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Hadji-Michael M, Catanzano M, McAllister E, Heyman I, Lack O, Murphy T, Gilmour J. Applying an Established Exposure Response Prevention Protocol for Young People With Tourette Syndrome in an Intensive, Group Format: A Feasibility Study. Clin Child Psychol Psychiatry 2024; 29:287-300. [PMID: 37210660 DOI: 10.1177/13591045231177365] [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] [Indexed: 05/22/2023]
Abstract
BACKGROUND The motor and vocal tics that characterise Tourette syndrome are stigmatizing and impact on quality of life. Behavioural interventions such as Exposure Response Prevention or Comprehensive Behavioural Interventions for Tics are first line treatment for Tourette syndrome, but availability is limited. This study is the first to explore the impact of an established manualised Exposure Response Prevention treatment protocol, developed for individual therapy, but here uniquely delivered intensively, to a group. METHODS A naturalistic study comprised of a consecutive series of children (N = 20), aged 8-16 years (M = 12, SD = 2.17) were offered Exposure Response Prevention in one of two groups, delivered in series within a specialist clinic. Young people received the equivalent of 12 sessions (matching the manualised individual protocol). RESULTS The YGTSS and Giles de la Tourette Syndrome Quality of Life Scale for Children and Adolescents (Satisfaction Scale) showed significant improvement following treatment with moderate to large effect sizes. Thirty-five percent of children demonstrated a reliable improvement on the YGTSS Global Tic Severity score. CONCLUSIONS These data suggest an established Exposure Response Prevention protocol can be delivered in an intensive, group setting with a positive clinical outcome. Replication in a randomized controlled trial is an important next step.
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Affiliation(s)
- Maria Hadji-Michael
- Tic Disorder Service, Psychological and Mental Health Service, Great Ormond Street Hospital, London, UK
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Matteo Catanzano
- Tic Disorder Service, Psychological and Mental Health Service, Great Ormond Street Hospital, London, UK
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Eve McAllister
- Tic Disorder Service, Psychological and Mental Health Service, Great Ormond Street Hospital, London, UK
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Isobel Heyman
- Tic Disorder Service, Psychological and Mental Health Service, Great Ormond Street Hospital, London, UK
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Oliver Lack
- Tic Disorder Service, Psychological and Mental Health Service, Great Ormond Street Hospital, London, UK
| | - Tara Murphy
- Tic Disorder Service, Psychological and Mental Health Service, Great Ormond Street Hospital, London, UK
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Jane Gilmour
- Tic Disorder Service, Psychological and Mental Health Service, Great Ormond Street Hospital, London, UK
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
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Bennett SD, Rojas N, Catanzano M, Roach A, Ching BC, Coughtrey AE, Heyman I, Liang H, Project Team L, Shafran R. Feasibility, acceptability and preliminary effectiveness of a mental health drop-in centre for the siblings of young people attending a paediatric hospital. J Child Health Care 2023:13674935231206895. [PMID: 37850534 DOI: 10.1177/13674935231206895] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
Siblings of children with long-term conditions (LTCs) can have significantly elevated mental health needs, but these are often overlooked. A pragmatic single-arm feasibility pilot assessed feasibility, acceptability and preliminary effectiveness of a drop-in centre in a paediatric hospital addressing mental health needs of patients with LTCs, their carers and siblings. The drop-in centre accepted self-referral and supplemented existing provision offering a suite of interventions, including signposting, diagnostic assessments and/or guided self-help. This paper reports on feasibility, acceptability and preliminary outcomes of this centre for siblings. Eighteen siblings aged 2-17 used the centre. Sixteen of their parents completed the Strengths and Difficulties Questionnaires at baseline and 6 months post-baseline, and ten completed parent-reported PedsQL across two time points. Preliminary effectiveness results demonstrated a decrease in mental health symptoms with large effect size (score reduction of 3.44, 95% CI [1.25, 5.63], d = 0.84) and small effect on quality of life, with scores increasing from a median of 69.91, 95% CI [53.57, 91.67], to a median of 80.44, 95% CI [67.39, 89.13], r = 0.11 for these siblings. 88% of parents were satisfied with this provision for their sibling child. This study highlights the feasibility and value of assessing siblings for emotional and behavioural difficulties and providing them with an accessible, effective and acceptable intervention.
