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Media-associated disorders in childhood and adolescence: Evidence paper of the joint addiction commision of the German societies and professional associations of child and adolescent psychiatry and psychotherapy Abstract. Media-associated disorders (MAD) describe the problematic use of the internet, certain electronic devices in general as well as digital applications. During childhood and adolescence, digital games and social media are the most commonly used applications. In May 2019, as first MAD "gaming disorder" was included as a clinical diagnosis in the ICD-11. The prevalence of MAD in German children and adolescents is estimated to lie between 3 % and 5 %. In most cases, MAD are accompanied by psychiatric comorbidities. MAD ensue because of dysfunctional learning processes in combination with general and specific risk factors. They are associated with neural changes like those of substance-associated addictions. Diagnostics can be based on validated questionnaires and clinical exploration, though a standardized diagnostic path is not yet common. Treatment depends on the level of severity and generally comprises outpatient, day-clinic, and inpatient therapy approaches with elements from cognitive-behavioral therapy and under parental involvement. Suitable treatments are not yet available in all German regions and have also not been sufficiently evaluated. Moreover, only a few studies exist on the efficacy of prevention measures addressing MAD in children and adolescents. Thus, further research is strongly required.

The Joint Commission on the Mental Health of Children (JCMHC) was a sprawling, multidisciplinary project that took shape in the years immediately after the assassination of President John F. Kennedy. Participants included child psychiatrists, educators, psychologists, social workers, philanthropists and other laypeople and professionals interested in the plight of children. While the original inspiration for the JCMHC was to address the potential for violence from disturbed children and adolescents, its findings and recommendations were an indictment of American society itself in which poor children went hungry, minority children were oppressed and there were not sufficient resources dedicated to the mental health of the nation's population of young people. The task forces and committees of the JCMHC spent significantly more time addressing prevention and mental health rather than mental illness. Two years into the work of the JCMHC, the leadership formed a committee to specifically examine issues related to race. The final report, published in popular book form as Crisis in Child Mental Health, arrived after the unraveling of the liberal consensus that had fueled President Lyndon Johnson's Great Society programs. Most of the proposed solutions for government intervention were ignored by the Nixon administration. The focus on mental health and the willingness to take a critical look at the detrimental effects of racism had represented child psychiatry at that time. In the decades that followed, however, child psychiatrists turned away from issues about prevention, race and environment and instead focused on the problems of mental illness in individual children., (© 2023 The Authors. Journal of The History of the Behavioral Sciences published by Wiley Periodicals LLC.)

Background: The strengths and difficulties questionnaire (SDQ) is one of the most common screening tools to detect children and adolescents who are at risk of mental health problems or have psychiatric disorders. The standard mode of SDQ completion is on paper; however, some studies used phone administration and argued that this is a feasible and valid method that can substitute in-person administration. However, few studies have investigated the validity and reliability of phone administration of the SDQ. Objectives: The current study aimed to compare the telephone versus paper-and-pencil administration of the SDQ among Iranian child and adolescent outpatients. Methods: Sixty six parents with children aged 3 to 15 years completed the SDQ questionnaire using paper-and-pencil and telephone interview techniques. The study was performed in 2016, and participants were from the city of Tehran (capital of Iran). Participants were first divided into two groups. Then, one of them first completed the questionnaire using the face-to-face interviews, and 3 to 4 days later, they again completed the questionnaire using the telephone interview. And the vice versa occurred for the other group. The Pearson correlation analysis was used to calculate the correlation between the two methods in each group separately. Intra-class correlation (ICC) analysis was used to investigate the association between the two administration methods. Results: A significant positive correlation was found between the two types of administration in both groups (P < 0.05). Intra-class correlation coefficients indicated a good correlation between the scores obtained from each method of administration (all P values were < 0.001). Conclusions: Telephone administration of SDQ is a reliable method for collecting data when studying emotional and behavioral symptoms in children and adolescents attending outpatient psychiatric centers. [ABSTRACT FROM AUTHOR]

Information on the YICAP/ECAP International Young Investigators Paper and Grant Writing Workshop held in Rees, Germany from September 18-19, 2014 is presented. Among the topics discussed at the workshop include the significance of research abstract and title, research time-management techniques, and the balance between professional and correct result interpretation. Young researcher participants are also given advice by editors.

Accessible Summary: What is known on the subject: Restraining and secluding health consumers for safety reasons continue to be used in psychiatric inpatient facilities even though they have no therapeutic value and have negative effects on consumers, families and staff.Six Core Strategies (6CS) for reducing seclusion and restraint have been developed to address this problem but there are very few effectiveness studies in inpatient adolescent psychiatric facilities. What the paper adds to existing knowledge: We used a mixed methods approach to evaluate the implementation of 6CS in an adolescent psychiatric facility. The implementation was successful. It eliminated the use of seclusion, substantially reduced the use of restraints and significantly reduced staff absenteeism.Using thematic analysis on feedback surveys, we identified five dominant themes that described consumers' and carers' experiences during their stay at the facility: communication, service delivery, flexibility, consistency and internal feeling states. What are the implications for practice: This study provides support for the feasibility of a comprehensive and broad‐based intervention program such as 6CS to reduce seclusion and restraint practices in inpatient mental health facilities.This study also demonstrates the value of using surveys to gather consumer and carer feedback and improve outcomes for service users. Introduction: Seclusion and restraint practices are routinely used in psychiatric facilities but are controversial for ethical, legal and safety reasons, and can cause significant harm to consumers, staff and organisations. Six Core Strategies (6CS) for reducing seclusion and restraint were developed to address this problem but very few studies have examined their effectiveness in adolescent settings. Aim/Question: To evaluate the implementation of 6CS in an adolescent inpatient psychiatric facility. Method: We retrieved archival data from an acute adolescent psychiatric ward that implemented the 6CS. Using a mixed methods approach, we evaluated outcomes on the use of seclusion and restraint, nursing staff sick leave and feedback surveys. Results: Findings showed an elimination of seclusion, and a significant reduction in restraint use and staff absenteeism in the 12 months after project implementation. Thematic analysis of feedback survey responses identified communication, service delivery, flexibility, consistency and internal feeling states as dominant themes in consumers' and carers' experience on the unit. Discussion: The 6CS is feasible and may be effective in reducing seclusion and restraint, which in turn may have a positive impact on staff wellbeing. Implications for Practice: Implementation of the 6CS with executive support, combined with staff and programmatic changes at a local level is recommended. [ABSTRACT FROM AUTHOR]

