Poster #60 - Mental health in children prenatally exposed to opiates compared to foster children

• In Event: 1-005 - Poster Session 01
  In Poster Session: PS 01 Section - Developmental Psychopathology

Integrative Statement

Prenatal exposure to opiates is associated with a range of difficulties in childhood (Baldacchino et.al.2014). Drug-exposed children may also be particularly susceptible to child protection concern and out-of home placement given their parent’s complex personal and mental health needs as well as their high levels of clinical surveillance under drug treatment. In Norway, there is mandatory reporting of substance abuse in pregnancy, and women in opioid maintenance treatment (OMT) are closely monitored after the child is born. Illicit drug use or drug abuse may lead to immediate out-of -home placement of the child.
The aim of this study is to investigate mental health in a group of school-aged children (N=77, 51% boys, mean age 8,5 years) prenatally exposed to methadone or buprenorphine. Sixty-one of the children lived with their birth parent(s), while 14 were in foster care. Caregivers were asked to complete the Strengths and Difficulties Questionnaire (SDQ) online. The comparison group comprised school aged foster children (N=222, mean age 8.9 years, 51 % boys). Previous findings have revealed high prevalence of mental disorders in this group (Lehmann et al., 2013).
In the current study, we compare mental health profiles in two high-risk groups: Opiate-exposed children and foster children. The fact that one in four opiate-exposed children lived in foster home, made it possible to establish a subgroup of these children that had been removed from home.

Table 1 shows the distribution of the SDQ-scores in the OMT group (divided into OMT_ home and OMT_ foster), and the comparison group of foster children.

An overview of the distributions of the SDQ-scores reveals that school-aged children prenatally exposed to opiates living in their birth families fare much better compared both to their foster-placed peers (Total score:
OMT_home vs OMT_foster: t(73)=5.29, p > .001) and a group of maltreated children living in foster care (OMT_ home vs Foster Children: t(281)=6.2, p > .001). The total SDQ-score in the OMT_ home group is only slightly higher than what was reported from a large-scale study of normative children in Norway (Heiervang et.al.2008). Children in the OMT_ home group were also rated higher in prosocial functioning than the two groups in living foster care. However, opiate-exposed children in foster care and foster children both present with significantly higher problem scores than the OMT_ home group (total score: OMT_foster vs Foster Children t(234)=0.87, p = .38). They also display similar problem profiles, especially evident in the elevated rates of hyperactivity-related problems which in this study are three times as high for out-of home placed children as in the normative group in Norway.
These preliminary findings may be discussed in the context of a double risk and vulnerability paradigm: Prenatal exposure may affect children’s level of stress tolerance and coping in psychosocially burdened families, which in turn may result in exacerbating problems when faced with the trauma of being removed from home. Or, some of the exposed children removed from home may already displayed difficulties that needed more support than the birth family was able to render.

Authors

• Monica Sarfi, University of Oslo, Norway
  Presenting Author

• Gabrielle Welle_Strand, Norwegian Centre for Addiction Research (SERAF)
  Non-Presenting Author

• Einar Heiervang, University of Oslo, Oslo University Hospital
  Non-Presenting Author

• Stine Lehmann, Norwegian Research Centre, Bergen
  Non-Presenting Author