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Affiliation(s)
- Sophie D Bennett
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Psychological and Mental Health Services, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Natalia Rojas
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Psychological and Mental Health Services, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Matteo Catanzano
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Psychological and Mental Health Services, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Anna Roach
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Psychological and Mental Health Services, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Brian Cf Ching
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Psychological and Mental Health Services, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Anna E Coughtrey
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Psychological and Mental Health Services, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Isobel Heyman
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Psychological and Mental Health Services, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Holan Liang
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Psychological and Mental Health Services, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Lucy Project Team
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Psychological and Mental Health Services, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Roz Shafran
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Psychological and Mental Health Services, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
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Catanzano M, Bennett SD, Fifield K, Xu L, Sanderson C, Coughtrey AE, Kerry E, Liang H, Heyman I, Shafran R. Efficient Sufficiency: A qualitative evaluation of a 1 year pilot study of young people and parents accessing a mental health drop-in centre in a paediatric hospital. Child Care Health Dev 2023; 49:332-345. [PMID: 36006804 PMCID: PMC10087919 DOI: 10.1111/cch.13051] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 08/19/2022] [Accepted: 08/20/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Children and young people with long-term physical health conditions (LTC) are known to have higher levels of co-morbid mental health problems than medically healthy children. Evidence-based treatments for mental health problems are effective in children who also have an LTC. This study aimed to explore the factors associated with participants' perceived acceptability and impact of a transdiagnostic mental health centre offering brief psychological assessment and treatment for children and young people and/or their families with mental health needs in the context of long term physical conditions. METHODS One-hundred twenty-eight patients attending the drop-in centre were invited to participate. Overall, 35 participated (31 parents/carers; 4 children and young people) in semi-structured interviews (either in person or by phone) exploring their experience of the centre. Interviews were audio-recorded, transcribed and checked. Framework analysis was then conducted on all transcripts. RESULTS Overall, participants found the drop-in centre highly acceptable and reported a positive experience. Reasons for this varied but broadly focused around four themes: (1) efficient sufficiency; (2) autonomy; (3) fusion of process and content factors and (4) (dis)parities of esteems and 'seeing both sides of the coin'. CONCLUSIONS Participants found the intervention acceptable. A mental health drop-in centre in a paediatric hospital appears to be a positive and valued adjunct to supplement existing mental health services.
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Affiliation(s)
- Matteo Catanzano
- UCL Great Ormond Street Institute of Child Health, London, UK.,Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Sophie D Bennett
- UCL Great Ormond Street Institute of Child Health, London, UK.,Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Kate Fifield
- UCL Great Ormond Street Institute of Child Health, London, UK.,Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Laila Xu
- UCL Great Ormond Street Institute of Child Health, London, UK
| | - Charlotte Sanderson
- UCL Great Ormond Street Institute of Child Health, London, UK.,Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Anna E Coughtrey
- UCL Great Ormond Street Institute of Child Health, London, UK.,Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Ellie Kerry
- UCL Great Ormond Street Institute of Child Health, London, UK.,Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Holan Liang
- UCL Great Ormond Street Institute of Child Health, London, UK.,Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Isobel Heyman
- UCL Great Ormond Street Institute of Child Health, London, UK.,Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Roz Shafran
- UCL Great Ormond Street Institute of Child Health, London, UK.,Great Ormond Street Hospital NHS Foundation Trust, London, UK
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Ching BC, Bennett SD, Heyman I, Liang H, Catanzano M, Fifield K, Berger Z, Gray S, Hewson E, Bryon M, Coughtrey AE, Shafran R. A survey of mental health professionals in a paediatric hospital during COVID-19. Clin Child Psychol Psychiatry 2022; 27:122-135. [PMID: 34289747 PMCID: PMC8811327 DOI: 10.1177/13591045211033186] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND There is little understanding of the mental health impact for young people with long-term physical health conditions and mental health professionals' experiences of supporting them during COVID-19. This service evaluation aimed to conduct a survey of the psychological services provided by mental health professionals in a paediatric hospital in relation to COVID-19. METHOD Clinical psychologists and assistant psychologists (n = 76) across the hospital were asked to complete a survey, asking about their perceptions of COVID-19's impact on patients and families and experiences of providing support during COVID-19. Open-ended survey questions were analysed qualitatively using framework analysis. RESULTS Respondents described perceived impacts on patients and families around social isolation, school closure, family relationships, physical health, mental health, treatments and social support. Respondents' experiences of providing mental health support during COVID-19 highlighted themes around providing remote/virtual support, workload and facilitators and barriers to their work. CONCLUSIONS Mental health professionals surveyed reported a complex mental health landscape in young people with long-term physical health conditions and their families during COVID-19. Service-wide involvement is needed to facilitate changes to support vital adaptations to remote/virtual working. Research on the mental health of young people with long-term physical health conditions and staff experiences of providing support is warranted.
