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LETTERS: Thomas Radecki Child psychiatric disorder and relative age in school year: Holding back may cause more harm than good BMJ 2003; 327: 1286 [Full text]

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Child psychiatric disorder and relative age in school year:influence of social norms

Dagmar Haller   (28 November 2003)

Child psychiatric disorder and relative age in school year:influence of social norms 28 November 2003
Dagmar Haller, research fellow Parkville, VIC 3052, Australia Send response to journal: Re: Child psychiatric disorder and relative age in school year:influence of social norms	Dear editor, The interesting letters by Radecki and by Greenwell highlight the influence of social norms on social integration in childhood. We could survey readers of the BMJ and ask them to remember the characteristics, including relative age, of those who were most bullied and seemed most unhappy in their class during childhood. Younger age would most certainly come out as a key factor in Australia and in many European countries. But in the U.S., and in different countries of Asia, Africa and Latin America, various patterns of risk could well emerge, in unison with varying patterns of social norms. According to WHO definition health is a state of physical, psychological and social well being. Very often, disruption at one level affects the other levels as well. Goodman and colleagues' study is well in accordance with this view. Repeating the study in the U.S. context (or in another country in which views on holding back are clearly different from those in Britain) would certainly give indications as to the magnitude of this "social norm effect" on the association between psychiatric disorder in childhood and relative age in school. We hope someone will be interested in taking up this challenge and look forward to reading about their results soon. Competing interests: None declared