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Ribas LH, Villar RS. The Role of Parental Emotional Health and Parenting Practices in Offspring Mental Health. Trends Psychiatry Psychother 2024. [PMID: 38648516 DOI: 10.47626/2237-6089-2024-0794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 04/18/2024] [Indexed: 04/25/2024]
Abstract
In the family social environment, children can experience and observe stressful situations, involving mental health and parental practices. The review by Mendes-Sousa et al. examines the relation between family stress, child development, and offspring mental health. Of the main results, we highlight the relationship between maternal depression with developmental delays and child internalizing and externalizing symptoms. Furthermore, negative parenting practices were also related to children's emotional and behavioral problems, while positive practices were beneficial to the socio-emotional development of offspring. The review warns about preventing socio-emotional problems in offspring, through promoting parental mental health, positive parenting practices, and cohesive family environments. Finally, we envision a significant path for subsequent research on maternal emotional overload and the central role of mothers in caring for their offspring, exploring shared care for children and potential public policies aimed at mothers' mental health and social inclusion.
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Affiliation(s)
- Larissa Hallal Ribas
- Catholic University of Pelotas, Postgraduate Program in Health and Behavior, Pelotas, RS, Brazil
| | - Rafaela Soares Villar
- Federal University of Pelotas, Postgraduate Program in Education, Pelotas, RS, Brazil
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Harbord J. The visualization of autism: Filming children at the Maudsley Hospital, London, 1957-8. Hist Human Sci 2024; 37:117-137. [PMID: 38698898 PMCID: PMC11060935 DOI: 10.1177/09526951241238650] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
This article examines three films made during the 1950s by Elwyn James Anthony at the psychotic clinic for children at the Maudsley Hospital that marked an important transition in the purpose and practice of visual documentation in a clinical setting: film as a research tool was transitioning from the recording of external signs as indicators of internal subjective states, to the capture of the visual flow of communication between subjects. It is a shift that had a particular impact on the emergent classification of autism, a modality not yet properly separated from the broader term of psychosis, as a non-relational condition whose visual capture demonstrated a void of inter-human communicational exchange. Film was significant not only as a recording apparatus, but as a method of cutting and crafting sequences of movements into brief repetitive motifs. The filmed behaviour of children remained opaque to interpretation, a 'finding' that facilitated the modelling of an emergent autism as subjects who were isolated, alienated and automaton-like, inhabiting a separate temporality. The article situates this 'second', affectless autism, within a broader context of post-war research into gestures as a language of the body, developed largely through an intellectual network of German émigré psychoanalysts who had fled to the US and UK in the 1930s.
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Rietmann FE. Mother-blaming revisited: Gender, cinematography, and infant research in the heyday of psychoanalysis. Hist Human Sci 2024; 37:87-116. [PMID: 38698899 PMCID: PMC11060937 DOI: 10.1177/09526951231187556] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
This article examines cinematographic observational studies of infants conducted by a loosely connected group of female psychologists and physicians in the USA from the 1930s to the 1960s. Largely forgotten today, these practitioners realized detailed and carefully planned research projects about infant behavior in a variety of settings-from the laboratory to the well-baby clinic. Although their studies were in conversation with better-known works, such as John Bowlby's research on attachment and René Spitz's films on institutionalized infants, they differed in a close examination of individual characteristics of babies and a critical attitude toward contemporary notions of 'pathological mothering'. In closely following the work of several researchers, including but not limited to pediatrician Margaret Fries (1898-1987), the clinical psychologist Sibylle Escalona (1915-96) and her team members-child psychiatrist Mary Leitch (1914-?) and avant-garde photographer Ellen Auerbach (1906-2004)-and psychologist Anneliese Korner (1918-2010), I argue that their cinematographic works shed a more nuanced light on the landscape of infant research and child psychiatry in the mid 20th century, and open a way for alternative readings of gender, psychoanalysis, and scientific observation at that time.
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Alexander JM, Yesodharan R, Nayak MG. Peer influence and its impact on behavior among South Indian adolescents: A descriptive cross-sectional study. J Educ Health Promot 2024; 13:98. [PMID: 38726084 PMCID: PMC11081441 DOI: 10.4103/jehp.jehp_697_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 09/02/2023] [Indexed: 05/12/2024]
Abstract
BACKGROUND Peer influence, the development of attitudes, and behavioral changes are some of the phenomenal changes that happen in adolescence. MATERIALS AND METHODS A descriptive cross-sectional study was undertaken to find out the association between peer influence and behavior among 355 adolescents within the age group of 16 to 18 years, randomly chosen from Pre-university schools of Udupi district, Karnataka using the Peer Influence Scale (PIS) and Strengths and Difficulties Questionnaire (SDQ). RESULT The results indicate that their peers highly influenced 43.9% of the participants. Meanwhile, 23.1% and 7.9% of adolescents who participated in the survey showed borderline and abnormal behavior, respectively. The association between peer influence and behaviour was assessed using the Chi-square test; the results (χ2=14.545, P = 0.001) revealed that peers highly influence adolescent behavior and change adolescent conduct significantly. CONCLUSION Adolescents should be aware of the accepted and non-accepted behaviors in society and be wise in choosing the right peers who later influence their behavior. Parents need to check the conduct of their children and guide them in developing their identity.
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Affiliation(s)
- Jisha M. Alexander
- Department of Psychiatric Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Renjulal Yesodharan
- Department of Psychiatric Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Malathi G. Nayak
- Department of Community Health Nursing, Manipal College of Nursing, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Zwolińska W, Bilska K, Tarhonska K, Reszka E, Skibińska M, Pytlińska N, Słopień A, Dmitrzak-Węglarz M. Biomarkers of Depression among Adolescent Girls: BDNF and Epigenetics. Int J Mol Sci 2024; 25:3281. [PMID: 38542252 PMCID: PMC10970207 DOI: 10.3390/ijms25063281] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 03/07/2024] [Accepted: 03/10/2024] [Indexed: 04/04/2024] Open
Abstract
Alterations in brain-derived neurotrophic factor (BDNF) expression have been suggested to mediate the influence of environmental factors on the emergence of depression through epigenetic modifications. However, research on this subject in the developmental population is lacking and the pathophysiology of adolescent depression remains unclear. We aimed to investigate the alterations in BDNF expression and global DNA methylation in depression among adolescent girls. Thirty female inpatients with the initial diagnosis of depression were assessed before and after the period of antidepressant treatment and compared with thirty age-matched healthy controls. The assessment involved BDNF and proBDNF serum levels, the BDNF gene exon IV promoter methylation, and global DNA methylation. The methylation level in the BDNF gene exon IV promoter was significantly lower in the studied group compared with the control and correlated negatively with the severity of depression. The test distinguished the studied group from the controls with a sensitivity of 37% and specificity of 90%. The differences were no longer present after the period of antidepressant treatment. No differences in the global DNA methylation, BDNF, and proBDNF levels were found. We concluded that decreased methylation in the BDNF exon IV promoter could be considered as a biomarker of a depression state among adolescent girls.
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Affiliation(s)
- Weronika Zwolińska
- Department of Child and Adolescent Psychiatry, Karol Jonscher Clinical Hospital, Poznan University of Medical Sciences, Szpitalna 27/33 St., 60-572 Poznan, Poland; (W.Z.); (N.P.); (A.S.)
| | - Karolina Bilska
- Department of Psychiatric Genetics, Medical Biology Center, Poznan University of Medical Sciences, Rokietnicka St. 8, 60-806 Poznan, Poland; (K.B.); (M.S.)
| | - Kateryna Tarhonska
- Department of Translational Research, Nofer Institute of Occupational Medicine, 91-348 Łódź, Poland; (K.T.); (E.R.)
| | - Edyta Reszka
- Department of Translational Research, Nofer Institute of Occupational Medicine, 91-348 Łódź, Poland; (K.T.); (E.R.)
| | - Maria Skibińska
- Department of Psychiatric Genetics, Medical Biology Center, Poznan University of Medical Sciences, Rokietnicka St. 8, 60-806 Poznan, Poland; (K.B.); (M.S.)
| | - Natalia Pytlińska
- Department of Child and Adolescent Psychiatry, Karol Jonscher Clinical Hospital, Poznan University of Medical Sciences, Szpitalna 27/33 St., 60-572 Poznan, Poland; (W.Z.); (N.P.); (A.S.)
| | - Agnieszka Słopień
- Department of Child and Adolescent Psychiatry, Karol Jonscher Clinical Hospital, Poznan University of Medical Sciences, Szpitalna 27/33 St., 60-572 Poznan, Poland; (W.Z.); (N.P.); (A.S.)
| | - Monika Dmitrzak-Węglarz
- Department of Psychiatric Genetics, Medical Biology Center, Poznan University of Medical Sciences, Rokietnicka St. 8, 60-806 Poznan, Poland; (K.B.); (M.S.)
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Abstract
OBJECTIVES Increasing numbers of youth experience mental illness, and also require and benefit from specialist child and adolescent mental health services (CAMHS). Worldwide, such services are underfunded and under-resourced, and services in Ireland are no different. It is vital that existing services are regularly reviewed for both efficacy and acceptability. Our objective was to review published studies evaluating service user satisfaction with CAMHS in Ireland and CAMHS therapeutic efficacy. METHODS MEDLINE, PsycINFO and CINAHL databases were systematically searched. Studies were included if they reported on service user satisfaction or an evaluation of CAMHS in Ireland. RESULTS From an initial 125 articles identified, 15 studies meet the inclusion criteria: four reporting on overall CAMHS satisfaction, three on satisfaction where a specific diagnosis was present, while eight evaluated various interventions offered. Whilst most service users perceived services to be satisfactory, important issues relating to accessibility were present. Evidence of efficacy was present for a small number of interventions, but studies were limited by methodological issues. CONCLUSIONS There is a dearth of studies evaluating CAMHS in Ireland. The extant literature suggests a positive experience once accessed, but long waiting times and poor collaboration are seen to limit services users' experience. More robust methodologically sound studies are urgently required. Given the expected increased demand linked to the current COVID-19 pandemic, coupled with the resultant compromised financial position, it is essential that scant resources are appropriately directed.
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Affiliation(s)
- D Leahy
- Department of Child and Adolescent Psychiatry North Lee North, Unit 9 St Stephen's Hospital, Glanmire, Cork, Ireland
| | - F McNicholas
- Child and Adolescent Psychiatry, University College Dublin, Dublin, Ireland
- Lucena CAMHS, SJOG, Rathgar, Dublin 6, Ireland
- CHI Crumlin, Dublin 12, Ireland
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Evans B. Child development, film evidence, and epidemiological sciences: Elwyn James Anthony and the 1957 Zurich International Congress of Psychiatry. Hist Psychiatry 2024; 35:62-84. [PMID: 38265041 PMCID: PMC10868148 DOI: 10.1177/0957154x231212325] [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] [Indexed: 01/25/2024]
Abstract
In 1957, the British-Indian child psychiatrist Dr Elwyn James Anthony travelled to the Zurich International Congress of Psychiatry to show a film featuring 70 children with such complex symptomatology and behaviour that they betrayed the certainty of contemporary theories of developmental psychology and psychoanalysis. This article examines the significance of Anthony's film to the creation of new scientific models in international developmental psychology and psychiatric epidemiology. It marked a significant change in the use of filmed evidence that sought to create a truly global and universalist approach to atypical child development based purely on scientific observations. This new observational work was important in shaping new internationally ratified models to study the epidemiology of children's psychiatric conditions.
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McGrath J, Cawley B, McTiernan D, Marques L, Goncerz E, Heron EA, Madden J, Bond L, Quinn C, Mulholland K, Dowling B. Service user satisfaction with care in a specialist service for young people with attention deficit hyperactivity disorder. Ir J Psychol Med 2024; 41:46-53. [PMID: 35361298 DOI: 10.1017/ipm.2022.15] [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: 11/07/2022]
Abstract
OBJECTIVES Consumer satisfaction is considered one of the most important measures of service quality in child mental health; however, there is limited understanding of factors that influence satisfaction. The objective of this study was to investigate key factors influencing satisfaction with care (SWC) in ADMiRE, a specialist service for young people (YP) with attention deficit hyperactivity disorder (ADHD). METHODS Parents/carers (n = 67) and YP > 9 years (n = 44) attending ADMiRE completed an anonymous Experience of Service Questionnaire (ESQ), a quantitative/qualitative measure of service user satisfaction. Parents/carers also completed symptom severity rating scales. Data were analysed to determine (i) overall SWC, (ii) the relationship between parent- and youth-reported SWC and (iii) the impact of symptom severity on SWC. Thematic analysis of qualitative ESQ data was completed. RESULTS Parents/carers were significantly more satisfied than YP (p = 0.028). Symptom severity did not impact significantly on parent/carer satisfaction. YP with severe hyperactive/impulsive and inattentive ADHD symptoms were significantly less satisfied with care than those with less severe ADHD symptoms (p = 0.022 and p = 0.017 respectively). Factors related to the therapeutic alliance were identified as being particularly important to both parents/carers and YP. CONCLUSIONS This is the first Irish study that has investigated the impact of symptom severity on service user satisfaction in a child mental health service. The results highlight the different perspectives of YP and parents and provide novel insights into the impact of symptom severity on service user satisfaction. The importance of the therapeutic alliance should not be underestimated in future development of services.
