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Reliford A, Liu A, Dhir S, Schlechter A. Race, Ethnicity, and the Medical "One-Liner": How Child and Adolescent Psychiatry Can Chart Its Own Antiracist Path Forward. Acad Psychiatry 2024; 48:178-182. [PMID: 37993762 DOI: 10.1007/s40596-023-01904-4] [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] [Received: 05/02/2023] [Accepted: 11/03/2023] [Indexed: 11/24/2023]
Affiliation(s)
- Aaron Reliford
- NYU Grossman School of Medicine, New York, NY, USA.
- Family Health Centers at NYU Langone Brooklyn, Brooklyn, NY, USA.
| | - Anni Liu
- NYU Grossman School of Medicine, New York, NY, USA
| | - Sakshi Dhir
- NYU Grossman School of Medicine, New York, NY, USA
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2
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Moreno C. Child psychiatry cannot afford not to properly study differences by sex. Eur Child Adolesc Psychiatry 2024; 33:957-959. [PMID: 38575666 DOI: 10.1007/s00787-024-02427-5] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Affiliation(s)
- Carmen Moreno
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, ISCIII, School of Medicine, Universidad Complutense, Madrid, Spain.
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3
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Gauld C, Viaux-Savelon S, Falissard B, Fourneret P. Precision child and adolescent psychiatry: reductionism, fad, or change of identity of the discipline? Eur Child Adolesc Psychiatry 2024; 33:1193-1196. [PMID: 37253832 DOI: 10.1007/s00787-023-02240-6] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 05/21/2023] [Indexed: 06/01/2023]
Affiliation(s)
- Christophe Gauld
- Service de Psychopathologie du Développement de l'Enfant et de l'Adolescent, Hospices Civils de Lyon, Lyon, France.
- Institut Des Sciences Cognitives Marc Jeannerod, UMR 5229 CNRS, Université Claude Bernard Lyon 1, 67 Bd Pinel, Lyon, France.
| | - Sylvie Viaux-Savelon
- Service de Psychopathologie du Développement de l'Enfant et de l'Adolescent, Hospices Civils de Lyon, Lyon, France
- Institut Des Sciences Cognitives Marc Jeannerod, UMR 5229 CNRS, Université Claude Bernard Lyon 1, 67 Bd Pinel, Lyon, France
| | - Bruno Falissard
- Centre de Recherche en Épidémiologie et Santé des Populations, CESP, INSERM U1018, Université Paris-Saclay, Paris, France
| | - Pierre Fourneret
- Service de Psychopathologie du Développement de l'Enfant et de l'Adolescent, Hospices Civils de Lyon, Lyon, France
- Institut Des Sciences Cognitives Marc Jeannerod, UMR 5229 CNRS, Université Claude Bernard Lyon 1, 67 Bd Pinel, Lyon, France
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García F, Klagges M, Leyton F, Nogales I, Mickman C, Martínez C, Tomicic A. Mental telehealth in a public child and adolescent psychiatry unit during the pandemic: a qualitative implementation study. Medwave 2024; 24:e2777. [PMID: 38513231 DOI: 10.5867/medwave.2024.02.2777] [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] [Subscribe] [Scholar Register] [Indexed: 03/23/2024] Open
Abstract
Background The COVID-19 pandemic led to a prompt implementation of remote care, especially in mental health care. The evidence supporting this modality of care is still emerging, with few qualitative studies describing its implementation in Latin American countries. This study aims to understand the perspectives of therapists and patients regarding the use of telehealth in a child and adolescent mental health unit of a Chilean public service. Methods This is a qualitative study. Two focus groups were defined with 14 professionals, and 16 in-depth interviews were conducted with users of an outpatient child and adolescent psychiatry unit. The data were analyzed using the grounded theory model. Results In the group of therapists, four main categories emerged: background of mental telehealth, implementation, mental telehealth from the therapist's position, and projections. Three main categories emerged in the patient's group: implementation, evaluation of mental telehealth users, and projections. Conclusions There are elements in common between the opinions of patients and therapists. Something to note within the patient's group is that, despite accepting remote care and recognizing its positive aspects, aside from the pandemic context, they prefer face-to-face or mixed care.
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Affiliation(s)
- Francisca García
- Departamento de Pediatría, Escuela de Medicina, Facultad de Medicina, Universidad de Valparaíso, Valparaíso, Chile
| | - Melannie Klagges
- Departamento de Pediatría, Escuela de Medicina, Facultad de Medicina, Universidad de Valparaíso, Valparaíso, Chile
| | - Fanny Leyton
- Departamento de Pediatría, Escuela de Medicina, Facultad de Medicina, Universidad de Valparaíso, Valparaíso, Chile
| | - Ingrid Nogales
- Departamento de Pediatría, Escuela de Medicina, Facultad de Medicina, Universidad de Valparaíso, Valparaíso, Chile
| | - Carolina Mickman
- Departamento de Pediatría, Escuela de Medicina, Facultad de Medicina, Universidad de Valparaíso, Valparaíso, Chile
| | - Claudio Martínez
- Instituto Milenio para la Investigación en Depresión y Personalidad (MIDAP), Santiago, Chile
| | - Alemka Tomicic
- Instituto Milenio para la Investigación en Depresión y Personalidad (MIDAP), Santiago, Chile
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Faraone SV, Newcorn JH, Wozniak J, Joshi G, Coffey B, Uchida M, Wilens T, Surman C, Spencer TJ. In Memoriam: Professor Joseph Biederman's Contributions to Child and Adolescent Psychiatry. J Atten Disord 2024; 28:550-582. [PMID: 38334088 PMCID: PMC10947509 DOI: 10.1177/10870547231225818] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
OBJECTIVE To provide an overview of Joe Biederman's contributions to child and adolescent psychiatry. METHOD Nine colleagues described his contributions to: psychopharmacology, comorbidity and genetics, pediatric bipolar disorder, autism spectrum disorders, Tourette's and tic disorders, clinical and neuro biomarkers for pediatric mood disorders, executive functioning, and adult ADHD. RESULTS Joe Biederman left us with many concrete indicators of his contributions to child and adolescent psychiatry. He set up the world's first pediatric psychopharmacology clinic and clinical research program in child adolescent psychiatry. As a young faculty member he began a research program that led to many awards and eventual promotion to full professor at Harvard Medical School. He was for many years the most highly cited researcher in ADHD. He achieved this while maintaining a full clinical load and was widely respected for his clinical acumen. CONCLUSION The world is a better place because Joe Biederman was here.
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Affiliation(s)
| | | | - Janet Wozniak
- Massachusetts General Hospital, Boston, USA
- Harvard Medical School, Boston, MA, USA
| | - Gagan Joshi
- Massachusetts General Hospital, Boston, USA
- Harvard Medical School, Boston, MA, USA
| | | | - Mai Uchida
- Massachusetts General Hospital, Boston, USA
- Harvard Medical School, Boston, MA, USA
| | - Timothy Wilens
- Massachusetts General Hospital, Boston, USA
- Harvard Medical School, Boston, MA, USA
| | - Craig Surman
- Massachusetts General Hospital, Boston, USA
- Harvard Medical School, Boston, MA, USA
| | - Thomas J. Spencer
- Massachusetts General Hospital, Boston, USA
- Harvard Medical School, Boston, MA, USA
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Affiliation(s)
- Ned H Kalin
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison
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7
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Malik S, Verma P, Ruaño G, Al Siaghy A, Dilawar A, Bishop JR, Strawn JR, Namerow LB. Pharmacogenetics in Child and Adolescent Psychiatry: Background and Evidence-Based Clinical Applications. J Child Adolesc Psychopharmacol 2024; 34:4-20. [PMID: 38377525 DOI: 10.1089/cap.2023.0074] [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: 02/22/2024]
Abstract
The efficacy and tolerability of psychotropic medications can vary significantly among children and adolescents, and some of this variability relates to pharmacogenetic factors. Pharmacogenetics (PGx) in child and adolescent psychiatry can potentially improve treatment outcomes and minimize adverse drug reactions. This article reviews key pharmacokinetic and pharmacodynamic genes and principles of pharmacogenetic testing and discusses the evidence base for clinical decision-making concerning PGx testing. This article reviews current guidelines from the United States Food and Drug Administration (FDA), the Clinical Pharmacogenetics Implementation Consortium (CPIC), and the Dutch Pharmacogenetics Working Group (DPWG) and explores potential future directions. This review discusses key clinical considerations for clinicians prescribing psychotropic medications in children and adolescents, focusing on antidepressants, antipsychotics, stimulants, norepinephrine reuptake inhibitors, and alpha-2 agonists. Finally, this review synthesizes the practical use of pharmacogenetic testing and clinical decision support systems.
