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Schultze-Lutter F, Banaschewski T, Barth GM, Bechdolf A, Bender S, Flechtner HH, Hackler S, Heuer F, Hohmann S, Holzner L, Huss M, Koutsouleris N, Lipp M, Mandl S, Meisenzahl E, Munz M, Osman N, Peschl J, Reissner V, Renner T, Riedel A, Romanos M, Romer G, Schomerus G, Thiemann U, Uhlhaas PJ, Woopen C, Correll CU, Care-Konsortium D. [Ethical Considerations of Including Minors in Clinical Trials Using the Example of the Indicated Prevention of Psychotic Disorders]. ZEITSCHRIFT FUR KINDER- UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2024; 52:261-289. [PMID: 38809160 DOI: 10.1024/1422-4917/a000981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2024]
Abstract
Ethical Considerations of Including Minors in Clinical Trials Using the Example of the Indicated Prevention of Psychotic Disorders Abstract: As a vulnerable group, minors require special protection in studies. For this reason, researchers are often reluctant to initiate studies, and ethics committees are reluctant to authorize such studies. This often excludes minors from participating in clinical studies. This exclusion can lead to researchers and clinicians receiving only incomplete data or having to rely on adult-based findings in the treatment of minors. Using the example of the study "Computer-Assisted Risk Evaluation in the Early Detection of Psychotic Disorders" (CARE), which was conducted as an 'other clinical investigation' according to the Medical Device Regulation, we present a line of argumentation for the inclusion of minors which weighs the ethical principles of nonmaleficence (especially regarding possible stigmatization), beneficence, autonomy, and fairness. We show the necessity of including minors based on the development-specific differences in diagnostics and early intervention. Further, we present specific protective measures. This argumentation can also be transferred to other disorders with the onset in childhood and adolescence and thus help to avoid excluding minors from appropriate evidence-based care because of insufficient studies.
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Affiliation(s)
- Frauke Schultze-Lutter
- Klinik für Psychiatrie und Psychotherapie, Medizinische Fakultät und Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
- Department of Psychology, Faculty of Psychology, Airlangga University, Surabaya, Indonesien
- Universitätsklinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Universität Bern, Schweiz
| | - Tobias Banaschewski
- Klinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Deutschland
| | - Gottfried M Barth
- Abteilung Psychiatrie, Psychosomatik und Psychotherapie im Kindes- und Jugendalter, Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Tübingen, Deutschland
| | - Andreas Bechdolf
- Vivantes Klinikum Am Urban und Vivantes Klinikum im Friedrichshain, Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Berlin, Deutschland
- Klinik für Psychiatrie und Psychotherapie, CCM, Charité - Universitätsmedizin Berlin, Deutschland
- Deutsches Zentrum für Psychische Gesundheit, Standort Berlin, Deutschland
| | - Stephan Bender
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Köln, Deutschland
| | - Hans-Henning Flechtner
- Universitätsklinik für Psychiatrie, Psychotherapie und psychosomatische Medizin des Kindes- und Jugendalters, Otto-von-Guericke Universität Magdeburg, Magdeburg, Deutschland
| | - Sandra Hackler
- Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, LVR-Klinik Bonn, Bonn, Deutschland
| | - Fabiola Heuer
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Charité - Universitätsmedizin Berlin, Deutschland
| | - Sarah Hohmann
- Klinik für Kinder- und Jugendpsychiatrie, -psychotherapie und -psychosomatik, Universitätsklinikums Hamburg-Eppendorf, Hamburg, Deutschland
| | - Laura Holzner
- Vivantes Klinikum Am Urban und Vivantes Klinikum im Friedrichshain, Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Berlin, Deutschland
| | - Michael Huss
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Universitätsmedizin der Johannes-Gutenberg-Universität Mainz; Mainz, Deutschland
| | - Nikolaos Koutsouleris
- Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität München, München, Deutschland
- Max Planck Institute of Psychiatry, Max Planck Fellow Group Precision Psychiatry, München, Deutschland
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Michael Lipp
- Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - Selina Mandl
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie der Universität München, Klinikum der Universität München, Deutschland
| | - Eva Meisenzahl
- Klinik für Psychiatrie und Psychotherapie, Medizinische Fakultät und Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
| | - Manuel Munz
