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  • Are school difficulties an early sign for mental disorder diagnosis and suicide prevention? A comparative study of individuals who died by suicide and control group
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2020-01-14
    Fabienne Ligier; Charles-Edouard Giguère; Charles-Edouard Notredame; Alain Lesage; Johanne Renaud; Monique Séguin

    Suicide is the third leading cause of death worldwide among youth aged 10- to 19, and mental disorders are often associated in the etiology of suicidal behavior. Mental disorders are often under-diagnosed and under-treated in young people, a situation likely to increase the severity of the disorder and suicide risk. Presence of school difficulties may, in some cases, be a consequence of mental disorder, and theses difficulties are observable. Therefore, early detection and early intervention of school difficulties may alleviate the development of mental disorders and suicide vulnerability. The aim of this study is to understand the link between school difficulties and suicide risk. We used the data bank gathered by the McGill Group on Suicide Studies over the past two decades through interviews with the relatives of individuals who died by suicide and with individuals from the community as a control group. We included data on common sociodemographic characteristics, life events and mental health characteristics identified before age 18, among individuals who died before the age of 35 or were interviewed before the age of 35. We identified 200 individuals who died by suicide and 97 living controls. We compared groups according to gender and characteristics. Within the total sample, 74% were male, 13% had met with academic failure, 18% had engaged in inappropriate behavior at school, and 18% presented combined school difficulties. Combined school difficulties (academic failure and inappropriate behavior) for both sexes and academic failure alone for males were associated with higher suicide risk before the age of 35. School difficulties generally began in early childhood and were linked to mental disorders/difficulties and substance abuse before age 18. This study underlines the importance for parents, teachers, and educators to identify children with school difficulties—academic failure and behavioral difficulties at school—as early as possible in order to be able to propose adapted interventions. Early identification and proper diagnosis may prevent chronicity of some disorders, accumulation of adverse events, and even suicide.

    更新日期:2020-01-14
  • Virtual reality exposure therapy for adolescents with fear of public speaking: a non-randomized feasibility and pilot study
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-12-27
    Smiti Kahlon; Philip Lindner; Tine Nordgreen

    Public Speaking Anxiety (PSA) is a common anxiety with onset in adolescence and early adulthood. With the advent of consumer virtual reality (VR) technology, VR-delivered exposure therapy is now a scalable and practical treatment option and has previously been shown to be efficacious with adults. In this non-randomized feasibility and pilot trial, we explore the effect of one-session (90 min) VR-delivered exposure therapy for adolescents (aged 13–16) with PSA. A total of 27 adolescents were recruited from Norwegian high schools and completed self-report measures of PSA twice prior to treatment, 1 week after treatment, and at 1 and 3 month follow-up. Heart rate was recorded during the treatment session. A low-cost head-mounted VR display with a custom-built VR stimuli material depicting a cultural and age appropriate classroom and audience were used when a series of speech (exposure exercises) were performed. Linear mixed effects model revealed a significant decrease in PSA symptoms (Cohen’s d = 1.53) pre-post treatment, and improvements were maintained at follow-ups. Physiological data revealed a small increase in heart rate during exposure tasks. Based on feedback from the adolescents, the feasibility of the intervention was increased during the trial. The results show that low-cost, consumer VR hardware can be used to deliver efficacious treatment for PSA in adolescents, in a feasible one-session format.

    更新日期:2019-12-27
  • Measuring children’s emotional and behavioural problems: are SDQ parent reports from native and immigrant parents comparable?
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-11-28
    Ronja A. Runge; Renate Soellner

    The number of immigrants worldwide is growing and migration might be a risk factor for the mental health of children. A reliable instrument is needed to measure immigrants' childrens mental health. The aim of the study was to test the measurement invariance of the parent version of the Strengths and Difficulties Questionnaire (SDQ) between German native, Turkish origin and Russian origin immigrant parents in Germany. The SDQ is one of the most frequently used screening instruments for mental health disorders in children. Differential Item Functioning (DIF) was tested in samples matched by socio-economic status, age and gender of the child. A logistic regression/item response theory hybrid method and a multiple indicators- multiple causes model (MIMIC) was used to test for DIF. Multi Group Confirmatory Factor analysis (MGCFA) was used to test for configural invariance. Parent reports of 10610 German native, 534 Russian origin and 668 Turkish origin parents of children aged 3–17 years were analysed. DIF items were found in both groups and with both methods. We did not find an adequate fit of the original five factor model of the SDQ for the Turkish origin group, but for the Russian origin group. An analysis of functional equivalence indicated that the SDQ is equally useful for the screening of mental health disorders in all three groups. Using the SDQ in order to compare the parent reports of native and immigrant parents should be done cautiously. Thus, the use of the SDQ in epidemiological studies and for prevention planning is questionable. However, the SDQ turns out to be a valid instrument for screening purposes in parents of native and immigrant children.

    更新日期:2019-11-29
  • The relationship between psychological Suzhi and social anxiety among Chinese adolescents: the mediating role of self-esteem and sense of security
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2018-12-13
    Zhaoxia Pan; Dajun Zhang; Tianqiang Hu; Yangu Pan

    High incidence and morbidity rates are found among adolescents with social anxiety disorder, a severe and harmful form of social phobia. Extensive research has been conducted to uncover the underlying psychological factors associated with the development and continuation of this disorder. Previous research has focused on single individual difference variables such as personality, cognition, or emotion; thus, the effect of an individual’s full psychological profile on social anxiety has rarely been studied. Psychological suzhi is a comprehensive psychological quality that has been promoted in Chinese quality-oriented education. This research aimed to explore how psychological suzhi affects Chinese adolescents’ social anxiety. A cross-sectional survey study was carried out among 1459 middle school students (683 boys and 776 girls) from various middle schools in seven provinces of China. Psychological suzhi, self-esteem, sense of security, and social anxiety were measured via four self-reported questionnaires: the Brief Psychological Suzhi Questionnaire for middle school students, the Chinese version of the Rosenberg Self-Esteem Scale, the Security Questionnaire, and the Social Avoidance and Distress Scale. Analyses showed that psychological suzhi is positively related to self-esteem and sense of security, and it is negatively correlated with social anxiety. The results also revealed that self-esteem partially mediates the relationship between adolescents’ psychological suzhi and social anxiety, with self-esteem and sense of security serving as chain mediators in the relationship between psychological suzhi and social anxiety. Results highlight that psychological suzhi is a protective factor against social anxiety. It can directly protect adolescents from social anxiety, and it also can protect them through affecting their self-esteem and sense of security. These results are discussed from the viewpoints of school leaders, psychology teachers, and school counsellors, who provide support to students to improve their social functioning within the school context. The findings of this study may provide new perspectives regarding the prevention and treatment of social anxiety.

    更新日期:2019-11-28
  • Starting from scratch: prevalence, methods, and functions of non-suicidal self-injury among refugee minors in Belgium
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2018-12-18
    Sarah Verroken; Chris Schotte; Ilse Derluyn; Imke Baetens

    As many refugee minors have gone/go through stressful life experiences and uncertainty, one might expect mental health issues, including self-injury. However, literature on non-suicidal self-injury (NSSI) in refugee minors is scarce. This study explores the prevalence, methods, and functions of NSSI in refugee minors in Belgium, and compares research results to the existing literature on NSSI in Western adolescents. Data were obtained from 121 refugee minors (mean age = 16.12, SD = 1.23; range 14–18 years) through schools located in the Flemish and Brussels-Capital regions of Belgium. The sample consists of 39.7% girls and 60.3% boys. Self-report questionnaires were used to explore socio-economic data, NSSI behaviour (e.g. The Brief Non-Suicidal Self-injury Assessment Tool; BNNSI-AT) and emotional and behavioural difficulties (The Strengths and Difficulties Questionnaire; SDQ). Non-parametric Chi square tests were used for statistical comparisons of the obtained data as well as independent-sample t-tests and Fisher’s exact tests. Results show a lifetime NSSI prevalence rate of 17.4%. Being accompanied or not, having both parents around, or living in an asylum centre did not influence NSSI prevalence. An average of 2.65 methods of NSSI was applied (SD = 2.50; range 1–9). The mean number of functions per person was six (SD = 4.97, range 0–16), with automatic functions reported the most. The data do point towards a greater psychological strain, with 68.4% reporting more than five acts of NSSI. Results of the SDQ’s Total Difficulties Scale and, more specifically, of the Emotional Problems, Conduct Problems, Peer Problems and Impact Scales indicate a substantial risk of clinically significant problems within the NSSI group. The Peer Problems and Impact Scales also point towards a high risk for suicidality amongst self-injuring refugees. Prevalence rates, methods and functions are comparable to Western samples. However, the higher incidence of the NSSI and the results on the SDQ also emphasise the vulnerability of refugee minors.

    更新日期:2019-11-28
  • The NSSI Family Distress Cascade Theory
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2018-12-18
    Lisa Waals; Imke Baetens; Peter Rober; Stephen Lewis; Hanna Van Parys; Eveline R. Goethals; Janis Whitlock

    Nonsuicidal self-injury (NSSI) is a complex behaviour and occurs most commonly during adolescence. This developmental period is characterized by the drive to establish an equilibrium between personal autonomy and connectedness with primary caregivers. When an adolescent self-injures, caregivers often experience confusion about how to react. Reports of feeling guilt, fear, and shame are common in the wake of learning about a child’s self-injury. This cascade of negative feelings and self-appraisals may lead to hypervigilance and increased caregiver efforts to control the child’s behaviour. The adolescent may experience this as an intrusion, leading to worse family functioning and increased risk of NSSI. This cascade is not well acknowledged or articulated in current literature. This article remedies this gap by presenting the NSSI Family Distress Cascade.

    更新日期:2019-11-28
  • The relationship between the development of social competence and sleep in infants: a longitudinal study
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2018-12-18
    Etsuko Tomisaki; Emiko Tanaka; Taeko Watanabe; Ryoji Shinohara; Maki Hirano; Yoko Onda; Yukiko Mochizuki; Yuko Yato; Noriko Yamakawa; Tokie Anme

    Many reports argue that sleep is important for children’s health, learning, and academic performance. The purpose of this longitudinal study was to examine the association between sleep and the development of social competence in infants. This study was conducted as part of a Japan Science and Technology Agency (JST) project. Caregivers responded to the Japan Children’s Study Sleep Questionnaire when children were 18 months old. The interactions of caregivers and children were observed when children were 18, 30, and 42 months old, and rated with the Interaction Rating Scale, which is a measure of social competence. Nocturnal sleep duration of more than 10 h and an earlier bed time than 22:00 were significantly correlated with two trajectory groups (low point and high point transition groups) of children’s social competence at 18, 30, and 42 months. Further, total sleep duration of more than 12.25 h and an earlier bed time than 22:00 were significantly correlated with the trajectory of children’s social competence at 18, 30, and 42 months. Sleep duration and sleep onset time are important factors in children’s development of social competence. Trial registration The ethics committee of the JST approved this study on March 19, 2001. The registration number is 356-1.

    更新日期:2019-11-28
  • Earthquake exposures and mental health outcomes in children and adolescents from Phulpingdanda village, Nepal: a cross-sectional study
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2018-12-20
    Jessica S. Schwind; Clara B. Formby; Susan L. Santangelo; Stephanie A. Norman; Rebecca Brown; Rebecca Hoffman Frances; Elisabeth Koss; Dibesh Karmacharya

    Mental health issues can reach epidemic proportions in developed countries after natural disasters, but research is needed to better understand the impact on children and adolescents in developing nations. A cross-sectional study was performed to examine the relationship between earthquake exposures and depression, PTSD, and resilience among children and adolescents in Phulpingdanda village in Nepal, 1 year after the 2015 earthquakes, using the Depression Self-Rating Scale for Children, Child PTSD Symptom Scale, and the Child and Youth Resilience Measure, respectively. To quantify exposure, a basic demographic and household questionnaire, including an earthquake exposure assessment tool for children and adolescents, was created. Of the 62 respondents interviewed, 3.23% and 4.84% displayed symptomatology of depression and PTSD. A large number of respondents interviewed scored high for resiliency (80.65%). All 62 respondents were displaced from their household and witnessed severe damage of both their homes and village. The number of earthquake exposures had a strong, positive correlation with PTSD symptomatology. Although the number of respondents who showed signs of depression and PTSD symptomatology was lower than anticipated, resilience scores were considerably higher. Future research should explore which protective factors may contribute to high resiliency in Nepali children and adolescents.