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Affiliation(s)
- Salma Malik
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, Connecticut, USA
- Division of Child and Adolescent Psychiatry, Institute of Living/Hartford Hospital, Hartford, Connecticut, USA
| | - Pragya Verma
- Division of Child and Adolescent Psychiatry, Institute of Living/Hartford Hospital, Hartford, Connecticut, USA
| | - Gualberto Ruaño
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Areej Al Siaghy
- Division of Child and Adolescent Psychiatry, Institute of Living/Hartford Hospital, Hartford, Connecticut, USA
| | | | - Jeffrey R Bishop
- Department of Experimental and Clinical Pharmacology, University of Minnesota College of Pharmacy, Minneapolis, Minnesota, USA
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Jeffrey R Strawn
- Department of Psychiatry & Behavioral Neuroscience, University of Cincinnati, College of Medicine, Cincinnati, Ohio, USA
| | - Lisa B Namerow
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, Connecticut, USA
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8
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Ünver H, Ceylan BG, Erdoğdu Yıldırım AB, Perdahlı Fiş N. Child and adolescent psychiatry outpatient clinic admissions of anorexia nervosa patients before and during the COVID-19 Pandemic (January 2015-January 2022)-A retrospective cohort from a tertiary referral hospital in Turkey. J Child Adolesc Psychiatr Nurs 2024; 37:e12435. [PMID: 37443291 DOI: 10.1111/jcap.12435] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 07/02/2023] [Accepted: 07/04/2023] [Indexed: 07/15/2023]
Affiliation(s)
- Hatice Ünver
- Child and Adolescent Psychiatry Department, Marmara University Medical Faculty, Istanbul, Turkey
| | - Beyzanur Gökçe Ceylan
- Child and Adolescent Psychiatry Department, Marmara University Medical Faculty, Istanbul, Turkey
| | | | - Neşe Perdahlı Fiş
- Child and Adolescent Psychiatry Department, Marmara University Medical Faculty, Istanbul, Turkey
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9
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Hagstrøm J, Nielsen T, Sørensen ME, Aagaard K, Arendt Rasmussen M, Rosenberg JB, Mohammadzadeh P, Sevelsted A, Hernández-Lorca M, Fagerlund B, Rydkjær J, Pagsberg AK, Kaufman J, Ebdrup BH, Bilenberg N, Jepsen JRM. Dimensional profiling of psychopathology in children and adolescents based on the K-SADS-PL and an analysis of the construct validity of two ADHD symptom dimensions. Nord J Psychiatry 2024; 78:71-78. [PMID: 37755235 DOI: 10.1080/08039488.2023.2262997] [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: 04/12/2023] [Accepted: 09/21/2023] [Indexed: 09/28/2023]
Abstract
OBJECTIVES The traditional view on psychiatric disorders as categorical and distinct is being challenged by perspectives emphasizing the relevance of dimensional and transdiagnostic assessment. However, most diagnostic instruments are based on a categorical view with a threshold-approach to disease classification. METHODS We here describe algorithms for dimensionalizing the psychopathological ratings of the widely used diagnostic interview for children and adolescents, the Kiddie-Schedule for Affective Disorders and Schizophrenia - Present and Lifetime Version (K-SADS-PL). We further evaluate the criterion-related construct validity of the dimensionalized attention-deficit/hyperactivity disorder (ADHD) scales using Rasch models in a sample of 590 children (mean age 10.29 (.36), 49% girls). RESULTS The algorithms generate scores of current symptom load, i.e., the sum of clinician-rated symptoms within each disorder assessed with the interview. We found support for counting symptoms of inattention and hyperactivity/impulsivity, respectively, but not for a single combined ADHD scale. CONCLUSIONS The algorithms constitute an initial step in creating a framework for clinician-rated dimensional analyses of symptoms derived from the K-SADS-PL, but future studies are needed to further evaluate the construct validity of the remaining scales and the reliability and clinical utility of the method. We believe that our proposed algorithms offer a novel method of dimensional psychopathological assessment, which can be applied in multiple branches of child and adolescent psychiatry.
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Affiliation(s)
- Julie Hagstrøm
- Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
| | - Tine Nielsen
- Department of Psychology, Faculty of Social Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Applied Research in Education and Social Science, UCL University College, Odense, Denmark
| | - Mikkel E Sørensen
- Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Center Glostrup, Glostrup, University of Copenhagen, Denmark
| | - Kristina Aagaard
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
| | - Morten Arendt Rasmussen
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
- Department of Food Science, University of Copenhagen, Frederiksberg, Denmark
| | - Julie B Rosenberg
- Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Center Glostrup, Glostrup, University of Copenhagen, Denmark
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Parisa Mohammadzadeh
- Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Center Glostrup, Glostrup, University of Copenhagen, Denmark
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Astrid Sevelsted
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
| | - María Hernández-Lorca
- Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Gentofte, Denmark
| | - Birgitte Fagerlund
- Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
- Department of Psychology, Faculty of Social Sciences, University of Copenhagen, Copenhagen, Denmark
- Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Center Glostrup, Glostrup, University of Copenhagen, Denmark
| | - Jacob Rydkjær
- Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
| | - Anne Katrine Pagsberg
- Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Joan Kaufman
- Center for Child and Family Traumatic Stress, Kennedy Krieger Institute, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Bjørn H Ebdrup
- Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Center Glostrup, Glostrup, University of Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Niels Bilenberg
- Department of Child and Adolescent Mental Health Odense, Research Unit (University Function), Mental Health Services in the Region of Southern Denmark, Odense C, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Jens Richardt Møllegaard Jepsen
- Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
- Center for Neuropsychiatric Schizophrenia Research (CNSR), Mental Health Center Glostrup, Glostrup, University of Copenhagen, Denmark
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Degenhardt F, Wohlleber E, Jamra RA, Hebebrand J. [Genetic Diagnostics in Everyday Clinical Practice in Child and Adolescent Psychiatry: Indications, Framework Conditions, Hurdles, and Proposed Solutions]. Z Kinder Jugendpsychiatr Psychother 2024; 52:43-59. [PMID: 37641943 DOI: 10.1024/1422-4917/a000941] [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] [Indexed: 08/31/2023]
Abstract
Genetic Diagnostics in Everyday Clinical Practice in Child and Adolescent Psychiatry: Indications, Framework Conditions, Hurdles, and Proposed Solutions Abstract: Health insurance covers medically necessary genetic testing in Germany. Diagnostic genetic testing has become increasingly important for child and adolescent psychiatry (CAP), reflected by the rising number of national guidelines relevant to CAP, including genetic testing in the recommended diagnostic work-up. However, implementation of theses guidelines in routine clinical care is lacking. This article provides a concise overview of the relevance of genetic testing in CAP-related national guidelines. It outlines the legal and financial framework for genetic testing in Germany. Furthermore, it points out barriers to implementation and offers potential solutions. It then provides examples from clinical practice highlighting the potential benefits patients and their family members might have from receiving a genetic diagnosis. The article closes by outlining future CAP-relevant areas in which genetic testing may become clinically relevant.
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Affiliation(s)
- Franziska Degenhardt
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, LVR-Universitätsklinikum Essen, Kliniken und Institut der Universität Duisburg-Essen, Deutschland
| | | | - Rami Abou Jamra
- Institut für Humangenetik, Universitätsklinikum Leipzig, Deutschland
| | - Johannes Hebebrand
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, LVR-Universitätsklinikum Essen, Kliniken und Institut der Universität Duisburg-Essen, Deutschland
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Arango C. Child and adolescent psychiatry in the context of disease prevention. Span J Psychiatry Ment Health 2024; 17:1-2. [PMID: 38242591 PMCID: PMC10893780 DOI: 10.1016/j.sjpmh.2024.01.001] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 01/05/2024] [Indexed: 01/21/2024]
Affiliation(s)
- Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Maranon, School of Medicine, Universidad Complutense, ISGM, CIBERSAM, Madrid, Spain.
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Kandsperger S, Ecker A, Schleicher D, Wirth M, Brunner R, Jarvers I. Emergency-related inpatient admissions in child and adolescent psychiatry: comparison of clinical characteristics of involuntary and voluntary admissions from a survey in Bavaria, Germany. Eur Child Adolesc Psychiatry 2024; 33:303-313. [PMID: 36792866 PMCID: PMC10805847 DOI: 10.1007/s00787-023-02154-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 01/26/2023] [Indexed: 02/17/2023]
Abstract
Emergency inpatient admissions of children and adolescents are more difficult if the patient is admitted involuntarily and/or the caregivers or custodians of institutional care are absent. The present study aimed to clinically characterize involuntary versus voluntary admissions by examining the reasons for presentation and associated factors. We retrospectively analyzed patients who presented to the emergency department of a hospital for child and adolescent psychiatry in Bavaria, Germany, and were admitted as inpatients for crisis intervention in the 4th quarter of 2014-2018. Reasons for presentation, clinical and sociodemographic characteristics, and type of admission (voluntary versus involuntary) were analyzed for 431 emergency inpatient admissions. A total of 106 (24.6%) patients were involuntarily admitted. In a binominal logistic regression, presentation due to alcohol consumption, deviant social behavior, and psychosocial burden was positively associated, whereas difficulties at school and depression were negatively associated, with the likelihood of involuntary admission. 58.5% of the 123 unaccompanied patients were admitted involuntarily. Reasons for the presentation of unaccompanied and voluntary inpatient admissions were suicidal thoughts, psychosocial burden, and externalized aggression. A substantial number of child and adolescent psychiatric admissions represent emergency admissions. Involuntarily admitted patients and unaccompanied children/adolescents represent a non-negligible proportion of clinical routine and the clinical and legal background factors need to be further clarified in future studies. This study is registered in the German Clinical Trials Register (24 September 2019, DRKS00017689).
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Affiliation(s)
- Stephanie Kandsperger
- Clinic of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Regensburg, Regensburg, Germany.
| | - Angelika Ecker
- Clinic of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Regensburg, Regensburg, Germany
| | - Daniel Schleicher
- Clinic of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Regensburg, Regensburg, Germany
| | - Michael Wirth
- Clinic of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Regensburg, Regensburg, Germany
| | - Romuald Brunner
- Clinic of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Regensburg, Regensburg, Germany
| | - Irina Jarvers
- Clinic of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Regensburg, Regensburg, Germany
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Lynch S, Becker T, Shanker P, Martin D, Staudenmaier P, Leong A, Rice T. Predictors and Correlates of Positive Urine Drug Screening in a Retrospective Cohort Analysis of Child and Adolescent Psychiatry Inpatients Throughout the COVID-19 Pandemic. Subst Use Addctn J 2024; 45:33-43. [PMID: 38258854 DOI: 10.1177/29767342231210711] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
BACKGROUND AND OBJECTIVES Youth substance use is associated with significant psychological, neurological, and medical complications. Risk factors for substance use among children and adolescents in the general population include peer and/or parental substance use, certain psychiatric illnesses (eg, Attention-Deficit/Hyperactivity Disorder, depression), and history of maltreatment. Co-occurring substance use and psychiatric illness have been associated with increased suicidality, but few prior studies have characterized substance use among child/adolescent inpatients. As such, it remains unclear how substance use contributing to acute psychiatric presentations has changed since the start of the COVID-19 pandemic. METHODS This is a retrospective cohort study of 816 unique child/adolescent psychiatry inpatients with urine drug screening (UDS) results from a diverse urban setting. Charts of patients hospitalized between June 1, 2018 and November 30, 2021 were reviewed for sociodemographic characteristics, indication for admission, psychiatric history, hospital course, treatment plan, and discharge diagnosis. Differences in sociodemographic and clinical characteristics, such as age, race, and diagnoses, between patients with and without positive UDS were explored throughout various periods of the COVID-19 pandemic. Descriptive and comparative statistics were performed, as well as a logistic regression model to identify the predictors of positive UDS. RESULTS Of the study sample, 18% had a positive UDS. Older age, diagnosis of impulsive or behavioral disorder, and a history of violence were found to be predictors of positive UDS. Asian/South Asian or Hispanic/LatinX race and history of a developmental or intellectual disability were found to be negative predictors. The frequency of positive UDS in this population did not change based on COVID-19. DISCUSSION AND CONCLUSIONS Multiple factors may predispose children and adolescents to substance use. Though no impact of COVID-19 was found in this sample, longer-term studies are needed. SCIENTIFIC SIGNIFICANCE This study identifies independent predictors of active substance use in the child and adolescent psychiatric inpatient population.