Introduction: This paper describes the process of implementing a family focused model, The Family Model, in child and adolescent and adult mental health services in Sweden. Additionally, it describes a service development project carried out in both services within a defined geographical area of Region Stockholm. The Family Model is a communication tool designed to assist clinicians in both services to have family focused conversations with their patients and relatives. Internationally, the needs of individuals experiencing mental health challenges (parents, children and young people) and their close relatives are now well recognized, but barriers to family focused practice nevertheless persist. The aim of this study was to better understand clinicians' experiences in implementing The Family Model in both services. Methods: Three preplanned focus group interviews were carried out with 14 clinicians and managers across both services and the data were analyzed in accordance with methods of Naturalistic inquiry. Result: Findings suggest that The Family Model has utility in both services. The Naturalistic inquiry analyses revealed three main themes: individual, relational and organizational aspects with a total of 10 sub-themes of how the models influence the participants. Furthermore, analyses on a meta understanding level explored that participants underwent a developmental journey in learning about and using The Family Model in practice which was expressed through three themes: "Useful for burdened families", "Influencing prevention", and "To integrate this would be fantastic". Conclusions: The Family Model, when adapted for the Swedish context, is a useful tool for assisting experienced clinicians to engage in family focused practice in both child and adolescent and adult mental health services. The Family Model highlights different aspects in everyday clinical services that were of special interest for clinicians, families, and the system. Future research could explore families' perspectives of the utility of the model. [ABSTRACT FROM AUTHOR]

This paper describes how, in the wake of a spate of fatal knife crime in one London borough, the council, Clinical Commissioning Group (CCG) and Child and Adolescent Mental Health Service (CAMHS) got together to think about how to improve outcomes for their young people. Starting with schools and pupil referral units, the CAMHS and educational psychology service were commissioned to work with whole staff groups, from senior leadership to lunchtime monitors and playground staff, to embed trauma informed policy and practice. The aim was to spread understanding about complex developmental trauma; what it is, how it affects the behaviour and experience of children and families, and how to work with it. Given how widespread trauma is, the objective was also to think about what might need to change in the environment and ethos of the borough's schools as a result. Following the project's initial success, its scope and remit were expanded to support services on a policy level, while also working with their staff to think about the impact of trauma, and how best to support children and families who have been affected by it. As well as teaching about trauma, the project is primarily an experiential one. This paper explores the impact on staff who were involved in the project; what came out of it for them personally in terms of changes to their thinking and outlook, and what they saw as the changes for the children and families they worked with. [ABSTRACT FROM AUTHOR]

Grunya Efimovna Sukhareva's seminal role in being the first to publish a clinical description of autistic traits in 1925, before both Kanner and Asperger, has been revealed relatively recently. Nevertheless, Sukhareva's work is little known and largely unrecognised beyond Russia. Amidst calls for greater recognition of her pivotal contribution in the genesis of autism conceptualisation and categorisation, this article provides a biographical and historical background. Sukhareva's wide-ranging psychiatric work is adumbrated and her pioneering efforts in conceptualising both schizophrenia and autism are elucidated. The article reflects on possible explanations for the belated and incomplete recognition of Sukhareva's role. The current article indicates how Sukhareva's work was ahead of its time in reflecting modern criteria for autism diagnoses and in its focus on female case studies. Sukhareva's somewhat precarious position as a foremost psychiatrist condemned in the Stalinist years for being anti-Marxist is explicated. The article outlines further directions for academic research on Sukhareva's work and contributions. [ABSTRACT FROM AUTHOR]

In line with these papers on comorbidity in ASD, Manolova et al. present an original toolkit for detailed assessment of psychological functioning of children with ASD in the early life years. Keywords: atypical development; typical development; autism spectrum disorder; comorbidity; adverse childhood experiences EN atypical development typical development autism spectrum disorder comorbidity adverse childhood experiences 1 3 3 01/11/22 20220103 NES 220103 The conceptualization of Autistic Spectrum Disorder (ASD) has changed from a condition that is narrowly defined and rare, to one that is defined by a wider set of diagnostic criteria and is far more common in the population. [Extracted from the article]