    更新日期:2019-11-28
  • Parent and peer relationships as longitudinal predictors of adolescent non-suicidal self-injury onset
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-01-03
    Sarah E. Victor; Alison E. Hipwell; Stephanie D. Stepp; Lori N. Scott

    Adolescence is characterized by developmental changes in social relationships, which may contribute to, or protect against, psychopathology and risky behaviors. Non-suicidal self-injury (NSSI) is one type of risky behavior that typically begins during adolescence and is associated with problems in relationships with family members and peers. Prior research on social factors in adolescent NSSI has been limited, however, by a narrow focus on specific interpersonal domains, cross-sectional methods, retrospective self-report of childhood experiences, and a failure to predict NSSI onset among as-yet-unaffected youth. We investigated these relationships in 2127 urban-living adolescent girls with no NSSI history at age 13, who were participating in a longitudinal cohort study (Pittsburgh Girls Study). We used discrete-time survival analyses to examine the contribution of time-varying interpersonal risk factors, assessed yearly at ages 13–16, to NSSI onset assessed in the following year (ages 14–17), controlling for relevant covariates, such as depression and race. We considered both behavioral indicators (parental discipline, positive parenting, parental monitoring, peer victimization), and cognitive/affective indicators (quality of attachment to parent, perceptions of peers, and perceptions of one’s own social competence and worth in relation to peers) of interpersonal difficulties. Parental harsh punishment, low parental monitoring, and poor quality of attachment to parent predicted increased odds of subsequent adolescent NSSI onset, whereas positive parenting behaviors reduced the odds of next year NSSI onset. Youth who reported more frequent peer victimization, poorer social self-worth and self-competence, and more negative perceptions of peers were also at increased risk of NSSI onset in the following year. When tested simultaneously, no single parenting variable showed a unique association with later NSSI onset; in contrast, peer victimization and poor social self-worth each predicted increased odds of later NSSI onset in an omnibus model of peer and parent relationship characteristics. In this urban sample of adolescent girls, both peer and parent factors predicted new onset NSSI, although only peer factors were associated with subsequent NSSI in combined multivariate models. Results further suggest that both behavioral and cognitive/affective indicators of interpersonal problems predict NSSI onset. These findings highlight the relevance of family and peer relationships to NSSI onset, with implications for prevention of NSSI onset among at-risk youth.

    更新日期:2019-11-28
  • Therapeutic factors that promote recovery in high-risk adolescents intensive group psychotherapeutic MBT programme
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-01-10
    Kirsten Hauber; Albert E. Boon; Robert Vermeiren

    The aim of this study was to investigate whether therapeutic factors as identified by Yalom and potential additional therapeutic factors could be found in the qualitative individual reports of high-risk adolescents with personality disorders at the end of an intensive group psychotherapeutic MBT programme and whether the therapeutic factors were related to therapy outcomes. At the end of treatment, 70 adolescents were asked to write a farewell letter. Content analysis of the letters was performed by two independent raters, using the 12 therapeutic factors of Yalom and potential additional therapeutic factors as coding categories. The factors were related to outcome, operationalized as a decrease in psychological symptoms as measured with the Symptom Check List 90 (SCL-90). All therapeutic factors of Yalom and four new factors were identified in the letters, ranging from 1 to 97%. The factors of ‘cohesion’ (97%), ‘interpersonal learning output’ (94%), ‘guidance’ (98%) and ‘identification’ (94%) were found in most letters. By contrast, ‘universality’ (1%), ‘family re-enactment’ (3%) and ‘instillation of hope’ (1%) were found in very few letters. The factors ‘interpersonal learning input’, ‘self-esteem’ and ‘turning point’ were significantly associated with therapeutic recovery. Large presence differences were encountered in therapeutic factors associated with resilience processes and the resolution of psychological distress. Although a relationship was found between certain factors and change in symptoms, it was unclear whether the factors had led to such change. Further research seems important for treatment in general and for the personalization of treatment.

    更新日期:2019-11-28
  • Child mental illness and the help-seeking process: a qualitative study among parents in a Ugandan community
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-01-11
    V. Skylstad; A. Akol; G. Ndeezi; J. Nalugya; K. M. Moland; J. K. Tumwine; I. M. S. Engebretsen

    Child mental illness contributes significantly to the burden of disease worldwide, and many are left untreated due to factors on both the provider and user side. Recognising this, the Ugandan Ministry of Health recently released the Child and Adolescent Mental Health (CAMH) Policy Guidelines. However, for implementation to be successful the suggested policy changes must resonate with the service users. To better understand the sociocultural factors influencing parental mental help-seeking, we sought insights from parents in the Mbale district of eastern Uganda. In this qualitative study, eight focus group discussions were conducted with mothers and fathers in urban and rural communities. Parents of children younger than 10 years were purposively selected to discuss a vignette story about a child with symptoms of depression or ADHD as well as general themes relating to child mental illness. The data were analysed using qualitative content analysis. Descriptions of severe symptoms and epileptic seizures were emphasised when recognising problem behaviour as mental illness, as opposed to mere ‘stubbornness’ or challenging behaviour. A mixture of supernatural, biomedical, and environmental understandings as underlying causes was reflected in the help-seeking process, and different treatment providers and relevant institutions, such as schools, were contacted simultaneously. A notion of weakened community social support structures hampered access to care. Awareness of symptoms closer to normal behaviour must be increased in order to improve the recognition of common mental illnesses in children. Stakeholders should capitalise on the common recognition of the importance of the school when planning the upscaling of and improved access to services. Multifactorial beliefs within the spiritual and biomedical realms about the causes of mental illness lead to multisectoral help-seeking, albeit without collaboration between the various disciplines. The CAMH Policy Guidelines do not address traditional service providers or provide a strategy for better integration of services, which might mean continued fragmentation and ineffective service provision of child mental health care.

    更新日期:2019-11-28
  • The relation between mental health problems and future violence among detained male juveniles
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-01-12
    Olivier F. Colins; Thomas Grisso

    Detention personnel may assume that mental health problems heighten the likelihood of future violence in detained youth. This study explored whether brief mental health screening tools are of value for alerting staff to a detained youth’s potential for future violent offending. Boys (n = 1259; Mean age = 16.65) completed the Massachusetts Youth Screening Instrument-Second Version (MAYSI-2) and the Strengths and Difficulties Questionnaire (SDQ) as part of a clinical protocol. Official records were collected to index past and future violent offending. A few significant positive and negative relationships between MAYSI-2 and SDQ scale scores and future violent offending were revealed, after controlling for age, past violent offending, and follow-up time. These relations were almost entirely dissimilar across the ethnic groups, even to the extent of finding opposite relations for boys in different ethnic groups. The small number of relations and their small effect sizes suggest little likelihood that screening for mental health problems in boys who are detained in the Netherlands offers any potential for identifying youth at risk for committing future violent crimes. The current findings also suggest that ethnic differences in the relation between mental health problems and future criminality must be considered in future studies.

    更新日期:2019-11-28
  • The effects of parental opioid use on the parent–child relationship and children’s developmental and behavioral outcomes: a systematic review of published reports
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-01-12
    Magdalena Romanowicz; Jennifer L. Vande Voort; Julia Shekunov; Tyler S. Oesterle; Nuria J. Thusius; Teresa A. Rummans; Paul E. Croarkin; Victor M. Karpyak; Brian A. Lynch; Kathryn M. Schak

    Between 2009 and 2014, nearly 3% of US children (age ≤ 17 years) lived in households with at least 1 parent with substance use disorder. The present systematic review aimed to evaluate effects of parental opioid use disorder on the parent–child relationship and child developmental and behavioral outcomes. Several databases were comprehensively searched for studies published from January 1980 through February 2018 that reviewed effects of parental opioid addiction on parent–child relationships and outcomes of children (age, 0–16 years). Of 304 unique studies, 12 evaluated effects of parental opioid addiction on the parent–child relationship as the primary outcome and on children’s outcomes, including behaviors and development. Observation of mother–child interaction showed that mothers with opioid use disorders are more irritable, ambivalent, and disinterested while showing greater difficulty interpreting children’s cues compared with the control group. Children of parents with opioid use disorders showed greater disorganized attachment; they were less likely to seek contact and more avoidant than children in the control group. The children also had increased risk of emotional and behavioral issues, poor academic performance, and poor social skills. Younger children had increased risk of abuse or neglect, or both, that later in life may lead to such difficulties as unemployment, legal issues, and substance abuse. Current evidence shows association between parental opioid addiction and poorer mother–child attachment and suboptimal child developmental and behavioral outcomes. Further research and treatment targeting children and families with parental opioid use are needed to prevent difficulties later in life.

    更新日期:2019-11-28
  • Overview of European forensic youth care: towards an integrative mission for prevention and intervention strategies for juvenile offenders
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-01-14
    Fleur Souverein; Tycho Dekkers; Elena Bulanovaite; Theo Doreleijers; Heidi Hales; Riittakerttu Kaltiala-Heino; Aurelio Oddo; Arne Popma; Nora Raschle; Klaus Schmeck; Marco Zanoli; Thimo van der Pol

    All over Europe youth delinquency is decreasing; our understanding of the factors related to juvenile delinquency and the characteristics of effective forensic youth care has increased substantially. However, effective prevention and intervention strategies are not always employed due to financial, demographical and socio-political challenges countries face, while the burden of mental health in juvenile justice populations is high. With this commentary, we highlight the importance of international collaboration to set out a direction to improve forensic youth care, to bundle our strengths and overcome our challenges. It is a continuation of the course that was set out by Doreleijers and Fegert (Child Adolesc Psychiatry Ment Health 5:20, 2011), in their editorial they highlighted the importance of collaboration and presented an overview of the state of the art on forensic youth care in eight European countries (and Russia). With this manuscript, we present an overview of statistics in juvenile justice of all European countries and present an integrated mission statement for forensic youth care, which was formulated in a keynote debate at the 6th biennial congress of the European Association for Forensic Child and Adolescent Psychiatry, Psychology and other involved professions (EFCAP).

    更新日期:2019-11-28
  • Maternal and peer attachment, identity formation, and non-suicidal self-injury: a longitudinal mediation study
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-01-19
    Amarendra Gandhi; Koen Luyckx; Geert Molenberghs; Imke Baetens; Lien Goossens; Shubhada Maitra; Laurence Claes

    Non-suicidal self-injury (NSSI) is defined as the repetitive, direct, and deliberate destruction of one’s body tissue without an intention to die. Existing cross-sectional research indicates that the association between maternal/peer attachment and NSSI is mediated by identity synthesis and confusion. However, longitudinal confirmation of the aforementioned mediation models is necessary as cross-sectional models are known to be biased. Consequently, the aim of the present study was to investigate whether identity formation mediates the association between attachment and NSSI in a longitudinal design. Three waves of self-report questionnaires data (1 year apart) were collected on maternal and peer attachment, identity, and NSSI from students of a high school in Belgium (at Time 1: Mean age = 15.0 years, SD = 1.85, range = 11–19 years, 50.6% female). Both cross-lagged (between-person) and parallel process latent growth curve (within-person) mediation analyses were used to test the mediation models. Findings of the cross-lagged analyses indicated unidirectional associations among the study variables, that is, from attachment to identity to NSSI. Parallel process latent growth mediation analyses showed that the association between the slope of maternal attachment and the slope of NSSI was mediated by the slopes of identity synthesis and confusion. Peer attachment models did not fit the data. The current work demonstrated that dysfunctional maternal and peer attachment may lead to disturbances in identity formation, which, in turn, may lead to increased NSSI. Additionally, within-person analysis indicated that the growth rate of maternal attachment predicted the growth rate of NSSI through the growth rate of identity synthesis and confusion. The clinical relevance of these findings is discussed.

