Skip to main content
Erschienen in: Social Psychiatry and Psychiatric Epidemiology 5/2011

01.05.2011 | Original Paper

The impact of perinatal and socioeconomic factors on mental health problems of children from a poor Brazilian city: a longitudinal study

verfasst von: Juliana D. M. Rodriguez, Antônio A. M. da Silva, Heloisa Bettiol, Marco A. Barbieri, Roberto J. Rona

Erschienen in: Social Psychiatry and Psychiatric Epidemiology | Ausgabe 5/2011

Einloggen, um Zugang zu erhalten

Abstract

Background

Low birth weight and preterm birth, and social disadvantage may negatively affect mental health of children, but findings have been inconsistent.

Objectives

To assess the influence of perinatal and social factors on mental health problems in children aged 7–9 years.

Methods

A random sample of 805 births in São Luís, Brazil was studied in 1997/1998 and again in 2005/2006. Perinatal, socioeconomic and demographic variables were assessed within 24 h after delivery. The Strengths and Difficulties Questionnaire (SDQ) was used to assess mental health problems in the children. Simple and multiple Poisson regressions were used for statistical analysis.

Results

The overall prevalence of mental health problems in the total sample was 47.7%. The prevalences of emotional and conduct problems were 58.2 and 48.8%, respectively. Only paternal age (<20 years) was associated with mental health problems as measured by the full SDQ scale (prevalence ratio PR = 1.27). Children born to single mothers (PR = 1.31) and those with birth weight from 1,500 to 2,499 g (PR = 1.18) and from 2,500 to 2,999 g (PR = 1.17) had a higher risk of emotional problems, but those from low income families had a lower risk (PR = 0.80). Children with a father of less than 20 years had a higher risk of having problems with their peers (PR = 1.75). A maternal education of 9 years or over was inversely associated with peer (PR = 0.70) and conduct problems (PR = 0.73). Girls had a lower risk of conduct (PR = 0.77) and hyperactivity problems (PR = 0.68). A maternal education of 4 years or less increased the risk of hyperactivity (PR = 1.48).