This paper describes the implementation of Behavioral Activation (BA) as the core psychotherapy treatment within a broader clinician-led effort to establish a care pathway for adolescent depression in an academic medical center that served public and private hospital systems. This quality improvement effort required a standardized yet flexible approach to psychotherapy to be used by clinicians with a range of experience and training backgrounds while serving diverse clinical populations in child psychiatry and pediatric clinics. This paper highlights implementation of BA in treating adolescent depression across these varying systems. In particular, the paper emphasizes the application of BA as a principle-driven, treatment that enables flexibility across settings while remaining rooted in scientific evidence. The paper also reviews lessons learned from this effort that may support efforts to implement BA in other clinical settings and systems. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

This review of current literature demonstrates the psychological implications of skin conditions. Skin conditions of varying severity can impact the quality of patients' lives and have psychiatric consequences. This impact provides a need for healthcare providers to consider the psychological implications of one's skin conditions and their effect on quality of life. The psychological challenges that arise from varying skin conditions show the potential need for both dermatological and psychiatric interventions. The following literature review details the psychiatric consequences of skin conditions under various conditions. It first looks at literature highlighting the psychiatric consequences experienced through various age ranges, from adults to adolescents and children. The paper then explores multiple skin conditions and their psychological effect before highlighting some of the interactions that stress has on the skin that could further exacerbate one's condition. Finally, it examines how patients characterize their experience with their skin condition and goes into some clinical case studies of patients with psychological implications as a result of their skin disorder. The paper also highlights the magnitude of dermatologic patients experiencing psychological conditions in conjunction with their skin conditions. [ABSTRACT FROM AUTHOR]

Background: The rising percentage of children and adolescents experiencing mental disorders brought attention to the emerging opportunities for proactive oral health interventions in this population. Currently, existing guidelines focus mainly on oral health in general practice and on adults residing in care homes. This report aims to provide a broad overview of the effectiveness of oral health interventions for children and adolescents with mental disorders. Method: This review followed the PRISMA (Preferred Reporting Items for Systematic Review and Meta‐Analyses 2020) statement. The initial electronic search yielded a total of 3710 articles. The search identified 2354 potential papers after removing duplicates and 2301 articles were excluded by title and abstract. The full texts of the remaining 53 articles and nine articles from the citation searching were screened and 15 articles matched the inclusion criteria. The Mixed‐Method Appraisal Tool (MMAT) was used for quality appraisal. Results: The thematic analysis resulted in four main themes which were educational intervention, physical intervention, clinical intervention, and a combination of both educational and clinical intervention. Conclusion: We presented the findings in a narrative synthesis with the primary outcomes which served as answers to our main research question that prompted this systematic review. [ABSTRACT FROM AUTHOR]

Introduction: The Mental Welfare Commission for Scotland published a report into the death of a young person, with recommendations for the Royal College of Psychiatry in Scotland Child and Adolescent Faculty; to explore if there were barriers to the use of Clozapine in young people in Scotland. Methods: A mixed-methods study was performed using a cross-sectional survey of clinicians working in child and adolescent psychiatry across Scotland, to determine attitudes towards clozapine use and the perceived barriers and facilitators to clozapine treatment. Results: Results suggest that there may be a lack of clearly defined pathways within and between services, as well as a lack of resources provided for the necessary monitoring of a young person started on clozapine. Multiple respondents felt unskilled in clozapine initiation and had not accessed formal training. The most frequently mentioned themes for improving facilitation of clozapine prescription were that of increased resources and training. Discussion: National policymakers including the Mental Welfare Commission, NHS Education for Scotland, and NHS Scotland should consider these findings to address the potential underutilisation of clozapine for people aged under 18 in services across Scotland. A review of current service provision should take place, with consideration of whether the facilitators to clozapine prescription which our study has highlighted could be implemented more effectively. This may help reduce identified barriers and increase clozapine prescription to those who would benefit from it, potentially improving outcomes for young people with treatment-resistant psychosis. [ABSTRACT FROM AUTHOR]

This study systematically reviewed the literature on perceived school safety. We investigated the prevalence, factors and associated mental health difficulties, as well as cross-cultural findings. Five databases were searched up to 9 February 2021 for peer-reviewed papers published in English. We included quantitative studies that explored the perception of school safety among children and adolescents. The reference lists of the selected papers were also searched. We conducted a narrative synthesis of the included studies. The review included 43 papers. The mean prevalence of the students who felt unsafe at school was 19.4% and ranged from 6.1% to 69.1%. Their perceived safety was associated with a wide range of personal, school, and social factors. Not feeling safe at school was related to being victimized and mental health difficulties, including depressive symptoms and suicidal behavior. Higher perceived school safety was associated with measures such as the presence of a security officer and fair school rule enforcement. The results showed the lack of cross-cultural studies on perceived school safety. Empirical studies are needed that examine the mechanisms of school safety, using valid measures. A clear definition of school safety should be considered a key aspect of future studies. [ABSTRACT FROM AUTHOR]

Background: Although it is true that adolescence is a stage of evolutionary development in which there are innumerable windows of opportunity, it is also the peak age at which some psychiatric disorders may appear. On the other hand, music is an auditory stimulus that interests and motivates youngsters, as it is used for identity, social connection, and emotional regulation. Methods: We conducted a strategic search by consulting scientific databases. The following search terms were employed: Music Therapy AND Psychology AND Psychiatry AND Adolescents. The following international electronic databases were searched: Medline, Ovid, and Cochrane Library. Results: A total of 142 sources were identified from which 9 papers on music therapy published exclusively in scientific journals specialized in psychology or child psychiatry were selected. The total number of participants was 651. The studies reported that music therapy interventions have the potential to improve self-esteem, social engagement, decrease social isolation, and depressive and anxiety symptoms in psychiatric adolescents (both in inpatient and outpatient settings). Conclusion: Given the heterogeneity and methodological quality of the few studies included, it is complex to extrapolate and generalize results. More quality research is needed to expand music therapy interventions on youth mental health. [ABSTRACT FROM AUTHOR]

