Thomas Grisso points out that youth with mental disorders make up a significant subgroup of youth who appear in U.S. juvenile courts. And he notes that juvenile justice systems today are struggling to determine how best to respond to those youths' needs, both to safeguard their own welfare and to reduce re-offending and its consequences for the community. In this article, Grisso examines research and clinical evidence that may help in shaping a public policy that addresses that question. Clinical science, says Grisso, offers a perspective that explains why the symptoms of mental disorders in adolescence can increase the risk of impulsive and aggressive behaviors. Research on delinquent populations suggests that youth with mental disorders are, indeed, at increased risk for engaging in behaviors that bring them to the attention of the juvenile justice system. Nevertheless, evidence indicates that most youth arrested for delinquencies do not have serious mental disorders. Grisso explains that a number of social phenomena of the past decade, such as changes in juvenile law and deficiencies in the child mental health system, appear to have been responsible for bringing far more youth with mental disorders into the juvenile justice system. Research shows that almost two-thirds of youth in juvenile justice detention centers and correctional facilities today meet criteria for one or more mental disorders. Calls for a greater emphasis on mental health treatment services in juvenile justice, however, may not be the best answer. Increasing such services in juvenile justice could simply mean that youth would need to be arrested in order to get mental health services. Moreover, many of the most effective treatment methods work best when applied in the community, while youth are with their families rather than removed from them. A more promising approach, argues Grisso, could be to develop community systems of care that create a network of services cutting across public child
In this paper, the author points out that youth with mental disorders make up a significant subgroup of youth who appear in U.S. juvenile courts. And he notes that juvenile justice systems today are struggling to determine how best to respond to those youths' needs, both to safeguard their own welfare and to reduce re-offending and its…
Murphey, David; Barry, Megan; Vaughn, Brigitte
Mental disorders are diagnosable conditions characterized by changes in thinking, mood, or behavior (or some combination of these) that can cause a person to feel stressed out and impair his or her ability to function. These disorders are common in adolescence. This "Adolescent Health Highlight" presents the warning signs of mental disorders;…
Substance Abuse and Mental Health Services Administration (DHHS/PHS), Rockville, MD. Center for Mental Health Services.
This factsheet describes the different mental, emotional, and behavior problems that can occur during childhood and adolescence. The incidence and symptoms of the following disorders are discussed: (1) anxiety disorders (including phobia, generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, post-traumatic stress disorder);…
de Vries, Ulrike; Lehmkuhl, Gerd; Petermann, Franz
On the basis of the high prevalence for behavioural problems and mental disorders in adolescence and its persistence into adulthood it is tested whether and based upon which emphasis this topic is considered in the recent discussion on psychotherapy. Therefore, a bibliometric analysis is given that summarizes the issue in the 2011 and 2012 volumes of representative German child and adolescent psychological and psychiatric journals. The focus lies on conduct disorder, depression, deliberate self-harm, dissociative disorder, and post traumatic stress disorder.
Papachristou, Ec; Anagnostopoulos, Dk
The percentage of people with mental retardation in the general population is estimated at about 2.3%, with adolescence (15-20 years) constituting the development period during which a peak in rates of mental retardation is observed. The increased prevalence of adolescence may be explained from the fact that the specified requirements of the school initially, and society later, inevitably lead to comparative evaluation of the teen with mental retardation in relation to peers, thus making mental retardation more apparent. Adolescents with mental retardation face a number of physical and psychological needs which are not often distinguishable and as a consequence undergo the deterioration of their already burdened quality of life. In particular, mental health problems occur 3 to 4 times more often in adolescents with mental retardation compared with adolescents of the general population. This review presents the most recent epidemiological findings regarding the correlation between behavioral disorders, substance use and the possible comorbidity in adolescents with intellectual disability, both at community level and residential care level. Epidemiological data indicate that behavioral disorders are among the most common types of psychopathology in mentally retarded adolescents with the severity and symptoms varying depending on the personal characteristics of each adolescent. Regarding substance use, the available data show that the rates of substance use (alcohol, smoking, illicit drugs) are lower in this specific population group but the differences over the last years tend to be eliminated. Finally, according to the few surveys that were examined referring to the comorbidity of behavioral disorders and substance use in adolescents with intellectual disability, the results were contradictory. Specifically, while behavioral disorders continued to be one of the most common types of psychopathology, the related substances disorders indicated lower rates compared to
Farbstein, Ilana; Mansbach-Kleinfeld, Ivonne; Levinson, Daphna; Goodman, Robert; Levav, Itzhak; Vograft, Itzik; Kanaaneh, Rasim; Ponizovsky, Alexander M.; Brent, David A.; Apter, Alan
Background: The development of epidemiological instruments has enabled the assessment of mental disorders in youth in countries that plan policy according to evidence-based principles. The Israel Survey of Mental Health among Adolescents (ISMEHA) was conducted in 2004-2005 in a representative sample of 957 adolescents aged 14-17 and their mothers.…
Lopes, Claudia S; Abreu, Gabriela de Azevedo; dos Santos, Debora França; Menezes, Paulo Rossi; de Carvalho, Kenia Mara Baiocchi; Cunha, Cristiane de Freitas; de Vasconcellos, Mauricio Teixeira Leite; Bloch, Katia Vergetti; Szklo, Moyses
ABSTRACT OBJECTIVE To describe the prevalence of common mental disorders in Brazilian adolescent students, according to geographical macro-regions, school type, sex, and age. METHODS We evaluated 74,589 adolescents who participated in the Cardiovascular Risk Study in Adolescents (ERICA), a cross-sectional, national, school-based study conducted in 2013-2014 in cities with more than 100,000 inhabitants. A self-administered questionnaire and an electronic data collector were employed. The presence of common mental disorders was assessed using the General Health Questionnaire (GHQ-12). We estimated prevalence and 95% confidence intervals of common mental disorders by sex, age, and school type, in Brazil and in the macro-regions, considering the sample design. RESULTS The prevalence of common mental disorders was of 30.0% (95%CI 29.2-30.8), being higher among girls (38.4%; 95%CI 37.1-39.7) when compared to boys (21.6%; 95%CI 20.5-22.8), and among adolescents who were from 15 to 17 years old (33.6%; 95%CI 32.2-35.0) compared to those aged between 12 and 14 years (26.7%; 95%CI 25.8-27.6). The prevalence of common mental disorders increased with age for both sexes, always higher in girls (ranging from 28.1% at 12 years to 44.1% at 17 years) than in boys (ranging from 18.5% at 12 years to 27.7% at 17 years). We did not observe any significant difference by macro-region or school type. Stratified analyses showed higher prevalence of common mental disorders among girls aged from 15 to 17 years of private schools in the North region (53.1; 95%CI 46.8-59.4). CONCLUSIONS The high prevalence of common mental disorders among adolescents and the fact that the symptoms are often vague mean these disorders are not so easily identified by school administrators or even by health services. The results of this study can help the proposition of more specific prevention and control measures, focused on highest risk subgroups. PMID:26910549
Lopes, Claudia S; Abreu, Gabriela de Azevedo; dos Santos, Debora França; Menezes, Paulo Rossi; de Carvalho, Kenia Mara Baiocchi; Cunha, Cristiane de Freitas; de Vasconcellos, Mauricio Teixeira Leite; Bloch, Katia Vergetti; Szklo, Moyses
OBJECTIVE To describe the prevalence of common mental disorders in Brazilian adolescent students, according to geographical macro-regions, school type, sex, and age. METHODS We evaluated 74,589 adolescents who participated in the Cardiovascular Risk Study in Adolescents (ERICA), a cross-sectional, national, school-based study conducted in 2013-2014 in cities with more than 100,000 inhabitants. A self-administered questionnaire and an electronic data collector were employed. The presence of common mental disorders was assessed using the General Health Questionnaire (GHQ-12). We estimated prevalence and 95% confidence intervals of common mental disorders by sex, age, and school type, in Brazil and in the macro-regions, considering the sample design. RESULTS The prevalence of common mental disorders was of 30.0% (95%CI 29.2-30.8), being higher among girls (38.4%; 95%CI 37.1-39.7) when compared to boys (21.6%; 95%CI 20.5-22.8), and among adolescents who were from 15 to 17 years old (33.6%; 95%CI 32.2-35.0) compared to those aged between 12 and 14 years (26.7%; 95%CI 25.8-27.6). The prevalence of common mental disorders increased with age for both sexes, always higher in girls (ranging from 28.1% at 12 years to 44.1% at 17 years) than in boys (ranging from 18.5% at 12 years to 27.7% at 17 years). We did not observe any significant difference by macro-region or school type. Stratified analyses showed higher prevalence of common mental disorders among girls aged from 15 to 17 years of private schools in the North region (53.1; 95%CI 46.8-59.4). CONCLUSIONS The high prevalence of common mental disorders among adolescents and the fact that the symptoms are often vague mean these disorders are not so easily identified by school administrators or even by health services. The results of this study can help the proposition of more specific prevention and control measures, focused on highest risk subgroups.
Pirdehghan, Azar; Vakili, Mahmood; Rajabzadeh, Yavar; Puyandehpour, Mohammad; Aghakoochak, Arezoo
Background Child abuse is a serious social health problem all over the world with important adverse effects. Objectives The aim of this study was to extend our understanding of the relation between mental disorders and child abuse. Materials and Methods The study was designed as a cross-sectional survey on 700 students in secondary schools using multiple cluster sampling in Yazd, Iran in 2013. We applied 2 self reported questionnaires: DASS (depression anxiety stress scales)-42 for assessing mental disorders (anxiety, stress and depression) and a standard self-reported valid and reliable questionnaire for recording child abuse information in neglect, psychological, physical and sexual domains. The collected data was analyzed using SPSS software. P-values < 0.05 were considered as significant. Results There was a statically significant correlation between mental disorder and child abuse score (Spearman rho: 0.2; P-value < 0.001). The highest correlations between mental disorders and child abuse were found in psychological domain, Spearman’s rho coefficients were 0.46, 0.41 and 0.36 for depression, anxiety and stress respectively (P-value < 0.001). Based on the results of logistic regression for mental disorder, females, last born adolescents and subjects with drug or alcohol abuser parents had mental disorder odds of 3, 0.4 and 1.9 times compared to others; and severe psychological abuse, being severely neglected and having sexual abuse had odds 90, 1.6 and 1.5 respectively in another model. Conclusions Programming for mandatory reporting of child abuse by physicians and all health care givers e.g. those attending schools or health centers, in order to prevent or reduce its detrimental effects is useful and success in preventing child abuse could lead to reductions in the prevalence of mental disorders. PMID:27437096
Cheng, Tyrone C.; Lo, Celia C.
This research is a secondary data analysis of the impact of adolescents' mental/substance-use disorders and dual diagnosis on their utilization of drug treatment and mental health services. By analyzing the same teenagers who participated in the NIMH Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) study, logistic…
Jörg, Frederike; Visser, Ellen; Ormel, Johan; Reijneveld, Sijmen A; Hartman, Catharina A; Oldehinkel, Albertine J
The aim of the study was to estimate the proportion of adolescents with and without a psychiatric diagnosis receiving specialist mental health care and investigate their problem levels as well as utilization of other types of mental health care to detect possible over- and undertreatment. Care utilization data were linked to psychiatric diagnostic data of 2230 adolescents participating in the TRAILS cohort study, who were assessed biannually starting at age 11. Psychiatric diagnoses were established at the fourth wave by the Composite International Diagnostic Interview. Self-, parent- and teacher-reported emotional and behavioral problems and self-reported mental health care use were assessed at all four waves. Of all diagnosed adolescents, 35.3 % received specialist mental health care. This rate increased to 54.5 % when three or more disorders were diagnosed. Almost a third (28.5 %) of specialist care users had no psychiatric diagnosis; teachers gave them relatively high ratings on attention and impulsivity subscales. Diagnosed adolescents without specialist mental health care also reported low rates of other care use. We found no indication of overtreatment. Half of the adolescents with three or more disorders do not receive specialist mental health care nor any other type of care, which might indicate unmet needs.
Kouider, Esmahan Belhadj; Koglin, Ute; Lorenz, Alfred L; Dupont, Marc; Petermann, Franz
The study examines ethnic differences in mental disorders in a child and adolescent psychiatry population in a major German city from 2007 to 2011 (N = 5,680). Risks of developing specific mental disorders were calculated. African migrant children and adolescents showed higher risk in traumatic stress and adjustment disorders (F 43 in ICD-10), the Asiatic group in dissociative disorders (F 44-45). Compared to other European migrants the German children and adolescents without migration background had a higher risk of affective disorders (F 3). Adolescents (N = 3,556) with Russian and Polish background had a higher risk of disorders induced by psychotropic substances (F 1). Turkish and Arabic adolescents had a 4- to 5-times increasing risk in schizophrenia as well as schizotypal or delusional disorders (F 2). In addition, mental disorders were influenced by gender and nationality. These study results suggest that a different vulnerability to specific mental disorders is associated to ethnicity.
Bao, Lin; Brownlie, E B; Beitchman, Joseph H
Longitudinal research on mental health development beyond adolescence among nonclinical populations is lacking. This study reports on psychiatric disorder trajectories from late adolescence to young adulthood in relation to childhood and adolescent risk factors. Participants were recruited for a prospective longitudinal study tracing a community sample of 5-year-old children with communication disorders and a matched control cohort to age 31. Psychiatric disorders were measured at ages 19, 25, and 31. Known predictors of psychopathology and two school-related factors specifically associated with language disorder (LD) were measured by self-reports and semistructured interviews. The LD cohort was uniquely characterized by a significantly decreasing disorder trajectory in early adulthood. Special education was associated with differential disorder trajectories between LD and control cohorts, whereas maltreatment history, specific learning disorder, family structure, and maternal psychological distress were associated with consistent trajectories between cohorts. From late adolescence to young adulthood, childhood LD was characterized by a developmentally limited course of psychiatric disorder; maltreatment was consistently characterized by an elevated risk of psychiatric disorder regardless of LD history, whereas special education was associated with significantly decreasing risk of psychiatric disorder only in the presence of LD.
Background: Co-occurring mental health disorders are widespread among substance using adolescents. Severity of victimization may be an important factor in explaining co-occurrence of mental health problems among adolescents with substance misuse problems. Purpose: The purpose of this study was to evaluate whether severe victimization experiences…
Brown, Larry K.; Hadley, Wendy; Stewart, Angela; Lescano, Celia; Whiteley, Laura; Donenberg, Geri; DiClemente, Ralph
Objective: To examine the relationship between psychiatric disorders and sexual behaviors among adolescents receiving mental health treatment. Adolescents in mental health treatment have been found to have higher rates of HIV risk behavior than their peers, but data concerning the relationship between psychopathology and risk are inconsistent and…
Mental disorders include a wide range of problems, including Anxiety disorders, including panic disorder, obsessive-compulsive disorder, post- ... disorders, including schizophrenia There are many causes of mental disorders. Your genes and family history may play a ...
This study examined whether parents of adolescents diagnosed with mental disorders self-blame for their child's disorders; their reasons for self-blame; and the relationships between parental self-blame and lower psychological well-being, perceived stigmatization, social support, potential hereditary factors related to adolescents' mental…
Noel, Melanie; Groenewald, Cornelius B; Beals-Erickson, Sarah E; Gebert, J Thomas; Palermo, Tonya M
Chronic pain in childhood and adolescence has been shown to heighten the risk for depressive and anxiety disorders in specific samples in adulthood; however, little is known about the association between a wider variety of chronic pains and internalizing mental health disorders. Using nationally representative data, the objectives of this study were to establish prevalence rates of internalizing mental health disorders (anxiety and depressive disorders) among cohorts with or without adolescent chronic pain, and to examine whether chronic pain in adolescence is associated with lifetime history of internalizing mental health disorders reported in adulthood. Data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) was used (N = 14,790). Individuals who had chronic pain in adolescence subsequently reported higher rates of lifetime anxiety disorders (21.1% vs 12.4%) and depressive disorders (24.5% vs 14.1%) in adulthood as compared with individuals without a history of adolescent chronic pain. Multivariate logistic regression confirmed that chronic pain in adolescence was associated with an increased likelihood of lifetime history of anxiety disorders (odds ratio: 1.33; 95% confidence interval: 1.09-1.63, P = 0.005) and depressive disorders (odds ratio: 1.38; confidence interval: 1.16-1.64, P < 0.001) reported in adulthood. Future research is needed to examine neurobiological and psychological mechanisms underlying these comorbidities.
Gatta, Michela; Zotto, Lara Dal; Nequinio, Giulia; Col, Lara Del; Sorgato, Rosaria; Ceranto, Giovanni; Testa, Costantino Paolo; Pertile, Riccardo; Battistella, Pier Antonio
Several studies have demonstrated that the family members of adolescents with mental diseases experience distress, anxiety and depression, as well as economic strain, all of which contribute to physical and psychological caregiver morbidity. The aim of this study was to assess the effectiveness of intervention to improve the caregiving experience…
Tegethoff, Marion; Stalujanis, Esther; Belardi, Angelo; Meinlschmidt, Gunther
Background The objective was to estimate temporal associations between mental disorders and physical diseases in adolescents with mental-physical comorbidities. Methods This article bases upon weighted data (N = 6483) from the National Comorbidity Survey Adolescent Supplement (participant age: 13–18 years), a nationally representative United States cohort. Onset of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition lifetime mental disorders was assessed with the fully structured World Health Organization Composite International Diagnostic Interview, complemented by parent report. Onset of lifetime medical conditions and doctor-diagnosed diseases was assessed by self-report. Results The most substantial temporal associations with onset of mental disorders preceding onset of physical diseases included those between affective disorders and arthritis (hazard ratio (HR) = 3.36, 95%-confidence interval (CI) = 1.95 to 5.77) and diseases of the digestive system (HR = 3.39, CI = 2.30 to 5.00), between anxiety disorders and skin diseases (HR = 1.53, CI = 1.21 to 1.94), and between substance use disorders and seasonal allergies (HR = 0.33, CI = 0.17 to 0.63). The most substantial temporal associations with physical diseases preceding mental disorders included those between heart diseases and anxiety disorders (HR = 1.89, CI = 1.41 to 2.52), epilepsy and eating disorders (HR = 6.27, CI = 1.58 to 24.96), and heart diseases and any mental disorder (HR = 1.39, CI = 1.11 to 1.74). Conclusions Findings suggest that mental disorders are antecedent risk factors of certain physical diseases in early life, but also vice versa. Our results expand the relevance of mental disorders beyond mental to physical health care, and vice versa, supporting the concept of a more integrated mental-physical health care approach, and open new starting points for early disease prevention and better treatments, with relevance for various medical disciplines. PMID:27768751
McLaughlin, Katie A.; Green, Jennifer Greif; Alegria, Margarita; Costello, E. Jane; Gruber, Michael J.; Sampson, Nancy A.; Kessler, Ronald C.
Objective: To examine whether food insecurity is associated with past-year "DSM-IV" mental disorders after controlling for standard indicators of family socioeconomic status (SES) in a U.S. national sample of adolescents. Method: Data were drawn from 6,483 adolescent-parent pairs who participated in the National Comorbidity Survey Replication…
Brown, Larry K.; Hadley, Wendy; Stewart, Angela; Lescano, Celia; Whiteley, Laura; Donenberg, Geri; DiClemente, Ralph
Objective To examine the relationship between psychiatric disorders and sexual behaviors among adolescents receiving mental health treatment. Adolescents in mental health treatment have been found to have higher rates of HIV risk behavior than their peers, but data concerning the relationship between psychopathology and risk are inconsistent and limited. Method Eight hundred and forty adolescents (56% female, 58% African American, mean age 14.9 years) and their parents completed computerized assessments of psychiatric symptoms via the Computerized Diagnostic Interview Schedule for Children (C-DISC). Adolescents also reported on sexual risk behaviors (vaginal/anal sex, condom use at last sex) and completed urine screens for a sexually transmitted infection (STI). Results Adolescents meeting criteria for Mania, externalizing disorder (Oppositional Defiant, Conduct, and Attention Deficit Hyperactivity Disorders) or comorbid internalizing (Major Depressive, Generalized Anxiety, and Post-Traumatic Stress Disorders) and externalizing disorders were significantly more likely to report a lifetime history of vaginal or anal sex than those who did not meet criteria for any psychiatric disorder (OR = 2.0, 2.3 and 1.9, respectively). Adolescents meeting criteria for Mania were significantly more likely to have two or more partners in the past 90 days (OR= 3.2) and test positive for a STI (OR = 4.3) relative to adolescents who did not meet criteria for a psychiatric disorder. Conclusions The presence of internalizing and externalizing disorders, especially Mania, suggests the need for careful screening and targeting of adolescent sexual behavior during psychiatric treatment. PMID:20658815
Bronsard, Guillaume; Alessandrini, Marine; Fond, Guillaume; Loundou, Anderson; Auquier, Pascal; Tordjman, Sylvie; Boyer, Laurent
Abstract It remains unclear whether children and adolescents in the child welfare system (CWS) exhibit a higher prevalence of mental disorders compared with the general population. The objective of this study was to perform a systematic review and meta-analysis to assess the prevalence of mental disorders in the CWS. All of the epidemiological surveys assessing the prevalence of mental disorders in children and adolescents in the CWS were included. The pooled prevalence was estimated with random effect models. Potential sources of heterogeneity were explored using meta-regression analyses. Eight studies provided prevalence estimates that were obtained from 3104 children and adolescents. Nearly 1 child or adolescent of every 2 (49%; 95% confidence interval (CI) 43–54) was identified as meeting criteria for a current mental disorder. The most common mental disorder was disruptive disorder (27%; 95% CI 20–34), including conduct disorder (20%; 95% CI 13–27) and oppositional defiant disorder (12%; 95% CI 10–14). The prevalence of attention-deficit/hyperactivity disorder was estimated to be 11% (95% CI 6–15). The prevalence estimates of anxiety and depressive disorders were 18% (95% CI 12–24) and 11% (95% CI 7–15). Posttraumatic stress disorder had the lowest prevalence (4%; 95% CI 2–6). High prevalences of mental disorders in the CWS were reported, which highlights the need for the provision of qualified service. The substantial heterogeneity of our findings is indicative of the need for accurate epidemiological data to effectively guide public policy. PMID:26886603
Vicente, Benjamin; Saldivia, Sandra; de la Barra, Flora; Kohn, Robert; Pihan, Ronaldo; Valdivia, Mario; Rioseco, Pedro; Melipillan, Roberto
Background: In Latin America, there is limited research on the prevalence of mental disorders in children and adolescents. This Chilean survey is the first national representative survey in the Latin American region to examine the prevalence of Diagnostic and Statistical Manual-IV (DSM-IV) psychiatric disorders in the region in children and…
Vilarins, Natália Pereira Gonçalves
This article examines how adolescent offenders with mental disorders are treated by socio-educative internment treatment. These adolescents come under the aegis of medicine and justice in a contradictory relationship between full protection, vulnerability of a developing person with a mental disorder and a juvenile delinquency offense. In this respect, the legal punishment prevails to the detriment of health care. After approval of the research project by an Ethics Research Committee, field research was conducted in the Youth Detention Unit of the Pilot Plan of the Brazilian Federal District. Data were collected through research of documents involving 35 medical records of adolescent users of psychotropic drugs in 2010, as well as participant observation and semi-structured interviews with professionals from the Youth Detention Unit and adolescent judiciary. In the review of the care provided to adolescent offenders with mental disorders under the childhood and youth policy and the mental health policy, it was revealed that the mental health care provided in the Youth Detention Unit or in the external mental health care services involved the prescription of medication.
Jozefiak, Thomas; Kayed, Nanna Sønnichsen; Rimehaug, Tormod; Wormdal, Anne Kristine; Brubakk, Ann Mari; Wichstrøm, Lars
Most adolescents are placed in residential youth care (RYC) because of severe psychosocial strains and child maltreatment, which represent risk factors for developing mental disorders. To plan RYC units and ensure that residents receive evidence-based psychiatric interventions, it is necessary to obtain reliable and valid prevalence estimates of mental disorders in this population. However, there is a lacuna of research on diagnoses derived from standardized clinical interviews. The aim of this study was to assess the prevalence and comorbidity of mental disorders applying diagnostic interviews in an entire population of adolescents living in RYC in Norway. All young people in RYC were invited to participate in the study. Eighty-six RYC institutions with 601 eligible adolescents were included and 400 adolescents, 12-20 years old, participated in the study, yielding a response rate of 67 %. Anonymous Child Behaviour Checklist scores for 141 (70 %) of the declining residents were also available, allowing diagnoses according to the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) for 541 youths to be estimated. Diagnoses were assessed by trained interviewers with the Child and Adolescent Psychiatric Assessment interview (CAPA). Seventy-six point two per cent (71.5-80.8 CI 95 %) of adolescents received at least one 3-month DSM-IV diagnosis. Prevalence rates for internalizing psychiatric disorders were higher than for behavioural disorders. Comorbidity was high between these two groups. Mental disorders were prevalent among children and youth in RYC. Our results create major concerns and challenge the existing organization of the RYC system.
McLaughlin, Katie A.; Green, Jennifer Greif; Alegría, Margarita; Costello, E. Jane; Gruber, Michael J.; Sampson, Nancy A.; Kessler, Ronald C.
Objective To examine whether food insecurity is associated with past-year DSM-IV mental disorders after controlling for standard indicators of family socioeconomic status (SES) in a U.S. national sample of adolescents. Method Data were drawn from 6,483 adolescent–parent pairs who participated in the National Comorbidity Survey Replication Adolescent Supplement, a national survey of adolescents 13 to 17 years old. Frequency and severity of food insecurity were assessed with questions based on the U.S. Department of Agriculture’s Food Security Scale (standardized to a mean of 0, variance of 1). DSM-IV mental disorders were assessed with the World Health Organization Composite International Diagnostic Interview. Associations of food insecurity with DSM-IV/Composite International Diagnostic Interview diagnoses were estimated with logistic regression models controlling for family SES (parental education, household income, relative deprivation, community-level inequality, and subjective social status). Results Food insecurity was highest in adolescents with the lowest SES. Controlling simultaneously for other aspects of SES, standardized food insecurity was associated with an increased odds of past-year mood, anxiety, behavior, and substance disorders. A 1 standard deviation increase in food insecurity was associated with a 14%increase in the odds of past-year mental disorder, even after controlling for extreme poverty. The association between food insecurity and mood disorders was strongest in adolescents living in families with a low household income and high relative deprivation. Conclusions Food insecurity is associated with a wide range of adolescent mental disorders independently of other aspects of SES. Expansion of social programs aimed at decreasing family economic strain might be one useful policy approach for improving youth mental health. PMID:23200286
O’Leary-Barrett, Maeve; Pihl, Robert O.; Artiges, Eric; Banaschewski, Tobias; Bokde, Arun L. W.; Büchel, Christian; Flor, Herta; Frouin, Vincent; Garavan, Hugh; Heinz, Andreas; Ittermann, Bernd; Mann, Karl; Paillère-Martinot, Marie-Laure; Nees, Frauke; Paus, Tomas; Pausova, Zdenka; Poustka, Luise; Rietschel, Marcella; Robbins, Trevor W.; Smolka, Michael N.; Ströhle, Andreas; Schumann, Gunter; Conrod, Patricia J.
Objective To investigate the role of personality factors and attentional biases towards emotional faces, in establishing concurrent and prospective risk for mental disorder diagnosis in adolescence. Method Data were obtained as part of the IMAGEN study, conducted across 8 European sites, with a community sample of 2257 adolescents. At 14 years, participants completed an emotional variant of the dot-probe task, as well two personality measures, namely the Substance Use Risk Profile Scale and the revised NEO Personality Inventory. At 14 and 16 years, participants and their parents were interviewed to determine symptoms of mental disorders. Results Personality traits were general and specific risk indicators for mental disorders at 14 years. Increased specificity was obtained when investigating the likelihood of mental disorders over a 2-year period, with the Substance Use Risk Profile Scale showing incremental validity over the NEO Personality Inventory. Attentional biases to emotional faces did not characterise or predict mental disorders examined in the current sample. Discussion Personality traits can indicate concurrent and prospective risk for mental disorders in a community youth sample, and identify at-risk youth beyond the impact of baseline symptoms. This study does not support the hypothesis that attentional biases mediate the relationship between personality and psychopathology in a community sample. Task and sample characteristics that contribute to differing results among studies are discussed. PMID:26046352
This paper concerns future policy development and programs of research for the prevention of mental disorders based on research emerging from fetal and early life programming. The current review offers an overview of findings on pregnancy exposures such as maternal mental health, lifestyle factors, and potential teratogenic and neurotoxic exposures on child outcomes. Outcomes of interest are common child and adolescent mental disorders including hyperactive, behavioral and emotional disorders. This literature suggests that the preconception and perinatal periods offer important opportunities for the prevention of deleterious fetal exposures. As such, the perinatal period is a critical period where future mental health prevention efforts should be focused and prevention models developed. Interventions grounded in evidence-based recommendations for the perinatal period could take the form of public health, universal and more targeted interventions. If successful, such interventions are likely to have lifelong effects on (mental) health. PMID:24559477
Gurovich, I Ia; Visnevskaia, L Ia; Preĭs, V B
A study of patients registered in the adolescent rooms of the psychoneurological outpatient centres of two districts of Moscow showed that the structure of psychic pathology of this population is characterized by a greater proportion, as compared with children, of psychotic forms, with non-psychotic psychic diseases and mental retardation still occupying the leading place. Almost one-third of patients (largely those with non-psychotic forms of psychogenic and exogenous-organic nature and a superficial level of disturbances observed) have good prognosis in terms of their cure including the discarding off the record in the relevant dispensary. Activation of extrahospital forms of care including improvement of the microsocial environment is required.
Nesvåg, Ragnar; Hartz, Ingeborg; Bramness, Jørgen G; Hjellvik, Vidar; Handal, Marte; Skurtveit, Svetlana
Antipsychotic drugs are used increasingly by children and adolescents and there is concern about off-label use. We aimed to study which substances, and for which mental disorder diagnoses, antipsychotic drugs were prescribed to 0-18-year-old boys and girls in Norway. Linked data from the national health registry for prescription drugs in 2010 and mental disorder diagnoses in 2008-2012 were used to study the prevalence of antipsychotic drug use, the type of antipsychotic drug substances used, mental disorder diagnoses in users and distribution of drugs per diagnostic category across gender. In total, 0.18% of Norwegian children and adolescents were prescribed antipsychotic drugs during 2010, of which there were more boys (0.23%) than girls (0.13%). Risperidone was the most frequently used substance among boys (57.4%) and girls (32.3%), followed by aripiprazole (19.4%) in boys and quetiapine (27.4%) in girls. The most common mental disorder diagnoses among male users were hyperkinetic (49.9%) and autism spectrum disorder (27.1%), while anxiety disorders (41.5%) and depressive illness (33.6%) were most common among female users. A schizophrenia-like psychosis diagnosis was given to 11.1% of the male and 18.2% of the female users. A hyperkinetic disorder was diagnosed among 56.9% and 52.4% of the male risperidone and aripiprazole users, respectively. Among female quetiapine users, 57.1% were diagnosed with anxiety disorders and 52.4% with depressive illness. These results demonstrate that children and adolescents who use antipsychotic drugs are predominantly diagnosed with non-psychotic mental disorders such as hyperkinetic disorder among boys and anxiety disorder or depressive illness among girls.
Shaffer, David, Ed.; And Others
The book describes Project Prevention, an interdisciplinary project developed by the American Academy of Child and Adolescent Psychiatry, to identify risk factors for mental disorders and preventive interventions. After an introductory chapter, the following eight chapters cover: the scope of Project Prevention; children at high risk (e.g.,…
Einfeld, Stewart L.; Ellis, Louise A.; Emerson, Eric
Background: Mental disorder and intellectual disability each accounts for substantial burden of disease. However, the extent of this co-occurrence varies substantially between reports. We sought to determine whether studies in children and/or adolescents with acceptably rigorous methods can be distinguished from existing reports, and whether key…
Young, Cara C; Calloway, Susan J
Health promotion, disease prevention and anticipatory guidance are the hallmarks of nursing practice, particularly in pediatrics. While there is a wealth of information on anticipatory guidance for the pediatric patient at different ages and developmental stages, there is a paucity of information on anticipatory guidance for the adolescent and emerging adult in transitioning to manage their own health care. While an established need for anticipatory guidance and a transition plan from pediatric to adult health care is apparent for youth routinely followed for significant medical, intellectual, or developmental conditions, a group particularly vulnerable to destabilization of their health as they transition to self-directed adult health care management is composed of youth with mental health disorders. The risk for destabilization increases as they move away from social supports to the university setting. This article reviews available literature on anticipatory guidance for the college bound adolescent with a mental health disorder and makes recommendations for transition planning including examining the college and community services that would support mental health as well as personal choices regarding lifestyle habits while attending the university. Recommendations are made for nurses to be the leaders in filling this anticipatory guidance gap in preparing youth with mental health disorders for a successful transition to and through college life.
Fazel, Seena; Doll, Helen; Langstrom, Niklas
The article presents a meta-analysis of all existing surveys on the prevalence of psychiatric morbidity in adolescents in juvenile detention and correctional facilities in order to assess the prevalence of mental disorders. Findings indicate adolescents in detention are 10 times more likely to suffer from psychosis than the general adolescent…
Benjet, Corina; Borges, Guilherme; Méndez, Enrique; Albor, Yesica; Casanova, Leticia; Orozco, Ricardo; Curiel, Teresa; Fleiz, Clara; Medina-Mora, María Elena
Half of mental disorders have their first onset before adulthood when the presence of a disorder may be particularly disruptive to developmental milestones. Retrospective prevalence estimates have been shown to underestimate the burden of mental illness and scarce data are available on the incidence of disorders throughout the adolescent period, especially in developing countries. Thus, the objective was to determine the incidence of mental disorders in an 8-year period from adolescence to young adulthood, onset of service use and their predictors in a Mexican cohort. 1071 respondents from a representative two-wave panel sample participated in the Mexican Adolescent Mental Health Survey in 2005 and in the follow-up survey in 2013. Disorders were evaluated with the World Mental Health Composite International Diagnostic Interview. 37.9% experienced the onset of a psychiatric disorder and 28.4% sought services for the first time. Substance use disorders had the greatest incidence, followed by mood and behavior disorders, anxiety disorders and lastly eating disorders. Sex, age, school dropout, childhood adversities and prior mental disorders predicted the onset of new disorders. Being female, having more educated parents and most classes of disorder predicted first time service use. These findings contribute to a paradigm shift in conceptions of mental disorder similar to how we think of common physical afflictions as near universal experiences across the life course, but less frequent at any given moment. Adolescents are particularly vulnerable. Therefore, public health policy should focus on early universal promotion of positive mental health and structural determinants of mental health.
Battista, Susan R.; Pencer, Alissa; McGonnell, Melissa; Durdle, Heather; Stewart, Sherry H.