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Affiliation(s)
- Brian Cf Ching
- UCL Great Ormond Street Institute of Child Health, 11700University College London, London, UK.,Psychological and Mental Health Services, 4956Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Sophie D Bennett
- UCL Great Ormond Street Institute of Child Health, 11700University College London, London, UK.,Psychological and Mental Health Services, 4956Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Isobel Heyman
- UCL Great Ormond Street Institute of Child Health, 11700University College London, London, UK.,Psychological and Mental Health Services, 4956Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Holan Liang
- UCL Great Ormond Street Institute of Child Health, 11700University College London, London, UK.,Psychological and Mental Health Services, 4956Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Matteo Catanzano
- UCL Great Ormond Street Institute of Child Health, 11700University College London, London, UK.,Psychological and Mental Health Services, 4956Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Kate Fifield
- UCL Great Ormond Street Institute of Child Health, 11700University College London, London, UK.,Psychological and Mental Health Services, 4956Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Zoe Berger
- Psychological and Mental Health Services, 4956Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Suzanne Gray
- Psychological and Mental Health Services, 4956Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Emma Hewson
- Psychological and Mental Health Services, 4956Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Mandy Bryon
- Psychological and Mental Health Services, 4956Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Anna E Coughtrey
- UCL Great Ormond Street Institute of Child Health, 11700University College London, London, UK.,Psychological and Mental Health Services, 4956Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Roz Shafran
- UCL Great Ormond Street Institute of Child Health, 11700University College London, London, UK.,Psychological and Mental Health Services, 4956Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
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Bennett SD, Kerry E, Fifield K, Ching BCF, Catanzano M, Liang H, Heyman I, Coughtrey AE, Sanderson C, Rojas N, Shafran R. A drop‐in centre for treating mental health problems in children with chronic illness: Outcomes for parents and their relationship with child outcomes. JCPP Advances 2021. [DOI: 10.1002/jcv2.12046] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- Sophie D. Bennett
- UCL Great Ormond Street Institute of Child Health London UK
- Great Ormond Street Hospital for Children NHS Foundation Trust London UK
| | - Eleanor Kerry
- UCL Great Ormond Street Institute of Child Health London UK
- Great Ormond Street Hospital for Children NHS Foundation Trust London UK
| | - Kate Fifield
- UCL Great Ormond Street Institute of Child Health London UK
- Great Ormond Street Hospital for Children NHS Foundation Trust London UK
| | - Brian C. F. Ching
- UCL Great Ormond Street Institute of Child Health London UK
- Great Ormond Street Hospital for Children NHS Foundation Trust London UK
| | - Matteo Catanzano
- UCL Great Ormond Street Institute of Child Health London UK
- Great Ormond Street Hospital for Children NHS Foundation Trust London UK
| | - Holan Liang
- UCL Great Ormond Street Institute of Child Health London UK
- Great Ormond Street Hospital for Children NHS Foundation Trust London UK
| | - Isobel Heyman
- UCL Great Ormond Street Institute of Child Health London UK
- Great Ormond Street Hospital for Children NHS Foundation Trust London UK
| | - Anna E. Coughtrey
- UCL Great Ormond Street Institute of Child Health London UK
- Great Ormond Street Hospital for Children NHS Foundation Trust London UK
| | - Charlotte Sanderson
- UCL Great Ormond Street Institute of Child Health London UK
- Great Ormond Street Hospital for Children NHS Foundation Trust London UK
| | - Natalia Rojas
- UCL Great Ormond Street Institute of Child Health London UK
- Great Ormond Street Hospital for Children NHS Foundation Trust London UK
