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The environment influences the way we act, react and adapt to our surroundings whether it is consciously or unconsciously. Though it is widely accepted that multiple interacting systems influence human behaviour and development across the life span, the reality of teasing these factors apart is difficult and challenging. In this brief commentary on Czernine and colleagues' important and timely paper, ‘Can a modernised psychiatric unit space reduce the use of coercive measures in child and adolescent psychiatry?’, I evaluate and build on the evidence presented by making constructive suggestions on ways of improving the status quo healthcare and treatment conditions for children and adolescents today. The underlying assumption is that by furthering this complex yet important area of research in the field of psychiatry and adjacent disciplines, we can improve existing healthcare systems and processes that are aligned with meeting child and adolescent needs. [ABSTRACT FROM AUTHOR]

The importance of multi-agency collaboration has been emphasised in virtually every piece of recently published guidance relating to the development of children's services including CAMHS. The Government Green Paper,Every child matters(), which proposes the development of Children's Trusts, will further impact on this agenda. Surprisingly, there has been much less written about factors contributing to the success of multi-agency collaboration than there has about barriers to it. Research is beginning to emerge informing on key criteria required for the development of multi-agency collaborations for children with mental health problems. Much work remains to be undertaken on the use of language and definitions between agencies before a common understanding about children's needs and the services they require can evolve. [ABSTRACT FROM AUTHOR]

We are in a competitive, burgeoning market for journals and currently in a transition to open access publications, with the aim of making research more widely accessible. Where is the place for practice‐based journals in this new and evolving world of publishing? The recent growth of CAMH in terms of Impact Factor, downloads and submissions suggests there is a need for such journals. Professionals are swamped with research findings, often contradictory, sometimes inflammatory, with little time to explore the meaning of these findings within the real world. This editorial reflects on the need for academics and practitioners to be able to debate the evidence base within the real world context (or to consider the lack of it) to inform practice and policy, and also on the importance of providing a platform for topics that are current and/or controversial. Recent contributions to CAMH are highlighted, namely the perceived gender gap in research on emotional disorders in women and girls, and the need for an ethical data sharing framework for academics to investigate the potential harms and benefits of technology. CAMH will continue to ask questions, and aim to remain relevant by focusing on both the evidence and real world context, in order to inform best practice and policy decisions. [ABSTRACT FROM AUTHOR]

It is now widely agreed that meeting the mental health needs of children and young people is a task only possible if all children's services work together. Recent epidemiological data indicate that schools are a key entry point to mental health services for children and young people, and have an important role in the assessment and management of children with neurodevelopmental disorders. This paper explores the rationale for collaborative working between health and educational professionals, examines some examples of good practice, explores factors contributing to their success or failure and considers future developments. [ABSTRACT FROM AUTHOR]

Background: Depression as a disorder in childhood began to be increasingly recognised in the 1970s. Epidemiologic community and clinic-based studies have characterised the prevalence, clinical course, and complications of this illness throughout childhood and adolescence into adulthood. This paper reviews two instruments for assessing depression in prepubertal children – the Dominic Interactive and The Preschool Age Psychiatric Assessment. Both instruments are useful in screening for psychiatric disorders and reliably identifying the presence of depressive symptoms in young children. [ABSTRACT FROM AUTHOR]