Conclusions

Socioeconomic and demographic conditions were better predictors of mental health problems in children than birth weight or preterm birth. However, since most effect sizes were small most mental health problems were, unexplained by the variables in the study.
Literatur
1.
Zurück zum Zitat Andrade SA, Santos DN, Bastos AC, Pedromonico MR, de Almeida-Filho N, Barreto ML (2005) Family environment and child’s cognitive development: an epidemiological approach. Rev Saude Publica 39:606–611PubMedCrossRef Andrade SA, Santos DN, Bastos AC, Pedromonico MR, de Almeida-Filho N, Barreto ML (2005) Family environment and child’s cognitive development: an epidemiological approach. Rev Saude Publica 39:606–611PubMedCrossRef
2.
Zurück zum Zitat Barros AJ, Hirakata VN (2003) Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio. BMC Med Res Methodol 3:21PubMedCrossRef Barros AJ, Hirakata VN (2003) Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio. BMC Med Res Methodol 3:21PubMedCrossRef
3.
Zurück zum Zitat Bhutta AT, Cleves MA, Casey PH, Cradock MM, Anand KJ (2002) Cognitive and behavioural outcomes of school-aged children who were born preterm: a meta-analysis. JAMA 288:728–737PubMedCrossRef Bhutta AT, Cleves MA, Casey PH, Cradock MM, Anand KJ (2002) Cognitive and behavioural outcomes of school-aged children who were born preterm: a meta-analysis. JAMA 288:728–737PubMedCrossRef
4.
Zurück zum Zitat Cabrera NJ, Tamis-LeMonda CS, Bradley RH, Hofferth S, Lamb ME (2000) Fatherhood in the twenty-first century. Child Dev 71:127–136PubMedCrossRef Cabrera NJ, Tamis-LeMonda CS, Bradley RH, Hofferth S, Lamb ME (2000) Fatherhood in the twenty-first century. Child Dev 71:127–136PubMedCrossRef
5.
Zurück zum Zitat Cardoso VC, Simoes VM, Barbieri MA, Silva AA, Bettiol H, Alves MT, Goldani MZ (2007) Profile of three Brazilian birth cohort studies in Ribeirao Preto, SP and São Luís, MA. Braz J Med Biol Res 40:1165–1176PubMedCrossRef Cardoso VC, Simoes VM, Barbieri MA, Silva AA, Bettiol H, Alves MT, Goldani MZ (2007) Profile of three Brazilian birth cohort studies in Ribeirao Preto, SP and São Luís, MA. Braz J Med Biol Res 40:1165–1176PubMedCrossRef
6.
Zurück zum Zitat CNDSS (2008) Relatório Final da Comissão Nacional sobre Determinantes Sociais da Saúde: As Causas Sociais das Iniqüidades em Saúde no Brasil. In: Editora Fiocruz, p 216 CNDSS (2008) Relatório Final da Comissão Nacional sobre Determinantes Sociais da Saúde: As Causas Sociais das Iniqüidades em Saúde no Brasil. In: Editora Fiocruz, p 216
7.
Zurück zum Zitat Cury CR, Golfeto JH (2003) Strengths and Difficulties Questionnaire (SDQ): a study of school children in Ribeirao Preto. Rev Bras Psiquiatr 25:139–145PubMedCrossRef Cury CR, Golfeto JH (2003) Strengths and Difficulties Questionnaire (SDQ): a study of school children in Ribeirao Preto. Rev Bras Psiquiatr 25:139–145PubMedCrossRef
8.
Zurück zum Zitat DeWolfe N, Byrne JM, Bawden HN (2000) ADHD in preschool children: parent-rated psychosocial correlates. Dev Med Child Neurol 42:825–830PubMed DeWolfe N, Byrne JM, Bawden HN (2000) ADHD in preschool children: parent-rated psychosocial correlates. Dev Med Child Neurol 42:825–830PubMed
9.
Zurück zum Zitat Elhamid AA, Howe A, Reading R (2009) Prevalence of emotional and behavioural problems among 6–12 year old children in Egypt. Soc Psychiatry Psychiatr Epidemiol 44:8–14PubMedCrossRef Elhamid AA, Howe A, Reading R (2009) Prevalence of emotional and behavioural problems among 6–12 year old children in Egypt. Soc Psychiatry Psychiatr Epidemiol 44:8–14PubMedCrossRef
10.
Zurück zum Zitat Ferriolli SH, Marturano EM, Puntel LP (2007) Family context and child mental health problems in the family health program. Rev Saude Publica 41:251–259PubMedCrossRef Ferriolli SH, Marturano EM, Puntel LP (2007) Family context and child mental health problems in the family health program. Rev Saude Publica 41:251–259PubMedCrossRef
