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Dapprich AL, Derks LM, Holtmann M, Lange WG, Legenbauer T, Becker ES. Hostile and threatening interpretation biases in adolescent inpatients are specific to callous-unemotional traits and social anxiety. Eur Child Adolesc Psychiatry 2024; 33:1143-1150. [PMID: 37256378 PMCID: PMC11032296 DOI: 10.1007/s00787-023-02227-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 05/05/2023] [Indexed: 06/01/2023]
Abstract
Psychopathological syndromes, such as disruptive behavior and anxiety disorders in adolescence, are characterized by distorted cognitions and problematic behavior. Biased interpretations of ambiguous social situations can elicit both aggressive and avoidance behavior. Yet, it is not well understood whether different interpretation biases are specific to different syndromes, or whether they can co-occur. We assessed both hostile and threatening interpretation biases in identical social situations, and proposed that they are uniquely related to callous-unemotional (CU) traits and social anxiety, respectively. We also explored the role of gender and age herein. The sample consisted of 390 inpatients between 10 and 18 years of age with a variety of psychiatric disorders. Hostile and threatening interpretations were assessed with the Ambiguous Social Scenario Task (ASST) consisting of 10 written vignettes. Both CU-traits and social anxiety were assessed with self-report questionnaires. Results showed that, overall, CU-traits were related to more hostile interpretations, whereas social anxiety was related to more threatening interpretations. In addition, in boys, hostile and threatening interpretations correlated significantly positive with each other. Age was not related to interpretation biases. Together, these results generally support the content-specificity of interpretation biases in concepts relevant to disruptive behavior disorders and anxiety disorders, and indicate that different interpretation biases can co-occur specifically in boys.
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Affiliation(s)
- Anna L Dapprich
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.
| | - Laura M Derks
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
- LWL-University Hospital Hamm for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Ruhr-University Bochum, Bochum, Germany
| | - Martin Holtmann
- LWL-University Hospital Hamm for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Ruhr-University Bochum, Bochum, Germany
| | - Wolf-Gero Lange
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Tanja Legenbauer
- LWL-University Hospital Hamm for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Ruhr-University Bochum, Bochum, Germany
| | - Eni S Becker
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
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Legenbauer T, Kirschbaum-Lesch I, Jörke C, Kölch M, Reis O, Berger C, Dück A, Schulte-Markwort M, Becker-Hebly I, Bienioschek S, Schroth J, Ruckes C, Deuster O, Holtmann M. Bright Light Therapy as Add-On to Inpatient Treatment in Youth With Moderate to Severe Depression: A Randomized Clinical Trial. JAMA Psychiatry 2024:2816353. [PMID: 38477894 PMCID: PMC10938243 DOI: 10.1001/jamapsychiatry.2024.0103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 01/18/2024] [Indexed: 03/14/2024]
Abstract
Importance Major depressive disorder is one of the most common mental disorders among adolescents, entailing severe, long-term psychosocial impairment and a high risk of chronicity. In view of the large number of patients requiring treatment, along with insufficient treatment responses with small effect sizes, innovative adjunctive treatment strategies are urgently needed. Objective To investigate whether the effect of adolescent psychiatric inpatient treatment as usual for major depressive disorder can be enhanced by simultaneous use of morning bright light therapy. Design, Setting, and Participants This was a double-blind, placebo-controlled randomized parallel-group trial with enrollment between March 2018 and November 2020 and follow-up completed in May 2021. The study took place among inpatients at 4 university hospitals for child and adolescent psychiatry across Germany. Of 248 eligible youth aged 12 to 18 years fulfilling ICD-10 criteria for major depressive disorder, 227 were randomized to bright light therapy (n = 116) or placebo red light (n = 111); 151 participants completed the study. Interventions Up to 20 sessions of either morning bright light therapy with an intensity of 10 000 lux or placebo red light (100 lux) in addition to multimodal inpatient treatment as usual over 4 weeks. Main Outcomes and Measures The primary outcome was the change in Beck Depression Inventory-II (BDI-II) score from baseline to posttreatment in the intention-to-treat sample. Results Among the 224 patients included in the intention-to-treat analyses (192 girls and 32 boys; mean [SD] age, 15.5 [1.4] years), the mean (SD) BDI-II score at baseline was 37.3 (8.7). BDI-II scores were significantly reduced after 4 weeks (postassessment) by a mean of -7.5 (95% CI, -9.0 to -6.0; Hedges g = 0.71). Bright light therapy had no impact on this change (no significant group × time effect). Loss to follow-up was 31% (n = 69) at 16 weeks and 49% (n = 110) at 28 weeks. There were 10 serious adverse events throughout the whole trial, which were not considered related to study treatment. Conclusions and Relevance The findings in this study did not indicate superiority of bright light therapy over placebo red light therapy in a large sample of adolescent inpatients with moderate or severe major depressive disorder. Both groups benefited equally from treatment as usual, showing relevant symptom reduction. Trial Registration German Clinical Trials Register: DRKS00013188.
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Affiliation(s)
- Tanja Legenbauer
- LWL University Hospital Hamm for Child and Adolescent Psychiatry, Ruhr-University Bochum, Hamm, Germany
| | - Inken Kirschbaum-Lesch
- LWL University Hospital Hamm for Child and Adolescent Psychiatry, Ruhr-University Bochum, Hamm, Germany
| | - Carina Jörke
- LWL University Hospital Hamm for Child and Adolescent Psychiatry, Ruhr-University Bochum, Hamm, Germany
| | - Michael Kölch
- Department of Child and Adolescent Psychiatry and Psychotherapy, Brandenburg Medical School, Faculty of Health Sciences Brandenburg, Neuruppin, Germany
- Department of Child and Adolescent Psychiatry and Neurology, Rostock University Medical Center, Rostock, Germany
| | - Olaf Reis
- Department of Child and Adolescent Psychiatry and Neurology, Rostock University Medical Center, Rostock, Germany
| | - Christoph Berger
- Department of Child and Adolescent Psychiatry and Neurology, Rostock University Medical Center, Rostock, Germany
| | - Alexander Dück
- Department of Child and Adolescent Psychiatry and Neurology, Rostock University Medical Center, Rostock, Germany
| | | | - Inga Becker-Hebly
- Department of Child and Adolescent Psychiatry, Hamburg University, Hamburg, Germany
| | - Stefanie Bienioschek
- Department of Child and Adolescent Psychiatry and Psychotherapy, Brandenburg Medical School, Faculty of Health Sciences Brandenburg, Neuruppin, Germany
| | - Jennifer Schroth
- Department of Child and Adolescent Psychiatry and Psychotherapy, Brandenburg Medical School, Faculty of Health Sciences Brandenburg, Neuruppin, Germany
| | - Christian Ruckes
- Interdisciplinary Centre for Clinical Trials, University Medical Center, Mainz, Germany
| | - Oliver Deuster
- Interdisciplinary Centre for Clinical Trials, University Medical Center, Mainz, Germany
| | - Martin Holtmann
- LWL University Hospital Hamm for Child and Adolescent Psychiatry, Ruhr-University Bochum, Hamm, Germany
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Zepf FD, König L, Kaiser A, Ligges C, Ligges M, Roessner V, Banaschewski T, Holtmann M. [Beyond NICE: Updated Systematic Review on the Current Evidence of Using Puberty Blocking Pharmacological Agents and Cross-Sex-Hormones in Minors with Gender Dysphoria]. Z Kinder Jugendpsychiatr Psychother 2024. [PMID: 38410090 DOI: 10.1024/1422-4917/a000972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
Beyond NICE: Updated Systematic Review on the Current Evidence of Using Puberty Blocking Pharmacological Agents and Cross-Sex-Hormones in Minors with Gender Dysphoria Abstract: Objective: The suppression of physiological puberty using puberty-blocking pharmacological agents (PB) and prescribing cross-sex hormones (CSH) to minors with gender dysphoria (GD) is a current matter of discussion, and in some cases, PB and CSH are used in clinical practice for this particular population. Two systematic reviews (one on PB, one on CSH treatment) by the British National Institute for Clinical Excellence (NICE) from 2020 indicated no clear clinical benefit of such treatments regarding critical outcome variables. In particular, these two systematic NICE reviews on the use of PB and CSH in minors with GD detected no clear improvements of GD symptoms. Moreover, the overall scientific quality of the available evidence, as discussed within the above-mentioned two NICE reviews, was classified as "very low certainty" regarding modified GRADE criteria. Method: The present systematic review presents an updated literature search on this particular topic (use of PB and CSH in minors with GD) following NICE principles and PICO criteria for all relevant new original research studies published since the release of the two above-mentioned NICE reviews (updated literature search period was July 2020-August 2023). Results: The newly conducted literature search revealed no newly published original studies targeting NICE-defined critical and important outcomes and the related use of PB in minors with GD following PICO criteria. For CSH treatment, we found two new studies that met PICO criteria, but these particular two studies had low participant numbers, yielded no significant additional clear evidence for specific and clearly beneficial effects of CSH in minors with GD, and could be classified as "low certainty" tfollowing modified GRADE criteria. Conclusions: The currently available studies on the use of PB and CSH in minors with GD have significant conceptual and methodological flaws. The available evidence on the use of PB and CSH in minors with GD is very limited and based on only a few studies with small numbers, and these studies have problematic methodology and quality. There also is a lack of adequate and meaningful long-term studies. Current evidence doesn't suggest that GD symptoms and mental health significantly improve when PB or CSH are used in minors with GD. Psychotherapeutic interventions to address and reduce the experienced burden can become relevant in children and adolescents with GD. If the decision to use PB and/or CSH is made on an individual case-by-case basis and after a complete and thorough mental health assessment, potential treatment of possibly co-occurring mental health problems as well as after a thoroughly conducted and carefully executed individual risk-benefit evaluation, doing so as part of clinical studies or research projects, as currently done in England, can be of value in terms of generation of new research data. The electronic supplement (ESM) 1 is an adapted and abreviated English version of this work.
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Affiliation(s)
- Florian D Zepf
- Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Friedrich Schiller University Jena, Jena, Germany
- German Center for Mental Health (DZPG), Site Jena-Magdeburg-Halle, Jena, Germany
| | - Laura König
- Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Friedrich Schiller University Jena, Jena, Germany
- German Center for Mental Health (DZPG), Site Jena-Magdeburg-Halle, Jena, Germany
| | - Anna Kaiser
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Carolin Ligges
- Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Friedrich Schiller University Jena, Jena, Germany
- German Center for Mental Health (DZPG), Site Jena-Magdeburg-Halle, Jena, Germany
| | - Marc Ligges
- Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Friedrich Schiller University Jena, Jena, Germany
- German Center for Mental Health (DZPG), Site Jena-Magdeburg-Halle, Jena, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, TU Dresden, Dresden, Germany
- German Center for Child and Adolescent Health (DZJK), partner site Leipzig-Dresden, Germany
| | - Tobias Banaschewski
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
- German Center for Mental Health (DZPG), partner site Mannheim-Heidelberg-Ulm, Germany
| | - Martin Holtmann
- LWL-Universitätsklinik Hamm der Ruhr-Universität Bochum, Hamm, Germany
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Klein F, Möllerherm J, Holtmann M, Kronmüller KT. [Interinstitutional cooperation between youth welfare services, child and adolescent psychiatry and adult psychiatry - an empirical study]. Psychiatr Prax 2023; 50:415-423. [PMID: 37487511 PMCID: PMC10667064 DOI: 10.1055/a-2117-9720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 05/11/2023] [Indexed: 07/26/2023]
Abstract
Family support in Germany is provided by a conglomerate of different support systems. In order to optimize the networking and cooperation of these inter-institutional support systems, it is important to gain a deeper understanding of the existing cooperation structures. Against this background, different qualitative and quantitative aspects were surveyed and analyzed by means of a questionnaire among participants from different help systems. The results point in particular to the currently existing special role of adult psychiatry.
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Affiliation(s)
- Fabian Klein
- Klinik für Psychiatrie und Psychotherapie, LWL-Klinikum
Gütersloh, Gütersloh
| | - Julia Möllerherm
- Klinik für Psychiatrie und Psychotherapie, LWL-Klinikum
Gütersloh, Gütersloh
| | - Martin Holtmann
- Klinik für Kinder- und Jugendpsychiatrie, Psychotherapie und
Psychosomatik, LWL-Universitätsklinik Hamm der Ruhr-Universität
Bochum, Hamm
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Holtmann M. Der erschütternde Seismograf – Zur Rolle der Kinder- und Jugendpsychiatrie in der Transgender-Kontroverse. Z Kinder Jugendpsychiatr Psychother 2023; 51:347-350. [PMID: 37681654 DOI: 10.1024/1422-4917/a000943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Affiliation(s)
- Martin Holtmann
- LWL-Universitätsklinik Hamm der Ruhr-Universität Bochum, Hamm, Deutschland
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Holtmann M. [Not Available]. Z Kinder Jugendpsychiatr Psychother 2023; 51:179. [PMID: 36897300 DOI: 10.1024/1422-4917/a000924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Affiliation(s)
- Martin Holtmann
- Klinik für Kinder- und Jugendpsychiatrie, Psychotherapie und Psychosomatik, LWL-Universitätsklinik Hamm der Ruhr-Universität Bochum, Deutschland
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Holtmann M, Hinney A, Konrad K, Schimmelmann B. Neue Junior-Herausgeber_innen. Z Kinder Jugendpsychiatr Psychother 2023; 51:9. [PMID: 36606336 DOI: 10.1024/1422-4917/a000919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Holtmann M, Lehmkuhl G, Plener P, Kölch M. Die COVID-19-Pandemie und seelische Gesundheit bei Minderjährigen: Herausforderungen für die Kinder- und Jugendpsychiatrie und -psychotherapie. Z Kinder Jugendpsychiatr Psychother 2023; 51:1-7. [PMID: 36606335 DOI: 10.1024/1422-4917/a000918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Martin Holtmann
- Klinik für Kinder- und Jugendpsychiatrie, Psychotherapie und Psychosomatik, LWL-Universitätsklinik Hamm der Ruhr-Universität Bochum, Deutschland
| | - Gerd Lehmkuhl
- Kinder- und Jugendpsychiatrie Psychotherapie und Psychosomatik, Uniklinik Köln, Deutschland
| | - Paul Plener
- Universitätsklinik für Kinder- und Jugendpsychiatrie, Medizinische Universität Wien, Österreich
| | - Michael Kölch
- Klinik für Psychiatrie, Neurologie, Psychosomatik und Psychotherapie im Kindes- und Jugendalter, Universitätsmedizin Rostock, Deutschland
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Jendreizik LT, Hautmann C, von Wirth E, Dose C, Thöne AK, Treier AK, Banaschewski T, Becker K, Brandeis D, Geissler J, Hebebrand J, Hohmann S, Holtmann M, Huss M, Jans T, Kaiser A, Millenet S, Poustka L, Schneider P, Döpfner M. The importance of familial risk factors in children with ADHD: direct and indirect effects of family adversity, parental psychopathology and parenting practices on externalizing symptoms. Child Adolesc Psychiatry Ment Health 2022; 16:96. [PMID: 36461089 PMCID: PMC9717533 DOI: 10.1186/s13034-022-00529-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 11/17/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Children experiencing unfavorable family circumstances have an increased risk of developing externalizing symptoms. The present study examines the direct, indirect and total effects of family adversity, parental psychopathology, and positive and negative parenting practices on symptoms of attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) in children with ADHD. METHODS Data from 555 children (M = 8.9 years old, 80.5% boys) who participated in a multicenter study on the treatment of ADHD (ESCAschool) were analyzed using structural equation modeling (SEM). RESULTS The SEM analyses revealed that (a) family adversity and parental psychopathology are associated with both child ADHD and ODD symptoms while negative parenting practices are only related to child ODD symptoms; (b) family adversity is only indirectly associated with child ADHD and ODD symptoms, via parental psychopathology and negative parenting practices; (c) the detrimental effect of negative parenting practices on child ADHD and ODD symptoms is stronger in girls than in boys (multi-sample SEM); (d) there are no significant associations between positive parenting practices and child ADHD or ODD symptoms. CONCLUSIONS Family adversity, parental psychopathology, and negative parenting practices should be routinely assessed by clinicians and considered in treatment planning. Trial registration (18th December 2015): German Clinical Trials Register (DRKS) DRKS00008973.
