Heeft wetenschappelijk onderzoek op het terrein van de kinder- en jeugdpsychiatrie opgeleverd wat we verwacht hadden?

  • Frank C. Verhulst


In de somatische gezondheidszorg, vooral in de preventieve gezondheidszorg, heeft empirisch wetenschappelijk onderzoek bijgedragen aan het vergroten van de gezondheid. De vraag is of dit ook geldt voor de kinder- en jeugdpsychiatrie. Lange tijd speelde wetenschappelijk onderzoek in de kinder- en jeugdpsychiatrie immers geen rol, enkele uitzonderingen daargelaten. Dit artikel geeft een selectief overzicht over de rol van wetenschappelijk onderzoek in de kinder- en jeugdpsychiatrie. Dit vak heeft de afgelopen decennia weer aansluiting gevonden bij andere medische disciplines. Hierin heeft wetenschappelijk onderzoek een belangrijke rol gespeeld. Toch heeft wetenschappelijk onderzoek maar weinig bijgedragen aan verbetering van preventie en interventie van psychiatrische stoornissen bij kinderen en adolescenten. Blijkbaar is de etiologische en fenotypische heterogeniteit zo complex dat de toepassing van nieuwe technieken, zoals de genetica en (neuro)imaging, binnen de kinder- en jeugdpsychiatrie niet tot de grote successen heeft geleid die in de algemene geneeskunde plaatsvonden.


In somatic healthcare, preventive healthcare in particular, empirical scientific research has helped improve health. The question is whether this also applies to psychiatry for children and adolescents. After all, there was a lengthy period during which scientific research played no part in child and adolescent psychiatry (with just a few exceptions). This article gives a selective overview of the role of scientific research in child and adolescent psychiatry. Over recent decades, this field has once again found its place in amongst other medical disciplines. Scientific research has played a key role in this. Nevertheless, scientific research has contributed little to improvements in prevention and interventions for psychiatric disorders in children and adolescents. It would seem that the aetiological and phenotypic heterogeneity is so complex that applying new techniques such as genetics, imaging and neuro-imaging has not led to the major successes in child and adolescent psychiatry that have been achieved in medicine in general.