11.
Zurück zum Zitat Fitzgerald M, Jeffers A (1994) Psychosocial factors associated with psychological problems in Irish children and their mothers. Econ Soc Rev 25:285–301 Fitzgerald M, Jeffers A (1994) Psychosocial factors associated with psychological problems in Irish children and their mothers. Econ Soc Rev 25:285–301
12.
Zurück zum Zitat Fleiss JL, Williams JB, Dubro AF (1986) The logistic regression analysis of psychiatric data. J Psychiatr Res 20:195–209PubMedCrossRef Fleiss JL, Williams JB, Dubro AF (1986) The logistic regression analysis of psychiatric data. J Psychiatr Res 20:195–209PubMedCrossRef
13.
Zurück zum Zitat Fleitlich B, Goodman R (2001) Social factors associated with child mental health problems in Brazil: cross sectional survey. BMJ 323:599–600PubMedCrossRef Fleitlich B, Goodman R (2001) Social factors associated with child mental health problems in Brazil: cross sectional survey. BMJ 323:599–600PubMedCrossRef
14.
Zurück zum Zitat Fleitlich BW, Goodman R (2000) Epidemiologia. Rev Bras Psiquiatr 22:02–06CrossRef Fleitlich BW, Goodman R (2000) Epidemiologia. Rev Bras Psiquiatr 22:02–06CrossRef
15.
Zurück zum Zitat Gale CR, Martyn CN (2004) Birth weight and later risk of depression in a national birth cohort. Br J Psychiatry 184:28–33PubMedCrossRef Gale CR, Martyn CN (2004) Birth weight and later risk of depression in a national birth cohort. Br J Psychiatry 184:28–33PubMedCrossRef
16.
Zurück zum Zitat Gilliom M, Shaw DS (2004) Codevelopment of externalizing and internalizing problems in early childhood. Dev Psychopathol 16:313–333PubMedCrossRef Gilliom M, Shaw DS (2004) Codevelopment of externalizing and internalizing problems in early childhood. Dev Psychopathol 16:313–333PubMedCrossRef
17.
Zurück zum Zitat Goldberg DP, Gater R, Sartorius N, Ustun TB, Piccinelli M, Gureje O, Rutter C (1997) The validity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychol Med 27:191–197PubMedCrossRef Goldberg DP, Gater R, Sartorius N, Ustun TB, Piccinelli M, Gureje O, Rutter C (1997) The validity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychol Med 27:191–197PubMedCrossRef
18.
Zurück zum Zitat Goodman R (2001) Psychometric properties of the Strengths and Difficulties Questionnaire. J Am Acad Child Adolesc Psychiatry 40:1337–1345PubMedCrossRef Goodman R (2001) Psychometric properties of the Strengths and Difficulties Questionnaire. J Am Acad Child Adolesc Psychiatry 40:1337–1345PubMedCrossRef
19.
Zurück zum Zitat Goodman R (1997) The Strengths and Difficulties Questionnaire: a research note. J Child Psychol Psychiatry 38:581–586PubMedCrossRef Goodman R (1997) The Strengths and Difficulties Questionnaire: a research note. J Child Psychol Psychiatry 38:581–586PubMedCrossRef
20.
Zurück zum Zitat Goodman R, Neves dos Santos D, Robatto Nunes AP, Pereira de Miranda D, Fleitlich-Bilyk B, Almeida Filho N (2005) The Ilha de Mare study: a survey of child mental health problems in a predominantly African-Brazilian rural community. Soc Psychiatry Psychiatr Epidemiol 40:11–17PubMedCrossRef Goodman R, Neves dos Santos D, Robatto Nunes AP, Pereira de Miranda D, Fleitlich-Bilyk B, Almeida Filho N (2005) The Ilha de Mare study: a survey of child mental health problems in a predominantly African-Brazilian rural community. Soc Psychiatry Psychiatr Epidemiol 40:11–17PubMedCrossRef
21.
Zurück zum Zitat Halpern R, Figueiras AC (2004) Environmental influences on child mental health. J Pediatr (Rio J) 80:S104–S110 Halpern R, Figueiras AC (2004) Environmental influences on child mental health. J Pediatr (Rio J) 80:S104–S110
22.
Zurück zum Zitat Hille ET, den Ouden AL, Saigal S, Wolke D, Lambert M, Whitaker A, Pinto-Martin JA, Hoult L, Meyer R, Feldman JF, Verloove-Vanhorick SP, Paneth N (2001) Behavioural problems in children who weigh 1,000 g or less at birth in four countries. Lancet 357:1641–1643PubMedCrossRef Hille ET, den Ouden AL, Saigal S, Wolke D, Lambert M, Whitaker A, Pinto-Martin JA, Hoult L, Meyer R, Feldman JF, Verloove-Vanhorick SP, Paneth N (2001) Behavioural problems in children who weigh 1,000 g or less at birth in four countries. Lancet 357:1641–1643PubMedCrossRef