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Affiliation(s)
- Sean Lynch
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York, NY, USA
| | - Timothy Becker
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, New York, NY, USA
| | - Parul Shanker
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York, NY, USA
| | - Dalton Martin
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, Mount Sinai Morningside, New York, NY, USA
| | - Paige Staudenmaier
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York, NY, USA
| | - Alicia Leong
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Timothy Rice
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, Mount Sinai Morningside, New York, NY, USA
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Johansson BA, Holmström E, Westling S, Eberhard S, Rask O. Implementation of Brief Admission by Self-Referral in Child and Adolescent Psychiatry in Sweden: Insights from Implementers and Staff. Int J Environ Res Public Health 2023; 21:35. [PMID: 38248500 PMCID: PMC10815113 DOI: 10.3390/ijerph21010035] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 12/14/2023] [Accepted: 12/23/2023] [Indexed: 01/23/2024]
Abstract
Brief admission by self-referral, which allows patients to briefly admit themselves to a psychiatric ward, is a crisis intervention designed to reduce suicide and self-harm. This method was introduced in Sweden for adult patients in 2015, achieving high patient satisfaction and good acceptance among staff. In 2018, the method was adapted and implemented in pediatric psychiatry. The present study comprehensively describes the multifaceted strategies for implementing brief admissions, including planning, education, financing, restructuring, quality management, and policy implementation and reform. It also includes staff's opinions of the practice of brief admissions for young people. Neither of these topics has been addressed in the existing literature. During the study period (April 2018-April 2021), 63 brief admission contracts were established. The number of new contracts increased exponentially (12.7%) per quarter (p < 0.05), and staff satisfaction with both the implementation and its benefits for unstable patients was high. Brief admission by self-referral can be successfully implemented in pediatric psychiatry and appears to be a functional crisis management method for adolescents.
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Affiliation(s)
- Björn Axel Johansson
- Region Skåne, Psychiatry, Habilitation & Aid, Child and Adolescent Psychiatry, Regional Inpatient Care, Emergency Unit, 20502 Malmö, Sweden; (E.H.); (S.E.); (O.R.)
- Department of Clinical Sciences Lund, Division of Child & Adolescent Psychiatry, Lund University, 22100 Lund, Sweden
| | - Eva Holmström
- Region Skåne, Psychiatry, Habilitation & Aid, Child and Adolescent Psychiatry, Regional Inpatient Care, Emergency Unit, 20502 Malmö, Sweden; (E.H.); (S.E.); (O.R.)
| | - Sofie Westling
- Department of Clinical Sciences, Malmö, Psychiatry, Lund University, 22100 Lund, Sweden;
- Office for Psychiatry and Habilitation, Psychiatric Clinic Lund, Region Skåne, 22185 Lund, Sweden
| | - Sophia Eberhard
- Region Skåne, Psychiatry, Habilitation & Aid, Child and Adolescent Psychiatry, Regional Inpatient Care, Emergency Unit, 20502 Malmö, Sweden; (E.H.); (S.E.); (O.R.)
- Department of Clinical Sciences Lund, Division of Child & Adolescent Psychiatry, Lund University, 22100 Lund, Sweden
| | - Olof Rask
- Region Skåne, Psychiatry, Habilitation & Aid, Child and Adolescent Psychiatry, Regional Inpatient Care, Emergency Unit, 20502 Malmö, Sweden; (E.H.); (S.E.); (O.R.)
- Department of Clinical Sciences Lund, Division of Child & Adolescent Psychiatry, Lund University, 22100 Lund, Sweden
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15
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Novins DK, Carlson GA, Fadus MC, Vande Voort JL, Croarkin PE, Arnold LE. Hats Off: Journal Awards 2023. J Am Acad Child Adolesc Psychiatry 2023; 62:1382-1383. [PMID: 38035915 DOI: 10.1016/j.jaac.2023.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 08/25/2023] [Indexed: 12/02/2023]
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16
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Grundel S, Flechtner HH, Butzmann J, Benner P, Kaasch AJ. Twice weekly polymerase chain reaction (PCR) surveillance swabs are not as effective as daily antigen testing for containment of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) outbreaks: A modeling study based on real world data from a child and adolescent psychiatry clinic. Infect Control Hosp Epidemiol 2023; 44:1987-1994. [PMID: 37424231 PMCID: PMC10755159 DOI: 10.1017/ice.2023.94] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 01/26/2023] [Accepted: 04/19/2023] [Indexed: 07/11/2023]
Abstract
OBJECTIVE In the coronavirus disease 2019 (COVID-19) pandemic, child and adolescent psychiatry wards face the risk of severe acute respiratory coronavirus 2 (SARS-CoV-2) introduction and spread within the facility. In this setting, mask and vaccine mandates are hard to enforce, especially for younger children. Surveillance testing may detect infection early and enable mitigation measures to prevent viral spread. We conducted a modeling study to determine the optimal method and frequency of surveillance testing and to analyze the effect of weekly team meetings on transmission dynamics. DESIGN AND SETTING Simulation with an agent-based model reflecting ward structure, work processes, and contact networks from a real-world child and adolescent psychiatry clinic with 4 wards, 40 patients, and 72 healthcare workers. METHODS We simulated the spread of 2 SARS-CoV-2 variants over 60 days under surveillance testing with polymerase chain reaction (PCR) tests and rapid antigen tests in different scenarios. We measured the size, peak, and the duration of an outbreak. We compared medians and percentage of spillover events to other wards from 1,000 simulations for each setting. RESULTS The outbreak size, peak, and duration were dependent on test frequency, test type, SARS-CoV-2 variant, and ward connectivity. Under surveillance conditions, joint staff meetings and therapists shared between wards did not significantly change median outbreak size under surveillance conditions. With daily antigen testing, outbreaks were mostly confined to 1 ward and median outbreak sizes were lower than with twice-weekly PCR testing (1 vs 22; P < .001). CONCLUSION Modeling can help to understand transmission patterns and guide local infection control measures.
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Affiliation(s)
- Sara Grundel
- Computational Methods in Systems and Control Theory, Max Planck Institute for Dynamics of Complex Technical Systems, Magdeburg, Germany
| | - Hans-Henning Flechtner
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatic Medicine, Medical Faculty, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Jana Butzmann
- Institute of Medical Microbiology and Hospital Hygiene, Medical Faculty, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Peter Benner
- Computational Methods in Systems and Control Theory, Max Planck Institute for Dynamics of Complex Technical Systems, Magdeburg, Germany
| | - Achim J. Kaasch
- Institute of Medical Microbiology and Hospital Hygiene, Medical Faculty, Otto von Guericke University Magdeburg, Magdeburg, Germany
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17
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Vitry S, Da Silva T. [The benefits of corporal mediation in the psychic care of adolescents]. Soins Psychiatr 2023; 44:38-41. [PMID: 37926500 DOI: 10.1016/j.spsy.2023.09.012] [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] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
The actuation of the body and the bodily experience of each experience induce a continuous reshaping of the cerebral configuration of the human being, from birth to death. This ontogenetic dynamic is particularly important during adolescence. The young person's personality, still under construction, can be thrown off balance by traumatic experiences or repeated neglect. Adapted physical activity and psychomotricity, which focus on movement and the body, can help restore balance.
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18
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Böge I, Frisch S, Gretzinger C. [Does Provision of Care in Child and Adolescent Psychiatry End when Viruses Come? Hometreatment in Times of Covid-19]. Prax Kinderpsychol Kinderpsychiatr 2023; 72:625-638. [PMID: 37971697 DOI: 10.13109/prkk.2023.72.7.625] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
During the Covid-19 pandemic, provision of care in child and adolescent psychiatry was a challenge: Emergency presentations as well as psychiatric problems in children and adolescents increased, while at the same time capacity of inpatient treatment was reduced due to closed inpatient departments and staff shortage. Altogether quarantine, social distancing, testing and hygenic measures complicated daily life as well as inpatient treatment. This article describes the change in numbers of inpatient emergency admissions and prevalent mental health diagnoseses, as well as the role of hometreatment during Covid-19 pandemic. It can be demonstrated that the hometreatment team was able to operate without reduction of treatment capacities throughout the Covid-19 pandemic as long as they took care that basic hygienic measures were in place, Not one single case of Covid-19 infection was transmitted. Hometreatment proved to be an effective treatment alternative for children and adolescents with mental health problems and their families during Covid-19.
