ASD Symptom Severity in Adolescence of Individuals Diagnosed with PDD-NOS in Childhood: Stability and the Relation with Psychiatric Comorbidity and Societal Participation

The current 7-year follow-up study investigated: (1) the stability of ASD severity, and (2) associations of ASD severity in adolescence with (a) childhood and concurrent psychiatric comorbidity, and (b) concurrent societal functioning. The Autism Diagnostic Observation Schedule (ADOS) and the Diagnostic Interview Schedule for Children were administered in childhood (ages 6-12) and in adolescence (ages 12-20) to 72 individuals with a pervasive developmental disorder-not otherwise specified (PDD-NOS). ADOS calibrated severity scores showed a large stability (r = .51). Psychiatric comorbidity in childhood and adolescence were not associated with ASD severity in adolescence. Mental health care use (87 %) and special education needs were high (71 %). Reevaluation of ASD severity and psychiatric comorbidity later in life seem useful when PDD-NOS is diagnosed in childhood.

[Counseling in the Dutch youth mental health care: a survey]

A recent survey amongst 48 key figures from all 51 Dutch institutions for youth mental health care service confirmed the hypothesis that counselling in the Dutch youth mental health care service hardly ever follows a standard pattern. In their reactions to this survey, professionals seem to be strongly in favour of a methodical form of counselling that is firmly based on scientific principles. Based on this survey, a review of the literature and panel discussions, an evidence-based counseling procedure for the youth mental health care was developed.

[Child and adolescent psychiatry: a profession and its identity II]

BACKGROUND

Up till the 1970s child and adolescent psychiatry had no distinctive diagnostic system of its own. From the 1980s onwards qualitative information-gathering (e.g. via discussion or play-situations) was no longer regarded as adequate and the standardised gathering of (quantitative) information became the cornerstone of the diagnostic process. This development fundamentally changed the child psychiatrist's profession and its identity.

AIM

To investigate the specific features that are required in current child and adolescent psychiatry.

METHOD

In this article we will clarify the change in the child psychiatrist's profession and identity by outlining how child an adolescent psychiatry evolved as from the early 1980s. We will do this by concentrating on the diagnostic process. The treatment aspect will be discussed only briefly.

RESULTS

Over the last 25 years the role of the child psychiatrist has undoubtedly changed. From being mainly a diagnostician and/or being personally responsible for treating the child or adolescent the child psychiatrist has become increasingly the person who controls the diagnostic process and plans treatment.

CONCLUSION

Over the last two decades the diagnostic technique of the child psychiatrist has developed in a new direction. The child psychiatrist has chosen instead to elucidate a patient's referral and to discuss the reasons for a request for assistance and/or care. The psychiatrist uses many types of information and a multitude of informants and methods. This development has led to a fundamental change in the child psychiatrist's profession and its identity.

The history and current status of child and adolescent psychiatric day-treatment programs in The Netherlands

Although its history in Netherlands is a short one, day treatment for children and adolescents is in great demand and an increase in the number of centers throughout the country has been planned. It serves as both a primary and a secondary treatment modality. While the theoretical frames of reference among day units vary, psychoanalytic and systems thinking are the leading orientations. All day units operate with a multidisciplinary staff who work intensively and therapeutically with the children and their families. The day unit at Sophia Children's Hospital in Rotterdam is described as an example of an existing program.