| | - Roz Shafran
- UCL Great Ormond Street Institute of Child Health London UK
- Great Ormond Street Hospital for Children NHS Foundation Trust London UK
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6
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Catanzano M, Bennett SD, Tibber MS, Coughtrey AE, Liang H, Heyman I, Shafran R. A Mental Health Drop-In Centre Offering Brief Transdiagnostic Psychological Assessment and Treatment in a Paediatric Hospital Setting: A One-Year Descriptive Study. Int J Environ Res Public Health 2021; 18:ijerph18105369. [PMID: 34069973 PMCID: PMC8157880 DOI: 10.3390/ijerph18105369] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 05/06/2021] [Accepted: 05/13/2021] [Indexed: 11/16/2022]
Abstract
AIM This study was part of a broader project to examine the acceptability, feasibility and impact of a transdiagnostic mental health drop-in centre offering brief psychological assessment and treatment for children and young people and/or their families with mental health needs in the context of long-term physical health conditions (LTCs). The aims of this investigation were to characterise: (i) the use of such a centre, (ii) the demographics and symptoms of those presenting to the centre, and (iii) the types of support that are requested and/or indicated. METHODS A mental health "booth" was located in reception of a national paediatric hospital over one year. Characteristics of young people with LTCs and their siblings/parents attending the booth were defined. Emotional/behavioural symptoms were measured using standardised questionnaires including the Strengths and Difficulties Questionnaire (SDQ). Participants subsequently received one of four categories of intervention: brief transdiagnostic cognitive behaviour therapy (CBT), referral to other services, neurodevelopmental assessment or signposting to resources. RESULTS One hundred and twenty-eight participants were recruited. The mean age of young people was 9.14 years (standard deviation: 4.28); 61% identified as white and 45% were male. Over half of young people recruited scored in the clinical range with respect to the SDQ. Presenting problems included: anxiety (49%), challenging behaviour (35%), low mood (22%) and other (15%). CONCLUSIONS A considerable proportion of young people with LTC in a paediatric hospital scored in the clinical range for common mental health problems, indicating a potential for psychological interventions.
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Affiliation(s)
- Matteo Catanzano
- UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK; (S.D.B.); (A.E.C.); (H.L.); (I.H.); (T.L.P.T.); (R.S.)
- Great Ormond Street Hospital for Children NHS Foundation Trust, London WC1N 3JH, UK
- Correspondence: ; Tel.: +44-(0)20-7405-9200
| | - Sophie D Bennett
- UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK; (S.D.B.); (A.E.C.); (H.L.); (I.H.); (T.L.P.T.); (R.S.)
- Great Ormond Street Hospital for Children NHS Foundation Trust, London WC1N 3JH, UK
| | - Marc S Tibber
- Research Department of Clinical, Educational and Health Psychology, University College London, London WC1E 6BT, UK;
| | - Anna E Coughtrey
- UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK; (S.D.B.); (A.E.C.); (H.L.); (I.H.); (T.L.P.T.); (R.S.)
- Great Ormond Street Hospital for Children NHS Foundation Trust, London WC1N 3JH, UK
| | - Holan Liang
- UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK; (S.D.B.); (A.E.C.); (H.L.); (I.H.); (T.L.P.T.); (R.S.)
- Great Ormond Street Hospital for Children NHS Foundation Trust, London WC1N 3JH, UK
| | - Isobel Heyman
- UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK; (S.D.B.); (A.E.C.); (H.L.); (I.H.); (T.L.P.T.); (R.S.)
- Great Ormond Street Hospital for Children NHS Foundation Trust, London WC1N 3JH, UK
| | - The Lucy Project Team
- UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK; (S.D.B.); (A.E.C.); (H.L.); (I.H.); (T.L.P.T.); (R.S.)
- Great Ormond Street Hospital for Children NHS Foundation Trust, London WC1N 3JH, UK
| | - Roz Shafran
- UCL Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK; (S.D.B.); (A.E.C.); (H.L.); (I.H.); (T.L.P.T.); (R.S.)