  1. Achenbach, T. M. (1966). The classification of children’s psychiatric symptoms: A factor-analytic study. Psychological Monographs, 80(615), 1–37. doi: 10.1037/h0093906, 5968338.CrossRefPubMedGoogle Scholar
  2. Achenbach, T. M. (1974). Developmental psychopathology (2nd ed.). New York: Ronald Press, Wiley.Google Scholar
  3. Achenbach, T. M. (1978). The Child Behavior Profile: I. Boys aged 6–11. Journal of Consulting and Clinical Psychology, 46, 478–488. doi: 10.1037/0022-006X.46.3.478, 670491.CrossRefPubMedGoogle Scholar
  4. Achenbach, T. M. (2009). The Achenbach system of empirically based assessment (ASEBA): Development, findings, theory, and applications. Burlington: University of Vermont, Research Center for Children, Youth, & Families.Google Scholar
  5. Achenbach, T. M., & Rescorla, L. A. (2007). Multicultural understanding of child and adolescent psychopathology: Implications for mental health assessment. New York: The Guilford Press.Google Scholar
  6. Achenbach, T. M., McConaughy, S. H., & Howell, C. T. (1987). Child/adolescent behavioral and emotional problems: Implications of cross-informant correlations for situational specificity. Psychological Bulletin, 101, 213–232. doi: 10.1037/0033-2909.101.2.213, 3562706.CrossRefPubMedGoogle Scholar
  7. Achenbach, T. M., Becker, B., Döpfner, M., Heiervang, E., Roessner, V., Steinhausen, H., et al. (2008). Multicultural assessment of child and adolescent psychopathology with ASEBA and SDQ instruments: Research findings, applications, and future directions. Journal of Child Psychology and Psychiatry and Allied Disciplines, 49, 251–275. doi: 10.1111/j.1469-7610.2007.01867.x.CrossRefGoogle Scholar
  8. Achenbach, T. M., McConaughy, S. H., Ivanova, M. Y., & Rescorla, L. A. (2012). Manual for the ASEBA Brief Problem Monitor™(BPM). Burlington: University of Vermont, Research Center for Children, Youth, & Families.Google Scholar
  9. Althaus, M. (2000). Visual attention and autonomic adaptivity to attention-demanding tasks in children with autistic-type behavioral problems. Groningen: Rijksuniversiteit Groningen, Academisch Proefschrift.Google Scholar
  10. American Psychiatric Association (1980). Diagnostic and statistical manual of mental disorders (3rd ed.) (DSM-III). Washington, DC: Author.Google Scholar
  11. Andreasen, N. C. (2001). Brave new brain. Oxford: Oxford University Press.Google Scholar
  12. Angold, A., & Fisher, P. W. (1999). Interviewer based interviews. In D. Shaffer, C. P. Lucas, & E. Richters (eds.), Diagnostic Assessment in Child and Adolescent Psychopathology (pp. 34–36). New York: The Guildford Press.Google Scholar
  13. Buitelaar, J. K. (1991). Psychopharmacology of autism: Clinical and ethological studies on the behavioural effects of a synthetic adrenocorticotrophic hormone (4–9) analog. Utrecht: Rijksuniversiteit Utrecht, Academisch proefschrift.Google Scholar
  14. Cantwell, D. P. (1988). DSM-III studies. In M. Rutter, A. Hussain Tuma, & I. S. Lann (eds.), Assessment and diagnosis in child psychopathology (pp. 3–35). London: David Fulton Publishers.Google Scholar
  15. Caspi, A., McClay, J., Moffitt, T. E., Mill, J., Martin, J., Craig, I. W., et al. (2002). Role of genotype in the cycle of violence in maltreated children. Science, 297, 851–854. doi: 10.1126/science,1072290, 12161658.CrossRefPubMedGoogle Scholar
  16. Caspi, A., Sugden, K., Moffitt, T. E., Taylor, A., Craig, I. W., Harrington, H., et al. (2003). Influence of life stress on depression: Moderation by a polymorphism in the 5-HTT gene. Science, 301(5631), 386–389. doi: 10.1126/science,1083968, 12869766.CrossRefPubMedGoogle Scholar
  17. Coghill, D., & Sonuga-Barke, E. (2012). Annual research review: Categories versus dimensions in the classification and conceptualisation of child and adolescent mental disorders – implications of recent empirical study. Journal of Child Psychology and Psychiatry, 53, 469–489. doi: 10.1111/j.1469-7610.2011.02511.x, 22288576.CrossRefPubMedGoogle Scholar
  18. Conners, C. K., & Eisenberg, L. (1963). The effects of methylphenidate on symptomatology and learning in disturbed children. American Journal of Psychiatry, 120, 459–466. doi: 10.1176/ajp.120.5.458.CrossRefGoogle Scholar
  19. Conners, C. K., Eisenberg, L., & Barcai, A. (1967). Effect of dextroamphetamine on children: Studies on subjects with learning disabilities and school behaviour problems. Archives of General Psychiatry, 17, 478–485. doi: 10.1001/archpsyc.1967.01730280094011, 4861380.CrossRefPubMedGoogle Scholar
  20. Crone, E. (2008). Het puberende brein. Amsterdam: Bert Bakker.Google Scholar
  21. Davey Smith, G. (2011). Epidemiology, epigenetics and the ‘Gloomy Prospect’: Embracing randomness in population health research and practice. International Journal of Epidemiology, 40, 537–562. doi: 10.1093/ije/dyr117.CrossRefGoogle Scholar