(1) Aims: This paper aims to analyze the factors affecting children's mental health during home quarantine from the perspective of family composition in a specific Chinese context where historically, families are small in size. (2) Methods: Here, 10,210 online questionnaires from 3 junior high schools in Xi'an and Hanzhong from 23 to 27 February 2020, were collected to explore the impact of family factors on children's mental health in Northwest China during home quarantine based on the ecosystem theory, by using OLS, logit regression models, and the Shapley value decomposition method. (3) Results: The mental health of northwestern Chinese children changed significantly after home quarantine. We also found that during home quarantine, some factors, such as a high-income family, lack of siblings, living with parents, mothers with middle- or high-level occupations, frequent parent–child communication, and better parent–child relationships, were positively related to children's mental health. (4) Conclusions: Different from previous studies, this paper found that the psychological condition of children in Northwest China tended to be improved during the epidemic. In addition, family factors, especially the parent–child interaction, played an important role in the mental health of children during the epidemic. [ABSTRACT FROM AUTHOR]

To estimate the prevalence of current DSM-5 disorders in children 9 to 10 years of age and their associations with sociodemographic and physical characteristics. In this analysis of Adolescent Brain Cognitive Development (ABCD) first wave study data, current child mental disorders were based on the computerized parent version of Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS) for DSM-5 (N = 11,874) supplemented with the child version of K-SADS for mood and selected anxiety disorders and with teacher Brief Problem Monitor ratings for the attention and externalizing scales. Child sociodemographic (race/ethnicity, nativity, parental marital status, parental education, family income) and physical (sex, pubertal stage, weight status, maternal age) characteristics were derived from parent report and anthropometric measurement. Odds ratio (OR) with 95% CI assessed associations with child mental disorders. The prevalence of any current mental disorder was 10.11%, including 11.48% among boys and 8.68% among girls. After controlling for several sociodemographic and physical characteristics, boys (OR = 1.53, 95% CI = 1.17-1.99), children from families with incomes below $25,000 (OR = 2.05, 95% CI = 1.31-3.22) and families with incomes of $25,000 to $49,000 (OR = 1.90, 95% CI = 1.20-3.00) (reference: $75,000), and obese children (OR = 1.45, 95% CI = 1.16-1.81) (reference: healthy weight) were at increased risk for any current child mental disorder. Children from the lowest family income group were at particularly high risk for attention-deficit/hyperactivity disorder (OR = 3.86, 95% CI = 1.69-8.79) and disruptive behavior disorders (OR = 4.13, 95% CI = 1.86-9.15). These patterns underscore the importance of strengthening service planning, preventive interventions, and etiological research focused on children from low-income families. We worked to ensure sex and gender balance in the recruitment of human participants. 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. 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. We actively worked to promote sex and gender balance in our author group. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work. [ABSTRACT FROM AUTHOR]

Quantifying the severity of neurological disorders, such as attention-deficit/hyperactivity disorder (ADHD), is encouraged in practice. To explore the methodological properties of data-driven classification, this study aimed to develop computerized adaptive testing (CAT) based on Bayesian networks to classify ADHD symptom severity for individual subjects efficiently. The Current Symptoms Scale was used to build an ADHD symptom severity classifier in a sample of 892 college students, and the CAT making use of information gains from conditional probabilities of the Bayesian network was evaluated through a simulation study. The results showed that distributing 8 out of 18 items on average to an individual subject would result in 85% classification accuracy, supporting the adaption of surveying ADHD to digital platforms demanding much-shortened scales. The severity classifier based on Bayesian networks can assist diagnostic tasks via a data-driven mechanism. Further, integrating CAT into the classifier can shorten the scale while maintain acceptable measurement quality. The ADHD symptoms were used in the paper; however, the proposed method applies to other psychological symptoms as well. The impact and limitations of the CAT for ADHD were discussed, and several suggestions for future research were provided. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has impacted on psychiatric symptoms of children and young people, but many psychiatric services have been disrupted. It is unclear how service use, self-harm and suicide has changed since the pandemic started. To gain timely information, this systematic review focused on studies based on administrative data that compared psychiatric service use, self-harm and suicide before and during the pandemic among children and young people. Methods and finding: A systematic review of studies published in English from 1 January 2020 to 22 March 2021 was conducted, using the Web of Science, PubMed, Embase and PsycINFO databases. Increases or reductions in service use were calculated and compared using percentages. Of the 2,676 papers retrieved, 18 were eligible for the review and they provided data from 19 countries and regions. Most studies assessed changes during the early phase of the COVID-19 pandemic, from March to July 2020, and three assessed the changes until October 2020. Fifteen studies reported a total of 21 service use outcomes that were quantitively examined. More than three-quarters of the 21 outcomes (81%) fell by 5–80% (mean reduction = 27.9%, SD = 35%). Ten of the 20 outcomes for psychiatric emergency department (ED) services reduced by 5% to 80% (mean = 40.1%, SD = 34.9%) during the pandemic. Reductions in service use were also recorded for ED visits due to suicide ideation and self-harm, referrals to secondary mental health services, psychiatric inpatient unit admissions and patients receiving treatment for eating disorders. However, there were also some increases. Suicide rate and the number of ED visits due to suicide attempts have increased, and there was an increase in the number of treatment sessions in a service that provided telemedicine. Conclusion: Most of the studies showed reductions in the use of psychiatric services by children and young people during the early phase of the pandemic and this highlighted potential delays or unmet needs. Suicide rate has increased during the second wave of the pandemic. Further studies are needed to assess the pattern of service use in the later phases of the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Clinical High-Risk State for Psychosis and Familial Vulnerability: the Manifold Intersection... Nine papers in this Research Topic broadly addressed a clinical high-risk state (CHR) of psychosis in children and adolescents mainly by ultra-high risk (UHR) but also by basic symptom criteria ([12], [13]). Keywords: prevention; family; high risk; prognosis; severe mental disorder; suicide; developmental; psychopathology EN prevention family high risk prognosis severe mental disorder suicide developmental psychopathology 1 4 4 01/11/22 20211221 NES 211221 Serious Mental Illnesses (SMI), such as depressive, bipolar, and psychotic disorders, often start in childhood and adolescence, are the leading cause of disability in young people and tend to cause life-long disability ([1]-[4]). Prevention, family, high risk, prognosis, suicide, developmental, psychopathology, severe mental disorder However, within the framework of the early detection of psychosis, a positive family history of psychosis even in combination with a recent drop in functioning was an insufficient predictor of a conversion to first-episode psychosis by itself when compared to symptom-based risk criteria ([12]-[14]). [Extracted from the article]