There is a high overlap between substance misuse and mental health disorders in adolescents. Certain personality traits (i.e., sensation seeking, impulsivity, hopelessness, and anxiety sensitivity) may be related to increased risk for mental health symptoms and/or substance misuse. The current study examined the relationships between personality…
Xiuqin, Huang; Huimin, Zhang; Mengchen, Li; Jinan, Wang; Ying, Zhang; Ran, Tao
The objectives of this study were to compare the personality profiles of adolescent males with and without Internet addiction disorder (IAD), and to determine if IAD is associated with specific parental rearing behaviors. A total of 304 subjects (204 IAD positive and 100 IAD negative controls) completed three instruments: Symptom Checklist-90-revision (SCL-90-R), Eysenck Personality Questionnaire Revised (EPQ-R), and Egna Minnen av Barndoms Uppfostran--'My Memories of Upbringing' (EMBU). SCL-90-R profiles of adolescents with IAD revealed comparatively higher mean scores for all of the nine domains, and significantly higher scores for obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, and paranoid ideation; the mean global symptom index of adolescents with IAD was also significantly higher by approximately 10%. EPQ profiles of adolescents with IAD showed that Internet-dependent individuals tended to exhibit a significantly lower degree of extraversion and a significantly higher degree of psychoticism when compared with the control group. EMBU profiles revealed that adolescents with IAD generally rated both maternal and paternal rearing practices as lacking in emotional warmth, being over-involved, rejecting, and punitive (mothers only). The results of this study confirm that IAD often occurs concurrently with mental symptoms and personality traits such as introversion and psychoticism. Adolescents with IAD consistently rated parental rearing behaviors as being over-intrusive, punitive, and lacking in responsiveness. These findings suggest that the influences of parenting style and family function are important factors in the development of Internet dependency.
Ezpeleta, Lourdes; Guillamón, Noemí; Granero, Roser; de la Osa, Núria; María Domènech, Josep; Moya, Isabel
This paper reports rates of psychopathology in a population of 9- and 13-yr olds from a Spanish slum. Two cohorts of all the children born in 1989 and in 1993 and registered in the census of a municipality in 2001 were assessed over a 3-yr period with structured diagnostic interviews and functional measures. In the first year of the study 79 (53.7%) children of the adolescent 13-yr-old population and 72 (59.5%) of the pre-adolescent 9-yr-old population participated. Between 30% and 60% of preadolescents and between 30% and 50% of adolescents presented some mental disorder. Anxiety and disruptive behavior disorders were the most frequent disorders in both cohorts. For both genders, the highest risk for any psychopathology was at 10 yr. We found that, psychopathology and functional impairment decreased with age, and that the psychopathology of children in a peripheral slum of a big city is 3 times higher than the median of the general population. This information should be useful for administrators providing services for children from the most disadvantaged segment of the population.
Puberty is characterized by a complexity of different developmental tasks. During this period of sometimes dramatic changes, the adolescent must find a new balance between personal experiences and the demands made by the environment. In this period of development, some 18% of all adolescents experience a mental crisis, and 5% need specialist treatment. Such mental disorders in puberty as anorexia nervosa, depression or suicidality can be classified on the basis of their development and course. They must be taken seriously and treated as early as possible.
Merikangas, Kathleen Ries; He, Jian-ping; Burstein, Marcy; Swanson, Sonja A.; Avenevoli, Shelli; Cui, Lihong; Benjet, Corina; Georgiades, Katholiki; Swendsen, Joel
Objective: To present estimates of the lifetime prevalence of "DSM-IV" mental disorders with and without severe impairment, their comorbidity across broad classes of disorder, and their sociodemographic correlates. Method: The National Comorbidity Survey-Adolescent Supplement NCS-A is a nationally representative face-to-face survey of…
Polanczyk, Guilherme V.; Salum, Giovanni A.; Sugaya, Luisa S.; Caye, Arthur; Rohde, Luis A.
Background: The literature on the prevalence of mental disorders affecting children and adolescents has expanded significantly over the last three decades around the world. Despite the field having matured significantly, there has been no meta-analysis to calculate a worldwide-pooled prevalence and to empirically assess the sources of…
Eckhoff, Christian; Straume, Bjørn; Kvernmo, Siv
Objectives To examine the association between multisite musculoskeletal pain in adolescence and mental health disorders in young adulthood. Design and setting Data were obtained from a linkage between the Norwegian Patient Registry (2008–2012) and the Norwegian Arctic Adolescent Health Study, a school-based survey conducted among 10th grade students in North Norway (2003–2005). Participants In total, 3987 (68%) of all 5877 invited participants consented to the registry linkage. Outcome measures Mental healthcare use and disorders from age 18–20 to 23–25 years (5 years). Methods Musculoskeletal pain was measured by the number of musculoskeletal pain sites. Multivariable logistic regression was used to explore the association with later mental healthcare use and disorders. Results Multisite adolescent musculoskeletal pain was significantly associated with an increase in mental healthcare use and mental health disorders in young adulthood. The relationship was stronger for anxiety and mood disorders, in both genders. Overall, the association between musculoskeletal pain and later mental health problems was attenuated after controlling for adolescent psychosocial and mental health problems, not by physical or sedentary activity. This could be due to confounding or mediation. However, when examining different mental health disorders, we found musculoskeletal pain to be significantly associated with anxiety disorders, and showing a strong trend in mood disorders, when adjusted for the adolescent factors. Conclusions Physicians should be aware that multisite adolescent pain is associated with mental health problems in adolescence, and that these adolescents are at increased risk of mental health disorders in young adulthood. As youth troubled by mental health problems commonly present physical symptoms it is important to examine for psychosocial problems in order to offer early interventions. PMID:28188150
Chen, Xiaojin; Thrane, Lisa; Whitbeck, Les B.; Johnson, Kurt
This study examined the associations between lifetime mental disorder, comorbidity, and self-reported postrunaway arrests among 428 (187 males, 241 females) homeless and runaway youth. The analysis examined the pattern of arrests across five lifetime mental disorders (alcohol abuse, drug abuse, conduct disorder, major depressive episode, and…
Kaltiala-Heino, Riittakerttu; Ranta, Klaus; Fröjd, Sari
School performance, involvement in bullying and frequent absences from school are indicators of not only cognitive and social skills but also mental health. Mental disorders may interfere with learning and adjustment in many ways. Mental disorders may bring about problems in attention and motivation, and failure in schoolwork often makes an adolescent vulnerable to mental disorders. Early recognition of and prompt intervention in specific learning difficulties may prevent mental disorders. Adolescents involved in bullying present with increased risk of both internalising and externalising mental disorders, as do adolescents who are frequently absent from school, whether due to illness or due to truancy. Peer rejection is an important warning sign during adolescent development. These features can fairly easily be recognised at school, and school's psychosocial support systems should have plans for intervention. Mental health promotion in school should comprise approaches that make school safe and involving for all, and individual interventions for those at risk.
Lahey, Benjamin B.; D'Onofrio, Brian M.; Waldman, Irwin D.
Epidemiology uses strong sampling methods and study designs to test refutable hypotheses regarding the causes of important health, mental health, and social outcomes. Epidemiologic methods are increasingly being used to move developmental psychopathology from studies that catalogue correlates of child and adolescent mental health to designs that…
Blasco-Fontecilla, Hilario; Carballo, Juan J.; Garcia-Nieto, Rebeca; Lopez-Castroman, Jorge; Alegria, Analucia A.; Basurte-Villamor, Ignacio; Sevilla-Vicente, Juncal; Navarro-Jimenez, Rocio; Legido-Gil, Teresa; Morant-Ginestar, Consuelo; Jimenez-Arriero, Miguel Angel; Saiz-Ruiz, Jeronimo; Baca-Garcia, Enrique
Objectives. To examine whether age of First diagnosis, gender, psychiatric comorbidity, and treatment modalities (pharmacotherapy or psychotherapy) at Child and Adolescent Mental Health Services (CAMHS) moderate the risk of Adult Mental Health Services (AMHS) utilization in patients diagnosed with hyperkinetic disorder at CAMHS. Methods. Data were derived from the Madrid Psychiatric Cumulative Register Study. The target population comprised 32,183 patients who had 3 or more visits at CAMHS. Kaplan-Meier curves were used to assess survival data. A series of logistic regression analyses were performed to study the role of age of diagnosis, gender, psychiatric comorbidity, and treatment modalities. Results. 7.1% of patients presented with hyperkinetic disorder at CAMHS. Compared to preschool children, children and adolescents first diagnosed with hyperkinetic disorder at CAMHS were more likely to use AMHS. Female gender and comorbidity with affective disorders, schizophrenia, schizotypal and delusional disorders increased the risk of use of AMHS. Pharmacological or combined treatment of hyperkinetic disorder diagnosed at CAMHS was associated with increased risk of use at AMHS. Conclusions. Older age of first diagnosis, female gender, psychiatric comorbidity, and pharmacological treatment at CAMHS are markers of risk for the transition from CAMHS to AMHS in patients with hyperkinetic disorder diagnosed at CAMHS. PMID:22654608
Abbas, Sascha; Ihle, Peter; Adler, Jürgen-Bernhard; Engel, Susanne; Günster, Christian; Holtmann, Martin; Kortevoss, Axel; Linder, Roland; Maier, Werner; Lehmkuhl, Gerd; Schubert, Ingrid
Children and adolescents with mental health problems need effective and safe therapies to support their emotional and social development and to avoid functional impairment and progress of social deficits. Though psychotropic drugs seem to be the preferential treatment, psychotherapy and psychosocial interventions are essential in mental health care. For Germany, current data on the utilization of psychotherapy and psychosocial interventions in children with mental health problems is lacking. To analyse why certain children and adolescents with mental or behavioural disorders do and others do not receive non-drug treatment, we assessed predictors associated with specific non-drug psychiatric/psychotherapeutic treatment including psychosocial interventions, psychotherapy and other non-drug treatments. The study is based on data of two large German health insurance funds, AOK and TK, comprising 30 % of the German child and adolescent population. Predictors of non-drug psychiatric/psychotherapeutic treatment were analysed for 23,795 cases and two controls for every case of the same age and sex in children aged 0-17 years following a new diagnosis of mental or behavioural disorder in 2010. Predictors were divided according to Andersen's behavioural model into predisposing, need and enabling factors. The most prominent and significant predictors positively associated with non-drug psychiatric/psychotherapeutic treatment were the residential region as predisposing factor; specific, both ex- and internalizing, mental and behavioural disorders, psychiatric co-morbidity and psychotropic drug use as need factors; and low area deprivation and high accessibility to outpatient physicians and inpatient institutions with non-drug psychiatric/psychotherapeutic department as enabling factors. In conclusion, the present study suggests that the residential region as proxy for supply of therapist and socioeconomic situation is an influencing factor for the use of psychotherapy. The
Kislitsyna, Ol'ga Anatol'evna
Attention to problems of health has traditionally been focused on problems of physical health, in spite of very clear signs that the number of cases of impaired health of a psychosocial and mental character is rising. According to estimates of the World Health Organization (WHO), as many as 20 percent of children and adolescents suffer from…
Motlagh, Mohammad Esmaeil; Kelishadi, Roya; Qorbani, Mostafa; Keikha, Mojtaba; Ataie-Jafari, Asal; Ardalan, Gelayol; Heshmat, Ramin; Jari, Mohsen
Background: Behavioral disorders are common in the pediatric age group. This study aims to assess the relationship between the frequency of behavioral and mental disorders and counseling with family members and friends in a representative sample of Iranian children and adolescents. Methods: In this nationwide study, 14880 school students, aged 6–18 years, were selected by cluster and stratified multi-stage sampling method from 30 provinces in Iran. The World Health Organization Global School-based Health Survey questionnaire was used. Results: Overall, 13486 students (49.2% girls) with the mean (standard deviation) age of 12.47 (3.36) years completed the study. According to the students’ self-report, 56.1% of boys and 42.2% of girls shared their problems with their fathers. All behavioral disorders were less prevalent in children and adolescents who consulted with their father compared with those who did not (P < 0.001). In addition, 84.6% of boys and 84.0% of girls shared their problem with their mother. All behavioral disorders were less prevalent in children and adolescents who consulted with their mother compared with those who did not (P < 0.001). 45.6% of boys and 44.8% of girls shared their problem with their brother or sister. Some behavioral disorders were less prevalent in children and adolescents who consulted with their brother or sister (P < 0.01); however, the prevalence was not statistically different for most disorders (P > 0.05). Moreover, 60.4% of boys and 66.0% of girls shared their problems with their friends. The prevalence of most behavioral disorders was lower in those who consulted with their friends (P < 0.001). Conclusions: Children and adolescents should be encouraged to consult with their parents and friends about their problems. Parents should offer their children an opportunity to express their views and wishes about their problems. PMID:27014431
Al Riyami, Asya A; Al Adawi, Samir H; Al Kharusi, Hilal A; Morsi, Magdi M; Jaju, Sanjay S
Background Recent corpus of research suggests that psychiatric disorders amongst adolescents and youths are an emerging global challenge, but there is paucity of studies exploring health services utilization by this age group in Arab region. Aim This study focus on the health services utilization and the barriers among school going adolescents and youths with DSM IV disorders in the country Oman, whose population is predominantly youthful. Methods Representative sample of secondary school Omani adolescents and youths were concurrently interviewed for the (i) presence of DSM IV mental disorders using the face-to-face interview, World Mental Health-Composite International Diagnostic Interview (WMH-CIDI), (ii) tendency for health care utilization and (iii) predictors of utilization with clinical and demographic background. Results The proportions of lifetime cases having ever made treatment contact are low, being 5.2% for any anxiety disorder and 13.2% for any mood disorder category. None of these anxiety cases made treatment contact in the year of onset of the disorder, and the median delay when they eventually made treatment contact is about 14 years. In any mood disorders category only 3.6% made contact within the 1st year of onset with the median delay in initial treatment contact is two years for the Bipolar disorder (broad), four years for Any Mood disorder and nine years for the Major Depressive Disorder group. Male gender is significantly associated with less likelihood of making treatment contact when suffering from Social phobia (p = 0.000), Major Depressive Disorder (p = 0.000) and Bipolar Disorder (p = 0.000). The younger cohorts of 14-16 years and 17-18 years of Social phobic made significantly less lifetime any treatment contact (p = 0.000). The 14-16 year olds were significantly less likely to make lifetime any treatment contact for Bipolar Mood disorder (p = 0.000), while the 17-18 group were 1.5 times more likely to do so. Over past 12 months only
Russell, P S; Mammen, P; Nair, M K C; Russell, Sushila; Shankar, S R
India has a huge child and adolescent population. Psychiatric disorders are widely prevalent and the mental health needs of these children are well recognized. Nonetheless, there are no country-centric and child specific mental health policies, plans or programs. There is also a significant lack of human resources for child and adolescent mental health in India. This combination of factors makes the primary care a critical setting for the early identification, treatment, consultation and referral of children and adolescents with mental health and developmental needs. Even though the importance of primary care as a system for addressing the mental health care has been recognized for decades, its potential requires further development in India as the Child and Adolescent Mental Health Services (CAMHS) emerge and evolve. A country and child specific mental health policy, plan and program needs to be formulated as well an integrated, multi-tier CAMHS with a focus on the primary-care physicians as care providers for this population has to be developed.
Kaltiala-Heino, Riittakerttu; Rimpela, Matti; Rantanen, Paivi; Rimpela, Arja
Surveys Finnish adolescents about bullying and victimization in relations to psychosomatic symptoms, depression, anxiety, eating disorders and substance use. Anxiety, depression, and psychosomatic symptoms were most frequent among bully-victims and equally common among bullies and victims. Argues that bullying should be seen as an indicator of…
Petrov, Megan E; Lichstein, Kenneth L; Baldwin, Carol M
The study determined the prevalence of sleep disorders by ethnicity and sex, and related daytime functioning, working memory, and mental health among older adolescent to emerging adult college students. Participants were U.S.A. undergraduates (N = 1684), aged 17-25, recruited from 2010 to 2011. Participants completed online questionnaires for all variables. Overall, 36.0% of the sample screened positive for sleep disorders with insomnia, restless legs syndrome, and periodic limb movement disorder being the most prevalent. Women reported more insomnia and daytime impairment. African-Americans reported more early morning awakenings and less daytime impairment. Students with insomnia symptoms or restless legs syndrome tended to have lower working memory capacities. Students with nightmares or parasomnias had greater odds for mental disorders. In an older adolescent to emerging adult college student sample, sleep disorders may be a common source of sleep disturbance and impairment. Certain sleep disorders may be associated with lower working memory capacity and poor mental health.
Background Resources for supporting children and adolescents with psychiatric disorders continue to be scarce. Economics research can identify current patterns of expenditure, and help inform allocation of treatment and support resources between competing needs or uses. Scope and methods The aim was to identify the costs of supporting children and adolescents, the economic impacts of childhood psychiatric disorders in adulthood and any new evidence on the cost-effectiveness of interventions. An electronic search of databases (including PubMed, Medline and Psychinfo) identified peer-reviewed journal articles published between 2005 and 2012. Findings Sixty-seven papers provided data on support and treatment costs now or in the future, or cost-effectiveness analyses of services. Half the articles came from the United States. Most articles focussed on autism spectrum disorder (ASD; 23 articles), attention deficit hyperactivity disorder (ADHD; n = 15), conduct disorder (CD; n = 7), and anxiety or depression (n = 8). Conclusion Only 14 studies used a cost perspective wider than health care; most included education costs (n = 11), but only five included costs to the justice system. The number of studies estimating costs to the family has increased, particularly for children with autism spectrum disorder (ASD). In the United Kingdom, support costs for children and adolescents with conduct disorder (CD) appear to be lower than for those with attention deficit hyperactivity disorder (ADHD), although for the United States, the opposite may be true. Support costs for children and adolescents with ASD may be higher than both CD and ADHD. However, there were many differences between the samples and the methods employed making comparisons between studies difficult. Outcomes in adulthood include negative impacts on (mental) health, quality of life, public sector services, employment status and income. The evidence base is improving for child and adolescent psychiatric
García-Soriano, Gemma; Roncero, María
Obsessive-compulsive disorder (OCD) is a frequent and disabling disorder with a long delay in seeking help that could partly be due to poor mental health literacy and stigmatizing attitudes. This study analyzes the mental health literacy and stigma associated with symmetry/order and aggression-related OCD in a Spanish adolescent sample. This age group was chosen because adolescence is a vulnerable period for the development of OCD, and adolescents are often reluctant to seek professional help. One hundred and two non-clinical adolescents read two vignettes describing symmetry/order and aggression-related OCD. Then, referring to these two vignettes, they answered questions related to problem recognition, causality perception, need for treatment, treatment recommendations, and stigma. Results show that a high percentage of adolescents recognize the interference of order- and aggression-related OCD, consider that a peer with order- or aggression-related OCD needs treatment, and would recommend a formal source of help. Although order symptoms are highly recognized as OCD by adolescents, aggression-related OCD is frequently misidentified as schizophrenia or depression. Results also show higher levels of stigmatizing attitudes in adolescents, associated with aggression-OCD (versus order-OCD), especially in male adolescents and adolescents with no previous experience with mental health services/providers. Results suggest the need to develop school-based programs emphasizing OCD content heterogeneity, especially the aggression, sexual, and religious contents, and work toward eliminating stigma.
Hagel, Lilian Day; Mainieri, Alberto Scolfano; Zeni, Cristian Patrick; Wagner, Mario Bernardes
Objective: Compare a questionnaire based on the HEADSS approach (QBH-16) and the Child Behavior Checklist (CBCL) in the screening of mental disorder in adolescents with behavioral problems. Methods: Adolescents from both genders 12-17 years-old presenting behavioral problems without a previous diagnosis of mental disorder were referred from…
Laghi, Fiorenzo; Federico, Francesca; Lonigro, Antonia; Levanto, Simona; Ferraro, Maurizio; Baumgartner, Emma; Baiocco, Roberto
This study examined mentalizing abilities, social behavior, and social impact of adolescents who expressed the willingness to become peer buddies for adolescents with Autism Spectrum Disorders, and adolescents selected by their teachers and peers. Twenty-seven teachers and 395 adolescents from public high schools completed mentalizing abilities, social status, behavioral, and peer buddy nomination measures. Findings suggest that social status and preference play a significant role in the selection of peer buddies by both teachers and classmates. Furthermore, more advanced Theory of Mind (ToM) abilities and the engagement in prosocial behaviors differentiated peers selected as buddies from other classmates. When compared with nonparticipating students, adolescents who expressed willingness to participate were more often girls, and were more prosocial. Agreement between teacher and peer nominations of best peer was moderate.
Coghill, David; Sonuga-Barke, Edmund J. S.
The question of whether child and adolescent mental disorders are best classified using dimensional or categorical approaches is a contentious one that has equally profound implications for clinical practice and scientific enquiry. Here, we explore this issue in the context of the forth coming publication of the DSM-5 and ICD-11 approaches to…
Mond, J. M.; Marks, P.; Hay, P. J.; Rodgers, B.; Kelly, C.; Owen, C.; Paxton, S. J.
This research examined the "mental health literacy" of adolescents concerning eating-disordered behavior. A vignette describing a fictional 16-year old female meeting diagnostic criteria for bulimia nervosa was presented to 522 female high school students, followed by a series of questions concerning treatment of and treatment-seeking…
Zulauf Logoz, Marina
The Revision and 5th Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5): Consequences for the Diagnostic Work with Children and Adolescents.The present paper describes and discusses the major revisions in DSM-5 for children and adolescents. A major modification is that the separate chapter for disorders first diagnosed in childhood and adolescence was abandoned in favour of the integration of these clinical pictures into the relevant disorder-specific chapters. Several new diagnoses and diagnostic groups were introduced: "Disruptive mood regulation disorder" is a new diagnosis; the different diagnoses for autism were brought together into one, and a new diagnostic group for obsessive-compulsive disorders has been established. The developmental approach of DSM-5 and the integration of dimensional assessment tools are to be welcomed. Practice will show if the critiques afraid of possible increases in prevalences or those who approve the changes will end up being right.
The effect of school violence on mental health was examined among 12,366 Aboriginal children and adolescents, primarily First Nations, Métis, and Inuit residing off reservations in the Canadian provinces and territories. Analyses were based on the 2006 Aboriginal Peoples' Survey, a postcensal national survey of Aboriginal youth aged 6-14 years. More than one-fifth of students in the sample attended schools where violence was perceived as a problem. The occurrence of psychological or nervous disorders was about 50% higher among students exposed to school violence than among other students. School violence was a significant predictor of mental health difficulties, irrespective of socioeconomic and demographic characteristics. Virtually the entire effect was mediated by interpersonal processes, or negative quality of parent-child and peer relationships, while the effect was not explained by cultural detachment through lack of interactions with Elders and traditional language ability/use. Results underscored school violence as a significant public health concern for Aboriginal elementary and high school students, and the need for evidence-based mental health interventions for at-risk populations.
... Chats with Experts Clinical Trials Share Child and Adolescent Mental Health Overview Teen Depression Study: Understanding Depression ... Continue reading Recruitment Begins for Landmark Study of Adolescent Brain Development September 13, 2016 • Press Release The ...
Larm, Peter; Silva, Teresa C; Hodgins, Sheilagh
Little is known about adult outcomes of males who as adolescents sought treatment for alcohol misuse or drug use, and who additionally were engaging or not engaging in other forms of delinquency. Since the rates of negative outcomes vary in the general population, the study determined whether the sub-groups of clinic attendees fared differently as compared to males of the same age who had not sought treatment for substance misuse from age 21 to 45. Adolescent males who consulted the only substance misuse clinic in a Swedish city between 1968 and 1971 were divided into four groups: ALCOHOL no drug use, no criminal offending (n=52); ALCOHOL+D no drug use, plus criminal offending (n=105); DRUG use, no criminal offending (n=92); and DRUG+D plus criminal offending (n=474). These four groups were compared to a general population sample (GP) of males matched on age and birthplace, who did not seek treatment for SM in adolescence. National Swedish registers provided data on death, hospitalizations for substance misuse (SM), mental and physical disorders, and criminal convictions. Compared to the GP, and after controlling for co-occurring adult outcomes, ALCOHOL showed elevated risks for SM hospitalization and convictions for violent crimes, and DRUG showed elevated risks for SM hospitalization, convictions for non-violent crimes, and hospitalization for psychosis. ALCOHOL+D and DRUG+D showed increased risk for SM hospitalization, violent and non-violent convictions, and DRUG+D additionally, for death, and hospitalizations for psychosis and physical illness. Misuse of alcohol without drug use or other delinquency in adolescence was associated with increased risk for convictions for violent crimes during the subsequent 25 years, in addition to SM, while adolescent drug use without other forms of delinquency was associated with increased risks for convictions for non-violent crimes, hospitalizations for SM, and non-affective psychosis. Cannabis use, with and without
Background Paediatricians can be empowered to address the Priority Mental Health Disorders at primary care level. To evaluate the effectiveness of a collaborative workshop in enhancing the adolescent psychiatry knowledge among paediatricians. Methods A 3-day, 27-hours workshop was held for paediatricians from different regions of India under the auspices of the National Adolescent Paediatric Task Force of the Indian Academy of Paediatrics. A 5-item pretest-posttest questionnaire was developed and administered at the beginning and end of the workshop to evaluate the participants' knowledge acquisition in adolescent psychiatry. Bivariate and multivariate analyses were performed on an intention-to-participate basis. Results Forty-eight paediatricians completed the questionnaire. There was significant enhancement of the knowledge in understanding the phenomenology, identifying the psychopathology, diagnosing common mental disorder and selecting the psychotropic medication in the bivariate analysis. When the possible confounders of level of training in paediatrics and number of years spent as paediatrician were controlled, in addition to the above areas of adolescent psychiatry, the diagnostic ability involving multiple psychological concepts also gained significance. However, both in the bivariate and multivariate analyses, the ability to refer to appropriate psychotherapy remained unchanged after the workshop. Conclusions This workshop was effective in enhancing the adolescent psychiatry knowledge of paediatricians. Such workshops could strengthen paediatricians in addressing the priority mental health disorders at the primary-care level in countries with low-human resource for health as advocated by the World Health Organization. However, it remains to be seen if this acquisition of adolescent psychiatry knowledge results in enhancing their adolescent psychiatry practice. PMID:20167069
Berney, T. P.; Jones, P. M.
Eight cases of early onset bipolar affective disorder in adolescents with mental impairment are described, focusing on age of onset; common characteristics such as rapid cycling, mixed affective states, and lithium resistance; and the likelihood that cerebral dysfunction might cause a secondary form of bipolar disorder. (JDD)
Herpertz-Dahlmann, Beate; Dempfle, Astrid; Konrad, Kerstin; Klasen, Fionna; Ravens-Sieberer, Ulrike
This study reports the outcomes of childhood and adolescent eating-disordered behaviour on the development of body mass index (BMI) and psychological functioning in young adulthood in a population-based sample in Germany (the BELLA study). Information at baseline and follow-up was obtained through a telephone interview and mailed self-report questionnaires. At both measurement points, BMI, eating disorder symptoms (SCOFF questionnaire), and symptoms of depression and anxiety were assessed in the same cohort of 771 participants (n = 420 females, n = 351 males). The age range at baseline was 11-17 years, and the age range at follow-up was 17-23 years. High scores for eating-disordered behaviour in childhood or adolescence significantly predicted eating-disordered behaviour in young adulthood (multiplicative effect estimate: 1.31; 95 % CI: 1.2-1.42, p < 0.0001), although there was a decline in prevalence (from 19.3 to 13.8 %, p = 0.002) and severity (mean decrease in SCOFF 0.07, 95 % CI: -0.01-0.14, p = 0.06). After accounting for potentially confounding variables at baseline (SES, probands' BMI, parental BMI, depressive symptoms), participants with more eating disorder symptoms at baseline had a higher risk of developing overweight (odds ratio (OR): 1.58; 95 % CI: 1.19-2.09, p = 0.001), obesity (OR = 1.67; 95 % CI: 1.03-2.66, p = 0.03), and depressive symptoms at follow-up (additive effect estimate: 0.45; 95 %CI: 0.19-0.7, p = 0.0006). Early symptoms of depression showed a significant relationship with extreme underweight in young adulthood (OR = 1.13; 95 %CI: 1.01-1.25, p = 0.02). The high stability of eating disorder symptoms and the significant association with overweight and worse mental health in adulthood underscore the need for early detection and intervention during childhood and adolescence. Youth with depression should be monitored for the development of restrictive eating disorders.
Over the past decade, the number of girls involved with the juvenile justice system has increased substantially. Available research suggests that large numbers of these girls have serious mental health problems often associated with histories of sexual and/or physical abuse or neglect. Delinquent girls with serious mental health problems pose a…
Sitholey, Prabhat; Agarwal, Vivek; Vrat, Satya
Ancient Indian mental concepts of children and adolescents are very similar to the contemporary modern concepts. The ancient concepts were based on a very positive regard for the children's development, education and future independence, adult role and contribution to society. Children were wanted and considered precious. The children were categorized in to 4 different varnas based on their intelligence, abilities, merit and aptitude and educated accordingly, away from their home, at Gurukuls. They had universal right to education. Girls received attention equal to boys. The boys were expected to earn their livelihood, while the girls were expected to be homemakers. Graduation of the young person at the end of education and return to home marked the emancipation from adolescence. Children's physical and mental health and its disorders were given due attention. Aetiology and treatment of physical and mental disorders was in accordance with the overall scientific development of those times. PMID:23858268
Cornish, Rosie P; John, Ann; Boyd, Andy; Tilling, Kate; Macleod, John
Objective To compare the prevalence of common mental disorders (CMDs) derived from data held in primary care records with that measured using the revised Clinical Interview Schedule (CIS-R) in order to assess the potential robustness of findings based only on routinely collected data. Design and setting Comparison study using linkage between the Avon Longitudinal Study of Parents and Children (ALSPAC) and electronic primary care records. Participants We studied 1562 adolescents who had completed the CIS-R in ALSPAC at age 17–18 years and had linkage established to their primary care records. Outcome measures Outcome measures from ALSPAC were whether or not an individual met International Classification of Diseases-10 criteria for a diagnosis of (1) a CMD or, specifically, (2) depression. Lists of Read codes corresponding to diagnoses, symptoms and treatments were used to create 12 definitions of CMD and depression alone using the primary care data. We calculated sensitivities and specificities of these, using CIS-R definitions as the reference standard. Results Sensitivities ranged from 5.2% to 24.3% for depression and from 3.8% to 19.2% for CMD. The specificities of all definitions were above 98% for depression and above 96% for CMD. For both outcomes, the definition that included current diagnosis, treatment or symptoms identified the highest proportion of CIS-R cases. Conclusions Most individuals meeting case definitions for CMD based on primary care data also met CIS-R case definitions. Conversely many individuals identified as cases using the CIS-R had no evidence of CMD in their clinical records. This suggests that clinical databases are likely to yield underestimates of the burden of CMD in the population. However, clinical records appear to yield valid diagnoses which may be useful for studying risk factors and consequences of CMD. The greatest epidemiological value may be obtained when information is available from survey and clinical records. PMID
Bauer, M; Banaschewski, T; Heinz, A; Kamp-Becker, I; Meyer-Lindenberg, A; Padberg, F; Rapp, M A; Rupprecht, R; Schneider, F; Schulze, T G; Wittchen, H-U
Mental disorders are among the greatest medical and social challenges facing us. They can occur at all stages of life and are among the most important commonly occurring diseases. In Germany 28 % of the population suffer from a mental disorder every year, while the lifetime risk of suffering from a mental disorder is almost 50 %. Mental disorders cause great suffering for those affected and their social network. Quantitatively speaking, they can be considered to be among those diseases creating the greatest burden for society due to reduced productivity, absence from work and premature retirement. The Federal Ministry of Education and Research is funding a new research network from 2015 to 2019 with up to 35 million euros to investigate mental disorders in order to devise and develop better therapeutic measures and strategies for this population by means of basic and translational clinical research. This is the result of a competitive call for research proposals entitled research network for mental diseases. It is a nationwide network of nine consortia with up to ten psychiatric and clinical psychology partner institutions from largely university-based research facilities for adults and/or children and adolescents. Furthermore, three cross-consortia platform projects will seek to identify shared causes of diseases and new diagnostic modalities for anxiety disorders, attention deficit hyperactivity disorders (ADHS), autism, bipolar disorders, depression, schizophrenia and psychotic disorders as well as substance-related and addictive disorders. The spectrum of therapeutic approaches to be examined ranges from innovative pharmacological and psychotherapeutic treatment to novel brain stimulation procedures. In light of the enormous burden such diseases represent for society as a whole, a sustainable improvement in the financial support for those researching mental disorders seems essential. This network aims to become a nucleus for long overdue and sustained
Fabiano, Gregory A; Pelham, William E
In the past decade, increased emphasis has been placed on identifying treatments for childhood disorders that are supported by empirical evidence of their effectiveness. This process was spearheaded by an American Psychological Association division 12 task force that identified evidence-based treatments--mostly for disorders of adulthood. Because of the publication of the task force results, other studies have been published that contribute to the knowledge base of evidence-based treatment, and these studies are briefly reviewed. Across evidence-based treatments, common features of effective treatments, such as parent involvement, use of a treatment manual, and the emphasis on generalization of treatment effects to natural settings, are also identified and reviewed.Introduction
Crowe, Barbara, Ed.
Whether new to the profession or an experienced clinician, this text provides a wealth of state-of-the-art information for undergraduates, graduates and professionals. This volume covers the wide range of mental disorder diagnoses and addresses specific populations such as forensic and drug and alcohol rehabilitation. How music therapy is used…
When in need of medical treatment, Korean citizens have a choice of practitioners of western medicine (WM) or Traditional Korean Medicine (TKM). However, the two branches frequently conflict with one another, particularly with regard to mental disorders. This study was designed to compare the utilization of WM and TKM, focusing on child/adolescent patients with mental disorders. We analyzed F-code (Mental and behavioral disorders) claims from the Korean Health Insurance Review and Assessment Service, including data from 0–18-year-old patients from 2010 to 2012. Slightly more men than women utilized WM, while TKM use was almost evenly balanced. WM claims increased with advancing age, whereas utilization of TKM was common for the 0-6 age group. In WM and TKM, the total number of claims relying on the National Health Insurance Service (NHIS) was 331,154 (92.78%) and 73,282 (97.85%), respectively, and the number of claims relying on medical aid was 25,753 (7.22%) and 1,610 (2.15%), respectively. The most frequent F-coded claim in WM was F90 (Hyperkinetic disorders), with 64,088 claims (17.96%), and that in TKM was F45 (Somatoform disorders), with 28,852 claims (38.52%). The prevalence of a single disorder without comorbidities was 168,764 (47.29%) in WM and 52,615 (70.25%) in TKM. From these data, we conclude that WM takes prevalence over TKM in cases of attention deficit/hyperactivity disorder (ADHD), as well as in psychological problems such as depression and anxiety. On the other hand, patients utilizing TKM more commonly present with physical health problems including somatoform problems, sleep, and eating disorders. PMID:27134500
Yen, Cheng-Fang; Chou, Wen-Jiun; Liu, Tai-Ling; Ko, Chih-Hung; Yang, Pinchen; Hu, Huei-Fan
The aims of this study were to examine the prevalence rates and multilevel correlates of cyberbullying victims and perpetrators among male adolescents diagnosed with attention-deficit/hyperactivity disorder (ADHD) in Taiwan. The relationships between cyberbullying involvement and depression, anxiety, and suicidality were also examined. The experiences of cyberbullying victimization and perpetration in 251 male adolescents with ADHD were assessed. Logistic regression analysis was used to examine the correlates of cyberbullying victims and perpetrators. The relationships between cyberbullying involvement and depression, anxiety, and suicidality were examined using multiple regression analysis. A total of 48 (19.1%) and 36 (14.3%) participants reported that they were cyberbullying victims or perpetrators, respectively. Those who had increased age and a higher parental occupational socioeconomic status, and reported more severe traditional passive bullying victimization were more likely to be cyberbullying victims. Those who had increased age and combined-type ADHD, and reported lower BAS reward responsiveness, more severe Internet addiction and more severe traditional passive bullying perpetration were more likely to be cyberbullying perpetrators. Cyberbullying victims reported more severe depression and suicidality than those who were not cyberbullying victims. A high proportion of male adolescents with ADHD are involved in cyberbullying. Clinicians, educational professionals, and parents of adolescents should monitor the possibility of cyberbullying involvement among male adolescents with ADHD who exhibit the cyberbullying correlates identified in this study.