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Affiliation(s)
- Lea Teresa Jendreizik
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
| | - Christopher Hautmann
- grid.6190.e0000 0000 8580 3777School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Elena von Wirth
- grid.6190.e0000 0000 8580 3777School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Christina Dose
- grid.6190.e0000 0000 8580 3777School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ann-Kathrin Thöne
- grid.6190.e0000 0000 8580 3777School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Anne-Katrin Treier
- grid.6190.e0000 0000 8580 3777School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Tobias Banaschewski
- grid.7700.00000 0001 2190 4373Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Katja Becker
- grid.10253.350000 0004 1936 9756Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty of the Philipps-University Marburg, Marburg, Germany ,grid.8664.c0000 0001 2165 8627Center for Mind, Brain and Behavior (CMBB), University of Marburg and Justus Liebig University Giessen, Marburg, Germany
| | - Daniel Brandeis
- grid.7700.00000 0001 2190 4373Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany ,grid.7400.30000 0004 1937 0650Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zürich, Zurich, Switzerland ,grid.5801.c0000 0001 2156 2780Neuroscience Center Zürich, University and ETH Zürich, Zurich, Switzerland
| | - Julia Geissler
- grid.411760.50000 0001 1378 7891Center of Mental Health, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany
| | - Johannes Hebebrand
- grid.5718.b0000 0001 2187 5445Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Sarah Hohmann
- grid.7700.00000 0001 2190 4373Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Martin Holtmann
- grid.5570.70000 0004 0490 981XLWL-University Hospital for Child and Adolescent Psychiatry, Ruhr-University Bochum, Hamm, Germany
| | - Michael Huss
- grid.410607.4Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Thomas Jans
- grid.411760.50000 0001 1378 7891Center of Mental Health, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany
| | - Anna Kaiser
- grid.7700.00000 0001 2190 4373Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Sabina Millenet
- grid.7700.00000 0001 2190 4373Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Luise Poustka
- grid.411984.10000 0001 0482 5331Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Priska Schneider
- grid.411544.10000 0001 0196 8249Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Manfred Döpfner
- grid.6190.e0000 0000 8580 3777School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany ,grid.6190.e0000 0000 8580 3777Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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Martin F, Holtmann M, Legenbauer T. Better safe than sorry: Divergent error-related negativity and error positivity in shame-prone adolescents. Int J Psychophysiol 2022; 182:81-89. [DOI: 10.1016/j.ijpsycho.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 10/06/2022] [Accepted: 10/07/2022] [Indexed: 11/06/2022]
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Keller F, Kühner C, Alexandrowicz RW, Voderholzer U, Meule A, Fegert JM, Legenbauer T, Holtmann M, Bräscher AK, Cordes M, Fehm L, Fladung AK, Fydrich T, Hamm A, Heider J, Hoyer J, In-Albon T, Lincoln TM, Lutz W, Margraf J, Renneberg B, Schlarb A, Schöttke H, Teismann T, Velten J, Willutzki U, Witthöft M, Ziem M, Hautzinger M. Zur Messqualität des Beck-Depressionsinventars (BDI-II) in unterschiedlichen klinischen Stichproben. Zeitschrift für Klinische Psychologie und Psychotherapie 2022. [DOI: 10.1026/1616-3443/a000676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Theoretischer Hintergrund: Das BDI-II ist ein Selbstbeurteilungsinstrument zur Erfassung des Schweregrads einer Depression. Es liegen kaum Analysen mit Modellen aus der Item-Response-Theorie (IRT) vor. Fragestellung: Wie hoch ist die Messgenauigkeit des BDI-II über die unterschiedlichen Ausprägungen des latenten Traits (Depressivität) hinweg und sind die Kategorien der Items jeweils aufsteigend geordnet? Methode: Anhand von sechs großen Datensätzen aus verschiedenen klinischen Bereichen wurden psychometrische Analysen mit dem Graded Response Model durchgeführt. Ergebnisse: In allen Stichproben fand sich eine hohe interne Konsistenz. Die Schwellenwerte waren mit Ausnahme von Item 6 („Bestrafungsgefühle“) geordnet. Gemäß Testinformationsfunktion misst das BDI-II im mittleren bis hohen Depressionsbereich sehr gut (Reliabilität > .90) und im unteren Bereich gut. Schlussfolgerung: Für das BDI-II ergibt sich eine hohe und relativ gleichbleibende Messpräzision über einen weiten Bereich des latenten Traits, weshalb es insbesondere im klinischen, aber auch im nicht klinisch relevanten Wertebereich zur Erhebung des Schweregrades einer Depression gut geeignet ist.
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Affiliation(s)
- Ferdinand Keller
- Klinik für Kinder- und Jugendpsychiatrie / Psychotherapie, Universitätsklinikum Ulm, Deutschland
| | - Christine Kühner
- AG Verlaufs- und Interventionsforschung, Zentralinstitut für Seelische Gesundheit, Mannheim, Medizinische Fakultät Mannheim, Universität Heidelberg, Deutschland
| | | | - Ulrich Voderholzer
- Klinik für Psychiatrie und Psychotherapie, Klinikum der LMU München, Deutschland
- Schön Klinik Roseneck, Prien am Chiemsee, Deutschland
- Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Freiburg, Deutschland
| | - Adrian Meule
- Klinik für Psychiatrie und Psychotherapie, Klinikum der LMU München, Deutschland
- Schön Klinik Roseneck, Prien am Chiemsee, Deutschland
| | - Jörg M. Fegert
- Klinik für Kinder- und Jugendpsychiatrie / Psychotherapie, Universitätsklinikum Ulm, Deutschland
| | - Tanja Legenbauer
- LWL-Universitätsklinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Ruhr-Universität Bochum, Hamm, Deutschland
| | - Martin Holtmann
- LWL-Universitätsklinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Ruhr-Universität Bochum, Hamm, Deutschland
| | | | - Martin Cordes
- Institut für Psychologie, Poliklinische Psychotherapieambulanzen, Universität Osnabrück, Deutschland
| | - Lydia Fehm
- Institut für Psychologie, Humboldt-Universität zu Berlin, Deutschland
| | - Anne-Katharina Fladung
- Institut für Psychologie, Arbeitsbereich Klinische Psychologie und Psychotherapie, Universität Hamburg, Deutschland
| | - Thomas Fydrich
- Institut für Psychologie, Humboldt-Universität zu Berlin, Deutschland
| | - Alfons Hamm
- Zentrum für Psychologische Psychotherapie, Universität Greifswald, Deutschland
| | - Jens Heider
- Psychotherapeutische Universitätsambulanz, Campus Landau, Universität Koblenz-Landau, Deutschland
| | - Jürgen Hoyer
- Institut für Klinische Psychologie und Psychotherapie, Technische Universität Dresden, Deutschland
| | - Tina In-Albon
- Klinische Psychologie und Psychotherapie des Kindes- und Jugendalters, Universität Koblenz-Landau, Deutschland
| | - Tania M. Lincoln
- Institut für Psychologie, Arbeitsbereich Klinische Psychologie und Psychotherapie, Universität Hamburg, Deutschland
| | - Wolfgang Lutz
- Poliklinische Psychotherapieambulanz, Klinische Psychologie und Psychotherapie, Universität Trier, Deutschland
| | - Jürgen Margraf
- Forschungs- und Behandlungszentrum für psychische Gesundheit, Fakultät für Psychologie, Ruhr-Universität Bochum, Deutschland
| | - Babette Renneberg
- Hochschulambulanz für Psychotherapie, Diagnostik und Gesundheitsförderung, Freie Universität Berlin, Deutschland
| | - Angelika Schlarb
- Klinische Psychologie und Psychotherapie des Kindes- und Jugendalters, Abteilung für Psychologie, Universität Bielefeld, Deutschland
| | - Henning Schöttke
- Institut für Psychologie, Klinische Psychologie und Psychotherapie, Universität Osnabrück, Deutschland
| | - Tobias Teismann
- Forschungs- und Behandlungszentrum für psychische Gesundheit, Fakultät für Psychologie, Ruhr-Universität Bochum, Deutschland
| | - Julia Velten
- Forschungs- und Behandlungszentrum für psychische Gesundheit, Fakultät für Psychologie, Ruhr-Universität Bochum, Deutschland
| | - Ulrike Willutzki
- Department für Psychologie und Psychotherapie, Fakultät für Gesundheit, Universität Witten / Herdecke, Deutschland
| | - Michael Witthöft
- Psychologisches Institut, Johannes-Gutenberg-Universität Mainz, Deutschland
| | - Max Ziem
- Institut für Klinische Psychologie und Psychotherapie, Technische Universität Dresden, Deutschland
| | - Martin Hautzinger
- Klinische Psychologie und Psychotherapie, Fachbereich Psychologie, Eberhard-Karls-Universität Tübingen, Deutschland
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12
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Lollies F, Schnatschmidt M, Bihlmeier I, Genuneit J, In-Albnon T, Holtmann M, Legenbauer T, Schlarb AA. Associations of sleep and emotion regulation processes in childhood and adolescence - a systematic review, report of methodological challenges and future directions. Sleep Sci 2022; 15:490-514. [PMID: 36419813 PMCID: PMC9670771 DOI: 10.5935/1984-0063.20220082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 11/03/2021] [Indexed: 07/25/2023] Open
Abstract
Sleep and emotions are closely associated; however, the methodological challenges in the examination of sleep and the processes of emotion regulation in children and adolescents have not been investigated so far. Additionally, there is the demand to identify the levels of emotion regulating processes in which problematic or restricted sleep causes effect. Experimental sleep deprivation as well as prevalent sleep problems have been found to have negative influence on mental health and regulating functions. This review focuses first on the methodological protocols of the included studies. Subsequently, the results are summarized in the context of a multilevel model of emotion regulation. Thereafter, suggestions for future directions are given. Sleep problems and sleep deprivation are associated with a decrease of functional emotion regulating behavior and impaired emotion generation, and prolonged sleep enhances better mood and affect states, positive emotion expression, and faster sensory processing in response to emotional stimuli. This literature review highlights the limitations in current research, focusing on types of measurements, task characteristics, and data analysis. At the conclusion, suggestions are given for the future research direction in the field of sleep and emotion regulation in children and adolescents.
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Affiliation(s)
- Friederike Lollies
- Bielefeld University, Faculty for Psychology and Sports - Bielefeld
- North Rhine Westphalia - Germany
| | - Marisa Schnatschmidt
- Bielefeld University, Faculty for Psychology and Sports - Bielefeld
- North Rhine Westphalia - Germany
| | - Isabell Bihlmeier
- University of Tuebingen, Faculty of Science, Clinical Psychology -
Tuebingen - Baden -Wuerttemberg - Germany
| | - Jon Genuneit
- Leipzig University, Pediatric Epidemiology, Department of
Pediatrics, Medical Faculty - Leipzig - Saxony - Germany
| | - Tina In-Albnon
- University of Koblenz-Landau, Clinical Child and Adolescent
Psychology and Psychotherapy - Koblenz-Landau - Rhineland Palatinate - Germany
| | - Martin Holtmann
- Ruhr University Bochum, LWL - University Hospital Hamm for Child
and Adolescent Psychiatry - Hamm - North Rhine Westphalia - Germany
| | - Tanja Legenbauer
- Ruhr University Bochum, LWL - University Hospital Hamm for Child
and Adolescent Psychiatry - Hamm - North Rhine Westphalia - Germany
| | - Angelika Anita Schlarb
- Bielefeld University, Faculty for Psychology and Sports - Bielefeld
- North Rhine Westphalia - Germany
- University of Tuebingen, Faculty of Science, Clinical Psychology -
Tuebingen - Baden -Wuerttemberg - Germany
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13
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Derks LM, Becker ES, Rinck M, Holtmann M, Legenbauer T. I C U but I don't care: Callous-unemotional traits and approach-avoidance behaviour in conduct disorder. J Behav Ther Exp Psychiatry 2022; 76:101743. [PMID: 35738690 DOI: 10.1016/j.jbtep.2022.101743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 03/15/2022] [Accepted: 04/06/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND OBJECTIVES Conduct disorder (CD) is associated with deficits in social-emotional behaviour, such as increased levels of aggression. Callous-unemotional (CU-) traits foster those deficits and contribute to severe rates of instrumental aggression in CD. Previous studies of that increase in aggression have mainly focused on intentional aspects of behaviour. Unintentional behaviour, such as automatic approach and avoidance, has not been taken into account despite being highly relevant for behaviour. Therefore, the relevance of CU-traits for automatic actions and the feasibility of an approach-avoidance-task to measure those actions in CD-patients were investigated in a study series. METHODS Study 1 22 CD-patients executed an approach-avoidance task, where participants pushed or pulled pictures of emotional faces using a joystick. CU-traits were assessed via parent-report. Study 2 28 CD-patients and 19 typically developing children (TD) executed the AAT. Again, CU-traits were assessed via parent-report. RESULTS The AAT was a feasible instrument to measure automatic action tendencies and revealed that, while TD-children showed an avoidance bias towards angry faces, CD-patients showed a lack of automatic avoidance of anger. Across the whole sample (TD and CD combined), CU-traits predicted less threat avoidance. LIMITATIONS The small sample size may have limited the power to detect smaller approach-avoidance tendencies towards other emotions. CONCLUSIONS The findings suggest that CD is associated with a lack of automatic avoidance of social threat and that CU-traits predict that lack of avoidance. Divergent automatic threat responding might underlie the extreme levels of instrumentally aggressive behaviour observed in CD-patients with distinctive CU-traits.
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Affiliation(s)
- Laura Maria Derks
- Department for Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, LWL University Hospital of the Ruhr-University Bochum, Hamm, Germany; Behavioural Science Institute, Radboud-University Nijmegen, the Netherlands.
| | - Eni Sabine Becker
- Behavioural Science Institute, Radboud-University Nijmegen, the Netherlands
| | - Mike Rinck
- Behavioural Science Institute, Radboud-University Nijmegen, the Netherlands; Department of Psychology, Ruhr-Universität Bochum, Germany
| | - Martin Holtmann
- Department for Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, LWL University Hospital of the Ruhr-University Bochum, Hamm, Germany; Department of Psychology, Ruhr-Universität Bochum, Germany
| | - Tanja Legenbauer
- Department for Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, LWL University Hospital of the Ruhr-University Bochum, Hamm, Germany; Department of Psychology, Ruhr-Universität Bochum, Germany
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14
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Legenbauer T, Baldus C, Mokros L, Kretzschmar L, Schulz A, Herdering R, Huhn C, Kaffke L, Schiller S, Daubmann A, Zapf A, Holtmann M, Arnaud N, Thomasius R. Ergebnisse eines achtsamkeitsbasierten Gruppentherapieprogramms zur
Behandlung von Jugendlichen mit Abhängigkeitserkrankungen (IMAC-Mind
Teilprojekt 7). Suchttherapie 2022. [DOI: 10.1055/s-0042-1755981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/22/2023]
Affiliation(s)
- T Legenbauer
- LWL Universitätsklinikum Hamm der Ruhr-Universität
Bochum, Klinik für Kinder- und Jugendpsychiatrie, Psychotherapie und
Psychosomatik, Hamm
| | - C Baldus
- Deutsches Zentrum für Suchtfragen des Kindes- und Jugendalters,
Hamburg
| | - L Mokros
- LWL Universitätsklinikum Hamm der Ruhr-Universität
Bochum, Klinik für Kinder- und Jugendpsychiatrie, Psychotherapie und
Psychosomatik, Hamm
| | - L Kretzschmar
- LWL Universitätsklinikum Hamm der Ruhr-Universität
Bochum, Klinik für Kinder- und Jugendpsychiatrie, Psychotherapie und
Psychosomatik, Hamm
| | - A Schulz
- Deutsches Zentrum für Suchtfragen des Kindes- und Jugendalters,
Hamburg
| | - R Herdering
- LWL Universitätsklinikum Hamm der Ruhr-Universität
Bochum, Klinik für Kinder- und Jugendpsychiatrie, Psychotherapie und
Psychosomatik, Hamm
| | - C Huhn
- LWL Universitätsklinikum Hamm der Ruhr-Universität
Bochum, Klinik für Kinder- und Jugendpsychiatrie, Psychotherapie und
Psychosomatik, Hamm
| | - L Kaffke
- LWL Universitätsklinikum Hamm der Ruhr-Universität
Bochum, Klinik für Kinder- und Jugendpsychiatrie, Psychotherapie und
Psychosomatik, Hamm
| | - S Schiller
- Deutsches Zentrum für Suchtfragen des Kindes- und Jugendalters,
Hamburg
| | - A Daubmann
- Institut für Medizinische Biometrie und Epidemiologie,
Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - A Zapf
- Institut für Medizinische Biometrie und Epidemiologie,
Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - M Holtmann
- LWL Universitätsklinikum Hamm der Ruhr-Universität
Bochum, Klinik für Kinder- und Jugendpsychiatrie, Psychotherapie und
Psychosomatik, Hamm
| | - N Arnaud
- Deutsches Zentrum für Suchtfragen des Kindes- und Jugendalters,
Hamburg
| | - R Thomasius
- Deutsches Zentrum für Suchtfragen des Kindes- und Jugendalters,
Hamburg
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15
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Becker ABC, Lüken LM, Kelker L, Holtmann M, Daseking M, Legenbauer T. Cognitive Profiles of Adolescent Inpatients with Substance Use Disorder. Children 2022; 9:children9050756. [PMID: 35626933 PMCID: PMC9139439 DOI: 10.3390/children9050756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/19/2022] [Accepted: 05/19/2022] [Indexed: 11/16/2022]
Abstract
The prevalence of substance abuse is high during adolescence, and several studies have linked the use of alcohol and cannabis in adolescence to different cognitive impairments. To investigate whether specific cognitive deficits can be observed in adolescents with substance use disorder (SUD), we compared the cognitive profiles of inpatient adolescents diagnosed with SUD to a control group matched for sex, age and educational status. The inpatient adolescents received diagnoses of cannabis use disorder, alcohol use disorder or both. We compared the WISC-V profiles of 22 inpatients (45.5% female, Mage: 14.5; SD: 0.8) and the WAIS-IV profiles of 27 inpatients (44.4% female, Mage: 17.1; SD: 0.9) to 49 matched control participants with no diagnosed SUD. At the time of testing, participants were hospitalized for treatment of their SUD and were abstinent for a period of at least 6 weeks. To gain greater power, we jointly analyzed the Verbal Comprehension Index, Working Memory Index, Processing Speed Index and Full Scale IQ as assessed by WISC-V and WAIS-IV. The clinical group performed significantly worse than the control group on all the above indices. When only the group of inpatients was observed, in a model with the factors sex, educational status, presence of a comorbid diagnosis of depression and the number of comorbid diagnoses, only the factor educational status was significantly associated with the Full Scale IQ, whereas the factors sex and a comorbid diagnosis of depression in this group were associated with the Processing Speed Index. The results show that adolescents diagnosed with SUD (cannabis and/or alcohol) display broad cognitive impairments after 6 weeks of abstinence. Future research is required to further explore the role of comorbid diagnoses.
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Affiliation(s)
- Angelika Beate Christiane Becker
- Department of Educational Psychology, Helmut-Schmidt-University/University of the Federal Armed Forces, 22043 Hamburg, Germany; (L.K.); (M.D.)
- Correspondence:
| | - Luisa Marie Lüken
- LWL University Hospital for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Ruhr University Bochum, 59071 Hamm, Germany; (L.M.L.); (M.H.); (T.L.)
- Department of Psychology, University of Münster, 48149 Münster, Germany
| | - Lea Kelker
- Department of Educational Psychology, Helmut-Schmidt-University/University of the Federal Armed Forces, 22043 Hamburg, Germany; (L.K.); (M.D.)
| | - Martin Holtmann
- LWL University Hospital for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Ruhr University Bochum, 59071 Hamm, Germany; (L.M.L.); (M.H.); (T.L.)
| | - Monika Daseking
- Department of Educational Psychology, Helmut-Schmidt-University/University of the Federal Armed Forces, 22043 Hamburg, Germany; (L.K.); (M.D.)
| | - Tanja Legenbauer
- LWL University Hospital for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Ruhr University Bochum, 59071 Hamm, Germany; (L.M.L.); (M.H.); (T.L.)