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Affiliation(s)
- Isabel Böge
- Steiermärkische Krankenanstaltengesellschaft m.b.H., LKH Graz II, Standort Süd Wagner-Jauregg-Platz 1 A-8053 Graz Österreich
| | - Sabine Frisch
- Abt. für Psychiatrie und Psychotherapie des Kindes und Jugendalters am ZfP Südwürttemberg, Ravensburg Deutschland
| | - Corinna Gretzinger
- Abteilung für Psychiatrie und Psychotherapie des Kindes und Jugendalters am ZfP Südwürttemberg, Ravensburg Deutschland
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19
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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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20
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Rutten AX, Vermeiren RRJM, Bongers IL, Van Nieuwenhuizen C. Likelihood of identifying autistic traits with the autism spectrum quotient (AQ) in male juveniles with autism spectrum disorder (ASD) and severe behavioral problems (SBPs). BMC Psychiatry 2023; 23:694. [PMID: 37749505 PMCID: PMC10521445 DOI: 10.1186/s12888-023-05200-1] [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: 05/26/2023] [Accepted: 09/18/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND When screening for autism spectrum disorders (ASD), the Autism Spectrum Quotient (AQ) is generally considered to be useful. Whether the AQ is also a suitable screener for ASD in juveniles with severe behavioral problems (SBPs) is unknown. Due to the overlap of symptoms between ASD and SBPs, particularly in juveniles low on empathy, the screening capacity of the AQ might be constrained. The aim of the present study was to investigate whether (comorbid) SBPs affect the screening capacity of the AQ. The hypothesis is that male juveniles with SBPs - but without a diagnosis of ASD - will score higher than male juveniles without both SBPs and ASD. METHOD The AQ was completed by 216 male juveniles aged 15-18 years treated at an outpatient department of child and adolescent psychiatry. The 216 participants were categorized into four groups according to a clinical diagnosis of ASD and SBPs (defined as disruptive behavior disorder and/or delinquent behavior). Using multinomial logistic regression, we investigated whether the four identified groups, based on a diagnosis of ASD and SBPs, scored differently for the total score and subscales of the AQ. RESULTS Participants in the group with ASD (ASD+) but without SBPs (SBP-) were more likely to report higher levels of autistic traits than the reference group without both ASD and SBPs (ASD-SBP-), except for the subscale on attention to detail (ASD+SBP- OR = 1.04; 95%CI = 0.98-1.11). Participants in the group with both ASD and SBPs were more likely to report higher levels for the total AQ score (ASD+SBP+ OR = 1.03; 95%CI = 1.00-1.05) and the communication subscale of the AQ (ASD+SBP+ OR = 1.18; 95%CI = 1.07-1.31) than the reference group without both ASD and SBPs. CONCLUSION In outpatient male juveniles, SBPs do not affect the screening capacity of the AQ for autistic traits. In spite of the well-known overlap of symptoms between ASD and SBPs, male juveniles with SBPs but without a diagnosis of ASD do not score higher on the AQ than male juveniles without SBPs and without a diagnosis of ASD.
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Affiliation(s)
- Alexa X Rutten
- Centre for Child and Adolescent Psychiatry, GGzE, P.O. Box 909, Eindhoven, DP, 8001, 5600 AX, The Netherlands.
- Scientific Center for Care and Wellbeing, Tilburg University, Tranzo, Tilburg, The Netherlands.
| | - Robert R J M Vermeiren
- Department of Child and Adolescent Psychiatry, LUMC-Curium, Leiden University Medical Center, Leiden, The Netherlands
- Youz, Parnassia Group, The Hague, The Netherlands
| | - Ilja L Bongers
- Centre for Child and Adolescent Psychiatry, GGzE, P.O. Box 909, Eindhoven, DP, 8001, 5600 AX, The Netherlands
- Scientific Center for Care and Wellbeing, Tilburg University, Tranzo, Tilburg, The Netherlands
| | - Chijs Van Nieuwenhuizen
- Centre for Child and Adolescent Psychiatry, GGzE, P.O. Box 909, Eindhoven, DP, 8001, 5600 AX, The Netherlands
- Scientific Center for Care and Wellbeing, Tilburg University, Tranzo, Tilburg, The Netherlands
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21
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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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22
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Englert E, Haas CR. [Practical Guideline on Dealing with Transgender Patients in Child and Adolescent Psychiatric Inpatient Settings]. Z Kinder Jugendpsychiatr Psychother 2023; 51:367-374. [PMID: 37681648 DOI: 10.1024/1422-4917/a000942] [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] [Indexed: 09/09/2023]
Abstract
Practical Guideline on Dealing with Transgender Patients in Child and Adolescent Psychiatric Inpatient Settings Abstract: The guideline provided by the Federal Association of Leading Medical Directors for Child and Adolescent Psychiatry offers a framework for dealing with transgender patients in child and adolescent psychiatric clinics. It addresses the clinical challenges arising from the significant increase in transgender patients and the paradigm shift in the medical field. The guideline includes recommendations for dealing with transgender patients in various settings. Key treatment principles comprise adopting a destigmatizing approach, using preferred names and pronouns, accommodating individual room assignments, and considering relevant comorbidities. Only experienced medical doctors and psychotherapists should carry out diagnosis and treatment. The goals for supporting adolescents with gender dysphoria include promoting self-acceptance, addressing negative emotions, facilitating social integration, and fostering identity development.
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Affiliation(s)
- Ekkehart Englert
- Klinik für Kinder- und Jugendpsychiatrie, Psychotherapie und Psychosomatik, Helios Klinikum Erfurt, Erfurt, Deutschland
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23
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Leijten P. Editorial: How Online Treatment Research Can Enrich Child and Adolescent Psychiatry. J Am Acad Child Adolesc Psychiatry 2023; 62:963-964. [PMID: 37172819 DOI: 10.1016/j.jaac.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 05/03/2023] [Indexed: 05/15/2023]
Abstract
Evidence is accumulating that treatment for psychiatric problems can in some cases be effectively delivered online.1 Online treatment does not necessarily imply less therapist support (eg, treatment can be delivered through video call), but most online treatments are at least in part self-directed. Research on online treatment therefore not only answers to calls from policy makers and clinical practice about when online treatment can safely replace or outperform in-person treatment, but also challenges assumptions on hypothesized key therapeutic principles (eg, essential common elements) and can discover new therapeutic principles.
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24
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Ryan K, Hosanagar A. Ketamine Use in Child and Adolescent Psychiatry: Emerging Data in Treatment-Resistant Depression, Insights from Adults, and Future Directions. Curr Psychiatry Rep 2023; 25:337-344. [PMID: 37389787 DOI: 10.1007/s11920-023-01432-w] [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] [Accepted: 05/30/2023] [Indexed: 07/01/2023]
Abstract
PURPOSE OF REVIEW The following review will explore ketamine's antidepressant and antisuicidal properties in adults, review of what is known about ketamine's safety in children, and summarize the limited information we have on ketamine's role in treating depression and suicidal ideation in adolescents with depression. Future directions for ketamine's role in child psychiatry based on animal and adult studies will also be explored. RECENT FINDINGS Over the past 20 years, ketamine has emerged as a novel treatment for depression and suicidal ideation in adults. In recent years, these studies have been extended to adolescents. In 2021, the first placebo-controlled trial examining ketamine's antidepressant potential in adolescents was performed, demonstrating superior efficacy over midazolam. Initial studies suggest that ketamine functions as a rapidly acting antidepressant in adolescents. Case reports suggest that ketamine may also reduce suicidal ideation in this population. However, existing studies are small, and more research is needed to solidify these findings and inform clinical practice.
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Affiliation(s)
- Kaitlyn Ryan
- Department of Psychiatry, Adolescent Partial Hospitalization Program, Trinity Health Ann Arbor Hospital, Ann Arbor, MI, USA.
| | - Avinash Hosanagar
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA
- Mental Health Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
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25
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Johansson BA, Holmström E, Eberhard S, Lindgren A, Rask O. Introducing brief admissions by self-referral in child and adolescent psychiatry: an observational cohort study in Sweden. Lancet Psychiatry 2023; 10:598-607. [PMID: 37343577 DOI: 10.1016/s2215-0366(23)00157-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 05/02/2023] [Accepted: 05/03/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND Brief admission by self-referral, a novel crisis intervention designed to reduce suicide and self-harm in adults, was adopted for adolescents in paediatric psychiatry in Malmö, Sweden, in 2018. We aimed to investigate changes in utilisation of emergency psychiatric care. METHODS We did an observational longitudinal cohort study in The University Hospital in Malmö, Sweden, which provides the only psychiatric emergency unit with 24 h psychiatric facilities in Region Skåne. Eligible patients were those aged 13-17 years who were admitted to the psychiatric facility, who had at least one emergency visit or admission during the 6 months before admission, and had prominent features of instability and self-harm, corresponding to at least three of the nine criteria for borderline personality disorder as per the DSM-5 as assessed by a paediatric psychiatrist during the admission. Patients with intellectual disabilities, psychosis, or language barriers were excluded. Patients who signed a brief admissions contract between April 1, 2018, and April 30, 2021, were eligible for inclusion in the study. A brief admissions contract allows patients to admit themselves to psychiatric emergency care for a transitory time. The primary outcome measures were the number of emergency visits, emergency admissions, inpatient days, and episodes of coercive (involuntary) care, compared at individual level before and after signing the brief admissions contract until end of follow-up. The number of visits and days were modelled using random-effects Poisson regression models, and the relative changes in the expected numbers of days per time unit were reported as rate ratios (RRs). FINDINGS Of the 928 patients admitted to the psychiatric facility between April 1, 2018, and April 30, 2021, 60 were excluded, and a further 801 did not meet the inclusion criteria for age, previous emergency visits, or having at least three of the nine criteria of borderline personality disorder. 67 patients were eligible for inclusion, but four patients did not sign a contract. 63 patients were included in the study, including 60 females (95%) and three (5%) males, with a mean age of 14·8 years (SD 1·7). Ethnicity data were not collected. Patients were followed up for a median of 13·5 months (IQR 9·2 -19·6). After signing the contract, there was a decrease in the number of emergency visits (RR 0·22 [95% CI 0·15-0·32]; p<0·0001), emergency admissions (RR 0·26 [0·19-0·35]; p<0·0001), inpatient days (RR 0·29 [0·26-0·32]; p<0·0001), and inpatient days including brief admissions (RR 0·44 [95% CI 0·40-0·48]; p<0·0001). Episodes of coercive care did not change significantly (RR 0·99 [95% CI 0·40-2·43]; p=0·98). Psychiatric evaluation due to persistent suicidal ideations immediately after discharge was required for five patients. INTERPRETATION Our findings suggest that brief admissions can be successfully implemented in paediatric psychiatry and appear to be an effective crisis management method for adolescents, associated with reduced demand for emergency care. Future randomised controlled trials are warranted. FUNDING Region Skåne Health Care Authority.