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik des Kindes- und Jugendalters des Zentrums für Integrative Psychiatrie, Universitätsklinikum Schleswig-Holstein (UKSH), Campus Kiel, Deutschland
| | - Naweed Osman
- Klinik für Psychiatrie und Psychotherapie, Medizinische Fakultät und Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
| | - Jens Peschl
- Klinik für Psychiatrie und Psychotherapie, Medizinische Fakultät und Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
| | - Volker Reissner
- Abteilung für Kinder- und Jugendpsychiatrie, LVR-Klinikum Düsseldorf, Heinrich-Heine-Universität Düsseldorf, Deutschland
| | - Tobias Renner
- Abteilung Psychiatrie, Psychosomatik und Psychotherapie im Kindes- und Jugendalter, Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Tübingen, Deutschland
| | - Anett Riedel
- Universitätsklinik für Psychiatrie, Psychotherapie und psychosomatische Medizin des Kindes- und Jugendalters, Otto-von-Guericke Universität Magdeburg, Magdeburg, Deutschland
| | - Marcel Romanos
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Universitätsklinikum Würzburg, Deutschland
| | - Georg Romer
- Klinik für Kinder- und Jugendpsychiatrie, -psychosomatik und -psychotherapie, Universitätsklinikum Münster, Deutschland
| | - Georg Schomerus
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universität Leipzig, Leipzig, Deutschland
| | - Ulf Thiemann
- Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, LVR-Klinik Bonn, Bonn, Deutschland
| | - Peter J Uhlhaas
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Charité - Universitätsmedizin Berlin, Deutschland
- Institute of Neuroscience and Psychology, University of Glasgow, UK
| | | | - Christoph U Correll
- Deutsches Zentrum für Psychische Gesundheit, Standort Berlin, Deutschland
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Charité - Universitätsmedizin Berlin, Deutschland
- The Zucker Hillside Hospital, Department of Psychiatry, Northwell Health, Glen Oaks, NY, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Department of Psychiatry and Molecular Medicine, Hempstead, NY, USA
| | - das Care-Konsortium
- Klinik für Psychiatrie und Psychotherapie, Medizinische Fakultät und Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
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Salazar de Pablo G, Catalan A, Vaquerizo Serrano J, Pedruzo B, Alameda L, Sandroni V, Armendariz A, Rodriguez V, Arango C, Moreno C, Downs J, Abbott C, Shin JI, Solmi M, Fusar-Poli P, Correll CU. Negative symptoms in children and adolescents with early-onset psychosis and at clinical high-risk for psychosis: systematic review and meta-analysis. Br J Psychiatry 2023; 223:282-294. [PMID: 37194556 PMCID: PMC10331322 DOI: 10.1192/bjp.2022.203] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 11/22/2022] [Accepted: 12/10/2022] [Indexed: 05/18/2023]
Abstract
BACKGROUND Early-onset psychosis (EOP) refers to the development of a first episode of psychosis before 18 years of age. Individuals at clinical high risk for psychosis (CHR-P) include adolescents and young adults, although most evidence has focused on adults. Negative symptoms are important prognostic indicators in psychosis. However, research focusing on children and adolescents is limited. AIMS To provide meta-analytical evidence and a comprehensive review of the status and advances in the diagnosis, prognosis and treatment of negative symptoms in children and adolescents with EOP and at CHR-P. METHOD PRISMA/MOOSE-compliant systematic review (PROSPERO: CRD42022360925) from inception to 18 August 2022, in any language, to identify individual studies conducted in EOP/CHR-P children and adolescents (mean age <18 years) providing findings on negative symptoms. Findings were systematically appraised. Random-effects meta-analyses were performed on the prevalence of negative symptoms, carrying out sensitivity analyses, heterogeneity analyses, publication bias assessment and quality assessment using the Newcastle-Ottawa Scale. RESULTS Of 3289 articles, 133 were included (n = 6776 EOP, mean age 15.3 years (s.d. = 1.6), males = 56.1%; n = 2138 CHR-P, mean age 16.1 years (s.d. = 1.0), males = 48.6%). There were negative symptoms in 60.8% (95% CI 46.4%-75.2%) of the children and adolescents with EOP and 79.6% (95% CI 66.3-92.9%) of those at CHR-P. Prevalence and severity of negative symptoms were associated with poor clinical, functional and intervention outcomes in both groups. Different interventions were piloted, with variable results requiring further replication. CONCLUSIONS Negative symptoms are common in children and adolescents at early stages of psychosis, particularly in those at CHR-P, and are associated with poor outcomes. Future intervention research is required so that evidence-based treatments will become available.