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16
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Kirschbaum-Lesch I, Byrne JEM, Holtmann M, Murray G, Legenbauer T. Translation and validation of the SCRAM questionnaire in a German adolescent inpatient sample. Chronobiol Int 2022; 39:1027-1035. [PMID: 35393906 DOI: 10.1080/07420528.2022.2058957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Sleep, depressive symptoms and circadian preference are highly interconnected processes. Evidence suggests that, especially in adolescence, all processes should be considered in the assessment and treatment of patients with clinically relevant psychopathology. The SCRAM (Sleep, Circadian Rhythms, and Mood) questionnaire was developed and validated in a student sample as a promising tool to conjointly measure and separate sleep, circadian preference and depression symptomatology. The present study aims to validate a German version of the SCRAM questionnaire in an adolescent psychiatric inpatient sample. A two-step analytic strategy consisting of an exploratory factor analysis EFA followed by confirmatory factor analyses (CFA) was conducted. The EFA was run in the first half of the sample (n = 422, M = 14.92, SD = 1.67). To validate the factor structure of the EFA and the original study, two CFA`s were performed in the second half of the adolescent sample (n = 438, M = 15.07, SD = 1.68). The EFA analysis revealed a 4-factor model with 12 items. Two Sleep items and one Morningness item had cross-factor loadings. The fit indices in the CFA were good using the factor model of the original study, whereas the 4-factor model of the EFA did not converge. The German SCRAM factor model seems structurally sound in an adolescent inpatient sample, but questions remain regarding the role of diagnosis, gender, external correlates, and examining the change scores of the SCRAM scores with treatment. Before this application, further research is needed to replicate the factor structure, investigate test-retest reliability, predictive and discriminant validity and test in more generalizable samples.
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Affiliation(s)
- Inken Kirschbaum-Lesch
- Hospital for Child and Adolescent Psychiatry and Psychotherapy, Ruhr-University BochumLWL-University, Hamm, Germany
| | - Jamie E M Byrne
- School of Psychology, Deakin University, Burwood, Victoria, Australia
| | - Martin Holtmann
- Hospital for Child and Adolescent Psychiatry and Psychotherapy, Ruhr-University BochumLWL-University, Hamm, Germany
| | - Greg Murray
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Tanja Legenbauer
- Hospital for Child and Adolescent Psychiatry and Psychotherapy, Ruhr-University BochumLWL-University, Hamm, Germany
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17
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Banaschewski T, Döpfner M, Fegert JM, Flechtner HH, Freitag CM, Holtmann M, Kamp-Becker I, Konrad K, Poustka L, Renner T, Roessner V, Romanos M, Schulte-Körne G, Thomasius R, Zepf F, Kölch M. Psychische Gesundheit und Krankheit bei Kindern und Jugendlichen: Herausforderungen für die beiden neuen Deutschen Forschungszentren DZKJ und DZPG. Z Kinder Jugendpsychiatr Psychother 2022; 50:85-89. [PMID: 35274572 DOI: 10.1024/1422-4917/a000856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Tobias Banaschewski
- Klinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim, Universität Heidelberg
| | - Manfred Döpfner
- Klinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters, Universitätsklinik Köln
| | - Jörg M Fegert
- Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie des Universitätsklinikums Ulm
| | - Hans-Henning Flechtner
- Universitätsklinik für Psychiatrie, Psychotherapie und Psychosomatische Medizin des Kindes- und Jugendalters, Otto-von-Guericke Universität Magdeburg
| | - Christine M Freitag
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Universitätsklinikum Frankfurt, Goethe-Universität, Frankfurt am Main
| | | | - Inge Kamp-Becker
- Klinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Philipps-Universität Marburg
| | - Kerstin Konrad
- Klinik für Kinder- und Jugendpsychiatrie und -psychotherapie der RWTH Aachen
| | - Luise Poustka
- Klinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Universität Göttingen
| | - Tobias Renner
- Abteilung Psychiatrie, Psychosomatik und Psychotherapie im Kindes- und Jugendalter, Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Tübingen
| | - Veit Roessner
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Technische Universität Dresden
| | - Marcel Romanos
- Zentrum für Psychische Gesundheit (ZEP), Klinik und Poliklinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Universitätsklinikum Würzburg, Würzburg
| | - Gerd Schulte-Körne
- LMU Klinikum, Klinik und Poliklinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, München
| | - Rainer Thomasius
- Deutsches Zentrum für Suchtfragen des Kindes- und Jugendalters (DZSKJ), Universitätsklinikum Hamburg-Eppendorf
| | - Florian Zepf
- Klinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie Universitätsklinikum Jena
| | - Michael Kölch
- Klinik für Psychiatrie, Neurologie, Psychosomatik und Psychotherapie im Kindes- und Jugendalter, Universitätsmedizin Rostock
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18
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Lindenberg K, Holtmann M. [Inclusion of gaming disorder as a behavioral addiction in ICD-11]. Z Kinder Jugendpsychiatr Psychother 2022; 50:1-7. [PMID: 34974738 DOI: 10.1024/1422-4917/a000837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Inclusion of gaming disorder as a behavioral addiction in ICD-11 Abstract. With the inclusion of the new category "disorders due to addictive behaviors" in ICD-11, it has been officially recognized by the WHO that highly rewarding behaviors, analogous to psychotropic substances, can become addictive. In addition to gambling disorder, which was already listed in ICD-10, computer gaming disorder was added as a new diagnosis in this category. The phenotype is characterized by loss of control, priority of gaming over other activities, continuation of gaming despite negative consequences, and the condition of significant impairment caused by the symptomatology. Disorder-typical pathomechanisms include consumption-dependent factors, developmental factors, changes in reward sensitivity and processing, and biased reward expectations (cognitions). Psychotherapeutic care for children, adolescents, and young adults with this disorder, who now comprise a substantial proportion of outpatient care, is challenging. In addition to the development of valid diagnostic tools and effective intervention methods, there is a great need for further training in child and adolescent psychiatry and psychotherapy on this new disorder.
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Affiliation(s)
- Katajun Lindenberg
- Institut für Psychologie, Goethe-Universität Frankfurt, Frankfurt am Main
| | - Martin Holtmann
- LWL-Universitätsklinik Hamm der Ruhr-Universität Bochum, Hamm
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19
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Berger C, Dück A, Gest S, Jonas L, Kölch M, Martin F, Reis O, Schroth J, Legenbauer T, Holtmann M. Possible Effects of Bright Light Therapy on Electroencephalogram-Vigilance in the Treatment of Depression in Adolescents: A Pilot Study. Front Psychiatry 2022; 13:820090. [PMID: 35633803 PMCID: PMC9133446 DOI: 10.3389/fpsyt.2022.820090] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 04/14/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Chronotherapeutic treatments for depression, such as bright light therapy (BLT), are non-invasive and produce almost no side effects. However, study evidence for reliable neurobiological changes associated with treatment response is still rare. Several studies using EEG-vigilance indicate higher arousal and a later decline during resting state in adult depressive patients compared to healthy controls. To our knowledge, there are no study reports on EEG-vigilance in depressive youth to date. METHODS A total of 11 adolescents with depression receiving BLT were compared to 11 age and gender-matched patients with depression receiving treatment as usual (TAU). The BLT was administered in the morning for 2 weeks on five consecutive days per week. The depressive symptomatology was assessed using the Beck Depression Inventory (BDI-II) and the resting state electroencephalogram (EEG) of 20 min was recorded. EEG and BDI-II were assessed before and after 10 days of treatment. Vigilance level and vigilance decline were estimated using the VIGALL toolbox. RESULTS Brain arousal increased after 10 days of bright light therapy in adolescents with depression. Severe depressive symptoms were associated with higher brain arousal levels; the BDI-II sum score correlated negatively with the amount of drowsiness. LIMITATIONS The sample size was small and participants' brain arousal at baseline was not matched and differed between BLT and TAU groups. CONCLUSION The BLT might have an additional effect on brain arousal. EEG-vigilance seems to be a reliable and valid marker for neurobiological changes that are probably associated with depression and its treatment and, therefore, might be of clinical relevance.
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Affiliation(s)
- Christoph Berger
- Department for Child and Adolescent Psychiatry and Neurology, University Medical Centre Rostock, Rostock, Germany
| | - Alexander Dück
- Department for Child and Adolescent Psychiatry and Neurology, University Medical Centre Rostock, Rostock, Germany
| | - Stephanie Gest
- Landschaftsverband Westfalen-Lippe (LWL) University Hospital Hamm for Child and Adolescent Psychiatry, Ruhr University Bochum, Bochum, Germany
| | - Lena Jonas
- Department for Child and Adolescent Psychiatry and Neurology, University Medical Centre Rostock, Rostock, Germany
| | - Michael Kölch
- Department for Child and Adolescent Psychiatry and Neurology, University Medical Centre Rostock, Rostock, Germany
| | - Franziska Martin
- Landschaftsverband Westfalen-Lippe (LWL) University Hospital Hamm for Child and Adolescent Psychiatry, Ruhr University Bochum, Bochum, Germany
| | - Olaf Reis
- Department for Child and Adolescent Psychiatry and Neurology, University Medical Centre Rostock, Rostock, Germany
| | - Jennifer Schroth
- Department for Child and Adolescent Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany
| | - Tanja Legenbauer
- Landschaftsverband Westfalen-Lippe (LWL) University Hospital Hamm for Child and Adolescent Psychiatry, Ruhr University Bochum, Bochum, Germany
| | - Martin Holtmann
- Landschaftsverband Westfalen-Lippe (LWL) University Hospital Hamm for Child and Adolescent Psychiatry, Ruhr University Bochum, Bochum, Germany
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20
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Perthes K, Kirschbaum-Lesch I, Legenbauer T, Holtmann M, Hammerle F, Kolar DR. Emotion regulation in adolescents with anorexia and bulimia nervosa: Differential use of adaptive and maladaptive strategies compared to healthy adolescents. Int J Eat Disord 2021; 54:2206-2212. [PMID: 34542185 DOI: 10.1002/eat.23608] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 09/08/2021] [Accepted: 09/09/2021] [Indexed: 01/29/2023]
Abstract
OBJECTIVE Adolescents with anorexia (AN) and bulimia nervosa (BN) often struggle with emotion regulation (ER). These difficulties have predominantly been assessed across emotions, without considering adaptive and maladaptive ER separately. We compared adolescents with AN or BN to healthy adolescents (HCs) regarding the adaptive and maladaptive ER of three emotions. METHOD A treatment-seeking sample of 197 adolescents (atypical/full-threshold AN: N = 118, atypical/full-threshold BN: N = 32; HC: N = 47) reported emotion-specific ER with the FEEL-KJ questionnaire. Mixed models were calculated for adaptive and maladaptive ER to assess differences between emotions (anxiety, anger, and sadness) and groups (AN, BN, and HC). RESULTS Main effects of emotion (p < .001) and group (p < .001) were found, but no interaction effects were found (p > .05). Post hoc tests showed lower maladaptive and higher adaptive ER for anxiety than anger or sadness (p < .001). AN and BN reported lower adaptive (p < .001) and higher maladaptive ER than HCs (p < .001). BN showed the highest levels of maladaptive ER (p = .009). DISCUSSION The differences between AN and BN in adaptive and maladaptive ER should be considered. Furthermore, investigating differences in ER of other emotions in eating disorders might be promising.
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Affiliation(s)
- Karin Perthes
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medicine of the Johannes Gutenberg-University, Mainz, Germany
| | - Inken Kirschbaum-Lesch
- LWL University Hospital Hamm for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatic, Ruhr University Bochum, Hamm, Germany
| | - Tanja Legenbauer
- LWL University Hospital Hamm for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatic, Ruhr University Bochum, Hamm, Germany
| | - Martin Holtmann
- LWL University Hospital Hamm for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatic, Ruhr University Bochum, Hamm, Germany
| | - Florian Hammerle
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medicine of the Johannes Gutenberg-University, Mainz, Germany
| | - David R Kolar
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medicine of the Johannes Gutenberg-University, Mainz, Germany.,Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
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21
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Arnaud N, Holtmann M, Melchers P, Klein M, Schimansky G, Krömer T, Reis O, Thomasius R. [Use of Electronic Cigarettes (e-cigs) and e-Shishas by Children and Adolescents: Evidence Paper of the Joint Addiction Commission of the German Societies and Professional Associations of Child and Adolescent Psychiatry and Psychotherapy]. Z Kinder Jugendpsychiatr Psychother 2021; 50:121-132. [PMID: 34668740 DOI: 10.1024/1422-4917/a000831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Use of Electronic Cigarettes (e-cigs) and e-Shishas by Children and Adolescents: Evidence Paper of the Joint Addiction Commission of the German Societies and Professional Associations of Child and Adolescent Psychiatry and Psychotherapy Abstract. The particular risks associated with the consumption of electronic cigarettes (e-cigs) in children and adolescents are not sufficiently considered in the health policy discourse. The present article evaluates the current dissemination and consumption patterns of e-cigarettes as well as the health risks attached to children and adolescents. Based on data from current national and international studies, there has been a clear increase in the consumption of e-cigarettes over the past years. This stands in sharp contrast to the overall decline in tobacco consumption among both children and adolescents in Germany. Young people without tobacco experience are now consuming more frequently e-cigarettes than those who occasionally or regularly use tobacco. They also are experimenting more frequently with conventional cigarettes if they have previously consumed e-cigarettes. The largely unregulated availability of e-cigarette products to the newest generation, such as JUUL, led to a dramatic increase in their prevalence among high-school students in the USA. Products with high nicotine content and multiple flavors are being marketed intensively as trendy lifestyle products to young user groups via advertising and social media campaigns. These products are also becoming increasingly relevant in Germany. The success of tobacco prevention in recent years is presently jeopardized by the ongoing effective advertising for e-cigarettes. The Addiction Commission of the German Child and Youth Psychiatric Federations and Scientific Societies therefore call for an immediate, strict, and comprehensive ban of e-cigarette advertising.
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Affiliation(s)
- Nicolas Arnaud
- Deutsches Zentrum für Suchtfragen des Kindes- und Jugendalters (DZSKJ), Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - Martin Holtmann
- LWL-Universitätsklinik Hamm der Ruhr-Universität Bochum, Klinik für Kinder- und Jugendpsychiatrie, Psychotherapie und Psychosomatik, Hamm
| | - Peter Melchers
- Klinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Klinikum Oberberg, Kreiskrankenhaus Gummersbach und Klinik Marienheide, Gummersbach
| | | | - Gisela Schimansky
- Praxis für Kinder- und Jugendpsychiatrie und Psychotherapie Dr. Schimansky, Hannover
| | - Thomas Krömer
- Gemeinschaftspraxis für Kinder- und Jugendpsychiatrie, Psychotherapie & Psychosomatik, Hamburg
| | - Olaf Reis
- Klinik für Psychiatrie, Neurologie, Psychosomatik und Psychotherapie im Kindes- und Jugendalter, Universitätsmedizin Rostock, Rostock
| | - Rainer Thomasius
- Deutsches Zentrum für Suchtfragen des Kindes- und Jugendalters (DZSKJ), Universitätsklinikum Hamburg-Eppendorf, Hamburg
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22
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Özgen H, Spijkerman R, Noack M, Holtmann M, Schellekens A, Dalsgaard S, van den Brink W, Hendriks V. Treatment of Adolescents with Concurrent Substance Use Disorder and Attention-Deficit/Hyperactivity Disorder: A Systematic Review. J Clin Med 2021; 10:jcm10173908. [PMID: 34501355 PMCID: PMC8432200 DOI: 10.3390/jcm10173908] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 08/22/2021] [Accepted: 08/26/2021] [Indexed: 11/17/2022] Open
Abstract
Childhood attention-deficit/hyperactivity disorder (ADHD) is a risk factor for the development of substance abuse and substance use disorders (SUD) in adolescence and (early) adulthood. ADHD and SUD also frequently co-occur in treatment-seeking adolescents, which complicates diagnosis and treatment, and is associated with poor treatment outcomes. In this study, we provide a systematic review of controlled studies on the effectiveness of pharmacological, psychosocial, and complementary treatments of ADHD in adolescents with and without comorbid SUD. In addition, we review the longitudinal association between pharmacotherapy for childhood ADHD and the development of SUD in adolescence and early adulthood. We conducted a systematic review of the research literature published since 2000 using Medline, PsycINFO, and the Cochrane Database of Systematic Reviews databases to select randomized clinical trials, observational studies, and meta-analyses. The quality of the evidence from each study was rated using the SIGN grading system. Based on the limited evidence available, strong clinical recommendations are not justified, but provisionally, we conclude that stimulant treatment in children with ADHD may prevent the development of SUD in adolescence or young adulthood, that high-dose stimulant treatment could be an effective treatment for adolescents with ADHD and SUD comorbidity, that cognitive behavior therapy might have a small beneficial effect in these patients, and that alternative treatments are probably not effective. More studies are needed to draw definitive conclusions that will allow for strong clinical recommendations.
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Affiliation(s)
- Heval Özgen
- Parnassia Addiction Research Centre (PARC), Parnassia Psychiatric Institute, 2512 HN The Hague, The Netherlands; (R.S.); (V.H.)
- Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
- Correspondence:
| | - Renske Spijkerman
- Parnassia Addiction Research Centre (PARC), Parnassia Psychiatric Institute, 2512 HN The Hague, The Netherlands; (R.S.); (V.H.)
| | - Moritz Noack
- Department of Child and Adolescent Psychiatry, LWL-University Hospital, Hamm, Ruhr-University Bochum, 44801 Bochum, Germany; (M.N.); (M.H.)
| | - Martin Holtmann
- Department of Child and Adolescent Psychiatry, LWL-University Hospital, Hamm, Ruhr-University Bochum, 44801 Bochum, Germany; (M.N.); (M.H.)
| | - Arnt Schellekens
- Department of Psychiatry, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands;
- Donders Institute for Brain Cognition and Behavior, Radboud University Nijmegen, 6525 AJ Nijmegen, The Netherlands
- International Collaboration on ADHD and Substance Abuse (ICASA) Foundation, 6500 HE Nijmegen, The Netherlands;
| | - Søren Dalsgaard
- Department of Economics and Business Economics, Aarhus University, DK-8210 Aarhus, Denmark;
| | - Wim van den Brink
- International Collaboration on ADHD and Substance Abuse (ICASA) Foundation, 6500 HE Nijmegen, The Netherlands;
- Amsterdam University Medical Centers, Location Academic Medical Center, 1106 AZ Amsterdam, The Netherlands
| | - Vincent Hendriks
- Parnassia Addiction Research Centre (PARC), Parnassia Psychiatric Institute, 2512 HN The Hague, The Netherlands; (R.S.); (V.H.)
- Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
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23
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Thöne AK, Junghänel M, Görtz-Dorten A, Dose C, Hautmann C, Jendreizik LT, Treier AK, Vetter P, von Wirth E, Banaschewski T, Becker K, Brandeis D, Dürrwächter U, Geissler J, Hebebrand J, Hohmann S, Holtmann M, Huss M, Jans T, Ketter J, Legenbauer T, Millenet S, Poustka L, Renner T, Romanos M, Uebel-von Sandersleben H, Wenning J, Ziegler M, Döpfner M. Disentangling symptoms of externalizing disorders in children using multiple measures and informants. Psychol Assess 2021; 33:1065-1079. [PMID: 34435849 DOI: 10.1037/pas0001053] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The trait impulsivity theory suggests that a single, highly heritable externalizing liability factor, expressed as temperamental trait impulsivity, represents the core vulnerability for externalizing disorders. The present study sought to test the application of latent factor models derived from this theory to a clinical sample of children. Participants were 474 German children (age 6-12 years, 81% male) with symptoms of attention-deficit/hyperactivity disorder and externalizing behavior problems participating in an ongoing multicenter intervention study. Using confirmatory factor analyses (CFA) and exploratory structural equation modeling (ESEM), we evaluated several factor models of externalizing spectrum disorders (unidimensional; first-order correlated factors; higher-order factor; fully symmetrical bifactor; bifactor S-1 model). Furthermore, we assessed our prevailing factor models for measurement invariance across raters (clinicians, parents, teachers) and assessment modes (interview, questionnaires). While both CFA and ESEM approaches provided valuable insights into the multidimensionality, ESEM solutions were generally superior since they showed a substantially better model fit and less biased factor loadings. Among the models tested, the bifactor S-1 CFA/ESEM models, with a general hyperactivity-impulsivity reference factor, displayed a statistically sound factor structure and allowed for straightforward interpretability. Furthermore, these models showed the same organization of factors and loading patterns, but not equivalent item thresholds across raters and assessment modes, highlighting cross-situational variability in child behavior. Our findings are consistent with the assumption of the trait impulsivity theory that a common trait, presented as hyperactivity-impulsivity symptoms, underlies all externalizing disorders. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
| | | | | | - Christina Dose
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP)
| | | | | | | | - Paula Vetter
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP)
| | - Elena von Wirth
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP)
| | | | - Katja Becker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy
| | - Daniel Brandeis
- Department of Child and Adolescent Psychiatry and Psychotherapy
| | - Ute Dürrwächter
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy
| | | | - Johannes Hebebrand
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy
| | - Sarah Hohmann
- Department of Child and Adolescent Psychiatry and Psychotherapy
| | | | - Michael Huss
- Department of Child and Adolescent Psychiatry and Psychotherapy
| | | | - Johanna Ketter
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy
| | | | - Sabina Millenet
- Department of Child and Adolescent Psychiatry and Psychotherapy
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy
| | - Tobias Renner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy
| | | | | | - Jasmin Wenning
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy
| | - Mirjam Ziegler
- Department of Child and Adolescent Psychiatry and Psychotherapy
| | - Manfred Döpfner
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP)
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24
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Aggensteiner PM, Albrecht B, Strehl U, Wörz S, Ruckes C, Freitag CM, Rothenberger A, Gevensleben H, Millenet S, Hohmann S, Banaschewski T, Legenbauer T, Holtmann M, Brandeis D. Can neurophysiological markers of anticipation and attention predict ADHD severity and neurofeedback outcomes? Biol Psychol 2021; 165:108169. [PMID: 34416347 DOI: 10.1016/j.biopsycho.2021.108169] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 07/12/2021] [Accepted: 08/12/2021] [Indexed: 01/23/2023]
Abstract
Neurophysiological measures of preparation and attention are often atypical in ADHD. Still, replicated findings that these measures predict which patients improve after Neurofeedback (NF), reveal neurophysiological specificity, and reflect ADHD-severity are limited. METHODS We analyzed children's preparatory (CNV) and attentional (Cue-P3) brain activity and behavioral performance during a cued Continuous Performance Task (CPT) before and after slow cortical potential (SCP)-NF or semi-active control treatment (electromyogram biofeedback). Mixed-effects models were performed with 103 participants at baseline and 77 were assessed for pre-post comparisons focusing on clinical outcome prediction, specific neurophysiological effects of NF, and associations with ADHD-severity. RESULTS Attentional and preparatory brain activity and performance were non-specifically reduced after treatment. Preparatory activity in the SCP-NF group increased with clinical improvement. Several performance and brain activity measures predicted non-specific treatment outcome. CONCLUSION Specific neurophysiological effects after SCP-NF were limited to increased neural preparation associated with improvement on ADHD-subscales, but several performance and neurophysiological measures of attention predicted treatment outcome and reflected symptom severity in ADHD. The results may help to optimize treatment.
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Affiliation(s)
- Pascal-M Aggensteiner
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
| | - Björn Albrecht
- Clinic for Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany; Philipps-University Marburg, Department of Psychology, Marburg, Germany
| | - Ute Strehl
- Institute for Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany
| | - Sonja Wörz
- Institute for Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany
| | - Christian Ruckes
- Interdisciplinary Center for Clinical Trials at the University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Christine M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Aribert Rothenberger
- Clinic for Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Holger Gevensleben
- Clinic for Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Sabina Millenet
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Sarah Hohmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Tanja Legenbauer
- LWL-University Hospital for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Ruhr University Bochum, Hamm, Germany
| | - Martin Holtmann
- LWL-University Hospital for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Ruhr University Bochum, Hamm, Germany
| | - Daniel Brandeis
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry, University of Zürich, Zürich, Switzerland; Center for Integrative Human Physiology, University of Zürich, Zürich, Switzerland; Neuroscience Center Zürich, Swiss Federal Institute of Technology and University of Zürich, Zürich, Switzerland
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25
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Özgen H, Spijkerman R, Noack M, Holtmann M, Schellekens ASA, van de Glind G, Banaschewski T, Barta C, Begeman A, Casas M, Crunelle CL, Daigre Blanco C, Dalsgaard S, Demetrovics Z, den Boer J, Dom G, Eapen V, Faraone SV, Franck J, González RA, Grau-López L, Groenman AP, Hemphälä M, Icick R, Johnson B, Kaess M, Kapitány-Fövény M, Kasinathan JG, Kaye SS, Kiefer F, Konstenius M, Levin FR, Luderer M, Martinotti G, Matthys FIA, Meszaros G, Moggi F, Munasur-Naidoo AP, Post M, Rabinovitz S, Ramos-Quiroga JA, Sala R, Shafi A, Slobodin O, Staal WG, Thomasius R, Truter I, van Kernebeek MW, Velez-Pastrana MC, Vollstädt-Klein S, Vorspan F, Young JT, Yule A, van den Brink W, Hendriks V. [International Consensus Statement for the Screening, Diagnosis, and Treatment of Adolescents with Concurrent Attention-Deficit/Hyperactivity Disorder and Substance Use Disorder]. Z Kinder Jugendpsychiatr Psychother 2021; 50:54-67. [PMID: 34397296 DOI: 10.1024/1422-4917/a000828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
International Consensus Statement for the Screening, Diagnosis, and Treatment of Adolescents with Concurrent Attention-Deficit/Hyperactivity Disorder and Substance Use Disorder Abstract. Background: Childhood attention-deficit/hyperactivity disorder (ADHD) is a risk factor for substance misuse and substance use disorder (SUD) in adolescence and (early) adulthood. ADHD and SUD also frequently co-occur in treatment-seeking adolescents, which complicates diagnosis and treatment and is associated with poor treatment outcomes. Research on the effect of treatment of childhood ADHD on the prevention of adolescent SUD is inconclusive, and studies on the diagnosis and treatment of adolescents with ADHD and SUD are scarce. Thus, the available evidence is generally not sufficient to justify robust treatment recommendations. Objective: The aim of the study was to obtain a consensus statement based on a combination of scientific data and clinical experience. Method: A modified Delphi study to reach consensus based upon the combination of scientific data and clinical experience with a multidisciplinary group of 55 experts from 17 countries. The experts were asked to rate a set of statements on the effect of treatment of childhood ADHD on adolescent SUD and on the screening, diagnosis, and treatment of adolescents with comorbid ADHD and SUD. Results: After 3 iterative rounds of rating and adapting 37 statements, consensus was reached on 36 of these statements representing 6 domains: general (n = 4), risk of developing SUD (n = 3), screening and diagnosis (n = 7), psychosocial treatment (n = 5), pharmacological treatment (n = 11), and complementary treatments (n = 7). Routine screening is recommended for ADHD in adolescent patients in substance abuse treatment and for SUD in adolescent patients with ADHD in mental healthcare settings. Long-acting stimulants are recommended as the first-line treatment of ADHD in adolescents with concurrent ADHD and SUD, and pharmacotherapy should preferably be embedded in psychosocial treatment. The only remaining no-consensus statement concerned the requirement of abstinence before starting pharmacological treatment in adolescents with ADHD and concurrent SUD. In contrast to the majority, some experts required full abstinence before starting any pharmacological treatment, some were against the use of stimulants in the treatment of these patients (independent of abstinence), while some were against the alternative use of bupropion. Conclusion: This international consensus statement can be used by clinicians and patients together in a shared decision-making process to select the best interventions and to reach optimal outcomes in adolescent patients with concurrent ADHD and SUD.
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Affiliation(s)
- Heval Özgen
- Diese Autor_innen haben zu gleichen Teilen zu diesem Beitrag beigetragen.,Parnassia Addiction Research Centre (PARC), Parnassia Psychiatric Institute, Den Haag, Niederlande.,Curium, Department of Child and Adolescent Psychiatry, Leiden University Medical Center, Leiden, Niederlande
| | - Renske Spijkerman
- Diese Autor_innen haben zu gleichen Teilen zu diesem Beitrag beigetragen.,Parnassia Addiction Research Centre (PARC), Parnassia Psychiatric Institute, Den Haag, Niederlande
| | - Moritz Noack
- LWL-Universitätsklinik Hamm der Ruhr-Universität Bochum, Hamm, Deutschland
| | - Martin Holtmann
- LWL-Universitätsklinik Hamm der Ruhr-Universität Bochum, Hamm, Deutschland
| | - Arnt S A Schellekens
- Department of Psychiatry, Donders institute, Radboud UMC, Nijmegen, Niederlande.,Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Radboud UMC, Nijmegen, Niederlande
| | - Geurt van de Glind
- Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Radboud UMC, Nijmegen, Niederlande.,International Collaboration on ADHD and Substance Abuse (ICASA) Foundation, Nijmegen, Niederlande
| | - Tobias Banaschewski
- Klinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters, Zentralinstitut für Seelische Gesundheit, Mannheim, Deutschland
| | - Csaba Barta
- Department of Medical Chemistry, Molecular Biology and Pathobiochemistry, Semmelweis University, Budapest, Ungarn.,Institute of Psychology, Faculty of Humanities and Social Sciences, Pázmány Péter Catholic University, Budapest, Ungarn
| | | | - Miguel Casas
- Department of Psychiatry and Legal Medicine, Autonomous University of Barcelona, Barcelona, Spanien
| | - Cleo L Crunelle
- Department of Psychiatry, University Hospital Brussels, Brüssel, Belgien
| | - Constanza Daigre Blanco
- Department of Psychiatry, Mental Health and Addictions, Addiction and Dual Diagnosis Section, Hospital Universitari Vall d'Hebron, Barcelona, Spanien.,Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Spanien.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spanien
| | - Søren Dalsgaard
- Department of Economics and Business Economics, Aarhus University, Aarhus, Dänemark
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Ungarn
| | | | - Geert Dom
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), Antwerp University (UA), Antwerpen, Belgien
| | - Valsamma Eapen
- Academic Unit of Infant, Child, Adolescent Psychiatry South West Sydney, University of New South Wales, Sydney, New South Wales, Australien
| | - Stephen V Faraone
- Department of Psychiatry, SUNY Upstate Medical University, Syracuse, New York, USA
| | - Johan Franck
- Child- and Adolescent Department, Piteå Hospital, Region Norrbotten, Piteå, Schweden
| | - Rafael A González
- Centre for Mental Health, Division of Brain Sciences, Department of Medicine, Imperial College London, London, Vereinigtes Königreich.,East London NHS Foundation Trust, Child and Adolescent Mental Health Service (CAMHS) - ADHD clinic, London, Vereinigtes Königreich
| | - Lara Grau-López
- Department of Psychiatry, Mental Health and Addictions, Addiction and Dual Diagnosis Section, Hospital Universitari Vall d'Hebron, Barcelona, Spanien.,Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Spanien.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spanien.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spanien
| | - Annabeth P Groenman
- Department of Psychology, University of Amsterdam, Amsterdam, Niederlande.,Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, Niederlande
| | - Malin Hemphälä
- Child- and Adolescent Department, Piteå Hospital, Region Norrbotten, Piteå, Schweden
| | - Romain Icick
- Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris, Frankreich.,INSERM U1144, Paris, Frankreich.,Inserm UMR-S1144, Université de Paris, Paris, Frankreich
| | - Brian Johnson
- Department of Psychiatry, SUNY Upstate Medical University, Syracuse, New York, USA
| | - Michael Kaess
- Universitätsklinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Universität Bern, Bern, Schweiz.,Klinik für Kinder- und Jugendpsychiatrie, Zentrum für psychosoziale Medizin, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - Máté Kapitány-Fövény
- Faculty of Health Sciences, Semmelweis University, Budapest, Ungarn.,Drug Outpatient Centre, Nyírő Gyula National Institute of Psychiatry and Addictions, Budapest, Ungarn
| | - John G Kasinathan
- Adolescent Mental Health, Justice Health and Forensic Mental Health Network, Sydney, New South Wales, Australien
| | - Sharlene S Kaye
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australien
| | - Falk Kiefer
- Klinik für Abhängiges Verhalten und Suchtmedizin, Zentralinstitut für seelische Gesundheit, Mannheim, Deutschland
| | - Maija Konstenius
- Child- and Adolescent Department, Piteå Hospital, Region Norrbotten, Piteå, Schweden
| | - Frances R Levin
- Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, New York, USA
| | - Mathias Luderer
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie, Universitätsklinikum Frankfurt, Goethe Universität, Frankfurt am Main, Deutschland
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging, Clinical Sciences, University "G. d'Annunzio", Chieti-Pescara, Chieti, Italien
| | - Frieda I A Matthys
- Department of Psychiatry, UZ Brussel, Vrije Universiteit Brussel (VUB), Brüssel, Belgien
| | - Gergely Meszaros
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Semmelweis University, Budapest, Ungarn
| | - Franz Moggi
- Universitätsklinik für Psychiatrie, Universität Bern, Bern, Schweiz
| | - Ashmita P Munasur-Naidoo
- Department of Pharmacy, Nelson Mandela University, Port Elizabeth, Südafrika.,Cipla Medpro Pharmaceuticals, Durban, Südafrika
| | - Marianne Post
- Brijder Youth Addiction Treatment, Parnassia Psychiatric Institute, Den Haag, Niederlande
| | - Sharon Rabinovitz
- School of Criminology and The Unit for Excellence in Research & Study of Addiction (ERSA), The Center for Rehabilitation Research, University of Haifa, Haifa, Israel
| | - J Antoni Ramos-Quiroga
- Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Spanien.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spanien.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spanien.,Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spanien
| | - Regina Sala
- Centre for Psychiatry, Wolfson Institute, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, Vereinigtes Königreich
| | - Abu Shafi
- East London NHS Foundation Trust, London, Vereinigtes Königreich
| | - Ortal Slobodin
- Department of Education, Ben-Gurion University, Beer-Sheva, Beer-Sheva, Israel
| | - Wouter G Staal
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, Niederlande.,Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, Niederlande
| | - Rainer Thomasius
- Deutsches Zentrum für Suchtfragen des Kindes- und Jugendalters, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - Ilse Truter
- Drug Utilization Research Unit (DURU), Department of Pharmacy, Nelson Mandela University, Port Elizabeth, Südafrika
| | - Michiel W van Kernebeek
- Department of Psychiatry, Universitair Ziekenhuis Brussel (UZ Brussel), Vrije Universiteit Brussel (VUB), Brüssel, Belgien
| | | | - Sabine Vollstädt-Klein
- Klinik für Abhängiges Verhalten und Suchtmedizin, Zentralinstitut für seelische Gesundheit, Mannheim, Deutschland
| | - Florence Vorspan
- INSERM U1144, Paris, Frankreich.,Département de Psychiatrie et de Médecine Addictologique, Hôpital Fernand Widal, Paris, Frankreich.,Faculté de Médecine, Université de Paris, Paris, Frankreich.,FHU NOR-SUD Network of Research in Substance Use Disorders, Paris, Frankreich
| | - Jesse T Young
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australien.,Murdoch Children's Research Institute, Melbourne, Victoria, Australien.,School of Population and Global Health, The University of Western Australia, Perth, Washington, Australien.,National Drug Research Institute, Curtin University, Perth, Washington, Australien
| | - Amy Yule
- Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Wim van den Brink
- International Collaboration on ADHD and Substance Abuse (ICASA) Foundation, Nijmegen, Niederlande.,Amsterdam University Medical Centers, location Academic Medical Center, Amsterdam, Niederlande
| | - Vincent Hendriks
- Parnassia Addiction Research Centre (PARC), Parnassia Psychiatric Institute, Den Haag, Niederlande.,Curium, Department of Child and Adolescent Psychiatry, Leiden University Medical Center, Leiden, Niederlande
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26
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Grenz PJ, Thonig D, Holtmann M, Miyamoto K, Kumar S, Schwier E, Okuda T, Henk J, Donath M. Adlayer influence on Dirac-type surface state at W(110). J Phys Condens Matter 2021; 33:285504. [PMID: 33946058 DOI: 10.1088/1361-648x/abfdf3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 05/04/2021] [Indexed: 06/12/2023]
Abstract
In a combined experimental and theoretical study, we investigated how Fe and Co adlayers on W(110) affect the Dirac-type surface state (DSS). Angle-resolved photoelectron spectroscopy data show an increase in binding energy of 75 meV and 107 meV for Fe and Co, respectively. In order to identify the origin of the energy shift we performed first-principles calculations of the surface electronic structure. The inward surface relaxation of the uncovered W(110) surface is lifted by the adlayers. This structural change is one reason of the energy shift of the DSS. Furthermore, the Fe and Co adlayers change the surface potential, which results in an additional energy shift of the DSS.