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Affiliation(s)
- Jane McGrath
- Department of Psychiatry, Trinity Centre for Health Sciences, St James's Hospital, Trinity College Dublin, Dublin, Ireland
- ADMiRE, Linn Dara Child and Adolescent Mental Health Services, Cherry Orchard Hospital, Ballyfermot, Dublin, Ireland
| | - Barbara Cawley
- ADMiRE, Linn Dara Child and Adolescent Mental Health Services, Cherry Orchard Hospital, Ballyfermot, Dublin, Ireland
| | - Daniel McTiernan
- ADMiRE, Linn Dara Child and Adolescent Mental Health Services, Cherry Orchard Hospital, Ballyfermot, Dublin, Ireland
| | - Liliana Marques
- ADMiRE, Linn Dara Child and Adolescent Mental Health Services, Cherry Orchard Hospital, Ballyfermot, Dublin, Ireland
| | - Ewa Goncerz
- ADMiRE, Linn Dara Child and Adolescent Mental Health Services, Cherry Orchard Hospital, Ballyfermot, Dublin, Ireland
| | - Elizabeth A Heron
- Department of Psychiatry, Trinity Centre for Health Sciences, St James's Hospital, Trinity College Dublin, Dublin, Ireland
| | - Jamie Madden
- Centre for Veterinary Epidemiology and Risk Analysis (CVERA), School of Veterinary Medicine, University College Dublin, Dublin, Ireland
| | - Laura Bond
- ADMiRE, Linn Dara Child and Adolescent Mental Health Services, Cherry Orchard Hospital, Ballyfermot, Dublin, Ireland
| | - Catherine Quinn
- ADMiRE, Linn Dara Child and Adolescent Mental Health Services, Cherry Orchard Hospital, Ballyfermot, Dublin, Ireland
| | - Ken Mulholland
- ADMiRE, Linn Dara Child and Adolescent Mental Health Services, Cherry Orchard Hospital, Ballyfermot, Dublin, Ireland
| | - Brenda Dowling
- ADMiRE, Linn Dara Child and Adolescent Mental Health Services, Cherry Orchard Hospital, Ballyfermot, Dublin, Ireland
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Parker AJ, Brock P, Kryza‐Lacombe M, Briggs‐Gowan M, Dougherty LR, Wakschlag LS, Wiggins JL. What I see, what you say: How cross-method variation sharpens characterization of irritability in early childhood. Int J Methods Psychiatr Res 2024; 33:e2019. [PMID: 38481064 PMCID: PMC10937815 DOI: 10.1002/mpr.2019] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 12/13/2023] [Accepted: 02/28/2024] [Indexed: 03/17/2024] Open
Abstract
OBJECTIVES Identification of clinically significant irritability in preschool age is important to implement effective interventions. However, varying informant and measurement methods display distinct patterns. These patterns are associated with concurrent and future mental health concerns. Patterns across multi-informant methods in early-childhood irritability may have clinical utility, identifying risk for impaired psychosocial functioning. METHODS Using data from the Multidimensional Assessment of Preschoolers Study (N = 425), latent profile analysis identified irritability patterns through the parent-reported Multidimensional Assessment Profile Scales-Temper Loss (MAPS-TL), parent-reported interviewer-rated Preschool Age Psychiatric Assessment (PAPA), and observer-rated Disruptive Behavior Diagnostic Observation Schedule (DB-DOS). These profiles were characterized on protective factors, global functioning, and mental health syndromes, concurrently and at early school age and preadolescent follow-up. RESULTS Fit indices favored a five-class model: Low All, High Observation with Examiner (high DB-DOS Examiner Context), High All, High Parent Report (high MAPS-TL/PAPA), and Very High Parent Report (very high MAPS-TL/PAPA). Whereas Low All and High Observation with Examiner exhibited strong psychosocial functioning, remaining profiles showed impaired psychosocial functioning, with the Very High Parent Report group showing higher impairment at follow-ups, ds = 0.37-1.25. CONCLUSIONS Multi-informant measurements of irritability may have utility for clinical prediction, and future studies should test utility for diagnostic precision.
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Affiliation(s)
| | - Peyton Brock
- Department of PsychologySan Diego State UniversitySan DiegoCaliforniaUSA
| | - Maria Kryza‐Lacombe
- San Diego State University/University of CaliforniaSan Diego Joint Doctoral Program in Clinical PsychologySan DiegoCaliforniaUSA
| | - Margaret Briggs‐Gowan
- Child and Adolescent PsychiatryUniversity of Connecticut Health SystemFarmingtonConnecticutUSA
| | | | - Lauren S. Wakschlag
- Feinberg School of Medicine and Institute for Innovations in Developmental SciencesNorthwestern UniversityEvanstonIllinoisUSA
| | - Jillian Lee Wiggins
- Department of PsychologySan Diego State UniversitySan DiegoCaliforniaUSA
- San Diego State University/University of CaliforniaSan Diego Joint Doctoral Program in Clinical PsychologySan DiegoCaliforniaUSA
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Hudson LD, Ward J, Vázquez-Vázquez A, Settle K, Cornaglia F, Gibson F, Phillips K, Mathews G, Roberts H, Roland D, Nicholls DE, Elphinstone H, Viner R. Mental Health Admissions to Paediatric Wards Study (MAPS): a protocol for the analysis of Hospital Episode Statistics (HES) data. BMJ Paediatr Open 2024; 8:e002352. [PMID: 38286521 DOI: 10.1136/bmjpo-2023-002352] [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: 10/23/2023] [Accepted: 11/25/2023] [Indexed: 01/31/2024] Open
Abstract
INTRODUCTION Children and young people (CYP) presenting with a mental health (MH) crisis are frequently admitted to general acute paediatric wards as a place of safety. Prior to the pandemic, a survey in England showed that CYP occupied 6% of general paediatric inpatient beds due to an MH crisis, and there have been longstanding concerns about the quality of care to support these patients in this setting. Mental Health Admissions to Paediatric Wards Study aims to generate a theory of change (ToC) model to improve the quality of care for CYP admitted to acute paediatric services after presenting in a MH crisis. METHODS AND ANALYSIS We will undertake a national (England), sequential, mixed methods study to inform a ToC framework alongside a stakeholder group consisting of patients, families/carers and healthcare professionals (HCPs). Our study consists of four work packages (WP) undertaken over 30 months. WP1 is limited to using national routine administrative data to identify and characterise trends in MH admissions in acute paediatric wards in England between 2015- 2022. ETHICS AND DISSEMINATION WP1 received ethical approval (Ref 23/NW/0192). We will publish the overall synthesis of data and the final ToC to improve care of CYP with MH crisis admitted to general acute paediatric settings. As coproducers of the ToC, we will work with our stakeholder group to ensure wide dissemination of findings. Potential impacts will be on service development, new models of care, training and workforce planning.
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Affiliation(s)
- Lee Duncan Hudson
- Population, Policy and Practice Research Programme, UCL Great Ormond Street Institute of Child Health, London, UK
- Great Ormond Street Hospital for Children NHS Trust, London, UK
| | - Joseph Ward
- Population, Policy and Practice Research Programme, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Adriana Vázquez-Vázquez
- Population, Policy and Practice Research Programme, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Kate Settle
- Population, Policy and Practice Research Programme, UCL Great Ormond Street Institute of Child Health, London, UK
| | | | - Faith Gibson
- Population, Policy and Practice Research Programme, UCL Great Ormond Street Institute of Child Health, London, UK
- Great Ormond Street Hospital for Children NHS Trust, London, UK
- University of Surrey, Guildford, UK
| | - Kirsty Phillips
- Population, Policy and Practice Research Programme, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Gabrielle Mathews
- CYP Transformation Team, NHS England and NHS Improvement London, London, UK
| | - Helen Roberts
- Population, Policy and Practice Research Programme, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Damian Roland
- SAPPHIRE Group, Population Health Sciences, Leicester University, Leicester, UK
- Paediatric Emergency Medicine Leicester Academic (PEMLA) Group, Children's Emergency Department, Leicester Royal Infirmary, Leicester, UK
| | | | - Holly Elphinstone
- Population, Policy and Practice Research Programme, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Russell Viner
- Population, Policy and Practice Research Programme, UCL Great Ormond Street Institute of Child Health, London, UK
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Lee CM, Jeung J, Yonek JC, Farghal M, Steinbuchel P. Using human-centered design to develop and implement a pediatric mental health care access program. Front Psychiatry 2024; 14:1283346. [PMID: 38260798 PMCID: PMC10802988 DOI: 10.3389/fpsyt.2023.1283346] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 12/08/2023] [Indexed: 01/24/2024] Open
Abstract
In 2019, the University of California at San Francisco (UCSF) launched the Child and Adolescent Psychiatry Portal (CAPP), a pediatric mental health care access (PMHCA) program providing remote mental health consultation services to pediatric primary care providers (PCPs) throughout Northern and Central California. The development and implementation of CAPP was guided by Human-Centered Design (HCD), an iterative, rapid-paced innovation process focusing on stakeholders' needs and experiences, which shaped the development of CAPP's programs. The resulting key programmatic elements are designed for pediatric workforce development: (1) PCP consultation with a child and adolescent psychiatrist via a telephone warmline; and (2) training and education for providers. CAPP has grown rapidly since its launch, having enrolled 1,714 providers from 257 practices spread across 36 counties and provided 3,288 consults on 2,703 unique lives as of August 2023. Preliminary evaluation findings indicate high PCP satisfaction with CAPP's services, despite continued challenges of integrating behavioral health into primary care. Throughout the HCD and implementation process, multidisciplinary partnerships have proven critical in providing end-user input to inform and improve program design. This growing network of partnerships, developed through the cultivation of personal relationships and trust over time, has also proven essential for CAPP's rapid growth and sustainability. Overall, this Community Case Study highlights the critical role of partnerships and the importance of taking a people-centered approach, as captured in CAPP's motto, "Connecting for Care."
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Affiliation(s)
- Chuan Mei Lee
- Child and Adolescent Psychiatry Portal, Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
- Clinical Excellence Research Center, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Joan Jeung
- Child and Adolescent Psychiatry Portal, Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
- Department of Pediatrics, Division of Developmental Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Juliet C. Yonek
- Child and Adolescent Psychiatry Portal, Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Mahmoud Farghal
- Child and Adolescent Psychiatry Portal, Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Petra Steinbuchel
- Child and Adolescent Psychiatry Portal, Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
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Mutlu C, Birinci T, Senel A, Mustafaoglu R, Bulanık Koc E, Karacetin G, Kaya Mutlu E. A multi-dimensional assessment of internet gaming disorder in children and adolescents: A case-control study. Work 2024; 77:1089-1099. [PMID: 38007630 DOI: 10.3233/wor-220652] [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: 11/27/2023] Open
Abstract
BACKGROUND Internet gaming disorder (IGD) leads to social disturbances and isolation, neglect of daily responsibilities, behavioral disorders, and physical impairments. OBJECTIVE This study aimed to investigate the effect of IGD on spine biomechanics, range of motion in the neck and low back, and lung functions and respiratory muscle strength in children and adolescents. METHODS Sixty-four children and adolescents with IGD (Group I) and 41 healthy controls (Group II) were included in the study. The outcomes were assessed with the Visual Analogue Scale (VAS), Internet Addiction Scale, active range of motion (AROM) in the neck and lumbar spine, posture and spinal alignment, lung function tests, and respiratory muscle strength. RESULTS There is a significant difference in pain intensity at rest, during activity, and daily sitting time between groups (p < 0.05). Craniovertebral angle, shoulder asymmetry, thoracic kyphosis angle, cervical extension and rotation, and right lumbar rotation significantly decreased in Group I than in Group II (p < 0.05). Besides, the PEF, FEF 25-75%, and respiratory muscle strength were lower in Group I than in Group II (p < 0.05). With a multiple linear regression model, MEP, FEV1, and weekly time spent playing online games were significant predictors of internet addiction intensity (R2 = 0.28; p = 0.02, p = 0.01, and p < 0.001, respectively). CONCLUSION Postural misalignment and increased sedentary time cause physical health deterioration and negatively affect lung functions in children and adolescents with IGD. Consequently, considering both psychological and physical health is necessary to assess the problematic nature of internet gaming. A comprehensive assessment and multidisciplinary team approach is essential to managing the IGD.