23.
Zurück zum Zitat Hosmer DW, Lemeshow S (2000) Applied logistic regression. Wiley, New YorkCrossRef Hosmer DW, Lemeshow S (2000) Applied logistic regression. Wiley, New YorkCrossRef
24.
Zurück zum Zitat GE IB (2004) Resultados da Amostra do Censo Demográfico 2000—Malha municipal digital do Brasil: situação em 2001. IBGE, Rio de Janeiro GE IB (2004) Resultados da Amostra do Censo Demográfico 2000—Malha municipal digital do Brasil: situação em 2001. IBGE, Rio de Janeiro
25.
Zurück zum Zitat Jansen PW, Raat H, Mackenbach JP, Jaddoe VW, Hofman A, Verhulst FC, Tiemeier H (2009) Socioeconomic inequalities in infant temperament: the generation R study. Soc Psychiatry Psychiatr Epidemiol 44:87–95PubMedCrossRef Jansen PW, Raat H, Mackenbach JP, Jaddoe VW, Hofman A, Verhulst FC, Tiemeier H (2009) Socioeconomic inequalities in infant temperament: the generation R study. Soc Psychiatry Psychiatr Epidemiol 44:87–95PubMedCrossRef
26.
Zurück zum Zitat Johnson S (2007) Cognitive and behavioural outcomes following very preterm birth. Semin Fetal Neonatal Med 12:363–373PubMedCrossRef Johnson S (2007) Cognitive and behavioural outcomes following very preterm birth. Semin Fetal Neonatal Med 12:363–373PubMedCrossRef
27.
Zurück zum Zitat Kelly YJ, Nazroo JY, McMunn A, Boreham R, Marmot M (2001) Birthweight and behavioural problems in children: a modifiable effect? Int J Epidemiol 30:88–94PubMedCrossRef Kelly YJ, Nazroo JY, McMunn A, Boreham R, Marmot M (2001) Birthweight and behavioural problems in children: a modifiable effect? Int J Epidemiol 30:88–94PubMedCrossRef
28.
Zurück zum Zitat Kramer MS, Seguin L, Lydon J, Goulet L (2000) Socio-economic disparities in pregnancy outcome: why do the poor fare so poorly? Paediatr Perinat Epidemiol 14:194–210PubMedCrossRef Kramer MS, Seguin L, Lydon J, Goulet L (2000) Socio-economic disparities in pregnancy outcome: why do the poor fare so poorly? Paediatr Perinat Epidemiol 14:194–210PubMedCrossRef
29.
Zurück zum Zitat Martins Mde F, da Costa JS, Saforcada ET, Cunha MD (2004) Quality of the environment and associated factors: a pediatric study in Pelotas, Rio Grande do Sul, Brazil. Cad Saude Publica 20:710–718PubMedCrossRef Martins Mde F, da Costa JS, Saforcada ET, Cunha MD (2004) Quality of the environment and associated factors: a pediatric study in Pelotas, Rio Grande do Sul, Brazil. Cad Saude Publica 20:710–718PubMedCrossRef
30.
Zurück zum Zitat Mathews TJ, MacDorman MF (2008) Infant mortality statistics from the 2005 period linked birth/infant death data set. Natl Vital Stat Rep 57:1–32PubMed Mathews TJ, MacDorman MF (2008) Infant mortality statistics from the 2005 period linked birth/infant death data set. Natl Vital Stat Rep 57:1–32PubMed
31.
Zurück zum Zitat Mello M, Mello A, Kohn R (2007) Epidemiologia da saúde mental no Brasil. Artmed, Porto Alegre Mello M, Mello A, Kohn R (2007) Epidemiologia da saúde mental no Brasil. Artmed, Porto Alegre
32.
Zurück zum Zitat Nomura Y, Rajendran K, Brooks-Gunn J, Newcorn JH (2008) Roles of perinatal problems on adolescent antisocial behaviours among children born after 33 completed weeks: a prospective investigation. J Child Psychol Psychiatry 49:1108–1117PubMedCrossRef Nomura Y, Rajendran K, Brooks-Gunn J, Newcorn JH (2008) Roles of perinatal problems on adolescent antisocial behaviours among children born after 33 completed weeks: a prospective investigation. J Child Psychol Psychiatry 49:1108–1117PubMedCrossRef
33.
Zurück zum Zitat Orlebeke JF, Knol DL, Verhulst FC (1999) Child behaviour problems increased by maternal smoking during pregnancy. Arch Environ Health 54:15–19PubMedCrossRef Orlebeke JF, Knol DL, Verhulst FC (1999) Child behaviour problems increased by maternal smoking during pregnancy. Arch Environ Health 54:15–19PubMedCrossRef