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Affiliation(s)
- P J Grenz
- Physikalisches Institut, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 10, 48149 Münster, Germany
| | - D Thonig
- Department of Physics and Astronomy, Material Theory, University Uppsala, Box 516, 75120 Uppsala, Sweden
- School of Science and Technology, Örebro University, 701 82 Örebro, Sweden
| | - M Holtmann
- Physikalisches Institut, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 10, 48149 Münster, Germany
| | - K Miyamoto
- Hiroshima Synchrotron Radiation Center, Hiroshima University, 2-313 Kagamiyama, Higashi-Hiroshima 739-0046, Japan
| | - S Kumar
- Hiroshima Synchrotron Radiation Center, Hiroshima University, 2-313 Kagamiyama, Higashi-Hiroshima 739-0046, Japan
| | - E Schwier
- Hiroshima Synchrotron Radiation Center, Hiroshima University, 2-313 Kagamiyama, Higashi-Hiroshima 739-0046, Japan
| | - T Okuda
- Hiroshima Synchrotron Radiation Center, Hiroshima University, 2-313 Kagamiyama, Higashi-Hiroshima 739-0046, Japan
| | - J Henk
- Institute of Physics, Martin Luther University Halle-Wittenberg, 06099 Halle, Saale, Germany
| | - M Donath
- Physikalisches Institut, Westfälische Wilhelms-Universität Münster, Wilhelm-Klemm-Straße 10, 48149 Münster, Germany
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27
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Lehmkuhl G, Holtmann M. „Learning from Stories“: Die Bedeutung von Fallgeschichten für Diagnostik und Therapie. Z Kinder Jugendpsychiatr Psychother 2021; 49:89-91. [PMID: 33666496 DOI: 10.1024/1422-4917/a000776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Gerd Lehmkuhl
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters der Universität zu Köln
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28
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Kirschbaum-Lesch I, Holtmann M, Legenbauer T. Deficits in Emotion Regulation Partly Mediate the Relation Between Sleep Problems and Depressive Symptoms in Adolescent Inpatients With Depression. Front Psychiatry 2021; 12:622833. [PMID: 34122162 PMCID: PMC8195336 DOI: 10.3389/fpsyt.2021.622833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 04/08/2021] [Indexed: 11/13/2022] Open
Abstract
Sleep problems are a risk factor for the development of depressive disorders and influence the severity and treatment of depressive symptoms negatively. To enhance treatment for depression in young people, it is important to advance the understanding of the relationship between sleep problems and depressive symptoms. Since deficits in emotion regulation are discussed as possible underlying mechanisms, the present study investigated the mediating effect of maladaptive and adaptive strategies for emotion regulation on the association between sleep problems and depressive symptoms. Emotion regulation strategies, depression and sleep quality were assessed via self-report in a large clinical sample of 602 adolescents (age 13-18 years) who reported clinically relevant symptoms of depression. The questionnaires were assessed at admission for inpatient psychiatric treatment. Correlation and mediation analyses were performed. There was a significant partial mediation effect (β = 0.554, p < 0.001, R 2 = 0.527), indicating that sleep problems influenced depressive symptoms via the decreased use of adaptive strategies and the increased use of maladaptive strategies. Additionally, a direct effect of sleep problems on depressive symptoms emerged (β = 0.251, p < 0.001, R 2 = 0.364). This cross-sectional study provides first indications that additional treatment modules focusing on sleep and ER skills in prevention and treatment programs for adolescents would be important steps. Longitudinal studies are needed to substantiate these results.
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Affiliation(s)
- Inken Kirschbaum-Lesch
- LWL-University Hospital for Child and Adolescent Psychiatry and Psychotherapy Hamm, Ruhr-University Bochum, Bochum, Germany
| | - Martin Holtmann
- LWL-University Hospital for Child and Adolescent Psychiatry and Psychotherapy Hamm, Ruhr-University Bochum, Bochum, Germany
| | - Tanja Legenbauer
- LWL-University Hospital for Child and Adolescent Psychiatry and Psychotherapy Hamm, Ruhr-University Bochum, Bochum, Germany
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29
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Leopold K, Bauer M, Bechdolf A, Correll CU, Holtmann M, Juckel G, Lambert M, Meyer TD, Pfeiffer S, Kittel-Schneider S, Reif A, Stamm TJ, Rottmann-Wolf M, Mathiebe J, Kellmann EL, Ritter P, Krüger-Özgürdal S, Karow A, Sondergeld LM, Roessner V, Sauer C, Pfennig A. Efficacy of cognitive-behavioral group therapy in patients at risk for serious mental illness presenting with subthreshold bipolar symptoms: Results from a prespecified interim analysis of a multicenter, randomized, controlled study. Bipolar Disord 2020; 22:517-529. [PMID: 32112496 DOI: 10.1111/bdi.12894] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Most patients with bipolar disorders (BD) exhibit prodromal symptoms before a first (hypo)manic episode. Patients with clinically significant symptoms fulfilling at-risk criteria for serious mental illness (SMI) require effective and safe treatment. Cognitive-behavioral psychotherapy (CBT) has shown promising results in early stages of BD and in patients at high risk for psychosis. We aimed to investigate whether group CBT can improve symptoms and functional deficits in young patients at risk for SMI presenting with subthreshold bipolar symptoms. METHOD In a multicenter, randomized, controlled trial, patients at clinical risk for SMI presenting with subthreshold bipolar symptoms aged 15-30 years were randomized to 14 weeks of at-risk for BD-specific group CBT or unstructured group meetings. Primary efficacy endpoints were differences in affective symptomatology and psychosocial functioning at 14 weeks. At-risk status was defined as a combination of subthreshold bipolar symptomatology, reduction of psychosocial functioning and a family history for (schizo)affective disorders. A prespecified interim analysis was conducted at 75% of the targeted sample. RESULTS Of 128 screened participants, 75 were randomized to group CBT (n = 38, completers = 65.8%) vs unstructured group meetings (n = 37, completers = 78.4%). Affective symptomatology and psychosocial functioning improved significantly at week 14 (P < .001) and during 6 months (P < .001) in both groups, without significant between-group differences. Findings are limited by the interim character of the analysis, the use of not fully validated early detection interviews, a newly adapted intervention manual, and the substantial drop-outs. CONCLUSIONS Results suggest that young patients at-risk for SMI presenting with subthreshold bipolar symptoms benefit from early group sessions. The degree of specificity and psychotherapeutic interaction needed requires clarification.
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Affiliation(s)
- Karolina Leopold
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany.,Department of Psychiatry, Psychotherapy and Psychosomatics, Vivantes Klinikum Am Urban, Berlin, Germany
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Andreas Bechdolf
- Department of Psychiatry, Psychotherapy and Psychosomatics, Vivantes Klinikum Am Urban, Berlin, Germany.,Department of Psychiatry and Psychotherapy, University Hospital Cologne, University Cologne, Köln, Germany
| | - Christoph U Correll
- Psychiatry and Molecular Medicine Hofstra Northwell School of Medicine, Hempstead, NY, USA.,Center for Psychiatric Neuroscience Feinstein Institute for Medical Research, Manhasset, NY, USA.,Department of Psychiatry, Recognition and Prevention (RAP) Program, The Zucker Hillside Hospital, Long Island, USA.,Department of Child and Adolescent Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Martin Holtmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, LWL-University Hospital Hamm, Ruhr-University, Bochum, Germany
| | - Georg Juckel
- Department of Psychiatry and Psychotherapy, LWL- University Hospital Bochum, Ruhr-University, Bochum, Germany
| | - Martin Lambert
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Thomas D Meyer
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas HSC at Houston, Houston, TX, USA
| | - Steffi Pfeiffer
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Sarah Kittel-Schneider
- Department of Psychiatry and Psychotherapy, University Hospital Würzburg, Würzburg, Germany.,Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Frankfurt, Germany
| | - Andreas Reif
- Department of Psychiatry and Psychotherapy, University Hospital Würzburg, Würzburg, Germany.,Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Frankfurt, Germany
| | - Thomas J Stamm
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany.,Department of Psychiatry, Psychotherapy and Psychosomatic, Medical School Brandenburg, Neuruppin, Germany
| | - Maren Rottmann-Wolf
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Josephine Mathiebe
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Eva L Kellmann
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Philipp Ritter
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Seza Krüger-Özgürdal
- Department of Psychiatry and Psychotherapy, LWL- University Hospital Bochum, Ruhr-University, Bochum, Germany
| | - Anne Karow
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lene-Marie Sondergeld
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany.,Department of Psychiatry, Psychotherapy and Psychosomatic, Medical School Brandenburg, Neuruppin, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Cathrin Sauer
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Andrea Pfennig
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
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30
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Thöne AK, Görtz-Dorten A, Altenberger P, Dose C, Geldermann N, Hautmann C, Jendreizik LT, Treier AK, von Wirth E, Banaschewski T, Brandeis D, Millenet S, Hohmann S, Becker K, Ketter J, Hebebrand J, Wenning J, Holtmann M, Legenbauer T, Huss M, Romanos M, Jans T, Geissler J, Poustka L, Uebel-von Sandersleben H, Renner T, Dürrwächter U, Döpfner M. Toward a Dimensional Assessment of Externalizing Disorders in Children: Reliability and Validity of a Semi-Structured Parent Interview. Front Psychol 2020; 11:1840. [PMID: 32849082 PMCID: PMC7396521 DOI: 10.3389/fpsyg.2020.01840] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 07/06/2020] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE This study assesses the reliability and validity of the DSM-5-based, semi-structured Clinical Parent Interview for Externalizing Disorders in Children and Adolescents (ILF-EXTERNAL). METHOD Participant data were drawn from the ongoing ESCAschool intervention study. The ILF-EXTERNAL was evaluated in a clinical sample of 474 children and adolescents (aged 6-12 years, 92 females) with symptoms of attention-deficit/hyperactivity disorder (ADHD). To obtain interrater reliability, the one-way random-effects, absolute agreement models of the intraclass correlation (ICC) for single ICC(1,1) and average measurements ICC(1,3) were computed between the interviewers and two independent raters for 45 randomly selected interviews involving ten interviewers. Overall agreement on DSM-5 diagnoses was assessed using Fleiss' kappa. Further analyses evaluated internal consistencies, item-total correlations as well as correlations between symptom severity and the degree of functional impairment. Additionally, parents completed the German version of the Child Behavior Checklist (CBCL) and two DSM-5-based parent questionnaires for the assessment of ADHD symptoms and symptoms of disruptive behavior disorders (FBB-ADHS; FBB-SSV), which were used to evaluate convergent and divergent validity. RESULTS ICC coefficients demonstrated very good to excellent interrater reliability on the item and scale level of the ILF-EXTERNAL [scale level: ICC(1,1) = 0.83-0.95; ICC(1,3) = 0.94-0.98]. Overall kappa agreement on DSM-5 diagnoses was substantial to almost perfect for most disorders (0.38 ≤ κ ≤ 0.94). With some exceptions, internal consistencies (0.60 ≤ α ≤ 0.86) and item-total correlations (0.21 ≤ r it ≤ 0.71) were generally satisfactory to good. Furthermore, higher symptom severity was associated with a higher degree of functional impairment. The evaluation of convergent validity revealed positive results regarding clinical judgment and parent ratings (FBB-ADHS; FBB-SSV). Correlations between the ILF-EXTERNAL scales and the CBCL Externalizing Problems were moderate to high. Finally, the ILF-EXTERNAL scales were significantly more strongly associated with the CBCL Externalizing Problems than with the Internalizing Problems, indicating divergent validity. CONCLUSION In clinically referred, school-age children, the ILF-EXTERNAL demonstrates sound psychometric properties. The ILF-EXTERNAL is a promising clinical interview and contributes to high-quality diagnostics of externalizing disorders in children and adolescents.
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Affiliation(s)
- Ann-Kathrin Thöne
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Anja Görtz-Dorten
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Paula Altenberger
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Christina Dose
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Nina Geldermann
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Christopher Hautmann
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Lea Teresa Jendreizik
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Anne-Katrin Treier
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Elena von Wirth
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Daniel Brandeis
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
- Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University and ETH Zürich, Zurich, Switzerland
| | - Sabina Millenet
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Sarah Hohmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Katja Becker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty, Philipps-University Marburg, Marburg, Germany
- Center for Mind, Brain and Behavior, University of Marburg and Justus Liebig University Giessen, Marburg, Germany
| | - Johanna Ketter
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty, Philipps-University Marburg, Marburg, Germany
| | - Johannes Hebebrand
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Jasmin Wenning
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Martin Holtmann
- LWL-University Hospital for Child and Adolescent Psychiatry, Ruhr-University Bochum, Hamm, Germany
| | - Tanja Legenbauer
- LWL-University Hospital for Child and Adolescent Psychiatry, Ruhr-University Bochum, Hamm, Germany
| | - Michael Huss
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Marcel Romanos
- Center of Mental Health, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Würzburg, Germany
| | - Thomas Jans
- Center of Mental Health, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Würzburg, Germany
| | - Julia Geissler
- Center of Mental Health, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Würzburg, Germany
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Henrik Uebel-von Sandersleben
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Tobias Renner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Tübingen University Hospital, Tübingen, Germany
| | - Ute Dürrwächter
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Tübingen University Hospital, Tübingen, Germany
| | - Manfred Döpfner
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
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31
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Paschke K, Holtmann M, Melchers P, Klein M, Schimansky G, Krömer T, Reis O, Wartberg L, Thomasius R. [Media-associated disorders in childhood and adolescence: Evidence paper of the joint addiction commision of the German societies and professional associations of child and adolescent psychiatry and psychotherapy]. Z Kinder Jugendpsychiatr Psychother 2020; 48:303-317. [PMID: 32614281 DOI: 10.1024/1422-4917/a000735] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Media-associated disorders in childhood and adolescence: Evidence paper of the joint addiction commision of the German societies and professional associations of child and adolescent psychiatry and psychotherapy Abstract. Media-associated disorders (MAD) describe the problematic use of the internet, certain electronic devices in general as well as digital applications. During childhood and adolescence, digital games and social media are the most commonly used applications. In May 2019, as first MAD "gaming disorder" was included as a clinical diagnosis in the ICD-11. The prevalence of MAD in German children and adolescents is estimated to lie between 3 % and 5 %. In most cases, MAD are accompanied by psychiatric comorbidities. MAD ensue because of dysfunctional learning processes in combination with general and specific risk factors. They are associated with neural changes like those of substance-associated addictions. Diagnostics can be based on validated questionnaires and clinical exploration, though a standardized diagnostic path is not yet common. Treatment depends on the level of severity and generally comprises outpatient, day-clinic, and inpatient therapy approaches with elements from cognitive-behavioral therapy and under parental involvement. Suitable treatments are not yet available in all German regions and have also not been sufficiently evaluated. Moreover, only a few studies exist on the efficacy of prevention measures addressing MAD in children and adolescents. Thus, further research is strongly required.