Dwairy, Marwan; Menshar, Kariman E
Three questionnaires that measure parenting style, adolescent-family connectedness, and mental health were administered to 351 Egyptian adolescents. Results show that in rural communities the authoritarian style is more predominant in the parenting of male adolescents, while the authoritative style is more predominant in the parenting of female adolescents. In urban communities, on the other hand, the authoritarian style was more predominant in the parenting of female adolescents. The connectedness of all female adolescents with their family was stronger than that of male adolescents. The connectedness of girls was found to be more emotional and financial in villages and to be more functional in town. Female adolescents reported a higher frequency of psychological disorders. Mental health was associated with authoritative parenting, but not with authoritarian parenting. It seems that authoritarian parenting within an authoritarian culture is not as harmful as within a liberal culture.
One of the fundamental difficulties in devising a classification of mental disorders is the lack of agreement among psychiatrists regarding the concepts upon which it should be based: diagnoses can rarely be verified objectively and the same or similar conditions are described under a confusing variety of names. This situation militates against the ready exchange of ideas and experiences and hampers progress. As a first step towards remedying this state of affairs, the author of the article below has undertaken a critical survey of existing classifications. He shows how some of the difficulties created by lack of knowledge regarding pathology and etiology may be overcome by the use of “operational definitions” and outlines the basic principles on which he believes a generally acceptable international classification might be constructed. If this can be done it should lead to a greater measure of agreement regarding the value of specific treatments for mental disorders and greatly facilitate a broad epidemiological approach to psychiatric research. PMID:13834299
Eliot, Alexandra O.; Baker, Christina Wood
Described a sample of eating disordered adolescent males who were seen for treatment at Boston Children's Hospital Outpatient Eating Disorders Clinic. Findings suggest the idea that clinicians, coaches, peers, and family should encourage young men to share concerns about body image and weight at an earlier, less severe juncture, with the assurance…
Stiffman, Arlene Rubin, Ed.; Davis, Larry E., Ed.
The essays collected in this book examine the effects of ethnicity on the mental health of adolescents. A dual set of issues emerges throughout the volume: the importance of adolescent mental health in contributing to adult well-being, and the necessity of understanding ethnicity in studying and treating mental health problems. The book is divided…
Ganser, Helene G; Münzer, Annika; Seitz, Diana C M; Witt, Andreas; Goldbeck, Lutz
Victims of child abuse and neglect are more likely to develop emotional and behavioral problems than their non-abused peers. In many cases they do not receive evidence based treatments. Based on pilot studies and clinical experience, a structured and manualized case-management protocol was developed to provide child welfare professionals guidance, direction and support in helping these families find and engage in appropriate treatment. The protocol is described. A survey among child welfare workers indicates a lack of knowledge about mental disorders in victims of child abuse as well as an insufficient cooperation between the child welfare and the mental healthcare system. Child welfare workers who have applied the manual evaluate it positively. This study shows that the structured case-management can be implemented in a child welfare setting.
Eaton, William W.; Martins, Silvia S.; Nestadt, Gerald; Bienvenu, O. Joseph; Clarke, Diana; Alexandre, Pierre
In the last decade, there has been an increase in interest in the burden of chronic and disabling health conditions that are not necessarily fatal, such as the mental disorders. This review systematically summarizes data on the burden associated with 11 major mental disorders of adults. The measures of burden include estimates of prevalence, mortality associated with the disorders, disabilities and impairments related to the disorders, and costs. This review expands the range of mental disorders considered in a report on the global burden of disease, updates the literature, presents information on the range and depth of sources of information on burden, and adds estimates of costs. The purpose is to provide an accessible guide to the burden of mental disorders, especially for researchers and policy makers who may not be familiar with this subfield of epidemiology. PMID:18806255
Borges, Guilherme; Benjet, Corina; Medina-Mora, Maria Elena; Orozco, Ricardo; Nock, Matthew
The study examines data from the Mexican Adolescent Mental Health Survey to study the prevalence and risk factors for suicide ideation, plan, and attempt among Mexican adolescents. The results reveal patterns of the risk factors and suggest that intervention should focus on adolescents with mental disorders to effectively prevent suicides.
Lakhan, Shaheen E; Vieira, Karen F
According to the Diagnostic and Statistical Manual of Mental Disorders, 4 out of the 10 leading causes of disability in the US and other developed countries are mental disorders. Major depression, bipolar disorder, schizophrenia, and obsessive compulsive disorder (OCD) are among the most common mental disorders that currently plague numerous countries and have varying incidence rates from 26 percent in America to 4 percent in China. Though some of this difference may be attributable to the manner in which individual healthcare providers diagnose mental disorders, this noticeable distribution can be also explained by studies which show that a lack of certain dietary nutrients contribute to the development of mental disorders. Notably, essential vitamins, minerals, and omega-3 fatty acids are often deficient in the general population in America and other developed countries; and are exceptionally deficient in patients suffering from mental disorders. Studies have shown that daily supplements of vital nutrients often effectively reduce patients' symptoms. Supplements that contain amino acids also reduce symptoms, because they are converted to neurotransmitters that alleviate depression and other mental disorders. Based on emerging scientific evidence, this form of nutritional supplement treatment may be appropriate for controlling major depression, bipolar disorder, schizophrenia and anxiety disorders, eating disorders, attention deficit disorder/attention deficit hyperactivity disorder (ADD/ADHD), addiction, and autism. The aim of this manuscript is to emphasize which dietary supplements can aid the treatment of the four most common mental disorders currently affecting America and other developed countries: major depression, bipolar disorder, schizophrenia, and obsessive compulsive disorder (OCD). Most antidepressants and other prescription drugs cause severe side effects, which usually discourage patients from taking their medications. Such noncompliant patients who
Ray, Shannon L.
Research indicates that the primary onset of eating disorders occurs in adolescence and that there is a growing prevalence of adolescent males with eating disorders. This article describes the eating disorders of anorexia nervosa and bulimia nervosa as they relate to adolescent males. Diagnostic criteria, at-risk groups, and implications for…
Espinola-Nadurille, Mariana; Vargas Huicochea, Ingrid; Raviola, Giuseppe; Ramirez-Bermudez, Jesus; Kutcher, Stan
This column provides an overview of child and adolescent mental health services in Mexico, where prevalence rates of mental disorders among young people are up to twice as high as U.S. and Canadian rates. The mental health care system in Mexico is underdeveloped and underfunded, and for the approximately 40% of the population with no insurance, access to and quality of care are particularly poor. This column offers policy recommendations aimed at better meeting the needs of this vulnerable population.
Beers, Lee; Southammakosane, Cathy; Lewin, Amy
Adolescent parenthood is associated with a range of adverse outcomes for young mothers, including mental health problems such as depression, substance abuse, and posttraumatic stress disorder. Teen mothers are also more likely to be impoverished and reside in communities and families that are socially and economically disadvantaged. These circumstances can adversely affect maternal mental health, parenting, and behavior outcomes for their children. In this report, we provide an overview of the mental health challenges associated with teen parenthood, barriers that often prevent teen mothers from seeking mental health services, and interventions for this vulnerable population that can be integrated into primary care services. Pediatricians in the primary care setting are in a unique position to address the mental health needs of adolescent parents because teens often turn to them first for assistance with emotional and behavioral concerns. Consequently, pediatricians can play a pivotal role in facilitating and encouraging teen parents’ engagement in mental health treatment. PMID:24298010
Boström, Petra; Johnels, Jakob Åsberg; Thorson, Maria; Broberg, Malin
Few studies have explored the subjective mental health of adolescents with intellectual disabilities, while proxy ratings indicate an overrepresentation of mental health problems. The present study reports on the design and an initial empirical evaluation of the Well-being in Special Education Questionnaire (WellSEQ). Questions, response scales,…
Goodwin, Renee D; Cowles, Robert A; Galea, Sandro; Jacobi, Frank
Although previous studies have suggested an association between various gastrointestinal disorders and mood and anxiety disorders, no previous study has examined the relationship between a diagnosis of gastritis and mood and anxiety disorders in the community. This work aimed to investigate the association between physician-diagnosed gastritis and DSM-IV mood and anxiety disorders among adults in the general population, and to examine sex differences in these relationships. Data were drawn from a population-based, representative sample of 4181 adults aged 18-79 in the German National Health Interview and Examination Survey. Anxiety disorders (27.0% vs. 15.3%) and affective disorders (20.1% vs. 11.5%) were significantly more common among adults with compared to without a diagnosis of gastritis. Lifetime and current physician diagnosed gastritis were associated with an increased prevalence of panic attacks, social phobia, any mood disorder and major depression, compared to those without gastritis. There were no significant sex differences in these associations. A diagnosis of gastritis appears to be associated with significantly increased odds of mood and anxiety disorders among adults in the general population. Contrary to findings from animal studies, we found the relationship between gastritis and mood/anxiety consistent among both sexes.
Byrne, Sadhbh; Swords, Lorraine; Nixon, Elizabeth
This study assessed mental health literacy in Irish adolescents (N = 187), and explored participants' help-giving responses toward hypothetical depressed peers. Participants read five vignettes, each describing an adolescent experiencing a life difficulty; two of the characters met "Diagnostic and Statistical Manual of Mental Disorders"…
Föcker, Manuel; Antel, Jochen; Ring, Stefanie; Hahn, Denise; Kanal, Özlem; Öztürk, Dana; Hebebrand, Johannes; Libuda, Lars
While vitamin D is known to be relevant for bone health, evidence has recently accumulated for an impact on mental health. To identify the potential benefits and limitations of vitamin D for mental health, an understanding of the physiology of vitamin D, the cut-off values for vitamin D deficiency and the current status of therapeutic trials is paramount. Results of a systematic PUBMED search highlight the association of vitamin D levels and mental health conditions. Here, we focus on children and adolescents studies as well as randomized controlled trials on depression in adults. 41 child and adolescent studies were identified including only 1 randomized controlled and 7 non-controlled supplementation trials. Overall, results from 25 cross-sectional studies as well as from 8 longitudinal studies suggest a role of vitamin D in the pathogenesis of mental disorders in childhood and adolescence. Findings from supplementation trials seem to support this hypothesis. However, randomized controlled trials in adults revealed conflicting results. Randomized controlled trials in childhood and adolescents are urgently needed to support the potential of vitamin D as a complementary therapeutic option in mental disorders. Study designs should consider methodological challenges, e.g., hypovitaminosis D at baseline, appropriate supplementation doses, sufficient intervention periods, an adequate power, clinically validated diagnostic instruments, and homogenous, well-defined risk groups.
Caamaño, Marta; Boada, Leticia; Merchán-Naranjo, Jessica; Moreno, Carmen; Llorente, Cloe; Moreno, Dolores; Arango, Celso; Parellada, Mara
This study analyzes subclinical psychopathology in children and adolescents with autism spectrum disorders (ASD) without mental retardation with no comorbid disorder, assessed by an extensive general psychopathology interview. The K-SADS-PL was administered to a group of 25 patients with ASD (mean age = 12.80 ± 2.86 years) and 25 healthy controls…
Abrahamian, Heidemarie; Kautzky-Willer, Alexandra; Rießland-Seifert, Angelika; Fasching, Peter; Ebenbichler, Christoph; Hofmann, Peter; Toplak, Hermann
Psychiatric disorders and psychological problems are common in patients with diabetes mellitus. There is a twofold increase in depression which is associated with suboptimal glycemic control and increased morbidity and mortality. Other psychiatric disorders with a higher incidence of diabetes mellitus are cognitive impairment, dementia, disturbed eating behaviour, anxiety disorders, schizophrenia, bipolar disorders and borderline personality disorder. The coincidence of mental disorders and diabetes mellitus has unfavourable influences on metabolic control and micro- and macroangiopathic late complications. Improvement of therapeutic outcome is a challenge in the modern health care system. The intentions behind this position paper are to rise awareness of this special set of problems, to intensify cooperation between involved health care providers and to reduce incidence of diabetes mellitus as well as morbidity and mortality from diabetes in this patient group.
Sharif, Farkhondeh; Mahmoudi, Asyeh; Shooshtari, Ali Alavi; Vossoughi, Mehrdad
Background: Bipolar Mood Disorder (BMD) is a type of mood disorder which is associated with various disabilities. The family members of the patients with BMD experience many difficulties and pressures during the periods of treatment, rehabilitation and recovery and their quality of life (QOL) is threatened. In the present study, we aimed to evaluate the effect of family-centered education on mental health and QOL of families with adolescents suffering from BMD. Methods: In this randomized controlled clinical trial performed on 40 families which were mostly mothers of the adolescents with BMD referred to the psychiatric clinics affiliated to Shiraz University of Medical Sciences during 2012-13. They were randomly assigned to intervention and control groups. Results: The results of single factor multivariate ANOVA/single-factor multivariate analysis of variance and Bonferroni post hoc tests showed that the interaction between the variables of group and time was significant (P<0.001). The mean of QOL and mental health scores increased in the intervention group, but it decreased in the control group at three measurement time points. Conclusion: The study findings confirmed the effectiveness of family-centered psychoeducation program on Mental Health and Quality of life of the families of adolescents with Bipolar Mood Disorder. Trial Registration Number: IRCT201304202812N15 PMID:27382589
Cheseldine, Sally E.; Jeffree, Dorothy M.
A survey of 245 severely mentally handicapped adolescents was conducted to investigate basic skills needed for an independent life style. Interviews covered such areas as eating and drinking skills, domestic tasks, cleanliness and health, and use of amenities. (SB)
Green, Jennifer Greif; McLaughlin, Katie A.; Alegria, Margarita; Costello, E. Jane; Gruber, Michael J.; Hoagwood, Kimberly; Leaf, Philip J.; Olin, Serene; Sampson, Nancy A.; Kessler, Ronald C.
Objective: Although schools are identified as critical for detecting youth mental disorders, little is known about whether the number of mental health providers and types of resources that they offer influence student mental health service use. Such information could inform the development and allocation of appropriate school-based resources to…
Simpson, Annabelle K; Magid, Viktoriya
Cannabis use in the adolescent population poses a significant threat of addiction potential resulting in altered neurodevelopment. There are multiple mechanisms of treatment of cannabis use disorder including behavioral therapy management and emerging data on treatment via pharmacotherapy. Recognizing the diagnostic criteria for cannabis use disorder, cannabis withdrawal syndrome, and mitigating factors that influence adolescent engagement in cannabis use allows for comprehensive assessment and management in the adolescent population.
... for Families Guide Panic Disorder In Children And Adolescents No. 50; Updated July 2013 Panic disorder is a common and treatable disorder. Children and adolescents with panic disorder have unexpected and repeated periods ...
Merikangas, Kathleen Ries; He, Jian-ping; Burstein, Marcy; Swendsen, Joel; Avenevoli, Shelli; Case, Brady; Georgiades, Katholiki; Heaton, Leanne; Swanson, Sonja; Olfson, Mark
Objective: Mental health policy for youth has been constrained by a paucity of nationally representative data concerning patterns and correlates of mental health service utilization in this segment of the population. The objectives of this investigation were to examine the rates and sociodemographic correlates of lifetime mental health service use…
Plancherel, Bernard; Bolognini, Monique
Focused on mental health and protective factors in early adolescence. Significant relations between coping strategies and mental health were found, which are different according to gender: girls invest in more social relations, negative feelings, and consumption habits; boys often use sense of humor, or practice a hobby or sport. (JBJ)
Flórez Quintero, Daian Tatiana
A problem for both philosophers of Psychiatry and Psychiatrists within the domain of nosology is to determine which could be the more appropriate model to classify mental illnesses. Such an endeavor also requires questioning the very nature of mental illness. While trying to cope with the philosophical challenges of such a task, Peter Zachar purports to show that the nosological work in Psychiatry should not adhere to the model of natural kinds. He even considers that it is mistaken to treat mental disorders as natural kinds. Nonetheless, Zachar's view on the existence of natural kinds-even in domains where there is little room for doubting about their existence, like Chemistry-is very unstable. In 2001 he holds that there are no natural kinds, but in 2008 he argues that his objections to the model of natural kinds are more the manifestation of his skepticism against a tradition. Although the problem of the existence of natural kinds shall not be dealt with in this article, a brief description on how deflated is Zachar's view on this matter in 2008 is presented, with the central part of the article devoted to reconstruct and examine his rationale for the thesis that mental disorders are not natural kinds. In the critical section of this paper, it is suggested that, although Zachar's thesis may be right, the arguments he gives to support it are quite flawed.
Dawson, P J
The biological model has become the touchstone for our thinking on mental disorder. The success of this model has relegated opposing views to the sidelines. Philosophers have been considering the nature of mind for well over 2500 years, and their speculations may provide a useful antidote to the creeping reductionism and materialism inherent in simple biology. The emphasis in philosophical theories is on the nature of the mental and the structuring role of the mind in our construction of reality. This paper focuses on three philosophers, Kant, Heidegger and Husserl, and their contribution to our understanding of the nature of psychopathology. The biological theory is re-examined from the differing perspectives offered, and some of the assumptions on which it is based are subjected to criticism. The emphasis, found in the philosophical theories, on the mental as opposed to the physiological aspects of the mind, is considered to be more germane to the practical and therapeutic concerns of those who must deal with the dis-ease of mental disorder.
Objective World Health Organization has identified Priority Mental Health Disorders (PMHD) of adolescence. To effectively address these disorders at the primary care level paediatricians have to be trained in the low-income countries, which often have paucity of mental health resources. We studied: (1) the need of psychiatric training required among paediatricians; (2) if the content and process of the model workshop suits them to identify and treat these disorders. Methods Forty-eight paediatricians completed evaluation questionnaire at the end of a 3-day workshop on adolescent psychiatry. They participated in a focused group discussion addressing the areas in psychiatry that needs to be strengthened in these workshops, the changes in the content and process of the workshop to bolster their learning. Qualitative and descriptive analyses were appropriately used. Results Training in adolescent psychiatry was considered necessary among the paediatricians at zonal level frequently to develop their private practice, treat psychiatric disorders confidently, make correct referrals, and learn about counselling. Prioritizing training from under and postgraduate training, integrate psychiatry training with conference, conducting special workshops or Continuing Medical Education were suggested as ways of inculcating adolescent psychiatry proficiency. Mental status examination, psychopathology and management of the PMHD were considered by the respondents as important content that need to be addressed in the program but aspects of behavioural problems and developmental disabilities were also identified as areas of focus to gain knowledge and skill. Appropriate group size, flexibility in management decisions to fit the diverse clinical practice- settings was appreciated. Lack of skills in giving clinical reasoning in relation to PMHD, time management and feedback to individuals were identified as required components in the collaborative effort of this manner. Providing
Eddy, Kamryn T.; Doyle, Angela Celio; Hoste, Renee Rienecke; Herzog, David B.; Le Grange, Daniel
A study to examine the kind of eating disorders not otherwise specified (EDNOS) among adolescents encountered during treatment at an outpatient eating disorder clinic is conducted. Results indicate that EDNOS is more predominant among adolescents seeking treatment for eating disorders.
Patel, Dilip R.; Greydanus, Donald E.; Pratt, Helen D.; Phillips, Elaine L.
Reviews research on eating disorders in adolescent athletes, including prevalence, its uncommonness among male athletes, risk factors, medical complications, prevention strategies, and implications for sport and exercise participation, management, and prognosis. (EV)
"Consciousness" "mood," "identity" and "personality" are all emergent properties from whole-brain organizations; these are typically disturbed in psychiatric disorders. This work proposes that the underlying etiopathology of mental disorders originates from disturbances to global brain dynamics, or "Globalopathies" that are divided into three major interdependent types (1) "Resting-State Networkpathies," in personality disorders, (2) "Entropiathies" in mood disorders, and (3) "Connectopathies" in psychosis and schizophrenia spectrum disorders. Novel approaches of processing signals from the brain are beginning to reveal brain organization in health and disease. For example a "small world network" has been described for optimal brain functions and breakdown of that organization might underlie relevant psychiatric manifestations. A novel diagnostic reformulation can be generated based on pathologies of whole brain organizations, such new brain related diagnostic nosology is testable and thus can be validated. Once validated Globalopathies can provide for "Global-therapies" i.e., interventions that can reorganize the brain and cure psychiatric disorders. The technology for such interventions is becoming available.
Sasot-Llevadot, Jordi; Ibáñez-Bordas, Rosa M; Soto-López, Antonio; Montañés-Rada, Francisco; Gastaminza-Pérez, Xavier; Alda-Díez, José A; Cantó-Díez, Tomás; Catalá, Miguel A; Ferrin-Erdozáin, Maite; García-Giral, Marta; Graell-Bernal, Montserrat; Granada-Jiménez, Olvido; Herreros-Rodríguez, Óscar; Mardomingo-Sanz, María J; Mojarro-Práxedes, Dolores; Morey-Canyelles, Jaume; Ortiz-Guerra, Juan; Pàmies-Massana, Montserrat; Rey-Sánchez, Francisco; Romera-Torrens, María; Rubio-Morell, Belén; Ruiz-Lázaro, Pedro M; Ruiz-Sanz, Francisco
In this paper, the Special Interest Group on Attention Deficit Hyperactivity Disorder (GEITDAH, from its name in Spanish) presents a consensus reached by experts from all over Spain on conduct disorders in children and adolescents. Following the initial work by the team at the Pedopsychiatry Unit at the Quiron-Teknon Hospital in Barcelona, agreements have been reached on a number of basic aspects that could be the starting point for future consensuses. A top priority aim of the work was also to update the criteria in the Diagnostic and statistical manual of mental disorders, fifth edition, for conduct disorders in children and adolescents, together with their comorbidity with attention deficit hyperactivity disorder.
The need for guidelines for early intervention of children experiencing Attention Deficit Hyperactivity Disorders (ADHD) was identified by the Australian Early Intervention Network (AusEinet). This document attempts to guide appropriate practice in the care of children and adolescents with ADHD. The guidelines are designed to provide information…
... page: https://medlineplus.gov/news/fullstory_163120.html Plastic Surgeons Often Miss Patients' Mental Disorders 10 percent ... News) -- Nearly one in 10 patients seeking facial plastic surgery suffers from a mental illness that distorts ...
Bloomfield, Elana R; Shatkin, Jess P
Childhood parasomnias and movement disorders arise from a variety of etiologic factors. For some children, psychopathology plays a causal role in sleep disorders; in other cases, recurrent parasomnia episodes induce psychopathology. Current research reveals complex interconnections between sleep and mental health. As such, it is important that clinicians consider the impact psychiatric disorders have on childhood parasomnias. This article describes common parasomnias and movement disorders in children and adolescents, with emphasis on psychologic and behavioral comorbidities.
Suicide is a conscious act of the will with personal and societal ramifications. Its conscious and volitional nature deepens its tragic impact. India has high suicide rates compared to the other countries and also has intriguing distinctiveness due to the reports of higher rates from areas with better health indices and gender opportunities. In this article, I present a broader paradigm, in contrast to the usual 'mental disorder paradigm', which puts forward practical points for a multi-level engagement of healthcare service, community and policy makers. PMID:28031585
This book presents an overview of the major types of mental disorders, accompanied by treatment models that are structured, comprehensive, grounded in research, and likely to be effective. Chapter topics are: (1) "Introduction to Effective Treatment Planning"; (2) "Mental Disorders in Infants, Children, and Adolescents"; (3) "Situationally…
Calvo Sagardoy, Rosa; Gallego Morales, Luis Tomás; Solórzano Ostolaza, Gloria; Kassem García, Soledad; Morales Martínez, Carmen; Codesal Julián, Rosana; Blanco Fernández, Ascensión
Objetivo y métodos: Actualmente se destaca la importancia de las dificultades de reconocimiento emocional y los problemas en cognición social (ToM), en la predisposición y mantenimiento de los Trastornos de Conducta Alimentaria (TCA). La mayoría de los estudios han sido realizados en pacientes adultos y pocos han analizado estas características en pacientes adolescentes. Este estudio examina las dificultades de reconocimiento emocional y cognición social en 48 pacientes con Anorexia Nerviosa (AN) y Bulimia Nerviosa (BN), adultas y adolescentes, con diversos grados de gravedad y las compara con grupos control sano. Para evaluar estas dificultades se han utilizado los siguientes cuestionarios: TAS-20 y el RME. Resultados: Conforme a lo establecido en nuestras hipótesis, las pacientes con AN y BN presentan mayores dificultades en el reconocimiento que los sujetos control. Las dificultades están moduladas por la edad y la gravedad del trastorno. Las pacientes adultas y más graves presentan más problemas en el reconocimiento emocional que las adolescentes menos graves. No se han obtenido diferencias en función del diagnóstico ni del índice de masa corporal (IMC). Contrariamente a lo esperado en la hipótesis sobre la teoría de la mente, las pacientes AN y BN, adultas y adolescentes mantienen intacta su capacidad para atribuir estados mentales a otros, realizando la tarea de mentalización de forma similar a los sujetos control. Únicamente las pacientes con más tratamientos previos y mayor duración del trastorno muestran un rendimiento ligeramente inferior. No existe relación con el IMC ni con los síntomas alimentarios. Conclusiones: Dado que todas las pacientes TCA tienen dificultades emocionales, es esencial que se introduzcan técnicas terapéuticas que faciliten el reconocimiento y la aceptación en el tratamiento. Puesto que las dificultades se intensifican en el transcurso del trastorno, los tratamientos de pacientes adolescentes tienen que
Baird, Sarah; de Hoop, Jacobus; Ozler, Berk
We investigate the effects of a positive income shock on mental health among adolescent girls using evidence from a cash transfer experiment in Malawi. Offers of cash transfers strongly reduced psychological distress among baseline schoolgirls. However, these large beneficial effects declined with increases in the transfer amount offered to the…
Mok, Pearl L.H.; Webb, Roger T.; Appleby, Louis; Pedersen, Carsten Bøcker
Although links between childhood residential mobility and subsequently increased risks of psychopathology have been well documented, associations across the full spectrum of psychiatric disorders are unknown. We conducted a population-based study of all 1,439,363 persons born in Denmark during 1971–1997 to investigate relationships between childhood cross-municipality residential moves from year of birth to age 14 years and the development of a range of psychiatric disorders from mid-adolescence to early middle age. We examined: (1) Any substance misuse disorders; specifically alcohol misuse, and cannabis misuse; (2) Any personality disorders; specifically antisocial, and borderline personality disorders; (3) Schizophrenia and related disorders; specifically schizophrenia, and schizoaffective disorder; (4) Any mood disorders; specifically bipolar disorder, and depressive disorder; (5) Any anxiety and somatoform disorders; specifically obsessive compulsive disorder; (6) Any eating disorders; specifically anorexia nervosa. Childhood residential mobility was associated with elevated risks of developing most psychiatric disorders, even after controlling for potential confounders. The associations generally rose with increasing age at moving and were stronger for multiple moves in a year compared to a single move. Links were particularly strong for antisocial personality disorder, any substance misuse disorder, and cannabis misuse in particular, for which the highest increases in risks were observed if relocation occurred during adolescence. Childhood residential change was not linked to subsequent risk of developing an eating disorder. Frequent residential mobility could be a marker for familial adversities. Mental health services and schools need to be vigilant of the psychosocial needs of children, particularly adolescents, who have recently moved homes. PMID:27074536
Ashby, Bethany; Ranadive, Nikhil; Alaniz, Veronica; St John-Larkin, Celeste; Scott, Stephen
Purpose Mental health issues in perinatal adolescents are well documented and studies have shown high rates of depressive disorders among this population. Treatment is challenging because pregnant adolescents are poorly adherent with mental health services. We describe a novel integrated mental health care program for pregnant and parenting adolescent mothers and their children. Methods The Colorado Adolescent Maternity Program (CAMP) is a comprehensive, multidisciplinary teen pregnancy and parenting medical home program serving an ethnically diverse and low socioeconomic status population in the Denver metro area. We describe the Healthy Expectations Adolescent Response Team (HEART), an embedded mental health care program focused on improving identification of mental health symptoms and increasing rates mental health treatment in adolescent mothers. Results From January 1, 2011-January 16 2014, 894 pregnant adolescents were enrolled in CAMP and 885 patients were screened for mental health issues. Prior to HEART's inception, 20 % of patients were identified as having mood symptoms in the postpartum period. Successful referrals to community mental health facilities occurred in only 5 % of identified patients. Following the creation of HEART, 41 % of patients were identified as needing mental health services. Nearly half of the identified patients (47 %) engaged in mental health treatment with the psychologist. Demographic factors including age, parity, ethnicity, and parent and partner involvement did not have a significant impact on treatment engagement. Trauma history was associated with lower treatment engagement. Conclusion Our findings suggest that an embedded mental health program in an adolescent obstetric and pediatric medical home is successful in improving identification and engagement in mental health treatment. Key components of the program include universal screening, intensive social work and case management involvement, and ready access to onsite
Christie, Grant; Black, Stella; Dunbar, Lucy; Pulford, Justin; Wheeler, Amanda
Adolescent mental health workers are generally poor at identifying and treating co-existing alcohol and other drug (AOD) disorder. This study aimed to evaluate the utility and acceptability of an AOD screening and brief intervention (BI) training package delivered to child and adolescent mental health workers and its impact on relevant attitudes,…
Melnyk, Bernadette M.; Jacobson, Diana; Kelly, Stephanie; O'Haver, Judith; Small, Leigh; Mays, Mary Z.
Background: Obesity and mental health disorders are 2 major public health problems in American adolescents, with prevalence even higher in Hispanic teens. Despite the rapidly increasing incidence and adverse health outcomes associated with overweight and mental health problems, very few intervention studies have been conducted with adolescents to…
Clausen, J A
My aim in this paper is to examine the application of the concept stigma to mental disorder and to the mentally ill. I believe that the loose use of this term serves to obscure the real issues that must be confronted in attempting to change public response to mental disorder. I shall examine recent, and in my opinion ill-advised, use of the concept stigma and then present some data that bear upon social responses to mentally ill patients and former patients in contemporary America. My data are derived from a long-term study of mental patients and their families, and I shall document that their feelings of stigmatization are not so much a consequence of the response of others to their having been hospitalized for mental illness or labeled mentally ill as of self-doubts or chronic manifestations of mental illness.
Lederbogen, F; Ströhle, A
There are numerous associations between stress, mental disorders and coronary heart disease (CHD). Exposure to an acute stressor leads to activation of the hypothalamus-pituitary-adrenal and sympathoadrenal systems and chronic stressors are associated with sustained functional changes of these systems. Experiencing acute and chronic stress is paralleled by an increased incidence of mental disorders with the most consistent evidence on the triggering of major depressive episodes. Various mental disorders, including depression, anxiety and schizophrenia, are associated with an increased risk of CHD. Furthermore, acute and chronic stressors have been identified as risk factors or triggers of acute coronary syndromes. Thus therapeutic strategies aim at reducing subjective stress experience, therapy of mental disorders and treatment of cardiac risk factors known to be more prevalent in increased stress states and mental disorders.
Perrin, James M; Houtrow, Amy; Kelleher, Kelly; Hoagwood, Kimberly; Stein, Ruth E K; Zima, Bonnie
The Supplemental Security Income Program (SSI) provides financial support to low-income households with children and youth with severe disabilities. The program included children when it began in the early 1970s. The numbers of children receiving SSI benefits increased substantially in the early 1990s, in part through an expansion of the listings of mental health conditions with which children could become eligible. Over the past 20 years, larger numbers of children have received SSI benefits for mental disorders, and these increases have led to questions from the press and Congress regarding these numbers. Do they indicate more of an increase in mental disorders among SSI children than in the general population? The National Academy of Medicine (NAM; formerly the Institute of Medicine) convened a study panel to examine what is known about mental disorders among the child SSI population and how that compares with evidence about mental disorders in children in general. The NAM report provides detailed information about how SSI works, about the changing numbers of children receiving SSI for mental disorders, and some comparisons with other evidence about rising rates of mental disorders in the general population and especially among children living in poverty. The report indicates that increasing numbers of children with mental disorders in SSI mirror similar increases in the population in general. This article summarizes key evidence from the NAM report and suggests the implications for pediatricians.
Davidson, Leslie L; Grigorenko, Elena L; Boivin, Michael J; Rapa, Elizabeth; Stein, Alan
Globally, there is a crucial need to prioritize research directed at reducing neurological, mental health and substance-use disorders in adolescence, which is a pivotal age for the development of self-control and regulation. In adolescence, behaviour optimally advances towards adaptive long-term goals and suppresses conflicting maladaptive short-lived urges to balance impulsivity, exploration and defiance, while establishing effective societal participation. When self-control fails to develop, violence, injury and neurological, mental health and substance-use disorders can result, further challenging the development of self-regulation and impeding the transition to a productive adulthood. Adolescent outcomes, positive and negative, arise from both a life-course perspective and within a socioecological framework. Little is known about the emergence of self-control and regulation in adolescents in low- and middle-income countries where enormous environmental threats are more common (for example, poverty, war, local conflicts, sex trafficking and slavery, early marriage and/or pregnancy, and the absence of adequate access to education) than in high-income countries and can threaten optimal neurodevelopment. Research must develop or adapt appropriate assessments of adolescent ability and disability, social inclusion and exclusion, normative development, and neurological, mental health and substance-use disorders. Socioecological challenges in low- and middle-income countries require innovative strategies to prevent mental health, neurological and substance-use disorders and develop effective interventions for adolescents at risk, especially those already living with these disorders and the consequent disability.
Muuss, Rolf E.
Examines anorexia nervosa, an eating disorder seen with increasing frequency, especially among adolescent girls. Presents five theories about causation, discusses early characteristics, typical family patterns, physical and medical characteristics, social adjustment problems, and society's contribution to anorexia. Describes course of the…
Commentary: Transdiagnostic neuroscience of child and adolescent mental disorders--differentiating decision-making in attention-deficit/hyperactivity disorder, conduct disorder, depression and anxiety. A commentary on Sonuga-Barke et al. (2016).
Rohde, Luis Augusto
Sonuga-Barke, Cortese, Fairchild, and Stringaris offer us new insights not only on the neuropsychological processes and neurobiological mechanisms involved in the decision-making process but also how some of the most relevant child mental disorders might impact this process through a very comprehensive review of the pertinent literature. Although it is difficult to select specific points for discussing in a so dense review, I would like to highlight some aspects for 'whetting readers appetite' and seduce them to be in contact with the fascinating neurobiology behind an essential aspect of our lives.