    更新日期:2019-11-28
  • Mental health and associated stress factors in accompanied and unaccompanied refugee minors resettled in Germany: a cross-sectional study
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-01-30
    Lauritz Rudolf Floribert Müller; Karl Phillipp Büter; Rita Rosner; Johanna Unterhitzenberger

    Studies throughout Europe have shown that asylum-seeking children and adolescents (ASC) are at risk of developing mental disorders. The most common mental-health problems in ASC include posttraumatic stress symptoms (PTSS), internalizing symptoms such as depression and anxiety, and externalizing behaviour. Being an unaccompanied refugee minor (URM) was found to be highly predictive for higher levels of psychological distress within ASC. Nevertheless, and even though Germany is Europe’s biggest host country for ASC, studies that reliably examine the mental health of both URM and accompanied refugee minors (ARM) in Germany with psychometrically tested measures are still lacking. A cross-sectional survey in 19 facilities for minor refugees in Bavaria, Germany, screening for PTSS, depression, anxiety, externalizing behaviour, and post-migration factors was conducted. Participants were 98 ASC (URM, n = 68; ARM, n = 30) primarily from Afghanistan, Syria, and Eritrea. In 35.7% of interviews, interpreters were involved. Both URM and ARM reported high levels of psychological distress and large numbers of potentially traumatic events, with 64.7% of URM and 36.7% of ARM scoring above the clinical cut-off for PTSS, 42.6% of URM and 30% of ARM for depression, and 38.2% of URM and 23.3% of ARM for anxiety. The total number of traumatic experiences was found to be the most robust predictor for PTSS, depression, and anxiety. Lower levels of individual resources, lower levels of social support in the host country, and poorer German language proficiency were associated with higher levels of psychological distress within both groups. URM reported significantly more traumatic events than ARM. ASC in Germany are severely distressed and burdened by the experiences of various types of potentially traumatic events. The levels of distress found in the current study correspond with rates that have been reported in previous studies with ASC throughout Europe. Limitations of the present study include the convenience sample and the cross-sectional nature of findings.

    更新日期:2019-11-28
  • Clinicians’ attitudes toward standardized assessment and diagnosis within child and adolescent psychiatry
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-02-12
    M. Danielson; A. Månsdotter; E. Fransson; S. Dalsgaard; J-O. Larsson

    There is a strong call for clinically useful standardized assessment tools in everyday child and adolescent psychiatric practice. The attitudes of clinicians have been raised as a key-facilitating factor when implementing new methods. An explorative study was conducted aimed to investigate the clinicians’ attitudes regarding standardized assessments and usefulness of diagnoses in treatment planning. 411 mental health service personnel working with outpatient and inpatient assessment and treatment within the specialist child and adolescent mental health services, Stockholm County Council were asked to participate in the study, of which 345 (84%) agreed answer a questionnaire. The questionnaire included questions regarding Attitudes toward Standardized Assessment and Utility of Diagnosis. Descriptive analyses were performed and four subscales were compared with information from a similar study in US using the same instruments. The demographic and professional characteristics (age, working years, gender, education, profession, management position, involvement in assessment, level of service) in terms of prediction of attitudes were studied by univariate and multivariate linear regressions. Overall, the clinicians had quite positive attitudes and were more positive compared to a similar study conducted in the US earlier. There were differences in attitudes due to several characteristics but the only characteristic predicting all subscales was type of profession (counselor, nurse, psychiatrist, psychologist, other), with counselors being less positive than other groups. The overall positive attitudes toward standard assessment are of importance in the development of evidence-based practice and our study implies that clinicians in general value and are willing to use standardized assessment. Nevertheless, there are specific issues such as adequate training and available translated assessment instrument that need to be addressed. When implementing new methods in practice, there are general as well as specific resistances that need to be overcome. Studies in different cultural settings are of importance to further extend the knowledge of what is general and what is specific barriers.

    更新日期:2019-11-28
  • The bumpy road to change: a retrospective qualitative study on formerly detained adolescents’ trajectories towards better lives
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-02-25
    Nele Van Hecke; Wouter Vanderplasschen; Lore Van Damme; Stijn Vandevelde

    Currently, the risk-oriented focus in forensic youth care is increasingly complemented by a growing interest in strengths-based approaches. Knowledge on how detention and the subsequent period in the community is experienced by adolescents, and which elements are helpful in achieving better lives can contribute to this emerging field. The current study aimed to retrospectively explore adolescents’ experiences from the moment they were detained until 6 to 12 months after they left the institution, identifying positive aspects and strengths. In-depth interviews were conducted with 25 adolescents (both boys and girls, 15–18 years old) on average 8 months after discharge from a closed institution in Belgium. A thematic analysis was performed using NVivo 11. Five themes and corresponding subthemes were identified: (1) adolescents’ own strengths and resilience, (2) re-building personally valued lives, (3) making sense of past experiences, (4) moving away from a harmful lifestyle, and (5) (in-)formal supports. Most adolescents are on their way to finding a new balance in life, however, for a subgroup of them, this is still fragile. Adolescents highly emphasize the importance of feeling closely connected to at least one person; to receive practical help with regard to finances, work and housing; and to be able to experience pleasure and joy in their lives. Adolescents’ narratives suggest that starting a journey towards a normative good life often goes along with an initial difficult period because of a sense of loss with regard to their former life. This stresses the importance of targeting rehabilitation towards prosocial goals and enhancing adolescents’ quality of life on those life domains that matter most for them. Furthermore, we stress the importance of helping adolescents in overcoming structural barriers as a first step in supporting them in their trajectories towards better lives.

    更新日期:2019-11-28
  • Favourable short-term course and outcome of pediatric anxiety spectrum disorders: a prospective study from India
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-02-28
    Preeti Kandasamy; Satish C. Girimaji; Shekhar P. Seshadri; Shoba Srinath; John Vijay Sagar Kommu

    Although anxiety disorders are the most prevalent psychiatric disorders among children and adolescents, there is a paucity of research on the course and outcome of anxiety spectrum disorders in low and middle-income countries. 60 children and adolescents aged 6–16 years with anxiety spectrum disorders attending the child and adolescent psychiatry department in a tertiary care center from India were included after taking written informed consent and assent in this prospective study conducted between April 2012 to May 2014. Assessments were done at baseline, 12 weeks and 24 weeks using pediatric anxiety rating scale, clinical global impression-severity, clinical global assessment scale and pediatric quality of life scale; MINI-KID (version 6.0) was used to examine remission status. Mean age of children was 12.68 years and mean duration of illness was 34.52 months. Follow-up rate at 24 weeks was 80% with a remission rate of 64.6%. Socio-demographic factors did not affect the baseline severity or course and outcome measures. Children with greater baseline severity and social phobia had a less favorable outcome at 24 weeks. Improvements made in the initial 12 weeks were maintained at 24 weeks follow up. These findings are in line with earlier studies from high-income countries. Small sample size, attrition, rater bias. The study has shown a favorable outcome in children and adolescents with anxiety spectrum disorders receiving treatment-as-usual in a tertiary care setting. Adolescents who present with greater severity, comorbid with other anxiety disorders and depression at baseline require intensive intervention, and long-term follow up. There is a need for interventional research with specific focus on universal preventive programs for anxiety spectrum disorders that are feasible for delivery in low and middle-income countries.

    更新日期:2019-11-28
  • Gender differences in Korean adolescents who died by suicide based on teacher reports
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-03-11
    Song Jung; Dayoung Lee; Sungjun Park; Kangwoo Lee; Yong-Sil Kweon; Eun-Jin Lee; Kyung Hee Yoon; Hannah Cho; Hyeji Jung; Ah Reum Kim; Bo-Ram Shin; Hyun Ju Hong

    We investigated the characteristics of adolescents who committed suicide in South Korea, and how these characteristics differed by gender. Data from middle and high school students who committed suicide between 2014 and 2016 were analyzed. We evaluated differences in suicide method and place, personal characteristics, and school life characteristics by gender using the Chi square test and t test. Jumping from a high place was the most common suicide method for both male and female students. A significantly greater proportion of female adolescents had experienced depressive symptoms, previous self-injury, previous suicide attempts, and had problems with school attendance and peers. Additionally, they were more likely to be classified as high risk according to a school-based mental health screening test and to utilize professional mental health treatment services. Our results demonstrate that adolescents who committed suicide exhibited gender differences in personal characteristics and school life. These characteristics might aid in the development of adolescent suicide policies and intervention programs.

    更新日期:2019-11-28
  • Maltreatment history, trauma symptoms and research reactivity among adolescents in child protection services
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-03-11
    Randall Waechter; Dilesha Kumanayaka; Colleen Angus-Yamada; Christine Wekerle; Savanah Smith

    There is a well-documented link between child maltreatment and poor health across the lifespan. This provides a strong case for ongoing research with youth involved in the child welfare system to reduce negative outcomes and support resilience while being inclusive of youth voices. However, detailed inquiries about maltreatment history and health consequences may cause re-experiencing of events and psychological distress for study participants. Data that accounts for different contexts, such as severity of maltreatment history and current trauma symptomatology, have been limited in considering the question of potential harms to youth who participate in research—especially longitudinal studies. This study compared self-reported impact of research participation against maltreatment history and current post-traumatic stress symptomatology among a randomly selected group of adolescents (< 18 years old) in the child protection service (CPS) system. Adolescents who report more serious child maltreatment and current trauma symptom severity reported higher scores on distress questions from pre- to post-assessment participation. Critically, participants who were more negatively impacted by study involvement also reported greater benefit from study involvement. The increase in both negative and positive impact does not shift the risk/reward ratio for participation, as risks alone do not increase for this vulnerable group of CPS involved youth. These results are consistent with previous findings from studies involving non-CPS populations and underlies the importance of empirical data to address the question of change in the risk/reward ratio and what factors might play a role in any change. This information can inform inclusion/exclusion criteria for future research with these vulnerable populations, thereby reducing the risk of distress among study participants.

    更新日期:2019-11-28
  • Utilizing a family-based economic strengthening intervention to improve mental health wellbeing among female adolescent orphans in Uganda
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-03-11
    Apollo Kivumbi; William Byansi; Fred M. Ssewamala; Nabunya Proscovia; Christopher Damulira; Phionah Namatovu

    It is estimated that almost 20% of the world’s adolescents have experienced or are experiencing a mental health problem. Several factors have been associated with the onset of adolescent mental health disorders, including poverty, child abuse and violence, particularly among adolescent girls. This paper examines the effect of participating in a family-based economic strengthening intervention on the mental health well-being of female adolescent orphans impacted by HIV/AIDS in rural Uganda. Data utilized in this study was from the Bridges to the Future Study (2011–2016), an economic empowerment intervention aimed at improving health outcomes of orphaned children. Adolescents were randomly assigned to either the control condition receiving bolstered standard of care services for orphaned adolescents; or one of two treatment conditions receiving bolstered standard of care as well as an economic empowerment intervention comprising of a child development account, a mentorship program and workshops on financial management and microenterprise development. Data was collected at baseline, 12- and 24-months post intervention initiation. Multilinear regression analyses were conducted to examine the impact of an economic empowerment intervention on mental health functioning of female participants over time. Mental health functioning was measured by: (1) the Child Depression Inventory; (2) Beck Hopelessness Scale; and (3) Tennessee Self Concept Scale. Analysis results show an improvement in mental health functioning over time among female participants receiving the intervention compared to their control counterparts. Specifically, compared to participants in the control condition, participants receiving the intervention reported a reduction in depressive symptoms from baseline to 12-months follow-up (b = − 1.262, 95% CI − 2.476, − 0.047), and an additional 0.645-point reduction between baseline and 24-months follow-up (b = − 1.907, 95% CI − 3.192, − 0.622). Participants receiving the intervention reported significant improvement in their reported self-concept from baseline to 24 months follow-up (b = 3.503 (95% CI 1.469, 5.538) compared to participants in the control condition. Empowerment of young girls, either in the form of peer mentorship and/or economic strengthening seems to significantly improve the overall mental health functioning of adolescent girls impacted by HIV and AIDS in low-income settings.