- Great Ormond Street Hospital for Children NHS Foundation Trust, London WC1N 3JH, UK
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Catanzano M, Bennett SD, Kerry E, Liang H, Heyman I, Coughtrey AE, Fifield K, Taylor C, Dalgleish T, Xu L, Shafran R. Evaluation of a mental health drop-in centre offering brief transdiagnostic psychological assessment and treatment for children and adolescents with long-term physical conditions and their families: a single-arm, open, non-randomised trial. Evid Based Ment Health 2021; 24:25-32. [PMID: 33243761 PMCID: PMC7958088 DOI: 10.1136/ebmental-2020-300197] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/24/2020] [Accepted: 10/27/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND Children and young people with long-term physical conditions have significantly elevated mental health needs. Transdiagnostic, brief psychological interventions have the potential to increase access to evidence-based psychological treatments for patients who attend health services primarily for physical health needs. OBJECTIVE A non-randomised study was conducted to assess the impact of brief, transdiagnostic psychological interventions in children and young people presenting at a drop-in mental health centre in the reception area of a paediatric hospital. METHODS 186 participants attending a transdiagnostic mental health drop-in centre were allocated to assessment and psychological intervention based on a clinical decision-making algorithm. Interventions included signposting, guided self-help based on a modular psychological treatment and referral to the hospital's paediatric psychology service. The primary transdiagnostic mental health outcome measure was the parent-reported Strengths and Difficulties Questionnaire (SDQ), which was given at baseline and 6 months post-baseline. FINDINGS There was a significant positive impact of attending the drop-in mental health centre on the SDQ (Cohen's d=0.22) and on the secondary outcome measure of Paediatric Quality of life (Cohen's d=0.55). CONCLUSIONS A mental health drop-in centre offering brief, transdiagnostic assessment and treatment may reduce emotional and behavioural symptoms and improve quality of life in children and young people with mental health needs in the context of long-term physical conditions. A randomised controlled trial to investigate the specificity of any effects is warranted. CLINICAL IMPLICATIONS Drop-in centres for mental health needs may increase access and have beneficial effects for children and young people with physical conditions.
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Affiliation(s)
- Matteo Catanzano
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Psychological and Mental Health Services, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Sophie D Bennett
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Psychological and Mental Health Services, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Ellie Kerry
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Psychological and Mental Health Services, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Holan Liang
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Psychological and Mental Health Services, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Isobel Heyman
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Psychological and Mental Health Services, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Anna E Coughtrey
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Psychological and Mental Health Services, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Kate Fifield
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Psychological and Mental Health Services, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Chloe Taylor
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Psychological and Mental Health Services, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Tim Dalgleish
- MRC Cognition and Brain Sciences Unit, Cambridge, Cambridgeshire, UK
| | - Laila Xu
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Roz Shafran
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
- Psychological and Mental Health Services, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
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8
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Catanzano M, Bennett SD, Sanderson C, Patel M, Manzotti G, Kerry E, Coughtrey AE, Liang H, Heyman I, Shafran R. Brief psychological interventions for psychiatric disorders in young people with long term physical health conditions: A systematic review and meta-analysis. J Psychosom Res 2020; 136:110187. [PMID: 32688073 DOI: 10.1016/j.jpsychores.2020.110187] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [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] [Received: 02/18/2020] [Revised: 05/13/2020] [Accepted: 06/27/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Rates of psychiatric disorders are considerably elevated in young people with long term physical health conditions. Currently few children obtain effective mental health treatments in the context of long term physical health conditions, and ways to improve access to evidence-based mental health interventions are urgently needed. One approach is to deploy briefer, more economical, yet still evidence-based, treatments. The objective of this review was to evaluate the efficacy of brief interventions targeting psychiatric disorders in children and young people with long term physical health conditions. METHODS Predefined terms relating to brief psychological interventions for psychiatric disorders in children with long term physical health conditions were used to search relevant databases. A systematic review and meta-analysis was carried out in accordance with the Cochrane guidelines. Two reviewers independently screened titles and abstracts, extracted the data and conducted risk of bias assessments. RESULTS A total of 12 randomised controlled trials were found to meet the inclusion criteria of the review. Of those, three studies were suitable for meta-analysis. A large effect size in favour of brief cognitive behavioural therapy for anxiety was found (g = - 0.95, CI -1.49 to -0.041; p < .001) with non-significant moderate-substantial heterogeneity (I2 = 58%; p = .09). CONCLUSION This review suggests there is preliminary evidence that brief interventions, based on cognitive behavioural principles, may benefit young people with an anxiety disorder in the context of a long term physical health condition. There was insufficient evidence to assess whether this held true for depression and disruptive behaviour.