Giummarra, Melita J.; Haslam, Nick
The structure of lay people's concepts of childhood mental disorder was investigated in a questionnaire study and examined for convergence with the Diagnostic and Statistical Manual (DSM-IV). Eighty-four undergraduates who had no formal education in abnormal psychology rated 54 conditions--36 DSM-IV childhood disorders and 18 non-disorders--on…
Knowledge and beliefs about mental disorders; attitudes that promote help-seeking; knowledge of risk factors and causes, treatments and self-help, and professional help available are all elements of mental health literacy. The complexities of practice with suicidal adolescents and young people suffering from mental health concerns require…
Autism spectrum disorders (ASDs) are a group of neurodevelopmental disorders including autistic disorder, Asperger syndrome, and pervasive developmental disorder not otherwise specified as to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. All these categories are grouped together in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, classification under the category of Autism Spectrum Disorders.Behavioral disorders including irritability, attention-deficit/hyperactivity disorder (ADHD) symptoms, and aggression are additional symptoms found in up to 20% of children and adolescents with ASD and require careful evaluation for appropriate treatment. Attention-deficit/hyperactivity disorder is defined by impaired attention, hyperactivity, and impulsivity, whereas ASD is defined by social dysfunction, communicative impairment, and restricted/repetitive behaviors. They should be distinctly evaluated in children and adolescents with ASD and intellectual disability in contrast to individuals without intellectual disability, because significant differences between these conditions exist. Mood disorders are also common in ASD and should be systematically investigated in this population of children and adolescents. Approximately 50% of children and adolescents with ASD receive medication for comorbid behavioral/ADHD and mood symptoms, mostly stimulants, antiepileptics and antipsychotics. Guidelines for the evaluation and treatment including medications for ADHD-like symptoms have recently been provided and should be carefully considered. Antiepileptic drugs are commonly used in ASDs with epilepsy, because seizures are associated with ASD in 10% to 30% of young patients, and as mood stabilizers. Lithium is another option for children and adolescents with ASD who present with symptoms of a mood disorder, such as elevated moods/euphoria, mania, and paranoia, whether accompanied or not by irritability. Experimental treatments are under
Benjet, Corina; Borges, Guilherme; Méndez, Enrique; Fleiz, Clara; Medina-Mora, Maria Elena
The purpose of this paper is to estimate the impact of chronic adversity on psychopathology in adolescents, taking into account the type of adversity, number of adversities experienced and type of psychiatric disorder, as well as to estimate the impact on severity of the disorder. A total of 3,005 male and female adolescents from the Mexican Adolescent Mental Health Survey aged 12-17 years were interviewed in a stratified multistage general population probability survey. Assessment of 20 DSM-IV disorders, disorder severity and 12 chronic childhood adversities were assessed with the adolescent version of the World Mental Health Composite International Diagnostic Interview (WMH-CIDI-A). Family dysfunction adversities including abuse presented the most consistent associations between chronic adversity and psychopathology and their impact was generally non-specific with regard to the type of disorder. Parental divorce, parental death and economic adversity were not individually associated with psychopathology. Among those with a psychiatric disorder, sexual abuse and family violence were associated with having a seriously impairing disorder. The odds of having a psychiatric disorder and a serious disorder increased with increasing numbers of adversities; however, each additional adversity increased the odds at a decreasing rate. While the study design does not allow for conclusions regarding causality, these findings suggest general pathways from family dysfunction to psychopathology rather than specific associations between particular adversities and particular disorders, and provide further evidence for the importance of family-focused intervention and prevention efforts.
Hartshorn, Kelley J. Sittner; Whitbeck, Les B.; Prentice, Patricia
Indigenous adolescents are overrepresented at multiple stages of the justice system, but we know very little about the role that mental health, particularly substance use disorder, plays in Indigenous pathways to arrest. This study examined the association between substance use disorder, its comorbidity with other disorders, and arrest using a longitudinal sample of Indigenous youth from the Northern Midwest and Canada. Of the 16% of youth who reported at least one arrest at Wave 5, half met criteria for substance abuse/dependence, and slightly more for conduct disorder. Substance abuse/dependence and conduct disorder were each associated with an increased risk of arrest, although co-occurring disorders were not. The reciprocal effects of arrest and mental disorder are discussed. PMID:26759503
Dow, Dorothy E; Turner, Elizabeth L; Shayo, Aisa M; Mmbaga, Blandina; Cunningham, Coleen K; O'Donnell, Karen
AIDS-related mortality among HIV-positive adolescents has risen by 50% despite the scale up of antiretroviral therapy (ART). ART maladherence likely plays a role in the increase of AIDS-related deaths among adolescents and has shown to be associated with psychosocial and mental health difficulties. Addressing the specific mental health needs of HIV-positive adolescents is critical to ending the HIV epidemic. This cross-sectional study prospectively enrolled HIV-positive adolescents (12-24 years) in Moshi, Tanzania. A structured questionnaire was administered that included questions about home, school, adherence, and measures of stigma (Berger Stigma Scale) and mental health. Mental health measures included depression (Patient Health Questionnaire-9), emotional/behavioral difficulties (Strengths and Difficulties Questionnaire), and traumatic experiences/post-traumatic stress symptoms (The University of California Los Angeles-post-traumatic stress disorder-Reaction Index). Mental health difficulties were prevalent among HIV-positive adolescents and were associated with incomplete adherence and stigma. Resources are needed to reduce HIV stigma and address mental health among HIV-positive adolescents in low-resource settings. This will improve not only mental health, but may also improve ART adherence and virologic suppression, improving overall health of the individual and reducing the risk of HIV transmission to others.
Martín-Fernández, María; Matalí, Josep Lluís; García-Sánchez, Sara; Pardo, Marta; Lleras, María; Castellano-Tejedor, Carmina
Demand for treatment for problems related to the use of video games have increased significantly in adolescents. Most cases have a comorbid mental disorder that jeopardises both pathologies. The aim of this study is to describe profiles of adolescents with Internet Gaming Disorder (IGD) according to comorbidity and analyze treatment response at 3 and 6 months. A sample of 86 patients which consulted in the Addictive Behavior Unit of a hospital was assessed with diagnostic criteria for IGD, the interview K-SADS-PL for mental disorders and the Clinical Global Impression (CGI) to treatment progress. Of the initial sample, 68,6% (n = 59) met diagnostic criteria for IGD. Of these, the 45,76% matched an internalizing profile, presenting comorbidity with Mood Disorders (44,4%), Anxiety Disorders (44,4%) and Personality Disorders (11,1%). The externalizing profile would comprise 52,54% of the sample presenting Disruptive Behavior Disorder (48,4%=, ADHD (29%) and Disruptive Behavior Disorders not otherwise specified (22,6%). Unlike externalizing, the internalizing patients had a family history of psychiatric problems (63%), difficulties in social relationships (77,8%) and seemed to use video games preferably to escape discomfort (66,7%). After 3 months the externalizing profile showed improvements. Comorbid disorders allow the discrimination of two IGD profiles in adolescents and these could influence treatment response. Therefore, it is important to assess comorbidities to design a more accurate intervention focused on the specificities of each profile.
In recent years, the network approach to psychopathology has been advanced as an alternative way of conceptualizing mental disorders. In this approach, mental disorders arise from direct interactions between symptoms. Although the network approach has led to many novel methodologies and substantive applications, it has not yet been fully articulated as a scientific theory of mental disorders. The present paper aims to develop such a theory, by postulating a limited set of theoretical principles regarding the structure and dynamics of symptom networks. At the heart of the theory lies the notion that symptoms of psychopathology are causally connected through myriads of biological, psychological and societal mechanisms. If these causal relations are sufficiently strong, symptoms can generate a level of feedback that renders them self‐sustaining. In this case, the network can get stuck in a disorder state. The network theory holds that this is a general feature of mental disorders, which can therefore be understood as alternative stable states of strongly connected symptom networks. This idea naturally leads to a comprehensive model of psychopathology, encompassing a common explanatory model for mental disorders, as well as novel definitions of associated concepts such as mental health, resilience, vulnerability and liability. In addition, the network theory has direct implications for how to understand diagnosis and treatment, and suggests a clear agenda for future research in psychiatry and associated disciplines. PMID:28127906
... SCHEDULE FOR RATING DISABILITIES Disability Ratings Mental Disorders § 4.125 Diagnosis of mental disorders. (a) If the diagnosis of a mental disorder does not conform to DSM-IV or is not supported by the... substantiate the diagnosis. (b) If the diagnosis of a mental disorder is changed, the rating agency...
... SCHEDULE FOR RATING DISABILITIES Disability Ratings Mental Disorders § 4.125 Diagnosis of mental disorders. (a) If the diagnosis of a mental disorder does not conform to DSM-IV or is not supported by the... substantiate the diagnosis. (b) If the diagnosis of a mental disorder is changed, the rating agency...
... SCHEDULE FOR RATING DISABILITIES Disability Ratings Mental Disorders § 4.125 Diagnosis of mental disorders. (a) If the diagnosis of a mental disorder does not conform to DSM-IV or is not supported by the... substantiate the diagnosis. (b) If the diagnosis of a mental disorder is changed, the rating agency...
Jacobs, David H.
"Diagnostic and Statistical Manual of Mental Disorders, fifth edition" ("DSM-5") promises a refined definition of mental disorder, which is tantamount to acknowledging that prior "DSM" definitions have failed to clarify what mental disorder is and why a person should be considered mentally disordered. Since the…
Massey-Stokes, Marilyn S.
Discusses unhealthy dieting behaviors that can lead to eating disorders during adolescence. Outlines ways middle school and high school teachers and administrators can aid in the prevention of disordered eating among adolescents. Lists resources for eating disorders awareness and prevention. (SR)
Eaton, Nicholas R; Rodriguez-Seijas, Craig; Krueger, Robert F; Campbell, W Keith; Grant, Bridget F; Hasin, Deborah S
Narcissistic personality disorder (NPD) shows high rates of comorbidity with mood, anxiety, substance use, and other personality disorders. Previous bivariate comorbidity investigations have left NPD multivariate comorbidity patterns poorly understood. Structural psychopathology research suggests that two transdiagnostic factors, internalizing (with distress and fear subfactors) and externalizing, account for comorbidity among common mental disorders. NPD has rarely been evaluated within this framework, with studies producing equivocal results. We investigated how NPD related to other mental disorders in the internalizing-externalizing model using diagnoses from a nationally representative sample (N = 34,653). NPD was best conceptualized as a distress disorder. NPD variance accounted for by transdiagnostic factors was modest, suggesting its variance is largely unique in the context of other common mental disorders. Results clarify NPD multivariate comorbidity, suggest avenues for classification and clinical endeavors, and highlight the need to understand vulnerable and grandiose narcissism subtypes' comorbidity patterns and structural relations.
Hamdan, Sami; Auerbach, Judy; Apter, Alan
The objective is to study the influence of polygamous versus monogamous marriage on the mental health of adolescents in an Israeli Bedouin population. Pupils aged 11-18 years attending schools in Bedouin Arab communities in southern Israel were asked to complete a demographic questionnaire and a panel of psychological instruments measuring competence and behavioral problems, anxiety and depression. Findings were compared between pupils of families with one wife and pupils of families with more than one wife. The population comprised 406 pupils of mean age 14.5 years; 56% were female. Fifty-three percent were from polygamous marriages and 47% from monogamous marriages. After allowing for the influence of socioeconomic factors, there were no differences between offspring of polygamous marriages and those of monogamous marriages for any of the psychological scales. When polygamy is the accepted practice in a particular social milieu, it does not have a deleterious psychological effect on adolescents.
Cummings, Janet R
Most adolescents with depressive disorders do not receive any mental health services, even though effective treatments exist. Although research has examined numerous individual-level factors associated with mental health service use among depressed adolescents, less is known about the role of contextual factors. This study examines the relationship between contextual-level socioeconomic status (SES) and clinic-based mental health counseling use among US adolescents with high depressive symptoms in urban and suburban areas. Data from the first two waves of the National Longitudinal Study of Adolescent Health (N = 1,133; 59 % female) were analyzed using multilevel logistic models in which adolescents were nested within counties. After controlling for individual-level predisposing, enabling, and need characteristics, as well as county racial/ethnic composition, county SES was positively associated with clinic-based counseling use among depressed youth. A one standard deviation increase in the county affluence index was associated with 43 % greater odds of receiving any clinical counseling services. Furthermore, the positive relationship between county affluence and clinical counseling use was no longer significant after controlling for the county supply of mental health specialist physicians. The results indicate that county residential context is a key correlate of mental health service use among depressed adolescents, such that those who live in lower SES counties with fewer mental health specialists are less likely to receive treatment.
Robertson, Angela A.; Dill, Patricia L.; Husain, Jonelle; Undesser, Cynthia
The prevalence of psychiatric disorders among incarcerated juveniles in Mississippi was examined. A total of 482 adolescents completed a diagnostic questionnaire and a subset (N = 317) was assessed with face-to-face semistructured interview. Most of the study participants met criteria for one mental disorder, 71?85% depending on assessment method,…
Peltonen, Kirsi; Ellonen, Noora; Larsen, Helmer B; Helweg-Larsen, Karin
Being the target of parental violent acts decreases child adjustment and increases the likelihood of mental health problems in childhood and adolescence. Our study analyses how different types of parental violence ranging from verbal threats and swearing to hitting and kicking a child, are associated with child adjustment, indicated by strengths and difficulties scale (SDQ) total problem score, internalizing and externalizing problems as well as prosocial behaviour. We also study whether girls and boys and youths in two Nordic countries respond differently to parental violence. The data consists of a large-scale community sample of 15-16-year old Finnish (n = 5,762) and Danish (n = 3,943) adolescents. The representative data of continental Finland and its Finnish and Swedish speaking ninth graders as well as representative data of Danish ninth grade pupils were collected by the Police College of Finland and in Denmark by the National Institute of Public Health, University of Southern Denmark. The results show a clear dose-response effect between parental violent behaviour and the adolescent's problems. The more severe forms of parental violence were associated with higher levels of SDQ total difficulties and internalizing and externalizing symptoms. There was also a connection between parental violence and the deterioration of prosocial behaviour. The association was gender and nationality specific. The findings imply a high prevalence of parental violence and adverse mental health among the affected Finnish and Danish adolescents. Though the laws have been set in motion to prevent the use of parental physical violence the challenges remain in several domains of child protection, general health care, prevention and intervention.
Choi, Heeseung; Meininger, Janet C.; Roberts, Robert E.
Limited data on ethnic group differences among young adolescents exist regarding the prevalence of mental distress, social stress, and resources. The aim of this cross-sectional study was to examine ethnic differences among African American (AA), European American (EA), Hispanic American (HA), and Asian American adolescents in mental distress,…
Rose, Theda; Joe, Sean; Shields, Joseph; Caldwell, Cleopatra H.
The influence of family, school, and religious social contexts on the mental health of Black adolescents has been understudied. This study used Durkheim's social integration theory to examine these associations in a nationally representative sample of 1,170 Black adolescents, ages 13-17. Mental health was represented by positive and negative…
Boysen, Guy; Ebersole, Ashley; Casner, Robert; Coston, Nykhala
Research indicates that stereotypes can intersect. For example, the intersection of stereotypes about gender and mental disorders could result in perceptions of gendered mental disorders. In the current research, Studies 1 and 2 showed that people view specific disorders as being masculine or feminine. The masculine stereotype included antisocial personality disorder, addictions, and paraphilias. The feminine stereotype included eating disorders, histrionic personality disorder, body dysmorphia, and orgasmic disorder. In both studies, the perception of disorders as masculine was positively correlated with stigma. Study 3 showed that the positive correlation between masculinity and stigma also occurred when examining specific symptoms rather than full mental disorders. The findings provide further evidence for the intersection of stereotypes and indicate a novel factor in the understanding of stigma.
Dwairy, Marwan; Menshar, Kariman E.
Three questionnaires that measure parenting style, adolescent-family connectedness, and mental health were administered to 351 Egyptian adolescents. Results show that in rural communities the authoritarian style is more predominant in the parenting of male adolescents, while the authoritative style is more predominant in the parenting of female…
Bottino, Sara Mota Borges; Bottino, Cássio M C; Regina, Caroline Gomez; Correia, Aline Villa Lobo; Ribeiro, Wagner Silva
Cyberbullying is a new form of violence that is expressed through electronic media and has given rise to concern for parents, educators and researchers. In this paper, an association between cyberbullying and adolescent mental health will be assessed through a systematic review of two databases: PubMed and Virtual Health Library (BVS). The prevalence of cyberbullying ranged from 6.5% to 35.4%. Previous or current experiences of traditional bullying were associated with victims and perpetrators of cyberbullying. Daily use of three or more hours of Internet, web camera, text messages, posting personal information and harassing others online were associated with cyberbullying. Cybervictims and cyberbullies had more emotional and psychosomatic problems, social difficulties and did not feel safe and cared for in school. Cyberbullying was associated with moderate to severe depressive symptoms, substance use, ideation and suicide attempts. Health professionals should be aware of the violent nature of interactions occurring in the virtual environment and its harm to the mental health of adolescents.
Hertel, Janine; Schütz, Astrid; Lammers, Claas-Hinrich
Emotional abilities were measured with a performance test of emotional intelligence (The Mayer-Salovey-Caruso Emotional Intelligence Test; Mayer, Salovey, & Caruso, 2002) in patients diagnosed with major depressive disorder, substance abuse disorder, or borderline personality disorder (BPD), and a nonclinical control group. Findings showed that all clinical groups differed from controls with respect to their overall emotional intelligence score, which dovetails with previous findings from self-report measures. Specifically, we found that the ability to understand emotional information and the ability to regulate emotions best distinguished the groups. Findings showed that patients with substance abuse disorder and BPD patients were most impaired.
Stewart, Shannon L; Baiden, Philip; Theall-Honey, Laura
The objectives of this study were to examine the prevalence of non-suicidal self-injury (NSSI) among adolescents with mental health needs and specific factors associated with NSSI among adolescents aged 14 to 18 years who received mental health services in adult mental health facilities in Ontario, Canada. Data on 2,013 adolescents were obtained from the Ontario Mental Health Reporting System using the Resident Assessment Instrument-Mental Health (RAI-MH) and were analyzed using logistic regression. Approximately, 20.2% (407 adolescents) of the sample engaged in NSSI within the last 12 months. Results from multivariate logistic regression indicate that females were 2.19 times more likely to engage in NSSI than males. Intentional misuse of prescription medication emerged as the most important factor associated with NSSI. Other factors found to be associated with NSSI included multiple psychiatric admissions, sexual abuse, use of alcohol, mood disorders (e.g., depression), adjustment disorders, personality disorders and symptoms of depression. The article discusses the implications of the findings, with suggestions for future research.
Sharma, Namita; Dua, Radha
Mental health is the ability to adjust oneself satisfactorily to the various strains of life. Mental health and Education are closely related to each other. Sound mental is prerequisite for the learner. In this era of severe competition to excel or to be on the top is pressurizing today's adolescents to the utmost. Besides a number of factors like…
Mallett, Christopher A.
Objectives: The purpose of this study was to investigate the historical construction and empirical support of two child and adolescent behaviorally based mental health disorders: oppositional defiant and conduct disorders. Method: The study utilized a historiography methodology to review, from 1880 to 2012, these disorders' inclusion in…
McDonald, Catherine C.; Richmond, Therese R.
Urban adolescents are exposed to a substantial amount of community violence which has the potential to influence psychological functioning. To examine the relationship between community violence exposure and mental health symptoms in urban adolescents, a literature review using MEDLINE, CINAHL, PubMed, PsycINFO, CSA Social Services, and CSA Sociological Abstracts was conducted. Search terms included adolescent/adolescence, violence, urban, mental health, well-being, emotional distress, depression, anxiety, posttraumatic stress disorder, and aggression. Twenty six empirical research articles from 1997–2007 met inclusion criteria for review. Findings indicate an influence of community violence exposure on mental health symptoms, particularly posttraumatic stress and aggression. Mediators and moderators for community violence exposure and mental health symptoms help explain relationships. Limitations in the literature are the lack of consistency in measurement and analysis of community violence exposure, including assessment of proximity and time frame of exposure, and in analysis of victimization and witnessing of community violence. Knowledge about identification of urban adolescents exposed to chronic community violence and who experience mental health symptoms is critical to mental health nursing practice and research. PMID:19012675
Schneider, Sophie C; Mond, Jonathan; Turner, Cynthia M; Hudson, Jennifer L
The aim of the current study was to establish the prevalence of subthreshold body dysmorphic disorder (subthreshold-BDD) in a community sample of adolescents, and to compare disorder correlates in individuals with subthreshold-BDD to those with probable full-syndrome BDD (probable-BDD) and those without BDD (non-BDD). Self-report questionnaires assessing DSM-IV BDD criteria, past mental health service use, and symptoms of body dysmorphic disorder, anxiety, depression, obsessive-compulsive disorder and eating disorders, were completed by 3149 Australian high school students (mean age =14.6 years, 63.5% male). Male participants also completed measures assessing quality of life, muscularity concerns, emotional symptoms, conduct problems, hyperactivity, and peer problems. The prevalence of subthreshold-BDD was 3.4%, and probable-BDD was 1.7%. Compared to the non-BDD group, subthreshold-BDD was associated with elevated symptoms of comorbid psychopathology and greater past mental health service use, and in male-only measures, with poorer quality of life and elevated muscularity concerns. Subthreshold-BDD participants reported significantly lower mental health service use, and fewer symptoms of depression, eating disorders, and hyperactivity than probable-BDD participants, however, other comorbid symptoms did not differ significantly between these groups. These findings indicate that subthreshold-BDD is associated with substantial difficulties for adolescents in the general community. BDD screening should include subthreshold presentations, as these may be an important target for early intervention programs.
Legerstee, Jeroen S.; Garnefski, Nadia; Verhulst, Frank C.; Utens, Elisabeth M. W. J.
The present study investigated differences in cognitive coping strategies between anxiety-disordered and non-anxious adolescents. In addition, the interaction effect with gender as well as differences between specific anxiety diagnoses was examined. A clinical sample of 159 anxiety-disordered adolescents and a general community sample of 370…
Kutcher, Stan; Murphy, Andrea; Gardner, David
The article examines the World Health Organization's Model List of Essential Medicines (EML) and suggests modification for appropriate psychopharmacological treatment of child- and adolescent-onset mental disorders. The EML enlists few of the psychotropic medicines that are useful for the treatment of young people thereby limiting the…
Becker, Stephen P.; Langberg, Joshua M.
Objective: This study investigated the role of sluggish cognitive tempo (SCT) in relation to externalizing and internalizing mental health problems, academic functioning, and social functioning among young adolescents with attention-deficit/hyperactivity disorder (ADHD). Method: In all, 57 youth ages 10 to 14 participated in the study. Parents…
Martin-Contero, M C; Secades-Villa, R; Aparicio-Migueza, A; Tirapu-Ustarroz, J
Introduccion. La empatia es un subproceso de la cognicion social que se define como la capacidad de comprender y compartir los pensamientos, deseos y sentimientos de otra persona, y es crucial en muchas formas de interaccion social adaptativa. Es un fenomeno contextual, flexible y multidimensional que se relaciona con diferentes procesos y redes neuronales. Objetivo. Evaluar la empatia en una muestra de sujetos con diagnosticos que se engloban dentro de la categoria de trastorno mental grave en tratamiento en un programa de rehabilitacion psicosocial. Sujetos y metodos. Participaron 22 personas con trastorno mental grave en tratamiento en programas de rehabilitacion psicosocial y 22 controles sanos. Se aplico a cada sujeto una bateria de pruebas: cociente de empatia, Reading the Mind in the Eyes Test (test de la mirada) e indice de reactividad interpersonal. Resultados. En el test de la mirada, el grupo experimental puntuo significativamente menos que el grupo control (t = 2,8; p < 0,05). En el resto de variables no se encontraron diferencias estadisticamente significativas. Conclusiones. Las personas con trastorno mental grave no muestran un deficit generalizado de la empatia; sin embargo, muestran dificultades a la hora de reconocer estados emocionales mediante la mirada, lo que indica un procesamiento de la informacion para las caras diferente a los sujetos de la poblacion normal.
Lund, Christina; Forsman, Anders; Anckarsäter, Henrik; Nilsson, Thomas
Criminal recidivism was studied during 2 years in a Swedish population-based cohort (N = 318) of mentally disordered male offenders who had undergone a pretrial forensic psychiatric investigation, been convicted in subsequent trials, and been sentenced to forensic psychiatric treatment (FPT; n = 152), prison (n = 116), or noncustodial sanctions (n = 50). Recidivism was analysed in relation to index sanctions, levels of supervision, diagnoses, and criminological factors. Significantly lower recidivism in the FPT group was related to lower crime rates during periods at conditional liberty in this group alone, and recidivism was significantly more common among offenders with at least one of the two diagnoses of substance abuse disorder and personality disorder than among those with psychotic or other mental disorders alone. Age at index crime and number of previous crimes emerged as significant predictors of recidivism. The results of this study suggest that the relapse rates depend as much on level of supervision as on individual characteristics.
Kryspin-Exner, Ilse; Felnhofer, Anna; Kothgassner, Oswald D
The emersion of the Internet did not only change human communication and information seeking, it also contributed to manifold alterations in the manifestation, perception and treatment of mental disorders. Thus, one focus of current psychological research lies on the relationship between the new medium and psychosocial functioning. This review embraces recent results on this topic following a discussion from two different perspectives: first, it poses the question, whether the Internet - due to its very specific character - is capable of creating new mental disorders and second, it asks whether rare disorders may possibly be uncovered by the Internet or if already known disorders may be sustained and intensified by the online medium. Accordingly, the first part of this review deals with the conceptual basis of problematic Internet use, Internet addiction and problematic online-gaming as an example of specific internet use. Predisposing psychosocial factors, such as social isolation, depression and compulsive behavior are reviewed as potential triggers for these new internet- related disorders. The second part however draws upon two already existing groups of psychological disorders: eating disorders in relation to Pro-Ana and Pro-Mia on the one hand and Body Integrity Identity Disorder (BIID) on the other hand. Recent research is discussed to explore the sustaining and intensifying effect of the Internet on these disorders.
Roberson, Anthony James; Kjervik, Diane K.
The purpose of this paper is to present the findings of a small-scale study in which the decision-making process of adolescents who consent to psychiatric mental health treatment was examined. Sixteen (16) adolescents were interviewed about their decisions related to initial and continued treatment, along with their understanding of minor consent laws. Interviews were audio-recorded, and transcripts were analyzed through concept analysis. Findings are presented in the context of the decision-making steps and research questions. Most adolescents did not recognize consequences related to psychiatric mental health treatment and did not assimilate and integrate information provided to them about treatment choices. Adolescents disagreed with current minor consent laws that allow minors to consent to certain healthcare treatments without the required consent of the parent. Further, adolescents reported that a collaborative approach in making decisions about the adolescent's psychiatric mental health treatment was most facilitative of achieving the goals of treatment. PMID:22474581
Rosen, David S
The incidence and prevalence of eating disorders in children and adolescents has increased significantly in recent decades, making it essential for pediatricians to consider these disorders in appropriate clinical settings, to evaluate patients suspected of having these disorders, and to manage (or refer) patients in whom eating disorders are diagnosed. This clinical report includes a discussion of diagnostic criteria and outlines the initial evaluation of the patient with disordered eating. Medical complications of eating disorders may affect any organ system, and careful monitoring for these complications is required. The range of treatment options, including pharmacotherapy, is described in this report. Pediatricians are encouraged to advocate for legislation and policies that ensure appropriate services for patients with eating disorders, including medical care, nutritional intervention, mental health treatment, and care coordination.
Blueprint for Change: Research on Child and Adolescent Mental Health. Report of the National Advisory Mental Health Council's Workgroup on Child and Adolescent Mental Health Intervention Development and Deployment.
National Inst. of Mental Health (DHHS), Bethesda, MD.
Findings from research in neurobiology, genetics, behavioral science, and social science have led to an increased understanding of the complex interactions among genetic and socioenvironmental factors and their contribution to child and adolescent mental disorders. Although scientifically proven interventions are available, the gap between…
Mohammadi, Mohammad Reza; Salmanian, Maryam; Asadian-koohestani, Fatemeh; Ghanizadeh, Ahmad; Alavi, Ali; Malek, Ayyoub; Dastgiri, Saeed; Moharreri, Fatemeh; Hebrani, Paria; Arman, Soroor; Khoshhal Dastjerdi, Javad; Motavallian, Ali
Objective: The aim of the present study was to investigate the epidemiology of psychiatric disorders in children and adolescents in five provinces of Iran: Tehran, Shiraz, Isfahan, Tabriz and Mashhad. Method: In the present study, we selected 9,636 children and adolescents aged 6–18 years through multistage cluster random sampling method from Tehran, Shiraz, Isfahan, Tabriz and Mashhad. We instructed the clinical psychologists to complete the Strengths and Difficulties Questionnaire (SDQ) for the participants, andthose who received a high score on SDQ, completed the Persian version of Kiddie-SADS-Present and Lifetime Version (K-SADS-PL). We used descriptive analysis and 95% confidence interval to investigate the relationship between scores of the K-SADS questionnaire and demographic factors. We used one-way ANOVA to test the significant differences among the disorders according to sex, age and province of residence. Results: Based on the results, oppositional defiant disorder (ODD) (4.45%) had the highest prevalence of psychiatric disorders in the five provinces and substance abuse and alcohol abuse (0%) had the lowest prevalence. In addition, attention deficit hyperactivity disorder (ADHD) had the most prevalence in boys (5.03%) and ODD had the most prevalence in girls (4.05%). Among the three age groups, 6 to 9 year olds had the highest rates of ADHD (5.69%); 10 to 14 and 15 to 18 year olds had the highest rates of ODD (4.32% and 4.37% respectively). Among the five provinces, Tehran and Mashhad allocated the highest rates of ODD; Isfahan and Shiraz had the highest rates of ADHD; and Tabriz had the highest rates of social phobia. Conclusion: The current study revealed that the overall frequency of psychiatric disorders based on Kiddie-SADS-Present and Lifetime Version (K-SADS-PL) was higher than a similar study. Moreover, in this study, among the five provinces, Tehran and Mashhad allocated the highest rates of ODD; Isfahan and Shiraz had the highest rates of
Filho, Alceu Gomes Correia; Bodanese, Rafael; Silva, Tatiana Laufer; Alvares, Julia Paglioza; Aman, Michael; Rohde, Luis Augusto
Objective: To evaluate the short-term efficacy and tolerability of risperidone and methylphenidate for reducing symptoms related to attention-deficit/hyperactivity disorder (ADHD) in children and adolescents with moderate mental retardation. Method: In a 4-week, single-blind, parallel-group trial, 45 subjects with moderate mental retardation and…
Rotberg, Benyamin; Schoen, Gila; Zalsman, Gil
Anxiety disorders are the most common psychiatric illnesses in children and adolescents. They are associated with significant distress and impairment. Most of the children and adolescents with anxiety disorders are not detected and only a minority receives adequate treatment. Anxious children and adolescents often follow a chronic course of disease with elevated risk of depressive disorders, substance abuse and even suicide. Risk factors for anxiety disorders are complex and consist of intricate interplay of multiple factors, including genetic makeup and environmental risks. Effective, evidence-based treatments for anxiety disorders in children and adolescents consist of cognitive-behavioral therapy and pharmacotherapy with serotonin specific reuptake inhibitors. Further research is needed to design high-quality screening tools for anxiety disorders in the primary care setting.
BROCKINGTON, IAN; CHANDRA, PRABHA; DUBOWITZ, HOWARD; JONES, DAVID; MOUSSA, SUAAD; NAKKU, JULIET; QUADROS FERRE, ISABEL
This guidance details the needs of children, and the qualities of parenting that meet those needs. Parental mental disorders can damage the foetus during pregnancy through the action of drugs, prescribed or abused. Pregnancy and the puerperium can exacerbate or initiate mental illness in susceptible women. After their birth, the children may suffer from the social disadvantage associated with severe mental illness. The parents (depending on the disorder, its severity and its persistence) may have intermittent or prolonged difficulties with parenting, which may sometimes result in childhood psychological disturbance or child maltreatment. This guidance considers ways of preventing, minimizing and remedying these effects. Our recommendations include: education of psychiatrists and related professions about the effect of parental mental illness on children; revision of psychiatric training to increase awareness of patients as caregivers, and to incorporate relevant assessment and intervention into their treatment and rehabilitation; the optimum use of pharmacological treatment during pregnancy; pre-birth planning when women with severe mental illness become pregnant; development of specialist services for pregnant and puerperal women, with assessment of their efficacy; community support for parenting by mothers and fathers with severe mental disorders; standards of good practice for the management of child maltreatment when parents suffer from mental illness; the importance of multi-disciplinary teamwork when helping these families, supporting their children and ensuring child protection; the development of child and adolescent mental health services worldwide. PMID:21633678
Brockington, Ian; Chandra, Prabha; Dubowitz, Howard; Jones, David; Moussa, Suaad; Nakku, Juliet; Quadros Ferre, Isabel
This guidance details the needs of children, and the qualities of parenting that meet those needs. Parental mental disorders can damage the foetus during pregnancy through the action of drugs, prescribed or abused. Pregnancy and the puerperium can exacerbate or initiate mental illness in susceptible women. After their birth, the children may suffer from the social disadvantage associated with severe mental illness. The parents (depending on the disorder, its severity and its persistence) may have intermittent or prolonged difficulties with parenting, which may sometimes result in childhood psychological disturbance or child maltreatment. This guidance considers ways of preventing, minimizing and remedying these effects. Our recommendations include: education of psychiatrists and related professions about the effect of parental mental illness on children; revision of psychiatric training to increase awareness of patients as caregivers, and to incorporate relevant assessment and intervention into their treatment and rehabilitation; the optimum use of pharmacological treatment during pregnancy; pre-birth planning when women with severe mental illness become pregnant; development of specialist services for pregnant and puerperal women, with assessment of their efficacy; community support for parenting by mothers and fathers with severe mental disorders; standards of good practice for the management of child maltreatment when parents suffer from mental illness; the importance of multi-disciplinary teamwork when helping these families, supporting their children and ensuring child protection; the development of child and adolescent mental health services worldwide.
Keyes, Margaret A.; Sharma, Anu; Elkins, Irene J.; Iacono, William G.; McGue, Matt
Objective To determine whether adopted youth are at excess risk for clinically relevant behavioral and emotional problems. Design We examined whether adopted and non-adopted adolescents differed on quantitative indicators of mental health and the prevalence of childhood disorders, and whether differences exist between internationally and domestically placed adoptees. Setting Assessments occurred at the University of Minnesota from 1998-2004. Participants Adolescents adopted in infancy were systematically ascertained from records of three large Minnesota adoption agencies; non-adopted adolescents were ascertained from Minnesota birth records. The final sample included these adolescents with their rearing parents. Main Exposure The main exposure was adoptive status: non-adopted (N=540), international adoptive placement (N=514), or domestic adoptive placement (N=178). Main Outcome Measures DSM-IV clinical assessments based on child and parent reports of attention-deficit/hyperactivity, oppositional defiant, conduct, major depressive, and separation anxiety disorders; teacher reports of psychological health; and contact with mental health professionals. Results Adoptees scored only moderately higher than non-adoptees on quantitative measures of mental health. Nonetheless, being adopted approximately doubled the odds of having contact with a mental health professional (OR=2.05, CI=1.48, 2.84) and of having a disruptive behavior disorder (OR=2.34, CI=1.72, 3.19). Relative to international adoptees, domestic adoptees had higher odds of having an externalizing disorder (OR=2.60, CI=1.67, 4.04). Conclusions Moderate mean differences in quantitative indicators of mental health can lead to substantial differences in disorder prevalence. While the majority of adopted youth are psychologically healthy, they may be at elevated risk for some externalizing disorders, especially among those domestically placed. PMID:18458187
Ghanizadeh, A; Mansoori, Y; Ashkani, H; Fallahzadeh, M H; Derakhshan, A; Shokrpour, N; Akhondzadeh, S
This cross-sectional study evaluated the prevalence of major depressive disorder and depressive symptoms in children and adolescents after renal transplantation. A total of 71 patients who had undergone renal transplantation were interviewed in person using the Farsi (Persian) version of the Kiddie Schedule for Affective Disorders and Schizophrenia and Diagnostic and Statistical Manual of Mental Disorders diagnostic criteria. Major depressive disorder, depressive symptoms, and suicidal behaviors were assessed. The rate of major depressive disorder was 2.8%; two-thirds of the patients had irritability; and approximately 40% had recurrent thoughts of death and suicidal ideation. The rate of major depressive disorder was lower than in other chronic diseases such as thallasemia or hemophilia; however, the rate of suicidal behaviors was high.