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Affiliation(s)
- Caner Mutlu
- Department of Child and Adolescent Mental Health and Diseases, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - Tansu Birinci
- Department of Physiotherapy and Rehabilitationf, Faculty of Health Sciences, Istanbul Medeniyet University, Istanbul, Turkey
| | - Aybike Senel
- Division of Physiotherapy and Rehabilitation, Institute of Graduate Studies, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Rustem Mustafaoglu
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Esra Bulanık Koc
- Clinic of Child and Adolescent Psychiatry, Bakirkoy Research and Training Hospital for Psychiatric and Neurological Diseases, University of Health Science, Istanbul, Turkey
| | - Gul Karacetin
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bandirma Onyedi Eylul University, Bandirma, Turkey
| | - Ebru Kaya Mutlu
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bandirma Onyedi Eylul University, Bandirma, Turkey
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13
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Lefèvre-Utile J. [Restraint in child psychiatry]. Soins 2024; 69:31-33. [PMID: 38296417 DOI: 10.1016/j.soin.2023.12.007] [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: 02/07/2024]
Abstract
In child psychiatry, there are significant ethical challenges when patients put themselves at risk or refuse to cooperate in their care. This article illustrates two situations of violence and restraints and looks at how the vulnerability of caregivers can be acknowledged in order to find the best balance between the imperatives of protection and the respect of young inpatients in child psychiatry.
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Affiliation(s)
- Jean Lefèvre-Utile
- Service de psychiatrie de l'enfant et de l'adolescent, hôpital Pitié-Salpêtrière, AP-HP, 47-83 boulevard de l'Hôpital, 75013 Paris, France; Équipe de recherches en éthique et épistémologie, Université Paris-Saclay, CESP, U1018, Inserm, hôpital Paul-Brousse, 16 avenue Paul-Vaillant-Couturier, 94800 Villejuif, France; Ingram School of Nursing McGill University, 680 Sherbrooke West, Suite 1800, Montréal, Canada.
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14
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Prasad V, Rezel-Potts E, White P, Downs J, Boddy N, Sayal K, Sonuga-Barke E. Use of healthcare services before diagnosis of attention-deficit/hyperactivity disorder: a population-based matched case-control study. Arch Dis Child 2023; 109:46-51. [PMID: 37903632 PMCID: PMC10803994 DOI: 10.1136/archdischild-2023-325637] [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] [Received: 03/28/2023] [Accepted: 09/19/2023] [Indexed: 11/01/2023]
Abstract
OBJECTIVE To compare use of healthcare services and reasons for attendance by children and young people (CYP) with attention-deficit/hyperactivity disorder (ADHD) versus non-ADHD controls. DESIGN Population-based matched case-control study. SETTING English primary care electronic health records with linked hospital records from the Clinical Practice Research Datalink, 1998-2015. PARTICIPANTS 8127 CYP with an ADHD diagnosis aged 4-17 years at the time of diagnosis and 40 136 non-ADHD controls matched by age, sex and general practitioner (GP) practice. MAIN OUTCOME MEASURES Medical diagnoses, prescriptions, hospital admissions and hospital procedures in the 2 years before diagnosis (or the index date for controls). RESULTS CYP with ADHD attended healthcare services twice as often as controls (rate ratios: GP: 2.0, 95% CI=2.0, 2.1; hospital 1.8, 95% CI=1.8, 1.9). CYP with ADHD attended their GP, received prescriptions and were admitted to hospital for a wide range of reasons. The strongest association for GP attendances, comparing CYP with versus without ADHD, was for 'mental and behavioural disorders' (OR=25.2, 95% CI=23.3, 27.2). Common reasons for GP attendance included eye, ear, nose, throat, oral (OR=1.5, 95% CI=1.4, 1.5) and conditions such as asthma (OR=1.3, 95% CI=1.3, 1.4) or eczema (OR=1.2, 95% CI=1.0, 1.3). CONCLUSIONS Two years before diagnosis, CYP with ADHD attended healthcare services twice as often as CYP without. CYP with ADHD had increased rates of physical conditions, such as asthma and eczema. These contacts may be an opportunity for earlier recognition and diagnosis of ADHD.
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Affiliation(s)
- Vibhore Prasad
- Population Health Science, King's College London, London, UK
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- School of Medicine, University of Nottingham, Nottingham, Nottinghamshire, UK
| | | | - Patrick White
- Population Health Science, King's College London, London, UK
| | - Johnny Downs
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Nicholas Boddy
- School of Medicine, University of Nottingham, Nottingham, Nottinghamshire, UK
| | - Kapil Sayal
- CANDAL (Centre for ADHD and Neuro-Developmental Disorders Across the Lifespan), Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Edmund Sonuga-Barke
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
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15
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Pennick H, Cousins L, Marikar D. Medical emergencies in eating disorders. Arch Dis Child Educ Pract Ed 2023; 108:410-415. [PMID: 37643838 DOI: 10.1136/archdischild-2022-324484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 08/14/2023] [Indexed: 08/31/2023]
Affiliation(s)
- Holly Pennick
- Paediatrics, West Suffolk Hospitals NHS Trust, Bury Saint Edmunds, Suffolk, UK
| | - Lesley Cousins
- Child and Adolescent Eating Disorder Service, Norfolk and Suffolk NHS Foundation Trust, Norwich, Norfolk, UK
| | - Dilshad Marikar
- Paediatrics, West Suffolk Hospitals NHS Trust, Bury Saint Edmunds, Suffolk, UK
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16
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Banerjee A, Johnson B, Kauer A, Gunderson C, Stevens HE. Common Issues for General Practitioners in the Medical Management of Child and Adolescent Psychiatric Care. J Pediatr Pharmacol Ther 2023; 28:595-602. [PMID: 38025144 PMCID: PMC10681082 DOI: 10.5863/1551-6776-28.7.595] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 01/11/2023] [Indexed: 12/01/2023]
Abstract
With a limited number of child and adolescent psychiatrists available to see youth patients, many common psychiatric problems in youth are managed by other providers. Clinical pearls from experts in child and adolescent psychiatry can help general practitioners with this management. Some common issues are discussed here for which practical guidance is offered, ranging from approaches to assessment and how to start and titrate medications for the treatment of attention deficit hyperactivity disorder, depression, and sleep problems.
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Affiliation(s)
- Ashmita Banerjee
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA
| | - Burgundy Johnson
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA
| | - Aaron Kauer
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA
| | - Carissa Gunderson
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA
| | - Hanna E. Stevens
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA
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17
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Minnis H. Abuse, neglect and neurodevelopment across the life course: what can paediatricians and child psychiatrists do about this together? The Illingworth-Rees keynote lecture 2023. Arch Dis Child 2023:archdischild-2023-325942. [PMID: 37788885 DOI: 10.1136/archdischild-2023-325942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 08/25/2023] [Indexed: 10/05/2023]
Abstract
Paediatricians and child psychiatrists share complex cases, often associated with abuse, neglect and other 'Adverse Childhood Experiences (ACEs)'. ACEs are associated in a dose-response relationship with both mental and physical health problems across the life span. We found that 9-year-old children who had been abused and neglected were much more likely to also have symptoms of heritable neurodevelopmental conditions (NDCs) such as ADHD, autism and intellectual disabilities. To our surprise, these were not caused by the abuse and neglect. Instead, both the NDCs and the abuse and neglect were being caused by additional genetic factors. We also found that children who have experienced abuse and neglect, and who also have NDCs, are at twice the risk of developing symptoms of severe mental illness in adolescence. This has caused us to develop our 'Double Jeopardy' hypothesis-that experiencing both abuse and neglect and NDCs in childhood might double the risk of a range of physical and mental health problems across the life span.Both paediatricians and child psychiatrists will be faced with children who have complex problems, and they will sometimes need to work together to solve these-whether or not abuse or neglect is in the mix.Dr Corinne Rees's words were prescient: 'The truth that psychological issues and behaviour are integral to all illness indicates the necessity for every doctor to feel competent in considering their relevance'. As paediatricians and child psychiatrists, let's move forward together to overcome the mind-body dichotomy for the benefit of our patients.
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Affiliation(s)
- Helen Minnis
- School of Health and Wellbeing, University of Glasgow, Glasgow G12 8TB, UK
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18
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Arai Y, Sasayama D, Suzuki K, Nakamura T, Kuraishi Y, Washizuka S. Association between Children's Difficulties, Parent-Child Sleep, Parental Control, and Children's Screen Time: A Cross-Sectional Study in Japan. Pediatr Rep 2023; 15:668-678. [PMID: 37987285 PMCID: PMC10661245 DOI: 10.3390/pediatric15040060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/19/2023] [Accepted: 11/06/2023] [Indexed: 11/22/2023] Open
Abstract
Children's screen time may affect their growth and development. However, differences in the impact of various psychiatric and psychological factors on children's screen time is a research gap. This study aimed to explore the differences in the influence of related factors affecting children's screen time based on their sleep, difficulties, and parental control among Japanese elementary and junior high school students. A cross-sectional survey was conducted among parents in Japan. Data on screen time duration, parent-child background, strengths and difficulties, sleep variables, and parental control types were collected from 225 households. A regression analysis revealed that high Strengths and Difficulties Questionnaire (SDQ) scores (β = 0.166, p = 0.008), sleep duration (β = -0.281, p < 0.001), and parental control (β = -0.204, p = 0.001) were significantly related to children's screen time. Additionally, it was found that parents' late bedtimes affect children's screen time by mediating children's sleep duration. This study, together with previous research, provides comprehensive insights into design interventions to decrease the screen time of children in the Japanese context.
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Affiliation(s)
- Yusuke Arai
- Department of Psychiatry, Shinshu University School of Medicine, Matsumoto-City 390-8621, Japan; (Y.A.); (T.N.); (Y.K.); (S.W.)
- Department of Psychiatry, Kurita Hospital, Nagano-City 380-0921, Japan
| | - Daimei Sasayama
- Department of Psychiatry, Shinshu University School of Medicine, Matsumoto-City 390-8621, Japan; (Y.A.); (T.N.); (Y.K.); (S.W.)
| | - Kazuhiro Suzuki
- Department of Psychiatry, Shinshu University School of Medicine, Matsumoto-City 390-8621, Japan; (Y.A.); (T.N.); (Y.K.); (S.W.)
- Department of Community Mental Health, Shinshu University School of Medicine, Matsumoto-City 390-8621, Japan
| | - Toshinori Nakamura
- Department of Psychiatry, Shinshu University School of Medicine, Matsumoto-City 390-8621, Japan; (Y.A.); (T.N.); (Y.K.); (S.W.)
| | - Yuta Kuraishi
- Department of Psychiatry, Shinshu University School of Medicine, Matsumoto-City 390-8621, Japan; (Y.A.); (T.N.); (Y.K.); (S.W.)
| | - Shinsuke Washizuka
- Department of Psychiatry, Shinshu University School of Medicine, Matsumoto-City 390-8621, Japan; (Y.A.); (T.N.); (Y.K.); (S.W.)
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19
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Legrand-Vyskoc A. [Conversion disorder, caring for body, mind]. Soins Psychiatr 2023; 44:30-33. [PMID: 37926498 DOI: 10.1016/j.spsy.2023.09.010] [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
Conversion disorder is a psychiatric disorder whose clinic and management lie at the crossroads between body and mind. It challenges healthcare professionals in terms of diagnosis, further investigation, referral and care. A number of questions arise, such as how caregivers perceive the relationship between body and mind, the place of the psychiatric hypothesis among the initial diagnostic hypotheses, and the temporality of care.
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Affiliation(s)
- Aurore Legrand-Vyskoc
- Service de psychiatrie de l'enfant et de l'adolescent, CHU de Clermont-Ferrand, 58 rue Montalembert, 63000 Clermont-Ferrand, France; Université Clermont-Auvergne, 28 place Henri-Dunant, 63000 Clermont-Ferrand, France.
