year-olds. Child Dev 75(4):1085–1097. doi:10.1111/j.1467-8624.2004.00727.x

    Article  PubMed  Google Scholar 

  70. Barker ED, Jaffee SR, Uher R, Maughan B (2011) The contribution of prenatal and postnatal maternal anxiety and depression to child maladjustment. Depress Anxiety 28(8):696–702. doi:10.1002/da.20856

    Article  PubMed  Google Scholar 

  71. Davis EP, Sandman CA (2012) Prenatal psychobiological predictors of anxiety risk in preadolescent children. Psychoneuroendocrinology 37(8):1224–1233. doi:10.1016/j.psyneuen.2011.12.016

    Article  PubMed Central  PubMed  Google Scholar 

  72. Goodman A, Heiervang E, Fleitlich-Bilyk B, Alyahri A, Patel V, Mullick MS, Slobodskaya H, Dos Santos DN, Goodman R (2012) Cross-national differences in questionnaires do not necessarily reflect comparable differences in disorder prevalence. Soc Psychiatry Psychiatr Epidemiol 47(8):1321–1331. doi:10.1007/s00127-011-0440-2

    Article  PubMed Central  PubMed  Google Scholar 

  73. Maoz H, Goldstein T, Goldstein BI, Axelson DA, Fan JY, Hickey MB, Monk K, Sakolsky D, Diler RS, Brent D, Kupfer DJ, Birmaher B (2014) The effects of parental mood on reports of their children’s psychopathology. J Am Acad Child Adolesc Psychiatry 53(10):1111–1122. doi:10.1016/j.jaac.2014.07.005

    Article  PubMed Central  PubMed  Google Scholar 

  74. Boyle MH, Pickles AR (1997) Influence of maternal depressive symptoms on ratings of childhood behavior. J Abnorm Child Psychol 25(5):399–412. doi:10.1023/a:1025737124888

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

This study was supported by Grand Challenges Canada (GCC#0058-03), Government of Canada, under the Saving Brains programme. We thank Jill Ahs for her contribution to the project-planning phase, writing of the proposal, and gathering and developing methods for data collection. We are especially grateful to the study participants who gave their and their children’s time to be interviewed.

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA

    Joanna Maselko & Lauren Franz

  2. Human Development Research Foundation, Islamabad, Pakistan

    Siham Sikander & Omer Bangash

  3. University of Essex, Colchester, UK

    Sonia Bhalotra

  4. Duke Global Health Institute, Duke University, Durham, NC, USA

    Joanna Maselko, Lauren Franz, Nima Ganga, Divya Guru Rajan & Karen O’Donnell

  5. University of Liverpool, Liverpool, UK

    Atif Rahman

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  1. Joanna Maselko
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Correspondence to Joanna Maselko.

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Maselko, J., Sikander, S., Bangash, O. et al. Child mental health and maternal depression history in Pakistan. Soc Psychiatry Psychiatr Epidemiol 51, 49–62 (2016). https://doi.org/10.1007/s00127-015-1143-x

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