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Affiliation(s)
- Björn Axel Johansson
- Region Skåne, Psychiatry, Habilitation & Aid, Child and Adolescent Psychiatry, Regional Inpatient Care, Emergency Unit, Malmö, Sweden; Department of Clinical Sciences Lund, Division of Child & Adolescent Psychiatry, Lund University, Lund, Sweden.
| | - Eva Holmström
- Region Skåne, Psychiatry, Habilitation & Aid, Child and Adolescent Psychiatry, Regional Inpatient Care, Emergency Unit, Malmö, Sweden
| | - Sophia Eberhard
- Region Skåne, Psychiatry, Habilitation & Aid, Child and Adolescent Psychiatry, Regional Inpatient Care, Emergency Unit, Malmö, Sweden; Department of Clinical Sciences Lund, Division of Child & Adolescent Psychiatry, Lund University, Lund, Sweden
| | - Anna Lindgren
- Department of Mathematical Statistics, Centre for Mathematical Sciences, Lund University, Lund, Sweden
| | - Olof Rask
- Region Skåne, Psychiatry, Habilitation & Aid, Child and Adolescent Psychiatry, Regional Inpatient Care, Emergency Unit, Malmö, Sweden; Department of Clinical Sciences Lund, Division of Child & Adolescent Psychiatry, Lund University, Lund, Sweden
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26
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Schreiber J, Richards MC. Adventures in Fortnite: Selections From Connect Corner. J Am Acad Child Adolesc Psychiatry 2023; 62:831. [PMID: 37030422 PMCID: PMC10162506 DOI: 10.1016/j.jaac.2023.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 03/30/2023] [Indexed: 04/10/2023]
Abstract
JAACAP Connect, our developmental journal, began publishing in 2014 to support "the development of writing and editing skills among members of the American Academy of Child and Adolescent Psychiatry." JAACAP Connect "is dedicated to engaging trainees and practitioners in the process of continuous and applied career learning through readership, authorship, and publication experiences that emphasize translation of research findings into the day-to-day clinical practice of child and adolescent psychiatry." Over the past 8 years, dozens of new or early career authors have worked closely with JAACAP Connect editors to develop manuscripts into published articles.
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Weisbrot DM, Carlson GA, Ettinger AB, Reed ML, Fanning KM, Bostic RC. Psychiatric Characteristics of Students Who Make Threats Toward Others at School. J Am Acad Child Adolesc Psychiatry 2023; 62:764-776. [PMID: 36608740 DOI: 10.1016/j.jaac.2022.12.016] [Citation(s) in RCA: 2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 10/04/2022] [Accepted: 12/27/2022] [Indexed: 01/04/2023]
Abstract
OBJECTIVE While studies have focused on identifying potential school shooters, little is known about the mental health and other characteristics of students who make threats. This study aimed to describe these students and factors prompting psychiatric interventions and treatment recommendations. METHOD Child and adolescent psychiatry threat assessment evaluations of 157 consecutive school-referred youths in grades K-12 between 1998 and 2019 were reviewed for demographics, reasons for referral, nature of threat, psychiatric diagnosis, and psychiatric and educational recommendations. Predictors of recommendations for psychiatric interventions were modeled using multivariable logistic regression as a function of above-mentioned covariates. RESULTS Mean (SD) age of referred students was 13.37 (2.79) years; 88.5% were male; 79.7%, White; 11.6%, Hispanic; 10.1%, Black; 2.5%, Asian. Of students, 51.6% were receiving special education services. Verbal threat was made by 80%, and 29.3% brought a weapon to school. History included being bullied in 43.4%, traumatic family events in 52.2%, physical abuse in 5.1%, sexual abuse in 5.7%, and verbal abuse in 36.3%. Frequently encountered psychiatric diagnoses were attention-deficit/hyperactivity, learning, depressive, anxiety, and autism spectrum disorders, usually in combinations. History of medication treatment was reported in 79 (50.3%) and psychotherapeutic interventions in 57 (36.3%). Recommendations to return the student to their prior schools were made for 63.1%. Recommendations for psychotherapy were made for 79.9%, medication for 88.5%, and both for 70.1%. Therapeutic school setting or psychiatric hospitalization was more likely recommended (with statistical significance) with a prior threat history (odds ratio [OR] 5.47, 95% CI 1.91-15.70), paranoid symptoms (OR 5.72, 95% CI 1.55-21.14, p = .009), autism spectrum disorders (OR 3.45, 95% CI 1.32-9.00), mood disorder (OR 5.71, 95% CI 1.36-23.96), personality disorder (OR 9.47, 95% CI 1.78-50.55), or with psychotherapy recommendation (OR 4.84, 95% CI 1.08-21.75). CONCLUSION Students who make threats have diverse psychiatric profiles and warrant treatments. A trauma and/or abuse history is common. Evaluations of youths who make threats need to go beyond simply assessing the threat itself and should include identifying underlying psychiatric problems. Psychiatric evaluation of students who issue threats of any type can lead to revelations about psychiatric diagnoses and crucial treatment and educational recommendations. DIVERSITY & INCLUSION STATEMENT The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.
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Affiliation(s)
| | | | - Alan B Ettinger
- United Medical Monitoring and United Diagnostics, Garden City Park, New York
| | | | | | - Ryan C Bostic
- MIST Research and Statistical Consulting, Wilmington, Delaware
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Daniels TE, Victor C, Smith EM, Belgrave C, Robinson E, Wolff JC, Hunt J, Brannan EH. Associations of Restraint and Seclusion With Race and Ethnicity on an Adolescent Inpatient Psychiatry Service. J Am Acad Child Adolesc Psychiatry 2023; 62:503-506. [PMID: 36736689 PMCID: PMC10543036 DOI: 10.1016/j.jaac.2022.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 09/30/2022] [Accepted: 01/24/2023] [Indexed: 02/01/2023]
Abstract
There is limited work examining the association of race and ethnicity with restraint and seclusion (R/S) in pediatric inpatient psychiatric units. The present study assessed risk of R/S by race and ethnicity based on a retrospective review of electronic medical records (EMRs) from an adolescent inpatient psychiatric service. Demographic, diagnostic, and R/S data were analyzed for all 1,865 admissions of 1,327 patients from an adolescent unit at a child and adolescent psychiatric hospital from June 2018 to June 2021. R/S occurred in 459 of the admissions. For the purpose of patient privacy and statistical analysis, race was grouped into the following: Black or African American, other (American Indian or Alaskan Native, Asian, multiracial, other), and White. Patients identified as unknown were not included in the analysis. A binary logistic regression with a repeated subject effect regressed R/S onto race and adjusted for age, gender, and length of stay (LOS). There was an overall significant association of R/S and race (χ22 = 16.81, p < .001), but not ethnicity. In a regression model adjusted for age, gender, and LOS, patients identified as Black or African American were at significantly higher risk of R/S compared with patients identified as White (odds ratio = 1.66, p = .036). There was no significant difference in risk of R/S between patients identified as White vs other. Younger age and longer LOS were also significantly associated with R/S. These findings highlight a critical health care disparity related to race on an inpatient adolescent psychiatry service. There is likely a combination of individual and systemic factors leading to discriminatory practices in the use of R/S. Future work will assess potential associations with diagnosis and child welfare involvement and will examine additional characteristics of R/S. Focus groups held with hospital and community stakeholders will guide next steps to address these findings.
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Affiliation(s)
- Teresa E Daniels
- Warren Alpert Medical School, Brown University, Providence, Rhode Island; Initiative on Stress, Trauma, and Resilience (STAR), Warren Alpert Medical School, Brown University, Providence, Rhode Island.
| | - Colleen Victor
- Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Eric M Smith
- Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Christa Belgrave
- Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Erica Robinson
- Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Jennifer C Wolff
- Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Jeffrey Hunt
- Warren Alpert Medical School, Brown University, Providence, Rhode Island
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Weinberg D, Stevens GWJM, Peeters M, Visser K, Tigchelaar J, Finkenauer C. The social gradient in adolescent mental health: mediated or moderated by belief in a just world? Eur Child Adolesc Psychiatry 2023; 32:773-782. [PMID: 34750712 PMCID: PMC10147736 DOI: 10.1007/s00787-021-01905-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 10/29/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE A social gradient in adolescent mental health exists: adolescents with higher socioeconomic status (SES) have fewer mental health problems than their peers with lower SES. Little is known about whether adolescents' societal beliefs play a role in this social gradient. Belief in a just world (BJW) may be a mediator or moderator of the social gradient in adolescent mental health. METHODS Using data from 848 adolescents (Mage = 17) in the Netherlands, path analyses examined whether two indicators of BJW (general and personal) mediated or moderated the associations between two indicators of SES (family affluence and perceived family wealth), and four indicators of adolescent mental health problems (emotional symptoms, conduct problems, hyperactivity, and peer problems). RESULTS Adolescents with lower family affluence and lower perceived family wealth reported more emotional symptoms, and the association between perceived family wealth and emotional symptoms was mediated by lower personal and general BJW. Furthermore, higher personal BJW amplified the negative association between SES and peer problems. CONCLUSION This study suggests BJW may both mediate and amplify the social gradient in adolescent mental health. Adolescents' beliefs about society may be important to include in research aimed at understanding this social gradient.