Dans cet article, l'auteure retrace les premiers moments de l'introduction de la psychanalyse en pédopsychiatrie et le contexte de leur émergence dans les années 1920 et 1930 en France. Ils sont contemporains de la difficile introduction de la psychanalyse dans l'univers médical. La psychanalyse de l'enfant apparaît alors comme une prophylaxie des troubles névrotiques et suscite l'intérêt des psychopédagogues et des éducateurs. L'auteure retrace les travaux pionniers de la psychanalyste Sophie Morgenstern au sein de la consultation de psychiatrie infantile de Georges Heuyer, et ceux de Pierre Mâle dans sa consultation de psychiatrie infantile à Henri Rousselle. Celui-ci deviendra, à la Libération, le spécialiste de la psychothérapie de l'adolescent. Cependant, l'héritage de Morgenstern va être oublié ou renié par ceux qui vont lui succéder, et elle s'interroge sur les raisons de ce phénomène. Ces travaux pionniers, qui dessinent un nouveau visage de l'enfance normale et anormale, vont connaître une forte expansion après la Seconde Guerre mondiale. In this paper, the author describes the first moments of the introduction of psychoanalysis in child psychiatry and the context of their emergence in the 1920s and 1930s in France. They are contemporaneous with the difficult introduction of psychoanalysis into the medical world. Child psychoanalysis then appeared as a prophylaxis of neurotic disorders, and aroused the interest of educational psychologists and educators. It traces the pioneering work of psychoanalyst Sophie Morgenstern in Georges Heuyer's child psychiatry consultation, and that of Pierre Mâle in Henri Rousselle's child psychiatry consultation. After the Liberation, he became the recognized specialist in adolescent psychotherapy. On the other hand, Morgenstern's legacy will be forgotten or disowned by those who will succeed her, and the author wonders about the reasons for this phenomenon. This pioneering work, which drew a new face of normal and abnormal childhood, was to be greatly expanded after the Second World War. [ABSTRACT FROM AUTHOR]

Self-injurious behavior (SIB) is a challenging behavior in autism, and some issues about this theme is still unclear, mainly in children and adolescents without intellectual disability. According to the behavioral analysis theoretical model, SIB can fulfill different roles. We conducted a systematic review in order to investigate the prevalence rates and risk factors according to the classification framework based on functional SIB analysis in this group of patients. MEDLINE, Embase, and PsycINFO were searched, and 14 papers fulfilled the criteria for further investigation, which corresponds to 7649 non-intellectually-impaired autistic individuals (82.3% males). The prevalence rates of SIB in the sample ranged between 10.1–70.5%; Besides, some variables, such as sociodemographic characteristics and ASD severity, were analyzed as risk factors according to age and type of SIB described in studies. We discuss our findings based on a novel classification model to contribute to the gaps in understanding this complex phenomenon. [ABSTRACT FROM AUTHOR]

This paper describes how, in the wake of a spate of fatal knife crime in one London borough, the council, Clinical Commissioning Group (CCG) and Child and Adolescent Mental Health Service (CAMHS) got together to think about how to improve outcomes for their young people. Starting with schools and pupil referral units, the CAMHS and educational psychology service were commissioned to work with whole staff groups, from senior leadership to lunchtime monitors and playground staff, to embed trauma informed policy and practice. The aim was to spread understanding about complex developmental trauma; what it is, how it affects the behaviour and experience of children and families, and how to work with it. Given how widespread trauma is, the objective was also to think about what might need to change in the environment and ethos of the borough's schools as a result. Following the project's initial success, its scope and remit were expanded to support services on a policy level, while also working with their staff to think about the impact of trauma, and how best to support children and families who have been affected by it. As well as teaching about trauma, the project is primarily an experiential one. This paper explores the impact on staff who were involved in the project; what came out of it for them personally in terms of changes to their thinking and outlook, and what they saw as the changes for the children and families they worked with. [ABSTRACT FROM AUTHOR]

