Epi in the News

Hello all...
I must say that this article is kind of chilling. I mean we all knew the pandemic was taking a toll on the kids forced to stay inside for months together and I am sure the majority of us were just not willing to acknowledge it.. therefore to see it written down with numerical evidence feels like a punch in the gut... Ok so emotional things aside...

1) The disease has been classified here as likelihood of getting a mental disorder, with a ordinal scale of " unlikely, possibly, or probably". From what I have understood, it looks like this information is based on questionnaires that parents, children and young ppl have answered, related to emotions behaviour concentation etc. So, ofcourse this is a very subjective evaluation of the likelihood of mental health. That is a disadvantage. Plus I am not sure how much reliable is the questionnaire, and I am sure it would have been filled online- which could again introduce a lot of bias. On the plus side- its simpler, cost effective, and more likely to be completed in comparison to having a complete formal mental health evaluation by a professional... Parents might be more reluctant for the former.

2) I think over time, probably more number of ppl become aware and agree to participate in trials. As we speak, the world is becoming smaller and smaller and people are becoming more aware of mental health issues. So, maybe more likely that increased number of ppl will participate and be willing to share accurate information.

3) The descriptive epidemiology here is the rates that they have stated- one in 6 children have a probable mental health disorder in 2020.
Analytic epidemiology is where they have looked at exposures and tried to find an association between the exposure and outcome. For example "It also found that children aged five to 16 with a probable mental disorder were more than twice as likely to live in a household that had fallen behind with payments (16.3%), than children unlikely to have a mental disorder (6.4%)."

here are my answers:

Answer 1:
Advantages:
1. Can be administered to a larger population.
2. Less time consuming compared to psychologist assessing individual children
3. Cost-effective
Disadvantages:
1. since it is a subjective way of assessing the mental disorder, misclassification bias could have occurred.
2. Method of administrating the questionnaire is not very clear. If it was an online survey, selection bias could have occurred due to poor response rate
3. study participants may not be a true representation of the study population (because of the online survey)

Answer 2:
1. Case definition to diagnose mental disorder would have been different from previous years
2. environmental factors due to lockdown could have aggravated the mental disorder as they were mentioned in the article.
3. unit of analysis might be different

4. Increase in prevalence might be due to increase in number of cases due to lockdown or due to prolonged duration of the disease(non availability of medical treatment options due to lock down)

Answer 3:
Descriptive Epidemiology:
1. proportion of children having a mental disorder
2. specific reasons explaining why lockdown aggravated the mental disorder
3. proportion of mental disorders in different ethnic background
Analytical:
1. Likelihood of a mental disorder among men and women
2. effect of age in mental disorder
3. effect of lockdown in mental disorder

suggestions and comments are most welcome

sam

Great answers Fathima and Sam!

I agree. The only bits where I'm not sure I agree with you are the examples of descriptive and analytic epidemiology. I think everthing from the 2020 study is descriptive except the bit at the end where the University of Exeter researcher talks about BME families being more intergenerational and larger and this being a potential protective factor. For an analytic study you need a comparison group. This is a cross sectional observational study. I suppose you could use the 2017 study as a comparison group and then argue that the changes in results between 2020 and 2017 were analytical epidemiology too.

What do you think?

Judith