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Affiliation(s)
- Dominic Weinberg
- Department of Interdisciplinary Social Science, Faculty of Social and Behavioural Sciences, Utrecht University, Padualaan 14, 3584 CH, Utrecht, The Netherlands.
| | - Gonneke W J M Stevens
- Department of Interdisciplinary Social Science, Faculty of Social and Behavioural Sciences, Utrecht University, Padualaan 14, 3584 CH, Utrecht, The Netherlands
| | - Margot Peeters
- Department of Interdisciplinary Social Science, Faculty of Social and Behavioural Sciences, Utrecht University, Padualaan 14, 3584 CH, Utrecht, The Netherlands
| | - Kirsten Visser
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Utrecht, The Netherlands
| | - Jet Tigchelaar
- Department of Law, Faculty of Law, Economics and Governance, Utrecht University, Utrecht, The Netherlands
| | - Catrin Finkenauer
- Department of Interdisciplinary Social Science, Faculty of Social and Behavioural Sciences, Utrecht University, Padualaan 14, 3584 CH, Utrecht, The Netherlands
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30
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Stellungnahme der DGKJP und der BAG KJPP zur geplanten Krankenhausreform bezogen auf die Kinder- und Jugendpsychiatrie und Psychotherapie. Z Kinder Jugendpsychiatr Psychother 2023; 51:252-258. [PMID: 37194633 DOI: 10.1024/1422-4917/a000932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
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31
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Remschmidt H. [Not Available]. Z Kinder Jugendpsychiatr Psychother 2023; 51:169-170. [PMID: 36897301 DOI: 10.1024/1422-4917/a000921] [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] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Affiliation(s)
- Helmut Remschmidt
- Klinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Universität Marburg, Deutschland
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32
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Affiliation(s)
- Luisa Lázaro
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic of Barcelona, C/Villarroel 170, 08036, Barcelona, Spain.
- CIBERSAM, IDIBAPS, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
- Asociación Española de Psiquiatría del Niño y del Adolescente AEPNyA, Madrid, Spain.
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33
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Geschäftsstelle der DGKJP, Aktion Psychisch Kranke e. V. Einsatz und Finanzierung von Sprachmittler_innen in der Kinder- und Jugendpsychiatrie und Psychotherapie. Z Kinder Jugendpsychiatr Psychother 2023; 51:174-5. [PMID: 36897302 DOI: 10.1024/1422-4917/a000922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
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34
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Fegert JM, Deetjen U. [Not Available]. Z Kinder Jugendpsychiatr Psychother 2023; 51:89-91. [PMID: 36897297 DOI: 10.1024/1422-4917/a000925] [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] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Affiliation(s)
- Jörg M Fegert
- Klinik für Kinder- und Jugendpsychiatrie, Psychotherapie, Universitätsklinikum Ulm, Deutschland
- Kompetenznetz Präventionsmedizin Baden-Württemberg, Deutschland
| | - Ulrike Deetjen
- McKinsey & Company, Deutschland
- McKinsey Health Institute, Deutschland
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35
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Tonyali A, Karacetin G, Yesilkaya C, Arik FNT, Kayan Ocakoglu B. Appearance of extrapyramidal symptoms in adolescent psychiatry patients during COVID-19 infection. J Med Virol 2023; 95:e28556. [PMID: 36738231 DOI: 10.1002/jmv.28556] [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] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 01/08/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023]
Abstract
Since the start of the pandemic, there has been an increase in the incidence of psychiatric morbidity among those infected with coronavirus disease 2019 (COVID-19) and those indirectly affected by COVID-19. There has been a considerable increase in the number of individuals with such psychiatric conditions as depression, acute stress disorders, anxiety, and posttraumatic stress disorder (PTSD). About one-third of patients with COVID-19 are reported to have developed short and long-term neuropsychiatric conditions such as delirium, agitation, altered consciousness, hypoxic encephalopathy encephalitis, dysexecutive syndrome, cerebrovascular complications (e.g., stroke), hypoxic encephalopathy, convulsions, neuromuscular dysfunction, demyelinating processes, or parkinsonism through several pathophysiological mechanisms. Nevertheless, as the pandemic progressed, data on neuropsychiatric manifestations implied that the pathologic capacity of COVID-19 and its association with the onset and/or exacerbation of psychiatric morbidity indicate that COVID-19 is potentially related to neuropsychiatric involvement. Patients with existing mental disorders under psychotropic treatment exposed to the COVID-19 infection have been represented by an increased risk of worsened psychiatric symptoms and expanded drug side effects. The present study aimed to describe five pediatric patients with various psychiatric illness that experienced COVID-19 infection and had potentially associated neuropsychiatric involvement, such as exacerbation of underlying psychiatric symptoms and extrapyramidal side effects. To the best of our knowledge, the present study is the first to describe adolescents with COVID-19 infection that presented with a series of manifestations in the form of an increase in extrapyramidal symptoms (EPS) during exacerbation of underlying psychiatric disease.
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Affiliation(s)
- Aysegul Tonyali
- Istanbul Bakırköy Prof. Dr. Mazhar Osman Training and Research Hospital, Istanbul, Turkey
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36
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Robin M, Schupak T, Bonnardel L, Polge C, Couture MB, Bellone L, Shadili G, Essadek A, Corcos M. Clinical Stakes of Sexual Abuse in Adolescent Psychiatry. Int J Environ Res Public Health 2023; 20:1071. [PMID: 36673831 PMCID: PMC9858972 DOI: 10.3390/ijerph20021071] [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] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 12/30/2022] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND The extent and nature of sexual abuse (SA) and its consequences in psychiatry are still poorly described in adolescence. OBJECTIVE This article describes the frequency of SA reported in an adolescent population hospitalized in psychiatry, and assesses its links with the severity of mental disorders and the medical issues of these adolescents. METHODS The study includes 100 patients for whom SA has been mentioned, among all patients aged 13 to 17 years old hospitalized for about 4 years. The characteristics of sexual abuse were correlated with the medical severity of the patients, as well as the number, the duration of their hospitalization(s), and the time until disclosure. RESULTS The results show the central place of SA in adolescent psychiatry, with a prevalence of 28.5% and a cumulative hospital stay which is five times longer than average. Correlations have been observed between the number of suicide attempts and the number of abuses reported. The medical severity of patients is significantly increased when the named aggressor is an adult. The number of hospitalizations is positively correlated with the number of reported abuses, as well as with the intrafamilial and adult status of the perpetrator. Finally, an early age of onset, repeated abuse, and the intrafamilial nature of the abuse are associated with a longer time to disclosure. CONCLUSIONS The severity of adolescent psychiatric situation is statistically in favor of a history of SA, which should therefore be actively explored during care.
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Affiliation(s)
- Marion Robin
- Département de Psychiatrie de L’adolescent et du Jeune Adulte, Institut Mutualiste Montsouris, 75014 Paris, France
- Centre de Recherche en Epidémiologie et Santé des Populations, INSERM U1178, Team PsyDev, 94807 Villejuif, France
| | - Thomas Schupak
- Département de Psychiatrie de L’adolescent et du Jeune Adulte, Institut Mutualiste Montsouris, 75014 Paris, France
| | - Lucile Bonnardel
- Département de Psychiatrie de L’adolescent et du Jeune Adulte, Institut Mutualiste Montsouris, 75014 Paris, France
| | - Corinne Polge
- Département de Psychiatrie de L’adolescent et du Jeune Adulte, Institut Mutualiste Montsouris, 75014 Paris, France
| | - Marie-Bernard Couture
- Département de Psychiatrie de L’adolescent et du Jeune Adulte, Institut Mutualiste Montsouris, 75014 Paris, France
| | - Laura Bellone
- Département de Psychiatrie de L’adolescent et du Jeune Adulte, Institut Mutualiste Montsouris, 75014 Paris, France
| | - Gérard Shadili
- Département de Psychiatrie de L’adolescent et du Jeune Adulte, Institut Mutualiste Montsouris, 75014 Paris, France
- Centre de Soins, d’Accompagnement et de Prévention en Addictologie, Émergence Espace Tolbiac, 75013 Paris, France
| | - Aziz Essadek
- Laboratoire Interpsy, Université de Lorraine, 54015 Nancy, France
| | - Maurice Corcos
- Département de Psychiatrie de L’adolescent et du Jeune Adulte, Institut Mutualiste Montsouris, 75014 Paris, France
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Açıkel SB, Artık A. THE ASSOCIATION BETWEEN ALTMETRIC, PLUMX METRICS AND CITATION COUNT OF PUBLICATIONS: A CROSS-SECTIONAL STUDY AMONG TOP CHILD AND ADOLESCENT PSYCHIATRY JOURNALS. Psychiatr Danub 2023; 35:220-225. [PMID: 37480309 DOI: 10.24869/psyd.2023.220] [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] [Indexed: 07/24/2023]
Abstract
BACKGROUND Altmetric Attention Score (AAS) and PlumX Metrics are becoming important to evaluate the impact of the publication in addition to classical scientific rating method such as citation count and impact factor. These metrics collect data about publications' tweet count, Facebook interaction count and other social interactions. In this study, it is aimed to examine the association between AAS, PlumX Metrics and citation count of top child and adolescent psychiatry. METHODS We identified the five journals and retrospectively analysed the publications published in 2019. All the original research articles, met analysis, and reviews were analysed. The articles were divided into two groups as original articles/research articles and meta-analysis/systematic review. We have hypothesized that there could be a positive correlation between AAS and PlumX Metrics data and citation count among these journals and there could be a difference between AAS, PlumX scores and citation count between original articles/research articles and meta-analysis/systematic review as their reading potential is different. RESULTS We have found a significant positive correlation between citation count, AAS and PlumX Metrics. This association continued after controlling the journal impact factor. In linear regression analysis, type of publication, total count of tweets, and Mendeley reads predicted the citation count. CONCLUSION In addition to the classical methods measuring the quality of the articles such as the total citation count and impact factor, the importance of AAS and PlumX Metrics has been increasing. It is important to share scientific publications on these platforms in order to increase the impact of the articles.
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Affiliation(s)
- Sadettin Burak Açıkel
- MD, Department of Child and Adolescent Psychiatry, Ankara University Faculty of Medicine, Ankara, TURKEY
| | - Abdulbaki Artık
- MD, Department of Child and Adolescent Psychiatry, University of Health Sciences Turkey, Gülhane Training and Research Hospital, Ankara, TURKEY
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Thun-Hohenstein L, Karwautz A. Versorgungssituation der Kinder- und Jugendpsychiatrie in Österreich – Stand 2022. Neuropsychiatr 2022; 36:149-150. [PMID: 36469295 DOI: 10.1007/s40211-022-00440-1] [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] [Accepted: 10/13/2022] [Indexed: 12/11/2022]
Affiliation(s)
- Leonhard Thun-Hohenstein
- Universitätsklinik für Kinder- und Jugendpsychiatrie, Paracelsus Medizinische Privatuniversität, Ignaz Harrerstraße 79, 5020, Salzburg, Österreich
| | - Andreas Karwautz
- Universitätsklinik für Kinder- und Jugendpsychiatrie, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich.