One of the outstanding differences of psychotherapy with children as distinguished from the treatment of adults is the fact that one's activity is not restricted to just one patient, the sick child, but that one has to deal with the parents and other significant people of the child's environment as well. Without undue exaggeration one might say that in many cases it is the parents who constitute the real problem in child psychiatry. They often seek help for their own difficulties in rearing their children, for their anxiety and guilt, and for their own annoyance and disappointment about the child's symptoms and shortcomings. I intend to discuss in this paper some problems in the handling of parents which I have encountered in the private practice of child psychiatry. I shall focus on those aspects which I personally have found difficult and many of which have remained unsolved problems in my daily work. I wish to apologize for presenting a paper which raises new questions instead of answering them. But I do hope to stimulate further thought by raising these questions and to clarify at least some of the issues involved. [ABSTRACT FROM AUTHOR]

Alzheimer's disease (AD) is the most common neurodegenerative disorder with the majority of patients classified as sporadic AD (sAD), in which etiopathogenesis remains unresolved. Though sAD is argued to be a polygenic disorder, apolipoprotein E (APOE) +4, was found three decades ago to pose the strongest genetic risk for sAD. Currently, the only clinically approved diseasemodifying drugs for AD are aducanumab (Aduhelm) and lecanemab (Leqembi). All other AD treatment options are purely symptomatic with modest benefits. Similarly, attention-deficit hyperactivity disorder (ADHD), is one of the most common neurodevelopmental mental disorders in children and adolescents, acknowledged to persist in adulthood in over 60% of the patients. Moreover, for ADHD whose etiopathogenesis is not completely understood, a large proportion of patients respond well to treatment (first-line psychostimulants, e.g., methylphenidate/MPH), however, no disease-modifying therapy exists. Interestingly, cognitive impairments, executive, and memory deficits seem to be common in ADHD, but also in early stages of mild cognitive impairment (MCI), and dementia, including sAD. Therefore, one of many hypotheses is that ADHD and sAD might have similar origins or that they intercalate with one another, as shown recently that ADHD may be considered a risk factor for sAD. Intriguingly, several overlaps have been shown between the two disorders, e.g., inflammatory activation, oxidative stress, glucose and insulin pathways, wingless-INT/mammalian target of rapamycin (Wnt/mTOR) signaling, and altered lipid metabolism. Indeed, Wnt/mTOR activities were found to be modified by MPH in several ADHD studies. Wnt/mTOR was also found to play a role in sAD and in animal models of the disorder. Moreover, MPH treatment in the MCI phase was shown to be successful for apathy including some improvement in cognition, according to a recent meta-analysis. In several AD animal models, ADHD-like behavioral phenotypes have been observed indicating a possible interconnection between ADHD and AD. In this concept paper, we will discuss the various evidence in human and animal models supporting the hypothesis in which ADHD might increase the risk for sAD, with common involvement of the Wnt/mTOR-pathway leading to lifespan alteration at the neuronal levels. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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Purpose: The prevalence of psychiatric disorders in children and young people is increasing, leading to recommendations that medical schools re-consider their curriculum content and teaching practices for child and adolescent psychiatry (CAP). The purpose of this paper is to seek guidance for undergraduate curriculum development from the wider literature on CAP curriculum content and teaching practices. Design/methodology/approach: A comprehensive search of the literature was conducted, focussing on studies that examined undergraduate teaching of CAP. In an attempt to establish whether there is an agreed level of curriculum content and teaching practices, literature from all over the world was included. Findings: Findings suggest that curriculum content and teaching practices are varied, therefore it was difficult to identify best practice upon which recommendations can be made. In addition, despite previous calls for curriculum improvements and expansion of learning objectives, recent studies suggest that there has been little change. Research limitations/implications: A common theme emerging was the importance of making the CAP curriculum relevant to all future doctors rather than only those who plan to specialise in CAP. Further research to determine what CAP knowledge, skills and attitudes non-psychiatrists think that medical students need to be taught is warranted. Originality/value: This paper reviewed the literature on undergraduate CAP teaching, highlighting common themes from the wider literature on medical curriculum development to inform how CAP curricula content can be developed to equip future doctors. [ABSTRACT FROM AUTHOR]

Aim: As increasing numbers of unaccompanied refugee minors (URMs) are arriving in Europe, there is a need to investigate which factors promote psychological resilience and improve their mental health. This review aims to identify preventive post settlement influences, including living arrangements, access to mental health services, and effective treatments that may improve mental health outcomes. Methods: A systematic literature review was conducted of published papers in any language for children (<18 years) entering a host country, unaccompanied and seeking asylum. Specific studies were eligible if they examined any treatment or nontreatment influences on mental health or psychological resilience for the URM. Thirteen published quantitative studies were identified. Results: URMs in more supportive living arrangements including foster care had lower risk of PTSD and lower depressive symptoms compared with those in semi‐independent care arrangements. URMs living in reception settings that restricted freedom had more anxiety symptoms. Regarding help seeking, one study found only 30% of URMs had foster parents or guardians who could detect a mental health need. Two papers found the URMs had low levels of contact with mental health services despite the high prevalence of psychiatric symptoms. URMs were less likely than accompanied children to receive trauma‐focused interventions, cognitive therapy, or even practical assistance with basic social needs. With regard to treatment evaluation, only case series were identified. Three studies found cognitive behavioural therapy improved PTSD symptoms and mental health outcomes. A less structured approach (mental health counselling alone) did not improve functional health outcomes. Conclusion: Higher support living arrangements with low restrictions are associated with lower psychological distress. Most URMs are not receiving psychological interventions, and there is a dearth of studies evaluating treatment effectiveness for this group. There is an urgent need for more research to investigate pathways to mental health services and treatment efficacy in this vulnerable group. [ABSTRACT FROM AUTHOR]

The scientific basis for practice in child psychiatry has developed apace. And has thrown up several quandries for an accepted paradigm for good practice anchored to the diagnostic schema developed in adult psychiatry. This paper hopes to stimulate discussion about where alternative paradigms might lead us on a path to precision medicine as applied to child psychiatry.