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Affiliation(s)
- Kerstin Paschke
- Deutsches Zentrum für Suchtfragen des Kindes- und Jugendalters (DZSKJ), Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - Martin Holtmann
- vLWL-Universitätsklinik Hamm der Ruhr-Universität Bochum, Klinik für Kinder- und Jugendpsychiatrie, Psychotherapie und Psychosomatik, Hamm
| | - Peter Melchers
- Klinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Klinikum Oberberg, Kreiskrankenhaus Gummersbach und Klinik Marienheide, Gummersbach
| | | | | | - Thomas Krömer
- Gemeinschaftspraxis für Kinder- und Jugendpsychiatrie, Psychotherapie & Psychosomatik, Hamburg
| | - Olaf Reis
- Klinik für Psychiatrie, Neurologie, Psychosomatik und Psychotherapie im Kindes- und Jugendalter, Universität Rostock, Rostock
| | - Lutz Wartberg
- Fakultät für Humanwissenschaften, MSH Medical School Hamburg, Hamburg
| | - Rainer Thomasius
- Deutsches Zentrum für Suchtfragen des Kindes- und Jugendalters (DZSKJ), Universitätsklinikum Hamburg-Eppendorf, Hamburg
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32
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Cortese S, Asherson P, Sonuga-Barke E, Banaschewski T, Brandeis D, Buitelaar J, Coghill D, Daley D, Danckaerts M, Dittmann RW, Doepfner M, Ferrin M, Hollis C, Holtmann M, Konofal E, Lecendreux M, Santosh P, Rothenberger A, Soutullo C, Steinhausen HC, Taylor E, Van der Oord S, Wong I, Zuddas A, Simonoff E. ADHD management during the COVID-19 pandemic: guidance from the European ADHD Guidelines Group. Lancet Child Adolesc Health 2020; 4:412-414. [PMID: 32311314 PMCID: PMC7164889 DOI: 10.1016/s2352-4642(20)30110-3] [Citation(s) in RCA: 127] [Impact Index Per Article: 31.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 04/07/2020] [Indexed: 12/17/2022]
Affiliation(s)
- Samuele Cortese
- Center for Innovation in Mental Health, University of Southampton and Solent NHS Trust, Southampton SO17 1BJ, UK; New York University Child Study Center, New York, NY, USA; Division of Psychiatry and Applied Psychology, School of Medicine and National Institute for Health Research MindTech Mental Health MedTech Cooperative and Centre for ADHD and Neurodevelopmental Disorders Across the Lifespan, Institute of Mental Health, University of Nottingham, UK.
| | - Philip Asherson
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Edmund Sonuga-Barke
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Department of Child & Adolescent Psychiatry, Aarhus University, Aarhus, Denmark
| | - Tobias Banaschewski
- Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Daniel Brandeis
- Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry, Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich, Zurich, Switzerland; Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland; ETH Zurich, Zurich, Switzerland
| | - Jan Buitelaar
- Radboud University Medical Center, Nijmegen, Netherlands
| | - David Coghill
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia; Murdoch Children's Research Institute, Melbourne, VIC, Australia; Royal Children's Hospital, Melbourne, Melbourne, VIC, Australia
| | - David Daley
- Division of Psychiatry and Applied Psychology, School of Medicine and National Institute for Health Research MindTech Mental Health MedTech Cooperative and Centre for ADHD and Neurodevelopmental Disorders Across the Lifespan, Institute of Mental Health, University of Nottingham, UK
| | - Marina Danckaerts
- Research Group of Developmental Psychiatry, Center for Developmental Psychiatry, KU Leuven, Leuven, Belgium; Department of Child and Adolescent Psychiatry, University Psychiatry Hospitals-KU Leuven, Leuven, Belgium
| | - Ralf W Dittmann
- Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Manfred Doepfner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine, and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Maite Ferrin
- Haringey Children and Adolescent Mental Health Service, National Health Service, London, UK; ReCognition Health, London, UK
| | - Chris Hollis
- Division of Psychiatry and Applied Psychology, School of Medicine and National Institute for Health Research MindTech Mental Health MedTech Cooperative and Centre for ADHD and Neurodevelopmental Disorders Across the Lifespan, Institute of Mental Health, University of Nottingham, UK
| | - Martin Holtmann
- LWL-University Hospital for Child and Adolescent Psychiatry, Ruhr-University Bochum, Hamm, Germany
| | - Eric Konofal
- Service de Physiologie Pédiatrique, Centre Pédiatrique des Pathologies Du Sommeil, Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Paris, France
| | - Michel Lecendreux
- Service de Physiologie Pédiatrique, Centre Pédiatrique des Pathologies Du Sommeil, Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Paris, France
| | - Paramala Santosh
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Aribert Rothenberger
- Klinik für Kinder und Jugendpsychiatrie/Psychotherapie, Universitätsmedizin, Georg-August Universität Göttingen, Göttingen, Germany
| | - César Soutullo
- Louis A Fallace Department of Psychiatry and Behavioral Science, University of Texas, Houston, TX, USA
| | - Hans-Christoph Steinhausen
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry, Zurich, Switzerland; Clinical Psychology and Epidemiology, Institute of Psychology, University of Basel, Basel, Switzerland; Department of Child and Adolescent Mental Health, University of Southern Denmark, Odense, Denmark; Child and Adolescent Mental Health Centre, Capital Region Psychiatry, Copenhagen, Denmark
| | - Eric Taylor
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Saskia Van der Oord
- Clinical Psychology, KU Leuven, Leuven, Belgium; Developmental Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - Ian Wong
- School of Pharmacy, University College London, London, UK
| | - Alessandro Zuddas
- Department of Biomedical Sciences, University of Cagliari & Antonio Cao Paediatric Hospital, G Brotzu Hospital Trust, Cagliari, Italy
| | - Emily Simonoff
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Lehmkuhl G, Holtmann M. Selbstmanagement und Achtsamkeit: Janusköpfige Therapieziele. Z Kinder Jugendpsychiatr Psychother 2020; 48:175-177. [PMID: 32370658 DOI: 10.1024/1422-4917/a000734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Gerd Lehmkuhl
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters der Universität zu Köln
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Thomasius R, Arnaud N, Holtmann M, Kiefer F. [Substance-related disorders in adolescence and young adulthood]. Z Kinder Jugendpsychiatr Psychother 2020; 48:448-452. [PMID: 32208050 DOI: 10.1024/1422-4917/a000725] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Substance-related disorders in adolescence and young adulthood Abstract. Adolescence is a critical period for the onset of addiction and comorbid psychological disorders. Although substance use disorders (SUD) are among the most prevalent psychiatric conditions and a leading cause for hospitalization in the young population, young people with SUD can be considered an underserved population. Existing capacities for the provision of specific health services including withdrawal treatment for young SUD patients are inadequate, and medical rehabilitation facilities are lacking almost completely. Because SUD often becomes a chronic condition with high degree of relapse, from a life-course perspective this demands a highly connected healthcare structure at the intersection of child and adolescent and adult psychiatry as well as other health services. These interconnected services must be sensitive to the developmental needs and aspects of adolescent SUD, such as motivational, social, and educational factors. Moreover, there is a need for ongoing and often multidisciplinary support during the transition from child and adolescent to adult psychiatry with a transparent medical documentation and clear allocation of costs. The establishment and formative evaluation of (specific) medical rehabilitation facilities for children, adolescents, and young adults is highly recommended to improve the current healthcare situation for young SUD patients.
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Affiliation(s)
- Rainer Thomasius
- Deutsches Zentrum für Suchtfragen des Kindes- und Jugendalters (DZSKJ), Universitätsklinikum Hamburg-Eppendorf
| | - Nicolas Arnaud
- Deutsches Zentrum für Suchtfragen des Kindes- und Jugendalters (DZSKJ), Universitätsklinikum Hamburg-Eppendorf
| | - Martin Holtmann
- Klinik für Kinder- und Jugendpsychiatrie LWL-Universitätsklinik Hamm der Ruhr-Universität Bochum
| | - Falk Kiefer
- Zentralinstitut für Seelische Gesundheit, Mannheim, Klinik für Abhängiges Verhalten und Suchtmedizin, Medizinische Fakultät Mannheim, Universität Heidelberg.,Feuerlein Centrum für Translationale Suchtmedizin, Universität Heidelberg
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Abstract
Gender identities in transition Abstract. In recent years, the healthcare system has been confronted with an increasing number of children and adolescents with gender nonconformity, gender incongruence, and gender dysphoria. Medical professionals are still debating how to interpret this phenomenon and how best to meet the healthcare needs of this diverse group of young people. Meanwhile, the transgender and gender nonconforming youths themselves face enormous challenges in finding appropriate support and treatment in the mental healthcare system. This article reviews the available epidemiological data, the paradigm shift in the social, legal, and medical systems, the developments in diagnostic classifications (DSM-5, ICD-11) as well as important aspects of the AWMF S3 guideline for adults with gender incongruence and gender dysphoria. In addition, it describes the complexity of working with transgender, gender nonconforming, and gender-questioning youth in the context of the current discourse and the underlying ethical dilemmas. In conclusion, this article outlines the challenges facing child and adolescent psychiatry and psychotherapy in this complex environment.
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Affiliation(s)
| | - Martin Holtmann
- LWL-Universitätsklinik Hamm der Ruhr-Universität Bochum, Hamm
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36
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Becker K, Banaschewski T, Brandeis D, Dose C, Hautmann C, Holtmann M, Jans T, Jendreizik L, Jenkner C, John K, Ketter J, Millenet S, Pauli-Pott U, Renner T, Romanos M, Treier AK, von Wirth E, Wermter AK, Döpfner M. Individualised stepwise adaptive treatment for 3-6-year-old preschool children impaired by attention-deficit/hyperactivity disorder (ESCApreschool): study protocol of an adaptive intervention study including two randomised controlled trials within the consortium ESCAlife. Trials 2020; 21:56. [PMID: 31918739 PMCID: PMC6953462 DOI: 10.1186/s13063-019-3872-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 10/31/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is a psychosocially impairing and cost-intensive mental disorder, with first symptoms occurring in early childhood. It can usually be diagnosed reliably at preschool age. Early detection of children with ADHD symptoms and an early, age-appropriate treatment are needed in order to reduce symptoms, prevent secondary problems and enable a better school start. Despite existing ADHD treatment research and guideline recommendations for the treatment of ADHD in preschool children, there is still a need to optimise individualised treatment strategies in order to improve outcomes. Therefore, the ESCApreschool study (Evidence-Based, Stepped Care of ADHD in Preschool Children aged 3 years and 0 months to 6 years and 11 months of age (3;0 to 6;11 years) addresses the treatment of 3-6-year-old preschool children with elevated ADHD symptoms within a large multicentre trial. The study aims to investigate the efficacy of an individualised stepwise-intensifying treatment programme. METHODS The target sample size of ESCApreschool is 200 children (boys and girls) aged 3;0 to 6;11 years with an ADHD diagnosis according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) or a diagnosis of oppositional defiant disorder (ODD) plus additional substantial ADHD symptoms. The first step of the adaptive, stepped care design used in ESCApreschool consists of a telephone-assisted self-help (TASH) intervention for parents. Participants are randomised to either the TASH group or a waiting control group. The treatment in step 2 depends on the outcome of step 1: TASH responders without significant residual ADHD/ODD symptoms receive booster sessions of TASH. Partial or non-responders of step 1 are randomised again to either parent management and preschool teacher training or treatment as usual. DISCUSSION The ESCApreschool trial aims to improve knowledge about individualised treatment strategies for preschool children with ADHD following an adaptive stepped care approach, and to provide a scientific basis for individualised medicine for preschool children with ADHD in routine clinical care. TRIAL REGISTRATION The trial was registered at the German Clinical Trials Register (DRKS) as a Current Controlled Trial under DRKS00008971 on 1 October 2015. This manuscript is based on protocol version 3 (14 October 2016).
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Affiliation(s)
- Katja Becker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty of the Philipps-University Marburg, Hans-Sachs-Str. 6, 35039 Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg and Justus Liebig University Giessen, Marburg, Germany
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Heidelberg University, Medical Faculty Mannheim, Mannheim, Germany
| | - Daniel Brandeis
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Heidelberg University, Medical Faculty Mannheim, Mannheim, Germany
| | - Christina Dose
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty of the University of Cologne, Cologne, Germany
- School of Child and Adolescent Cognitive Behaviour Therapy (AKiP), University Hospital of Cologne, Cologne, Germany
| | - Christopher Hautmann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty of the University of Cologne, Cologne, Germany
- School of Child and Adolescent Cognitive Behaviour Therapy (AKiP), University Hospital of Cologne, Cologne, Germany
| | - Martin Holtmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, LWL-University Hospital Hamm, Ruhr-University Bochum, Hamm, Germany
| | - Thomas Jans
- Centre of Mental Health, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany
| | - Lea Jendreizik
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty of the University of Cologne, Cologne, Germany
| | - Carolin Jenkner
- Clinical Trials Unit Freiburg, Medical Centre – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Katja John
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty of the Philipps-University Marburg, Hans-Sachs-Str. 6, 35039 Marburg, Germany
| | - Johanna Ketter
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty of the Philipps-University Marburg, Hans-Sachs-Str. 6, 35039 Marburg, Germany
| | - Sabina Millenet
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Heidelberg University, Medical Faculty Mannheim, Mannheim, Germany
| | - Ursula Pauli-Pott
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty of the Philipps-University Marburg, Hans-Sachs-Str. 6, 35039 Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg and Justus Liebig University Giessen, Marburg, Germany
| | - Tobias Renner
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Marcel Romanos
- Centre of Mental Health, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany
| | - Anne-Katrin Treier
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Heidelberg University, Medical Faculty Mannheim, Mannheim, Germany
| | - Elena von Wirth
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty of the University of Cologne, Cologne, Germany
- School of Child and Adolescent Cognitive Behaviour Therapy (AKiP), University Hospital of Cologne, Cologne, Germany
| | - Anne-Kathrin Wermter
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty of the Philipps-University Marburg, Hans-Sachs-Str. 6, 35039 Marburg, Germany
- Center for Mind, Brain and Behavior (CMBB), University of Marburg and Justus Liebig University Giessen, Marburg, Germany
| | - Manfred Döpfner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty of the University of Cologne, Cologne, Germany
- School of Child and Adolescent Cognitive Behaviour Therapy (AKiP), University Hospital of Cologne, Cologne, Germany
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37
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Özgen H, Spijkerman R, Noack M, Holtmann M, Schellekens ASA, van de Glind G, Banaschewski T, Barta C, Begeman A, Casas M, Crunelle CL, Daigre Blanco C, Dalsgaard S, Demetrovics Z, den Boer J, Dom G, Eapen V, Faraone SV, Franck J, González RA, Grau-López L, Groenman AP, Hemphälä M, Icick R, Johnson B, Kaess M, Kapitány-Fövény M, Kasinathan JG, Kaye SS, Kiefer F, Konstenius M, Levin FR, Luderer M, Martinotti G, Matthys FIA, Meszaros G, Moggi F, Munasur-Naidoo AP, Post M, Rabinovitz S, Ramos-Quiroga JA, Sala R, Shafi A, Slobodin O, Staal WG, Thomasius R, Truter I, van Kernebeek MW, Velez-Pastrana MC, Vollstädt-Klein S, Vorspan F, Young JT, Yule A, van den Brink W, Hendriks V. International Consensus Statement for the Screening, Diagnosis, and Treatment of Adolescents with Concurrent Attention-Deficit/Hyperactivity Disorder and Substance Use Disorder. Eur Addict Res 2020; 26:223-232. [PMID: 32634814 DOI: 10.1159/000508385] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 05/04/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Childhood attention-deficit/hyperactivity disorder (ADHD) is a risk factor for substance misuse and substance use disorder (SUD) in adolescence and (early) adulthood. ADHD and SUD also frequently co-occur in treatment-seeking adolescents, which complicates diagnosis and treatment and is associated with poor treatment outcomes. Research on the effect of treatment of childhood ADHD on the prevention of adolescent SUD is inconclusive, and studies on the diagnosis and treatment of adolescents with ADHD and SUD are scarce. Thus, the available evidence is generally not sufficient to justify robust treatment recommendations. OBJECTIVE The aim of the study was to obtain a consensus statement based on a combination of scientific data and clinical experience. METHOD A modified Delphi study to reach consensus based upon the combination of scientific data and clinical experience with a multidisciplinary group of 55 experts from 17 countries. The experts were asked to rate a set of statements on the effect of treatment of childhood ADHD on adolescent SUD and on the screening, diagnosis, and treatment of adolescents with comorbid ADHD and SUD. RESULTS After 3 iterative rounds of rating and adapting 37 statements, consensus was reached on 36 of these statements representing 6 domains: general (n = 4), risk of developing SUD (n = 3), screening and diagnosis (n = 7), psychosocial treatment (n = 5), pharmacological treatment (n = 11), and complementary treatments (n = 7). Routine screening is recommended for ADHD in adolescent patients in substance abuse treatment and for SUD in adolescent patients with ADHD in mental healthcare settings. Long-acting stimulants are recommended as the first-line treatment of ADHD in adolescents with concurrent ADHD and SUD, and pharmacotherapy should preferably be embedded in psychosocial treatment. The only remaining no-consensus statement concerned the requirement of abstinence before starting pharmacological treatment in adolescents with ADHD and concurrent SUD. In contrast to the majority, some experts required full abstinence before starting any pharmacological treatment, some were against the use of stimulants in the treatment of these patients (independent of abstinence), while some were against the alternative use of bupropion. CONCLUSION This international consensus statement can be used by clinicians and patients together in a shared decision-making process to select the best interventions and to reach optimal outcomes in adolescent patients with concurrent ADHD and SUD.