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Abstract
BACKGROUND AND RESEARCH QUESTION This article presents and analyses the landscape for inpatient child and adolescent psychiatric care in Austria and examines current data from June 2022. METHOD In June 2022, the authors surveyed the current status of child and adolescent psychiatric primary care in Austria. Both systemised beds and day hospital beds as well as the number of specialists and assistant doctors were taken into account. RESULTS A bed index of 0.05 beds/1000 inhabitants (as of 6/2022) was calculated, which is below the guideline for beds needed and does not correspond with the need depicted for sufficient provision of care ("Österreichischer Strukturplan Gesundheit"). Moreover, in June 2022, 40 beds had to be closed due to staff shortages and 26.5 training positions were vacant across Austria. DISCUSSION AND CONCLUSIONS Even though the training ratio was raised to 1:2 as of 07.02.2022 within the framework of the "Mangelfachverordnung" for a limited period of time until 31.05.2027, it is hardly possible to guarantee sufficient mental health care according to the increased demand for child and adolescent psychiatry, especially in times of the pandemic. Measures need to be urgently taken to improve child and adolescent psychiatric treatment options. In order to ensure adequate care for the increasing number of mentally ill children and adolescents (a) the number of beds must be increased, (b) structural deficits have to improve, and (c) innovative treatment options in the sense of inpatient-equivalent treatment (home treatment) has to be considered.
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Affiliation(s)
- Kathrin Sevecke
- Medizinische Universität Innsbruck, Christoph-Probst-Platz, Innrain 52, 6020, Innsbruck, Österreich.
- Abteilung für Kinder- und Jugendpsychiatrie, Psychotherapie und Psychosomatik, Tirol Kliniken, Milser Straße 10, 6060, Hall i. T., Österreich.
| | - Anna Wenter
- Medizinische Universität Innsbruck, Christoph-Probst-Platz, Innrain 52, 6020, Innsbruck, Österreich
- Institut für Psychologie, Fakultät für Psychologie und Sportwissenschaft, Leopold-Franzens-Universität Innsbruck, Universitätsstraße 5-7, 6020, Innsbruck, Österreich
| | - Isabel Böge
- Universitätsklinikum Graz, Auenbruggerplatz 1, 8036, Graz, Österreich
- Abteilung für Kinder- und Jugendpsychiatrie und Psychotherapie, LKH II, Wagner-Jauregg Platz 1, 8053, Graz, Österreich
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DeJong SM, Brooks D, Khan S, Reaves S, Busch B, Alicata D, Ramtekkar U, Vo LC, Pruitt D. The Impact of COVID-19 on Pediatric Telepsychiatry Training in Child and Adolescent Psychiatry Fellowships. Acad Psychiatry 2022; 46:740-745. [PMID: 34855156 PMCID: PMC8638234 DOI: 10.1007/s40596-021-01563-3] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 11/02/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE This report summarizes findings from a 2020 survey of US child and adolescent psychiatry training programs that explored the impact of the COVID-19 pandemic on pediatric telepsychiatry training. The authors hypothesized that telepsychiatry training significantly increased during the pandemic, in part due to legal and regulatory waivers during the COVID-19 public health emergency. METHODS In August 2020, an anonymous, 28-question online survey was emailed to all (138) accredited child psychiatry fellowships on the Accreditation Council for Graduate Medical Education website. Forty-nine programs responded (36%). This analysis focuses on three of the 28 questions relevant to the hypotheses: characteristics of the program's training in telepsychiatry; perceived impediments to clinical training; and perceived impediments to didactic training pre-COVID onset vs. post-COVID onset, respectively. Total scores were created to investigate differences in training programs and impediments to including telepsychiatry pre- and post-COVID onset. Paired sample t-tests were used to compare means pre- and post-COVID onset. RESULTS Results provided support for significant differences between training components related to telepsychiatry pre- and post-COVID onset, with participants reporting more training components post-COVID onset (M = 5.69) than pre-COVID onset (M = 1.80); t(48) = 9.33, p < .001. Participants also reported significantly fewer barriers to providing clinical experiences in pediatric telepsychiatry post-COVID onset (M = 2.65) than pre-COVID onset (M = 4.90); t(48) = - 4.20, p < .001. CONCLUSIONS During the COVID-19 pandemic, pediatric telepsychiatry training in child psychiatry fellowships increased significantly. Perceived barriers to providing clinical, but not didactic, training decreased significantly.
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Affiliation(s)
- Sandra M DeJong
- Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, USA.
| | - Deborah Brooks
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - Shabana Khan
- New York University (NYU) Grossman School of Medicine, New York, NY, USA
| | - Samantha Reaves
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - Bianca Busch
- Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Dan Alicata
- University of Hawaii at Manoa, John A. Burns School of Medicine, Honolulu, HI, USA
| | - Ujjwal Ramtekkar
- Nationwide Children's Hospital, The Ohio State University, Columbus, OH, USA
| | - Lan Chi Vo
- Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - David Pruitt
- University of Maryland School of Medicine, Baltimore, MD, USA
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Grassl R, Marte E. [Undersupply of child and adolescent psychiatric outpatient clinics in Austria that can meet minimum requirements]. Neuropsychiatr 2022; 36:165-172. [PMID: 36418738 DOI: 10.1007/s40211-022-00445-w] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 10/19/2022] [Indexed: 06/16/2023]
Abstract
This article is intended to provide an overview of the supply situation with independent outpatient clinics and dislocated Hospital ambulances for Child and Adolescent Psychiatry, taking into account minimum professional standards. The level of care, the mandate to provide care, requirements, structural quality criteria and implementation recommendations are described. 13 outpatient clinics and dislocated Hospital ambulances are described in a data matrix.A comprehensive Austria-wide survey of the staffing and care offerings identified 13 outpatient clinics and outpatient clinics that meet minimum standards. This proves a difference between the current situation and the number of outpatient clinics required nationwide of 26 to 36 (depending on the assessment 1/350k or 1/250k)Thus, the findings provided here, lead us to the conclusion that the patient care in Austria's child and adolescent psychiatric outpatient clinics is not sufficiently guaranteed due to the largely tolerated but technically incorrect interpretation of the legally valid minimum standards.If the current deficiencies are retained, a central child and adolescent psychiatric care level remains with an effectiveness of less than 50% of the Austrian health structure plan (OSG).
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Affiliation(s)
- Roland Grassl
- Soziale Dienste Burgenland Ges.m.b.H, Am Kurplatz 5, 7431, Bad Tatzmannsdorf, Österreich.
| | - Elisabeth Marte
- Ambulatorium "Am Ball", PVBZ Land Salzburg, Gailenbachweg 3, 5020, Salzburg, Österreich
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Sevecke K, Wenter A, Haid-Stecher N, Fuchs M, Böge I. [A three-country comparison of mental health and treatment options of children and adolescents with mental health problems in times after the COVID-19 pandemic]. Neuropsychiatr 2022; 36:192-201. [PMID: 36352338 PMCID: PMC9645753 DOI: 10.1007/s40211-022-00438-9] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 10/06/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND AND RESEARCH QUESTION The Austrian Society for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy (ÖGKJP) is publishing a series of articles in a special issue of Neuropsychiatrie dealing with the current provision of care in child and adolescent psychiatry. Aim of this article is to give an overview of provision of care for children and adolescents with mental health problems in Austria, Germany, and Switzerland and then draw conclusions for the Austrian child and adolescent psychiatric care landscape. METHOD First, epidemiologic data as well as different traditions and treatment philosophies and their effect for provision of care in child and adolescent psychiatry in Austria, Germany and Switzerland are presented. Subsequently, data of provided child and adolescent psychiatric care in Austria and Germany are presented and related to each other. RESULTS AND CONCLUSIONS On the basis of the data presented, the current deterioration of mental health in children and adolescents due to the pandemic as well as the deficit of available inpatient beds (0.03-0.09) there is an urgent need for action in Austrian provision of child and adolescent psychiatric care. An improvement of the structural deficits in the child and adolescent psychiatric research and care landscape, a significant increase of capacities for inpatient treatment, day-care as well as outpatient treatment with establishment of modern treatment options such as home treatment is necessary.
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Affiliation(s)
- Kathrin Sevecke
- Abteilung für Kinder- und Jugendpsychiatrie, Psychotherapie und Psychosomatik, Tirol Kliniken, Milser Straße 10, 6060, Hall i. T., Österreich.