This paper unpacks the legacy of racism and white supremacy in American child psychiatry, connecting them to current racist inequities, to reimagine an antiracist future for the profession, and to serve all children's mental health body and soul. History reveals how child psychiatry has neglected and even perpetuated the intergenerational trauma suffered by minoritized children and families. By refusing to confront racial injustice, it has centered on white children's protection and deleted their role in white supremacist violence. An antiracist future for the profession demands a profound historical reckoning and comprehensive reimagining, a process that this paper begins to unfold., Competing Interests: Disclosure The authors have no conflicts of interest to disclose. They collectively contributed hundreds of hours and centuries of lived experience. In the process, they endured retraumatization while confronting white supremacist violence and risking censure from their employers and institutions for their unapologetic, transparent approach. The emotional, intellectual, and physical toll of this labor on their bodies cannot be quantified. The only remuneration they received for their free labor was support from one another. While invaluable, this is also unacceptable. The motivation for their unpaid contribution is that it serves as an impetus and mandate to fund long overdue and desperately needed anti-racism initiatives in American child psychiatry., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Les notions de crise et d'urgence sont fréquemment confondues autant par les familles que par bon nombre de professionnels bien qu'elles ne soient pas synonymes. L'urgence en pédopsychiatrie correspond à une situation pathologique aiguë à laquelle s'associe la notion de risque vital pour le jeune. Alors que l'urgence exige une prise en charge immédiate du jeune, la crise nécessite, quant à elle, le développement de nouvelles manières de voir et de faire ainsi que de nouveaux mécanismes adaptatifs pour faire face aux changements. Suite à la nouvelle politique en santé mentale enfants-adolescents développée par le ministère de la Santé publique belge en 2015, l'unité thérapeutique adolescents destinée aux 10–18 ans de l'hôpital Vincent Van Gogh, a dédié 2 de ses 15 lits pour la prise en charge spécifique de la crise pédopsychiatrique. L'objectif de cet article est de présenter le fonctionnement du dispositif « lits de crise » au sein de l'unité. Seront définis tout d'abord la notion de crise ainsi que les modèles théoriques d'intervention proposés en clinique. Ensuite, le contexte historique de l'implémentation des lits de crises de l'hôpital VVG ainsi que leur fonctionnement seront évoqués. Enfin, 3 cas cliniques illustreront non seulement toute la prise en charge réalisée en unité de crise mais aussi les différentes issues possibles au terme du séjour. À travers ceux-ci, sera mis en évidence également l'impact qu'ont les facteurs individuels intrapsychiques et systémiques sur la crise et son devenir. The notions of crisis and emergency are frequently mixed up by family members, as well as by many professionals, although they are not synonymous. In child psychiatry, an emergency is an acute pathological situation which is associated with the idea that the child's life is in danger. While an emergency requires immediate care, a crisis requires the development of new ways of seeing and navigating the world, as well as new adaptive mechanisms to deal with these changes. Following the new child-adolescent mental health policy developed by the Belgian Ministry of Public Health in 2015, the therapeutic unit for adolescents (10 to 18-year-old) at the Vincent Van Gogh Hospital dedicated two of its fifteen beds to the treatment of child psychiatric crises. The objective of this paper is to present the functioning of the "crisis beds" device within the hospital unit. We will begin with a definition of the notion of crisis and of the theoretical models of intervention offered in clinics. This will be followed by an explanation of the historical context behind the implementation of the crisis beds in the Vincent Van Gogh hospital and a description of how this device works. We will conclude with an overview of three clinical cases which illustrate the extent of the treatment provided in the crisis unit and the different possible outcomes at the end of the stay. The influence of individual intrapsychic and systemic factors on the crisis and its aftermath will be highlighted through these cases. [ABSTRACT FROM AUTHOR]

From the 1920s, children in Switzerland were psychiatrically examined in observation wards. In many cases, these medical reports were linked to the placement of children in homes and foster families. Focusing on a specific case study of the observation institution Stephansburg in Zurich in 1944, this paper retraces the genesis of a child psychiatric report, identifying patterns by which the experts dealt with narratives of teachers, parents or school doctors. At a closer look, tests and medical examinations were not necessarily committed to a strictly scientific approach. The case study analysed in this paper indicates that experts in child psychiatry did not always apply expert knowledge when preparing their opinion. Rather, they resorted to a selection of aspects alien to psychiatry but suitable to satisfy the interests of the contracting authority. [ABSTRACT FROM AUTHOR]