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Affiliation(s)
- M Catanzano
- Great Ormond Street Hospital NHS Foundation Trust, Great Ormond Street, London, UK; UCL Great Ormond Street Institute of Child Health, London, UK.
| | - S D Bennett
- Great Ormond Street Hospital NHS Foundation Trust, Great Ormond Street, London, UK; UCL Great Ormond Street Institute of Child Health, London, UK
| | - C Sanderson
- UCL Great Ormond Street Institute of Child Health, London, UK
| | - M Patel
- Great Ormond Street Hospital NHS Foundation Trust, Great Ormond Street, London, UK; UCL Great Ormond Street Institute of Child Health, London, UK
| | - G Manzotti
- UCL Great Ormond Street Institute of Child Health, London, UK
| | - E Kerry
- Great Ormond Street Hospital NHS Foundation Trust, Great Ormond Street, London, UK; UCL Great Ormond Street Institute of Child Health, London, UK
| | - A E Coughtrey
- Great Ormond Street Hospital NHS Foundation Trust, Great Ormond Street, London, UK; UCL Great Ormond Street Institute of Child Health, London, UK
| | - H Liang
- Great Ormond Street Hospital NHS Foundation Trust, Great Ormond Street, London, UK; UCL Great Ormond Street Institute of Child Health, London, UK
| | - I Heyman
- Great Ormond Street Hospital NHS Foundation Trust, Great Ormond Street, London, UK; UCL Great Ormond Street Institute of Child Health, London, UK
| | - R Shafran
- Great Ormond Street Hospital NHS Foundation Trust, Great Ormond Street, London, UK; UCL Great Ormond Street Institute of Child Health, London, UK
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Batchelor R, Catanzano M, Kerry E, Bennett SD, Coughtrey AE, Liang H, Curry V, Heyman I, Shafran R. Debate: Lessons learned in lockdown - a one-day remotely delivered training on low-intensity psychological interventions for common mental health conditions. Child Adolesc Ment Health 2020; 25:175-177. [PMID: 32674222 DOI: 10.1111/camh.12402] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 05/24/2020] [Accepted: 06/05/2020] [Indexed: 12/18/2022]
Abstract
The coronavirus pandemic has highlighted the need for remote technologies to be used in child and adolescent mental health services. With the UK being placed in lockdown one week before a scheduled 'face-to-face' low-intensity CBT training day due to COVID-19, there was a need for rapid adaptations to be made to the content, structure and format of a training day for practitioners in mental health services, to suit the online environment. The content covered the core areas of low-intensity CBT in children and adolescents. Findings showed that the one-day low-intensity training day increased knowledge and understanding in all key areas measured, and was positively received, providing further evidence for the effectiveness and acceptability of remote delivery. Given discussed benefits of remote delivery, as well as rapid developments in technologies helping to address some of the challenges raised, going forward, remote delivery could continue to be beneficial for increasing access to much needed evidence-based interventions.
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Affiliation(s)
| | - Matteo Catanzano
- Great Ormond Street Hospital NHS Foundation Trust, London, UK.,UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Ellie Kerry
- Great Ormond Street Hospital NHS Foundation Trust, London, UK.,UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Sophie D Bennett
- Great Ormond Street Hospital NHS Foundation Trust, London, UK.,UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Anna E Coughtrey
- Great Ormond Street Hospital NHS Foundation Trust, London, UK.,UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Holan Liang
- Great Ormond Street Hospital NHS Foundation Trust, London, UK.,UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Vicki Curry
- Anna Freud Centre for Children and Families, London, UK
| | - Isobel Heyman
- Great Ormond Street Hospital NHS Foundation Trust, London, UK.,UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Roz Shafran
- Great Ormond Street Hospital NHS Foundation Trust, London, UK.,UCL Great Ormond Street Institute of Child Health, University College London, London, UK
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Bekheit M, Catanzano M, Shand S, Ahmed I, ELKayal ELS, Shehata GM, Zaki A. The role of graft reperfusion sequence in the development of non-anastomotic biliary strictures following orthotopic liver transplantation: A meta-analysis. Hepatobiliary Pancreat Dis Int 2019; 18:4-11. [PMID: 30579736 DOI: 10.1016/j.hbpd.2018.12.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 06/28/2018] [Accepted: 11/22/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND Liver transplant is a potential cure for liver failure and hepatic malignancy but there are many techniques which have been described for vascular reconstruction. This study was to compare the prevalence of non-anastomotic biliary stricture and other surgical complications based on Clavien-Dindo scoring system, in initial portal reperfusion (sequential) versus simultaneous or initial artery reperfusion. DATA SOURCES Meta-analysis of published studies comparing the outcomes of both techniques was carried out. Data search was conducted across the major databases and studies were selected under the guidance of the Cochrane guidelines for systematic reviews and meta-analysis. RESULTS Seven studies were included to address the primary and the secondary outcomes. No statistical difference was found in the incidence of non-anastomotic biliary strictures (OR = 0.40; P = 0.14), regardless of reperfusion technique. The pooled estimate of the Clavien-Dindo grading of complications was not significantly different between the techniques, though Clavien-Dindo II complications were higher in the simultaneous or initial artery reperfusion group than the initial portal reperfusion group (OR = 2.73; P = 0.01). Similarly, there was no difference in the operative time, hospital stay and other outcomes addressed in this report. CONCLUSIONS The available evidence suggests that there is no significant difference demonstrated in the rate of non-anastomotic biliary strictures or other complications, between the two techniques, except for Clavien-Dindo II complications.