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20
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Abstract
Objective There has been an increase in Child Psychiatry Access Programs (CPAP) across the United States to address the national child and adolescent psychiatry workforce shortage by supporting pediatric primary care providers (PCPs) in providing mental health services. The objective of this systematic review is to synthesize the expanding literature on CPAPs. Method A systematic literature search was conducted in PubMed, PsycInfo, Embase, and Web of Science databases to identify articles published from database inception to April 6, 2022, to identify CPAPs, defined as programs with mental health specialists providing rapid remote mental health consultation services to pediatric PCPs. Study outcomes included program adoption, provider experience, patient and caregiver experience, program cost, and patient mental health. Results None of the 33 included studies were randomized controlled trials. Most of the studies (n = 30) focused on program adoption and provider experience (n = 18). Few studies examined patient and caregiver experience (n = 2), program cost(n = 4), or patient mental health (n = 4) outcomes. CPAPs showed year-over-year growth in adoption and were generally well-received by providers and caregivers. Health care provision costs were quite varied. No articles reported on changes in patient mental health according to validated measures. Heterogeneity in the methodological quality, study design, and outcomes used to evaluate CPAPs hindered comparison among programs. Conclusion Rigorous research on the impact of CPAPs is lacking. Findings show high provider satisfaction with CPAPs, yet few studies examine patient-level mental health outcomes. CPAPs and funding agencies should consider prioritizing and investing in research to build the evidence base for CPAPs. Diversity & Inclusion Statement One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. Clinical trial registration information Child Psychiatry Access Programs: A Systematic Review; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020146410; CRD42020146410.
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Affiliation(s)
- Chuan-Mei Lee
- University of California, San Francisco
- Stanford University School of Medicine
| | | | | | | | | | | | - Christina Mangurian
- University of California, San Francisco
- Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital
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21
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Bödeker K, Watrin-Avino LM, Martin A, Schlensog-Schuster F, Janssen M, Friese L, Licata-Dandel M, Mall V, Teich-Bělohradský J, Izat Y, Correll CU, Möhler E, Paulus FW. Assessment and Diagnostic Classification Using DC:0-5 in Early Childhood Mental Health Clinics: The Protocol for the Developmental Psychiatry Diagnostic Challenges Study (DePsy). Children (Basel) 2023; 10:1770. [PMID: 38002860 PMCID: PMC10670515 DOI: 10.3390/children10111770] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 10/17/2023] [Accepted: 10/19/2023] [Indexed: 11/26/2023]
Abstract
Mental health problems in early childhood are common, but there is a lack of psychiatric research on this age group. DC:0-5 is a multiaxial classification system for mental disorders in early childhood, providing a framework for standardizing clinical practice and research. However, research on the validity of DC:0-5 is scarce. The Developmental Psychiatry Diagnostic Challenges Study (DePsy) is a multi-site, prospective clinical study including six German early childhood mental health (ECMH) clinics. The main objective of the study is to contribute to the validation of Axis I and Axis II of DC:0-5. A second aim of the study is to describe the population of the participating clinics regarding diagnoses, family context, and treatment outcomes. Additionally, the impact of environmental risk factors, including parental Adverse Childhood Experiences (ACEs) and media use, on child psychopathology and caregiver-child relationships will be examined. Over two years, patients aged 0.0-5.9 years old will be enrolled in the study. Assessments include ICD-10 and DC:0-5 diagnoses, developmental tests, video-based observations of caregiver-child interactions, and questionnaires on child psychopathology, media use, parental stress, and treatment satisfaction. Study results will promote the standardization of assessment and treatment in ECMH clinics aiming to improve the development of patients and their families.
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Affiliation(s)
- Katja Bödeker
- Department of Child and Adolescent Psychiatry, Charité—Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany; (L.M.W.-A.); (C.U.C.)
| | - Laura M. Watrin-Avino
- Department of Child and Adolescent Psychiatry, Charité—Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany; (L.M.W.-A.); (C.U.C.)
| | - Annick Martin
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Leipzig University Medical Center, Liebigstrasse 20a, 04103 Leipzig, Germany; (A.M.); (F.S.-S.)
| | - Franziska Schlensog-Schuster
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Leipzig University Medical Center, Liebigstrasse 20a, 04103 Leipzig, Germany; (A.M.); (F.S.-S.)
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, 3000 Berne, Switzerland
| | - Marius Janssen
- Department of Child and Adolescent Psychiatry, University of Münster, Schmeddingstraße 50, 48149 Münster, Germany; (M.J.); (L.F.)
| | - Lennart Friese
- Department of Child and Adolescent Psychiatry, University of Münster, Schmeddingstraße 50, 48149 Münster, Germany; (M.J.); (L.F.)
| | - Maria Licata-Dandel
- kbo-Kinderzentrum Munich, Technical University of Munich, Heiglhofstraße 65, 81377 München, Germany; (M.L.-D.); (V.M.)
- Department of Psychology, Charlotte-Fresenius-University, 80797 Munich, Germany
| | - Volker Mall
- kbo-Kinderzentrum Munich, Technical University of Munich, Heiglhofstraße 65, 81377 München, Germany; (M.L.-D.); (V.M.)
| | - Juliane Teich-Bělohradský
- Vivantes Clinic Friedrichshain, Child and Adolescent Psychiatry Berlin, Landsberger Allee 49, 10249 Berlin, Germany; (J.T.-B.); (Y.I.)
| | - Yonca Izat
- Vivantes Clinic Friedrichshain, Child and Adolescent Psychiatry Berlin, Landsberger Allee 49, 10249 Berlin, Germany; (J.T.-B.); (Y.I.)
| | - Christoph U. Correll
- Department of Child and Adolescent Psychiatry, Charité—Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany; (L.M.W.-A.); (C.U.C.)
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY 11004, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Department of Psychiatry and Molecular Medicine, Hofstra University, Hempstead, NY 11549, USA
- The Feinstein Institutes for Medical Research, Center for Psychiatric Neuroscience, Northwell Health, New Hyde Park, NY 11030, USA
- German Center for Mental Health (DZPG), Partner Site Berlin, 10785 Berlin, Germany
| | - Eva Möhler
- Department of Child and Adolescent Psychiatry, Saarland University Hospital, Kirrberger Straße 100, 66421 Homburg, Germany; (E.M.); (F.W.P.)
| | - Frank W. Paulus
- Department of Child and Adolescent Psychiatry, Saarland University Hospital, Kirrberger Straße 100, 66421 Homburg, Germany; (E.M.); (F.W.P.)
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22
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Ranjan R, Nath S, Jha S, Narasimha VL. Single parent adoption in India: Mental health and legal perspectives and the way forward. J Postgrad Med 2023; 69:215-220. [PMID: 37357486 PMCID: PMC10846805 DOI: 10.4103/jpgm.jpgm_718_22] [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: 09/09/2022] [Revised: 01/08/2023] [Accepted: 02/01/2023] [Indexed: 06/27/2023] Open
Abstract
Single parent adoption (SPA) is a relatively new construct worldwide and in India. The Ministry of Women and Child Development, Government of India, has laid down criteria for adoption in general and SPA in particular, in conjunction with the Juvenile Justice Act (Care and Protection of Children), 2015. There is scant literature on this topic of SPA, more so in India, that looks into the various psychological nuances of SPA from a mental health professional's (MHP) perspective. This review paper aims to assess SPA from the perspective of a MHP that will focus on its various legal nuances as well as the psychological connotations attached to it. For this, a search strategy was employed that included a thorough literature search from two databases (PubMed and Google Scholar) with relevant keywords related to the topic. The various legal issues pertaining to SPA in the current scenario, the psychological issues and challenges faced by single parents, the behavioral outcomes of adoptees who are adopted by single parents, and ways to deal with the various obstacles of SPA are discussed.
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Affiliation(s)
- R Ranjan
- Department of Psychiatry, All India Institute of Medical Sciences, Patna, Bihar, India
| | - S Nath
- Department of Psychiatry, All India Institute of Medical Sciences, Deoghar, Jharkhand, India
| | - S Jha
- Department of Psychiatry, All India Institute of Medical Sciences, Patna, Bihar, India
| | - VL Narasimha
- Department of Psychiatry, All India Institute of Medical Sciences, Deoghar, Jharkhand, India
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23
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Rothwell L, Vivek K, Nicholls D, Maconochie I, Dyer EM. Fifteen-minute consultation: Recognition and management of eating disorders presenting to the emergency department. Arch Dis Child Educ Pract Ed 2023; 108:330-334. [PMID: 35790339 DOI: 10.1136/archdischild-2021-323348] [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: 03/10/2022] [Accepted: 06/24/2022] [Indexed: 11/19/2022]
Abstract
Eating disorder presentations in children and young people during the COVID-19 pandemic have increased, and this has become a common presentation to paediatric emergency departments (EDs). We cover a structured approach on identifying and managing these presentations within the ED including history taking, what to look for on examination, what investigations are needed and how to decide who requires admission to hospital.
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Affiliation(s)
- Luke Rothwell
- Paediatric Emergency Department, Imperial College Healthcare NHS Trust, London, UK
| | - Kavyesh Vivek
- Faculty of Medicine, Imperial College London, London, UK
| | - Dasha Nicholls
- Department of Brain Sciences, Imperial College London, London, UK
| | - Ian Maconochie
- Paediatric Emergency Department, Imperial College Healthcare NHS Trust, London, UK
| | - Emma M Dyer
- Paediatric Emergency Department, Imperial College Healthcare NHS Trust, London, UK
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24
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Segre G, Cargnelutti C, Bersani C, Njogu W, Roberti E, Campi R, De Vita MV, Morino G, Canevini MP, Bonati M. Early detection of neurodevelopmental disorders in African children living in informal settlements in Nairobi. BMJ Paediatr Open 2023; 7:e002117. [PMID: 37890890 PMCID: PMC10619007 DOI: 10.1136/bmjpo-2023-002117] [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: 06/06/2023] [Accepted: 09/28/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Children in low-income and middle-income countries (LMICs) are at a substantially increased risk of delayed physical, emotional and sociocognitive outcomes, with consequential neurodevelopmental disorders. Evidence based, cost-effective and culturally appropriate screening tools are recommended for early identification of developmental disorders. METHODS The present study aims to assess the feasibility of early screening for neurodevelopmental disorders in children living in informal settlements in Nairobi, Kenya (Korogocho). The selected tools (ie, the CDC checklist and the Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R)), widely used in high-income countries, are applied in two different populations: one from Kenya (LMIC) and one from Italy, to compare the different scores. RESULTS Of 509 children screened, 8.6% were classified at-risk based on the results of the screening tools. Significant risk factors are history of low birth weight and Apgar score, presence of neurological disorders, malnutrition and/or rickets, younger age of the child and older age of the mother. Caesarean section delivery, first pregnancy and mothers' older age were common risk factors among the Kenyan and the Italian samples. The Italian sample had a significantly greater rate of missed milestones. CONCLUSIONS Our data demonstrate the feasibility of using the CDC and M-CHAT-R tools in informal settlement dwellers. Further studies are needed to explore the opportunity for early diagnosis of developmental disorders in LMICs.
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Affiliation(s)
- Giulia Segre
- Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Cecilia Cargnelutti
- Department of Health Sciences, Università degli Studi di Milano, Milano, Italy
| | - Carlotta Bersani
- Department of Health Sciences, Università degli Studi di Milano, Milano, Italy
| | | | - Elisa Roberti
- Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Rita Campi
- Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | | | | | | | - Maurizio Bonati
- Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
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25
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Albanna A, Soubra K, Alhashmi D, Alloub Z, AlOlama F, Hammerness P, Lakshmanan J, Hechtman L, Hamoda H. Effectiveness of collaborative tele-mental health care for children with attention deficit hyperactivity disorder in United Arab Emirates. East Mediterr Health J 2023; 29:742-748. [PMID: 37776136 DOI: 10.26719/emhj.23.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 04/01/2023] [Indexed: 10/01/2023]
Abstract
Background Attention deficit hyperactivity disorder is a common neurodevelopmental disorder. Accessing services for this disorder is a worldwide challenge and requires innovative interventions. Aims We aimed to investigate the effectiveness of tele-collaborative care for attention deficit hyperactivity disorder in primary health care centres in Dubai. Methods Six trained physicians started collaborative care clinics across Dubai. Eligible children aged 6-12 years attending primary health care centres with attention deficit hyperactivity disorder were randomly selected to receive telehealth collaborative care, or standard treatment. Baseline assessments were conducted using the Vanderbilt Behavioral Assessment Scale, the Columbia Impairment Scale, the Childhood Behavior Checklist, and the Strength and Difficulties Questionnaire. Waiting times and clinical and functional outcomes were measured in both groups and compared. Continuous variables were presented as means and standard deviations, categorical variables such as sex were presented as numbers and percentages, and continuous outcome variables were compared using the Student t-test. Results Among the referred children (n = 112), 11 boys and 6 girls met the eligibility criteria (mean age 7.8 years). The dropout rate at 6 months in the control group was 80%, compared with 50% in the intervention group. The mean waiting time was significantly shorter in the intervention group (1.3 weeks) than the control group (7.1 weeks); P = 0.026. The mean difference in the Childhood Behavior Checklist total score over time was significantly higher in the intervention group (P = 0.042), but the mean difference in the Vanderbilt scale was not significant. Conclusion Tele-collaborative care for children with attention deficit hyperactivity disorder within primary health care is feasible.