    更新日期:2019-11-28
  • Sibling relationships of female adolescents with nonsuicidal self-injury disorder in comparison to a clinical and a nonclinical control group
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-03-15
    Taru Tschan; Janine Lüdtke; Marc Schmid; Tina In-Albon

    Adolescents’ nonsuicidal self-injury (NSSI) leads to distress that affects the whole family system, and siblings are reported to suffer from disrupted family communication and functioning. So far, no studies have examined the quality of relationships between adolescents with NSSI and their siblings. The aim of the present study was to examine the sibling relationship quality of adolescents with NSSI, adolescents with other mental disorders without NSSI (clinical controls, CC), and adolescents without current or past experience of mental disorders (nonclinical controls, NC). 139 female adolescents aged 13–20 years (mean age = 16.18 years, SD = 1.62, NSSI: n = 56, CC: n = 33, NC: n = 50) and 73 siblings aged 10–28 years (mean age = 16.88 years, SD = 4.02, 60.3% female) participated. Self-report measures were used to assess psychopathology and sibling relationship quality. Siblings reported a wide range of negative emotional and familial consequences, such as feeling left alone with their sister’s issues or a distressing family situation, as a result of their sister’s NSSI. Siblings of adolescents with NSSI experienced significantly more coercion in the relationship with their sister compared to CC (d = 1.08) and NC (d = 0.67) siblings, indicating an imbalance of dominance and control in their relationship. Further, adolescents with NSSI reported significantly less warmth and empathy in the sibling relationship and higher rivalry scores between their siblings and themselves than NC adolescents, suggesting higher levels of parental favoritism among parents of adolescents with NSSI compared to NC parents (d = 0.93). Among siblings of adolescents with NSSI, high levels of warmth, conflict, and empathy were significantly associated with internalizing problems. For adolescents with NSSI a significant association was found between internalizing problems and coercion and externalizing problems and similarity. Given the negative impact of NSSI on siblings’ emotional well-being and family life, efforts should be made to offer siblings psychoeducation and support to help them cope with the emotional and familial consequences of their sister’s NSSI. Given adequate support, siblings can in turn be a source of emotional support for their sister.

    更新日期:2019-11-28
  • Pathways to a diagnosis of autism spectrum disorder in Germany: a survey of parents
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-03-21
    Juliana Höfer; Falk Hoffmann; Inge Kamp-Becker; Luise Poustka; Veit Roessner; Sanna Stroth; Nicole Wolff; Christian J. Bachmann

    Early identification of autism spectrum disorders (ASD) is a prerequisite for access to early interventions. Although parents often note developmental atypicalities during the first 2 years of life, many children with ASD are not diagnosed until school age. For parents, the long period between first parental concerns and diagnosis is often frustrating and accompanied by uncertainty and worry. This study retrospectively explored the trajectories of children with a confirmed ASD diagnosis during the diagnostic process, from first parental concerns about their child’s development until the definite diagnosis. A survey concerning the diagnostic process was distributed to parents or legal guardians of children with ASD from three specialized ASD outpatient clinics in Germany. The response rate was 36.9%, and the final sample consisted of carers of 207 affected children (83.6% male, mean age 12.9 years). The children had been diagnosed with childhood autism (55.6%), Asperger syndrome (24.2%), or atypical autism (20.3%). On average, parents had first concerns when their child was 23.4 months old, and an ASD diagnosis was established at a mean age of 78.5 months. Children with atypical autism or Asperger syndrome were diagnosed significantly later (83.9 and 98.1 months, respectively) than children with childhood autism (68.1 months). Children with an IQ < 85 were diagnosed much earlier than those with an IQ ≥ 85. On average, parents visited 3.4 different health professionals (SD = 2.4, range 1–20, median: 3.0) until their child received a definite ASD diagnosis. Overall, 38.5% of carers were satisfied with the diagnostic process. In this sample of children with ASD in Germany, the time to diagnosis was higher than in the majority of other comparable studies. These results flag the need for improved forms of service provision and delivery for suspected cases of ASD in Germany.

    更新日期:2019-11-28
  • CAPMH health-related quality of life among adolescent psychiatric outpatients: a 12-month follow-up study among 12–14-year-old Finnish boys and girls
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-03-26
    Anne Rissanen; Nina Lindberg; Mauri Marttunen; Harri Sintonen; Risto Roine

    Little is known about adolescents’ perceptions about their health-related quality of life (HRQoL) in the course of routine adolescent psychiatric treatment. The aim of this 1-year follow-up study was to investigate HRQoL and changes in it among youths receiving adolescent psychiatric outpatient treatment. The study comprised 158 girls and 82 boys aged 12–14 years from 10 psychiatric outpatient clinics in one Finnish hospital district. Same-aged population controls (210 girls and 162 boys) were randomly collected from comprehensive schools. HRQoL was measured using the 16D instrument. The questionnaire was self-administered when the adolescents entered the polyclinics (= baseline), after a treatment period of 6 months, and after 12 months. The mean age of respondents was 13.8 years (SD 0.63). At baseline, the mean HRQoL score of both female and male outpatients was significantly lower than that of population controls (p < 0.001). HRQoL of female patients was significantly worse than that of male patients (p < 0.001). In girls, HRQoL improved continuously during the 12-month follow-up, yet it remained worse than that of female population controls. Among boys, HRQoL was substantially better at the 6-month follow-up than at baseline, but this positive development was no longer seen at the 12-month follow-up. From the perspective of HRQoL, girls seem to benefit more than boys from adolescent psychiatric outpatient treatment. Possible explanations for this finding are discussed.

    更新日期:2019-11-28
  • Trauma-focused group intervention for unaccompanied young refugees: “Mein Weg”—predictors of treatment outcomes and sustainability of treatment effects
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-04-01
    Elisa Pfeiffer; Cedric Sachser; Dunja Tutus; Joerg M. Fegert; Paul L. Plener

    Current research on treatment predictors and long-term effects of trauma-focused interventions for (unaccompanied) refugee minors is limited. This secondary analysis of a recent randomised controlled trial (RCT), evaluating the trauma-focused group intervention “Mein Weg” (English “My Way”) compared to usual care, investigated several refugee-specific factors such as treatment predictors and sustainability of treatment gains. In total N = 50 participants (Mage = 17.00, 94% male) were included in this analysis. Evaluation of 3-month follow-up data included: posttraumatic stress symptoms [(PTSS) CATS-Self, CATS-Care], depression (PHQ-8), and dysfunctional posttraumatic cognitions (CPTCI-S). Baseline symptom severity of the above-mentioned measures, trauma load and socio-demographic factors were investigated as the treatment predictors. Intention-to-treat-analyses (ITT) revealed the sustainability of treatment effects in self-reported PTSS (pre to post change: 6.48 ± 1.60, d = 0.62, p < 0.001; post to 3-month follow-up change: 1.41 ± 1.96, d = 0.11, p = 0.47) and depression (pre to post change: 7.82 ± 2.09, d = 0.64, p < 0.001; post to 3-month follow-up change: 1.35 ± 2.17, d = 0.05, p = 0.54). Country of origin alone was a significant predictor of the change in PTSS (b = − 8.22 ± 3.53, t(30) = − 2.33, p = 0.027), and baseline levels of depression were a significant predictor of the change in depression (b = 0.83 ± 0.19, t(33) = 4.46, p < 0.001). This group intervention can serve as a valuable component in a stepped care approach with promising long-term effects for young refugees. Trial registration DRKS, #DRKS00010915. Registered 15 September 2016, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00010915

    更新日期:2019-11-28
  • Shaping the future of child and adolescent psychiatry
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-04-11
    Norbert Skokauskas; Daniel Fung; Lois T. Flaherty; Kai von Klitzing; Dainius Pūras; Chiara Servili; Tarun Dua; Bruno Falissard; Panos Vostanis; María Beatriz Moyano; Inna Feldman; Ciaran Clark; Vlatka Boričević; George Patton; Bennett Leventhal; Anthony Guerrero

    Child and adolescent psychiatry is in a unique position to respond to the growing public health challenges associated with the large number of mental disorders arising early in life, but some changes may be necessary to meet these challenges. In this context, the future of child and adolescent psychiatry was considered by the Section on Child and Adolescent Psychiatry of the World Psychiatric Association (WPA CAP), the International Association for Child and Adolescent Psychiatry and Allied Professions (IACAPAP), the World Association for Infant Mental Health (WAIMH), the International Society for Adolescent Psychiatry and Psychology (ISAPP), the UN Special Rapporteur on the Right to Health, representatives of the WHO Department of Mental Health and Substance Abuse, and other experts. We take this opportunity to outline four consensus priorities for child and adolescent psychiatry over the next decade: increase the workforce necessary for providing care for children, adolescents and families facing mental disorders; reorienting child and adolescent mental health services to be more responsive to broader public health needs; increasing research and research training while also integrating new research finding promptly and efficiently into clinical practice and research training; Increasing efforts in advocacy.

    更新日期:2019-11-28
  • Longitudinal studies in forensic child and adolescent psychiatry and mental health: CAPMH thematic series 2018/2019
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-04-11
    Klaus Schmeck; Jörg M. Fegert; Cyril Boonmann

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    更新日期:2019-11-28
  • Gender-specific substance use patterns and associations with individual, family, peer, and school factors in 15-year-old Portuguese adolescents: a latent class regression analysis
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-05-10
    João Picoito; Constança Santos; Isabel Loureiro; Pedro Aguiar; Carla Nunes

    Adolescence is a critical period of vulnerability to substance use. Recent research has shown that gender differences in adolescence substance use are complex and in constant flux. The present study aims to investigate gender differences in substance use and initiation patterns in male and female adolescents, and to assess individual, family, peer, and school associated factors of these patterns. We applied latent class regression analysis to a Portuguese representative population sample of 1551 15-year-old adolescents, drawn from the 2010 ‘Health Behavior in School-Aged Children’ survey, to characterise different profiles of substance use and initiation for boys and girls, and to identify factors associated with latent class membership, stratifying the associations analysis by gender. Three common classes were found for both genders, specifically, Non-Users (boys [B] 34.42%, girls [G] 26.79%), Alcohol Experimenters (B 38.79%, G 43.98%) and Alcohol and Tobacco Frequent Users (B 21.31%, G 10.36%), with two additional unique classes: Alcohol Experimenters and Tobacco Users in girls (18.87%), and Early Initiation and Poly-Substance Users in boys (5.48%). Poor school satisfaction, bullying, fighting and higher family affluence scale score formed a common core of associated factors of substance use, although we found gender differences in these associations. In girls, but not in boys, family factors were associated with more problematic substance use. Not living with both parents was associated with girl’s Alcohol and Tobacco Frequent Users (gATFU) class (OR 3.78 CI 1.18–12.11) and Alcohol Experimenters and Tobacco Users (AETU) class (OR 3.22 CI 1.4–7.44). Poor communication with mother was also associated with gATFU class membership (OR 3.82 CI 1.26–11.53) and AETU class (OR 3.66 CI 1.99–6.75). Additionally, a higher psychological symptoms score was associated with gATFU class membership (OR 1.16 CI 1.02–1.31). Although we found common patterns and associated factors between boys and girls, we report two unique patterns of substance use in boys and girls and specific associations between family, school and peers, and individual factors with these patterns. These findings underscore the need for substance use prevention and health promotion programmes that address potential differences in substance use patterns and associated factors.

    更新日期:2019-11-28
  • Providing manualized individual trauma-focused CBT to unaccompanied refugee minors with uncertain residence status: a pilot study
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-05-17
    Johanna Unterhitzenberger; Svenja Wintersohl; Margret Lang; Julia König; Rita Rosner

    Unaccompanied refugee minors (URMs) seeking asylum show high rates of posttraumatic stress disorder (PTSD), depression and anxiety. In addition, they experience post-migration stressors like an uncertain residence status. Therefore, psychotherapeutic interventions for URMs are urgently needed but have scarcely been investigated up to now. This study aimed to examine manualized individual trauma-focused cognitive behavioural therapy (TF-CBT) for URMs with PTSD involving their professional caregivers (i.e. social workers in child and adolescent welfare facilities). We conducted an uncontrolled pilot study with three follow-up assessments (post-intervention, 6 weeks, and 6 months). Participants who met the PTSD diagnostic criteria were treated in a university psychotherapeutic outpatient clinic in Germany with a mean of 15 sessions of TF-CBT. All participants (n = 26) were male UM (Mage = 17.1, SD = 1.0), predominately from Afghanistan (n = 19, 73.1%) and did not have a residence permit. The sample was severely traumatized according to the number of traumatic event types reported (M = 11.3, SD = 2.8). The primary outcome was PTSD measured with the Child and Adolescent Trauma Screen (CATS) and the Diagnostic Interview for Mental Disorders in Childhood and Adolescence (Kinder-DIPS). Secondary outcomes were depression, behavioural and somatic symptoms. All but the somatic symptoms were assessed in both self-report and proxy report. At post-intervention the completer sample (n = 19) showed significantly decreased PTSD symptoms, F(1, 18) = 11.41, p = .003, with a large effect size (d = 1.08). Improvements remained stable after 6 weeks and 6 months. In addition to PTSD symptoms, their caregivers reported significantly decreased depressive and behavioural symptoms in participants. According to the clinical interview, 84% of PTSD cases recovered after TF-CBT treatment. After 6 months, youths whose asylum request had been rejected showed increased PTSD symptoms according to individual trajectories in the Kinder-DIPS. The effect was, however, non-significant. Intervention studies are feasible with URMs. This pilot study presents preliminary evidence for the efficacy of an evidence-based intervention like TF-CBT in reducing PTSD symptoms in URMs. Stressors related to asylum proceedings after the end of therapy have the potential to negatively influence psychotherapy outcomes.