Antoniadis, D; Gouti, A; Kaloudi, E; Τourlende, N; Douzenis, A; Christodoulou, C; Lykouras, L; Livaditis, M; Samakouri, M
Attitudes and beliefs of the population regarding the mentally ill have been universally subject of many researches. Research of different groups' opinion for mental disorders has given remarkable findings that assist in the right design of psychiatric services. Objective of this thesis is to study the attitude of students towards mental illness. In particular, it intends to study the differences derived from the age, gender, place of birth, kind of studies, year of study, duration of stay at the place of studies and the existence of mental disorders in the student's family. Data were collected from 536 students randomly selected from Universities and Technological Institutions both in Athens and Thessaloniki. In general, the participants are being divided based on the subject of their studies in undergraduates of human sciences, exact sciences, social and health sciences. The short version of the scale "Community Attitudes Toward the Mentality III" (CAMI) was used, which consists of 26 questions sorted to four subscales (domination scale, humanism scale, social exclusion scale and the scale measuring the community beliefs regarding the care of mentally ill), along with a special questionnaire in order to collect social and demographic data. Students' attitudes towards mental illness are influenced by demographic factors, the department they are studying at and the year of study. Female gender (p=0.000), personal contact with mentally ill (p=0.012), studying in Universities (p=0.031) and especially social sciences (p=0.009) are associated with positive attitudes. On the contrary, less years of studying are associated with negative attitudes whereas older students appear to score less in the Domination Scale (p=0.000). It is significant that the place of birth (p=0,335) and the duration of stay at the place of studies (r=0.735) did not show any association with the variables studied in this research. However these results cannot be compared with older researches
A link between mental disorder and freedom is clearly present in the introduction of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). It mentions “an important loss of freedom” as one of the possible defining features of mental disorder. Meanwhile, it remains unclear how “an important loss of freedom” should be understood. In order to get a clearer view on the relationship between mental disorder and (a loss of) freedom, in this article, I will explore the link between mental disorder and free will. I examine two domains in which a connection between mental disorder and free will is present: the philosophy of free will and forensic psychiatry. As it turns out, philosophers of free will frequently refer to mental disorders as conditions that compromise free will and reduce moral responsibility. In addition, in forensic psychiatry, the rationale for the assessment of criminal responsibility is often explained by referring to the fact that mental disorders can compromise free will. Yet, in both domains, it remains unclear in what way free will is compromised by mental disorders. Based on the philosophical debate, I discuss three senses of free will and explore their relevance to mental disorders. I conclude that in order to further clarify the relationship between free will and mental disorder, the accounts of people who have actually experienced the impact of a mental disorder should be included in future research. PMID:20931360
Crutzen, Rik; De Nooijer, Jascha
Mental health problems are highly prevalent among adolescents, but a majority of adolescents is reluctant to seek help at mental health services because of shame and lack of anonymity. Intervening via chat (i.e. offering online support) could be a solution to remove these barriers and to reach adolescents. The dimensions of the RE-AIM model (reach, efficacy, adoption, implementation and maintenance) served as a guiding principle for discussing the potential of offering online support via chat. It appeared that the use of chat may be an appropriate way to reach adolescents and may have a positive impact on outcome measures related to mental health. Additional efforts are needed to stimulate adoption at the individual level (target group, intermediaries) and the organizational level. Future research needs to focus on the dissemination of chat-based interventions, differences between online peer support and online professional support, and the content of conversations via chat about mental health problems.
de Jong, Joop T V M; Komproe, Ivan H; Van Ommeren, Mark
Research into postconflict psychiatric sequelae in low-income countries has been focused largely on symptoms rather than on full psychiatric diagnostic assessment. We assessed 3048 respondents from postconflict communities in Algeria, Cambodia, Ethiopia, and Palestine with the aim of establishing the prevalence of mood disorder, somatoform disorder, post-traumatic stress disorder (PTSD), and other anxiety disorders. PTSD and other anxiety disorders were the most frequent problems. In three countries, PTSD was the most likely disorder in individuals exposed to violence associated with armed conflict, but such violence was a common risk factor for various disorders and comorbidity combinations in different settings. In three countries, anxiety disorder was reported most in people who had not been exposed to such violence. Experience of violence associated with armed conflict was associated with higher rates of disorder that ranged from a risk ratio of 2.10 (95% CI 1.38-2.85) for anxiety in Algeria to 10.03 (5.26-16.65) for PTSD in Palestine. Postconflict mental health programmes should address a range of common disorders beyond PTSD.
Hatala, Andrew R; Waldram, James B; Caal, Tomas
Several Indigenous communities around the globe maintain unique conceptions of mental illness and disorder. The Q'eqchi' Maya of southern Belize represent one Indigenous community that has maintained, due to highly "traditional" ways of life and the strong presence of many active localized healers or bush doctors, distinct conceptions of mental disorders as compared to Western psychiatric nosology. The purpose of this ethnographic study was to understand and interpret Q'eqchi' nosological systems of mental disorders involving the factors--spiritual, cultural, social, historical, cosmological, or otherwise--implicated in their articulation and construction. Over a period of 9 months, and with the help of cultural advisors from several Q'eqchi' communities, 94 interviews with five different traditional Q'eqchi' healers were conducted. This paper demonstrates that the mental illnesses recognized by the Q'eqchi' healers involved narrative structures with recognizable variations unfolding over time. What we present in this paper are 17 recognizable illnesses of the mind grouped within one of four broad "narrative genres." Each genre involves a discernible plot structure, casts of characters, themes, motifs, and a recognizable teleology or "directedness." In narrative terms, the healer's diagnostic and therapeutic work can be understood as an ability to discern plot, to understand and interpret a specific case within the board, empirically based structure of Q'eqchi' medical epistemology.
Knuth, Berenice Scaletzky; da Silva, Ricardo Azevedo; Oses, Jean Pierre; Radtke, Vinicius Augusto; Cocco, Rafaela Abreu; Jansen, Karen
The scope of this article is to deter mine the prevalence of common mental disorders (CMD) and Depression among Community Health Agents (CHA) and employees of Psychosocial Care Centers (CAPS). It is a cross-sectional descriptive study involving the target population of Community Health Workers and Psychosocial Care Center workers, linked to the Municipal Health Department of Pelotas in the Brazilian State of Rio Grande do Sul. The presence of common mental disorders was considered when the Self Report Questionnaire (SRQ) was > 7 and the occurrence of depression when BDI > 12. In total, 257 professionals participated in the study. Among mental health professionals (n = 119), the prevalence of CMDs was 25.2% and depression was 23.5%, while the prevalence of CMDs was 48.6% and depression was 29% among CHA (n = 138). The ratio of CMDs between the two groups of professionals was statistically different (p < 0.001). In this study, it was observed that the CAPS professionals are more adapted to work issues, with less perceived health problems arising from work and with a lower prevalence of mental disorders compared to CHA.
Ellis, B Heidi; MacDonald, Helen Z; Klunk-Gillis, Julie; Lincoln, Alisa; Strunin, Lee; Cabral, Howard J
This study examines the role of social identity (acculturation and gender) in moderating the association between discrimination and Somali adolescent refugees' mental health. Participants were English-speaking Somali adolescent refugees between the ages of 11 and 20 (N = 135). Perceived discrimination, trauma history, posttraumatic stress disorder (PTSD), depressive symptoms, and behavioral acculturation were assessed in structured interviews. Fourteen in-depth qualitative interviews and 3 focus groups were also conducted. Results indicated that discrimination was common and associated with worse mental health. For girls, greater Somali acculturation was associated with better mental health. Also, the association between discrimination and PTSD was less strong for girls who showed higher levels of Somali acculturation. For boys, greater American acculturation was associated with better mental health, and the association between discrimination and depression was less strong for boys with higher levels of American acculturation.
Boisseau, Christina L; Thompson-Brenner, Heather; Eddy, Kamryn T; Satir, Dana A
Impulsivity among individuals with eating disorders (EDs) is associated with severe comorbidities and poor treatment outcome. However, research investigating the construct of impulsivity in EDs is limited. The objectives of the present study were to characterize multiple dimensions of impulsivity in adolescents with EDs; determine if differences in impulsivity were associated with ED diagnosis and/or broader personality traits; and explore the relationship between impulsivity and etiologically significant variables. Experienced clinicians from a practice-research network provided data on ED symptoms, impulsive characteristics, personality pathology, The Diagnostic and Statistical Manual of Mental Disorders comorbidity, and family and developmental history for 120 adolescent patients with EDs. Three distinct types of impulsivity were identified: general, acting out, and aggressive/destructive. The impulsivity types showed specific relationships to ED diagnosis, broader personality factors, individual histories of adverse (traumatic) events, and family histories of externalizing disorders, supporting the importance of taking, assessing, and addressing impulsivity in ED research and treatment.
McBride, Michon Elizabeth
A generalized anxiety disorder diagnosis must include thorough history-taking, the use of age-appropriate screening tools, and physical assessment. Research and development into the use of screening tools and effectiveness of treatment strategies for generalized anxiety disorder is needed to better manage adolescents with the disorder.
Bartlett, Nancy H.; Vasey, Paul L.; Bukowski, William M.
Evaluates empirical studies to determine whether Gender Identity Disorder (GID) in children meets DSM-IV definitional criteria of mental illness. Concludes that children who experience a sense of inappropriateness in their culturally prescribed sex role but do not experience discomfort with their biological sex should not be considered to have a…
Rice, Frances; Lifford, Kate J.; Thomas, Hollie V.; Thapar, Anita
Objective: To assess the value of maternal and self-ratings of adolescent depression by investigating the extent to which these reports predicted a range of mental health and functional outcomes 4 years later. The potential influence of mother's own depressed mood on her ratings of adolescent depression and suicidal ideation on adolescent outcome…
McGeown, Sarah; Putwain, Dave; St. Clair-Thompson, Helen; Clough, Peter
This study sought to explore the concept of mental toughness (comprising the attributes challenge, commitment, control, and confidence) from the perceptions of adolescents, to better understand their views on these attributes and the extent to which each were regarded as important within an educational setting. In total, 54 adolescents (31 female)…
Petersen, Anne C.; And Others
This study examined the relation between family variables and the mental health outcomes of adolescents. Family members' feelings about one another were assessed when the children were in grades 6 and 8. Family members' closeness to one another was assessed when children were in grades 8 and 12, and in a 4-year follow-up study. Adolescents' mental…
Kranke, Derrick; Floersch, Jerry
This study investigated adolescents with a mental health diagnosis and their experience of stigma in schools. Forty adolescents between the ages of twelve and seventeen who met DSM-IV criteria for a psychiatric illness and who were prescribed psychiatric medication were selected. The Teen Subjective Experience of Medication Interview was used to…
Aalsma, Matthew C.; Varshney, Nicole M.; Arens, Daniel; Lapsley, Daniel K.
This paper describes a study that examined the relationship between two forms of adolescent narcissism and indicators of self-worth (positive adjustment and psychopathology) in a sample of 561 adolescents. School structure, academic performance, and school participation were also examined and mental health functioning was assessed by measures of…
Schultz, Jerelyn B.; Adams, Donna U.
Administered 50 needs statements to 134 minimally and mildly mentally disabled adolescent students to identify their family life education needs as a basis for curriculum development. Identified six clusters or groups of family life education needs: Basic Nutrition, Teenage Pregnancy, Sex Education, Developmental Tasks of Adolescents, Marriage and…
Awas, M; Kebede, D; Alem, A
Previous studies conducted in Ethiopia lack information on the prevalence of specific mental disorders in rural communities. The lifetime and one-month prevalence of specific ICD-10 mental disorders and their associated socio-demographic factors were determined using the translated Amharic version of the Composite International Diagnostic Interview (CIDI) in a rural population. A total of 501 community subjects selected from a predominantly rural district by stratified random sampling were interviewed by non-clinician interviewers. The weighted aggregate lifetime prevalence of psychiatric morbidity was 31.8% (26.7% when substance dependence was not included). The most frequent specific diagnoses were: dissociative disorders (6.3%), mood disorders (6.2%), somatoform disorders (5.9%), and anxiety disorders (5.7%). After adjustment in a multivariate logistic model, female sex was shown to have a statistically significant association with mood disorders (Odds Ratio, OR = 3.84, 95% CI: 1.90, 7.73) and somatoform disorders (OR = 2.30, 95% CI: 1.13, 4.60). Severe cognitive and mood disorders were significantly associated with being elderly, i.e. 60 or more years of age (OR = 7.71, 95% CI: 1.58, 7.53; and OR = 3.68, 95% CI = 1.36, 9.95, respectively). Khat dependence was associated with being Muslim and with earning a low income. (OR = 3.5, 95% CI: 1.02, 11.98; and OR = 0.32, 95% CI: 0.10, 0.96, respectively). It is concluded that psychiatric morbidity is a major public health problem in the rural community.
Celine, Thalappillil Mathew; Antony, Jimmy
Background: “Mental disorder” is the most common used term in the modern life and the main reason behind this may be the mechanical way of life or stress and strain among youth. Aim: To find the pattern of mental disorders of hospitalized patients in a medical college hospital from 1st April 2005 to 31st March 2010. Settings and Design: A retrospective study conducted among the patients admitted with mental disorders in a medical college hospital from 1st April 2005 to 31st March 2010. Materials and Methods: Data collected from the registers maintained in the medical records department. Statistical Analysis: Z test is used for the comparison of proportions. Results: A total of 7908 mental disorder cases reported in the medical college hospital, 5564 (70.36%) were males and 2344 (29.64%) were females. Most cases occurred in the age group of 30-44 years. Mental disorder was more among females than males in 0-29 years and ≥ 60 years, but in 30-59 years males were more. In each year, mental disorders were reported more in males than females. Of the cases, most of them were mood disorders. Mental and behavioral disorders due to psychoactive substance use were more among males but schizophrenia, delusional disorders, mood disorders, stress-related disorders, mental retardation, and so on were more among females. Conclusion: Mood disorder was the most occurred mental disorder and the next leading mental disorder was mental and behavioral disorders due to psychoactive substance use. Counseling can be helpful for preventing most of the mental disorders. Improve the mental health care facilities will be the solution for controlling the mental disorders. PMID:24791229
Askeland, Kristin Gärtner; Hysing, Mari; Aarø, Leif Edvard; Tell, Grethe S; Sivertsen, Børge
The aim of the study was to investigate mental health and resilience in adolescents who have been internationally adopted and their non-adopted peers and examine the potential interaction between adoption status and resilience on mental health problems. Data from the population based youth@hordaland-survey, conducted in Hordaland County, Norway, in 2012 was used. In all, 10 257 adolescents aged 16-19 years provided self-reported data on several mental health instruments. Of these, 45 adolescents were identified as internationally adopted. Adoptees reported more symptoms of depression, attention-deficit/hyperactivity disorder (ADHD), obsessive compulsive disorder (OCD) and perfectionism than non-adopted adolescents, but there were no differences regarding resilience. Adolescents with higher resilience scores reported fewer symptoms of mental health problems, however, no interaction effects were found for adoption status and total resilience score on measures of mental health problems. Our findings indicate that knowledge of resilience factors can form the basis for preventive interventions.
GÜMÜŞ, Yusuf Yasin; ÇAKIN MEMİK, Nursu; AĞAOĞLU, Belma
Introduction Our aim is to investigate the prevalence of comorbidity of anxiety disorders (AD) among patients newly diagnosed with attention deficit hyperactivity disorder (ADHD) and to compare symptom severity of ADHD and sociodemographic parameters between patients with and without AD. Methods Among 1683 children and adolescents admitted to Kocaeli University Medical Faculty, Child and Adolescent Mental Health Outpatient Clinic, 447 children and adolescents, who were preliminarily diagnosed as ADHD by clinical interview based on Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), were invited to participate in the second phase of the study. Kiddie Schedule for Affective Disorder and Schizophrenia, Present and Lifetime-Turkish Version were applied to children and adolescents with ADHD and one of their parents to support the diagnoses of both ADHD and AD. Mothers, fathers, and teachers of the children were asked to complete DSM-IV-Based Child and Adolescent Behavior Disorders Screening and Rating Scale. Results Our study group comprised 170 children and adolescents diagnosed with ADHD of whom 19.4% were girls and 80.6% were boys; 27.6% of patients diagnosed with ADHD showed AD comorbidity. Age of the parents at birth of the patients with AD was significantly lower than that of patients without AD. Conclusion In line with the previous studies, the comorbidity rate of AD was found to be higher among patients with ADHD than general population and clinical sample without ADHD. The possibility of comorbidity of AD in patients with ADHD should be considered because higher rates of AD are observed in ADHD and comorbidities of AD.
Alcohol, nicotine, and caffeine are the most widely consumed psychotropic drugs worldwide. They are largely consumed by normal individuals, but their use is even more frequent in psychiatric patients, Thus, patients with schizophrenia tend to abuse all three substances. The interrelationships between depression and alcohol are complex. These drugs can all create dependence, as understood in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Alcohol abuse is clearly deleterious to the brain, provoking acute and chronic mental disorders, ranging from intoxication with impairment of cognition, to delirium tremens, halluosis, and dementia. In contrast, the main health consequences of nicotine, notably cancer and cardiovascular disases, lie outside the realm of psychiatry However, the mes of nicotine dependence and motivation to smoke or quit are of concern to psychiatrists. PMID:22033899
Ayre, Karyn; Owen, Gareth S.; Moran, Paul
The use of the Mental Capacity Act 2005 in assessing decision-making capacity in patients with borderline personality disorder (BPD) is inconsistent. We believe this may stem from persisting confusion regarding the nosological status of personality disorder and also a failure to recognise the fact that emotional dysregulation and characteristic psychodynamic abnormalities may cause substantial difficulties in using and weighing information. Clearer consensus on these issues is required in order to provide consistent patient care and reduce uncertainty for clinicians in what are often emergency and high-stakes clinical scenarios. PMID:28184315
Beletsky, Vadim; Mirsattari, Seyed M.
Temporal lobe epilepsy (TLE), a subset of the seizure disorder family, represents a complex neuropsychiatric illness, where the neurological presentation may be complemented by varying severity of affective, behavioral, psychotic, or personality abnormalities, which, in turn, may not only lead to misdiagnosis, but also affect the management. This paper outlines a spectrum of mental health presentations, including psychosis, mood, anxiety, panic, and dissociative states, associated with epilepsy that make the correct diagnosis a challenge. PMID:22934158
... personality disorders. 4.127 Section 4.127 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS... and personality disorders. Mental retardation and personality disorders are not diseases or injuries... superimposed upon mental retardation or a personality disorder may be service-connected. (Authority: 38...
... personality disorders. 4.127 Section 4.127 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS... and personality disorders. Mental retardation and personality disorders are not diseases or injuries... superimposed upon mental retardation or a personality disorder may be service-connected. (Authority: 38...
... personality disorders. 4.127 Section 4.127 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS... and personality disorders. Mental retardation and personality disorders are not diseases or injuries... superimposed upon mental retardation or a personality disorder may be service-connected. (Authority: 38...
Dame, C; Casper, P
Bipolar disorder affects all age categories, included children and adolescents (in this case, prepubertal and early adolescent or PEA-BP). Its diagnosis at this age is difficult for two reasons: first, clinical symptoms are different from these encountered by adults and second, an important psychiatric comorbidity is often observed (especially with attention-deficit/hyperactivity disorder or ADHD). This review presents the clinical presentation, the differential diagnosis, the familial antecedents, the comorbidity and the treatment of the PEA-BP.
Kerwin, MaryLouise E.; Berkowitz, Robert I.
The fourth edition of the "Diagnostic Statistical Manual of Mental Disorders" (DSM) recognizes that feeding problems of infants and children are not typically the same as eating problems of adolescents, thus the addition of a broad diagnostic category, "Feeding and Eating Disorders of Infancy or Early Childhood." Subtypes are…
Tebeka, Sarah; Hoertel, Nicolas; Dubertret, Caroline; Le Strat, Yann
Despite the severity of the loss of a parent and the frequency of parental divorce, few studies compared their impact on mental health in the general adult population. The aim of this study was to estimate the prevalence, sociodemographic correlates, and psychiatric comorbidity of parental loss and parental divorce during childhood and adolescence. Data were drawn from the National Epidemiologic Survey on Alcohol and Related Conditions, a nationally representative sample of US adults (n = 43,093). Of the 43,093 participants, parental divorce during childhood or adolescence was reported by 5776 participants, whereas 3377 experienced parental death during childhood or adolescence. Participants reporting a history of parental divorce present a significantly higher prevalence of psychiatric disorders, particularly alcohol and drug use disorders compared with control subjects. While participants experiencing the death of a parent reported a poorer overall health, the prevalence of psychiatric disorder after 17 years of age was not significantly higher than that of the control subjects.
Mataix-Cols, David; Pertusa, Alberto
Background: The inclusion of a new mental disorder in the nomenclature is not a trivial matter. Many have highlighted the risks of an ever-increasing number of mental disorders and of overpathologizing human behaviour. Given the proposed inclusion of a new hoarding disorder (HD) in DSM-5 (Diagnostic and Statistical Manual of Mental Disorders,…
Bolton, Declan J; Robertson, Lucy J
Human infections with foodborne pathogenic organisms are relatively well described in terms of their overt physical symptoms, such as diarrhea, abdominal cramps, vomiting, fever, and associated sequelae. Indeed, some of these are key for diagnosis and treatment, although it should be noted that, for some foodborne pathogens, the physical symptoms might be more diffuse, particularly those associated with some of the foodborne parasites. In contrast, the impact of these pathogens on mental health is less well described, and symptoms such as depression, anxiety, and general malaise are usually ignored when foodborne infections are recorded. Despite this, it is generally accepted that there are several psychiatric disorders of unknown etiology that may be associated with microbial pathogens. Depression, autism, hypochondriasis and anxiety, schizophrenia, and Tourette syndrome probably have multiple contributing causes, among which foodborne pathogens may play a decisive or contributory role, possibly sharing pathophysiological pathways with other environmental triggers. This review focuses on foodborne parasites and bacterial pathogens. Some foodborne parasites, such as metacestodes of Taenia solium and tissue cysts (bradyzoites) of Toxoplasma gondii , may affect mental health by directly infecting the brain. In contrast, bacterial infections and other parasitic infections may contribute to mental illness via the immune system and/or by influencing neurotransmission pathways. Thus, cytokines, for example, have been associated with depression and schizophrenia. However, infectious disease models for psychiatry require a more complete understanding of the relationship between psychiatric disorders and microbial triggers. This article reviews the current state of knowledge on the role of foodborne parasitic and bacterial pathogens in mental illness and identifies some of the gaps that should be addressed to improve diagnosis and treatment of mental health issues that are
This paper sets out Kant's anthropological account of mental disorder. I begin with a discussion of the nature of Kant's 'pragmatic anthropology' and the implications of the fact that his discussion of mental disorder takes place in that context. I then set out Kant's taxonomy of the mind and discuss the various disorders affecting the cognitive faculty and the faculties of feeling and desire. I end with a brief discussion of Kant's views on the causes, preventions, and treatments of mental disorder.
Barter, Christine; Stanley, Nicky
This paper provides a narrative review of the knowledge on inter-personal violence and abuse (IPVA) in adolescents' intimate relationships. It draws on the authors' own research, published reviews, and a rapid review on IPVA victimization and mental health outcomes for adolescents. The research reviewed identified associations between adolescent IPVA and substance misuse, depressive symptoms and PTSD, eating disorders and suicidal thinking, and behaviour in young people. Generally, girls appeared more likely to report severe mental health outcomes than boys. Adolescents rarely disclose IPVA to adults and delivering preventative programmes that promote knowledge and help seeking may offer a means of building on young people's tendency to seek help from friends. These preventative interventions, usually delivered in schools, need to be closely linked to support services for adolescents who disclose abuse. While there are some practice examples of emerging interventions for both victims and perpetrators of adolescent IPVA, there is as yet little robust evidence regarding their effectiveness.
Stagi, Paolo; Galeotti, Simona; Mimmi, Stefano; Starace, Fabrizio; Castagnini, Augusto C
To examine clinical and demographic factors associated with continuity of care from child-adolescent (CAMHS) to adult mental health services (AMHS), we undertook a record-linkage study to the Adult Mental Health Information System including all those 16 years old and over who were listed between 2010 and 2013 in the Child and Adolescent Neuropsychiatry Information System in Emilia-Romagna, an Italian region of nearly 4.5 million residents. From a cohort of 8239 adolescents attending CAMHS (population at risk about 144,000), 821 (19.4 %) moved to AMHS, excluding cases with specific developmental disorders, whose conditions were not managed by adult psychiatrists, and those with mental retardation who attended usually social services. Young people referred for treatment to AMHS were more likely to receive a discharge diagnosis of schizophrenia and related disorders (Odds Ratio [OR] 3.92; 95 % confidence interval [CI] 2.17-7.08), personality disorders (OR 2.69; 95 % CI 1.89-3.83), and pervasive developmental disorders (OR 2.13; 95 % CI 1.51-2.99). Further factors predicting transfer to AMHS were not living with parents, inpatient psychiatric admission, and being on medication in the previous 24 months. These findings suggest that a relatively small number of adolescents moved to AMHS and are likely to reflect the configuration of local mental health services and alternative care available, mainly for those with less-severe mental disorders.
Wang, Zhizhong; Koenig, Harold G.; Zhang, Yuhong; Ma, Wanrui; Huang, Yueqin
Purpose The present study aims to examine the association between religious involvement and mental disorder (anxiety disorder, mood disorder, alcohol use disorder) in a general Chinese population, and explore connections between religious belief and mental disorders in the Hui and Han ethnic groups. Method Data were examined from a representative sample of 2,770 community-dwelling adults in the province of Ningxia located in western China. Self-reported religious attendance and the importance of religious in daily life were measured. The WHO Composite International Diagnostic Interview was used to diagnose mental disorders. Results In the overall sample, the importance of religious affiliation was positively associated with mental disorders (especially anxiety) (p<0.01). No association was found between any religious characteristic and mood disorders or alcohol use disorders. With regard to analyses within different ethnic groups, religious affiliation was positively associated with mental disorder in Han ethnicity (p<0.01), but not in Hui ethnicity. When stratified by age and ethnic group, religious affiliation was associated positively with mental disorder in younger Han (p<0.01); whereas high religiosity was associated positively with mental disorder in older Hui (p<0.05). Among older Hui, however, religious affiliation was inversely associated with mood disorder (p<0.05). Conclusions In contrast to most previous studies in Western populations, religious involvement is less likely to be inversely related to mental disorder in Mainland China, although this association varies by age and ethnic group. PMID:26030906
Drost, Louisa M; Cuijpers, Pim; Schippers, Gerard M
Adolescents with a mentally ill parent are at high risk for developing a disorder themselves. It is widely recommended that these adolescents be provided with preventive interventions designed especially for them, but their avoidance of professional help is a common problem. Because most teenagers in Western societies use the World Wide Web as a means of social interaction, use of the Internet for reaching these young people would appear to be a promising option. In this article, the authors describe the development of Survivalkid.nl, an interactive, Internet-delivered, preventive intervention for supporting adolescents with a mentally ill family member. Usage statistics with regard to frequency and duration of visits and amount of activity during visits suggest that: (a) the target group has been better served than before the site was launched; and (b) we have accomplished our goal of expanding the range of support.
Da Fonseca, D; Cury, F; Fakra, E; Rufo, M; Poinso, F; Bounoua, L; Huguet, P
During the past decade, several studies have reported positive effects of cognitive-behavioral therapy (CBT) in the treatment of children and adolescents with mental disorders. One of the most important CBT interventions is to teach children and adolescents to challenge negative thoughts that lead to maladjusted behaviors. Based on the implicit theories of intelligence framework, the main purpose of this study was to test whether an incremental theory manipulation could be used to affect IQ test performance in adolescents with Generalized Anxiety Disorder (GAD). Results showed that patients demonstrated enhanced IQ performance and experienced less state anxiety when they were exposed to an incremental theory of intelligence manipulation. Our findings suggest that incremental theory manipulation provides a useful cognitive strategy for addressing school-related anxiety in adolescents with mental disorders such as GAD.
Buser, Juleen K.
School counselors play an important role in identifying and intervening with students struggling with disordered eating (e.g., Bardick et al., 2004). Research has shown that American Indian adolescents report higher rates of certain disordered eating behaviors than other racial groups. The literature on the prevalence and etiology of disordered…
Wilkinson, Great Buyck; Taylor, Priscilla; Holt, Jan R.
Due to developmental issues and overlapping symptoms with other disorders, diagnosing bipolar disorder in adolescents is often a confusing and complex process. This article highlights diagnostic criteria, symptoms and behaviors, and the differential diagnosis process. Treatment options are also discussed. (Contains 17 references.) (GCP)
Seth, Puja; Lang, Delia L.; DiClemente, Ralph J.; Braxton, Nikia D.; Crosby, Richard A.; Brown, Larry K.; Hadley, Wendy; Donenberg, Geri R.
Background Adolescents with a history of psychiatric disorder(s) are particularly vulnerable to contracting sexually transmissible infections (STIs) as a result of psychological and emotional states associated with higher rates of risky sexual behaviour. The present study examined gender differences in sexual risk behaviours and STI among adolescents in mental health treatment. Methods Three hundred and seventy nine sexually active adolescents, aged 13–18 years, from a larger multisite study, who received mental health treatment during the past year, completed an audio computer-assisted self interview assessing sociodemographics, psychiatric symptomatology and HIV/STI risk behaviours, and provided urine specimens tested for STI. Results After controlling for covariates, multivariate logistic regression models indicated that female adolescents were more likely to have had an HIV test (adjusted odds ratio (AOR) = 3.2, P = 0.0001), obtain their HIV test results (AOR = 2.9, P = 0.03), refuse sex out of fear for STI acquisition (AOR = 1.7, P = 0.04), or avoid a situation that might lead to sex (AOR = 2.4, P = 0.001), and were less likely to have a casual sex partner (AOR = 0.40, P = 0.002). Additionally, females were more likely to report inconsistent condom use (AOR = 2.60, P = 0.001) and have a STI (AOR = 9.1, P = 0.0001) than their male counterparts. Conclusions Female adolescents receiving mental health treatment were more than nine times as likely to have an STI and more likely to use condoms inconsistently. The standard of care for mental health practice for adolescents should include referrals for STI screening and treatment as well as assessment and discussion of risky sexual behaviours as part of the treatment plan when indicated. Effective programs should address gender-specific communication and behavioural skills. PMID:22697141
Developmental coordination disorder (DCD) is a neurodevelopmental condition characterized by poor motor proficiency that interferes with an individual’s activities of daily living. These problems in motor coordination are prevalent despite children’s intelligence levels. Common symptoms include marked delays in achieving motor milestones and clumsiness, typically associated with poor balance, coordination, and especially handwriting skills. Currently, DCD is said to impact about 2–7% of school-age children. More importantly, DCD is considered to be one of the major health problems among school-aged children worldwide, with unique consequences to physical and mental health. Because these children and adolescents often experience difficulties participating in typical childhood activities (e.g., riding a bike), they tend to be more sedentary, more overweight/obese, at a higher risk for coronary vascular disease, and have lower cardiorespiratory and physical fitness than their typically developing peers. From another perspective, the motor difficulties have also been linked to an increased risk for mental health issues, such as higher anxiety and depression. The understanding of the health consequences associated with DCD offers practical applications for the understanding of the mechanisms and intervention protocols that can improve the consequences of this condition. In this review, I will explore such consequences and provide evidence for the implementation of interventions that focus on improving physical and mental health in this population. PMID:27822464
Wilens, Timothy E.; Biederman, Joseph; Kwon, Anne; Ditterline, Jeffrey; Forkner, Peter; Moore, Hadley; Swezey, Allison; Snyder, Lindsey; Henin, Aude; Wozniak, Janet; Faraone, Stephen V.
Objective: Previous work in adults and youths has suggested that juvenile onset bipolar disorder (BPD) is associated with an elevated risk of substance use disorders (SUD). Considering the public health importance of this issue, the authors now report on a controlled study of adolescents with and without BPD to evaluate the risk of SUD. Method:…
Das, Jai K; Salam, Rehana A; Lassi, Zohra S; Khan, Marium Naveed; Mahmood, Wajeeha; Patel, Vikram; Bhutta, Zulfiqar A
Many mental health disorders emerge in late childhood and early adolescence and contribute to the burden of these disorders among young people and later in life. We systematically reviewed literature published up to December 2015 to identify systematic reviews on mental health interventions in adolescent population. A total of 38 systematic reviews were included. We classified the included reviews into the following categories for reporting the findings: school-based interventions (n = 12); community-based interventions (n = 6); digital platforms (n = 8); and individual-/family-based interventions (n = 12). Evidence from school-based interventions suggests that targeted group-based interventions and cognitive behavioral therapy are effective in reducing depressive symptoms (standard mean difference [SMD]: -.16; 95% confidence interval [CI]: -.26 to -.05) and anxiety (SMD: -.33; 95% CI: -.59 to -.06). School-based suicide prevention programs suggest that classroom-based didactic and experiential programs increase short-term knowledge of suicide (SMD: 1.51; 95% CI: .57-2.45) and knowledge of suicide prevention (SMD: .72; 95% CI: .36-1.07) with no evidence of an effect on suicide-related attitudes or behaviors. Community-based creative activities have some positive effect on behavioral changes, self-confidence, self-esteem, levels of knowledge, and physical activity. Evidence from digital platforms supports Internet-based prevention and treatment programs for anxiety and depression; however, more extensive and rigorous research is warranted to further establish the conditions. Among individual- and family-based interventions, interventions focusing on eating attitudes and behaviors show no impact on body mass index (SMD: -.10; 95% CI: -.45 to .25); Eating Attitude Test (SMD: .01; 95% CI: -.13 to .15); and bulimia (SMD: -.03; 95% CI: -.16 to .10). Exercise is found to be effective in improving self-esteem (SMD: .49; 95% CI: .16-.81) and reducing
Penayo, U; Caldera, T; Jacobsson, L
In recent years the family perspective in Psychiatry has become more important a factor. Therefore this paper is aimed at examining the family structure of mentally disordered people in León, Nicaragua, as well as presenting the use of a Genogram in epidemiological research. 201 families were randomly selected, whose members were interviewed in two steps: a screening, and a diagnostic stage. The family map or Genogram for each family was analyzed with respect to adult and child cases, generations within the family, and other background variables.