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Affiliation(s)
- Ammar Albanna
- Al Jalila Children's Specialty Hospital, Dubai, United Arab Emirates
- Mohamed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
- Al Amal Psychiatric Hospital, Emirates Health Services, United Arab Emirates
| | - Karina Soubra
- Al Jalila Children's Specialty Hospital, Dubai, United Arab Emirates
| | - Deena Alhashmi
- Mohamed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Zainab Alloub
- Al Jalila Children's Specialty Hospital, Dubai, United Arab Emirates
| | | | - Paul Hammerness
- Department of Psychiatry, Boston Children's Hospital and Harvard Medical School, Boston, United States of America
| | - Jeyaseelan Lakshmanan
- Mohamed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | | | - Hesham Hamoda
- Department of Psychiatry, Boston Children's Hospital and Harvard Medical School, Boston, United States of America
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Wilkinson SR. Bowlby's five therapeutic tasks: bringing them up to date for children. BJPsych Bull 2023:1-5. [PMID: 37555334 DOI: 10.1192/bjb.2023.67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/10/2023] Open
Abstract
Bowlby remained attached to his psychoanalytic roots and conceptualised treatment in terms of one-to-one relationships, albeit acknowledging the need for a family formulation. Bowlby's five therapeutic tasks were never adapted to the current understanding of working with the relationships fostering the development and maintenance of children's attachment strategies. This paper goes through each of Bowlby's five tasks and adapts them to our current understanding of development, with consequences for prioritising family approaches, rather than a secure base alone with a therapist. In doing so I will review the process of achieving security, seeing it as more similar to an allostatic process than a state of homeostasis.
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Guo Q, Xia L, Guo R, Xu W, Zhang Y, Zhao C, Zhang P, Bai T, Ni X, Hao C, Xia K, Li W. Behavioural deficits of autism spectrum disorder and associations with different gene clusters: a study with the whole-genome transmission disequilibrium test. BMJ Paediatr Open 2023; 7:e001930. [PMID: 37407249 DOI: 10.1136/bmjpo-2023-001930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 05/17/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Autism spectrum disorder (ASD) is a diverse neurodevelopmental disease primarily distinguished by limited and stereotyped activities as well as impaired social interaction. Due to the high heritability of ASD, research on the disorder has emphasised on identifying the underlying genetic and epigenetic aetiology. Many ASD loci have been identified by genome-wide association studies (GWASs). However, GWASs are more susceptible to bias due to population stratification. Moreover, GWASs barely reflect the genetic aetiology of subtypes of behavioural deficits. METHODS We applied whole-genome transmission disequilibrium test (TDT) to reveal the gene sets that are significantly associated with the four behavioural subtypes of restricted repetitive behaviours in 334 ASD trios. We further mapped the clustered genes to pathways and enriched the SFARI genes in these pathways. RESULTS Four unique gene clusters (181 genes in total) that are related to four different behavioural subtypes in ASD were identified. 23 SFARI genes were enriched in these four clusters. Through pathway analysis, nine non-SFARI genes (CNDP1, ETNK1, ITPKB, KCNQ5, PDE4D, PDGFRA, PPARGC1A, ULK2, SYNJ2) were found to be linked to the SFARI genes, which may contribute to the development of ASD. Furthermore, we found that the mTOR pathway enriched with the CNDP1, PDE4D, ULK2 genes is associated with neurodevelopment. CONCLUSIONS Whole-genome TDT test is a unique tool in clustering genes related to ASD subtypes of behavioural deficits. Several new candidate genes for ASD are revealed by pathway analysis of the clustered genes. These findings are useful for understanding the underlying mechanism of ASD.
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Affiliation(s)
- Qi Guo
- Beijing Children's Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory for Genetics of Birth Defects, Beijing Pediatric Research Institute, Beijing, China
- MOE Key Laboratory of Major Diseases in Children, Beijing, China
| | - Lu Xia
- Xiangya Medical School of Central China University, Changsha, China
| | - Ruolan Guo
- Beijing Children's Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory for Genetics of Birth Defects, Beijing Pediatric Research Institute, Beijing, China
- MOE Key Laboratory of Major Diseases in Children, Beijing, China
| | - Wenjian Xu
- Beijing Children's Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory for Genetics of Birth Defects, Beijing Pediatric Research Institute, Beijing, China
- MOE Key Laboratory of Major Diseases in Children, Beijing, China
| | - Yue Zhang
- Beijing Children's Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory for Genetics of Birth Defects, Beijing Pediatric Research Institute, Beijing, China
- MOE Key Laboratory of Major Diseases in Children, Beijing, China
| | - Chunlin Zhao
- Beijing Children's Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory for Genetics of Birth Defects, Beijing Pediatric Research Institute, Beijing, China
- MOE Key Laboratory of Major Diseases in Children, Beijing, China
| | - Peng Zhang
- Beijing Children's Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory for Genetics of Birth Defects, Beijing Pediatric Research Institute, Beijing, China
- MOE Key Laboratory of Major Diseases in Children, Beijing, China
| | - Ting Bai
- Xiangya Medical School of Central China University, Changsha, China
| | - Xin Ni
- National Center for Children's Health, Beijing, China
| | - Chanjuan Hao
- Beijing Children's Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory for Genetics of Birth Defects, Beijing Pediatric Research Institute, Beijing, China
- MOE Key Laboratory of Major Diseases in Children, Beijing, China
| | - Kun Xia
- Xiangya Medical School of Central China University, Changsha, China
- Hengyang Medical School, University of South China, Hengyang, China
- MOE Key Laboratory of Pediatric Rare Diseases, Hengyang, China
| | - Wei Li
- Beijing Children's Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory for Genetics of Birth Defects, Beijing Pediatric Research Institute, Beijing, China
- MOE Key Laboratory of Major Diseases in Children, Beijing, China
- National Center for Children's Health, Beijing, China
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Philipp DA, Prime H, Darwiche J. An ultra-brief systemic intervention to address child mental health symptomatology. Fam Process 2023; 62:469-482. [PMID: 36959726 DOI: 10.1111/famp.12875] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 02/13/2023] [Accepted: 02/14/2023] [Indexed: 06/08/2023]
Abstract
Drawing on decades of research in family systems, coparenting, and developmental science, we present a clinical approach to address unmet service needs in children's mental health. Specifically, we describe Lausanne Family Play - Brief Intervention (LFP-B) - a manualized family systems approach providing a caregiver-caregiver-child therapy (and sibling/s, when applicable). The LFP-B is ultra-brief, typically delivered in as few as three sessions (two assessment sessions followed by a video feedback session), with the aim of reducing children's mental health symptomatology by enhancing the coparenting relationship. We review literature on systemic family therapies and provide a rationale for including coparents and children in child mental health care. We then provide a rationale for using behavioral observations and video feedback in treatment, drawing on research in related family-based treatments (e.g., parent-child therapies). Finally, we provide an overview of the LFP-B manual and a case illustration.
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Affiliation(s)
- Diane A Philipp
- Garry Hurvitz Centre for Community Mental Health at Sickkidis, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Heather Prime
- Department of Psychology, York University, Toronto, Ontario, Canada
- LaMarsh Centre for Child & Youth Research, York University, Toronto, Canada
| | - Joëlle Darwiche
- Family and Development Research Center, Institute of Psychology, University of Lausanne, Lausanne, Switzerland
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Walter HJ, Abright AR, Bukstein OG, Diamond J, Keable H, Ripperger-Suhler J, Rockhill C. Clinical Practice Guideline for the Assessment and Treatment of Children and Adolescents With Major and Persistent Depressive Disorders. J Am Acad Child Adolesc Psychiatry 2023; 62:479-502. [PMID: 36273673 DOI: 10.1016/j.jaac.2022.10.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 10/14/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To enhance the quality of care and clinical outcomes for children and adolescents with major depressive disorder (MDD) and persistent depressive disorder (PDD). The aims are as follows: (1) to summarize empirically based guidance about the psychosocial and psychopharmacologic treatment of MDD and PDD in children and adolescents; and (2) to summarize expert-based guidance about the assessment of these disorders as an integral part of treatment, and the implementation of empirically based treatments for these disorders in clinical practice. METHOD Statements about the treatment of MDD and PDD are based upon empirical evidence derived from a critical systematic review of the scientific literature conducted by the Research Triangle Institute International-University of North Carolina at Chapel Hill (RTI-UNC) Evidence-based Practice Center under contract with the Agency for Healthcare Research and Quality (AHRQ). Evidence from meta-analyses published since the AHRQ/RTI-UNC review is also presented to support or refute the AHRQ findings. Guidance about the assessment and clinical implementation of treatments for MDD and PDD is informed by expert opinion and consensus as presented in previously published clinical practice guidelines, chapters in leading textbooks of child and adolescent psychiatry, the DSM-5-TR, and government-affiliated prescription drug information websites. RESULTS Psychotherapy (specifically, cognitive-behavioral and interpersonal therapies) and selective serotonin reuptake inhibitor (SSRI) medication have some rigorous (randomized controlled trials, meta-analyses) empirical support as treatment options. Because effective treatment outcomes are predicated in part upon accuracy of the diagnosis, depth of the clinical formulation, and breadth of the treatment plan, comprehensive, evidence-based assessment may enhance evidence-based treatment outcomes. CONCLUSION Disproportionate to the magnitude of the problem, there are significant limitations in the quality and quantity of rigorous empirical support for the etiology, assessment, and treatment of depression in children and adolescents. In the context of a protracted severe shortage of child and adolescent-trained behavioral health specialists, the demonstration of convenient, efficient, cost-effective, and user-friendly delivery mechanisms for safe and effective treatment of MDD and PDD is a key research need. Other research priorities include the sequencing and comparative effectiveness of depression treatments, delineation of treatment mediators and moderators, effective approaches to treatment nonresponders and disorder relapse/recurrence, long-term effects and degree of suicide risk with SSRI use, and the discovery of novel pharmacologic or interventional treatments.
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Perlman P, Vorstman J, Hoang N, Summers J, Baribeau D, Cunningham J, Mulsant BH. Support to caregivers who have received genetic information about neurodevelopmental and psychiatric vulnerability in their young children: A narrative review. Clin Genet 2023. [PMID: 37098443 DOI: 10.1111/cge.14349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 04/17/2023] [Accepted: 04/18/2023] [Indexed: 04/27/2023]
Abstract
Diagnosis of pathogenic genetic variants associated with neurodevelopmental and psychiatric disorders (NPDs) is increasingly made early in life. This narrative review focuses on the need for, and provision of, psychological supports following genetic diagnosis. We conducted a literature search of publications on how caregivers are informed about the NPD vulnerability associated with genetic variants, challenges and unmet needs when receiving this information, and whether psychological supports are provided. Given its early recognition, the 22q11.2 deletion has been studied thoroughly for two decades, providing generalizable insights. This literature indicates the complex caregivers' needs related to learning about potential NPD vulnerabilities associated with a genetic variant, include how to communicate the diagnosis, how to identify early signs of NPDs, how to deal with stigma and a lack of medical expertise outside of specialized genetics clinics. With one exception, no publications describe psychotherapeutic support provided to parents. In the absence of support, caregivers struggle with several unmet needs regarding potential longer-term NPD implications of a genetic diagnosis. The field needs to go beyond explaining genetic diagnoses and associated vulnerabilities, and develop approaches to support caregivers with communicating and managing NPD implications across the child's lifespan.