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Affiliation(s)
- Gonzalo Salazar de Pablo
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Early Psychosis: Interventions and Clinical Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Child and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London, UK; and Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Ana Catalan
- Early Psychosis: Interventions and Clinical Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; and Mental Health Department, Biocruces Bizkaia Health Research Institute, Basurto University Hospital, Facultad de Medicina y Odontología, Campus de Leioa, University of the Basque Country, UPV/EHU, Vizcaya, Spain
| | - Julio Vaquerizo Serrano
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Borja Pedruzo
- Department of Psychiatry, Basurto University Hospital, Bilbao, Spain
| | - Luis Alameda
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program, University Hospital (CHUV), Lausanne, Switzerland; and Centro Investigacion Biomedica en Red de Salud Mental (CIBERSAM), Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocio, Departamento de Psiquiatria, Universidad de Sevilla, Sevilla, Spain
| | - Veronica Sandroni
- Department of Psychiatry, Faculty of Medicine, Université Paris Cité, Paris, France; and Department of Psychiatry, Groupe Hospitalier Paul Guiraud, Villejuif, France
| | - Alvaro Armendariz
- Department of Psychiatry and Psychology, Hospital Sant Joan de Déu de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Victoria Rodriguez
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Carmen Moreno
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Johnny Downs
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Chris Abbott
- Child and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London, UK
| | - Jae Il Shin
- Department of Paediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Marco Solmi
- Early Psychosis: Interventions and Clinical Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada; Department of Mental Health, The Ottawa Hospital, Ottawa, Ontario, Canada; and Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; OASIS service, South London and Maudsley NHS Foundation Trust, London, UK; and National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
| | - Christoph U Correll
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany; Department of Psychiatry, Northwell Health, The Zucker Hillside Hospital, Glen Oaks, New York, USA; Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/ Northwell, Hempstead, New York, USA; and Center for Psychiatric Neuroscience, The Feinstein Institutes for Medical Research, Manhasset, New York, USA
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Herwerth L, Prinz K, Brauner H, Müller K, Fleischhaker C. Psychosen aus dem schizophrenen Formenkreis im Jugendalter: Einflussfaktoren auf Neuropsychologie, Behandlungserfolg und Negativsymptomatik. ZEITSCHRIFT FÜR KINDER- UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2022; 51:196-206. [PMID: 36205021 DOI: 10.1024/1422-4917/a000903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Zusammenfassung. Fragestellung: Ziel der vorliegenden Studie war es, Einflussfaktoren auf den Erkrankungsverlauf von Kindern und Jugendlichen mit der Diagnose einer Psychose aus dem schizophrenen Formenkreis in einer stationären Eingliederungsmaßnahme zu untersuchen. Methodik: 33 Patient_innen (Durchschnittsalter 19.4 Jahre, SD = 2.3), davon 12 (36 %) weiblich, nahmen teil. Diese wurden mit klinischen Interviews (IRAOS, SANS/SAPS), neuropsychologischen Tests (WAIS-IV, TMT) und Fragebögen (FBB, BSCL) untersucht. Ergebnis: Korreliert waren das neuropsychologische Funktionsniveau und die prämorbide kognitive Leistungsfähigkeit, ebenso der Behandlungserfolg aus Patientensicht und eine gute Beziehung zum Therapeuten bzw. zur Therapeutin, außerdem eine stärkere Negativsymptomatik mit einer längeren Dauer der unbehandelten Psychose (DUP) und einem längeren ersten Krankenhausaufenthalt. Schlussfolgerung: Mögliche Ansatzpunkte zur besseren Behandlung von Jugendlichen mit Psychosen aus dem schizophrenen Formenkreis stellen eine Verkürzung der DUP und eine gute therapeutische Beziehung dar.