  22. Duncan, L. E. (2013). Paying attention to all results, positive and negative. Journal of the American Journal of Child and Adolescent Psychiatry, 52, 462–465. doi: 10.1016/j.jaac.2013.02.007.CrossRefGoogle Scholar
  23. Engeland, H. van. (1980). Over ontwikkelingspsychosen: Een psychofysiologisch onderzoek naar input-modulatiestoornissen. Utrecht: Academisch Proefschrift.Google Scholar
  24. Ferdinand, R. F. (1995). Psychopathology in adolescents and young adults. Rotterdam: Erasmus Universiteit, Academisch proefschrift.Google Scholar
  25. Fergusson, D. M. (1995). A brief introduction to structural equation models. In F. C. Verhulst, & H. M. Koot (eds.), The epidemiology of child and adolescent psychopathology (pp. 122–145). Oxford: Oxford University Press.Google Scholar
  26. Fox, J. P., Hall, C. E., & Elveback, L. R. (1970). Epidemiology: Man and disease (pp. 19–30). London: The MacMillan Company.Google Scholar
  27. Fraiberg, S. H. (1959). The magic years. New York: Charles Scribner’s Sons.Google Scholar
  28. Galton, F. (1876). The history of twins as a criterion of the relative powers of nature and nurture. Royal Anthropological Institute of Great Britain and Ireland Journal, 6, 391–406. doi: 10.2307/2840900.CrossRefGoogle Scholar
  29. Gunning, B. (1992). A controlled trial of clonidine in hyperkinetic children. Rotterdam: Erasmus Universiteit, Academisch proefschrift.Google Scholar
  30. Heijmens Visser, J. (2002). Long-term outcome of psychopathology in childhood and adolescence: A clinical epidemiological study. Rotterdam: Erasmus Universiteit, Academisch proefschrift.Google Scholar
  31. Hofstra, M. B. (2000). Psychopathology from childhood into adulthood: Follow-up of an epidemiological sample. Rotterdam: Erasmus Universiteit, Academisch proefschrift.Google Scholar
  32. Hudziak, J. J., & Novins, D. K. (2013). Illuminating the complexities of developmental psychopathology: Special series on longitudinal and birth cohort studies. Journal of the American Academy of Child and Adolescent Psychiatry, 52, 6–8. doi: 10.1016/j.jaac.2012.10.016, 23265628.CrossRefPubMedGoogle Scholar
  33. International Human Genome Sequencing Consortium (IHGSC). (2004). Finishing the euchromatic sequence of the human genome. Nature, 431, 931–945. doi: 10.1038/nature03001.CrossRefGoogle Scholar
  34. Koot, H. M., Crijnen, A. A. M., & Ferdinand, R. F. (1999). Child psychiatric epidemiology: Accomplishments and future directions. Assen: Van Gorcum.Google Scholar
  35. Mackenbach, J. P. (2011). Successen van preventie 1970–2010. Rotterdam: ErasmusMC, afdeling Maatschappelijke Gezondheidszorg.Google Scholar
  36. McGuffin, P., & Martin, N. (1999). Science, medicine, and the future. Behaviour and genes. British Medical Journal, 319(7201), 37–40. doi: 10.1136/bmj.319.7201.37, 1116141, 10390460.CrossRefPubMedPubMedCentralGoogle Scholar
  37. Meaney, M. J. (2001). Maternal care, gene expression, and the transmission of individual differences in stress reactivity across generations. Annual Review Neuroscience, 24, 1161–1192. doi: 10.1146/annurev.neuro.24.1.1161.CrossRefGoogle Scholar
  38. Meurs, I. van. (2009). Intergenerational transmission of child problem behavior. Rotterdam: Erasmus Universiteit, Academisch proefschrift.Google Scholar
  39. Minderaa, R. B. (1985). Neurochemical aspects of childhood autism. Rotterdam: Erasmus Universiteit, Academisch proefschrift.Google Scholar
  40. Molina, B. S., Hinshaw, S. P., Swanson, J. M., Arnold, L. E., Vitiello, B., Jensen, P. S., et al. (2009). The MTA at 8 years: Prospective follow-up of children treated for combined-type ADHD in a multisite study. Journal of the American Academy of Child and Adolescent Psychiatry, 48, 484–500. doi: 10.1097/CHI.0b013e31819c23d0, 3063150, 19318991.CrossRefPubMedPubMedCentralGoogle Scholar
  41. Oord, E. J. van den, Verhulst, F. C., & Boomsma, D. I. (1996). A genetic study of maternal and paternal ratings of problem behaviors in 3-year-old twins. Journal of Abnormal Psychology, 105, 349–357.Google Scholar
  42. Oosterlaan, J., Logan, G. D., & Sergeant, J. A. (1998). Response inhibition in AD/HD, CD, comorbid AD/HD + CD, anxious, and control children: A meta-analysis of studies with the stop task. Journal of Child Psychology and Psychiatry, 39, 411–425. doi: 10.1017/S0021963097002072, 9670096.CrossRefPubMedGoogle Scholar
  43. Plomin, R., & Daniels, D. (1987). Why are children in the same family so different from one another? Behavioral and Brain Sciences, 10, 1–16. doi: 10.1017/S0140525X00055941.CrossRefGoogle Scholar
  44. Plomin, R., DeFries, J. C., & McClearn, G. E. (1980). Behavioral genetics: A primer. San Francisco: W.H. Freema.Google Scholar
  45. Plomin, R., DeFries, J. C., & McGuffin, P. (2003). Behavioral genetics in the postgenomic era. Washington: American Psychological Association. doi: 10.1037/10480-000.CrossRefGoogle Scholar