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Affiliation(s)
- Polina Perlman
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jacob Vorstman
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Program in Genetics and Genome Biology, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Ny Hoang
- Program in Genetics and Genome Biology, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Genetic Counselling, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Jane Summers
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Danielle Baribeau
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Jessie Cunningham
- SickKids Hospital Library, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Benoit H Mulsant
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Centre for Addition and Mental Health, Toronto, Ontario, Canada
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Aran A, Harel M, Ovadia A, Shalgy S, Cayam-Rand D. Mediators of Placebo Response to Cannabinoid Treatment in Children with Autism Spectrum Disorder. J Clin Med 2023; 12:jcm12093098. [PMID: 37176538 PMCID: PMC10179251 DOI: 10.3390/jcm12093098] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/20/2023] [Accepted: 04/21/2023] [Indexed: 05/15/2023] Open
Abstract
The placebo response has a substantial impact on treatment outcome. However, data regarding mediators of the placebo response in children with autism spectrum disorder (ASD) are sparse. This retrospective study investigated possible mediators of the placebo response among participants of a placebo-controlled trial of cannabinoid treatment for behavioral problems in children with ASD (CBA trial, age 5-21 years). We used a specifically designed questionnaire to explore possible mediators of the placebo response in 88 participants of the CBA trial who received a placebo and had valid outcome scores. The parents of 67 participants completed the questionnaire. The placebo response was positively associated with the child's comprehension of the treatment purpose (p = 0.037). There was also a trend for participants who had a relative aggravation of symptoms before treatment onset to improve following placebo treatment (p = 0.053). No other domains, including parental expectations, previous positive experience with similar treatments (behavioral conditioning), parental locus of control, quality of the patient-physician relationships, and adherence to study medications were associated with placebo-response. This finding suggests that efforts to explain the treatment purpose to children with disabilities may enhance treatment efficacy in clinical practice and decrease differences in the placebo response between study arms. Contrary to our hypothesis, parental expectations regarding cannabinoid treatment were not associated with the placebo response.
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Affiliation(s)
- Adi Aran
- Neuropediatric Unit, Shaare Zedek Medical Center, Jerusalem 9103102, Israel
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
| | - Moria Harel
- Neuropediatric Unit, Shaare Zedek Medical Center, Jerusalem 9103102, Israel
| | - Aminadav Ovadia
- Psychology Department, Yezreel Valley College, Yezreel Valley 1930600, Israel
| | - Shulamit Shalgy
- Psychology Department, Yezreel Valley College, Yezreel Valley 1930600, Israel
| | - Dalit Cayam-Rand
- Neuropediatric Unit, Shaare Zedek Medical Center, Jerusalem 9103102, Israel
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Wang LJ, Li SC, Yeh YM, Lee SY, Kuo HC, Yang CY. Gut mycobiome dysbiosis and its impact on intestinal permeability in attention-deficit/hyperactivity disorder. J Child Psychol Psychiatry 2023. [PMID: 37016804 DOI: 10.1111/jcpp.13779] [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] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/23/2023] [Indexed: 04/06/2023]
Abstract
BACKGROUND Dysbiosis in the gut microbial community might be involved in the pathophysiology of attention-deficit/hyperactivity disorder (ADHD). The fungal component of the gut microbiome, namely the mycobiota, is a hyperdiverse group of multicellular eukaryotes that can influence host intestinal permeability. This study therefore aimed to investigate the impact of fungal mycobiome dysbiosis and intestinal permeability on ADHD. METHODS Faecal samples were collected from 35 children with ADHD and from 35 healthy controls. Total DNA was extracted from the faecal samples and the internal transcribed spacer regions were sequenced using high-throughput next-generation sequencing (NGS). The fungal taxonomic classification was analysed using bioinformatics tools and the differentially expressed fungal species between the ADHD and healthy control groups were identified. An in vitro permeability assay (Caco-2 cell layer) was used to evaluate the biological effects of fungal dysbiosis on intestinal epithelial barrier function. RESULTS The β-diversity (the species diversity between two communities), but not α-diversity (the species diversity within a community), reflected the differences in fungal community composition between ADHD and control groups. At the phylum level, the ADHD group displayed a significantly higher abundance of Ascomycota and a significantly lower abundance of Basidiomycota than the healthy control group. At the genus level, the abundance of Candida (especially Candida albicans) was significantly increased in ADHD patients compared to the healthy controls. In addition, the in vitro cell assay revealed that C. albicans secretions significantly enhanced the permeability of Caco-2 cells. CONCLUSIONS The current study is the first to explore altered gut mycobiome dysbiosis using the NGS platform in ADHD. The findings from this study indicated that dysbiosis of the fungal mycobiome and intestinal permeability might be associated with susceptibility to ADHD.
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Affiliation(s)
- Liang-Jen Wang
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Sung-Chou Li
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Yuan-Ming Yeh
- Genomic Medicine Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Sheng-Yu Lee
- Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Department of Psychiatry, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ho-Chang Kuo
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Chia-Yu Yang
- Department of Microbiology and Immunology, Molecular Medicine Research Center, Chang Gung University, Taoyuan, Taiwan
- Department of Otolaryngology Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
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Hansen AS, Kjaersdam Telléus G, Mohr-Jensen C, Færk E, Lauritsen MB. The effect of the Development and Well-Being Assessment as an adjunct to standard referral letters on referral decisions by child and adolescent mental health services - a randomized feasibility trial. Clin Child Psychol Psychiatry 2023; 28:434-449. [PMID: 35337193 DOI: 10.1177/13591045221081384] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background: High rejection rates for referrals to child and adolescent mental health services (CAMHS) are common. The most cited reasons for rejection are that the child does not have a clinical need for assessment and poor quality of the referrals. However, studies of interventions aimed at improving appropriateness of referrals are sparse. Methods: In this randomized feasibility trial, we tested if the Development and Well-Being Assessment (DAWBA) as an adjunct to referral letters could improve accuracy of referral decisions made by CAMHS. The primary outcome of the study was the proportion of "correct" referral decisions. Results: The study included 160 children referred to CAMHS. Almost all (95.6%) participants fulfilled criteria for a mental disorder and 82.1% also reported high impact of symptoms. Compared to the group who did not complete the DAWBA, referral decisions for the DAWBA group showed higher sensitivity (0.63 vs. 0.83), specificity (0.30 vs. 0.42), and negative predictive value (0.14 vs. 0.36) as well as slightly higher positive predictive value (0.81 vs. 0.86). Conclusions: The use of the DAWBA as an adjunct to standard referral letters could lead to more correct referral decisions and reduce the proportion of wrongful rejection referrals to CAMHS.
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Affiliation(s)
- Anna Sofie Hansen
- Department of Psychiatry, 53141Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Gry Kjaersdam Telléus
- Department of Psychiatry, 53141Aalborg University Hospital, Aalborg, Denmark.,Institute of Communication and Psychology, Aalborg University, Aalborg, Denmark
| | - Christina Mohr-Jensen
- Department of Psychiatry, 53141Aalborg University Hospital, Aalborg, Denmark.,Institute of Communication and Psychology, Aalborg University, Aalborg, Denmark
| | - Emil Færk
- Department of Psychiatry, 53141Aalborg University Hospital, Aalborg, Denmark
| | - Marlene Briciet Lauritsen
- Department of Psychiatry, 53141Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Bourke EM, Knott JC, Craig S, Babl FE. Management of paediatric acute severe behavioural disturbance in emergency departments across Australia: A PREDICT survey of senior medical staff. Emerg Med Australas 2023; 35:254-260. [PMID: 36328402 PMCID: PMC10946763 DOI: 10.1111/1742-6723.14105] [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] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 09/20/2022] [Accepted: 10/01/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Acute severe behavioural disturbance (ASBD) is a condition seen with increasing frequency in EDs. It poses a significant risk to the patient and those around them. Little is known about the epidemiology or most effective management in the paediatric population. The aim of the present study is to clarify the practice of senior emergency doctors in Australia when managing paediatric ASBD. METHODS The present study was a voluntary electronic questionnaire distributed to and undertaken by senior medical staff in EDs affiliated with the Paediatric Research in Emergency Departments International Collaborative (PREDICT) network. Respondents reported on exposure to and confidence in managing paediatric ASBD and their current practices. RESULTS A total of 227 (33%) clinicians completed the survey between February and May 2020. Most clinicians were caring for at least two young people with ASBD each week (72%), felt confident regarding the majority of components of management and referred to local clinical practice guidelines (69%). Agitation/sedation rating scales were seldom used (19%). There was a significant variation in self-reported management practices. The choice of whether to use medication at all, the medication chosen and route of administration all varied greatly. Respondents were more willing to provide parenteral medication to young people reported as having recreational drug intoxication (84%) than those with neurodevelopment disorders (65%) when the same degree of agitation was reported. CONCLUSIONS Within Australia, there is considerable variation in paediatric ASBD practice, in particular regarding medication provision. Further prospective research is required to inform best clinical practice.
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Affiliation(s)
- Elyssia M Bourke
- Emergency Research GroupMurdoch Children's Research InstituteMelbourneVictoriaAustralia
- Department of Critical CareThe University of MelbourneMelbourneVictoriaAustralia
- Emergency DepartmentGrampians HealthBallaratVictoriaAustralia
| | - Jonathan C Knott
- Department of Critical CareThe University of MelbourneMelbourneVictoriaAustralia
- Emergency DepartmentThe Royal Melbourne HospitalMelbourneVictoriaAustralia
| | - Simon Craig
- Emergency Research GroupMurdoch Children's Research InstituteMelbourneVictoriaAustralia
- Department of PaediatricsMonash UniversityMelbourneVictoriaAustralia
- Emergency DepartmentMonash Medical CentreMelbourneVictoriaAustralia
| | - Franz E Babl
- Emergency Research GroupMurdoch Children's Research InstituteMelbourneVictoriaAustralia
- Department of Critical CareThe University of MelbourneMelbourneVictoriaAustralia
- Emergency DepartmentThe Royal Children's HospitalMelbourneVictoriaAustralia
- Department of PaediatricsThe University of MelbourneMelbourneVictoriaAustralia
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Abbasi LN, Mazzawi T, Abasi L, Haj Ali S, Alqudah A, Al-Taiar H. The Prevalence and Associated Factors of Attention Deficit Hyperactivity Disorder Among Primary School Children in Amman, Jordan. Cureus 2023; 15:e37856. [PMID: 37214023 PMCID: PMC10199271 DOI: 10.7759/cureus.37856] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2023] [Indexed: 05/23/2023] Open
Abstract
Objective Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder characterized by impaired levels of inattention, disorganization and/or hyperactivity-impulsivity. The aim of this study was to estimate the prevalence of ADHD among primary school children in Jordan and assess the potential risk factors. Method A cross-sectional study was conducted in 2022-2023 on 1563 school children aged six to 12 years. ADHD was assessed using parent and teacher versions of the Conners Rating scale. Risk factors were evaluated through a sociodemographic questionnaire. A p-value set at <.05 was considered statistically significant. Results ADHD prevalence based on parents' and teachers' perspectives was 27.7% and 22.5%, respectively. Males, smoking during pregnancy, low birth weight, low parental education and unemployment, and public schools had increased ADHD rates. Conclusion ADHD presents a major problem among primary school children in Jordan. Early detection, prevention, and management of this disease require parents' and teachers' awareness and risk factor control.
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Affiliation(s)
| | | | - Lamees Abasi
- Pathology and Laboratory Medicine, King Hussein Medical Center, Royal Medical Services, Amman, JOR
| | - Sara Haj Ali
- Medicine, Al-Balqa Applied University, Al-Salt, JOR
| | - Abdallah Alqudah
- Medicine, University Hospitals Plymouth NHS Trust, Plymouth, GBR
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Julhan L, Lachal J. [Photographing to advance, the use of photography in psychotherapy]. Soins Psychiatr 2023; 44:18-20. [PMID: 37149326 DOI: 10.1016/j.spsy.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
The practice of the clinical psychologist in child psychiatry can be a perilous task. His balance, as precarious as it may be, lies in listening to and observing the patient, but also in the use of precious tools of which therapeutic mediations are a part. They allow to experiment a sensory-motor anchorage and bring a multidimensional vision necessary to the comprehension of the subject and his suffering. By creating an intermediary space between the I and the You, the outside and the inside, they determine a place where the psychotherapeutic work can take place.
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Affiliation(s)
- Lucile Julhan
- Service de psychiatrie de l'enfant et de l'adolescent, CHU de Clermont-Ferrand, 58 rue Montalembert, 63000 Clermont-Ferrand, France
| | - Jonathan Lachal
- Service de psychiatrie de l'enfant et de l'adolescent, CHU de Clermont-Ferrand, 58 rue Montalembert, 63000 Clermont-Ferrand, France; Université Clermont Auvergne, 28 place Henri-Dunant, 63000 Clermont-Ferrand, France; Université Paris-Saclay, UVSQ, Inserm, Centre de recherche en épidémiologie et santé des populations, Team DevPsy, 16 avenue Paul-Vaillant-Couturier, 94807 Villejuif cedex, France.