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Affiliation(s)
- Mohamed Bekheit
- Center of Liver Surgery and Transplantation, Paul Brousse Hospital, University of Paris-Sud, Villejuif Cedex, France; Medical Research Institute, University of Alexandria, Alexandria, Egypt; HPB Surgery Unit Department of Surgery, Aberdeen Royal Infirmary, Aberdeen, UK; Department of Surgery, Elkabbary General Hospital, Alexandria, Egypt; University of Aberdeen, Aberdeen, UK.
| | | | - Stuart Shand
- HPB Surgery Unit Department of Surgery, Aberdeen Royal Infirmary, Aberdeen, UK
| | - Irfan Ahmed
- HPB Surgery Unit Department of Surgery, Aberdeen Royal Infirmary, Aberdeen, UK; University of Aberdeen, Aberdeen, UK
| | - ELSaid ELKayal
- Department of Surgery, Alexandria Main University Hospital, Faculty of Medicine, Alexandria, Egypt
| | | | - Adel Zaki
- Medical Research Institute, University of Alexandria, Alexandria, Egypt
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Abstract
Background Laparoscopic sleeve gastrectomy (LSG) with staple line reinforcement (SLR) is a popular and safe treatment option for morbid obesity. We have developed, devised, and described our own method of stapleless laparoscopic sleeve gastrectomy, which in our limited study appeared safe, efficacious, and potentially cost-effective. Methods We analyzed the outcome of our modified LSG in a case series of three middle-aged women (median age 42 years old). Our main modification was sutured closure of the stomach rather than the commonly utilized technique of stapled closure. Our primary measure of success was the occurrence of post-operative leak. Secondary measures were (a) length of operation, (b) duration of inpatient stay, and (c) percentage of weight loss at 6 and 12 months post operation. Results Median operative time = 132 min (120–195 min), and median inpatient stays were 2 days. No post-operative leaks were recorded. The median excess weight loss at 6 months was 39% of initial weight loss and 57.7% at 12 months. Conclusions Stapleless LSG has the potential to be an affordable alternative to the traditional LSG. High-powered studies and a formal cost analysis are required.
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Affiliation(s)
- Matteo Catanzano
- Department of Surgery, Aberdeen Royal Infirmary, Foresterhill Health Campus, Aberdeen, AB252ZN, UK
| | - Lisa Grundy
- Department of Surgery, Aberdeen Royal Infirmary, Foresterhill Health Campus, Aberdeen, AB252ZN, UK
| | - Mohamed Bekheit
- Department of Surgery, Aberdeen Royal Infirmary, Foresterhill Health Campus, Aberdeen, AB252ZN, UK.
- Department of Surgery, El kabbary General Hospital, Alexandria, Egypt.
- Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK.
- Centre Hépato-Biliaire, 12 av. Paul Vaillant Couturier, AP-HP, Hôpital Paul Brousse, 94800, Villejuif, France.
- Inserm Unité 1193, 12 av. Paul Vaillant Couturier, 94800, Villejuif, France.
- Ecole doctorale Innovation Therapeutique, Universite Pais-Sud, Châtenay-Malabry Cedex, France.
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