This paper addresses child and adolescent psychopathology as it presents to general practitioners and paediatricians, and explores psychosocial aspects of unexplained medical symptoms in children and adolescents. High rates of psychopathology have been identified amongst children and adolescents attending general practice and paediatric services, most of it‘‘hidden’’ at presentation and emotional in nature. It is often linked to poor physical well being and to maternal stress focused on the child. It may be of special relevance to medical help seeking in socio-economically advantaged areas. Co-morbid psychopathology, mainly emotional disorders, is common amongst children with unexplained medical symptoms. However, there are specific psychosocial aspects that differentiate these children from those with emotional disorders. They involve disease beliefs, illness behaviour and predicament. The latter may be characterised by special reactivity to stress in children with personality vulnerability, in a context of parents with high levels of mental distress, unexplained medical symptoms and emotional over-involvement with the child. There is comparatively little interface work between CAMHS and primary health care. An important research priority would seem to lie in the development of interventions that can be adapted for use by primary care staff. Similarly, there are few dedicated CAMHS paediatric liaison teams. Their more extensive development should help attend in a more informed and focused way than at present to children and adolescents suffering from unexplained physical symptoms and disorders. Further research is needed into vulnerability mechanisms and maintaining factors, health beliefs, treatment engagement and interventions. [ABSTRACT FROM AUTHOR]

Journals reviewed in this article: International Journal of Infant Observation and its Applications (1998, 1999, 2000) , p.89 Journal of Child Psychotherapy (1998, 1999, 2000) , p.90 Families, Systems & Health (1999) , p.91 Families, Systems & Health (2000) , p.92 Journal of American Academy of Child and Adolescent Psychiatry (2000) , p.92 Adoption & Fostering (2000) , p.93 British Journal of Social Work (2000) , p.93. [ABSTRACT FROM AUTHOR]

Journals reviewed in this article: Journal of Autism and Developmental Disorders (1999) , p.37 Autism (2000) , p.38 Clinical Child Psychology and Psychiatry (2000) , p.38 Attachment and Human Development (1999—2000) , p.40 British Journal of Psychiatry (2000) , p.41 Journal of American Academy of Child and Adolescent Psychiatry (1999, 2000) , p.42 Journal of Abnormal Child Psychology (2000) , p.43. [ABSTRACT FROM AUTHOR]

Journals reviewed in this article: Children Looked After by Local Authorities (1998) , p.93 Department of Health. Quality Protects: A Framework for Action (1998) , p.93 The British Journal of Social Work (1998) , p.93 International Journal of Infant Observation and Its Applications (1997) , p.94 Journal of Child Psychotherapy (1998) , p.96. [ABSTRACT FROM AUTHOR]

Background:? This study explored the feasibility and validity of using brief clinician? and parent?rated measures routinely over 6?months in outpatient child psychiatry. Method:? All patients under 18?years of age seen for intake in the Child Psychiatry Clinic from 1 August 2007 through 31 July 2010 were eligible for inclusion in the study. Data were collected at intake for 1033 patients and at 3? and 6?month follow?up. Results:? ANOVA for repeated measures showed statistically significant improvements in total and subscale scores on all three measures (Brief Psychiatric Rating Scale for Children, Children's Global Assessment Scale, and Pediatric Symptom Checklist) at both second and third assessments. Conclusion:? The fact that both broadband and narrowband scales showed significant improvements over the first 6?months of care establishes the possibility that these measures could be used in experimental designs studying comparative effectiveness. [ABSTRACT FROM AUTHOR]

Presents letters to the editor of 'Child Psychology & Psychiatry' about articles on child psychology and psychiatry previously published in the periodical.

Understanding the root causes of child mistreatment and abuse should be a key concern of child and adolescent psychiatrists. However, the issue is often framed in such a way that we fail to ask how and why child abuse happens. One framework for the psychosocial motivations behind child abuse is the concept of childism, or prejudice against children. A series such as The Twilight Zone can offer a means of exploring unhealthy adult‐child dynamics and applying the concept of childism to better understand them. [ABSTRACT FROM AUTHOR]