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37
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Sanchez-Clemente N, Eisen S, Harkensee C, Longley N, O'Grady R, Ward A. Beyond arrival: safeguarding unaccompanied asylum-seeking children in the UK. Arch Dis Child 2023; 108:160-165. [PMID: 35728940 DOI: 10.1136/archdischild-2021-323648] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 05/23/2022] [Indexed: 11/04/2022]
Abstract
Unaccompanied children (also called unaccompanied minors) are children who have been separated from both parents and other relatives and are not being cared for by an adult who, by law or custom, is responsible for doing so. From 2010 to 2020, unaccompanied minors accounted on average for 15.4% of the total number of first-time asylum applicants aged less than 18 years in the UK. These young people risk their lives and undergo traumatic journeys in search of a better life. However, when they arrive in the UK, they are vulnerable to significant ongoing traumatic experiences.In this review, we look at the reasons young people are forced to flee their countries, how they make their journey, and the risks and dangers they face along the way. We examine safety and victimisation risks faced by children and young people after arrival in the UK, which mechanisms and processes exist to safeguard these individuals, and examine the data available on outcomes of unaccompanied asylum-seeking child (UASC. Finally, we share two case examples that represent both the strengths and weaknesses of existing processes for UASC.
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Affiliation(s)
| | - Sarah Eisen
- Paediatrics, University College London Hospitals NHS Foundation Trust, London, UK
| | | | - Nicky Longley
- Infection, Hospital for Tropical Diseases, London, UK.,CRD, London School of Hygiene and Tropical Medicine, London, UK
| | - Rob O'Grady
- Looked After Children Service, Camden Local Authority, London, UK
| | - Allison Ward
- Camden Integrated Services for Children, Central and North West London NHS Foundation Trust, London, UK
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38
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Spencer AE, Sikov J, Adams WG, Jellinek M, Murphy JM, Garg A. Addressing Social Determinants of Mental Health in Pediatrics During the Coronavirus Disease 2019 Pandemic. Acad Pediatr 2023; 23:263-264. [PMID: 36351513 PMCID: PMC9637283 DOI: 10.1016/j.acap.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/28/2022] [Accepted: 11/01/2022] [Indexed: 11/07/2022]
Affiliation(s)
- Andrea E Spencer
- Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children's Hospital of Chicago (AE Spencer), Chicago, Ill.
| | - Jennifer Sikov
- Department of Psychology, Florida International University (J Sikov), Miami, Fla
| | - William G Adams
- Department of Pediatrics, Boston University School of Medicine, Boston Medical Center (WG Adams), Boston, Mass
| | - Michael Jellinek
- Department of Psychiatry, Massachusetts General Hospital (M Jellinek and JM Murphy), Boston, Mass; Department of Psychiatry, Harvard Medical School (M Jellinek and JM Murphy), Boston, Mass
| | - J Michael Murphy
- Department of Psychiatry, Massachusetts General Hospital (M Jellinek and JM Murphy), Boston, Mass; Department of Psychiatry, Harvard Medical School (M Jellinek and JM Murphy), Boston, Mass
| | - Arvin Garg
- Department of Pediatrics, Child Health Equity Center, UMass Chan Medical School, UMass Memorial Children's Medical Center (A Garg), Worcester, Mass
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39
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Makushkin EV. [Diagnostic process and fundamentals of decision-making by a child psychiatrist at an outpatient site]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:5-13. [PMID: 37942967 DOI: 10.17116/jnevro20231230925] [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: 11/10/2023]
Abstract
Based on clinical models of problem situations, for the first time in the form of structured algorithms, the organization of a doctor's work is described - the process of operational activity of a specialist when considering medical, legal, departmental and interdepartmental issues in child psychiatry. The activity of a children's specialist, requiring intensification during outpatient admission, in its content represents a complex of sequential operational actions, built in stages, logical algorithms for making productive professional decisions. The algorithms of activity take into account the legal, diagnostic, clinical, therapeutic, rehabilitation and preventive stages in the organization of providing assistance. The productivity and efficiency of the work of a child psychiatrist, his specialization, experience, competencies, orientation in legislation and modern scientific and practical industry issues of diagnostics and assistance are indispensable components of the optimal process of organizing a doctor's activities. The availability and quality of assistance in modern society are achieved by observing the continuity of the activities of specialists, saving human resources, and developing service units. Of particular importance is the adoption of the right decisions by the health authorities and the achievement of an effective balance between community care, dispensary, hospital replacement technologies and inpatient specialized care.
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Affiliation(s)
- E V Makushkin
- National Medical Research Center for Children's Health, Moscow, Russia
- Mental Health Research Center, Moscow, Russia
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40
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Demircioğlu A, Atasavun Uysal S, Şanlı Dumankaya BB, Kırdı E, Tuna Çak Esen H, Dağ O, Topuz S, Topuz S. Do Children with Attention Deficit and Hyperactivity Disorder Present with Different Spatio-Temporal Gait Parameters? An Evaluation of the Relationship Between Gait and Gross Motor Skills. Alpha Psychiatry 2023; 24:1-7. [PMID: 36879997 PMCID: PMC9985067 DOI: 10.5152/alphapsychiatry.2023.22976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 11/16/2022] [Indexed: 01/12/2023]
Abstract
Objective The aim of the current study was to compare the spatio-temporal parameters of gait and gross motor skills in children with attention deficit hyperactivity disorder-combined type with those of typically developing children and to search the effect of motor skills on gait parameters in children with attention deficit hyperactivity disorder-combined type. Methods A total of 50 children (n = 25 attention deficit hyperactivity disorder-combined type, n = 25 typically developing children) aged 5-12 years were included. Gross motor skills were evaluated using the Bruininks-Oseretsky Test Second Edition-Short Form. Spatio-temporal parameters of gait were assessed with a GAITRite® computer-based system. Results In the subtests of Bruininks-Oseretsky Test Second Edition-Short Form (bilateral coordination (P < .001), balance (P = .013), running speed and agility (P = .003)), lower scores were obtained by the children with attention deficit hyperactivity disorder-combined type. The swing phase of gait was found to be longer in children with attention deficit hyperactivity disorder-combined type (P = .01). Conclusion The current study results show that gross motor skills are affected negatively and the swing phase is prolonged in children with attention deficit hyperactivity disorder-combined type. Upper limb coordination and balance were also seen to have an effect on the velocity, step, and stride length. It is important to include an objective gait assessment as well as gross motor skills in the comprehensive clinical evaluation of children with attention deficit hyperactivity disorder-combined type.
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Affiliation(s)
- Arzu Demircioğlu
- Department of Physiotherapy and Rehabilitation, Hacettepe University Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey
| | - Songül Atasavun Uysal
- Department of Physiotherapy and Rehabilitation, Hacettepe University Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey
| | - Buse Büşra Şanlı Dumankaya
- Department of Physiotherapy and Rehabilitation, Hacettepe University Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey
| | - Elif Kırdı
- Department of Physiotherapy and Rehabilitation, Hacettepe University Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey
| | - Halime Tuna Çak Esen
- Department of Pediatric Mental Health and Diseases, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Osman Dağ
- Department of Biostatistics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Semra Topuz
- Department of Physiotherapy and Rehabilitation, Hacettepe University Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey
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Valade F, Béliveau MJ, Breault C, Chabot B, Labelle F. Individual and cumulative risk factors in developmental language disorder: A case-control study. Clin Child Psychol Psychiatry 2023; 28:398-414. [PMID: 35797616 PMCID: PMC9893307 DOI: 10.1177/13591045221113389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Many mental disorders (MD) share common etiology, fuelling debates about the specificity of clinical categories and whether the presence of specific risk factors (RF) can distinguish among them. The study of developmental language disorder (DLD), more specifically, has been further hindered by a lack of consensus regarding its definition. These limitations increase the risk of under-detection and lifelong consequences for affected children. This paper aims (1) to document which individual RF allow differentiating DLD from other MD and (2) to compare the cumulative RF between children with DLD versus other MD. This case-control design study used medical records of a psychiatric sample of 795 preschoolers (mean age 4:11, 75% boys). A logistic regression measured the predictive value of potential RF on DLD. Later first sentences, maternal immigration and family history of language delay were identified as significant in explaining 30% of the variance for DLD diagnosis. An ANCOVA revealed that children with DLD were exposed to a significantly higher number of RF than were children with other MD. Public health policies informed with the knowledge of specific RF associated with DLD, and their cumulative impact, could improve early detection and reduce the cascade of negative consequences associated with DLD.
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Affiliation(s)
- Florence Valade
- Department of Psychology, 5622University of Montreal, Montreal, QC, Canada.,CIUSSS Nord-de-l'Ile-de-Montréal, Hôpital en santé mentale Rivière-des-Prairies, Montreal, QC, Canada
| | - Marie-Julie Béliveau
- Department of Psychology, 5622University of Montreal, Montreal, QC, Canada.,CIUSSS Nord-de-l'Ile-de-Montréal, Hôpital en santé mentale Rivière-des-Prairies, Montreal, QC, Canada
| | - Chantale Breault
- CIUSSS Nord-de-l'Ile-de-Montréal, Hôpital en santé mentale Rivière-des-Prairies, Montreal, QC, Canada.,School of Speech-Language Pathology and Audiology, 5622University of Montreal, Montreal, QC, Canada
| | - Benjamin Chabot
- Department of Psychology, 5622University of Montreal, Montreal, QC, Canada
| | - Fannie Labelle
- Department of Psychology, 5622University of Montreal, Montreal, QC, Canada.,CIUSSS Nord-de-l'Ile-de-Montréal, Hôpital en santé mentale Rivière-des-Prairies, Montreal, QC, Canada
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42
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Bolhuis K, Steenkamp LR, Tiemeier H, Blanken L, Pingault JB, Cecil CAM, El Marroun H. A Prospective Cohort Study on the Intergenerational Transmission of Childhood Adversity and Subsequent Risk of Psychotic Experiences in Adolescence. Schizophr Bull 2022; 49:799-808. [PMID: 36548471 PMCID: PMC10154714 DOI: 10.1093/schbul/sbac195] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND HYPOTHESIS Previous studies have shown a robust relationship between childhood adversity and subsequent psychotic symptoms. However, the role of familial risk factors underlying this relationship remains largely unclear. Here, we tested whether offspring childhood adversity and postnatal maternal psychopathology mediated the relationship between maternal childhood adversity and offspring psychotic experiences. STUDY DESIGN N = 3068 mother-offspring dyads were included. Maternal history of childhood adversity was retrospectively assessed using the Childhood Trauma Questionnaire during pregnancy. Maternal psychopathology was assessed during and after pregnancy. Twenty-four offspring childhood adversities were assessed by maternal interview when the child was 10 years old. Offspring psychotic experiences were examined using self-report at 14 years. Structural equation mediation models were conducted to explore whether maternal postnatal psychopathology and offspring childhood adversities sequentially mediated the relationship between maternal childhood adversity and offspring psychotic experiences. Analyses were adjusted for sociodemographic confounders. STUDY RESULTS Maternal history of childhood adversity was associated with offspring childhood adversities (β = 0.12, 95% CI: 0.09 to 0.16). Offspring childhood adversity mediated the association of maternal childhood adversity with offspring hallucinations (βindirect effect = 0.008, 95% CI: 0.002 to 0.014, proportion mediated = 16.3%) and delusions (βindirect effect = 0.006, 95% CI: 0.000 to 0.012, proportion mediated = 13.1%). CONCLUSIONS Intergenerational transmission of childhood adversity can be considered of relevance in the etiology of psychosis vulnerability and can potentially serve as a modifiable risk factor.
