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OBJECTIVE: To assess the relationship between trajectories of maternal depression from pregnancy to the child's age of 5 years and children's emotional and behavioral difficulties at age 5 years. STUDY DESIGN: Mother-child pairs (n = 1183) from the EDEN mother-child birth cohort study based in France were followed from 24 to 28 weeks of pregnancy to the child's fifth birthday. Children's behavior at age 5 years was assessed with the Strengths and Difficulties Questionnaire. Maternal depression was assessed repeatedly with the Center for Epidemiological Studies Depression questionnaire (pregnancy, 3, and 5 years of age) and the Edinburgh Postnatal Depression Scale (4, 8, and 12 months postpartum). Homogeneous latent trajectory groups of maternal depression were identified within the study population and correlated with Strengths and Difficulties Questionnaire scores by the use of multivariate linear regression analyzes. RESULTS: Five trajectories of maternal symptoms of depression were identified: no symptoms (62.0%); persistent intermediate-level depressive symptoms (25.3%); persistent high depressive symptoms (4.6%); high symptoms in pregnancy only (3.6%); and high symptoms in the child's preschool period only (4.6%). Children whose mothers had persistent depressive symptoms--either intermediate or high--had the greatest levels of emotional and behavioral difficulties at age 5 years. In addition, compared with children whose mothers were never depressed, those whose mothers had high symptoms in the preschool period also had increased levels of emotional symptoms, conduct problems, and peer problems. CONCLUSIONS: Maternal depression symptoms are related to children's emotional and behavioral problems, particularly if they are persistent (29.9%) or occur during early childhood (4.6%).

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Introducción: Desde principios de los años 2000, el consumo de Pasta Base de Cocaína (PBC) se hizo objeto de preocupación para los clínicos y los actores de Sanidad Pública en Uruguay. A pesar de la importancia del fenómeno existen muy pocos estudios sobre las condiciones psiquiátricas asociadas al consumo de PBC, especialmente en población pediátrica, siendo esta la más vulnerable y la que puede beneficiar de intervenciones precoces eficaces. El objetivo de este trabajo era determinar la asociación entre problemas psiquiátricos y consumo de PBC en niños y adolescentes hospitalizados. Método: Realizamos un estudio observacional comparativo, entre 2008 y 2010, en una población que consultaba en las urgencias del hospital pediátrico de Montevideo (Uruguay). Un grupo consumidor de PBC (N = 20) fue comparado con un grupo no consumidor de sustancias psicoactivas (N = 20) con el Child Behavior Checklist (CBCL) que mide los problemas emocionales y conductuales del joven. Resultados: El grupo consumidor de PBC mostraba niveles significativamente superiores de problemas externalizados e internalizados, particularmente comportamientos oposicionistas. Conclusiones: El consumo de PBC se asocia a niveles mayores de problemas psiquiátricos en los jóvenes. Actuar precozmente para prevenir el consumo de PBC y tratar los problemas externalizados en los consumidores parece esencial para mejorar la salud de los jóvenes en Uruguay.

ntroduction: Since the years 2000, the consumption of Cocaine Paste (CP) has become an important issue for clinicians and public health actors in Uruguay. In spite of the importance of the phenomenon few studies have focused on psychiatric conditions associated with CP consumption, especially in the paediatric population yet the most vulnerable and the one that could benefit from early effective interventions. The aim of this work was to determine the association between psychiatric problems and CP consumption in inpatients youths. Methods: We conducted an observational and comparative study between 2008 and 2010, in a paediatric population consulting in the child psychiatric emergency room of Montevideo (Uruguay). A group consuming CP (N = 20) was compared to a group not consuming psychoactive substances (N = 20) with the Child Behavior Checklist (CBCL). Results: The group consuming CP showed significantly higher levels of externalizing and internalizing problems, particularly oppositional behaviors. Conclusions: CP consumption is associated with higher levels of psychiatric symptoms in youths. Early interventions to prevent CP consumption and treat externalizing problems is of utmost importance to improve the health of youths in Uruguay.

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OBJECTIVE: To assess the link between childhood attention problems (AP) and substance use 18 years later. STUDY DESIGN: This cohort study was conducted in a community sample of 1103 French youths followed from 1991 to 2009. Exposures and covariates were childhood behavioral problems (based on parental report at baseline), early substance use, school difficulties, and family adversity. Outcome measures were regular tobacco smoking, alcohol problems, problematic cannabis use, and lifetime cocaine use (based on youth reports at follow-up). RESULTS: Individuals with high levels of childhood AP had higher rates of substance use (regular tobacco smoking, alcohol problems, problematic cannabis use, and lifetime cocaine use). However, when taking into account other childhood behavioral problems, early substance use, school difficulties, and family adversity, childhood AP were related only to regular tobacco smoking and lifetime cocaine use. Early cannabis exposure was the strongest risk factor for all substance use problems. CONCLUSION: This longitudinal community-based study shows that, except for tobacco and cocaine, the association between childhood AP and substance use is confounded by a range of early risk factors. Early cannabis exposure plays a central role in later substance use.

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