    更新日期:2019-11-28
  • Social factors associated with non-suicidal self-injury (NSSI)
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-06-12
    Rebecca C. Brown; Andreas Witt

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    更新日期:2019-11-28
  • The relationship between the psychological stress of adolescents in school and the prevalence of chronic low back pain: a cross-sectional study in China
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-06-17
    Qixiang Mei; Chunlin Li; Yue Yin; Qi Wang; Qiugen Wang; Guoying Deng

    Accumulating evidence supports an association between an unhealthy mental state and low back pain (LBP). However, the degree of the association between mental health and chronic low back pain (CLBP) in the general population is poorly understood. The objective of this study was to analyze the incidence of CLBP in Chinese college students and to examine the association between students’ unhealthy mental states and the prevalence of CLBP. This is a cross-sectional study. A total of 10,000 questionnaires were distributed in the second semester of the 2017–2018 academic year by the School of Medicine, Shanghai JiaoTong University. Eligible participants were students aged ≥ 18 years from randomly selected Chinese colleges. Participants completed a questionnaire survey that included items from the Symptom Checklist-90 (SCL-90) and items on demographic factors, LBP prevalence, quality of life at their university, study-related stress and interpersonal relationships. The evaluation of students’ mental states in the survey was divided into two major parts: direct and indirect indicators. A multivariate logistic regression model was mainly used to explore the relationship between CLBP and the students’ mental health. There was a high incidence of CLBP in the college students. Multiple logistic regression analysis indicated that the risk of CLBP increased with increasing scores on the SCL-90, and a clinically unhealthy mental state (scores greater than 3) was significantly associated with CLBP (adjusted odds ratios for depression, anxiety, coercion, paranoia, and interpersonal sensitivity were 7.209, 6.593, 3.959, 4.465, and 4.283, respectively; p < 0.001). Participants who had poor living habits or uncomfortable campus lives and those who experienced heavy academic pressure also showed a higher positive association with CLBP compared with the full sample. Unhealthy psychological conditions, which may be attributed to unsatisfying school lives, excessive learning pressure, and uncomfortable interpersonal relationships, represent a risk factor for CLBP in college students.

    更新日期:2019-11-28
  • Psychometric evaluation of a parent-rating and self-rating inventory for pediatric obsessive-compulsive disorder: German OCD Inventory for Children and Adolescents (OCD-CA)
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-06-18
    Julia Adam; Hildegard Goletz; Svenja-Kristin Mattausch; Julia Plück; Manfred Döpfner

    This study assesses the psychometric properties of the German version of the Padua Inventory-Washington State University Revision for measuring pediatric OCD. The parent-rating and self-rating inventory is assessed in a clinical sample (CLIN: n = 342, age range = 6–18 years) comprising an OCD subsample (OCDS: n = 181) and a non-OCD clinical subsample (non-OCD: n = 161), and in a community sample (COS: n = 367, age range = 11–18 years). An exploratory factor analysis yielded a four-factor solution: (1) Contamination & Washing, (2) Catastrophes & Injuries, (3) Checking, and (4) Ordering & Repeating. Internal consistencies of the respective scales were acceptable to excellent across all samples, with the exception of the self-report subscale Ordering and Repeating in the community sample. The subscales correlated highly with the total score. Intercorrelations between the subscales were mainly r ≤ .70, indicating that the subscales were sufficiently independent of each other. Convergent and divergent validity was supported. Participants in the OCD subsample scored significantly higher than those in the non-OCD clinical subsample and the COS on all scales. In the COS, self-rating scores were significantly higher than parent-rating scores on all scales, while significant mean differences between informants were only found on two subscales in the OCD subsample. The German version of the Padua Inventory-Washington State University Revision for measuring pediatric OCD is a promising, valid and reliable instrument to assess self-rated and parent-rated pediatric OCD symptoms in clinical and non-clinical (community) populations.

    更新日期:2019-11-28
  • Parental military deployment as risk factor for children’s mental health: a meta-analytical review
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-06-21
    Katrin Cunitz; Claudia Dölitzsch; Markus Kösters; Gerd-Dieter Willmund; Peter Zimmermann; Antje Heike Bühler; Jörg M. Fegert; Ute Ziegenhain; Michael Kölch

    There is evidence that military service increases the risk of psychosocial burden for not only service members but also their spouses and children. This meta-analysis aimed to systematically assess the association between military deployment of (at least one) parent and impact on children’s mental health. For this meta-analytic review, publications were systematically searched and assessed for eligibility based on predefined inclusion criteria (studies between 2001 until 2017 involving children with at least one parent working in military services). Measurements were determined by total problem scores of the children as well as symptoms of anxiety/depression, hyperactivity/inattention, and aggressive behavior. Meta-analyses aggregated the effect sizes in random-effect models and were calculated separately for the relation between parental deployment and civilian/normative data and for the relation between parental deployment and non-deployment. Age of the children was used as moderator variable to explore any potential source of heterogeneity between studies. Parental military deployment was associated with problems in children and adolescents compared to civilian/normative samples. Significant effect sizes reached from small to moderate values; the largest effect sizes were found for overall problems and specifically for anxious/depressive symptoms and aggressive behavior. Within the military group, children of deployed parents showed more problem behavior than children of non-deployed parents, but effect sizes were small. Age of the children had no moderating effect. The results emphasize that children of military members, especially with a deployed parent, should be assessed for emotional and behavioral problems.

    更新日期:2019-11-28
  • The Sävsjö-school-project: a cluster-randomized trial aimed at improving the literacy of beginners—achievements, mental health, school satisfaction and reading capacity at the end of grade three using an alternative school curriculum
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-06-24
    Göran Ahlqvist; Jan-Olov Larsson; Tatjana von Rosen; Mara Westling Allodi; Per-Anders Rydelius

    A curriculum was planned using modern concepts based on the “old” principles to test if such an educational intervention provided pupils with good mental health and a solid basis for good reading and writing skills, as well as generated a positive attitude to learn. These “old” principles were based on previous knowledge derived from school psychiatry (which in Sweden was a branch of child and adolescent psychiatry 1915–1970), educational psychology and the educational approach from the differentiating Swedish School system of 1946–1970 (itself based on the principles of curative education “Heilpädagogie”, which was later renamed mental health care). All six available schools in the small Swedish city of Sävsjö participated in the study. In these six schools there were eight preschool classes that included every 6-year old child living in the city. In total there were 184 families with 186 children (including 2 pairs of twins) who belonged to these preschool classes and were invited to take part in the study. One family moved just before school-start and 8 decided not to participate, thus 177 children (84 boys and 93 girls, aged 5.6–6.6 years) entered the study. The preschool classes were randomized into an experimental group with four preschool classes and a comparison group with four preschool classes. The experimental group followed a teaching program from the start of the preschool year until the end of grade 3 that was tailored to each student’s individual capacity based on the concepts of school maturation and curative education used in the Swedish schools during the period 1946–1970. The comparison group followed today’s average Swedish school curriculum. The project was planned as an intervention study covering the preschool year and the first 3 years of elementary school, which was to form a basis for a follow-up when the pupils had left senior high, the 12th year in Swedish public school. The outcome and the achievements were measured at end of grade 3 using standardized tests on reading, writing and mathematical skills. Behavior was assessed at school start and at end of grade 3 using the Child Behavior Check List (CBCL-scales) in addition to a questionnaire on Attention Deficit Hyperactivity Disorder (AD/HD) with criteria from DSM-IV. The children made a self-evaluation of their attitude towards learning. At the end of school year 3, the children in the experimental group had an improved reading capacity (p = 0.002, effect size(es) = 4.35) and reading comprehension (p = 0.03, es = 0.04). They evaluated their own reading (p = 0.02, es = 0.23), writing (p = 0.007, es = 0.35) and mathematical skills (p = 0.003, es = 0.48) as going “very well” when compared to comparison group. Differences regarding intelligence quotas between the groups at the start of school had disappeared by the end of grade 3. No differences referring to CBCL were found at end of grade 3. One child in the comparison group fulfilled criteria for AD/HD, according to parents and teachers. The alternative curriculum covering the preschool year through the first 3 years of elementary school based on the old principles from curative education (“Heilpädagogie”), educational psychology and school psychiatry gave the children in the experimental group a better reading capacity and reading comprehension. Trial registration The study started in 1998. The data were collected longitudinally and prospectively but have not been analyzed until now, with the children having left senior high. A retrospective registration in the ISRCTN is pending.

    更新日期:2019-11-28
  • The effects of comorbid Tourette symptoms on distress caused by compulsive-like behavior in very young children: a cross-sectional study
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-06-28
    Ryunosuke Goto; Miyuki Fujio; Natsumi Matsuda; Mayu Fujiwara; Marina Nobuyoshi; Maiko Nonaka; Toshiaki Kono; Masaki Kojima; Norbert Skokauskas; Yukiko Kano

    Many children 4 to 6 years old exhibit compulsive-like behavior, often with comorbid Tourette symptoms, making this age group critical for investigating the effects of having comorbid Tourette symptoms with compulsive-like behavior. However, these effects have not yet been elucidated: it is unclear whether having comorbid tics with compulsive-like behavior leads to lower quality of life. This cross-sectional study aims to investigate the effect of comorbid Tourette symptoms on distress caused by compulsive-like behavior in very young children. Self-administered questionnaires were distributed to guardians of children aged 4 to 6 attending any of the 59 public preschools in a certain ward in Tokyo, Japan. The questionnaire contained questions on the presence of Tourette symptoms, the presence of specific motor and vocal tics, frequency/intensity of compulsive-like behavior, and the distress caused by compulsive-like behavior, which was rated on a scale of 1 to 5. Additionally, questions on autism spectrum disorder (ASD) traits, attention-deficit/hyperactivity disorder (ADHD) traits, internalizing behavior traits, and externalizing behavior traits were included in the questionnaire as possible confounders of distress caused by compulsive-like behavior. Wilcoxon rank-sum tests were conducted to compare the distress caused by compulsive-like behavior and frequency/intensity of compulsive-like behavior between children in the Tourette symptoms group and the non-Tourette symptoms group. Furthermore, a stepwise regression analysis was performed to assess the effects of the independent variables on distress caused by compulsive-like behavior. Another stepwise regression analysis was performed to assess the relationship between distress caused by compulsive-like behavior and the presence of five specific motor and vocal tics. Of the 675 eligible participants, distress due to compulsive-like behavior was significantly higher in children in the Tourette symptoms group compared to the non-Tourette symptoms group (2.00 vs 1.00, P < 0.001). Stepwise regression analysis showed that frequency/intensity of compulsive-like behavior, being in the Tourette symptoms group, ASD traits, and internalizing behavior traits were predictors of distress due to compulsive-like behavior. Two specific tics, repetitive noises and sounds and repetitive neck, shoulder, or trunk movements, were significant predictors of distress due to compulsive-like behavior. Comorbid Tourette symptoms may worsen distress caused by compulsive-like behavior in children 4 to 6 years old, and specific motor and vocal tics may lead to greater distress.