Macleod, S; Appleton, R E
The aim of this review is to discuss some of the neurological diseases that present mainly in the adolescent period. The article focuses on the usual presentation and course of the more common, and some uncommon, epilepsies, neuromuscular disorders, neurodegenerative disorders, inflammatory disorders of the central nervous system and some other, miscellaneous conditions. The article ends with a very brief and general discussion about management issues in this age group. PMID:17264287
SAXENA, SHEKHAR; JANÉ-LLOPIS, EVA; HOSMAN, CLEMENS
There is sufficient evidence indicating the efficacy of interventions in reducing risk factors, increasing protective factors, preventing psychiatric symptoms and new cases of mental disorders. Macro-policy interventions to improve nutrition, housing and education or to reduce economic insecurity have proven to reduce mental health problems. Specific interventions to increase resilience in children and adolescents through parenting and early interventions, and programmes for children at risk for mental disorders such as those who have a mentally ill parent or have suffered parental loss or family disruption, have also shown to increase mental well-being and decrease depressive symptoms and the onset of depressive disorders. Interventions for the adult population, from macro-policy strategies, such as taxation of alcohol products or workplace legislation, to individual support for those with signs of a mental disorder, can reduce mental health problems and associated social and economic burdens. Exercise, social support or community participation have also shown to improve mental health of older populations. Public mental health will benefit from continuing building the evidence base through combining different evaluation methods across low, middle and high income countries. The translation of evidence into policy and practice calls for action at the international, national and local level, including building capacity, advocacy, mainstreaming mental health into public health and other policies and securing infrastructures and sustainability. Mental health professionals have an important role to play in improving the evidence on prevention and promotion in mental health, in engaging relevant stakeholders for developing programmes, and as professional care providers in their practice. PMID:16757984
The evolution of mental disorders, notably the most severe forms such as schizophrenia, is a constant concern in terms of the necessary assessment of treatments and their efficiency, and to the human and economic cost of the 'chronicity' of the disorders. Many patients experience a positive evolution, evaluated in terms of subjective quality of life. However, the concept of recovery does not seem appropriate. The field of representations which the patient and the caregiver form with regard to the disease and its curability is an important element. The co-construction of the patient's future, in an approach centred on the patient, on their freedom and their autonomy, opens up the way towards recovery.
Background The aims of this study were to assess the prevalence of a comorbid Attention Deficit Hyperactivity Disorder (ADHD) diagnosis in Borderline Personality Disorder (BPD), and its impact on the clinical presentation of BPD in adolescents, and to determine which type of impulsivity specifically characterizes adolescents with BPD-ADHD. Methods ADHD diagnoses were sought in a sample of 85 DSM-IV BPD adolescents drawn from the EURNET BPD. Axis-I and -II disorders were determined with the K-SADS-PL and the SIDP-IV, respectively. Impulsivity was assessed with the BIS-11. Results 11% (N = 9) of BPD participants had a current ADHD diagnosis. BPD-ADHD adolescents showed higher prevalence of Disruptive disorders (Chi2 = 9.09, p = 0.01) and a non-significant trend for a higher prevalence of other cluster B personality disorders (Chi2 = 2.70, p = 0.08). Regression analyses revealed a significant association between Attentional/Cognitive impulsivity scores and ADHD (Wald Z = 6.69; p = 0.01; Exp(B) = 2.02, CI 95% 1.19-3.45). Conclusions Comorbid ADHD influences the clinical presentation of adolescents with BPD and is associated with higher rates of disruptive disorders, with a trend towards a greater likelihood of cluster B personality disorders and with higher levels of impulsivity, especially of the attentional/cognitive type. A subgroup of BPD patients may exhibit developmentally driven impairments of the inhibitory system persisting since childhood. Specific interventions should be recommended for this subsample of BPD adolescents. PMID:21961882
This paper argues that the adolescent process needs to be accorded its own particularity of reference, especially where narcissism is concerned. The paper draws on literary and clinical examples to describe what is termed the "adolescent organisation". In many ways, this organisation reflects post-Kleinian theory of what constitutes narcissistic…
Sharma, Aditi; Morrow, Jonathan D
There are many facets of the neurobiology of substance use that are distinct in adolescence as compared with adulthood. The adolescent brain is subject to intense subcortical reward processes, but is left with an immature prefrontal control system that is often unable to resist the pull of potentially exciting activities like substance use, even when fully aware of the dangers involved. Peer influences serve only to magnify these effects and foster more sensation-seeking, risky behavior. The unique aspects of neurobiology should be taken into consideration when designing prevention programs and clinical interventions for adolescent substance use disorders.
Havas, Jano; de Nooijer, Jascha; Crutzen, Rik; Feron, Frans
Purpose: The purpose of this paper is to examine the needs and views of adolescents regarding the development of online support for mental health problems. Design/methodology/approach: Semi-structured qualitative focus group interviews were conducted with ten groups of Dutch adolescents (n=106), aged 12-19 years, from four urban secondary schools…
Lara, Diogo R
Caffeine intake is so common that its pharmacological effects on the mind are undervalued. Since it is so readily available, individuals can adjust their own dose, time of administration and dose intervals of caffeine, according to the perceived benefits and side effects of each dose. This review focuses on human studies of caffeine in subjects with and without psychiatric disorders. Besides the possibility of mild drug dependence, caffeine may bring benefits that contribute to its widespread use. These benefits seem to be related to adaptation of mental energy to the context by increasing alertness, attention, and cognitive function (more evident in longer or more difficult tasks or situations of low arousal) and by elevating mood. Accordingly, moderate caffeine intake (< 6 cups/day) has been associated with less depressive symptoms, fewer cognitive failures, and lower risk of suicide. However, its putative therapeutic effects on depression and ADHD have been insufficiently studied. Conversely, in rare cases high doses of caffeine can induce psychotic and manic symptoms, and more commonly, anxiety. Patients with panic disorder and performance social anxiety disorder seem to be particularly sensitive to the anxiogenic effects of caffeine, whereas preliminary data suggests that it may be effective for some patients with obsessive compulsive disorder (OCD). The threshold for the anxiogenic effect of caffeine is influenced by a polymorphism of the A2A receptor. In summary, caffeine can be regarded as a pharmacological tool to increase energy and effortful behavior in daily activities. More populational (cross-sectional and prospective) and experimental studies are necessary to establish the role of caffeine intake in psychiatric disorders, especially its putative efficacy on depressive mood and cognitive/attentional disorders.
Zullig, Keith J; Matthews-Ewald, Molly R; Valois, Robert F
Although emotional disorders and disordered eating behaviors are known to be related, the relationship between emotional self-efficacy (ESE) and disordered eating is unknown. This study examined the relationship between ESE and disordered eating in a statewide sample of public high school adolescents (n=2566). The Centers for Disease Control Youth Risk Behavior Survey and an adolescent ESE scale were utilized. Logistic regression adjusted for key covariates explored the relationship between low ESE and disordered eating among selected race and gender groups. Self-perceived weight as underweight or overweight; and dieting, vomiting or taking laxatives, taking diet pills, and fasting to lose weight were each associated (p<.05) with lower levels of ESE for certain race/gender groups. Findings provide increased justification for tailoring disordered eating interventions and treatments to accommodate the highest risk groups. Measures of ESE should be considered for adolescent mental health assessments in fieldwork, research, and evaluation efforts.
Carta, Mauro Giovanni; Fiandra, Teresa Di; Rampazzo, Lorenzo; Contu, Paolo; Preti, Antonio
Introduction: Mental disorders are the largest cause of the burden of disease in the world. Most of the burden affecting adult life has its onset during childhood and adolescence. The European Pact for Mental Health and Wellbeing calls for immediate action and investments in the mental health of children and adolescents. Schools may be the ideal location for promoting health and delivering healthcare services, since schools are a location where young people usually spend their daytime and socialize, schools are easily accessible to families, can provide non-stigmatizing health actions, and form links with the community. Aims and Goals of this Special Issue: This issue is developed within the framework of the Joint Action on Mental Health promoted by the European Commission. This special issue presents a set of systematic reviews on the evidence of the international literature on school interventions for the promotion of the mental health and wellbeing of children and adolescents. It is focused on five topical main areas: promoting general health and wellbeing; programs targeting specific mental disorders and conditions and integration of adolescents with mental health problems; Bullying; Sport; Alcohol and Drugs. An additional paper on the results of the largest epidemiological study conducted in some European countries on the prevalence and relative risk factors of mental disorders in school-age completes the issue. Conclusion: These reviews are a first contribution to address future European research and interventions, in particular about the multiple ways through which European policies could support the schooling and wellbeing of children and adolescents. PMID:25834625
de Assis, Simone Gonçalves; Avanci, Joviana Quintes; Pesce, Renata Pires; Ximenes, Liana Furtado
This article reflects about the situation of mental health and violence against Brazilian children and adolescents, proposing a discussion about the need for public health policies including these extremely relevant issues in their priority agenda. In Brazil, the debate about this problem has occurred in a fragmented and not very consistent way. This article presents a non-systematic selection of epidemiological investigations on this subject conducted in Brazilian schools and communities. The great variety and prevalence of familiar and community violence and of mental health problems is pointed out and the methodological differences between the studies and the concentration of studies in the South and Southeastern regions of the country are emphasized. The article still highlights to the scarce service network for dealing with this kind of problem and the lack of concern with the prevention of mental disorders and promotion of mental health.
Yen, Shirley; Gagnon, Kerry; Spirito, Anthony
The diagnosis of borderline personality disorder (BPD) in adolescents has been controversial. Thus, few studies have examined BPD in suicidal adolescents, even though it is strongly associated with suicidal behaviours in adults. This study examines differences between suicidal adolescents with (n = 47) and without (n = 72) BPD on history and characteristics of suicidal behaviour, Axis I co-morbidity, affect regulation and aggression. Assessments were completed with both adolescents and parents, and consensus ratings based on best available data were analysed. BPD participants were more likely to have a history of suicide attempts and to have been admitted because of a suicide attempt (vs. suicidal ideation). There were no significant differences in self-injurious behaviours or degree of suicidal ideation. BPD participants also had more psychiatric co-morbidity and higher aggression scores but no significant differences in affective dysregulation compared with suicidal adolescents without BPD. Diagnostic stability over 6 months was modest. Our results demonstrate that, compared with other acutely suicidal adolescents, the clinical profile of BPD participants is unique and suggests an increased risk for suicidal behaviours. This extends upon other studies that support the construct validity of BPD during adolescence and suggests that BPD should be considered in suicide risk assessment for adolescents.
Breslau, J.; Miller, E.; Jin, R.; Sampson, N. A.; Alonso, J.; Andrade, L. H.; Bromet, E. J.; de Girolamo, G.; Demyttenaere, K.; Fayyad, J.; Fukao, A.; Gălăon, M.; Gureje, O.; He, Y.; Hinkov, H. R.; Hu, C.; Kovess-Masfety, V.; Matschinger, H.; Medina-Mora, M. E.; Ormel, J.; Posada-Villa, J.; Sagar, R.; Scott, K. M.; Kessler, R. C.
Objective Estimate predictive associations of mental disorders with marriage and divorce in a cross-national sample. Method Population surveys of mental disorders included assessment of age at first marriage in 19 countries (n = 46 128) and age at first divorce in a subset of 12 countries (n = 30 729). Associations between mental disorders and subsequent marriage and divorce were estimated in discrete time survival models. Results Fourteen of 18 premarital mental disorders are associated with lower likelihood of ever marrying (odds ratios ranging from 0.6 to 0.9), but these associations vary across ages of marriage. Associations between premarital mental disorders and marriage are generally null for early marriage (age 17 or younger), but negative associations come to predominate at later ages. All 18 mental disorders are positively associated with divorce (odds ratios ranging from 1.2 to 1.8). Three disorders, specific phobia, major depression, and alcohol abuse, are associated with the largest population attributable risk proportions for both marriage and divorce. Conclusion This evidence adds to research demonstrating adverse effects of mental disorders on life course altering events across a diverse range of socioeconomic and cultural settings. These effects should be included in considerations of public health investments in preventing and treating mental disorders. PMID:21534936
McDermott, Brett M.; Cobham, Vanessa E.
Background From a global perspective, natural disasters are common events. Published research highlights that a significant minority of exposed children and adolescents develop disaster-related mental health syndromes and associated functional impairment. Consistent with the considerable unmet need of children and adolescents with regard to psychopathology, there is strong evidence that many children and adolescents with post-disaster mental health presentations are not receiving adequate interventions. Objective To critique existing child and adolescent mental health services (CAMHS) models of care and the capacity of such models to deal with any post-disaster surge in clinical demand. Further, to detail an innovative service response; a child and adolescent stepped-care service provision model. Method A narrative review of traditional CAMHS is presented. Important elements of a disaster response – individual versus community recovery, public health approaches, capacity for promotion and prevention and service reach are discussed and compared with the CAMHS approach. Results Difficulties with traditional models of care are highlighted across all levels of intervention; from the ability to provide preventative initiatives to the capacity to provide intense specialised posttraumatic stress disorder interventions. In response, our over-arching stepped-care model is advocated. The general response is discussed and details of the three tiers of the model are provided: Tier 1 communication strategy, Tier 2 parent effectiveness and teacher training, and Tier 3 screening linked to trauma-focused cognitive behavioural therapy. Conclusion In this paper, we argue that traditional CAMHS are not an appropriate model of care to meet the clinical needs of this group in the post-disaster setting. We conclude with suggestions how improved post-disaster child and adolescent mental health outcomes can be achieved by applying an innovative service approach. PMID:25045422
Herrera, Aubrey V; Benjet, Corina; Méndez, Enrique; Casanova, Leticia; Medina-Mora, Maria Elena
The normative process of autonomy development in adolescence involves changes in adolescents' information management typically characterized by decreasing disclosure and increasing concealment. These changes may have an important impact on the early detection and timely treatment of mental health conditions and risky behavior. Therefore, the objective was to extend our understanding of how these developmental changes in adolescent disclosure might impact adolescent mental health interviews. Specifically, we estimated the effects of third party presence and type of third party presence (adult, child, or both) on adolescents' reports of psychiatric symptoms, substance use, suicidal behavior, and childhood adversity. In this representative sample of 3005 adolescents from Mexico City (52.1 % female), administered the World Mental Health Composite International Diagnostic Interview (WMH-CIDI-A), adult presence influenced reporting the most; in their presence, adolescents reported more ADHD, parental mental illness and economic adversity, but less panic disorder, PTSD, drug use and disorder, and suicidal behavior. The presence of children was associated with increased odds of reporting conduct disorder, opportunity for drug use, parental criminal behavior, neglect, and the death of a parent. While adolescent information management strategies are normative and even desirable as a means of gaining emotional autonomy, they may also interfere with timely detection and treatment or intervention for mental health conditions and risky behaviors. Research and practical implications of these findings are discussed.
The relationship between three parenting styles (authoritarian, permissive, and authoritative) and the mental health of Arab adolescents was tested. It was hypothesized that parenting style toward boys would differ from that towards girls, psychological adjustment of girls would differ from that of boys, and that the authoritarian style applied within the authoritarian Arab society is not associated with poor psychological adjustment. The Parental Authority Questionnaire, Child Attitude Toward Parents, Lipsitt's Self-Concept Scale for Children, Rosenberg Self-Esteem Scale and the Psychological State Scale were administered to 431 Arab adolescents. Sex comparison revealed that the parenting style with regard to girls tends to be more authoritative and less authoritarian than with regard to boys. Girls scored higher than boys on identity disorder, anxiety disorder, and depression scales, whereas boys scored higher than girls on the behavior disorder scale. There was no significant relationship between the authoritarian parenting style and the mental health measures. A significant positive relationship exists between the authoritative parenting style and the mental health of children. Among boys, the permissive parenting style was associated with negative attitudes towards parents, lower self-esteem and increased identity, anxiety, phobia, depressive, and conduct disorders. It seems, therefore, that the effect of parenting style is culturally and gender dependent rather than universal.
Burnett Heyes, S; Pictet, A; Mitchell, H; Raeder, S M; Lau, J Y F; Holmes, E A; Blackwell, S E
Mental imagery has a powerful impact on emotion and cognitive processing in adults, and is implicated in emotional disorders. Research suggests the perspective adopted in mental imagery modulates its emotional impact. However, little is known about the impact of mental imagery in adolescence, despite adolescence being the key time for the onset of emotional dysfunction. We administered computerised positive versus mixed valence picture-word mental imagery training to male adolescent participants (N = 60, aged 11-16 years) across separate field and observer perspective sessions. Positive mood increased more following positive than mixed imagery; pleasantness ratings of ambiguous pictures increased following positive versus mixed imagery generated from field but not observer perspective; negative interpretation bias on a novel scrambled sentences task was smaller following positive than mixed imagery particularly when imagery was generated from field perspective. These findings suggest positive mental imagery generation alters mood and cognition in male adolescents, with the latter moderated by imagery perspective. Identifying key components of such training, such as imagery perspective, extends understanding of the relationship between mental imagery, mood, and cognition in adolescence.
Maksimović, Milos; Kocijancić, Radojka; Backović, Dusan; Ille, Tatjana; Paunović, Katarina
The change in socio-economic status, drastic decrease in living standards, war, and the introduction of sanctions to our country were complicated in addition by a large number of internally displaced people from Kosovo, which culminated with the 1999 NATO bombing. The aim of this investigation was to estimate the influence of internal displacement on the adaptation and mental health of adolescents. The investigation was conducted on 238 adolescents, comprising a control group of 206 adolescents from Belgrade and 32 internally displaced adolescents from Kosovo. A specific questionnaire regarding habits, behaviour, and psychosomatic state was used, as well as the Cornell Medical Index and the Eysenck Personality Questionnaire. Internally displaced adolescents from Kosovo exhibited greater difficulties in adapting and had worse school records than adolescents from Belgrade, one year after the change in their location. Immediately after the NATO bombing, both groups reacted in the same way: they often talked about the events they had survived, they were afraid of the sounds of alarm sirens and of aeroplanes, and in addition had similar dreams (no statistical variation between the groups). Emotional disturbances, one year after the bombing, were not observed in 40.6% of adolescents from Kosovo, compared to the figure of 74.8% for adolescents from Belgrade. Adolescents from Belgrade consumed alcohol significantly more often: 75.7% compared to 56.3% for adolescents from Kosovo. In addition, 20.4% of adolescents from Belgrade consumed psychoactive substances compared to 6.3% of adolescents from Kosovo. There was no significant difference between the examined groups in the total scores on the scale for neuroticism. All in all, the girls from both examined groups displayed neurotic tendencies more frequently than the boys.
Demurie, Ellen; De Corel, Maaike; Roeyers, Herbert
In research on theory of mind (ToM) in individuals with an autism spectrum disorder (ASD) mainly static mind-reading tasks were used. In this study both a static (Eyes Test) and a more naturalistic (empathic accuracy task) ToM measure were used to investigate the perspective taking abilities of adolescents with ASD (n = 13), adolescents with…
Graham, Sandra; Bellmore, Amy D.
In this article, the authors describe recent research on peer victimization and its mental health consequences during early adolescence. They begin with a working definition of peer victimization that distinguishes it from lethal school violence and from simple conflict between peers. They then present a psychosocial profile of youth who are…
Discusses how Orff-Schulwerk methods are used to teach music ensemble skills to mentally retarded adolescents. The author describes how the analysis of basic musical tasks reveals the essential subskills of motor coordination, timing, and attentiveness necessary to music-making. Specific teaching methods for skill development and Orff…
Vibulsri, Chamnong; And Others
Reported are three studies investigating the mental abilities of children and adolescents. The first study (by Chamnong Vibulsri) had three purposes: (1) to determine whether and how language affects logical thinking in Thai children; (2) to ascertain whether Piaget's or Bruner's theory would more accurately explain any such relationship; and (3)…
Rinckey, David Jason
Presented is a developmentally sequenced curriculum designed for teaching human sexuality to mentally impaired adolescents. A brief objective is presented, teaching methods are listed, and materials needed are described (in terms of author, title, source, and price) for each of the following topic areas: vocabulary of sexuality; fact vs. myths;…
Eisenberg, Leon; Belfer, Myron
The epidemiology of the mental and physical health of children and adolescents the world over reflects: the genomes they inherit (and the modifications those genes undergo in utero); the pregnancies that led to their births, whether their mothers survive those pregnancies, and whether their births were welcome; the parents, the neighbors, and the…
Investigated possible links between normative and political opposition, mental health, and the use of cannabis in prospective longitudinal study of Norwegian adolescents (n=1,311). Findings indicated that the group that experimented with cannabis was mainly characterized by political and normative "oppositional" engagement, but heavy…
This study examines the role that a history of child sexual abuse played in the diagnosis and treatment of mental disorders in a sample of 321 female offenders incarcerated in a maximum-security prison for women. The results show that a history of child sexual abuse increases the likelihood that an inmate would receive mental health treatment. Psychotropic medication is frequently prescribed in response to adjustment problems associated with childhood sexual abuse. White women who exhibit adjustment problems associated with a history of child sexual abuse are especially likely to be diagnosed as mentally disordered at admission and to be sent to the mental health unit for treatment. In the absence of a diagnosed mental disorder at admission, women who receive psychotropic medication to help them adjust to prison life are likely to be diagnosed with a mental disorder later on.
The population of people with congenital deafblindness faces challenges concerning communication and mobility. Due to the significance of the sensory loss it is difficult to diagnose mental and behavioral disorders. This article investigates the prevalence of mental and behavioral disorders among 95 congenitally deafblind adults. Seventy-four…
In this article, I address the issue of comorbidity and its prevalence in the prior "Diagnostic and Statistical Manual of Mental Disorders" ("DSM") classification systems. The focus on the topography or form of presenting problems as the venue for determining mental disorders is scrutinized as the possible cause. Addressing the…
Chavez, Mark; Insel, Thomas R.
The mission of the National Institute of Mental Health (NIMH) is to reduce the burden of mental and behavioral disorders through research, and eating disorders embody an important fraction of this burden. Although past and current research has provided important knowledge regarding the etiology, classification, pathophysiology, and treatment of…
Ramirez, Maria E.; McIntosh, David E.; Kruczek, Theresa
Eating disorders, once thought to be exclusively a disorder of the more affluent Western countries, are now spreading around the world. Despite the wealth of information on the prevalence of eating disorders in developed countries, epidemiological data for South America is scarce. The 26-item Eating Attitude Test (EAT-26) was used to explore the…
Darch, Kayleigh; Ellett, Lyn; Fox, Simone
Previous studies have identified a positive relationship between aggression and paranoia, yet the relationship between the emotion of anger and paranoia in forensic populations has not been examined. Possible confounding variables, such as social desirability and mood, should also be considered. Sixty-six participants who had a violent conviction and mental disorder completed self-report questionnaires that measured anger, paranoid ideation, socially desirable responding, anxiety, and depression. The findings indicated that increased anger was associated with increased paranoia. Partial correlations showed that anger remained significantly associated with paranoia after socially desirable responding, anxiety, depression, gender, and violence history were controlled, suggesting anger and paranoia were not associated due to indirect relationships with these constructs. This could suggest that integrative psychological interventions that consider experiences of both anger and paranoia may be beneficial with forensic populations.
Harnisher, Julie Laken; Abram, Karen; Washburn, Jason; Stokes, Marquita; Azores-Gococo, Nicole; Teplin, Linda
This study investigated the prevalence of loss due to death and its association with mental disorders in a random sample of 898 newly detained adolescents in Chicago, Illinois. Nearly 90% of youth experienced the loss of an important person; most had also experienced a “high-risk” loss (e.g., loss due to violence, sudden loss). Minority youth were at particular risk. Youth with any loss or multiple losses were more likely to have mood disorders and ADHD/behavioral disorders, respectively, than youth who had no such losses. Interventions focusing on modifiable protective factors following loss may increase positive outcomes in this vulnerable population. PMID:26405364
Deighton, Jessica; Argent, Rachel; De Francesco, Davide; Edbrooke-Childs, Julian; Jacob, Jenna; Fleming, Isobel; Ford, Tamsin; Wolpert, Miranda
The effectiveness of evidence-based practice in the treatment of children with conduct disorder (n = 186) or emotional disorders (n = 490) in routine care was examined using naturalistic, previously collected data from 30 child and adolescent mental health services. Repeated measures analysis of covariance was used to compare the outcomes of children who received parent training for conduct disorder and cognitive behavioural therapy for emotional disorders (evidence-based practice) with children who did not receive these treatments (non-evidence-based practice). There was a relatively low occurrence of evidence-based practice, particularly for children with conduct disorder. Both the evidence-based practice and non-evidence-based practice groups improve over time, with moderate effect sizes, and there were greater improvements associated with evidence-based practice for children with emotional disorders, based on child self-reported symptoms but not on parent report. In the present sample, significant differences were not found for conduct disorder. Findings provide tentative support for evidence-based practice for the treatment of emotional disorders in routine care settings.
This article considers the international human rights instruments which set minimum standards for the content and use of mental health legislation, and the extent to which they represent 'hard law' (binding and enforceable in domestic or international courts) or 'soft law' which is not strictly binding in the same sense but which may provide persuasive authority or may be used in debate to embarrass a Government into compliance. The article considers the extent to which these various instruments impose both 'negative obligations' on states not to interfere with rights such as physical integrity or protection against arbitrary detention and 'positive' obligations on states to take positive steps to uphold the rights of individuals. The article on the case law under the European Convention on Human Rights showing how 'soft law' sources are increasingly used by the Strasbourg Court as aids to construing the scope of Convention rights. The article concludes by suggesting that whilst mentally disordered people may be afforded different treatment in relation to general bioethics instruments on the international plane, they are also entitled to rights under Disability Conventions which enjoin states to take positive steps to promote equal treatment, social inclusion and protection against discrimination and stigma.
Stein, Dan J.; Aguilar-Gaxiola, Sergio; Alonso, Jordi; Bruffaerts, Ronny; de Jonge, Peter; Liu, Zharoui; Caldas-de-Almeida, Jose Miguel; O’Neill, Siobhan; Viana, Maria Carmen; Al-Hamzawi, Ali Obaid; Angermeyer, Mattias C.; Benjet, Corina; de Graaf, Ron; Ferry, Finola; Kovess-Masfety, Viviane; Levinson, Daphna; de Girolamo, Giovanni; Florescu, Silvia; Hu, Chiyi; Kawakami, Norito; Haro, Josep Maria; Piazza, Marina; Wojtyniak, Bogdan J; Xavier, Miguel; Lim, Carmen C.W.; Kessler, Ronald C.; Scott, Kate
Background Previous work has suggested significant associations between various psychological symptoms (e.g. depression, anxiety, anger, alcohol abuse) and hypertension. However, the presence and extent of associations between common mental disorders and subsequent adult onset of hypertension remains unclear. Further, there is little data available on how such associations vary by gender or over life course. Methods Data from the World Mental Health Surveys (comprising 19 countries, and 52,095 adults) were used. Survival analyses estimated associations between first onset of common mental disorders and subsequent onset of hypertension, with and without psychiatric comorbidity adjustment. Variations in the strength of associations by gender and by life course stage of onset of both the mental disorder and hypertension were investigated. Results After psychiatric comorbidity adjustment, depression, panic disorder, social phobia, specific phobia, binge eating disorder, bulimia nervosa, alcohol abuse, and drug abuse were significantly associated with subsequent diagnosis of hypertension (with ORs ranging from 1.1 to 1.6). Number of lifetime mental disorders was associated with subsequent hypertension in a dose-response fashion. For social phobia and alcohol abuse, associations with hypertension were stronger for males than females. For panic disorder, the association with hypertension was particularly apparent in earlier onset hypertension. Conclusions Depression, anxiety, impulsive eating disorders, and substance use disorders disorders were significantly associated with the subsequent diagnosis of hypertension. These data underscore the importance of early detection of mental disorders, and of physical health monitoring in people with these conditions.. PMID:24342112
Hoerr, Jordan; Fogel, Joshua; Van Voorhees, Benjamin
This paper examines the ecological association of dietary food intake with mental health outcomes on the group level across countries. Published data from the World Mental Health Survey were used to compare lifetime prevalence of four categories of mental health disorders (anxiety disorders, mood disorders, impulse control disorders, and substance use disorders) with a country's fish/seafood and sugar/sweetener supply quantity using the Spearman rank correlation. Data were compared for 17 countries across the world. Sugar and sweetener supply quantity was significantly and positively associated with anxiety disorders (rho=0.75, p=0.001), mood disorders (rho=0.75, p=0.001), impulse control disorders (rho=0.78, p=0.001), and substance use disorders (rho=0.68, p=0.007). Fish and seafood supply quantity had no significant association with any mental health disorders. Mental health disorders represent a significant health problem around the world. Public health measures aimed at improving the quality and availability of a nation's food supply could have a significant positive impact on mental health. Further randomized studies are needed to further validate the study findings.
Joffe, Victoria L.; Nippold, Marilyn A.
Purpose: This prologue introduces a clinical forum on adolescent language disorders, a topic that has long been of interest to school-based speech-language pathologists/therapists. Method: A rationale for the clinical forum is provided, and the content is contrasted with a previous forum on the same topic that was published nearly 20 years ago.…
Based on over a decade of work in the area of PTSD, including a longitudinal study of PTSD among adolescents, Dr. Yule provides an introduction to post-traumatic stress disorder as it occurs in youth. This includes a look at the manifestations of stress reactions, the incidence and prevalence of PTSD, and the relationship between levels of…
Le Heuzey, M-F
There has been an explosion of public interest and concern about children and adolescents who show an interest in changing their gender. And it is an emerging problem for pediatricians, which brings many inquiries about what to do? Both the diagnosis and treatment of gender identity disorder are controversial. But there are a new early treatment using puberty blocking hormones.
Braaten, Sheldon, Ed.; And Others
This book presents 17 papers from a 1982 national multidisciplinary conference on services for behaviorally disordered adolescents. The following papers are included: "Programming for Youth in Secondary Schools and the Community," (W. Van Til); "Who's Crazy? II" (C. Michael Nelson); "Correlates of Successful Adaptive Behavior: Comparative Studies…
Mesgarani, Mohsen; Hosseinbor, Mohsen; Shafiee, Shahla; Sarkoubi, Roghayeh
Background Today, ensuring people’s health and well-being has become a concern for societies. Health status results from an interaction of an individuals’ various psychological, social, and physical aspects. Objectives This study aims to investigate the relationship of parental mental health and dietary pattern with adolescent mental health. Patients and Methods In this study, 250 high school students in Shiraz were selected using random cluster sampling. The samples were analyzed using the Food Frequency Questionnaire (FFQ) and the General Health Questionnaire (GHQ-28). Results According to the findings, parental mental health explains 22% of the variance in children’s mental health, so that in simultaneous regression, physical dimensions, anxiety, social functioning, and depression predicted 13%, 24%, 11%, and 24% of the variance of criterion variables, respectively. No significant relationship was observed between dietary pattern and adolescent mental health dimensions. There was a significant negative relationship only between depression and vegetable intake. Moreover, fruit (r = 0.15, P < 0.05) and vegetable (r = 0.16, P < 0.05) intake had a significant relationship with parental mental health dimensions. Conclusions Parents’ mental health and their psychological characteristics can be related to children’s mental health and affect their dietary intake patterns. PMID:27218068
Martorell, Almudena; Gutierrez-Recacha, Pedro; Irazabal, Marcia; Marsa, Ferran; Garcia, Mercedes
Family impact (or family burden) is a concept born in the field of mental health that has successfully been exported to the ambit of intellectual disability (ID). However, differences in family impact associated with severe mental health disorders (schizophrenia), to ID or to mental health problems in ID should be expected. Seventy-two adults with…
Kelly, Thomas M.; Lynch, Kevin G.; Donovan, John E.; Clark, Duncan B.
Adolescents diagnosed with at least one mental disorder were studied to determine predictors of suicidal ideation and suicide attempts. Major depression was predictive of suicidal ideation and attempts for both genders. Chronic stress was found predictive of male suicidal ideations, while low self esteem and family dysfunction were predictive in…
Bussing, Regina; Meyer, Johanna; Zima, Bonnie T.; Mason, Dana M.; Gary, Faye A.; Garvan, Cynthia Wilson
Objective: This study examines the associations of childhood attention-deficit/hyperactivity disorder (ADHD) risk status with subsequent parental social network characteristics and caregiver strain in adolescence; and examines predictors of adolescent mental health service use. Methods: Baseline ADHD screening identified children at high risk (n = 207) and low risk (n = 167) for ADHD. At eight-year follow-up, parents reported their social network characteristics, caregiver strain, adolescents’ psychopathology and mental health service utilization, whereas adolescents self-reported their emotional status and ADHD stigma perceptions. Analyses were conducted using ANOVAs and nested logistic regression modeling. Results: Parents of youth with childhood ADHD reported support networks consisting of fewer spouses but more healthcare professionals, and lower levels of support than control parents. Caregiver strain increased with adolescent age and psychopathology. Increased parental network support, youth ADHD symptoms, and caregiver strain, but lower youth stigma perceptions were independently associated with increased service use. Conclusions: Raising children with ADHD appears to significantly impact parental social network experiences. Reduced spousal support and overall lower network support levels may contribute to high caregiver strain commonly reported among parents of ADHD youth. Parental social network experiences influence adolescent ADHD service use. With advances in social networking technology, further research is needed to elucidate ways to enhance caregiver support during ADHD care. PMID:26402692
Coyne, I; McNamara, N; Healy, M; Gower, C; Sarkar, M; McNicholas, F
Service user involvement is essential for quality care in the Child and Adolescent Mental Health Services (CAMHS). This study was conducted to explore adolescents' and parents' experiences of CAMHS in relation to accessibility, approachability and appropriateness. This study used a descriptive qualitative design, and focus groups and single interviews were conducted with adolescents (n = 15) and parents (n = 32) from three mental health clinics. Data were analysed using thematic analysis. Accessing mental health services was a challenging experience for many parents and adolescents due to knowledge deficit, lack of information and limited availability of specialist services. Some parents and adolescents reported positive experiences while others reported negative experiences. They expressed a need for more information, involvement in decision making, flexible scheduling of appointments, school support and parent support groups. The nature and quality of the relationship with staff was critical to positive experience with the service; therefore, frequent changes of medical staff was disruptive. Mental health nurses can play a vital role in ensuring continuity, assessing adolescents' participation preferences and advocating for their information needs with other members of the interdisciplinary team.
Rowe, Casey; Spelman, Lynda; Oziemski, Margaret; Ryan, Alexander; Manoharan, Shobhan; Wilson, Perry; Daubney, Michael; Scott, James
Acne is a common condition among adolescents and has the potential to negatively impact on the psychological well-being of those who suffer from it. In particular, depression and suicidal ideation are more common in adolescents with acne. Successful treatment of acne can improve the quality of life and reduce levels of anxiety and depression in these individuals. The current treatment of choice for severe or refractive acne is isotretinoin, a retinoid. While the possible causal association between isotretinoin and mental illness remains a controversial topic, a recent systematic review has presented evidence to support this relationship. In light of this evidence, a group of dermatologists and psychiatrists have collaborated to develop these recommendations to aid the safe prescribing of isotretinoin in adolescents. These clinical suggestions are aimed at practitioners in both disciplines to increase awareness of the current evidence in support of the association between isotretinoin and adolescent depression.
