Shadows of Dependence: Temperament and Behavioural Changes among Children of Fathers with Opioid Dependence.

Background: Parental opioid dependence has been associated with increased behavioural and emotional difficulties in children, including internalizing and externalizing problems. Despite the high prevalence of opioid use in our region, research on its impact on children of fathers with opioid dependence remains scarce. This study aimed to assess temperament and behavioural problems among children of fathers with opioid dependence. Methodology: In this observational case-control study, 30 children of fathers with opioid dependence were compared with 30 age and gender matched controls. Information was collected from mothers. Mothers were screened for psychopathology using the General Health Questionnaire (GHQ), and children's behavioural and temperamental characteristics were assessed using the Child Behaviour Checklist (CBCL) and Malhotra's Temperament Schedule (MTS). Results: No significant differences were observed between groups regarding age and gender. Children of opioid-dependent fathers exhibited significantly higher CBCL scores across internalizing domains (Anxious/Depressed: p=0.021; Withdrawn/Depressed: p=0.043; Somatic Complaints: p=0.004) and externalizing domains (Aggressive: p=0.001; Rule-Breaking: p=0.003). Significant temperament differences were observed, with lower sociability (p<0.001), higher emotionality (p<0.001), and greater distractibility (p=0.001) in these children in comparison to controls, while energy and rhythmicity did not differ significantly. Conclusion: Based on our findings, early identification and clinical screening are recommended to detect these behavioural and temperamental problems in childhood, as they may otherwise increase the risk of substance use and psychiatric disorders later in life. Family-centered interventions, along with supportive policy measures, can help prevent long-term adverse mental health outcomes in this vulnerable population.