    更新日期:2019-11-28
  • Reduced prefrontal hemodynamic response in pediatric autism spectrum disorder measured with near-infrared spectroscopy
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-06-28
    Mitsuhiro Uratani; Toyosaku Ota; Junzo Iida; Kosuke Okazaki; Kazuhiko Yamamuro; Yoko Nakanishi; Naoko Kishimoto; Toshifumi Kishimoto

    Functional neuroimaging studies suggest that prefrontal cortex dysfunction is present in people with autism spectrum disorder (ASD). Near-infrared spectroscopy is a noninvasive optical tool for examining oxygenation and hemodynamic changes in the cerebral cortex by measuring changes in oxygenated hemoglobin. Twelve drug-naïve male participants, aged 7–15 years and diagnosed with ASD according to DSM-5 criteria, and 12 age- and intelligence quotient (IQ)-matched healthy control males participated in the present study after giving informed consent. Relative concentrations of oxyhemoglobin were measured with frontal probes every 0.1 s during the Stroop color-word task, using 24-channel near-infrared spectroscopy. Oxyhemoglobin changes during the Stroop color-word task in the ASD group were significantly smaller than those in the control group at channels 12 and 13, located over the dorsolateral prefrontal cortex (FDR-corrected P: 0.0021–0.0063). The results suggest that male children with ASD have reduced prefrontal hemodynamic responses, measured with near-infrared spectroscopy.

    更新日期:2019-11-28
  • International findings with the Achenbach System of Empirically Based Assessment (ASEBA): applications to clinical services, research, and training
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-07-05
    Thomas M. Achenbach

    The purpose of this invited article is to present multicultural norms and related international findings obtained with the Achenbach System of Empirically Based Assessment (ASEBA) by indigenous researchers in over 50 societies. The article describes ASEBA instruments for which multicultural norms are available, plus procedures for constructing the multicultural norms. It presents applications to clinical services, including use of multi-informant data for assessing children and their parents. The Multicultural Family Assessment Module (MFAM) enables mental health providers to view side-by-side bar graphs of child and parent scores on syndromes, DSM-oriented scales, Internalizing, Externalizing, and Total Problems. Evidence-based assessment of progress and outcomes is facilitated by the Progress & Outcomes App (P&O App). Research applications are outlined, including longitudinal and outcomes research. Applications to training mental health providers include having trainees study standardized multi-informant assessment data prior to interviewing children and their parents. Trainees can also sharpen their clinical skills by completing assessment forms to describe children and their parents, and then using ASEBA software to compare their ratings with ratings by children, parents, and other informants. Practical evidence-based assessment instruments with multicultural norms enable mental health providers, researchers, and trainees to perform intake, progress, and outcome assessments of children and their parents in terms of a standardized international clinical data language.

    更新日期:2019-11-28
  • Goal setting improves retention in youth mental health: a cross-sectional analysis
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-07-09
    Alice J. Cairns; David J. Kavanagh; Frances Dark; Steven M. McPhail

    This study explored if a youth-specific mental health service routinely set goals with young people during initial intake/assessment and if goal setting and goal quality in this service was associated with patient retention. Consecutive initial assessments (n = 283) and administrative service data from two youth-specific health services in Australia were audited for evidence of goal setting, content and quality of the goal and number of therapy services provided after the intake/assessment process. Logistic regression was used to determine if goal setting was associated with disengagement after the assessment session, controlling for drug use, unemployment, age, gender, mental health diagnosis and service site. A consecutive sub-sample of 166 goals (74 participants), was analysed for goal quality. Each goal was assessed against three components of the SMART (specific, measurable, acceptable/achievable, realistic and timed goals) criteria; specific, measurable and timed; and assigned a goal quality score 1–3. A multiple regression explored whether goal quality was predictive of the number of sessions attended, controlling for the same variables as the logistic regression. Goal setting was evident in the records of 187 participants (66%). Although most goals were for emotional management, 24% addressed improvements in function. Of the 166 goals analysed in depth, 95 were specific, 23 measurable, but none were timed. Not setting goals during initial assessments correlated with service disengagement (OR 0.30, p > 0.001). Goal setting was positively associated with more therapy sessions attended, regardless of goal quality rating. Engagement and retention of young people within mental health services can be challenging. Clinical tools such as goal setting may keep young people engaged in services longer, potentially improving clinical outcomes. Further research exploring the effectiveness of current youth service models on client-specific goal based outcomes is recommended.

    更新日期:2019-11-28
  • Online sexual abuse of adolescents by a perpetrator met online: a cross-sectional study
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-08-24
    Linda S. Jonsson; Cecilia Fredlund; Gisela Priebe; Marie Wadsby; Carl Göran Svedin

    The current study aimed at exploring adolescents’ experiences of online sexual contacts leading to online sexual abuse by a perpetrator whom the victim had first met online. Associations with socio demographic background, experience of abuse, relation to parents, health and risk behaviors were studied. The participants were a representative national sample of 5175 students in the third year of the Swedish high school Swedish (M age = 17.97). Analyses included bivariate statistics and stepwise multiple logistic regression models. In total 330 (5.8%) adolescents had gotten to know someone during the preceding 12 months for the purpose of engaging in some kind of sexual activity online. Thirty-two (9.7%) of those, the index group, had felt that they had been persuaded, pressed or coerced on at least one occasion. Sexual interaction under pressure was seen as constituting sexual abuse. These adolescent victims of online sexual abuse, the index group, did not differ with respect to socio-demographic background from the adolescents without this experience, the reference group. The index group had significantly more prior experiences of different kind of abuse, indicating that they belong to a polyvictimized group. More frequent risk behavior, poorer psychological health, poorer relationships with parents and lower self-esteem also characterized the index group. Online sexual abuse, without experiences of offline abuse, was associated with a poorer psychological health, at least at the same level as offline sexual abuse only. The study made clear the importance of viewing online sexual abuse as a serious form of sexual abuse. Professionals meeting these children need to focus not only on their psychological health such as symptoms of trauma and depression but also need to screen them for online behavior, online abuse and other forms of previous abuse.

    更新日期:2019-11-28
  • Cannabis and amphetamine use and its psychosocial correlates among school-going adolescents in Ghana
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-08-29
    Kwaku Oppong Asante

    The aim of this study was to examine the prevalence of cannabis and amphetamine use and to determine its associated factors among school-going adolescents in Ghana. The 2012 Ghanaian Global School-based Student Health Survey on 3632 adolescents aged 11–19 years (mean = 15.1 years; SD = 1.4) was used. Participants for this study were sampled from selected junior (JHS) and senior high schools (SHS) in all the 10 administrative regions of Ghana. A two-stage cluster sampling design was used to select 25 senior high schools to represent all the 10 regions of Ghana. Information was collected with a self-administered structured questionnaire that contained information on demographics, alcohol, tobacco and other drug use, violence, and a range of other health-related behaviours. The result showed that past-month cannabis use was 5.3% and lifetime amphetamine use was 7.1% among students. In multivariate model, after controlling for other variables, school truancy and current cigarette smoking were associated with both past-month cannabis and lifetime amphetamine use. The number of close friends was associated with only past-month cannabis use. School environment factors (bullying victimisation and having been attacked) and parental substance use were associated with lifetime amphetamine use. This study identified a number of risk factors, including parental substance use and various risk behaviours, for both past-month cannabis and lifetime amphetamine use. School-based health intervention programmes should be developed taking into consideration the risk factors associated with cannabis and amphetamine use among school-going adolescents.

    更新日期:2019-11-28
  • Come together: case specific cross-institutional cooperation of youth welfare services and child and adolescent psychiatry
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-08-29
    Judith Mack; Sina Wanderer; Michael Kölch; Veit Roessner

    Due to the increasing rate of children and families who require support from both youth welfare services and from mental health services, a solid cross-institutional cooperation is needed to provide coordinated and integrated help. Studies involving not only qualitative, but also quantitative information from both services regarding not only general, but also case specific views on cross-institutional cooperation and psychosocial needs are lacking. Hence, we collected data from n = 96 children and families who received support from youth welfare office (YWO) and child and adolescents psychiatry (CAP) simultaneously. In a longitudinal survey, we assessed the evaluation of case specific cross-institutional cooperation and psychosocial needs by employees of YWO and CAP as well as descriptive data (including psychopathology of children) over a 6-month period. Repeated-measures ANOVAs were conducted to assess the effects of time and institution (YWO/CAP) on employees’ evaluation of case specific cross-institutional cooperation and psychosocial needs as well as children’s psychopathology. The data showed that generally YWO employees rated the case specific communication better than CAP employees. Furthermore, CAP employees estimated psychosocial needs higher than YWO employees did. The employees’ evaluation of total case specific cross-institutional cooperation did not differ between the employees of both institutions; it further did not change over time. The case specific evaluations did not correlate between the case responsible employees of YWO and CAP. The data showed satisfaction with the case specific cross-institutional cooperation in general, but meaningful differences in case specific ratings between both institutions indicate the possibility and need for improvement in daily work and cooperation as well as in regulations and contractual agreements. The implementation of more exchange of higher quality and transparency will ensure smoother cross-institutional cooperation. Future research should pursue this topic to convey the need for further improvement in cross-institutional cooperation into decision-making processes and to evaluate the success of innovative projects in this field.

    更新日期:2019-11-28
  • Mental health problems of children and adolescents, with and without migration background, living in Vienna, Austria
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-09-10
    Maria Teresa Gutmann; Metin Aysel; Zeliha Özlü-Erkilic; Christian Popow; Türkan Akkaya-Kalayci

    Compared to their indigenous peers, migrant children and adolescents are at increased risk for mental health problems. The aim of our study was to compare psychological disorders of children and adolescents with Turkish migration background and their native Austrian peers. We analysed 302 children and adolescents aged between 7 and 18 years. The sample consisted of 100 Austrian and 100 Turkish outpatients with mental health problems, and 102 healthy controls, 52 with Austrian and 50 with Turkish background, recruited from various Viennese local child and youth centres. Native patients had more frequently externalizing problems (42.1%) compared to the Turkish-speaking sample (28%). However, in the control group, Turkish-speaking children and adolescents had higher levels of internalizing, depressive and anxiety symptoms compared to their native peers. We found noticeable differences in psychological problems among children and adolescents with and without migration background. We assume that migration-related stress factors are responsible for these differences. Also, children and adolescents with migration background seek for psychological help less frequently than their indigenous peers.

    更新日期:2019-11-28
  • Omega-3 fatty acids for the treatment of depressive disorders in children and adolescents: a meta-analysis of randomized placebo-controlled trials
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-09-14
    Li Zhang; Huan Liu; Li Kuang; Huaqing Meng; Xinyu Zhou

    To investigate the efficacy and safety of omega-3 fatty acids (O3FA) in treating depressive disorders in children and adolescents. We conducted a comprehensive search in electronic databases and hand-searched articles included for relevant studies. We included randomized controlled trials which studied on O3FA for treatment of children and adolescents with depression. The standard mean differences (SMDs) and the odds ratios (ORs) with 95% confidence intervals (CIs) were estimated by a random-effects model. The primary outcomes were end-point depressive symptoms scores (efficacy) and all-cause discontinuation (safety). The secondary outcome of response rate was also assessed. Subgroup analyses were performed by age, severity of depression and dosage. Risk of bias assessment was performed based on the Jadad score and the Cochrane Collaboration’s risk-of-bias method. A total of four studies with 153 participants were included. In terms of efficacy, there was no significant difference of end-point depressive symptoms scores between O3FA and placebo (SMD = − 0.12, 95% CI − 0.53 to 0.30, P = 0.58; I2= 30%). In terms of safety, the all-cause discontinuation showed no statistical significance between O3FA and placebo (OR = 1.3, 95% CI 0.58 to 2.93, P = 0.53; I2= 0%). The response rate of O3FA was also not significant better than that of placebo (OR = 1.57, 95% CI 0.26 to 9.39, P = 0.62; I2= 71%). Besides, there were also no significant differences in those subgroup analyses outcomes. The risk of bias of included trials were not high. Only considering the limited evidence of O3FA in the acute treatment of major depressive disorder, it did not seem to offer a clear advantage for children and adolescents.