Perry, B D; Azad, I
Millions of children are exposed to traumatic experiences each year. Over 30% of these children develop a clinical syndrome with emotional, behavioral, cognitive, social, and physical symptoms called posttraumatic stress disorder. The symptoms of posttraumatic stress disorder fall into three clusters: reenactment of the traumatic event: avoidance of cues associated with the event or general withdrawal; and physiological hyperreactivity. Significant physical and medical problems in childhood, adolescence, and adulthood appear to be related to childhood trauma. Current treatment approaches include postacute psychoeducation, individual psychotherapy, pharmacotherapy, and cognitive-behavioral therapy. Despite increasing attention over the past 10 years, childhood posttraumatic stress disorder remains an understudied public health problem.
Wermter, Anne-Kathrin; Laucht, Manfred; Schimmelmann, Benno G; Banaschewski, Tobias; Banaschweski, Tobias; Sonuga-Barke, Edmund J S; Rietschel, Marcella; Becker, Katja
It is now generally accepted that complex mental disorders are the results of interplay between genetic and environmental factors. This holds out the prospect that by studying G x E interplay we can explain individual variation in vulnerability and resilience to environmental hazards in the development of mental disorders. Furthermore studying G x E findings may give insights in neurobiological mechanisms of psychiatric disorder and so improve individualized treatment and potentially prevention. In this paper, we provide an overview of the state of field with regard to G x E in mental disorders. Strategies for G x E research are introduced. G x E findings from selected mental disorders with onset in childhood or adolescence are reviewed [such as depressive disorders, attention-deficit/hyperactivity disorder (ADHD), obesity, schizophrenia and substance use disorders]. Early seminal studies provided evidence for G x E in the pathogenesis of depression implicating 5-HTTLPR, and conduct problems implicating MAOA. Since then G x E effects have been seen across a wide range of mental disorders (e.g., ADHD, anxiety, schizophrenia, substance abuse disorder) implicating a wide range of measured genes and measured environments (e.g., pre-, peri- and postnatal influences of both a physical and a social nature). To date few of these G x E effects have been sufficiently replicated. Indeed meta-analyses have raised doubts about the robustness of even the most well studied findings. In future we need larger, sufficiently powered studies that include a detailed and sophisticated characterization of both phenotype and the environmental risk.
Foley, Kimberly P; Haggerty, Treah S; Harrison, Natasha
Family physicians provide care for about one-third of the children and adolescents in the United States, many of whom present with psychological concerns. Family physicians often do not recognize these psychological disorders and therefore do not diagnose or treat them. This report describes the implementation of a curriculum designed to increase family medicine trainees' level of awareness that children/adolescents experience psychiatric conditions. This goal is achieved through the addition of a clinical child/adolescent psychologist faculty member, resident self-assessment of training needs and subsequent development of didactic presentations to address these needs. The curriculum relies on the acquisition of child/adolescent psychiatric screeners, development of child/adolescent-focused bibliotherapy materials, and the development of a longitudinal behavioral sciences curriculum. To facilitate the screening of child/adolescent psychiatric disorders, a comprehensive collection of age-appropriate psychiatric screeners were compiled and made readily available in all precepting areas. To assist with the identification of specific child/adolescent psychiatric deficit areas, family medicine resident physicians were presented with an inventory of child/adolescent psychiatric, psychosocial, and behavioral topics, based upon American Academy of Family Practice guidelines and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition psychiatric disorders, and self-selected training deficiencies.
Williams, Joah L; Rheingold, Alyssa A; Knowlton, Alice W; Saunders, Benjamin E; Kilpatrick, Dean G
Motor vehicle crashes (MVCs) are a leading cause of physical injuries and mortality among children and adolescents in the United States. The purpose of this study was to examine associations between having an MVC and mental health outcomes, including posttraumatic stress disorder (PTSD), depression, and drug and alcohol misuse in a nationally representative sample of adolescents. A sample of 3,604 adolescents, aged 12-17 years, was assessed as part of the 2005 National Survey of Adolescents-Replication (NSA-R) study. Data were weighted according to the 2005 U.S. Census estimates. Within this sample, 10.2% of adolescents reported having at least 1 serious MVC. The prevalence of current PTSD and depression among adolescents having an MVC was 7.4% and 11.2%, respectively. Analyses revealed that an MVC among adolescents aged 15 years and younger was independently associated with depression (OR = 2.17) and alcohol abuse (OR = 2.36) after adjusting for other risk factors, including a history of interpersonal violence. Among adolescents aged 16 years and older, an MVC was associated only with alcohol abuse (OR = 2.08). This study was the first attempt to explore adverse mental health outcomes associated with MVCs beyond traumatic stress symptoms among adolescents in a nationally representative sample.
Paula, Cristiane S.; Bordin, Isabel A. S.; Mari, Jair Jesus; Velasque, Luciane; Rohde, Luis A.; Coutinho, Evandro S. F.
Introduction Worldwide, a minority of disordered children/adolescents receives mental health assistance. In order to improve service access, it is important to investigate factors that influence the process leading to receiving care. Data on frequency and barriers for mental health service use (MHSU) among Brazilian children/adolescents are extremely scarce and are needed to guide public policy. Objectives To establish the frequency of MHSU among 6-to-16-year-old with psychiatric disorders from four Brazilian regions; and to identify structural/psychosocial/demographic barriers associated with child/adolescent MHSU. Methods Multicenter cross-sectional-study involving four towns from four out of five Brazilian regions. In each town, a representative sample of elementary public school students was randomly selected (sample: 1,721). Child/adolescent MHSU was defined as being seen by a psychologist/psychiatrist/neurologist in the previous 12 months. Standardized instruments measured: (1) children/adolescent characteristics [(1.1) Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS-PL)-psychiatric disorders; (1.2) Ten Questions Screen-neurodevelopment problems; (1.3) two subtests of WISC-III-estimated IQ; (1.4) Academic Performance Test-school performance)], (2) factors related to mothers/main caregivers (Self-Reporting Questionnaire-anxiety/depression), (3) family (Brazilian Research-Companies-Association's Questionnaire-SES). Results Only 19.8% of children/adolescents with psychiatric disorder have used mental health services in the previous 12 months. Multiple logistic regression modeling identified five factors associated with lower rates of MHSU (female gender, adequate school performance, mother/main caregiver living with a partner, lower SES, residing in deprived Brazilian regions) regardless of the presence of any psychiatric disorders/neurodevelopmental problems. Conclusions Only a small proportion of children/adolescents with
Patel, Vikram; Kleinman, Arthur
A review of English-language journals published since 1990 and three global mental health reports identified 11 community studies on the association between poverty and common mental disorders in six low- and middle-income countries. Most studies showed an association between indicators of poverty and the risk of mental disorders, the most consistent association being with low levels of education. A review of articles exploring the mechanism of the relationship suggested weak evidence to support a specific association with income levels. Factors such as the experience of insecurity and hopelessness, rapid social change and the risks of violence and physical ill-health may explain the greater vulnerability of the poor to common mental disorders. The direct and indirect costs of mental ill-health worsen the economic condition, setting up a vicious cycle of poverty and mental disorder. Common mental disorders need to be placed alongside other diseases associated with poverty by policy-makers and donors. Programmes such as investment in education and provision of microcredit may have unanticipated benefits in reducing the risk of mental disorders. Secondary prevention must focus on strengthening the ability of primary care services to provide effective treatment. PMID:14576893
Fairchild, Graeme; Hagan, Cindy C.; Walsh, Nicholas D.; Passamonti, Luca; Calder, Andrew J.; Goodyer, Ian M.
Background: Conduct disorder (CD) in female adolescents is associated with a range of negative outcomes, including teenage pregnancy and antisocial personality disorder. Although recent studies have documented changes in brain structure and function in male adolescents with CD, there have been no neuroimaging studies of female adolescents with CD.…
Georgiades, Katholiki; Lewinsohn, Peter M.; Monroe, Scott M.; Seeley, John R.
Objective: To examine the longitudinal association between individual subthreshold symptoms and onset of major depressive disorder (MDD) in adolescence. Method: Data for analysis come from the Oregon Adolescent Depression Project, a prospective epidemiological study of psychological disorders among adolescents, ages 14 to 18 years, from the…
Research related to identification of delinquents, causes of delinquency, and effective intervention to stop delinquency is reviewed in this paper. In summary, the review indicates that adolescent problems appear to be concentrated among those disadvantaged in a variety of ways. Further, the reviewed literature indicates that biases in the justice…
Shomaker, Lauren B; Furman, Wyndol
Perceived socio-cultural pressure to be thin has an important impact on disordered eating during early and middle adolescence, but less is known about late adolescence. Most prospective studies included only girls, and less is known about the influence on boys. This study investigated interpersonal influences on changes in late adolescent boys' and girls' symptoms of disordered eating over one year. Participants were a community sample of late adolescents 16-19 years of age (N=199; 49.75% girls), their mothers, and friends. Structural equation modeling revealed that interpersonal pressure to be thin and criticism about appearance predicted increases in disordered eating over time. Late adolescents', mothers' and friends' reports of pressure were associated with disordered eating at Time 1 and Time 2. Further, adolescents' perceptions and friends' reports of pressure to be thin predicted changes in disordered eating over time. Findings underscore the significance of interpersonal relationships for disordered eating during late adolescence in both girls and boys.
Thupayagale-Tshweneagae, G; Mokomane, Z
The purpose of this paper is to raise an argument that inclusiveness will lessen the pain of losing a parent among adolescents orphaned by AIDS and as a result, prevent future mental health problems that may occur because of inappropriate grieving and maladaptive coping strategies. Participation of adolescents orphaned by AIDS in decisions pertaining to their parents' illnesses and funeral arrangements, for example, may shorten the grieving process and allow for closure. The paper draws data from focus group discussions that were held with 15 adolescents orphaned by AIDS in urban South Africa. The focus group discussions that were structured around four themes: grieving patterns; coping strategies; experience with loss; and expectations. The results of the study demonstrate inclusiveness as an overarching factor in the healing process. The concept is thus a strong recommendation for mental health practice and further study.
Washburn, Jason J.; Romero, Erin Gregory; Welty, Leah J.; Abram, Karen M.; Teplin, Linda A.; McClelland, Gary M.; Paskar, Leah D.
Antisocial personality disorder (APD) is a serious public and mental health concern. Understanding how well conduct disorder (CD) and other mental disorders predict the development of APD among youths involved in the juvenile justice system is critical for prevention. The authors used a stratified random sample of 1,112 detained youths to examine…
Rossouw, Trudie I.; Fonagy, Peter
Objective: We examined whether mentalization-based treatment for adolescents (MBT-A) is more effective than treatment as usual (TAU) for adolescents who self-harm. Method: A total of 80 adolescents (85% female) consecutively presenting to mental health services with self-harm and comorbid depression were randomly allocated to either MBT-A or TAU.…
Due to several socio-political factors, to many psychiatrists only a strictly objective definition of mental disorder, free of value components, seems really acceptable. In this paper, I will explore a variant of such an objectivist approach to defining metal disorder, natural function objectivism. Proponents of this approach make recourse to the notion of natural function in order to reach a value-free definition of mental disorder. The exploration of Christopher Boorse's 'biostatistical' account of natural function (1) will be followed an investigation of the 'hybrid naturalism' approach to natural functions by Jerome Wakefield (2). In the third part, I will explore two proposals that call into question the whole attempt to define mental disorder (3). I will conclude that while 'natural function objectivism' accounts fail to provide the backdrop for a reliable definition of mental disorder, there is no compelling reason to conclude that a definition cannot be achieved. PMID:21255405
Due to several socio-political factors, to many psychiatrists only a strictly objective definition of mental disorder, free of value components, seems really acceptable. In this paper, I will explore a variant of such an objectivist approach to defining metal disorder, natural function objectivism. Proponents of this approach make recourse to the notion of natural function in order to reach a value-free definition of mental disorder. The exploration of Christopher Boorse's 'biostatistical' account of natural function (1) will be followed an investigation of the 'hybrid naturalism' approach to natural functions by Jerome Wakefield (2). In the third part, I will explore two proposals that call into question the whole attempt to define mental disorder (3). I will conclude that while 'natural function objectivism' accounts fail to provide the backdrop for a reliable definition of mental disorder, there is no compelling reason to conclude that a definition cannot be achieved.
Barrett, Barbara; Mosweu, Iris; Jones, Catherine Rg; Charman, Tony; Baird, Gillian; Simonoff, Emily; Pickles, Andrew; Happé, Francesca; Byford, Sarah
Autism spectrum disorder is a complex condition that requires specialised care. Knowledge of the costs of autism spectrum disorder, especially in comparison with other conditions, may be useful to galvanise policymakers and leverage investment in education and intervention to mitigate aspects of autism spectrum disorder that negatively impact individuals with the disorder and their families. This article describes the services and associated costs for four groups of individuals: adolescents with autistic disorder, adolescents with other autism spectrum disorders, adolescents with other special educational needs and typically developing adolescents using data from a large, well-characterised cohort assessed as part of the UK Special Needs and Autism Project at the age of 12 years. Average total costs per participant over 6 months were highest in the autistic disorder group (£11,029), followed by the special educational needs group (£9268), the broader autism spectrum disorder group (£8968) and the typically developing group (£2954). Specialised day or residential schooling accounted for the vast majority of costs. In regression analysis, lower age and lower adaptive functioning were associated with higher costs in the groups with an autism spectrum disorder. Sex, ethnicity, number of International Classification of Diseases (10th revision) symptoms, autism spectrum disorder symptom scores and levels of mental health difficulties were not associated with cost.
Qu, Yuan; Jiang, Hongyun; Zhang, Ni; Wang, Dahai; Guo, Lanting
To investigate the point prevalence of mental disorders in school students, multistage cluster stratified random sampling and two-phase survey methods were used to identify 40 primary and middle schools. The students were screened using the Chinese version of the Child Behavior Checklist and diagnosed using the Mini International Neuropsychiatric Interview. The prevalence of behavioral problems was 19.13%. The prevalence of behavioral problems significantly differed by sex, age, city of residence, and caretaker. The six-month prevalence of any mental disorder was 15.24% (95% CI: 15.49%–16.97%). Psychiatric disorders were more prevalent in boys (17.33%) relative to girls (13.11%; p < 0.01). The prevalence of mental disorders significantly differed by community and caretaker, and 36.46% of students exhibited comorbidity. Results demonstrated important mental health issues, with a high incidence of comorbidities, in this population. Students’ mental health requires increased attention, particularly in poverty-stricken areas and left-behind children and adolescents. PMID:25985310
Qu, Yuan; Jiang, Hongyun; Zhang, Ni; Wang, Dahai; Guo, Lanting
To investigate the point prevalence of mental disorders in school students, multistage cluster stratified random sampling and two-phase survey methods were used to identify 40 primary and middle schools. The students were screened using the Chinese version of the Child Behavior Checklist and diagnosed using the Mini International Neuropsychiatric Interview. The prevalence of behavioral problems was 19.13%. The prevalence of behavioral problems significantly differed by sex, age, city of residence, and caretaker. The six-month prevalence of any mental disorder was 15.24% (95% CI: 15.49%-16.97%). Psychiatric disorders were more prevalent in boys (17.33%) relative to girls (13.11%; p < 0.01). The prevalence of mental disorders significantly differed by community and caretaker, and 36.46% of students exhibited comorbidity. Results demonstrated important mental health issues, with a high incidence of comorbidities, in this population. Students' mental health requires increased attention, particularly in poverty-stricken areas and left-behind children and adolescents.
Cronin, Kathleen A.; Cuvo, Anthony J.
A task analysis model for analyzing and teaching community living skills to the mentally handicapped was developed and validated with five moderately retarded youths (ages 17 to 20 years) who were taught mending skills (sewing hems, buttons, and seams). (Author/DLS)
Alberta Learning, Edmonton.
This resource manual is designed to assist Alberta teachers in the identification and education of students with emotional disorders and/or mental illnesses. It takes a comprehensive look at six emotional disorders. The first section focuses on eating disorders. It describes the characteristics and symptoms of anorexia nervosa, bulimia nervosa,…
Davies, Jane; Lowes, Lesley
Against the backdrop of involving children and families in their own care and the clear need to protect their interest, this article will consider care within child and adolescent mental health services (CAMHS). Following a brief overview of the incidence and prevalence of mental health problems, the development and organization of CAMHS will be explored, giving consideration to some of the literature that discusses the effectiveness of services. A review of the literature revealed that, while there is some evidence of how children feel about the services they receive, there is not currently a significant amount of literature available. Nevertheless, these views are of value in relation to the development of service provision.
Background “Mental health for everyone” is a school program for mental health literacy and prevention aimed at secondary schools (13–15 yrs). The main aim was to investigate whether mental health literacy, could be improved by a 3-days universal education programme by: a) improving naming of symptom profiles of mental disorder, b) reducing prejudiced beliefs, and c) improving knowledge about where to seek help for mental health problems. A secondary aim was to investigate whether adolescent sex and age influenced the above mentioned variables. A third aim was to investigate whether prejudiced beliefs influenced knowledge about available help. Method This non-randomized cluster controlled trial included 1070 adolescents (53.9% boys, M age14 yrs) from three schools in a Norwegian town. One school (n = 520) received the intervention, and two schools (n = 550) formed the control group. Pre-test and follow-up were three months apart. Linear mixed models and generalized estimating equations models were employed for analysis. Results Mental health literacy improved contingent on the intervention, and there was a shift towards suggesting primary health care as a place to seek help. Those with more prejudiced beleifs did not suggest places to seek help for mental health problems. Generally, girls and older adolescents recognized symptom profiles better and had lower levels of prejudiced beliefs. Conclusions A low cost general school program may improve mental health literacy in adolescents. Gender specific programs and attention to the age and maturity of the students should be considered when mental health literacy programmes are designed and tried out. Prejudice should be addressed before imparting information about mental health issues. PMID:24053381
Legha, Rupinder K; Solages, Martine
This article presents an overview of child and adolescent mental health in Haiti, emphasizing the role of structural violence and the factors shaping child protection. The 2010 Haiti earthquake is discussed as an acute on chronic event that highlighted the lack of pre-existing formal biomedical mental health services and worsened the impact of structural violence. Considerations for long-term, sustainable, culturally relevant child and adolescent mental health care in Haiti are also provided.
Kelly, Claire M; Jorm, Anthony F; Wright, Annemarie
Good mental health literacy in young people and their key helpers may lead to better outcomes for those with mental disorders, either by facilitating early help-seeking by young people themselves, or by helping adults to identify early signs of mental disorders and seek help on their behalf. Few interventions to improve mental health literacy of young people and their helpers have been evaluated, and even fewer have been well evaluated. There are four categories of interventions to improve mental health literacy: whole-of-community campaigns; community campaigns aimed at a youth audience; school-based interventions teaching help-seeking skills, mental health literacy, or resilience; and programs training individuals to better intervene in a mental health crisis. The effectiveness of future interventions could be enhanced by using specific health promotion models to guide their development.
Hotchkiss, Brian L; Engels, James A; Forness, Michael
This article deals with common hip problems in the adolescent age group. Some of these problems, such as slipped capital femoral epiphysis, require urgent surgical treatment. Early detection is essential. Other problems, such as many of the athletic injuries, are less urgent but important to patients who desire rapid return to full athletic capacity. The emphasis here is on understanding the conditions and diagnosis. Surgical options are mentioned but not detailed. Office management, where appropriate, is discussed against the background of the natural history of the conditions. The intended audience is primary care physicians and orthopedic surgeons who may have limited exposure to some of these conditions.
Chung, Tammy; Martin, Christoper S.
This study examined the latent class structure of Diagnostic and Statistical Manual of Mental Disorders (text rev.; DSM-IV; American Psychiatric Association, 2000) symptoms used to diagnose cannabis, hallucinogen, cocaine, and opiate disorders among 501 adolescents recruited from addictions treatment. Latent class results were compared with the…
Hardan, Antonio; Sahl, Robert
A study of 233 children with developmental disorders and mental illness found that the most common psychiatric diagnoses were oppositional defiant disorder and attention deficit hyperactivity disorder. Pica, organic mental disorder, and autism were more often encountered in low functioning individuals, while depressive and speech/language…
Sar, Vedat; Onder, Canan; Kilincaslan, Ayse; Zoroglu, Süleyman S; Alyanak, Behiye
The aim of this study was to determine the prevalence of dissociative identity disorder (DID) and other dissociative disorders among adolescent psychiatric outpatients. A total of 116 consecutive outpatients between 11 and 17 years of age who were admitted to the child and adolescent psychiatry clinic of a university hospital for the 1st time were evaluated using the Adolescent Dissociative Experiences Scale, adolescent version of the Child Symptom Inventory-4, Childhood Trauma Questionnaire, and McMaster Family Assessment Device. All patients were invited for an interview with the Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D) administered by 2 senior psychiatrists in a blind fashion. There was excellent interrater reliability between the 2 clinicians on SCID-D diagnoses and scores. Among 73 participants, 33 (45.2%) had a dissociative disorder: 12 (16.4%) had DID, and 21 (28.8%) had dissociative disorder not otherwise specified. There was no difference in gender distribution, childhood trauma, or family dysfunction scores between the dissociative and nondissociative groups. Childhood emotional abuse and family dysfunction correlated with self-reported dissociation. Of the dissociative adolescents, 93.9% had an additional psychiatric disorder. Among them, only separation anxiety disorder was significantly more prevalent than in controls. Although originally designed for adults, the SCID-D is promising for diagnosing dissociative disorders in adolescents, its modest congruence with self-rated dissociation and lack of relationship between diagnosis and childhood trauma and family dysfunction suggest that the prevalence rates obtained with this instrument originally designed for adults must be replicated. The introduction of diagnostic criteria for adolescent DID in revised versions of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, would refine the assessment of dissociative disorders in this age group.
Bingham, Rachel; Banner, Natalie
Extensive and diverse conceptual work towards developing a definition of 'mental disorder' was motivated by the declassification of homosexuality from the Diagnostic and Statistical Manual in 1973. This highly politicised event was understood as a call for psychiatry to provide assurances against further misclassification on the basis of discrimination or socio-political deviance. Today, if a definition of mental disorder fails to exclude homosexuality, then it fails to provide this safeguard against potential abuses and therefore fails to do an important part of the work it was intended to do. We argue that fact-based definitions of mental disorder, relying on scientific theory, fail to offer a robust definition of mental disorder that excludes homosexuality. Definitions of mental disorder based on values do not fare better: these definitions are silent on questions about the diagnostic status of individuals in oppressive societies and over-inclusive of mental or behavioural states that happen to be negatively valued in the individual's social context. We consider the latest definition proposed for the Diagnostic and Statistical Manual-5 (DSM-5) in light of these observations. We argue that definition fails to improve on these earlier deficiencies. Its inclusion in the manual may offer false reassurance against repetition of past misclassifications. We conclude with a provocation that if candidate definitions of mental disorder are unable to exclude homosexuality, it might perhaps be preferable not to attempt a definition at all.
Chavez, Ligia; Mir, Karen; Canino, Glorisa
This article documents the initial development of a Spanish mental health quality of life (QOL) instrument based on the adolescents’ own assessment of important domains to their QOL. Using a grounded theory approach, we targeted five mental health disorders: Attention Deficit Hyperactivity Disorder (ADHD), Conduct Disorder (CD), Oppositional Defiant Disorder (ODD), Generalized Anxiety Disorder (GAD) and Major Depressive Disorder (MDD). In-depth interviews (n=40) and three focus groups (n=20) were conducted and analyzed using qualitative methods to guide the development of items. A convenient sample of island Puerto Rican adolescents aged 12–18 was recruited from outpatient mental health clinics. Qualitative analysis revealed a total of 87 themes. They were distributed based on core QOL domains such as (1) Self (2) Peers, (3) Family (4) School, and (5) Environment. Items were written based on prevailing themes and using as closely as possible, words and phrases used by the adolescents to describe their views and perceptions of quality of life. The goal for the AQOL-MHS is to pinpoint specific areas of health related QOL for each psychiatric diagnostic group that will provide valuable information to assist both patients and providers set, define and evaluate adequate mental health treatment goals. PMID:22528055
Vernberg, Eric M; Hambrick, Erin P; Cho, Bridget; Hendrickson, Michelle L
Positive psychology concepts and principles can be incorporated into preparedness, crisis response, and recovery phases of disaster mental health efforts to address the needs of children, adolescents, and families. This article articulates general developmental considerations for applying positive psychology in disaster mental health contexts and discusses how 5 essential elements of immediate and midterm mass trauma intervention identified by Hobfoll et al. (2007) may be infused in applications of positive psychology for children and adolescents. Specific strategies for working with children, adolescents, and their families in home, community, and school contexts are drawn in part from disaster mental health resources developed jointly by the National Child Traumatic Stress Network and National Center for Posttraumatic Stress Disorder, including the Psychological First Aid Field Operations Guide (Brymer et al., 2006), the Skills for Psychological Recovery Field Operations Guide (Berkowitz et al., 2010), and the Psychological First Aid for Schools Field Operations Manual (Brymer et al., 2012). Two case examples illustrate the use of positive psychology principles.
Hunter, Simon C.; Houghton, Stephen; Wood, Lisa
While there is increasing recognition of the need to go beyond measures of mental ill health, there is a relative dearth of validated tools for assessing mental well-being among adolescents. The Warwick-Edinburgh Mental Well-being Scale (WEMWBS) is a promising tool for use in this context, and this study evaluated its use in an Australian context.…
Escobar, María E; Pipman, Viviana; Arcari, Andrea; Boulgourdjian, Elisabeth; Keselman, Ana; Pasqualini, Titania; Alonso, Guillermo; Blanco, Miguel
The high prevalence of menstrual disorders during the first years after menarche is well recognized. This is usually a cause of concern for parents and patients, and a common reason for visiting the pediatrician. The immaturity of the hypothalamic-pituitary-ovarian axis is the major cause of these disorders, but there are also some general organic or emotional conditions that may alter the menstrual cycle, which is a sensitive indicator of health. Physiology of the menstrual cycle, its alterations, etiology, assessment, diagnosis and treatment are reviewed in this article.
Scott, Kate M.; Lim, Carmen; Al-Hamzawi, Ali; Alonso, Jordi; Bruffaerts, Ronny; Caldas-de-Almeida, José Miguel; Florescu, Silvia; de Girolamo, Giovanni; Hu, Chiyi; de Jonge, Peter; Kawakami, Norito; Medina-Mora, Maria Elena; Moskalewicz, Jacek; Navarro-Mateu, Fernando; O’Neill, Siobhan; Piazza, Marina; Posada-Villa, José; Torres, Yolanda; Kessler, Ronald C.
IMPORTANCE It is clear that mental disorders in treatment settings are associated with a higher incidence of chronic physical conditions, but whether this is true of mental disorders in the community, and how generalized (across a range of physical health outcomes) these associations are, is less clear. This information has important implications for mental health care and the primary prevention of chronic physical disease. OBJECTIVE To investigate associations of 16 temporally prior DSM-IV mental disorders with the subsequent onset or diagnosis of 10 chronic physical conditions. DESIGN, SETTING, AND PARTICIPANTS Eighteen face-to-face, cross-sectional household surveys of community-dwelling adults were conducted in 17 countries (47 609 individuals; 2 032 942 person-years) from January 1, 2001, to December 31, 2011. The Composite International Diagnostic Interview was used to retrospectively assess the lifetime prevalence and age at onset of DSM-IV–identified mental disorders. Data analysis was performed from January 3, 2012, to September 30, 2015. MAIN OUTCOMES AND MEASURES Lifetime history of physical conditions was ascertained via self-report of physician’s diagnosis and year of onset or diagnosis. Survival analyses estimated the associations of temporally prior first onset of mental disorders with subsequent onset or diagnosis of physical conditions. RESULTS Most associations between 16 mental disorders and subsequent onset or diagnosis of 10 physical conditions were statistically significant, with odds ratios (ORs) (95% CIs) ranging from 1.2 (1.0–1.5) to 3.6 (2.0–6.6). The associations were attenuated after adjustment for mental disorder comorbidity, but mood, anxiety, substance use, and impulse control disorders remained significantly associated with onset of between 7 and all 10 of the physical conditions (ORs [95% CIs] from 1.2 [1.1–1.3] to 2.0 [1.4–2.8]). An increasing number of mental disorders experienced over the life course was significantly
Kaslow, Nadine J.; Broth, Michelle Robbins; Smith, Chaundrissa Oyeshiku; Collins, Marietta H.
Emotional and behavioral symptoms and disorders are prevalent in children and adolescents. There has been a burgeoning literature supporting evidence-based treatments for these disorders. Increasingly, family-based interventions have been gaining prominence and demonstrating effectiveness for myriad childhood and adolescent disorders. This article…
Background To date, no studies have assessed in detail the characteristics, organisation, and functioning of Child and Adolescent Mental Health Services (CAMHS). This information gap represents a major limitation for researchers and clinicians because most mental disorders have their onset in childhood or adolescence, and effective interventions can therefore represent a major factor in avoiding chronicity. Interventions and mental health care are delivered by and through services, and not by individual, private clinicians, and drawbacks or limitations of services generally translate in inappropriateness and ineffectiveness of treatments and interventions: therefore information about services is essential to improve the quality of care and ultimately the course and outcome of mental disorders in childhood and adolescence. The present paper reports the results of the first study aimed at providing detailed, updated and comprehensive data on CAMHS of a densely populated Italian region (over 4 million inhabitants) with a target population of 633,725 subjects aged 0-17 years. Methods Unit Chiefs of all the CAMHS filled in a structured 'Facility Form', with activity data referring to 2008 (data for inpatient facilities referred to 2009), which were then analysed in detail. Results Eleven CAMHS were operative, including 110 outpatient units, with a ratio of approximately 20 child psychiatrists and 23 psychologists per 100,000 inhabitants aged 0-17 years. All outpatient units were well equipped and organized and all granted free service access. In 2008, approximately 6% of the target population was in contact with outpatient CAMHS, showing substantial homogeneity across the eleven areas thereby. Most patients in contact in 2008 received a language disorder- or learning disability diagnosis (41%). First-ever contacts accounted for 30% of annual visits across all units. Hospital bed availability was 5 per 100,000 inhabitants aged 0-17 years. Conclusion The percentage of
Lambert, M; Bock, T; Naber, D; Löwe, B; Schulte-Markwort, M; Schäfer, I; Gumz, A; Degkwitz, P; Schulte, B; König, H H; Konnopka, A; Bauer, M; Bechdolf, A; Correll, C; Juckel, G; Klosterkötter, J; Leopold, K; Pfennig, A; Karow, A
Numerous birth-control studies, epidemiological studies, and observational studies have investigated mental health and health care in childhood, adolescence and early adulthood, including prevalence, age at onset, adversities, illness persistence, service use, treatment delay and course of illness. Moreover, the impact of the burden of illness, of deficits of present health care systems, and the efficacy and effectiveness of early intervention services on mental health were evaluated. According to these data, most mental disorders start during childhood, adolescence and early adulthood. Many children, adolescents and young adults are exposed to single or multiple adversities, which increase the risk for (early) manifestations of mental diseases as well as for their chronicity. Early-onset mental disorders often persist into adulthood. Service use by children, adolescents and young adults is low, even lower than for adult patients. Moreover, there is often a long delay between onset of illness and first adequate treatment with a variety of linked consequences for a poorer psychosocial prognosis. This leads to a large burden of illness with respect to disability and costs. As a consequence several countries have implemented so-called "early intervention services" at the interface of child and adolescent and adult psychiatry. Emerging studies show that these health-care structures are effective and efficient. Part 1 of the present review summarises the current state of mental health in childhood, adolescence and early adulthood, including prevalence, age at onset, adversities, illness persistence, service use, and treatment delay with consequences.
Recommendations of British reports on education for mentally disordered prisoners include (1) financial flexibility to purchase educational services; (2) core teams of teachers, social service providers, and solicitors; and (3) 1 full-time teacher for every 15 offenders. (SK)
Crawford, Devan M.
This study reports on the effects maternal prenatal binge drinking, cigarette smoking, drug use, and pregnancy and birth complications on meeting criteria for psychiatric disorders at ages 10–12 and 13–15 years among 546 Indigenous adolescents from a single culture in the northern Midwest and Canada. Adolescent DSM-IV psychiatric disorders were assessed with the Diagnostic Interview Schedule for Children-Revised (DISC-R). Results indicate that maternal behaviors when pregnant have significant effects on adolescent psychiatric disorders even when controlling for age and gender of adolescent, family per capita income, living in a single mother household, and adolescent reports of mother’s positive parenting. PMID:18998209
Petersen, Jennifer L; Hyde, Janet S
Peer sexual harassment is a pervasive problem in schools and is associated with a variety of negative mental health outcomes. Objectification theory suggests that sexual attention in the form of peer harassment directs unwanted attention to the victim's body and may lead to a desire to alter the body via disordered eating. In the current study, we used latent growth modeling with a sample of 406 U.S. adolescents to examine the relationship between longitudinal trends in peer sexual harassment from 5th to 9th grade and disordered eating in 9th grade. Longitudinal trends in self-surveillance were proposed as a mediator of the relationships. Results indicated that the relationship between upsetting sexual harassment at 5th grade and disordered eating symptoms at 9th grade was mediated by self-surveillance at 5th grade. Girls reported more upsetting sexual harassment, more self-surveillance, and thus more disordered eating than boys did. These results are in accord with objectification theory, which proposes that sexual harassment is a form of sexual objectification and may lead to self-surveillance and disordered eating.
Obstfeld, Lisa S.; Meyers, Andrew W.
This article addresses the issue of adolescent sex education as a means of preventing sexuality-related disorders, including: sexual dysfunction; sexual deviance; physical health problems often contracted from sexual activity; and various psychological and sociological ill effects resulting from unplanned pregnancies. (Author/CJB)
The review presents a research perspective that defines mentalizing functions as a very promising topic to bridge psychopathology and neurobiological foundations of mental disorders. However, the high diversity of existing observations in mentalizing research calls for a structured assessment of functional mentalizing subdomains. A notable problem is the overlap of functional systems involved in mentalizing and emotion processing. A proposed solution is to conceptualize mentalizing functions due to their content (visuospatial vs. emotional) perspective and substrates (cognitive or explicit signals). This conceptual organization is mirrored in functional imaging experiments dissociating anteromedial and posterolateral brain regions, especially the involvement of the medial prefrontal cortex in mentalizing emotions and the temporoparietal cortex in visuospatial perspective taking. The present state and perspectives of mentalizing research are demonstrated in two major fields of mental disorders, depression and schizophrenia. In depression the existent contradictory findings demand a control of cognitive impairments, which are frequently associated with depressive disorders. In schizophrenia there is already consistent evidence that defines mentalizing functions as promising endophenotype, which can possibly link psychopathology to its neurobiological foundations.
Mukolo, Abraham; Heflinger, Craig Anne; Wallston, Kenneth A.