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Affiliation(s)
- Koen Bolhuis
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center - Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Lisa R Steenkamp
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center - Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center - Sophia Children's Hospital, Rotterdam, The Netherlands.,Department of Social and Behavioral Science, Harvard TH Chan School of Public Health, Boston, USA
| | - Laura Blanken
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center - Sophia Children's Hospital, Rotterdam, The Netherlands.,Department of Psychiatry, Amsterdam UMC - location AMC, Amsterdam, The Netherlands
| | - Jean-Baptiste Pingault
- Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, Faculty of Brain Sciences, University College London, London, UK
| | - Charlotte A M Cecil
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center - Sophia Children's Hospital, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Hanan El Marroun
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center - Sophia Children's Hospital, Rotterdam, The Netherlands.,Department of Pediatrics, Erasmus Medical Center - Sophia Children's Hospital, Rotterdam, The Netherlands.,Department of Psychology, Education and Child Studies, Erasmus School of Social and Behavioral Sciences, Erasmus University Rotterdam, Rotterdam, The Netherlands
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43
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Mavragani A, Ranganath V. An Emotional Bias Modification for Children With Attention-Deficit/Hyperactivity Disorder: Co-design Study. JMIR Form Res 2022; 6:e36390. [PMID: 36485019 PMCID: PMC9789490 DOI: 10.2196/36390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 10/23/2022] [Accepted: 11/11/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is one of the common neurodevelopment disorders. Children with ADHD typically have difficulties with emotional regulation. Previous studies have investigated the assessment for underlying emotional biases using the visual probe task. However, one of the significant limitations of the visual probe task is that it is demanding and repetitive over time. Previous studies have examined the use of gamification methods in addressing the limitations of the emotional bias visual probe task. There has also been increased recognition of the potential of participatory action research methods and how it could help to make the conceptualized interventions more relevant. OBJECTIVE The primary aim of this study was to collate health care professionals' perspectives on the limitations of the existing visual probe task and to determine if gamification elements were viable to be incorporated into an emotional bias modification task. METHODS A co-design workshop was conducted. Health care professionals from the Department of Development Psychiatry, Institute of Mental Health, Singapore, were invited to participate. Considering the COVID-19 pandemic and the restrictions, a web-based workshop was conducted. There were 3 main phases in the workshops. First, participants were asked to identify limitations and suggest potential methods to overcome some of the identified limitations. Second, participants were shown examples of existing gaming interventions in published literature and commercial stores. They were also asked to comment on the advantages and limitations of these interventions. Finally, participants were asked if gamification techniques would be appropriate. RESULTS Overall, 4 health care professionals consented and participated. Several limitations were identified regarding the conventional emotional bias intervention. These included the nature of the task parameters, included stimulus set, and factors that could have an impact on the accuracy of responding to the task. After examining the existing ADHD games, participants raised concerns about the evidence base of some of the apps. They articulated that any developed ADHD game ought to identify the specific skill set that was targeted clearly. Regarding gamification strategies, participants preferred economic and performance-based gamification approaches. CONCLUSIONS This study has managed to elucidate health care professionals' perspectives toward refining a conventional emotional bias intervention for children with ADHD. In view of the repetitiveness of the conventional task, the suggested gamification techniques might help in influencing task adherence and reduce the attrition rates.
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Affiliation(s)
| | - Vallabhajosyula Ranganath
- Anatomy, Office of Medical Education, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
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44
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Mao S, Fan X, Ma Y, Chen Y, Lv J, Yang R. Knowledge and beliefs about autism spectrum disorders among physicians: a cross-sectional survey from China. BMJ Paediatr Open 2022; 6:10.1136/bmjpo-2022-001696. [PMID: 36645801 PMCID: PMC9756177 DOI: 10.1136/bmjpo-2022-001696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The incidence of autism spectrum disorders (ASDs) is increasing greatly, with high demands for earlier diagnosis and intervention. However, little is known about ASD knowledge and beliefs among physicians in China. METHODS A questionnaire survey was used to assess the knowledge and beliefs about the diagnosis and management of ASD and 24 beliefs regarding the treatment and prognostic aspects of ASD among physicians of any medical specialty in China. RESULTS A total of 1160 physicians were recruited and surveyed, with an average score of 8.48±2.66 (total of 18 points) for the questionnaire on the main symptoms of ASD and 14.35±3.69 (total of 24 points) for beliefs about ASD. Physicians' age, sex, specialty and practice years were related to their knowledge of identifying patients with ASD. Physicians specialising in paediatrics/psychology/psychiatry scored higher than those specialising in other specialties both in response to diagnostic questions (8.98±2.63 vs 8.30±2.65, p<0.001) and beliefs about ASD (15.57±3.44 vs 13.97±3.97, p<0.001). CONCLUSIONS Knowledge and beliefs about ASD symptoms, diagnosis and treatment are insufficient among physicians in China. Education and training programmes on this topic should be enhanced in physicians of all specialties, especially for male physicians who have short years in practice.
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Affiliation(s)
- Shujiong Mao
- Department of Pediatrics, Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaoli Fan
- Department of Child Psychology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ye Ma
- Department of Child Psychology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yi Chen
- Department of Child Psychology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jiamin Lv
- Department of Child Psychology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Rongwang Yang
- Department of Child Psychology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
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45
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Tadros HJ, Rawlinson AR, Gupta D. Lessons from the family unit in paediatric heart transplantation: can we do better? Arch Dis Child 2022; 107:1000-1001. [PMID: 34281956 DOI: 10.1136/archdischild-2021-322101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 07/05/2021] [Indexed: 11/04/2022]
Affiliation(s)
- Hanna J Tadros
- Department of Pediatrics, University of Florida, Gainesville, Florida, USA.,Congenital Heart Center, Department of Pediatrics, University of Florida, Gainesville, Florida, USA
| | - Alana R Rawlinson
- Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida, USA
| | - Dipankar Gupta
- Department of Pediatrics, University of Florida, Gainesville, Florida, USA .,Congenital Heart Center, Department of Pediatrics, University of Florida, Gainesville, Florida, USA
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Ceccarelli C, Prina E, Muneghina O, Jordans M, Barker E, Miller K, Singh R, Acarturk C, Sorsdhal K, Cuijpers P, Lund C, Barbui C, Purgato M. Adverse childhood experiences and global mental health: avenues to reduce the burden of child and adolescent mental disorders. Epidemiol Psychiatr Sci 2022; 31:e75. [PMID: 36245402 DOI: 10.1017/S2045796022000580] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Mental disorders are one of the largest contributors to the burden of disease globally, this holds also for children and adolescents, especially in low- and middle-income countries. The prevalence and severity of these disorders are influenced by social determinants, including exposure to adversity. When occurring early in life, these latter events are referred to as adverse childhood experiences (ACEs).In this editorial, we provide an overview of the literature on the role of ACEs as social determinants of mental health through the lenses of global mental health. While the relation between ACEs and mental health has been extensively explored, most research was centred in higher income contexts. We argue that findings from the realm of global mental health should be integrated into that of ACEs, e.g. through preventative and responsive psychosocial interventions for children, adolescents and their caregivers. The field of global mental health should also undertake active efforts to better address ACEs in its initiatives, all with the goal of reducing the burden of mental disorders among children and adolescents globally.
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47
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Paterson-Brown L, Scally N, Imeson D, Jones A, Shivamurthy V. Catatonic conundrum. Arch Dis Child Educ Pract Ed 2022:archdischild-2021-322353. [PMID: 36175109 DOI: 10.1136/archdischild-2021-322353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 09/01/2022] [Indexed: 11/04/2022]
Abstract
Differentiating between physical and psychological causes of confusion and psychosis poses a significant challenge to clinicians across all disciplines of medicine. This case report explores the clinical presentation and diagnostic journey of an adolescent girl. She presented to the emergency department with acutely altered behaviour and went on to re-present on multiple occasions over the following months with symptoms suggestive of psychosis. The team faced diagnostic difficulty differentiating between organic and non-organic causes of altered behaviour and mental state. This article explores the challenge faced by the team during the assessment and diagnosis of this patient.
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Affiliation(s)
- Lucy Paterson-Brown
- Paediatric Rheumatology Department, Evelina London Children's Hospital Paediatrics, London, UK
| | - Niamh Scally
- General Paediatric Department, Croydon University Hospital, Croydon, UK
| | - Dorrie Imeson
- Liaison Child and Adolescent Psychiatry, Evelina London Children's Hospital, London, UK
| | - Alexandra Jones
- Paediatric Rheumatology Department, Evelina London Children's Hospital Paediatrics, London, UK
| | - Vinay Shivamurthy
- Paediatric Rheumatology Department, Evelina London Children's Hospital Paediatrics, London, UK
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48
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Israeli S, Kagan I, Yerushalmi S, Gelman S, Yarkoni I, Levitan L, Argo D, Kohn Y. COVID-19 outbreak in a child and adolescent psychiatric ward: Challenges and lessons to be learned -Case study. J Child Adolesc Psychiatr Nurs 2022; 36:17-20. [PMID: 36116026 PMCID: PMC9538402 DOI: 10.1111/jcap.12393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 08/28/2022] [Accepted: 09/05/2022] [Indexed: 02/04/2023]
Affiliation(s)
- Sagit Israeli
- Nurse ManagerChild and adolescent psychiatric wardJerusalem Mental Health CenterJerusalemIsrael
| | - Ilya Kagan
- Head, Nursing DepartmentAshkelon Academic CollegeAshkelonIsrael
| | - Sarit Yerushalmi
- Senior Coordinator, Nurses' Development, Nursing AdministrationJerusalem Mental Health CenterJerusalemIsrael
| | - Sophi Gelman
- Director of NursingJerusalem Mental Health CenterJerusalemIsrael
| | - Inbal Yarkoni
- Director of Nursing ServicesThe Government Hospitals' Division, Ministry of HealthJerusalemIsrael
| | - Larisa Levitan
- Head Nurse of Infectious Diseases PreventionJerusalem Mental Health CenterJerusalemIsrael
| | - Daniel Argo
- DirectorOpen Ward (B), Jerusalem Mental Health CenterJerusalemIsrael,Former Head of Infectious Diseases PreventionJerusalem Mental Health CenterJerusalemIsrael
| | - Yoav Kohn
- Clinical Associate Professor of PsychiatryHebrew University‐Hadassah School of MedicineJerusalemIsrael,Director, Child and Adolescent Psychiatric ward, Jerusalem Mental Health CenterJerusalemIsrael
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49
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Samani N, Davari Ashtiani R, Kheradmand A, Arabgol F. Experiences of parents of children with psychiatric disorder from Covid-19 pandemic and its related quarantine: A qualitative study. Health Sci Rep 2022; 5:e696. [PMID: 35989943 PMCID: PMC9382039 DOI: 10.1002/hsr2.696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 04/20/2022] [Accepted: 05/06/2022] [Indexed: 11/15/2022] Open
Abstract
Introduction Owing to the considerable mortality caused by Covid-19, different countries have made some decisions for dealing with this virus, one of which was quarantine. It was shown that a range of behavioral and emotional changes may exacerbate in children while staying more at home, and parents may then experience these positive or negative behavioral changes. The present study was conducted to examine the experiences of families with children with psychiatric disorders in a psychiatric outpatient clinic in Iran. Method The phenomenological method, which is a qualitative approach, was used in this study. The population was the parents of children with psychiatric disorders referred to the pediatric psychiatric clinic of Imam Hossein Hospital. Sampling was purposeful, which continued until data saturation. Finally, the number of included participants reached 14. As well, the Colaizzi method was used for data analysis. Results The results of this study included 12 secondary codes and 10 tertiary codes, which were divided into three main thematic groups as follows: effective factors for improving behavior, effective factors for worsening behavior, and affective factors on creating a new behavior during quarantine. Conclusion In conclusion, quarantine, social restrictions, closure of schools, and online classes can affect the mental health status of children and adolescents in different ways, especially in children with a history of psychiatric disorders.
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Affiliation(s)
- Nastaran Samani
- Department of Psychiatry, School of MedicineShahid Beheshti University of Medical SciencesTehranIran
| | - Rozita Davari Ashtiani
- Department of Psychiatry, Imam Hossein Hospital Clinical Research Development Center, School of MedicineShahid Beheshti University of Medical SciencesTehranIran
| | - Ali Kheradmand
- Department of Psychiatry, Taleghani Hospital Research Development Committee, School of MedicineShahid Beheshti University of Medical SciencesTehranIran
| | - Fariba Arabgol
- Department of Psychiatry, Imam Hossein Hospital Clinical Research Development Center, School of MedicineShahid Beheshti University of Medical SciencesTehranIran
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Abstract
Child psychiatry has undergone major changes over the last few decades, expanding its scope into ever more varied fields. The risk is to divide up the treatment of a single disorder into silos, to the detriment of global care. Indeed, if the diagnostic stage requires expertise, the follow-up must be organized in a global way where somatic problems have their place. The integrative approach makes it possible to respond to the different dimensions of the suffering and to involve the family, and even the social and school environment of the young patient.
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Affiliation(s)
- Romaric Laville
- Institut de l'enfant, de l'adolescent et du jeune adulte, 1 avenue du 11-Novembre-1918, 69200 Vénissieux, France.
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