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Affiliation(s)
- Heval Özgen
- Parnassia Addiction Research Centre (PARC), Parnassia Psychiatric Institute, The Hague, The Netherlands, .,Curium, Department of Child and Adolescent Psychiatry, Leiden University Medical Center, Leiden, The Netherlands,
| | - Renske Spijkerman
- Parnassia Addiction Research Centre (PARC), Parnassia Psychiatric Institute, The Hague, The Netherlands
| | - Moritz Noack
- Department of Child and Adolescent Psychiatry, LWL-University Hospital, Ruhr-University Bochum, Hamm, Germany
| | - Martin Holtmann
- Department of Child and Adolescent Psychiatry, LWL-University Hospital, Ruhr-University Bochum, Hamm, Germany
| | - Arnt S A Schellekens
- Department of Psychiatry, Donders institute, RadboudUMC, Nijmegen, The Netherlands.,Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), RadboudUMC, Nijmegen, The Netherlands
| | - Geurt van de Glind
- Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), RadboudUMC, Nijmegen, The Netherlands.,International Collaboration on ADHD and Substance Abuse (ICASA) Foundation, Nijmegen, The Netherlands
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry, Central Institute of Mental Health Mannheim (CIMH), Heidelberg University, Mannheim, Germany
| | - Csaba Barta
- Department of Medical Chemistry, Molecular Biology and Pathobiochemistry, Semmelweis University, Budapest, Hungary.,Institute of Psychology, Faculty of Humanities and Social Sciences, Pázmány Péter Catholic University, Budapest, Hungary
| | | | - Miguel Casas
- Department of Psychiatry and Legal Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Cleo L Crunelle
- Department of Psychiatry, University Hospital Brussels, Brussels, Belgium
| | - Constanza Daigre Blanco
- Department of Psychiatry, Mental Health and Addictions, Addiction and Dual Diagnosis Section, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | - Søren Dalsgaard
- Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | | | - Geert Dom
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), Antwerp University (UA), Antwerp, Belgium
| | - Valsamma Eapen
- Academic Unit of Infant, Child, Adolescent Psychiatry South West Sydney, University of New South Wales, Sydney, New South Wales, Australia
| | - Stephen V Faraone
- Department of Psychiatry, SUNY Upstate Medical University, Syracuse, New York, USA
| | - Johan Franck
- Child- and Adolescent Department, Piteå Hospital, Region Norrbotten, Piteå, Sweden
| | - Rafael A González
- Centre for Mental Health, Division of Brain Sciences, Department of Medicine, Imperial College London, London, United Kingdom.,East London NHS Foundation Trust, Child and Adolescent Mental Health Service (CAMHS) - ADHD clinic, London, United Kingdom
| | - Lara Grau-López
- Department of Psychiatry, Mental Health and Addictions, Addiction and Dual Diagnosis Section, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Annabeth P Groenman
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands.,Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Malin Hemphälä
- Child- and Adolescent Department, Piteå Hospital, Region Norrbotten, Piteå, Sweden
| | - Romain Icick
- Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Saint-Louis - Lariboisière - Fernand Widal, Paris, France.,INSERM U1144, Paris, France.,Inserm UMR-S1144, Université de Paris, Paris, France
| | - Brian Johnson
- Department of Psychiatry, SUNY Upstate Medical University, Syracuse, New York, USA
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.,Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Máté Kapitány-Fövény
- Faculty of Health Sciences, Semmelweis University, Budapest, Hungary.,Drug Outpatient Centre, Nyírő Gyula National Institute of Psychiatry and Addictions, Budapest, Hungary
| | - John G Kasinathan
- Adolescent Mental Health, Justice Health and Forensic Mental Health Network, Sydney, New South Wales, Australia
| | - Sharlene S Kaye
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Falk Kiefer
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Mannheim, Germany
| | - Maija Konstenius
- Child- and Adolescent Department, Piteå Hospital, Region Norrbotten, Piteå, Sweden
| | - Frances R Levin
- Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, New York, USA
| | - Mathias Luderer
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging, Clinical Sciences, University "G.d'Annunzio", Chieti-Pescara, Chieti, Italy
| | - Frieda I A Matthys
- Department of Psychiatry, UZ Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Gergely Meszaros
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Franz Moggi
- University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Ashmita P Munasur-Naidoo
- Department of Pharmacy, Nelson Mandela University, Port Elizabeth, South Africa.,Cipla Medpro Pharmaceuticals, Durban, South Africa
| | - Marianne Post
- Brijder Youth Addiction Treatment, Parnassia Psychiatric Institute, The Hague, The Netherlands
| | - Sharon Rabinovitz
- School of Criminology and The Unit for Excellence in Research & Study of Addiction (ERSA), The Center for Rehabilitation Research, University of Haifa, Haifa, Israel
| | - J Antoni Ramos-Quiroga
- Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain.,Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Regina Sala
- Centre for Psychiatry, Wolfson Institute, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, United Kingdom
| | - Abu Shafi
- East London NHS Foundation Trust, London, United Kingdom
| | - Ortal Slobodin
- Department of Education, Ben-Gurion University, Beer-Sheva, Beer-Sheva, Israel
| | - Wouter G Staal
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands.,Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
| | - Rainer Thomasius
- German Centre for Addiction Research in Childhood and Adolescence, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Ilse Truter
- Drug Utilization Research Unit (DURU), Department of Pharmacy, Nelson Mandela University, Port Elizabeth, South Africa
| | - Michiel W van Kernebeek
- Department of Psychiatry, Universitair Ziekenhuis Brussel (UZ Brussel), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | | | - Sabine Vollstädt-Klein
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Mannheim, Germany
| | - Florence Vorspan
- INSERM U1144, Paris, France.,Département de Psychiatrie et de Médecine Addictologique, Hôpital Fernand Widal, Paris, France.,Faculté de Médecine, Université de Paris, Paris, France.,FHU NOR-SUD Network of Research in Substance Use Disorders, Paris, France
| | - Jesse T Young
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,School of Population and Global Health, The University of Western Australia, Perth, Washington, Australia.,National Drug Research Institute, Curtin University, Perth, Washington, Australia
| | - Amy Yule
- Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Wim van den Brink
- International Collaboration on ADHD and Substance Abuse (ICASA) Foundation, Nijmegen, The Netherlands.,Amsterdam University Medical Centers, location Academic Medical Center, Amsterdam, The Netherlands
| | - Vincent Hendriks
- Parnassia Addiction Research Centre (PARC), Parnassia Psychiatric Institute, The Hague, The Netherlands.,Curium, Department of Child and Adolescent Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
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González RA, Vélez-Pastrana MC, Blankers M, Bäcker A, Konstenius M, Holtmann M, Levin FR, Noack M, Kaye S, Demetrovics Z, van de Glind G, van den Brink W, Schellekens A. Onset and Severity of Early Disruptive Behavioral Disorders in Treatment-Seeking Substance Use Disorder Patients with and without Attention-Deficit/Hyperactivity Disorder. Eur Addict Res 2020; 26:211-222. [PMID: 32594079 DOI: 10.1159/000508653] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 05/13/2020] [Indexed: 11/19/2022]
Abstract
AIMS This study addressed the age of onset of conduct disorder (CD) and oppositional defiant disorder (ODD) in treatment-seeking substance use disorder (SUD) patients with and without adult attention-deficit/hyperactivity disorder (ADHD) and its association with early onset of SUD. METHODS We examined data from the 2nd International ADHD in Substance Use Disorders Prevalence Study, including 400 adults in SUD treatment from Puerto Rico, Hungary, and Australia. ADHD, SUD, and CD/ODD were assessed with the Conners Adult ADHD Diagnostic Interview for DSM-IV, the MINI International Neuropsychiatric Interview, and the K-SADS, respectively. Cox regression analyses modeled time to emergence of CD/ODD separately for SUD patients with and without adult ADHD. Linear regression models examined associations between age of onset of SUD and presence of ADHD and adjusted for sex, age, and country. To assess the mediating role of CD/ODD on the association of ADHD with onset of SUD, adjusted regression models were estimated. RESULTS Treatment-seeking SUD patients with ADHD presented an earlier onset of CD/ODD compared with those without ADHD. CD/ODD symptom loads were higher among the SUD and ADHD group. Age of first substance use and SUD were significantly earlier in SUD patients with ADHD, and these findings remained significant after adjustment for demographics and coexisting CD/ODD. CONCLUSIONS ADHD is associated with earlier onset of SUD as well as with an earlier onset of more frequent and more severe disruptive behavioral disorders. These findings may inform preventive interventions to mitigate adverse consequences of ADHD.
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Affiliation(s)
- Rafael A González
- National Adoption and Fostering Service & National Conduct Problems Team, Michael Rutter Centre, South London and Maudsley NHS Foundation Trust, London, United Kingdom, .,Centre for Psychiatry, Imperial College London, London, United Kingdom,
| | - María C Vélez-Pastrana
- PhD Program in Clinical Psychology, Universidad Carlos Albizu, San Juan, Puerto Rico, USA
| | - Matthijs Blankers
- Arkin Mental Health Care, Department of Research, Amsterdam, The Netherlands.,Trimbos institute, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands.,Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Amanda Bäcker
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Maija Konstenius
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Martin Holtmann
- LWL-University Hospital for Child and Adolescent Psychiatry, Ruhr-University Bochum, Hamm, Germany
| | - Frances R Levin
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, New York, USA
| | - Moritz Noack
- LWL-University Hospital for Child and Adolescent Psychiatry, Ruhr-University Bochum, Hamm, Germany
| | - Sharlene Kaye
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Geurt van de Glind
- Radboudumc, Donders Centre for Medical Neuroscience, Department of Psychiatry, Nijmegen, The Netherlands.,Nijmegen Institute for Scientist Practitioners in Addiction, Nijmegen, The Netherlands
| | - Wim van den Brink
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Arnt Schellekens
- Radboudumc, Donders Centre for Medical Neuroscience, Department of Psychiatry, Nijmegen, The Netherlands.,Nijmegen Institute for Scientist Practitioners in Addiction, Nijmegen, The Netherlands
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Karow A, Holtmann M, Koutsouleris N, Pfennig A, Resch F. [Psychotic disorders in the transition phase: early detection and early intervention]. Fortschr Neurol Psychiatr 2019; 87:629-633. [PMID: 31756745 DOI: 10.1055/a-1025-1994] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Adolescence is a particularly vulnerable age for the first manifestation of psychoses due to the brain maturation process and especially with additional stress factors and these have negative psychosocial consequences for the affected persons and their relatives. The disadvantages of an early onset of the disease can be partially compensated for by high-quality early diagnosis and early treatment, taking into account transitional medical approaches. In order to promote a successful transition of adolescent patients with psychoses, there are practical recommendations for the establishment of community-based, flexible and follow-up early diagnosis and treatment networks in which employees work together across diagnosis, age, discipline, and setting, enabling a structured, comprehensive, patient-oriented and flexible successful transition.
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Affiliation(s)
- Anne Karow
- Psychiatrie und Psychotherapie, Universitätskrankenhaus Hamburg-Eppendorf
| | - Martin Holtmann
- Klinik für Kinder- und Jugendpsychiatrie, Psychotherapie und Psychosomatik, LWL-PsychiatrieVerbund Westfalen
| | | | - Andrea Pfennig
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, TU Dresden
| | - Franz Resch
- Kinder- und Jugendpsychiatrie, Universität Heidelberg
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Gest S, Frank M, Holtmann M, Schölmerich A, Legenbauer T. Der Zusammenhang zwischen Schlafproblemen, unzureichender Schlafdauer und psychischen Auffälligkeiten bei Kindern und Jugendlichen. Kindheit und Entwicklung 2019. [DOI: 10.1026/0942-5403/a000276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Schlafprobleme und eine unzureichende Schlafdauer können die psychische Gesundheit im Kindes- und Jugendalter nachhaltig beeinträchtigen. Daten von 6.670 Jungen und Mädchen im Alter von 11 – 13 und 14 – 17 Jahren, aus dem Kinder- und Jugendgesundheitssurvey (KIGGS), wurden getrennt nach Geschlechtern analysiert, um zu untersuchen, ob Schlafprobleme und eine unzureichende Schlafdauer mit einer höheren Risikowahrscheinlichkeit für psychische Auffälligkeiten einhergehen. Während Schlafprobleme unabhängig von Geschlecht und Alter mit einem höheren Risiko für alle Symptombereiche (OR = 1.52 – 3.49) verbunden sind, findet sich hinsichtlich einer geringen Schlafdauer nur bei Mädchen eine höheres Risikowahrscheinlichkeit für Auffälligkeiten im externalisierenden und internalisierenden Bereich. Damit scheint sich der Zusammenhang zwischen unzureichender Schlafdauer und psychischen Auffälligkeiten bei Jungen und Mädchen zu unterscheiden. Mögliche Ursachen und Implikationen für die pädiatrische und psychiatrische Praxis werden diskutiert.
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Affiliation(s)
- Stephanie Gest
- LWL-Universitätsklinik Hamm der Ruhr-Universität Bochum, Klinik für Kinder- und Jugendpsychiatrie, Psychotherapie und Psychosomatik Hamm
| | - Mirjam Frank
- Institut für Medizinische Informatik, Biometrie und Epidemiologie (IMIBE) Essen
| | - Martin Holtmann
- LWL-Universitätsklinik Hamm der Ruhr-Universität Bochum, Klinik für Kinder- und Jugendpsychiatrie, Psychotherapie und Psychosomatik Hamm
| | | | - Tanja Legenbauer
- LWL-Universitätsklinik Hamm der Ruhr-Universität Bochum, Klinik für Kinder- und Jugendpsychiatrie, Psychotherapie und Psychosomatik Hamm
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Aggensteiner PM, Brandeis D, Millenet S, Hohmann S, Ruckes C, Beuth S, Albrecht B, Schmitt G, Schermuly S, Wörz S, Gevensleben H, Freitag CM, Banaschewski T, Rothenberger A, Strehl U, Holtmann M. Slow cortical potentials neurofeedback in children with ADHD: comorbidity, self-regulation and clinical outcomes 6 months after treatment in a multicenter randomized controlled trial. Eur Child Adolesc Psychiatry 2019; 28:1087-1095. [PMID: 30610380 DOI: 10.1007/s00787-018-01271-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 12/20/2018] [Indexed: 10/27/2022]
Abstract
Despite sizeable short-term effects of neurofeedback (NF) therapy on attention-deficit and hyperactivity disorder (ADHD), longer-term clinical, comorbidity and self-regulation outcomes are less systematically studied. The aim of this largest NF follow-up to date was to evaluate these outcomes 6 months after NF compared to a semi-active control to disentangle specific from unspecific sustained effects. We performed a multicenter, randomized, parallel, controlled, clinical, superiority trial in five German university outpatient departments. Participants were eligible if they fulfilled DSM-IV-TR criteria for ADHD and were aged from 7 to 9 years. Participants were randomly assigned (1:1-ratio) to 25 sessions of slow cortical potential (SCP)-NF or electromyogram biofeedback (EMG-BF). Participants were not blinded, since they received instructions according to each treatment setting. Primary outcomes were parent ratings of ADHD. The trial was registered, number ISRCTN761871859. Both groups showed improvement of ADHD symptoms compared to baseline at 6-months follow-up with large effect sizes for SCP-NF (d = 1.04) and EMG-BF (d = 0.85), but without group differences. When analyzing all assessments (pre-test, post-test-1, post-test-2 and follow-up), a group-by-time interaction emerged (p = 0.0062), with SCP-NF showing stable improvement following treatment but EMG-BF showing a relapse from post-test-1 to post-test-2, and subsequent remission at follow-up. Six months after the end of treatment, improvement after SCP-NF remained large and stable. However, the lack of group differences at follow-up suggests shared specific and unspecific effects contributing to this clinical outcome. Our correlational results indicate specificity of SCP-NF for selected subscales after training, but not at follow-up.
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Affiliation(s)
- Pascal-M Aggensteiner
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany.
| | - D Brandeis
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany.,Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.,Neuroscience Centre Zurich, University and ETH Zurich, Zurich, Switzerland.,Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - S Millenet
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - S Hohmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - C Ruckes
- Interdisciplinary Center for Clinical Trials, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - S Beuth
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - B Albrecht
- Child and Adolescent Psychiatry, University Medical Center Göttingen, Göttingen, Germany
| | - G Schmitt
- Institute for Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany
| | - S Schermuly
- Institute for Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany
| | - S Wörz
- Institute for Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany
| | - H Gevensleben
- Child and Adolescent Psychiatry, University Medical Center Göttingen, Göttingen, Germany
| | - C M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - T Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - A Rothenberger
- Child and Adolescent Psychiatry, University Medical Center Göttingen, Göttingen, Germany
| | - U Strehl
- Institute for Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany
| | - M Holtmann
- LWL-University Hospital for Child and Adolescent Psychiatry, Ruhr-University Bochum, Hamm, Germany
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Kaufung C, Holtmann M, Boege I. [The Development of Medication and Psychotherapy from 1952 to 1957 in the Child and Adolescent Psychiatric Clinics Weissenau and Gütersloh]. Z Kinder Jugendpsychiatr Psychother 2019; 49:180-189. [PMID: 30777487 DOI: 10.1024/1422-4917/a000646] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The Development of Medication and Psychotherapy from 1952 to 1957 in the Child and Adolescent Psychiatric Clinics Weissenau and Gütersloh Abstract. Objective: As a result of recent discussions concerning the misuse of medication in children in postwar Germany, the paper analyzes the treatment methods, especially psychopharmacotherapy, as well as therapeutic approaches employed in two German child and adolescent psychiatric hospitals (Weissenau and Guetersloh). We investigated the progression of prescription and the administration of psychotropic and experimental drugs between 1952 and 1957. Methods: In total, 966 health records were extensively studied for the time period in question. Results: The use of psychotropic drugs was similar in both hospitals, yet even at that time the use of already established psychotropic drugs differed depending on the concept. Medication-induced fever and shock therapy via insulin were still in use in 1957. Occasionally, initial concepts of a therapeutic treatment approach were observed. Both institutions administered experimental drugs, albeit not in systematic clinical trials. Conclusion: The varying methods of treatment and medication strategies reflect the different setup and concept of the respective hospitals. Indications of dangerous medication trials were not detected. Keywords: child and adolescence psychiatry, psychotropic drugs, neuroleptics, experimental drugs, treatment methods.
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Affiliation(s)
- Carolin Kaufung
- ZfP Südwürttemberg, Akademisches Lehrkrankenhaus der Universität Ulm, Ravensburg
| | - Martin Holtmann
- LWL-Universitätsklinik Hamm der Ruhr-Universität Bochum, Hamm
| | - Isabel Boege
- ZfP Südwürttemberg, Akademisches Lehrkrankenhaus der Universität Ulm, Ravensburg
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Baldus C, Mokros L, Daubmann A, Arnaud N, Holtmann M, Thomasius R, Legenbauer T. Treatment effectiveness of a mindfulness-based inpatient group psychotherapy in adolescent substance use disorder - study protocol for a randomized controlled trial. Trials 2018; 19:706. [PMID: 30587217 PMCID: PMC6307182 DOI: 10.1186/s13063-018-3048-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 11/12/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Current treatments for adolescents with substance use disorder (SUD) have had only limited success. In recent years, research has underlined the role of self-regulatory processes and impulsivity in the development and maintenance of SUD in adolescents. Mindfulness has gained much attention due to its capacity to influence self-regulatory processes, particularly in adult populations. Initial studies have shown the potential of mindfulness-based approaches in younger SUD patients. The aim of the present clinical trial is to evaluate the added treatment effect of a mindfulness-based group psychotherapy ("Mind it!") for adolescents with SUD in comparison to the current standard treatment. Moreover, we seek to explore the feasibility of the intervention and possible mediators of treatment effects. METHODS/DESIGN There will be N = 340 participants aged between 13 and 19 years who are receiving child or adolescent psychiatric or psychotherapeutic inpatient or day treatment targeting their SUD and who have reported substance use 30 days before detoxification and do not show acute psychotic or suicidal symptoms at baseline. The study is a prospective randomized controlled multi-center trial in which patients are assessed: (1) after completing a prior detoxification phase (t0), (2) at 4 weeks (t1), (3) at 8 weeks (t2), and (4) at 6 months after t2 (t3). Participants in the intervention group will receive mindfulness-based group psychotherapy in addition to their existing treatment regime. The primary outcome is substance use in the past 30 days at follow-up based on the Timeline Followback self-report. Secondary outcomes include craving, severity of dependence, and abstinence motivation. Mindfulness, impulsivity, and emotion regulation will be analyzed as possible mediators of treatment effects. DISCUSSION This trial is expected to provide evidence of the added effect of a novel, safe, and feasible treatment option for adolescents with SUD. TRIAL REGISTRATION German Register of Clinical Studies, DRKS00014041 . Registered on 17 April 2018.