Background: There have been no comprehensive studies on trends in psychotropic medication use in child and adolescent inpatient settings. The aim of this nationwide study was to report changes in the psychotropic medication given to child and adolescent psychiatric inpatients across Finland and the factors associated with those changes. Methods: We asked the psychiatrist responsible for each inpatient to complete a questionnaire that included questions about the pharmacological treatment and background information. The data were collected on all inpatients on one selected study day in 2000 and 2011. Changes in the use of regular psychotropic medication were studied by comparing the data on 504 patients in 2000 and 412 patients in 2011. Results: The study showed that there had been a significant increase in the use of psychotropic medication from 2000 to 2011. According to the multivariate analysis, the increase in psychotropic medication was associated with the study year (in 2000 39%, in 2011 58%), but could not be explained by changes in diagnostic profiles, age distribution, suicidality, violence or the Children′s Global Assessment Scale scores. The use of combined psychotropic medication increased from 9% in 2000 to 25% in 2011. The increase in the use of antipsychotics among child inpatients was particularly noteworthy, with an increase from 10% to 32%. Conclusions: There is a need for evidence‐based studies to clarify recommendations for indications and treatment practices when using psychotropic medication in children and adolescents. Cross‐cultural studies of the use of psychotropic medication are warranted. [ABSTRACT FROM AUTHOR]

The article presents abstracts of the articles "Psychiatric Services and Training for Children and Adolescents in Europe: Results of a Country Survey" and "Attention-Deficit/Hyperactivity Disorder and Comorbidity in Brazil: Comparison Between Two Referred Samples."

Background The paediatric population is known to be at high risk for psychiatric problems. Paediatric liaison child/adolescent mental health services ( PL- CAMHS) have been developed to help increase recognition and management of psychiatric morbidity in the paediatric setting. This report describes clinical activity by a psychological medicine PL- CAMHS and considers specificity by comparing this with community/general CAMHS activity. Method Clinical information was obtained on consecutive patients seen by a PL- CAMHS in a UK tertiary specialist hospital. Where feasible this was compared with published data on national/community CAMHS work. Results Data was obtained on 800 patients (mean age 11.9, SD 3.8). Most referrals came from a variety of paediatric teams, nearly two-thirds were for psychosomatic problems or difficulties adjusting to physical illness. The majority had an ICD-10 psychiatric diagnosis (mostly adjustment, mood and anxiety, and somatoform disorders); problems were often complex and in about half, family difficulties were also noted; one-third had received prior mental health treatment. Virtually all children were seen by the PL service within a month of referral and only 2% of families failed to attend for assessment. Some level of clinical improvement was noted for the majority. There were indications of differences from national/community CAMHS work in referral source, take up rates and psychiatric diagnoses. Conclusions Paediatric liaison child and adolescent mental health services users commonly have characteristic psychiatric problems, interventions appear potentially effective and the work is specific and complementary of community CAMHS. Thus PL- CAMHS make a distinct contribution to the provision of truly comprehensive CAMHS. [ABSTRACT FROM AUTHOR]

Discusses some articles about child psychiatry. Ascertainment and clinical characteristics of monozygotic twins with attention-deficit/hyperactivity disorder; Use of antipsychotic drugs for treating aggressive children; Research update on sexual abuse.

Background:? There is a severe shortage of child and adolescent psychiatrists (CAPs) in the United States, an increasingly recognized high prevalence of mental disorders in young people, and widely supported goals to provide more mental health services in the primary care setting. Method:? A number of innovative, state?wide or more local, publically funded programs have been developed in the United States over the last several years to respond to these challenges and to provide CAP consultation to primary care physicians (PCPs) who wish to address the mental health disorders of their patients in the primary care setting. Results:? A number of these programs and their approaches to consultation are described. An example of a clinical scenario that might be addressed using this model of CAP/PCP collaboration is offered. Conclusions:? An innovative model of consultation to PCPs from CAPs appears able to facilitate the treatment of many young people with mental health disorders in the primary care setting. [ABSTRACT FROM AUTHOR]

Background: Atypical antipsychotics could be replacing traditional antipsychotics in the treatment of childhood disorders. Method: A postal survey was conducted of Child Psychiatrists in a region of the United Kingdom to evaluate their use of atypical antipsychotics for psychotic and non-psychotic conditions. Results: 97% of respondents reported prescribing atypical antipsychotics and at least 65% did so for non-psychotic indications although several concerns were raised. Differences in prescribing and monitoring practices between Community and Specialist services were noted. Conclusions: Atypical antipsychotics appear to play a significant role in current child psychiatry practice. Further discussions and research needs to occur about their use and guidelines produced. [ABSTRACT FROM AUTHOR]

