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Objective: We examined predictors and moderators of treatment outcome in mothers and children diagnosed with ADHD in a large multicentre RCT., Method: In total, 144 mother-child dyads with ADHD were randomly assigned to either a maternal ADHD treatment (group psychotherapy and open methylphenidate medication, TG) or to a control treatment (individual counselling without psycho- or pharmacotherapy, CG). After maternal ADHD treatment, parent-child training (PCT) for all mother-child dyads was added. The final analysis set was based on 123 dyads with completed primary outcome assessments (TG: n = 67, CG: n = 56). The primary outcome was the change in each child's externalizing symptoms. Multiple linear regression analyses were performed., Results: The severity of the child's externalizing problem behaviour in the family at baseline predicted more externalizing symptoms in the child after PCT, independent of maternal treatment. When mothers had a comorbid depression, TG children showed more externalizing symptoms after PCT than CG children of depressive mothers. No differences between the treatment arms were seen in the mothers without comorbid depression., Conclusions: Severely impaired mothers with ADHD and depressive disorder are likely to need additional disorder-specific treatment for their comorbid psychiatric disorders to effectively transfer the contents of the PCT to the home situation (CCTISRCTN73911400).

Objectives: Catatonic symptoms in children and adolescents have not been well investigated and there are hardly any evaluated recommendations for treatment. The present report deals with the course of disease and the therapy of a severe case of catatonic schizophrenia., Methods: Reported is the case of a 17-year-old-girl suffering from severe, life-threatening catatonic schizophrenia., Results: Following unsuccessful pre-treatment, medication with clozapine markedly improved the pathology., Conclusions: Further investigations and case reports about the course of disease and the therapy of the uncommon clinical picture of sever catatonic schizophrenia in children and adolescents are necessary.

Objectives: The present study analyses the long-term course of disease among patients who underwent inpatient psychotherapeutic treatment in a psychiatric hospital for children and adolescents., Methods: Assessed within the study was a sample of former patients (N = 104) hospitalised in "Haus Vogt" for at least six months from 1983 to 1988. The following instruments were used: Freiburger Strukturiertes Interview (FrStI), World Health Organisation Quality of Life Interview - short version (WHOQOL-BREF), Symptom Checklist of Derogatis - German version (SCL-90-R) and questionnaires for the assessment of the treatment (FBB)., Results: The quality of life (according to WHOQOL-BREF) of former patients is significantly worse on all relevant scales than that among the general population. The mental health (according to SCL-90-R) of the assessed sample is under average compared to that of the general population. In retrospect, satisfaction with treatment, as investigated by means of the FBB, differed considerably between the former "Haus Vogt" patient sample and a comparative sample from a psychiatric university hospital for children and adolescents. The biggest differences in satisfaction with treatment were found on the scale relationship with the therapist, which was much worse among the sample of former "Haus Vogt" patients than in the control group., Conclusions: The study shows positive long-term results in terms of the school and professional education attained later on. At the same time, the former patients showed persisting psychiatric symptoms and a considerably restricted quality of life.

Objectives: Evaluation of event-related potentials for selective attention in attention deficit/hyperactivity disordered children., Methods: Selective attention processes were examined in a group of 18 boys aged 6 to 12 years with attention deficit/hyperactivity disorder and compared with the data of a control group of 21 age and sex matched boys. Parallel thereto the event-related potentials (ERP) were derived during the test at the electrode positions Fz, Cz, Pz, and Oz with reference to the linked ears., Results: Two components of the contingent negative variation (CNV) with different topography were identified in the ERP following a preparatory stimulus (CNV-1: 600 to 1100 ms and CNV-2: 1000 to 1500 ms after the stimulus). There were no group differences at the behavioural level (number of correct detected targets, number of errors). Significant group differences resulted with regard to the topography of the two CNV components. Children with ADD showed an attenuated frontal CNV-1 amplitude and a trend towards increased CNV-1 and CNV-2 occipital amplitudes., Conclusions: The results support the hypothesis of impaired frontal inhibitory processes in children with ADD.

Atypical neuroleptic drugs have enriched our treatment programs, especially in childhood and adolescent schizophrenia. Reviewed here is the use of atypical neuroleptics in children and adolescents with a schizophrenic disorder. The receptor binding profile and pharmacological properties, indications, side effects, clinical application, and trials of atypical neuroleptic drugs are compared to the classical neuroleptic drug haloperidol in the treatment of adolescent schizophrenia. Special attention is paid to the most common atypical neuroleptics clozapine, olanzapine and risperidone since most studies are carried out with these compounds, most often with clozapine. More clinically controlled trials have to be conducted since only one has been performed to date. The place of atypical neuroleptic drugs is discussed and further studies are necessary in order to differentiate, and eventually broaden the spectrum of the indications tested thus far.

The influence of an oligoantigenic diet on different dimensions of the behavior of 21 children diagnosed as having attention-deficit hyperactivity disorder (ADHD) was examined. Treatment effects were assessed with three subjective measures (two questionnaires and an interview) and three objective measures (two attention tests and actometer). The study was divided into three phases: baseline, diet and provocation, each lasting three weeks. A crossover design was used. A significant effect was found for the subjective measures, but not for the objective measures. The results are discussed in terms of possible types of effects, e. g. rater effects and environmental effects. It may be that the oligoantigenic diet influences only certain dimensions of hyperactivity.