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Affiliation(s)
- Christiane Baldus
- German Centre for Addiction Research in Childhood and Adolescence, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Laura Mokros
- Landschaftsverband Westfalen-Lippe (LWL) University Hospital Hamm for Child and Adolescent Psychiatry, Ruhr-University Bochum, Hamm, Germany
| | - Anne Daubmann
- Department of Medical Biometry and Epidemiology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Nicolas Arnaud
- German Centre for Addiction Research in Childhood and Adolescence, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Holtmann
- Landschaftsverband Westfalen-Lippe (LWL) University Hospital Hamm for Child and Adolescent Psychiatry, Ruhr-University Bochum, Hamm, Germany
| | - Rainer Thomasius
- German Centre for Addiction Research in Childhood and Adolescence, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Tanja Legenbauer
- Landschaftsverband Westfalen-Lippe (LWL) University Hospital Hamm for Child and Adolescent Psychiatry, Ruhr-University Bochum, Hamm, Germany
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Affiliation(s)
- Martin Holtmann
- 1 LWL-Universitätsklinik Hamm der Ruhr-Universität Bochum, Hamm
| | - Benno G Schimmelmann
- 2 Universitätsklinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Universität Bern, Bern / KJP-Hoheluft, Hamburg
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Holtmann M, Mokros L, Kirschbaum-Lesch I, Kölch M, Plener PL, Ruckes C, Schulte-Markwort M, Legenbauer T. Adolescent depression: Study protocol for a randomized, controlled, double-blind multicenter parallel group trial of Bright Light Therapy in a naturalistic inpatient setting (DeLight). Trials 2018; 19:568. [PMID: 30340625 PMCID: PMC6194631 DOI: 10.1186/s13063-018-2949-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 09/28/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Depressive disorders are among the most prominent health problems in youth. Even with the best available pharmacological and non-pharmacological treatments, remission rates are low. Without early treatment, depression in youth is associated with a high risk of symptom progression, chronicity, co-morbidity, and suicidal behavior. Thus, adolescent depression is a prime candidate for innovation in treatment. In depressive adults, meta-analytic evidence has proven that bright light therapy (BLT) is a potent low-threshold intervention, promising due to easy application, low side effects, and optimized compliance. In adolescents, studies with small samples show promising effects. This randomized controlled trial will examine the effectiveness of BLT in youth inpatients. METHODS/DESIGN In this randomized, controlled, double-blind multicenter parallel group trial, morning BLT is applied for four weeks in addition to treatment as usual (TAU) for depressed youth inpatients (daily morning exposure to bright light via light-emitting glasses, 10,000 lx, for 30 min) and will be compared to a control condition (placebo light treatment, red light, identical light glasses). The primary objective is to assess whether BLT reduces symptoms of depression in youth with greater effect compared to placebo light therapy. Secondary objectives are to examine the impact of BLT on responder status, application of antidepressant medication, and further depression-related symptoms (sleep, activity, quality of life, satisfaction with health, general psychopathology, alertness, and circadian function). N = 224 patients will be recruited in a naturalistic inpatient setting. A follow-up will be carried out after three and six months. DISCUSSION The study aims to discuss and evaluate BLT as an additive method supporting standardized clinical procedures dealing with severe to moderate depressive symptoms in youth. TRIAL REGISTRATION German Clinical Trials Register, DRKS00013188 . Registered on November 30, 2017.
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Affiliation(s)
- Martin Holtmann
- Clinic for Child and Adolescent Psychiatry, LWL University Hospital Hamm of the Ruhr-University Bochum, Heithofer Allee 64, 59071 Hamm, Germany
| | - Laura Mokros
- Clinic for Child and Adolescent Psychiatry, LWL University Hospital Hamm of the Ruhr-University Bochum, Heithofer Allee 64, 59071 Hamm, Germany
| | - Inken Kirschbaum-Lesch
- Clinic for Child and Adolescent Psychiatry, LWL University Hospital Hamm of the Ruhr-University Bochum, Heithofer Allee 64, 59071 Hamm, Germany
| | - Michael Kölch
- Department Child and Adolescent Psychiatry and Psychotherapy, Brandenburg Medical School, Neuruppin, Germany
| | - Paul L. Plener
- Department of Child and Adolescent Psychiatry and Psychotherapy, Ulm University, Ulm, Germany
| | - Christian Ruckes
- Interdisciplinary Centre for Clinical Trials, Mainz University, Mainz, Germany
| | | | - Tanja Legenbauer
- Clinic for Child and Adolescent Psychiatry, LWL University Hospital Hamm of the Ruhr-University Bochum, Heithofer Allee 64, 59071 Hamm, Germany
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Langrock C, Hebebrand J, Radowksi K, Hamelmann E, Lücke T, Holtmann M, Legenbauer T, Schmidt B, Frank M, Jöckel KH, Reinehr T. Thyroid Hormone Status in Overweight Children with Attention Deficit/Hyperactivity Disorder. Horm Res Paediatr 2018; 89:150-156. [PMID: 29320782 DOI: 10.1159/000485620] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 11/23/2017] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND There is an ongoing discussion whether thyroid hormones are involved in the development and course of attention deficit/hyperactivity disorder (ADHD). Since obesity is associated with both higher thyroid-stimulating hormone (TSH) and free triiodothyronine (fT3) concentrations and increased rates of ADHD, we hypothesized that overweight children with ADHD show higher TSH and fT3 concentrations compared to overweight children without ADHD. METHODS TSH, fT3, fT4, and leptin levels were analyzed in 230 children (60.9% boys, 9.3 ± 1.7 years old, 35.7% migration background). The children were divided into four groups (I = 26 overweight children with ADHD, II = 56 normal-weight children with ADHD, III = 66 overweight children without ADHD, and IV = 82 normal-weight children without ADHD). Severity of ADHD was determined by the parent version of the Connors 3® rating scales. RESULTS Overweight children with ADHD did not differ significantly from overweight children without ADHD with respect to TSH, fT3, or fT4 concentrations. Comparing the thyroid hormones between the four groups also demonstrated no significant differences for TSH and fT4 concentrations. fT3 concentrations were significantly higher in normal-weight children with ADHD compared to normal-weight children without ADHD. Inattention and hyperactivity/impulsivity scores were not significantly related to TSH or fT3 in multiple regression analyses adjusted for age, gender, and migration background. In these analyses, TSH was associated with BMI SDS (β coefficient 0.19 ± 0.12, p = 0.002) and leptin (exp[β coefficient] 1.87 ± 1.36, p < 0.001). fT3 (β coefficient 0.06 ± 0.05, p = 0.009) and leptin (exp[β coefficient] 1.17 ± 1.13, p = 0.009) were also associated with BMI SDS. CONCLUSIONS Our findings confirm the relation between overweight and thyroid hormones but point against the hypothesis that thyroid hormones might link overweight and ADHD in children.
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Affiliation(s)
- Christian Langrock
- Department of Pediatric Endocrinology, Diabetes and Nutrition Medicine, Vestische Kinder- und Jugendklinik Datteln, University of Witten/Herdecke, Datteln, Germany
| | - Johannes Hebebrand
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Universitätsklinikum Essen (AöR), University of Duisburg-Essen, Duisburg, Germany
| | - Katharina Radowksi
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Universitätsklinikum Essen (AöR), University of Duisburg-Essen, Duisburg, Germany
| | - Eckard Hamelmann
- Children's Center Bethel, Protestant Hospital Bethel, Bielefeld, Germany
| | - Thomas Lücke
- Department of Neuropediatrics, University Children's Hospital, St. Josef Hospital Bochum, Ruhr University Bochum, Bochum, Germany
| | - Martin Holtmann
- LWL University Hospital for Child and Adolescent Psychiatry, Ruhr University Bochum, Bochum, Germany
| | - Tanja Legenbauer
- LWL University Hospital for Child and Adolescent Psychiatry, Ruhr University Bochum, Bochum, Germany
| | - Börge Schmidt
- Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Duisburg, Germany
| | - Mirjam Frank
- Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Duisburg, Germany
| | - Karl-Heinz Jöckel
- Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Duisburg, Germany
| | - Thomas Reinehr
- Department of Pediatric Endocrinology, Diabetes and Nutrition Medicine, Vestische Kinder- und Jugendklinik Datteln, University of Witten/Herdecke, Datteln, Germany
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47
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Schlarb AA, Holtmann M. Sleep medicine and sleep research in childhood and adolescence: wake up! Z Kinder Jugendpsychiatr Psychother 2018; 46:365-367. [PMID: 30204071 DOI: 10.1024/1422-4917/a000615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Angelika A Schlarb
- 1 Fakultät für Psychologie und Sportwissenschaft, Abteilung Psychologie, Arbeitseinheit Klinische Psychologie und Psychotherapie des Kindes- und Jugendalters, Universität Bielefeld, Bielefeld
| | - Martin Holtmann
- 2 LWL-Universitätsklinik Hamm der Ruhr-Universität Bochum, Hamm
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48
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Daley D, Van Der Oord S, Ferrin M, Cortese S, Danckaerts M, Doepfner M, Van den Hoofdakker BJ, Coghill D, Thompson M, Asherson P, Banaschewski T, Brandeis D, Buitelaar J, Dittmann RW, Hollis C, Holtmann M, Konofal E, Lecendreux M, Rothenberger A, Santosh P, Simonoff E, Soutullo C, Steinhausen HC, Stringaris A, Taylor E, Wong ICK, Zuddas A, Sonuga-Barke EJ. Practitioner Review: Current best practice in the use of parent training and other behavioural interventions in the treatment of children and adolescents with attention deficit hyperactivity disorder. J Child Psychol Psychiatry 2018; 59:932-947. [PMID: 29083042 DOI: 10.1111/jcpp.12825] [Citation(s) in RCA: 96] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/29/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Behavioural interventions are recommended for use with children and young people with attention deficit hyperactivity disorder (ADHD); however, specific guidance for their implementation based on the best available evidence is currently lacking. METHODS This review used an explicit question and answer format to address issues of clinical concern, based on expert interpretation of the evidence with precedence given to meta-analyses of randomised controlled trials. RESULTS On the basis of current evidence that takes into account whether outcomes are blinded, behavioural intervention cannot be supported as a front-line treatment for core ADHD symptoms. There is, however, evidence from measures that are probably blinded that these interventions benefit parenting practices and improve conduct problems which commonly co-occur with ADHD, and are often the main reason for referral. Initial positive results have also been found in relation to parental knowledge, children's emotional, social and academic functioning - although most studies have not used blinded outcomes. Generic and specialised ADHD parent training approaches - delivered either individually or in groups - have reported beneficial effects. High-quality training, supervision of therapists and practice with the child, may improve outcomes but further evidence is required. Evidence for who benefits the most from behavioural interventions is scant. There is no evidence to limit behavioural treatments to parents with parenting difficulties or children with conduct problems. There are positive effects of additive school-based intervention for the inattentive subtype. Targeting parental depression may enhance the effects of behavioural interventions. CONCLUSIONS Parent training is an important part of the multimodal treatment of children with ADHD, which improves parenting, reduces levels of oppositional and noncompliant behaviours and may improve other aspects of functioning. However, blinded evidence does not support it as a specific treatment for core ADHD symptoms. More research is required to understand how to optimise treatment effectiveness either in general or for individual patients and explore potential barriers to treatment uptake and engagement. In terms of selecting which intervention formats to use, it seems important to acknowledge and respond to parental treatment preferences.
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Affiliation(s)
- David Daley
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK.,NIHR MindTech Healthcare Technology Cooperative & Centre for ADHD and Neurodevelopmental Disorders Across the Lifespan CANDAL, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Saskia Van Der Oord
- Department of Psychology, KU Leuven, Leuven, Belgium.,University of Amsterdam, Amsterdam, The Netherlands
| | - Maite Ferrin
- Academic Unit of Psychology, Developmental Brain-Behaviour Laboratory, University of Southampton, Southampton, UK.,Huntercombe Hospital Maidenhead, Maidenhead, UK
| | - Samuele Cortese
- Academic Unit of Psychology, Developmental Brain-Behaviour Laboratory, University of Southampton, Southampton, UK.,Langone Medical Center, Child Study Center, New York University, New York, NY, USA
| | - Marina Danckaerts
- Department of Child and Adolescent Psychiatry, KU Leuven, Leuven, Belgium
| | - Manfred Doepfner
- Department for Child and Adolescent Psychiatry, University of Cologne, Cologne, Germany
| | - Barbara J Van den Hoofdakker
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, The Netherlands
| | - David Coghill
- The Royal Children's Hospital, University of Melbourne, Melbourne, Vic., Australia.,School of Medicine, University of Dundee, Dundee, UK
| | - Margaret Thompson
- Academic Unit of Psychology, Developmental Brain-Behaviour Laboratory, University of Southampton, Southampton, UK
| | - Philip Asherson
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Daniel Brandeis
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.,Department of Child and Adolescent Psychiatry & Psychotherapy, University Hospital of Psychiatry, Zürich, Switzerland
| | - Jan Buitelaar
- Department of Cognitive Neuroscience, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Ralf W Dittmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Chris Hollis
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK.,NIHR MindTech Healthcare Technology Cooperative & Centre for ADHD and Neurodevelopmental Disorders Across the Lifespan CANDAL, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Martin Holtmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, LWL-University Hospital Hamm, Ruhr University Bochum, Bochum, Germany
| | - Eric Konofal
- Pediatric Sleep Disorders Center, Hospital Robert Debré, Paris, France
| | - Michel Lecendreux
- Pediatric Sleep Disorders Center, Hospital Robert Debré, Paris, France
| | | | - Paramala Santosh
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Emily Simonoff
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Cesar Soutullo
- Child and Adolescent Psychiatry Unit, Department of Psychiatry and Medical Psychology, University of Navarra Clinic, Pamplona, Spain
| | - Hans Christoph Steinhausen
- Department of Psychology, University of Basel, Basel, Switzerland.,Department of Child and Adolescent Psychiatry, University of Zurich, Zurich, Switzerland.,Child and Adolescent Mental Health Centre, Capital Region Psychiatry, Copenhagen, Denmark
| | | | - Eric Taylor
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ian C K Wong
- Research Department of Practice and Policy, UCL School of Pharmacy, London, UK
| | - Alessandro Zuddas
- Child & Adolescent Neuropsychiatry Unit, Department of Biomedical Sciences, University of Cagliari & "A.Cao" Paediatric Hospital, Cagliari, Italy
| | - Edmund J Sonuga-Barke
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,University of Ghent, Ghent, Belgium.,University of Aarhus, Aarhus, Denmark
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Kirschbaum-Lesch I, Gest S, Legenbauer T, Holtmann M. Feasibility and Efficacy of Bright Light Therapy in Depressed Adolescent Inpatients. Z Kinder Jugendpsychiatr Psychother 2018; 46:423-429. [PMID: 30015544 DOI: 10.1024/1422-4917/a000603] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Bright light therapy (BLT) has recently come into increasing focus in the treatment of adolescent depression, whereby light glasses today appear to be more feasible than light therapy boxes. This study investigated the feasibility and efficacy of 4 weeks of BLT with light glasses. It also analyzed whether a treatment duration of 4 weeks of BLT yields larger effects than the 2 weeks of BLT investigated in previous studies. METHODS This first open-label, single-arm, prospective clinical trial pursued a naturalistic approach: 39 inpatients aged 12-18 years with moderate or severe depression received 4 weeks of morning BLT with light glasses in addition to usual treatment. Depressive symptoms, sleep problems, circadian phase, and the clinical global impression were assessed at several timepoints. In a second analysis, the data of the present study were compared to those from a previous pilot trial. RESULTS Depressive symptoms, sleep problems, and the global clinical impression improved significantly after BLT with light glasses, whereas the circadian phase did not change over time. Light glasses showed similarly positive effects on sleep parameters and depressive symptoms as light boxes. Contrary to expectation, prolonging BLT to 4 weeks did not yield larger effects on depressive symptoms and sleep complaints compared to 2 weeks of intervention. CONCLUSIONS Light glasses seem to be a feasible and highly acceptable method for the treatment of adolescent depression. Further randomized controlled trials are needed to obtain sufficient evidence regarding the efficacy of BLT as an add-on intervention to psychological and pharmacological approaches for adolescent depression.
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Affiliation(s)
- Inken Kirschbaum-Lesch
- 1 Ruhr-University Bochum, LWL-University Hospital for Child and Adolescent Psychiatry and Psychotherapy, Hamm, Germany
| | - Stephanie Gest
- 1 Ruhr-University Bochum, LWL-University Hospital for Child and Adolescent Psychiatry and Psychotherapy, Hamm, Germany
| | - Tanja Legenbauer
- 1 Ruhr-University Bochum, LWL-University Hospital for Child and Adolescent Psychiatry and Psychotherapy, Hamm, Germany.,a Contributed equally to the manuscript and study
| | - Martin Holtmann
- 1 Ruhr-University Bochum, LWL-University Hospital for Child and Adolescent Psychiatry and Psychotherapy, Hamm, Germany.,a Contributed equally to the manuscript and study
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50
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Holtmann M. [First results from the German Registry for Child and Adolescent Anorexia Nervosa – The German Journal for Child and Adolescent Psychiatry and Psychotherapy's Young Talent Award for Katharina Bühren and Manuel Föcker]. Z Kinder Jugendpsychiatr Psychother 2018; 46:189-190. [PMID: 29726757 DOI: 10.1024/1422-4917/a000582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Martin Holtmann
- 1 LWL-Universitätsklinik Hamm der Ruhr-Universität Bochum, Klinik für Kinder- und Jugendpsychiatrie, Psychotherapie und Psychosomatik, Bochum
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