Antibiotic consumption

The harms done to children by parental separation and their degree of resilience to such a trauma have been debated often. We know refugee children are at risk of mental health problems, but are these increased if the children are separated from their parents. In World War II (WWII), European children were often separated from their parents in the city and evacuated to foster homes in the country. Most studies of this situation struggle to differentiate war-related and separation-related mental health problems. A Finnish study compared data from a national census and a database recording psychiatric admissions to examine the effects of evacuation of 1425 Finnish children to Swedish foster homes during WWII. The novelty was that the researchers excluded single children and compared siblings who were evacuated with their non-evacuated siblings. The risk of admission to hospital for a psychiatric disorder did not differ between evacuated and non-evacuated siblings (hazard ratio (HR) = 0.89, 95% confidence interval (CI) 0.64 to 1.26). However, analysis of admissions for individual psychiatric disorders showed evacuated girls were significantly more likely than their non-evacuated sisters to be admitted to hospital in adulthood for a mood disorder (HR = 2.19, 95% CI 1.10 to 4.33). There is still risk of bias because we do not know what factors determined which siblings were evacuated and which remained.