Can a general health surveillance between birth and 10 months identify children with mental disorder at 1 1/2 year? A case-control study nested in cohort CCC 2000

Mental health surveillance in infancy was studied in an existing child health surveillance programme with child psychiatric disorder at 1 1/2 year as the outcome. Methods Children considered of concern by community health nurses were cases in a case control study nested in the Copenhagen Child Cohort (CCC 2000). Outcome was mental health status at 1 1/2 year assessed by clinical and standardised strategies, including videotape recordings, parent interviews and the instruments: CBCL 1 1/2-5, ITSCL, CHAT, Bayley Scales of Infant Development II, PC ERA and PIRGAS. Results The positive predictive value of concern in the first 10 months of living was 24% (CI 17.0-31.9), the negative predictive value was 85% (CI 77.9-89.6) and the sensitivity was 56% (CI 42.4-69.0). Concern about development was significantly associated with the child having a neuro-developmental disorder at 1 1/2 year, and concern about mother-child relationship was associated with emotional, behavioural, eating, and sleeping disturbances. Conclusions A general health surveillance program seems to have potentials to identify infants at risk for mental health problems provided standardised measures and specific training of the involved health professionals.