    更新日期:2019-11-28
  • Social anxiety disorder and emotion regulation problems in adolescents
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-09-30
    Petra Sackl-Pammer; Rebecca Jahn; Zeliha Özlü-Erkilic; Eva Pollak; Susanne Ohmann; Julia Schwarzenberg; Paul Plener; Türkan Akkaya-Kalayci

    Social anxiety disorder (SAD) in adolescents may be associated with the use of maladaptive emotion regulation (ER) strategies. The present study examined the use of maladaptive and adaptive ER strategies in adolescents with SAD. 30 adolescents with SAD (CLIN) and 36 healthy adolescents for the control group (CON) aged between 11 and 16 years were assessed with the standardized questionnaires PHOKI (Phobiefragebogen für Kinder und Jugendliche) for self-reported fears as well as FEEL-KJ (Fragebogen zur Erhebung der Emotionsregulation bei Kindern und Jugendlichen) for different emotion regulation strategies. Compared to controls, adolescents with SAD used adaptive ER strategies significantly less often, but made use of maladaptive ER strategies significantly more often. There was a significant positive correlation between maladaptive ER and social anxiety in adolescents. Examining group differences of single ER strategy use, the CLIN and CON differed significantly in the use of the adaptive ER strategy reappraisal with CLIN reporting less use of reappraisal than CON. Group differences regarding the maladaptive ER strategies withdrawal and rumination, as well as the adaptive ER strategy problem-solving were found present, with CLIN reporting more use of withdrawal and rumination and less use of problem-solving than CON. Promoting adaptive emotion regulation should be a central component of psychotherapy (cognitive behavioral therapy-CBT) for social anxiety in adolescents from the beginning of the therapy process. These findings provide rationale for special therapy programs concentrating on the establishment of different adaptive ER strategies (including reappraisal). As an increased use of maladaptive ER may be associated with SAD in adolescents, it may be paramount to focus on reduction of maladaptive ER (for example withdrawal and rumination) from the beginning of the psychotherapy process. Incorporating more ER components into psychotherapy (CBT) could increase the treatment efficacy. Further investigations of the patterns of emotion regulation in specific anxiety groups like SAD in adolescents is needed to continue to optimize the psychotherapy (CBT) concept.

    更新日期:2019-11-28
  • Executive functioning and neurodevelopmental disorders in early childhood: a prospective population-based study
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-10-22
    D. Louise Otterman; M. Elisabeth Koopman-Verhoeff; Tonya J. White; Henning Tiemeier; Koen Bolhuis; Pauline W. Jansen

    Executive functioning deficits are common in children with neurodevelopmental disorders. However, prior research mainly focused on clinical populations employing cross-sectional designs, impeding conclusions on temporal neurodevelopmental pathways. Here, we examined the prospective association of executive functioning with subsequent autism spectrum disorder (ASD) traits and attention-deficit/hyperactivity disorder (ADHD) traits. This study included young children from the Generation R Study, a general population birth cohort. The Brief Rating Inventory of Executive Function-Preschool Version was used to assess parent-reported behavioral executive functioning when the children were 4 years old. ASD traits were assessed at age 6 (n = 3938) using the parent-reported Social Responsiveness Scale. The Teacher Report Form was used to assess ADHD traits at age 7 (n = 2749). Children with high scores were screened to determine possible clinical ASD or ADHD diagnoses. We were able to confirm an ASD diagnosis for n = 56 children by retrieving their medical records and established an ADHD diagnosis for n = 194 children using the Diagnostic Interview Schedule for Children-Young Child version (DISC-YC). Data were analyzed using hierarchical linear and logistic regressions. Impaired executive functioning was associated with more ASD and ADHD traits across informants (for ASD traits and diagnoses: β = 0.33, 95% CI [0.30–0.37]; OR = 2.69, 95% CI [1.92–3.77], respectively; for ADHD traits and diagnoses: β = 0.12, 95% CI [0.07–0.16]; OR = 2.32, 95% CI [1.89–2.85], respectively). Deficits in all subdomains were associated with higher levels of ASD traits, whereas only impaired inhibition, working memory, and planning/organization were associated with more ADHD traits. The findings of the current study suggest a graded association of executive functioning difficulties along the continuum of ASD and ADHD and that problems in executive functioning may be a precursor of ASD and ADHD traits from an early age onwards.

    更新日期:2019-11-28
  • Mental health and risk behaviors of children in rural China with different patterns of parental migration: a cross-sectional study
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-10-22
    Feng Wang; Jingjing Lu; Leesa Lin; Xudong Zhou

    One in seven members of China’s population are migrants. There are an estimated 41 million children left behind in rural areas who are living without one or both of their parents. The impact of two- and single-parent migration on child mental health and risk behaviors is unclear. The aim of this study was to compare the mental health and risk behaviors among children whose parents are either both migrating (B-LBC), have one parent migrating (O-LBC) or those whose parents do not migrate (N-LBC). This study was a cross-sectional survey using a self-administered questionnaire conducted in rural areas with high proportions of left behind children (LBC) in Anhui Province, southeast China. The tools used were the Strength and Difficulties Questionnaires, Youth Risk Behavior Survey and the Young’s Internet Addiction Test for Chinese. Full data were available for 699 B-LBC, 552 O-LBC and 741 N-LBC. After adjusting for gender, age, grade, number of siblings and self-rated socio-economic status, B-LBC were significantly more likely to have higher emotional symptoms scores (B(SE) = 0.36(0.11), p < 0.01), higher hyperactivity scores (B(SE) = 0.22(0.11), p < 0.01) and higher total difficulties scores (B(SE) = 0.79(0.29), p < 0.01) than N-LBC. B-LBC were also more likely to be an addicted internet user (OR(95%CI) = 1.91(1.33, 2.76), p < 0.01) compared to N-LBC. However, there were no identified differences between O-LBC and N-LBC or between O-LBC and B-LBC in any measures. Our findings found that living with one parent or both parents was associated with better mental health and fewer risk behaviors than was being separated from both parents. Future research is needed to consider the implications of these findings for policies and programs to protect LBC, especially for those with two migrating parents.

    更新日期:2019-11-28
  • A pilot and feasibility study of a cognitive behavioural therapy-based anxiety prevention programme for junior high school students in Japan: a quasi-experimental study
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-10-31
    Ikuyo Ohira; Yuko Urao; Yasunori Sato; Toshiyuki Ohtani; Eiji Shimizu

    There is a good deal of evidence that cognitive behavioural therapy is effective for children and adolescents with anxiety-related problems. In Japan, an anxiety prevention programme based on cognitive behavioural therapy called ‘Journey of the Brave’ has been developed, and it has been demonstrated to be effective for elementary school students (aged 10–11 years). The purpose of this study was to have classroom teachers deliver the programme to junior high school students (aged 12–13 years) and to test the feasibility and efficacy of the programme in this setting. This study was a prospective observational study and was approved by the Chiba University Review Board. An intervention group consisting of six classes of students in their first year of junior high school at two different schools (n = 149; 81 boys, 68 girls) received seven 50-min programme sessions. Participants in the control group were recruited from four classes of students in their second year of junior high school at one school (n = 89; 51 boys, 38 girls). All participants completed the Spence Children’s Anxiety Scale at pre-test, post-test, and 2–3 month follow-up. Statistical analysis was conducted using a mixed-effects model for repeated measures model. Mean total anxiety scores indicated a non-significant decrease at the 2–3 month follow-up for the intervention group compared to the control group. The group differences on the SCAS from baseline to post-test was − .71 (95% CI − 2.48 to 1.06, p = .43), and the 2–3 month follow-up was − .49 (95% CI − 2.60 to 1.61, p = .64). In this pilot study, implementation of the programme confirmed the partial feasibility of the programme but did not elicit a significant reduction in anxiety scores. In addition, there are several methodological limitations to this study. In the future, we propose to test the feasibility and efficacy of the programme with the required sample size and by comparing groups with equal characteristics as well as by carrying out additional follow-up assessments. Trial registration UMIN000032517.

    更新日期:2019-11-28
  • Reduced caregiving quality measured during the strange situation procedure increases child’s autonomic nervous system stress response
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-10-31
    Franziska Köhler-Dauner; Eva Roder; Sabrina Krause; Anna Buchheim; Harald Gündel; Jörg M. Fegert; Ute Ziegenhain; Christiane Waller

    Dysfunctional maternal behavior has been shown to lead to disturbances in infant’s regulatory capacities and alterations in vagal reactivity. We aim to investigate the autonomic nervous system (ANS) response of the child during the strange situation procedure (SSP) in relation to the quality of maternal behavior. Twelve month after birth, 163 mother–child-dyads were investigated during the SSP. Heart rate (HR) and both, the parasympathetic branch (PNS) via the respiratory sinus arrhythmia (RSA) and the sympathetic branch (SNS) via the left ventricular ejection time (LVET) of the ANS were continuously determined during the SSP using electrocardiogram (ECG) and impedance cardiogram (ICG) measures. Maternal behavior was assessed by using the AMBIANCE measure. The ANS response in infants of mothers with disruptive behavior compared to infants of non-disruptive mothers was significantly altered during the SSP: HR increased especially when infants of disruptive mothers were alone with the stranger (F (1, 161) = 4.15, p = .04) with a significant vagal withdrawal when being in contact with the stranger despite of presence of the mother (F (1, 161) = 5.11, p = .03) and a significant increase in vagal tone during final reunion (F (1, 161) = 3.76, p = .05). HR increase was mainly based on a decrease in LVET (F (1, 161) = 4.08, p = .05) with a maximum infant’s HR when the stranger came into the room instead of the mother. Both, SNS and PNS branches of the child are significantly altered in terms of an ANS imbalance, especially during contract to a stranger, in relation to dysfunctional maternal behavior. Our findings suggest the importance of supporting high quality caregiving that enables the infant to adapt adequately to stressful interpersonal situations which is likely to promote later health.

    更新日期:2019-11-28
  • Moving from ‘personal communication’ to ‘available online at’: preprint servers enhance the timeliness of scientific exchange
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-10-31
    Daniel Poremski; Bruno Falissard; Jörg Fegert; Andreas Witt; Anna E. Ordóñez; Andrés Martin; Daniel Shuen Sheng Fung

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    更新日期:2019-11-28
  • Symptoms of posttraumatic stress disorder among targets of school bullying
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-11-09
    Fanny Carina Ossa; Reinhard Pietrowsky; Robert Bering; Michael Kaess

    The aim of this study was to investigate whether bullying among students is associated with symptoms of posttraumatic stress disorder (PTSD), and whether associations are comparable to other traumatic events leading to PTSD. Data were collected from 219 German children and adolescents: 150 students from grade six to ten and 69 patients from an outpatient clinic for PTSD as a comparison group. Symptoms of PTSD were assessed using the Children’s Revised Impact of Event Scale (CRIES) and the Posttraumatic Symptom Scale (PTSS-10). A 2 × 5 factorial analysis of variance (ANOVA) with the factors gender (male, female) and group (control, conflict, moderate bullying, severe bullying, traumatized) was used to test for significant differences in reported PTSD symptoms. Results showed that 69 (46.0%) students from the school sample had experienced bullying, 43 (28.7%) in a moderate and 26 (17.3%) in a severe way. About 50% of the severe bullying group reached the critical cut-off point for suspected PTSD. While the scores for symptoms of PTSD were significantly higher in bullied versus non-bullied students, no significant differences were found between patients from the PTSD clinic and students who experienced severe bullying. Our findings suggest that bullying at school is highly associated with symptoms of PTSD. Thus, prevention of bullying in school may reduce traumatic experiences and consequent PTSD development.