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Affiliation(s)
- Lisette Herwerth
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik im Kindes- und Jugendalter, Universitätsklinikum Freiburg, Deutschland
- Geteilte Erstautorenschaft
| | - Katharina Prinz
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik im Kindes- und Jugendalter, Universitätsklinikum Freiburg, Deutschland
- Geteilte Erstautorenschaft
| | - Heike Brauner
- Psychotherapeutisches Wohnheim für junge Menschen Leppermühle, Buseck bei Gießen, Deutschland
| | - Katarina Müller
- Psychotherapeutisches Wohnheim für junge Menschen Leppermühle, Buseck bei Gießen, Deutschland
| | - Christian Fleischhaker
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik im Kindes- und Jugendalter, Universitätsklinikum Freiburg, Deutschland
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Liangrong Z, Guican Z, Qi Z, Weirui Y, Yaqi Z, Tong L, Wenjing L, Ming Z, Nianhong G. Long-Term Outcomes and Predictors of Childhood-Onset Schizophrenia: A Naturalistic Study of 6-year Follow-Up in China. Front Psychiatry 2021; 12:679807. [PMID: 34393845 PMCID: PMC8360848 DOI: 10.3389/fpsyt.2021.679807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 06/30/2021] [Indexed: 11/15/2022] Open
Abstract
Objectives: The long-term outcome of childhood-onset schizophrenia (COS) and its influencing factors remain unclear. The current study aimed to assess the long-term outcomes of COS and identify possible outcome predictors. Methods: We retrospectively investigated 276 patients with COS. Diagnosis made according to the ICD-10 criteria for schizophrenia, and the age of the first onset was ≤ 14 years. Follow-up was completed for 170 patients, with a median follow-up period of 5.6 years. Outcome variables included occupational/education status and readmission. Spearman correlation was performed to assess the relationship between predictors and outcome variables. Binary logistic regression was conducted to detect possible predictor variables for outcome variables. Results: At the end of the follow-up, 89 patients (52.3%) were at school, 70 patients (41.2%) were employed, and only 11 patients (6.5%) were dropped out of school or unemployed. The duration to the first admission and depressive symptoms were identified as predictors of occupational/educational status. The length of follow-up and obsessive-compulsive symptoms (OCS) were distinguished as predictors of readmission. Duration to the first admission and length of follow-up were risk factors, and depressive symptoms and OCS were protective factors for the outcomes of COS. Conclusion: We found a favorable long-term outcome on occupational/education status in COS, and depressive symptoms and OCS may be associated with more positive long-term outcomes in COS. Our findings suggest that COS patients may benefit from early intervention and require appropriate treatment.
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Affiliation(s)
- Zheng Liangrong
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zhang Guican
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zhu Qi
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yang Weirui
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zhang Yaqi
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Li Tong
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Liang Wenjing
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zhang Ming
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Guan Nianhong
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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Abstract
OBJECTIVE Our aim was to perform an updated systematic review and meta-analysis on the efficacy and safety of adjunctive minocycline as a treatment of schizophrenia. METHODS We conducted a PubMed/Scopus database search from inception to 3 February 2016 for randomized, placebo-controlled trials (RCTs), open non-randomized studies, and case reports/series evaluating minocycline in patients with schizophrenia. Random-effects meta-analysis of positive, negative, depressive, and cognitive symptom rating scales, discontinuation and adverse effects rates calculating standardized mean difference (SMD), and risk ratios±95% confidence intervals (CI 95%) were calculated. RESULTS Six RCTs were eligible (minocycline n=215, placebo n=198) that demonstrated minocycline's superiority versus placebo for reducing endpoint Positive and Negative Syndrome Scale (PANSS) total scores (SMD=-0.59; CI 95%=[1.15, -0.03]; p=0.04), negative (SMD=-0.76; CI 95%=[-1.21, -0.31]; p=0.001); general subscale scores (SMD=-0.44; CI 95%=[-0.88, -0.00]; p=0.05), Clinical Global Impressions scores (SMD=-0.50; CI 95%=[-0.78, -0.22]; p<0.001); and executive functioning (SMD=0.22; CI 95%=[0.01, 0.44]; p=0.04). Endpoint PANSS positive symptom scores (p=0.13), depression rating scale scores (p=0.43), attention (p=0.47), memory (p=0.52), and motor speed processing (p=0.50) did not significantly differ from placebo, before execution of a trim-and-fill procedure. Minocycline did not differ compared to placebo on all-cause discontinuation (p=0.56), discontinuation due to inefficacy (p=0.99), and intolerability (p=0.51), and due to death (p=0.32). Data from one open-label study (N=22) and three case series (N=6) were consistent with the metaanalytic results. CONCLUSIONS Minocycline appears to be an effective adjunctive treatment option in schizophrenia, improving multiple relevant disease dimensions. Moreover, minocycline has an acceptable safety and tolerability profile. However, more methodologically sound and larger RCTs remain necessary to confirm and extend these results.
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Entwicklungsspezifische Aspekte in der Früherkennung und Frühbehandlung eines erhöhten Psychoserisikos. Prax Kinderpsychol Kinderpsychiatr 2017; 66:324-344. [DOI: 10.13109/prkk.2017.66.5.324] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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