34.
Zurück zum Zitat Paula CS, Duarte CS, Bordin IA (2007) Prevalence of mental health problems in children and adolescents from the outskirts of Sao Paulo city: treatment needs and service capacity evaluation. Rev Bras Psiquiatr 29:11–17PubMedCrossRef Paula CS, Duarte CS, Bordin IA (2007) Prevalence of mental health problems in children and adolescents from the outskirts of Sao Paulo city: treatment needs and service capacity evaluation. Rev Bras Psiquiatr 29:11–17PubMedCrossRef
35.
Zurück zum Zitat Prior M, Virasinghe S, Smart D (2005) Behavioural problems in Sri Lankan schoolchildren: associations with socio-economic status, age, gender, academic progress, ethnicity and religion. Soc Psychiatry Psychiatr Epidemiol 40:654–662PubMedCrossRef Prior M, Virasinghe S, Smart D (2005) Behavioural problems in Sri Lankan schoolchildren: associations with socio-economic status, age, gender, academic progress, ethnicity and religion. Soc Psychiatry Psychiatr Epidemiol 40:654–662PubMedCrossRef
36.
Zurück zum Zitat Ravens-Sieberer U, Wille N, Erhart M, Bettge S, Wittchen HU, Rothenberger A, Herpertz-Dahlmann B, Resch F, Holling H, Bullinger M, Barkmann C, Schulte-Markwort M, Dopfner M (2008) Prevalence of mental health problems among children and adolescents in Germany: results of the BELLA study within the National Health Interview and Examination Survey. Eur Child Adolesc Psychiatry 17(Suppl 1):22–33PubMedCrossRef Ravens-Sieberer U, Wille N, Erhart M, Bettge S, Wittchen HU, Rothenberger A, Herpertz-Dahlmann B, Resch F, Holling H, Bullinger M, Barkmann C, Schulte-Markwort M, Dopfner M (2008) Prevalence of mental health problems among children and adolescents in Germany: results of the BELLA study within the National Health Interview and Examination Survey. Eur Child Adolesc Psychiatry 17(Suppl 1):22–33PubMedCrossRef
37.
Zurück zum Zitat Reijneveld SA, de Kleine MJ, van Baar AL, Kollee LA, Verhaak CM, Verhulst FC, Verloove-Vanhorick SP (2006) Behavioural and emotional problems in very preterm and very low birthweight infants at age 5 years. Arch Dis Child Fetal Neonatal Ed 91:F423–F428PubMedCrossRef Reijneveld SA, de Kleine MJ, van Baar AL, Kollee LA, Verhaak CM, Verhulst FC, Verloove-Vanhorick SP (2006) Behavioural and emotional problems in very preterm and very low birthweight infants at age 5 years. Arch Dis Child Fetal Neonatal Ed 91:F423–F428PubMedCrossRef
38.
Zurück zum Zitat Roberts G, Howard K, Spittle AJ, Brown NC, Anderson PJ, Doyle LW (2008) Rates of early intervention services in very preterm children with developmental disabilities at age 2 years. J Paediatr Child Health 44:276–280PubMedCrossRef Roberts G, Howard K, Spittle AJ, Brown NC, Anderson PJ, Doyle LW (2008) Rates of early intervention services in very preterm children with developmental disabilities at age 2 years. J Paediatr Child Health 44:276–280PubMedCrossRef
39.
Zurück zum Zitat Rothenberger A, Becker A, Erhart M, Wille N, Ravens-Sieberer U (2008) Psychometric properties of the parent Strengths and Difficulties Questionnaire in the general population of German children and adolescents: results of the BELLA study. Eur Child Adolesc Psychiatry 17(Suppl 1):99–105PubMedCrossRef Rothenberger A, Becker A, Erhart M, Wille N, Ravens-Sieberer U (2008) Psychometric properties of the parent Strengths and Difficulties Questionnaire in the general population of German children and adolescents: results of the BELLA study. Eur Child Adolesc Psychiatry 17(Suppl 1):99–105PubMedCrossRef
40.
Zurück zum Zitat Saha S, Barnett AG, Buka SL, McGrath JJ (2009) Maternal age and paternal age are associated with distinct childhood behavioural outcomes in a general population birth cohort. Schizophr Res 115(2–3):130–135PubMedCrossRef Saha S, Barnett AG, Buka SL, McGrath JJ (2009) Maternal age and paternal age are associated with distinct childhood behavioural outcomes in a general population birth cohort. Schizophr Res 115(2–3):130–135PubMedCrossRef