Background: Childhood trauma subtypes sexual abuse, physical abuse, emotional maltreatment, and neglect may have differential effects on the brain that persist into adulthood. A systematic review of neuroimaging findings supporting these differential effects is as yet lacking. Objectives: The present systematic review aims to summarize the findings of controlled neuroimaging trials regarding long-term differential effects of trauma subtypes on the human brain. Methods: A systematic literature search was performed using the PubMed and PsycINFO databases from January 2017 up to and including January 2018. Additional papers were identified by a manual search in the reference lists of selected papers and of relevant review articles retrieved by the initial database search. Studies were then assessed for eligibility by the first author. Only original human studies directly comparing neuroimaging findings of exposed and unexposed individuals to well-defined emotional, physical or sexual childhood maltreatment while controlling for the effects of other subtypes were included. A visual summary of extracted data was made for neuroimaging modalities for which comparison between trauma subtypes was feasible, taking the studies' numbers and sample sizes into account. Results: The systematic literature search yielded 25 publications. Sexual abuse was associated with structural deficits in the reward circuit and genitosensory cortex and amygdalar hyperreactivity during sad autobiographic memory recall. Emotional maltreatment correlated with abnormalities in fronto-limbic socioemotional networks. In neglected individuals, white matter integrity and connectivity were disturbed in several brain networks involved in a variety of functions. Other abnormalities, such as reduced frontal cortical volume, were common to all maltreatment types. Conclusions: There is some evidence for long-term differential effects of trauma subtypes on the human brain. The observed alterations may result from both protective adaptation of and damage to the brain following exposure to threatening life events. Though promising, the current evidence is incomplete, with few brain regions and neuroimaging modalities having been investigated in all subtypes. The comparability of the available evidence is further limited by the heterogeneity of study populations regarding gender, age and comorbid psychopathology. Future neuroimaging studies should take this potentially differential role of childhood trauma subtypes into account. [ABSTRACT FROM AUTHOR]

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BACKGROUND: Public access to data has been a major step in attempting to reduce bias in scientific literature. Data to verify efficacy outcomes are now more accessible; however, little has been done to ensure public access to harms data from RCTs, which are equally important in ascertaining possible misreporting and protecting safety. OBJECTIVE: The treatment for adolescents with depression study (TADS) has influenced most international practice guidelines for treating children and adolescents with depression, supporting first-line prescription of fluoxetine in combination with cognitive behavioural therapy (CBT). However, after over 30 publications by the TADS team, reporting on harms remains highly deficient and we aimed to redress this lack. METHODS: In undertaking a restoring invisible and abandoned trials (RIAT) reanalysis of TADS' effectiveness and safety outcomes, we sought access to de-identified serious adverse events (SAE) data. RESULTS: This paper describes our unsuccessful efforts to obtain more detailed SAE data from TADS' data custodians, highlighting several problematic blocks to comprehensive safety reporting. CONCLUSION: Comprehensive access to clinical trial data is necessary to ensure safe and fully informed guidelines for treating children and adolescents with depression. [ABSTRACT FROM AUTHOR]

The paper focuses on child psychiatry and proposes psychoanalysis as a useful approach in understanding the child as a patient. The author highlights the fact that even before being an object of diagnostic evaluation, the child is an object for his parents and other adults who take care of him/her. Psychiatric evaluation may thus be facilitated by the Lacanian "mirror stage" and by the notion of object "little a". Both findings have the potential to illuminate the particular position of a child as being an object for others and can consequently help the medical doctor allow the object of consultation to represent itself as such; that is to say, as a subject. Such a representation is particularly difficult in the case of autism. The author thus proceeds to shows how autism has put the idea of the object of diagnostic evaluation to the test. [ABSTRACT FROM AUTHOR]

Objective: Classification systems and their practical implications have become increasingly important in child and adolescent psychiatry. This paper presents the evolution and practical applications of a multiaxial classification system for children and adolescents presenting to mental health services. Included are some worked examples demonstrating both the complexity of many presentations and how broadening the use of the multiaxial system can help in identifying appropriate interventions., Conclusions: Classification systems in child and adolescent psychiatry have largely remained uniaxial in nature. A multiaxial system encapsulates the broader biopsychosocial aspects of the presenting child or adolescent, and orders complex data in a concise manner. This approach can be used to concisely communicate with other treating clinicians, and assist with case reviews, formulation and teaching.

Copyright of Arab Journal of Psychiatry is the property of Arab Federation of Psychiatrists and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Longitudinal designs provide a strong inferential basis for uncovering reciprocal effects or causality between variables. For this analytic purpose, a cross-lagged panel model (CLPM) has been widely used in medical research, but the use of the CLPM has recently been criticized in methodological literature because parameter estimates in the CLPM conflate between-person and within-person processes. The aim of this study is to present some alternative models of the CLPM that can be used to examine reciprocal effects, and to illustrate potential consequences of ignoring the issue. A literature search, case studies, and simulation studies are used for this purpose. We examined more than 300 medical papers published since 2009 that applied cross-lagged longitudinal models, finding that in all studies only a single model (typically the CLPM) was performed and potential alternative models were not considered to test reciprocal effects. In 49% of the studies, only two time points were used, which makes it impossible to test alternative models. Case studies and simulation studies showed that the CLPM and alternative models often produce different (or even inconsistent) parameter estimates for reciprocal effects, suggesting that research that relies only on the CLPM may draw erroneous conclusions about the presence, predominance, and sign of reciprocal effects. Simulation studies also showed that alternative models are sometimes susceptible to improper solutions, even when reseachers do not misspecify the model. [ABSTRACT FROM AUTHOR]