- Medizinische Universität Innsbruck, Christoph-Probst-Platz 1, 6020, Innsbruck, Österreich.
| | - Anna Wenter
- Medizinische Universität Innsbruck, Christoph-Probst-Platz 1, 6020, Innsbruck, Österreich
| | - Nina Haid-Stecher
- Abteilung für Kinder- und Jugendpsychiatrie, Psychotherapie und Psychosomatik, Tirol Kliniken, Milser Straße 10, 6060, Hall i. T., Österreich
| | - Martin Fuchs
- Abteilung für Kinder- und Jugendpsychiatrie, Psychotherapie und Psychosomatik, Tirol Kliniken, Milser Straße 10, 6060, Hall i. T., Österreich
- Medizinische Universität Innsbruck, Christoph-Probst-Platz 1, 6020, Innsbruck, Österreich
| | - Isabel Böge
- Universitätsklinikum Graz, Auenbruggerplatz 1, 8036, Graz, Österreich
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Bezborodovs Ņ, Kočāne A, Rancāns E, Villeruša A. Clinical Utility of the Parent-Report Version of the Strengths and Difficulties Questionnaire (SDQ) in Latvian Child and Adolescent Psychiatry Practice. Medicina (B Aires) 2022; 58:medicina58111599. [PMID: 36363556 PMCID: PMC9694199 DOI: 10.3390/medicina58111599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/26/2022] [Accepted: 11/01/2022] [Indexed: 11/06/2022] Open
Abstract
Background and Objectives: Screening instruments can be crucial in child and adolescent mental healthcare practice by allowing professionals to triage the patient flow in a limited resource setting and help in clinical decision making. Our study aimed to examine whether the Strengths and Difficulties Questionnaire (SDQ), with the application of the original UK-based scoring algorithm, can reliably detect children and adolescents with different mental disorders in a clinical population sample. Materials and Methods: a total of 363 outpatients aged 2 to 17 years from two outpatient child psychiatry centres in Latvia were screened with the parent-report version of the SDQ and assigned clinical psychiatric diagnoses. The ability of the SDQ to predict the clinical diagnosis in major diagnostic groups (emotional, conduct, hyperactivity, and developmental disorders) was assessed. Results: The subscales of the parent-report SDQ showed a significant correlation with the corresponding clinical diagnoses. The sensitivity of the SDQ ranged 65–78%, and the specificity was 57–78%. The discriminative ability of the SDQ, as measured by the diagnostic odds ratio, did not quite reach the level of clinical utility in specialised psychiatric settings. Conclusions: We suggest the SDQ be used in primary healthcare settings, where it can be an essential tool to help family physicians recognise children needing further specialised psychiatric evaluation. There is a need to assess the psychometric properties and validate the SDQ in a larger populational sample in Latvia, determine the population-specific cut-off scores, and reassess the performance of the scale in primary healthcare practice.
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Affiliation(s)
- Ņikita Bezborodovs
- Department of Psychiatry and Narcology, Rīga Stradiņš University, LV-1007 Riga, Latvia
- Child Psychiatry Clinic, Children’s Clinical University Hospital, LV-1004 Riga, Latvia
- Correspondence: ; Tel.: +371-28343256
| | - Arta Kočāne
- Child Psychiatry Clinic, Children’s Clinical University Hospital, LV-1004 Riga, Latvia
| | - Elmārs Rancāns
- Department of Psychiatry and Narcology, Rīga Stradiņš University, LV-1007 Riga, Latvia
| | - Anita Villeruša
- Department of Public Health and Epidemiology, Rīga Stradiņš University, LV-1007 Riga, Latvia
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Patel K, Bansal E, Hassan Y, Kim S, Zaidi A, Rice T. Enriching Medical Students' Attitudes About Child and Adolescent Psychiatry Through Viewing of "Starless Dreams" in a Cross-Cultural Seminar on Adverse Childhood Experiences. Acad Psychiatry 2022; 46:640-643. [PMID: 35174456 PMCID: PMC8853425 DOI: 10.1007/s40596-022-01586-4] [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] [Received: 05/14/2021] [Accepted: 01/06/2022] [Indexed: 06/14/2023]
Affiliation(s)
- Krishna Patel
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Esha Bansal
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Yonis Hassan
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Susan Kim
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Arifa Zaidi
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Timothy Rice
- Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Hertz-Palmor N, Gothelf D. The importance of measuring quality of life as a treatment outcome in child and adolescent psychiatry. Eur Child Adolesc Psychiatry 2022; 31:1331-1335. [PMID: 35927527 DOI: 10.1007/s00787-022-02058-8] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Nimrod Hertz-Palmor
- The Child and Adolescent Psychiatry Division, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashmoer, 5262000, Ramat Gan, Israel
- School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel
| | - Doron Gothelf
- The Child and Adolescent Psychiatry Division, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashmoer, 5262000, Ramat Gan, Israel.
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
- Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel.
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Abstract
Child and adolescent psychiatry has an opportunity to adapt alongside the advancements in medical knowledge, post-graduate training, epidemiological realities and clinical service models. Here, we are guided by the mental health needs of our community's young and their families in our review of child and adolescent psychiatry training in Australia and New Zealand. We recognise that training must respond to clinical demand and service reform while ensuring a range of clinical and educational experiences to deliver expectable competencies in order to produce child and adolescent psychiatrists that meet the communities' needs now and in the future. We argue that training programmes be subject to rigorous evaluation by embedding continuing cycles of improvement including regular review and international bench marking.
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Affiliation(s)
- Iain E Perkes
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Kensington, NSW, Australia
- School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Kensington, NSW, Australia
- Department of Psychological Medicine, Sydney Children's Hospital Network, Randwick, NSW, Australia
| | - Matthew Eggleston
- Child, Adolescent and Family Service, Canterbury District Health Board, Christchurch, New Zealand
| | - Brian Jacobs
- The Department of Child and Adolescent Psychiatry, South London and Maudsley National Health Service Foundation Trust, London, UK
- The Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, London, UK
| | - Prue McEvoy
- Department of Child Protection, Government of South Australia, Adelaide, SA, Australia
- Department of Child Protection, Adelaide, SA, Australia
| | - Daniel Fung
- Department of Developmental Psychiatry, Institute of Mental Health, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- DUKE NUS Medical School, National University of Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Paul G Robertson
- Mindful, Department of Psychiatry, The University of Melbourne, Travancore, VIC, Australia
- Eastern Health Child and Youth Mental Health Service, Eastern Health, Melbourne, VIC, Australia
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47
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Shoemaker EZ, Brenner AM. Making More Child and Adolescent Psychiatrists: Responding to the National Emergency in Mental Health in Children and Adolescents. Acad Psychiatry 2022; 46:1-5. [PMID: 35169971 PMCID: PMC8852975 DOI: 10.1007/s40596-022-01597-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
| | - Adam M Brenner
- University of Texas Southwestern Medical Center, Dallas, TX, USA
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48
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Williamson E, Shoemaker E, Kim A, Joshi S, Lewis AL, Vandekar S, Zalpuri I, Kerlek A. Child and Adolescent Psychiatry Fellowship Program Participation in the National Resident Matching Program Match: Trends and Implications for Recruitment. Acad Psychiatry 2022; 46:25-30. [PMID: 34854071 DOI: 10.1007/s40596-021-01546-4] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 09/29/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Recruitment is one of the most important missions for the Child and Adolescent Psychiatry (CAP) Caucus of the American Association of Directors of Psychiatric Residency Training, the American Academy of Child and Adolescent Psychiatry, and the American Association of Directors of Child and Adolescent Psychiatry. A review of the National Resident Matching Program (NRMP) Match data is needed to inform current and future practices. METHODS The NRMP, Accreditation Council for Graduate Medical Education, and Association of American Medical College databases were queried from 1996 to 2021. RESULTS The NRMP data show that the number of programs participating in the Match has increased from 87 in 1996 to 106 in 2021 and that the percentage of programs that fill their positions in the Match is increasing and has increased from 41% in 1996 to 67% in 2021. However, each year, a percentage of programs do not fill their positions offered in the Match. The numbers indicate a surplus of positions for the number of applicants that appears to be increasing, and there are currently 49 more positions than applicants. CONCLUSIONS Trends in the CAP Match are encouraging, and importantly, more programs and applicants are using the Match. One concerning trend is the surplus of positions while there is a great need for child psychiatrists. More research is needed on the incentives for programs and applicants to participate in the Match and how to increase interest in child and adolescent psychiatry.
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Affiliation(s)
| | | | - Ahra Kim
- Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - A Lee Lewis
- Medical University of South Carolina, Charleston, SC, USA
| | - Simon Vandekar
- Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Anna Kerlek
- Nationwide Children's Hospital, Columbus, OH, USA
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49
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Khelifi L. [Professional identity and care practice in adolescent psychiatry]. Rev Infirm 2022; 71:47-49. [PMID: 35184861 DOI: 10.1016/j.revinf.2021.12.013] [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] [Indexed: 06/14/2023]
Abstract
In psychiatric wards, nurses are an essential professional group in institutional and hospital life. In full hospitalization units for adolescents with psychological disorders, their professional identity is constructed in a care approach, at the crossroads of care and education. Motivated by individuation and by a feeling of collective and institutional belonging in their care practices, this identity construction seems to be beneficial for the patients since it is reinvested in the therapeutic relationship between caregiver and patient.
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Affiliation(s)
- Linda Khelifi
- Institut de formation en soins infirmiers Avicenne Jean-Verdier, AP-HP, bâtiment l'Européen, 1-7 promenade Jean Rostand, 93000 Bobigny, France.
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50
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Cheng N, Mohiuddin S. Addressing the Nationwide Shortage of Child and Adolescent Psychiatrists: Determining Factors that Influence the Decision for Psychiatry Residents to Pursue Child and Adolescent Psychiatry Training. Acad Psychiatry 2022; 46:18-24. [PMID: 34767240 DOI: 10.1007/s40596-021-01554-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 08/07/2020] [Accepted: 10/21/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE This study aimed to identify factors that influence whether adult psychiatry residents choose to pursue fellowship training, particularly in child psychiatry. The study also assessed how child psychiatry is perceived among adult psychiatry residents as a subspecialty. METHODS Electronic surveys were administered to all adult psychiatry residents at the University of Michigan, Henry Ford Health System, and Authority Health. These three programs were selected for geographic convenience. The survey included demographic questions as well as Likert-scale statements that assessed the importance of various factors in determining future career choice. The survey also assessed the agreeability of various statements pertaining to the field of child psychiatry. RESULTS The most important factor for residents in deciding their specialty choice was personal interest, followed by work-life balance, the ability to work directly with patients, and the location of their future job. Over half of residents rated length of training as being "extremely important" or "very important," and fewer than 30% of residents surveyed felt that child psychiatry fellowship was too long. Child psychiatry is widely recognized by residents as having ample job opportunities. However, fewer than 30% of psychiatry residents surveyed rated a high level of interest in child psychiatry. CONCLUSION The knowledge of psychiatry residents' views on specialty selection could inform decision making around recruitment efforts. It may also gauge the efficacy and impact of different propositions made to increase child psychiatry recruitment, such as shortening fellowship training in child psychiatry and sponsoring mentorships and interest groups.
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Affiliation(s)
- Nancy Cheng
- University of Michigan, Michigan Medicine, Ann Arbor, MI, USA.
| | - Sarah Mohiuddin
- University of Michigan, Michigan Medicine, Ann Arbor, MI, USA
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