Links between Social Service Departments (SSDs) and CAMHS are explored and described through a national survey and a number of site visits.Data were collected via (1) a national questionnaire survey yielding a response rate of 75%, and (2) pre-selected site visits to seven SSDs.Additional to existing CAMHS assessment and treatment provision to SSDs, there is increasing outreach consultation and support, some provided through primary mental health workers and dedicated clinical psychology sessions. Some SSDs have developed innovative in-house provision for Tier 2 type referrals.Outreach and core CAMHS provision to SSDs need equal investment and development. [ABSTRACT FROM AUTHOR]

Background: This project surveyed the use of the Children Act and the Mental Health Act in in-patient child and adolescent mental health services in England and Wales. Methods: Data were collected as a day census from child and adolescent psychiatric inpatient units, questionnaire forms completed by consultant psychiatrists or key-workers. Returns were received from 71 of the 80 units. Results: One hundred and twenty-seven of the 663 patients had been admitted formally, the great majority under a section of the Mental Health Act. Compared with those admitted informally, those admitted formally were older, contained a higher proportion of males and had ‘adult-type diagnoses’, mainly schizophrenia, mood disorders and personality disorder. The clinical and psychosocial characteristics of formal and informal patients were consistent with these differences. Conclusions: This study provides a timely and useful snapshot of the use of the Acts in this population. [ABSTRACT FROM AUTHOR]

Surveys some of the psychometric and methodological issues that arise when the direct observation method is used in examining parent-child interaction. Reasons for using direct observation; Considerations for selecting a psychometric instrument; Coding schemes for sampling large numbers.

Features books and videotapes about child psychology and psychiatry. 'Video: HoNOSCA: Health of the Nation Outcome Scales for Children and Adolescents. Video Workshop'; 'Teaching With Confidence: A Guide to Enhancing Teacher Self-esteem,' by D. Lawrence; 'The Welfare of the Child. The Principle of the Law,' by K. O'Halloran.

Journals reviewed in this article: Child Abuse & Neglect (1998) , p.138 Child Abuse Review (1998) , p.138 Child Maltreatment (1998) , p.138 Pediatrics (1998) , p.140 Pediatrics (1999) , p.140. [ABSTRACT FROM AUTHOR]

Offers information on books about child psychiatry. 'Child Abuse, Psychotherapy and the Law,' by R. Kennedy; 'Counselling Children With Chronic Medical Conditions,' by M. Edwards and H. Davis; 'Working With the Dying and Bereaved: Systemic Approaches to Therapeutic Work,' by Pauline Sutcliffe.

Journals reviewed in this article: Pediatrics (1997) , p.139 Developmental Medicine and Child Neurology (1997) , p.139 British Medical Journal (1997) , p.140 Child Care Health and Development (1997) , p.140 European Journal of Special Needs Education (1997) , p.141 British Journal of Educational Psychology (1997) , p.142. [ABSTRACT FROM AUTHOR]

Focuses on the life and works of child psychiatrist Eric Taylor. Involvement in providing evidence on the drug treatment of attention deficit and hyperactivity disorder using stimulant medication to a Parliamentary Committee; Influence of his father on his career in child psychiatry; Achievements made during his clinical practice.

The article presents information about a book "Child Psychiatry Selection" which focuses on a research conducted by researchers on school attendance problems. They sampled a whole range of absence levels using information limited to that obtained from child and parents, and explored the child's psychopathology employing CAPA, the Child and Adolescent Psychiatric Assessment. Their community sample included about 1400 children aged 9-16. Three types of school attendance problems were described namely anxious school refusers, truants and mixed.