    更新日期:2019-11-28
  • Developing the universal unified prevention program for diverse disorders for school-aged children
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-11-13
    Shin-ichi Ishikawa; Kohei Kishida; Takuya Oka; Aya Saito; Sakie Shimotsu; Norio Watanabe; Hiroki Sasamori; Yoko Kamio

    Psychological problems during childhood and adolescence are highly prevalent, frequently comorbid, and incur severe social burden. A school-based universal prevention approach is one avenue to address these issues. The first aim of this study was the development of a novel, transdiagnostic cognitive-behavioral universal prevention program: The Universal Unified Prevention Program for Diverse Disorders (Up2-D2). The second aim of this study was to examine the acceptability and fidelity of the Up2-D2. Classroom teachers who attended a 1-day workshop implemented the Up2-D2 independently as a part of their regular curricula. To assess the acceptability of the Up2-D2, 213 children (111 boys and 102 girls) aged 9–12 years completed questionnaires about their enjoyment, comprehension, attainment, applicability, and self-efficacy after completing Lessons 1–12. For fidelity, research assistants independently evaluated audio files that were randomly selected and assigned (27.3%). Our preliminary evaluation revealed the program was highly enjoyable, clear, and applicable for students. In addition, self-efficacy demonstrated a trend of gradually increasing over the 12 sessions. The total fidelity observed in the two schools was sufficient (76.2%), given the length of the teacher training. The results of this study supported the theory that the Up2-D2 could be feasible in real-world school settings when classroom teachers implement the program. We discussed current research and practical issues of using universal prevention to address mental health problems in school, based on implementation science for user-centered design.

    更新日期:2019-11-28
  • Looking into the crystal ball: quality of life, delinquency, and problems experienced by young male adults after discharge from a secure residential care setting in the Netherlands
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2019-11-18
    E. A. W. Janssen-de Ruijter; E. A. Mulder; I. L. Bongers; L. Omlo; Ch. van Nieuwenhuizen

    Adolescents in residential care are a vulnerable population with many problems in several life areas. For most of these adolescents, these problems persist after discharge and into adulthood. Since an accumulation of risk factors in multiple domains increases the likelihood of future adverse outcomes, it would be valuable to investigate whether there are differences in life after residential care between subgroups based on multiple co-occurring risk factors. The aim of this exploratory follow-up study is to explore differences between young adults—classified in four risk profiles—in relation to life after discharge from a secure residential care setting. It is hypothesised that young adults with a profile with many risks in multiple domains will experience more problems after discharge, such as (persistent) delinquency, compared to young adults with a profile with lower risks. Follow-up data were collected from 46 former patients of a hospital for youth forensic psychiatry and orthopsychiatry in the Netherlands. In order to illustrate these young adults’ life after discharge, self-reported outcome measures divided into five domains (i.e., quality of life, daily life, social life, problems, and delinquency) were used. Differences between four classes based on pre-admission risk factors, which were identified in a previous study by latent class analysis, were explored by three (non-)parametric statistical tests. Life after discharge for most young adults was characterised by close friends and a high quality of life, but also by substance abuse, professional support, debts, and delinquency. Only a few significant differences between the classes were found, primarily between young adults with risk factors in the individual, family, school, and peer domains and young adults in the other three classes. Young adults experience a high quality of life after discharge from secure residential care, despite the presence of persistent problems. Some indications have been found that young adults with risk factors in four domains are at greatest risk for persistent problems in young adulthood. Because of the high amount of persistent problems, residential treatment and aftercare should focus more on patients’ long-term needs.

    更新日期:2019-11-28
  • Supervision trajectories of male juvenile offenders: growth mixture modeling on SAVRY risk assessments.
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2018-02-27
    Ed L B Hilterman,Ilja L Bongers,Tonia L Nicholls,Chijs van Nieuwenhuizen

    Background Structured risk/need assessment tools are increasingly used to orientate risk reduction strategies with juvenile offenders. The assumption is that the risk/need items on these tools are sufficiently sensitive to measure changes in the individual, family and/or contextual characteristics of juvenile offenders. However, there is very little research demonstrating the capacity of these tools to measure changes in juvenile offenders. Congruent with the developmental and life-course criminology theories (DLC) the objective of this study is to explore the existence of heterogeneous trajectories of juvenile offenders across the juvenile justice system as measured through five empirical risk/need areas based on the Structured Assessment of Violence Risk in Youth (SAVRY), one of the most widely applied risk assessment tools for juveniles. Methods This longitudinal study included 5205 male juvenile offenders who transitioned through the Catalan juvenile justice system between 2006 and 2014. During intervention they received at least two, and a maximum of seven, consecutive SAVRY risk/need assessments over an 18-month period. The heterogeneity of latent class trajectories was explored through growth mixture modeling (GMM). The trajectory class membership was linked to covariates through multinomial logistic regression analyses. Results Through GMM three to four heterogeneous trajectories, with high quality of separation, were identified in each of the risk/need areas. The trajectories with low risk/needs (45-77% of the sample) remained low and presented a very limited increase in risk/needs during the 18-month period. The high risk/need trajectories (20-37% of the sample) showed a limited decrease or no change. Between 5 and 13% of the sample had large reductions in their risk/needs levels, and approximately 5% showed a large increase in risk/needs. Conclusions In line with the DLC theories this study shows that trajectories on criminogenic risk/needs can be heterogeneous and indicate distinct rates of change over time. The results of this study also may suggest a limited sensibility to measure change over time of SAVRY's risk and protective items. Suggestions to improve the sensitivity of measuring change over time, such as shorter time frames or future-oriented time frames for the scoring of the items, are offered.

    更新日期:2019-11-01
  • Disruptive behavior scale for adolescents (DISBA): development and psychometric properties.
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2018-03-17
    Mahmood Karimy,Ahmad Fakhri,Esmaeel Vali,Farzaneh Vali,Feliciano H Veiga,L A R Stein,Marzieh Araban

    Background Growing evidence indicates that if disruptive behavior is left unidentified and untreated, a significant proportion of these problems will persist and may develop into problems linked with delinquency, substance abuse, and violence. Research is needed to develop valid and reliable measures of disruptive behavior to assist recognition and impact of treatments on disruptive behavior. The aim of this study was to develop and evaluate the psychometric properties of a scale for disruptive behavior in adolescents. Methods Six hundred high school students (50% girls), ages ranged 15-18 years old, selected through multi stage random sampling. Psychometrics of the disruptive behavior scale for adolescents (DISBA) (Persian version) was assessed through content validity, explanatory factor analysis (EFA) using Varimax rotation and confirmatory factor analysis (CFA). The reliability of this scale was assessed via internal consistency and test-retest reliability. Results EFA revealed four factors accounting for 59% of observed variance. The final 29-item scale contained four factors: (1) aggressive school behavior, (2) classroom defiant behavior, (3) unimportance of school, and (4) defiance to school authorities. Furthermore, CFA produced a sufficient Goodness of Fit Index > 0.90. Test-retest and internal consistency reliabilities were acceptable at 0.85 and 0.89, respectively. Conclusions The findings from this study suggest that the Iranian version of DISBA questionnaire has content validity. Further studies are needed to evaluate stronger psychometric properties for DISBA.

    更新日期:2019-11-01
  • Correction to: Somatic symptom and related disorders in children and adolescents: evaluation of a naturalistic inpatient multidisciplinary treatment.
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2018-11-10
    Pola Heimann,Beate Herpertz-Dahlmann,Jonas Buning,Norbert Wagner,Claudia Stollbrink-Peschgens,Astrid Dempfle,Georg G von Polier

    [This corrects the article DOI: 10.1186/s13034-018-0239-y.].

    更新日期:2019-11-01
  • Correction to: The Strengths and Difficulties Questionnaire (SDQ) in Africa: a scoping review of its application and validation.
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2018-02-14
    Nikhat Hoosen,Eugene Lee Davids,Petrus J de Vries,Maylene Shung-King

    [This corrects the article DOI: 10.1186/s13034-017-0212-1.].

    更新日期:2019-11-01
  • A boy with conduct disorder (CD), attention deficit hyperactivity disorder (ADHD), borderline intellectual disability, and 47,XXY syndrome in combination with a 7q11.23 duplication, 11p15.5 deletion, and 20q13.33 deletion.
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2016-09-22
    Gerasimos Kolaitis,Christian G Bouwkamp,Alexia Papakonstantinou,Ioanna Otheiti,Maria Belivanaki,Styliani Haritaki,Terpsihori Korpa,Zinovia Albani,Elena Terzioglou,Polyxeni Apostola,Aggeliki Skamnaki,Athena Xaidara,Konstantina Kosma,Sophia Kitsiou-Tzeli,Maria Tzetis

    BACKGROUND This is a case with multiple chromosomal aberrations which are likely etiological for the observed psychiatric phenotype consisting of attention deficit hyperactivity and conduct disorders. CASE PRESENTATION We report on an 11 year-old boy, admitted to the pediatric hospital for behavioral difficulties and a delayed neurodevelopmental trajectory. A cytogenetic analysis and high-resolution microarray comparative genomic hybridization (CGH) analysis was performed. The cytogenetic analysis revealed 47,XYY syndrome, while CGH analysis revealed an additional duplication and two deletions. The 7q11.23 duplication is associated with speech and language delay and behavioral symptoms, a 20q13.33 deletion is associated with autism and early onset schizophrenia and the 11p15.5 microdeletion is associated with developmental delay, autism, and epilepsy. The patient underwent a psychiatric history, physical examination, laboratory testing, and a detailed cognitive, psychiatric, and occupational therapy evaluation which are reported here in detail. CONCLUSIONS In the case of psychiatric patients presenting with complex genetic aberrations and additional psychosocial problems, traditional psychiatric and psychological approaches can lead to significantly improved functioning. Genetic diagnostic testing can be highly informative in the diagnostic process and may be applied to patients in psychiatry in case of complex clinical presentations.

    更新日期:2019-11-01
  • An adolescent with significant emotional and medically unexplained complaints: case report and proposal of an intervention.
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2015-10-17
    Alemayehu Negash,Mubarek Abera,Christine Gruber-Frank,Reiner Frank

    BACKGROUND Ethiopia is a country in which child and adolescent mental health needs are often not met. In order to promote capacity building, a Collaborative International Exchange Programme has been established between Jimma University at Jimma, Ethiopia, and Ludwig-Maximilian University in Munich, Germany. The programme focuses on training non-physician health professionals in mental health speciality. One of the courses in the training programme, child psychiatry, involves a child psychiatrist and a children's nurse supporting the management of a patient described in this case report. Its conceptual framework is based on the section "significant emotional and medically unexplained complaints" of the "WHO mental health GAP intervention guide for mental, neurological and substance use disorders in non-specialized health settings". OBJECTIVE The purpose of this case report is to promote confidence in mental health professionals when managing patients with similar conditions, and to stimulate further evaluation of the conceptual approach in developing countries. PATIENT The subject of this case report is a 14-year-old adolescent girl admitted to the psychiatric clinic at Jimma University Teaching Hospital. She was admitted for intractable retching, inability to eat, weight loss, and inability to walk. Challenges included the combination of medical and psychiatric symptoms, and the significant impairment of functioning in this adolescent. The first aim in the management of this patient was to guarantee vital functions. In a problem-oriented approach, different domains were addressed to restore nutritional, social, emotional, and motor functions. Treatment consisted of various elements of psychosocial interventions. The patient improved in 2 weeks and the final diagnosis was conversion disorder. CONCLUSION Psychosocial interventions can be developed in cooperation, and applied in a setting where little child mental health expertise is available. Case-based learning relying on local expertise is suitable in meeting local needs and in developing mental health services for children and adolescents.

    更新日期:2019-11-01
  • Psychosis in an adolescent girl: a common manifestation in Niemann-Pick Type C disease.
    Child Adolesc. Psychiatry Ment. Health (IF 1.642) Pub Date : 2014-07-30
    Sara Wouters,Linda De Meirleir,Edward Campforts,Annik Lampo

    Niemann-Pick disease type C (NP-C) is a rare autosomal-recessively inherited lysosomal storage disorder. It is caused by mutations in the NPC1 (95%) or NPC2 gene. It is a progressive and highly heterogeneous disease, characterized by the presentation of visceral, neurological, and psychiatric symptoms. Apart from the patients that die early from organic failure, most of the patients with juvenile and adolescent/adult onset of the disease, develop neurological and psychiatric symptoms. In some cases psychiatric signs, mostly psychosis, can be the first sign of the disease. A delay in diagnosis is often seen. By describing the case of a 16-year old girl, we would like to highlight current opinion about NP-C disease and resume recent findings on the clinical presentation, diagnosis and treatment. We focus on the psychiatric signs, and most important the specific combinations that are typical for the disease. There is no curative treatment for NP-C. Miglustat is used to modify neurological signs in NP-C.

    更新日期:2019-11-01
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