41.
Zurück zum Zitat Samara M, Marlow N, Wolke D (2008) Pervasive behaviour problems at 6 years of age in a total-population sample of children born at </= 25 weeks of gestation. Pediatrics 122:562–573PubMedCrossRef Samara M, Marlow N, Wolke D (2008) Pervasive behaviour problems at 6 years of age in a total-population sample of children born at </= 25 weeks of gestation. Pediatrics 122:562–573PubMedCrossRef
42.
Zurück zum Zitat Schmidt LA, Miskovic V, Boyle MH, Saigal S (2008) Shyness and timidity in young adults who were born at extremely low birth weight. Pediatrics 122:e181–e187PubMedCrossRef Schmidt LA, Miskovic V, Boyle MH, Saigal S (2008) Shyness and timidity in young adults who were born at extremely low birth weight. Pediatrics 122:e181–e187PubMedCrossRef
43.
Zurück zum Zitat Schothorst PF, Swaab-Barneveld H, van Engeland H (2007) Psychiatric disorders and MND in non-handicapped preterm children. Prevalence and stability from school age into adolescence. Eur Child Adolesc Psychiatry 16:439–448PubMedCrossRef Schothorst PF, Swaab-Barneveld H, van Engeland H (2007) Psychiatric disorders and MND in non-handicapped preterm children. Prevalence and stability from school age into adolescence. Eur Child Adolesc Psychiatry 16:439–448PubMedCrossRef
44.
Zurück zum Zitat Silva AA, Bettiol H, Barbieri MA, Brito LG, Pereira MM, Aragao VM, Ribeiro VS (2006) Which factors could explain the low birth weight paradox? Rev Saude Publica 40:648–655PubMed Silva AA, Bettiol H, Barbieri MA, Brito LG, Pereira MM, Aragao VM, Ribeiro VS (2006) Which factors could explain the low birth weight paradox? Rev Saude Publica 40:648–655PubMed
45.
Zurück zum Zitat Skovgaard AM, Olsen EM, Christiansen E, Houmann T, Landorph SL, Jorgensen T (2008) Predictors (0–10 months) of psychopathology at age 11/2 years—a general population study in The Copenhagen Child Cohort CCC 2000. J Child Psychol Psychiatry 49:553–562PubMedCrossRef Skovgaard AM, Olsen EM, Christiansen E, Houmann T, Landorph SL, Jorgensen T (2008) Predictors (0–10 months) of psychopathology at age 11/2 years—a general population study in The Copenhagen Child Cohort CCC 2000. J Child Psychol Psychiatry 49:553–562PubMedCrossRef
46.
Zurück zum Zitat 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 42:421–427PubMedCrossRef 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 42:421–427PubMedCrossRef
47.
Zurück zum Zitat Wang WL, Sung YT, Sung FC, Lu TH, Kuo SC, Li CY (2008) Low birth weight, prematurity, and paternal social status: impact on the basic competence test in Taiwanese adolescents. J Pediatr 153:333–338PubMedCrossRef Wang WL, Sung YT, Sung FC, Lu TH, Kuo SC, Li CY (2008) Low birth weight, prematurity, and paternal social status: impact on the basic competence test in Taiwanese adolescents. J Pediatr 153:333–338PubMedCrossRef
48.
Zurück zum Zitat Werner EE (1997) Vulnerable but invincible: high-risk children from birth to adulthood. Acta Paediatr Suppl 422:103–105PubMed Werner EE (1997) Vulnerable but invincible: high-risk children from birth to adulthood. Acta Paediatr Suppl 422:103–105PubMed
Metadaten
Titel
The impact of perinatal and socioeconomic factors on mental health problems of children from a poor Brazilian city: a longitudinal study
verfasst von
Juliana D. M. Rodriguez
Antônio A. M. da Silva
Heloisa Bettiol
Marco A. Barbieri
Roberto J. Rona
Publikationsdatum
01.05.2011
Verlag
Springer-Verlag
Erschienen in
Social Psychiatry and Psychiatric Epidemiology / Ausgabe 5/2011
Print ISSN: 0933-7954
Elektronische ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-010-0202-6

Weitere Artikel der Ausgabe 5/2011

Social Psychiatry and Psychiatric Epidemiology 5/2011 Zur Ausgabe

Update Psychiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.