  46. Reef, J. (2010). Adult consequences of child psychopathology. Rotterdam: Erasmus Universiteit, Academisch proefschrift.Google Scholar
  47. Remschmidt, H. (1996). Changing views: New perspectives in child psychiatric research. European Child and Adolescent Psychiatry, 5, 2–10. 9117535.PubMedGoogle Scholar
  48. Robins, L. N. (1974) Deviant children grown up: A sociological and psychiatric study of sociopathic personality. New York: Krieger.Google Scholar
  49. Roza, S. J. (2008). Prenatal and early postnatal brain development. Rotterdam: Erasmus Universiteit, Academisch proefschrift.Google Scholar
  50. Rutter, M. (2006). Genes and behavior: Nature-nurture interplay explained. Malden: Blackwell Publishing.Google Scholar
  51. Rutter, M., Tizard, J., & Whitmore, K. (1970). Education, health and behaviour. London: Longmans.Google Scholar
  52. Rutter, M., Taylor, E., & Hersov, L. (1994). Child and Adolescent Psychiatry: Modern approaches. London: Blackwell Scientific Publications.Google Scholar
  53. Silva, P. A., & Stanton, W. R. (1996). Child to Adult: The Dunedin Multidisciplinary Health and Development Study. Oxford: Oxford University Press.Google Scholar
  54. Stringaris, A. (2012). Predicting treatment outcomes: Encouraging findings from neuroimaging. Journal of the American Academy of Child and Adolescent Psychiatry, 51, 1228.Google Scholar
  55. Swaab, D. (2010). Wij zijn ons brein: Van baarmoeder tot Alzheimer. Amsterdam: Uitgeverij Contact.Google Scholar
  56. Szatmari, P., Charman, T., & Constantino, J. N. (2012). Into, and out of, the “Valley of Death”: Research in autism spectrum disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 51, 1108–1112. doi: 10.1016/j.jaac.2012.08.027, 23101736.CrossRefPubMedGoogle Scholar
  57. Thapar, A., & Rutter, M. (2009). Do prenatal risk factors cause psychiatric disorder? Be wary of causal claims. British Journal of Psychiatry, 195, 100–101. doi: 10.1192/bjp.bp.109.062828, 19648537.CrossRefPubMedGoogle Scholar
  58. Tiemeier, H., Velders, F. P., Szekely, E., Roza, S. J., Dieleman, G., Jaddoe, V. W., et al. (2012). The Generation R Study: A review of design, findings to date, and a study of the 5-HTTLPR by environmental interaction from fetal life onward. Journal of the American Academy of Child and Adolescent Psychiatry, 51, 1119–1135. doi: 10.1016/j.jaac.2012.08.021, 23101739.CrossRefPubMedGoogle Scholar
  59. Uher, R., & Rutter, M. (2012). Basing psychiatric classification on scientific foundation: Problems and prospects. International Review of Psychiatry, 24, 591–605. doi: 10.3109/09540261.2012.721346, 23244614.CrossRefPubMedGoogle Scholar
  60. Valk, J.C. van der, Verhulst, F. C., Stroet, T. M., & Boomsma, D. I. (1998). Quantitative genetic analysis of internalising and externalising problems in a large sample of 3-year-old twins. Twin Research, 1, 25–33.Google Scholar
  61. Verhulst, F. C. (1985) Mental Health in Dutch Children. Rotterdam: Erasmus Universiteit, Academisch proefschrift.Google Scholar
  62. Verhulst, F. C., & Koot, H. M. (1992). Child psychiatric epidemiology: Concepts, methods and findings. Newbury park: sage Publications. doi: 10.4135/9781483325804.CrossRefGoogle Scholar
  63. Verhulst, F. C., Ende, J. van der, Ferdinand, R. F., & Kasius, M. C. (1997). The prevalence of DSM-III-R diagnoses in a national sample of Dutch adolescents. Archives of General Psychiatry, 54, 329–336.Google Scholar
  64. Verhulst, F. C., Donker, A. G., & Hofstra, M. B. (2001). De ontwikkeling van antisociaal gedrag. In R. Loeber, N. W. Slot, & J. A. Sergeant (red.), Ernstige en gewelddadige jeugddelinquentie (pp. 155–170). Houten: Bohn Stafleu van Loghum.Google Scholar
  65. Vitaro, F., & Tremblay, R. E. (2008). Clarifying and maximizing the usefulness of targeted preventive interventions. In M. Rutter, D. V. M. Bishop, D. S. Pine, S. Scott, J. Stevenson, E. Taylor, & A. Thapar (eds.), Rutter’s Child and Adolescent Psychiatry (pp. 145–159). Malden: Blackwell Publishing.Google Scholar
  66. Weisz, J. R., & Gray, J. S. (2008). Evidence –based psychotherapy for children and adolescents: Data from the present and a model for the future. Child and Adolescent Mental Health, 13, 54–66. doi: 10.1111/j.1475-3588.2007.00475.x.CrossRefGoogle Scholar
  67. Weisz, J. R., Ugueto, A. M., Cheron, D. M., & Herren, J. (2013). Evidence-based youth psychotherapy in the mental health ecosystem. Journal of Clinical Child and Adolescent Psychology, 42, 274–286. doi: 10.1080/15374416.2013.764824, 23402704.CrossRefPubMedGoogle Scholar
  68. Wielemaker, J. F. (2009). Langdurig klinisch behandeld in de kinder- en jeugdpsychiatrie; een follow-up onderzoek na 5 tot 25 jaar. Rotterdam: Erasmus Universiteit, Academisch proefschrift.Google Scholar

Copyright information

© Bohn Stafleu van Loghum 2016

Authors and Affiliations

  • Frank C. Verhulst
    • 1
  1. 1.RotterdamThe Netherlands

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