Objective: To describe the state of the literature on stigma associated with children's mental disorders and highlight gaps in empirical work. Method: We reviewed child mental illness stigma articles in (English only) peer-reviewed journals available through Medline and PsychInfo. We augmented these with adult-oriented stigma articles that focus…
Abate, Anna; Marshall, Kaisa; Sharp, Carla; Venta, Amanda
High rates of posttraumatic stress disorder (PTSD) symptoms and elevated levels of aggression are common among youth in inpatient psychiatric settings. Several models link trauma exposure to aggression through anomalous mental state reasoning. Some theoretical frameworks linking trauma to aggression specify that the over-attribution of hostile mental states contributes to the development of aggressive behavior whereas other theories suggest that an inhibition of mental state reasoning leads to aggressive behavior. Using a sample of inpatient adolescents, the current study examined relations between PTSD symptoms and four forms of aggression, exploring the role of both over- and under-mentalizing (i.e., hypo- and hypermentalizing) as mediators and gender as a moderator. The results suggest that hypermentalizing, but not hypomentalizing, mediates the relation between trauma and aggression, extending prior research related to inpatient adolescents for the first time. Evidence of moderated mediation was noted, such that this mediational relation was evident for females but not males. The current study offers support for differential underlying causes of aggression among males and females with PTSD symptoms.
Wong, Y Joel; Rew, Lynn; Slaikeu, Kristina D
There is accumulating evidence that religiosity/spirituality (R/S) are important correlates of mental health in adult populations. However, the associations between R/S and mental heath in adolescent populations have not been systematically studied. The purpose of this article is to report on a systematic review of recent research on the relationships between adolescent R/S and mental health. Twenty articles between 1998 and 2004 were reviewed. Most studies (90%) showed that higher levels of R/S were associated with better mental health in adolescents. Institutional and existential dimensions of R/S had the most robust relationships with mental health. The relationships between R/S and mental health were generally stronger or more unique for males and older adolescents than for females and younger adolescents. Recommendations for future research and implications for mental health nursing are discussed.
Stewart, Angela J.; Theodore-Oklota, Christina; Hadley, Wendy; Brown, Larry K.
Objective This study explored whether adolescents with elevated symptoms of mania (ESM+) engage in more HIV risk behaviors than those with other psychiatric disorders and examined factors associated with HIV risk behavior among ESM+ adolescents. Method Eight hundred and forty adolescents (56% female, 58% African American, mean age 14.9 years) who received mental health treatment completed private, computer-based assessments of psychiatric disorders, sexual and substance use behaviors, and provided urine to screen for sexually transmitted infections (STI). Results Eighty-seven percent met criteria for a psychiatric disorder and among these youth 21% were considered ESM+. Compared to those with other psychiatric disorders, ESM+ were more likely to be sexually active (61.6% vs. 53.6%), have multiple sexual partners (58.6% vs. 37.5%), have unprotected sex (38.4% vs. 28.0%), exchange sex for money (4.7% vs. 1.2%) and to test positive for an STI (14.0% vs. 6.3%). Among ESM+ youth, sexual risk behaviors were primarily associated with individual factors (e.g., self-efficacy, impulsivity, and substance use) and varied depending on the type of sexual behavior (e.g., onset of sex, number of partners, and condom use). Conclusions Adolescents with ESM should be regularly screened for sexual risk behaviors and receive HIV prevention skills. Efforts to increase self-efficacy for safer sex, reduce impulsivity, and decrease substance use may be effective targets for sexual risk reduction among adolescents with ESM. PMID:22540428
Wittchen, Hans-Ulrich; Knappe, Susanne; Andersson, Gerhard; Araya, Ricardo; Banos Rivera, Rosa M; Barkham, Michael; Bech, Per; Beckers, Tom; Berger, Thomas; Berking, Matthias; Berrocal, Carmen; Botella, Christina; Carlbring, Per; Chouinard, Guy; Colom, Francesc; Csillag, Claudio; Cujipers, Pim; David, Daniel; Emmelkamp, Paul M G; Essau, Cecilia A; Fava, Giovanni A; Goschke, Thomas; Hermans, Dirk; Hofmann, Stefan G; Lutz, Wolfgang; Muris, Peter; Ollendick, Thomas H; Raes, Filip; Rief, Winfried; Riper, Heleen; Tossani, Eliana; van der Oord, Saskia; Vervliet, Bram; Haro, Josep M; Schumann, Gunter
Psychology as a science offers an enormous diversity of theories, principles, and methodological approaches to understand mental health, abnormal functions and behaviours and mental disorders. A selected overview of the scope, current topics as well as strength and gaps in Psychological Science may help to depict the advances needed to inform future research agendas specifically on mental health and mental disorders. From an integrative psychological perspective, most maladaptive health behaviours and mental disorders can be conceptualized as the result of developmental dysfunctions of psychological functions and processes as well as neurobiological and genetic processes that interact with the environment. The paper presents and discusses an integrative translational model, linking basic and experimental research with clinical research as well as population-based prospective-longitudinal studies. This model provides a conceptual framework to identify how individual vulnerabilities interact with environment over time, and promote critical behaviours that might act as proximal risk factors for ill-health and mental disorders. Within the models framework, such improved knowledge is also expected to better delineate targeted preventive and therapeutic interventions that prevent further escalation in early stages before the full disorder and further complications thereof develop. In contrast to conventional "personalized medicine" that typically targets individual (genetic) variation of patients who already have developed a disease to improve medical treatment, the proposed framework model, linked to a concerted funding programme of the "Science of Behaviour Change", carries the promise of improved diagnosis, treatment and prevention of health-risk behaviour constellations as well as mental disorders.
Van Damme, Lore; Colins, Olivier F; Vanderplasschen, Wouter
Detained minors display substantial mental health needs. This study focused on two features (psychopathology and self-esteem) that have received considerable attention in the literature and clinical work, but have rarely been studied simultaneously in detained youths. The aims of this study were to examine gender differences in psychiatric disorders and clusters of self-esteem, and to test the hypothesis that the cluster of adolescents with lower (versus higher) levels of self-esteem have higher rates of psychiatric disorders. The prevalence of psychiatric disorders was assessed in 440 Belgian, detained adolescents using the Diagnostic Interview Schedule for Children-IV. Self-esteem was assessed using the Self-perception Profile for Adolescents. Model-based cluster analyses were performed to identify youths with lower and/or higher levels of self-esteem across several domains. Girls have higher rates for most psychiatric disorders and lower levels of self-esteem than boys. A higher number of clusters was identified in boys (four) than girls (three). Generally, the cluster of adolescents with lower (versus higher) levels of self-esteem had a higher prevalence of psychiatric disorders. These results suggest that the detection of low levels of self-esteem in adolescents, especially girls, might help clinicians to identify a subgroup of detained adolescents with the highest prevalence of psychopathology.
Auerbach, Randy P.; Alonso, Jordi; Axinn, William G.; Cuijpers, Pim; Ebert, David D.; Green, Jennifer Greif; Hwang, Irving; Kessler, Ronald C.; Liu, Howard; Mortier, Philippe; Nock, Matthew K.; Pinder-Amaker, Stephanie; Sampson, Nancy A.; Aguilar-Gaxiola, Sergio; Al-Hamzawi, Ali; Andrade, Laura H.; Benjet, Corina; Caldas-de-Almeida, José Miguel; Demyttenaere, Koen; Florescu, Silvia; de Girolamo, Giovanni; Gureje, Oye; Haro, Josep Maria; Karam, Elie G.; Kiejna, Andrzej; Kovess-Masfety, Viviane; Lee, Sing; McGrath, John J.; O’Neill, Siobhan; Pennell, Beth-Ellen; Scott, Kate; ten Have, Margreet; Torres, Yolanda; Zaslavsky, Alan M.; Zarkov, Zahari; Bruffaerts, Ronny
Background Although mental disorders are significant predictors of educational attainment throughout the entire educational career, most research on mental disorders among students has focused on the primary and secondary school years. Methods The World Health Organization World Mental Health Surveys were used to examine the associations of mental disorders with college entry and attrition by comparing college students (n = 1,572) and nonstudents in the same age range (18–22; n = 4,178), including nonstudents who recently left college without graduating (n = 702) based on surveys in 21 countries (4 low/lower-middle income, 5 upper middle-income, 1 lower-middle or upper-middle at the times of two different surveys, and 11 high income). Lifetime and 12-month prevalence and age-of-onset of DSM-IV anxiety, mood, behavioural and substance disorders were assessed with the Composite International Diagnostic Interview. Results One-fifth (20.3%) of college students had 12-month DSM-IV/CIDI disorders. 83.1% of these cases had pre-matriculation onsets. Disorders with pre-matriculation onsets were more important than those with post-matriculation onsets in predicting subsequent college attrition, with substance disorders and, among women, major depression the most important such disorders. Only 16.4% of students with 12-month disorders received any 12-month healthcare treatment for their mental disorders. Conclusions Mental disorders are common among college students, have onsets that mostly occur prior to college entry, in the case of pre-matriculation disorders are associated with college attrition, and are typically untreated. Detection and effective treatment of these disorders early in the college career might reduce attrition and improve educational and psychosocial functioning. PMID:27484622
Trang, Phan Minh; Rocklöv, Joacim; Giang, Kim Bao; Nilsson, Maria
Background Some studies have shown a relationship between seasonality in weather patterns and depressive and behavioural disorders, especially in temperate climate regions. However, there is a lack of studies describing the seasonal patterns of hospital admissions for a variety of mental disorders in tropical and subtropical nations. The aim of this study has been to examine the relationship between seasons and daily hospital admissions for mental disorders in Hanoi, Vietnam. Designs A 5-year database (2008–2012) compiled by Hanoi Mental Hospital covering mental disorder admissions diagnosed by the International Classification of Diseases 10 was analysed. A negative binominal regression model was applied to estimate the associations between seasonality and daily hospital admissions for mental disorders, for all causes and for specific diagnoses. Results The summer season indicated the highest relative risk (RR=1.24, confidence interval (CI)=1.1–1.39) of hospital admission for mental disorders, with a peak in these cases in June (RR=1.46, CI=1.19–1.7). Compared to other demographic groups, males and the elderly (aged over 60 years) were more sensitive to seasonal risk changes. In the summer season, the RR of hospital visits among men increased by 26% (RR=1.26, CI=1.12–1.41) and among the elderly by 23% (RR=1.23, CI=1.03–1.48). Furthermore, when temperatures including minimum, mean, and maximum increased 1°C, the number of cases for mental disorders increased by 1.7%, 2%, and 2.1%, respectively. Conclusion The study results showed a correlation between hospital admission for mental disorders and season. PMID:27566716
Masi, G; Mucci, M; Favilla, L; Poli, P
The present report examines the clinical features of dysthymic disorder in a sample of adolescents with mild intellectual disability (ID). Frequency of symptoms, comorbidity, agreement between reports of subjects and parents, comparison between the frequency of depressive symptoms in subjects with ID and in two different groups of normal IQ dysthymic subjects (aged 7-11, 11 and 12-18 years) are described. The sample consisted of 12 subjects (age range = 12-25.6 years; mean age = 16.3 years) screened from unselected consecutively referred patients with mild ID. All the subjects were comprehensively diagnosed with a structured diagnostic interview, the Kiddie-Schedule for Affective Disorder and Schizophrenia (K-SADS), according to DSM-IV criteria. A symptomatic profile in the group with ID showed that intrapsychic and cognitive symptoms, such as depressed mood, irritability, pathological guilt and low self-image, were frequently reported in people with ID. Parents were less aware of depressed mood, but they reported high rates of low self-esteem; the agreement between the depressive reports of ID subjects and their parents was higher than in previous findings in normal IQ children. The symptomatic profile of subjects with ID was more comparable to that of prepubertal dysthymic children than that of dysthymic adolescents, but more significant are the analogies between dysthymic disorder in ID and normal IQ subjects. High rates of comorbidity with generalized anxiety disorder were evident in the group with ID. According to the present data, dysthymic disorder can be diagnosed in adolescents with mild ID. The K-SADS clinical interview seems to be a reliable instrument for the diagnosis and clinical definition of depressive symptomatology in this special population.
Slobodskaya, Helena R; Semenova, Nadezhda B
High rates of child mental health problems in the Russian Federation have recently been documented; the rates of youth suicide are among the highest in the world. Across the Russian regions, Republic of Tyva has one of the highest rates of child and adolescent suicide and the lowest life expectancy at birth. The aim of this study was to investigate the prevalence and associations of mental health problems in Native Tyvinian children and adolescents using internationally recognised measures and diagnoses. A two-stage, two-phase design involved selection of schools in five rural settlements in Western Tyva and two schools in the capital city followed by selection of Native Tyvinian children in grades 3-4 (ages 9-10) and 6-7 (ages 14-15). In the first phase, a screening measure of psychopathology, the Rutter Teacher Questionnaire, was obtained on 1048 children with a 97% participation rate. In the second phase, more detailed psychiatric assessments were carried out for subgroups of screen-positive and screen-negative children. The prevalence of mental health problems was about 25%, ranging from 40% in adolescent boys from rural areas to 9% in adolescent girls from the city. The patterning of disorders and risk factors were similar to those in other countries, rural areas were associated with an increased risk of psychopathology. The findings indicate that there is an urgent need for interventions to reduce risk in this population and provide effective help for Tyvinian children and adolescents with mental health problems.
McLeod, Jane D; Uemura, Ryotaro; Rohrman, Shawna
Prior research on the association of mental health and behavior problems with academic achievement is limited because it does not consider multiple problems simultaneously, take co-occurring problems into account, and control for academic aptitude. We addressed these limitations using data from the National Longitudinal Study of Adolescent Health (N = 6,315). We estimated the associations of depression, attention problems, delinquency, and substance use with two indicators of academic achievement (high school GPA and highest degree received) with controls for academic aptitude. Attention problems, delinquency, and substance use were significantly associated with diminished achievement, but depression was not. Combinations of problems involving substance use were especially consequential. Our results demonstrate that the social consequences of mental health problems are not the inevitable result of diminished functional ability but, rather, reflect negative social responses. These results also encourage a broader perspective on mental health by demonstrating that behavior problems heighten the negative consequences of more traditional forms of distress.
Ludermir, Ana Bernarda; Valongueiro, Sandra; de Araújo, Thália Velho Barreto
OBJECTIVE To investigate the association between common mental disorders and intimate partner violence during pregnancy. METHODS A cross sectional study was carried out with 1,120 pregnant women aged 18-49 years old, who were registered in the Family Health Program in the city of Recife, Northeastern Brazil, between 2005 and 2006. Common mental disorders were assessed using the Self-Reporting Questionnaire (SRQ-20). Intimate partner violence was defined as psychologically, physically and sexually abusive acts committed against women by their partners. Crude and adjusted odds ratios were estimated for the association studied utilizing logistic regression analysis. RESULTS The most common form of partner violence was psychological. The prevalence of common mental disorders was 71.0% among women who reported all form of violence in pregnancy and 33.8% among those who did not report intimate partner violence. Common mental disorders were associated with psychological violence (OR 2.49, 95%CI 1.8;3.5), even without physical or sexual violence. When psychological violence was combined with physical or sexual violence, the risk of common mental disorders was even higher (OR 3.45; 95%CI 2.3;5.2). CONCLUSIONS Being assaulted by someone with whom you are emotionally involved can trigger feelings of helplessness, low self-esteem and depression. The pregnancy probably increased women`s vulnerability to common mental disorders PMID:24789634
Stoddard, Joel; Stringaris, Argyris; Brotman, Melissa A; Montville, Daniel; Pine, Daniel S; Leibenluft, Ellen
Background Our objective was to compare self- and parent-reported irritability in youths with anxiety disorders, healthy youths, and those with mood disorders characterized by irritability. Irritability is a common but relatively understudied psychiatric symptom in child and adolescent anxiety disorders. In anxious youths, little is known about the severity of irritability, its impact on functioning, or the effect of informant source on reports of irritability. Methods We compared parent- and self-report forms of the Affective Reactivity Index (ARI), a validated measure of irritability, in youths ages 8–17 years with no psychopathology (healthy comparison, HC; n = 38), anxiety disorders (ANX; n = 42), bipolar disorder (BD; n = 35), or severe mood dysregulation (SMD; n = 61; a phenotype characterized by chronic, severely impairing irritability). Results Irritability was significantly higher in ANX than HC youths by both parent and self-report (partial η2 = 0.24 and 0.22, respectively, P’s < 0.001). Informant effects differed among ANX, BD, and SMD. Overall, parent-reported irritability was higher in BD with comorbid anxiety disorders and SMD with or without comorbid anxiety disorders than ANX (P’s < 0.007), but self-reported irritability was not significantly different among the three patient groups. Discussion By both parent and self-report, youths with anxiety disorders exhibit significantly more irritability and associated impairment than healthy subjects. Self-reported irritability in youths with anxiety disorders is comparable to that observed in youths with severe mood disorders, although parental reports of irritability differ among the disorders. Future research should examine the pathophysiology of anxiety-associated irritability, as well as its prognostic and treatment implications. PMID:23818321
Braun, Sharon A.; Cox, Jane A.
In this article, the authors provide an overview of the effectiveness of managed health care systems and their impact on mental health counselors. They review ethical and legal dilemmas involving informed consent, confidentiality, client autonomy, competence, treatment plans, and termination that had not existed prior to the introduction of…
Nuttall, Ena V.; And Others
The perceived mental health needs of adolescents were measured by questionnaire to groups of teenagers, parents, community child guidance personnel, self-help groups, police and court related people, school personnel, mental health administrators and area board members. (Author)
Trang, Phan Minh; Rocklöv, Joacim; Giang, Kim Bao; Kullgren, Gunnar; Nilsson, Maria
Studies in high-income countries have shown an association between heatwaves and hospital admissions for mental disorders. It is unknown whether such associations exist in subtropical nations like Vietnam. The study aim was to investigate whether hospital admissions for mental disorders may be triggered, or exacerbated, by heat exposure and heatwaves, in a low- and middle-income country, Vietnam. For this, we used data from the Hanoi Mental Hospital over five years (2008–2012) to estimate the effect of heatwaves on admissions for mental disorders. A zero-inflated negative binomial regression model accounting for seasonality, time trend, days of week, and mean humidity was used to analyse the relationship. Heatwave events were mainly studied as periods of three or seven consecutive days above the threshold of 35°C daily maximum temperature (90th percentile). The study result showed heatwaves increased the risk for admission in the whole group of mental disorders (F00-79) for more persistent heatwaves of at least 3 days when compared with non-heatwave periods. The relative risks were estimated at 1.04 (0.95–1.13), 1.15 (1.005–1.31), and 1.36 (1–1.90) for a one-, three- and seven-day heatwave, respectively. Admissions for mental disorders increased among men, residents in rural communities, and the elderly population during heatwaves. The groups of organic mental disorders, including symptomatic illnesses (F0-9) and mental retardation (F70-79), had increased admissions during heatwaves. The findings are novel in their focus on heatwave impact on mental diseases in a population habituating in a subtropical low- and middle-income country characterized by rapid epidemiological transitions and environmental changes. PMID:27195473
Tromp, Noor B; Koot, Hans M
The present study aimed to elucidate dimensions of normal and abnormal personality underlying DSM-IV personality disorder (PD) symptoms in 168 adolescents referred to mental health services. Dimensions derived from the Big Five of normal personality and from Livesley's (2006) conceptualization of personality pathology were regressed on interview-based DSM-IV PD symptom counts. When examined independently, both models demonstrated significant levels of predictive power at the higher order level. However, when added to the higher order Big Five dimensions, Livesley's higher and lower order dimensions afforded a supplementary contribution to the understanding of dysfunctional characteristics of adolescent PDs. In addition, they contributed to a better differentiation between adolescent PDs. The present findings suggest that adolescent PDs are more than extreme, maladaptive variants of higher order normal personality traits. Adolescent PDs seem to encompass characteristics that may be more completely covered by dimensions of abnormal personality. Developmental issues and implications of the findings are discussed.
Hayes, Joseph F; Maughan, Daniel L; Grant-Peterkin, Hugh
To date there have been few peer-reviewed studies on the feasibility, acceptability and effectiveness of digital technologies for mental health promotion and disorder prevention. Any evaluation of these evolving technologies is complicated by a lack of understanding about the specific risks and possible benefits of the many forms of internet use on mental health. To adequately meet the mental health needs of today's society, psychiatry must engage in rigorous assessment of the impact of digital technologies.
Currently, little is known about adolescents' self-stigma experiences as mental health (MH) treatment recipients. Hence, this study addresses the following two questions: (a) what are adolescents' and parents' perceptions of stigma and perceptions of the cause, controllability, and anticipated outcome (illness perceptions) of adolescents' MH…
Debbané, Martin; Badoud, Deborah; Balanzin, Dario; Eliez, Stephan
While schizotypal features are common during adolescence, they can also signal increased risk for the onset of schizophreniform disorders. Most studies with adolescents find that hallucination and delusion-like symptoms (positive schizotypal features) best predict future psychopathology. Still, the developmental process of positive schizotypy remains elusive, specifically with regards to 1) its relationships to negative and disorganization schizotypal dimensions; 2) its associations to maladaptive functioning during adolescence. This longitudinal study aimed to further characterize these relationships, thereby delineating "early and broadly defined psychosis risk mental states" (Keshavan et al., 2011). The current study presents the 3-year course of schizotypal trait expression in 34 clinical adolescents aged 12 to 18 years consulting for non-psychotic difficulties. Schizotypal expression was assessed twice using the Schizotypal Personality Questionnaire, accompanied by an examination of internalizing/externalizing problems using the Achenbach scales. Cross-sectional and longitudinal analyses were conducted to assess the expression and course of schizotypal dimensions; mediation analyses were further employed to highlight the developmental interactions promoting the maintenance of positive schizotypal expression. The results reveal that positive schizotypy, and more specifically unusual perceptual experiences, significantly declined during the study interval. Disorganization features were found to mediate the relationships between the negative and positive dimensions of schizotypy within and across evaluations. Somatic complaints and attentional difficulties further strengthened the expression of positive schizotypy during the study interval. These results suggest that the relationship between disorganization features and positive schizotypy may play a central role in establishing risk for psychosis during adolescence.
Borges, Guilherme; Medina-Mora, María Elena; López-Moreno, Sergio
Mental disorders, including substance abuse, are part of the Mexican epidemiologic scenario and will remain so during several decades. They may even become more prominent as causes of disease, disability, and death in our country. It is thus imperative to frame appropriate management strategies to curb these problems without delay. This paper aims at outlining epidemiology of mental diseases as a field of study, and to identify its limitations. Emphasis is made on common elements shared with other more traditional fields of epidemiology, as well as on the specific contributions made by this particular field to epidemiology and to psychiatry in general. This paper describes the main study designs and problems in this field of epidemiology, its usefulness in prevention actions, and future challenges. A unique characteristic of mental disorder epidemiology is that its target diseases manifest in two levels: behaviorally (for example, compulsive hand-washing) and as an element of the individual's mental life (e.g., obsession with bacteria being a constant, omnipresent health threat). It follows that much of the knowledge currently available on the phenomena of mental disorders in general is based on the self-reported insight of individuals. Trained clinicians have collected such reports by interview or with standardized questionnaires. This field of epidemiology is characterized by having two-sides: a mental disorder is a problem in and of itself, causing suffering and prompting the search for specialized care, as it has peculiar clinical manifestations. On the other hand, mental disorder epidemiology also focuses on determining factors (drug use, abuse, or addiction) and on the way these independent variables result in certain processes and outcomes (such as accidents, homicide, suicide, liver cirrhosis, etc.). Finally, the epidemiology of mental disorders has also been set apart by its focus in series of processes that are not suitably classified as syndromes, but
Prochaska, John D; Le, Vi Donna; Baillargeon, Jacques; Temple, Jeff R
This study examines results from three mental health screening measures in a cohort of adolescent public school students in seven public schools in Southeast Texas affiliated with the Dating it Safe study. We estimated the odds of receiving professional mental health treatment in the previous year given results from different mental health screening batteries: the CES-D 10 battery for depression screening, the Screen for Child Anxiety Related Disorders, and the Primary Care Posttraumatic Stress Disorder screen. Overall, students with higher scores on screening instruments for depression, posttraumatic stress disorder, and combinations of screening instruments were more likely to have sought past-year professional mental health treatment than non-symptomatic youth. However, the proportion of students screening positive and receiving professional treatment was low, ranging from 11 to 16 %. This study emphasizes the need for broader evaluation of population-based mental health screening among adolescents.
Oruche, Ukamaka M.; Draucker, Claire Burke; Al-Khattab, Halima; Cravens, Hillary A.; Lowry, Brittany; Lindsey, Laura M.
Adolescents with disruptive behavior disorders (DBD), including oppositional defiant disorder and conduct disorder, present unique challenges for their families. Although, most empirically supported treatments for DBD are family-based, the emphasis is typically on the behavior of the child rather than on the life challenges and resultant distress experienced by the family members. Fifteen families of adolescents with DBD were recruited from a large publicly funded Community Mental Health Center. For this report, data from in-depth interviews with the adolescents’ primary caregivers were analyzed by standard content analytic procedures to describe the challenges they experienced living with and caring for the adolescents. The primary caregivers reported that the challenges were overwhelming, demanding, and unrelenting. The two most salient challenges were (a) managing the adolescents’ aggressive, defiant, and deceitful behaviors, and (b) interacting frequently with a number of child-serving agencies. A number of clinical implications are drawn from these findings. PMID:25504213
Ponton, L E
Many review articles address the diverse and rapidly developing field of eating disorders, but there are far fewer articles addressing the specific population of adolescents. The social contributors (desire for thinness amplified by the media) to these illnesses are considerable and affect all adolescent and latency-age girls to some degree. Understanding the full range of behavior and those at high risk to develop pathology is important. Developing prevention programs that target adolescent girls and their families, schools, and the relevant media is also important. Prevention has been a much-neglected area within the field of eating disorders. The chronic nature of eating disorders characterized by remission and relapse bears further study. Attention to the factors that provoke a symptomatic period is crucial. Along with relapse and remission are shifts between diagnostic categories within the field of eating disorders and comorbid illnesses. A better understanding of the factors that cause these shifts to occur would be quite valuable. Outcome and prospective studies would provide valuable information about the course of the illnesses and further identify the individuals at high risk. Certain groups are known to be at high risk, such as girls involved in specific athletics (e.g., gymnastics) or career activities, but recent investigations have indicated that girls involved in what was previously believed to be a low risk activity, such as swimming, may also be at risk (Benson et al., 1990). Further investigation of these factors is crucial. Cultural factors play a role in these illnesses, and cross-cultural studies provide crucial information. We must also continue to explore the biological and psychological correlates of these illnesses and further define the complex and heterogeneous etiology of these illnesses. Their study still promises to yield exciting challenges. Increased public awareness regarding the need for treatment of these illnesses is a high
Mitchell, Paul; Smedley, Kirsty; Kenning, Cassandra; McKee, Amy; Woods, Debbie; Rennie, Charlotte E.; Bell, Rachel V.; Aryamanesh, Mitra; Dolan, Mairead
Many studies have identified high levels of mental health problems among adolescents in custody and there is increasing evidence that mental health problems in this population are associated with further offending and mental health problems into adulthood. Despite recent improvements in mental health provision within custodial settings there is…
March, John S.
Objective: Given striking advances in translational developmental neuroscience and its convergence with developmental psychopathology and developmental epidemiology, it is now clear that mental illnesses are best thought of as neurodevelopmental disorders. This simple fact has enormous implications for the nature and organization of psychotherapy…
Patel, Vikram; Flisher, Alan J; Nikapota, Anula; Malhotra, Savita
Children and adolescents in low and middle income countries (LAMIC) constitute 35-50% of the population. Although the population in many such countries is predominantly rural, rapid urbanisation and social change is under way, with an increase in urban poverty and unemployment, which are risk factors for poor child and adolescent mental health (CAMH). There is a vast gap between CAMH needs (as measured through burden of disease estimates) and the availability of CAMH resources. The role of CAMH promotion and prevention can thus not be overestimated. However, the evidence base for affordable and effective interventions for promotion and prevention in LAMIC is limited. In this review, we briefly review the public health importance of CAM disorders in LAMIC and the specific issues related to risk and protective factors for these disorders. We describe a number of potential strategies for CAMH promotion which focus on building capacity in children and adolescents, in parents and families, in the school and health systems, and in the wider community, including structural interventions. Building capacity in CAMH must also focus on the detection and treatment of disorders for which the evidence base is somewhat stronger, and on wider public health strategies for prevention and promotion. In particular, capacity needs to be built across the health system, with particular foci on low-cost, universally available and accessible resources, and on empowerment of families and children. We also consider the role of formal teaching and training programmes, and the role for specialists in CAMH promotion.
This paper discusses interrelations between creativity, mental disorders and their treatment. The psychology of creativity is very important for successful psychopharmacotherapy, but our knowledge about creativity is still insufficient. Even that which is known is not within the armamentarium of most practicing psychiatrists. In the first part of this article creativity and possible associations between creativity, mental health, and well-being are described. The second part deals with the intriguing relationship between creativity and mental disorders. The third part emphasizes the role of creativity in the treatment of mental disorders. This paper ends by underlining the importance of a creativity-enhancing oriented, and personal recovery-focused psychopharmacotherapy in helping psychiatric patients achieve fulfilled and purposeful lives.
Bagwell, Catherine L.; Molina, Brooke S.G.; Kashdan, Todd B.; Pelham, William E.; Hoza, Betsy
In this study, the authors examined the association between childhood attention-deficit/hyperactivity disorder (ADHD) and anxiety and mood disorders in adolescence. They compared a group of 142 adolescents ages 13 to 18 years with a history of ADHD in childhood to group of 100 community-recruited adolescents without ADHD. The two groups did not…
Bateman, Anthony; Fonagy, Peter
Mentalization is the process by which we implicitly and explicitly interpret the actions of ourselves and others as meaningful based on intentional mental states (e.g., desires, needs, feelings, beliefs, and reasons). This process is disrupted in individuals with comorbid antisocial (ASPD) and borderline personality disorder (BPD), who tend to misinterpret others' motives. Antisocial characteristics stabilize mentalizing by rigidifying relationships within prementalistic ways of functioning. However, loss of flexibility makes the person vulnerable to sudden collapse when the schematic representation is challenged. This exposes feelings of humiliation, which can only be avoided by violence and control of the other person. The common path to violence is via a momentary inhibition of the capacity for mentalization. In this article, the authors outline their current understanding of mentalizing and its relation to antisocial characteristics and violence. This is illustrated by a clinical account of mentalization-based treatment adapted for antisocial personality disorder. Treatment combines group and individual therapy. The focus is on helping patients maintain mentalizing about their own mental states when their personal integrity is challenged. A patient with ASPD does not have mental pain associated with another's state of mind; thus, to generate conflict in ASPD by thinking about the victim will typically be ineffective in inducing behavior change.
Becker, Sara J.; Swenson, Rebecca; Esposito-Smythers, Christianne; Cataldo, Andrea; Spirito, Anthony
Military families with adolescents experience high levels of stress associated with parental deployment, but many of these families do not seek or utilize mental health services. The current qualitative study was designed to better understand barriers to mental health treatment experienced by adolescents in military families. Focus groups and individual interviews were conducted with military adolescents (n = 13), military (non-enlisted) parents (n = 12), and mental health service providers who treat adolescents in military families (n = 20). Discussions primarily explored barriers to seeking treatment, with supplemental questions assessing the ideal elements of mental health services for this population. Seven barriers to engaging in mental health services were identified: four internal (confidentiality concerns, stigma, ethic of self-reliance, lack of perceived relevance) and three external (time and effort concerns, logistical concerns, financial concerns). Challenges engaging military adolescents in mental health services are discussed and several recommendations are offered for service providers attempting to work with this population. PMID:25574070
Golden, Neville H; Schneider, Marcie; Wood, Christine
Obesity and eating disorders (EDs) are both prevalent in adolescents. There are concerns that obesity prevention efforts may lead to the development of an ED. Most adolescents who develop an ED did not have obesity previously, but some teenagers, in an attempt to lose weight, may develop an ED. This clinical report addresses the interaction between obesity prevention and EDs in teenagers, provides the pediatrician with evidence-informed tools to identify behaviors that predispose to both obesity and EDs, and provides guidance about obesity and ED prevention messages. The focus should be on a healthy lifestyle rather than on weight. Evidence suggests that obesity prevention and treatment, if conducted correctly, do not predispose to EDs.
Ogorchukwu, Judith Miti; Sekaran, Varalakshmi Chandra; Nair, Sreekumaran; Ashok, Lena
Background: Early recognition of mental health problems gives an individual the opportunity for better long-term outcomes if intervention is initiated early. Mental health literacy is a related concept which is increasingly seen as an important measure of the awareness and knowledge of mental health disorders. Aim and Objectives: This study aimed at assessing the mental health literacy, help-seeking behavior and beliefs and attitudes related to mental illnesses among adolescents attending preuniversity colleges. Materials and Methods: A cross-sectional study was conducted among randomly selected preuniversity college students (n = 916). Data were collected through self-administered questionnaires. Data were computed using STATA. Analysis and interpretation were carried out using descriptives and Chi-square test. Results: Of the 916 respondents, 54.15% were male while 45.85% were female. The majority (78.60%) of the respondents ascribed to the Hindu religion, hailed largely from rural areas (57.21%) and were mostly studying in the 11th standard (72.49%). The percentage of mental health literacy among the respondents was very low, i.e., depression was identified by 29.04% and schizophrenia/psychosis was recognized by 1.31%. The study findings indicate that adolescents preferred reaching out more to informal sources including family members such as mothers than formal sources for self than for others indicating deeply prevalent stigmatizing attitudes toward mental health conditions. Conclusions: There is a need for immediate improvement in the knowledge of adolescents on mental health literacy which suggests that programs need to be developed such that adolescents can seek help from valid resources if the need were to arise and have appropriate knowledge on whom to approach for help. PMID:27335519
Wiener, Judith; Daniels, Lesley
This article reports on a qualitative study of the school experiences of adolescents with attention-deficit/hyperactivity disorder (ADHD) in the context of quantitative research on teacher attitudes and practices, adolescent self-appraisals, and social and family relationships. Twelve adolescents with ADHD participated in in-depth, semistructured…
Reinvall, Outi; Voutilainen, Arja; Kujala, Teija; Korkman, Marit
There is a paucity of research studying comprehensive neurocognitive profiles of adolescents with higher functioning autism spectrum disorders (ASD). This study compared the neurocognitive profiles of higher functioning adolescents with ASD (n = 30, mean age 13.5) with that of typically developing adolescents (n = 30; mean age 13.7). Adolescents…
Romano, Elisa; Zoccolillo, Mark; Paquette, Daniel
Objective: The study investigated histories of child maltreatment and psychiatric disorder in a high-risk sample of pregnant adolescents. Method: Cross-sectional data were obtained for 252 pregnant adolescents from high school, hospital, and group home settings in Montreal (Canada). Adolescents completed a child maltreatment questionnaire and a…
Kuo, Melissa H.; Orsmond, Gael I.; Coster, Wendy J.; Cohn, Ellen S.
This study explores how adolescents with autism spectrum disorder (ASD) use media, and the factors associated with their media use. A total of 91 adolescents with ASD and their parents completed mail-based surveys. In all, 78% of the adolescents with ASD watched television (approximately 2 h/day), and 98% used computers (approximately 5 h/day) on…
Bruffaerts, Ronny; Posada-Villa, Jose; Al-Hamzawi, Ali Obaid; Gureje, Oye; Huang, Yueqin; Hu, Chiyi; Bromet, Evelyn J.; Viana, Maria Carmen; Hinkov, Hristo Ruskov; Karam, Elie G.; Borges, Guilherme; Florescu, Silvia E.; Williams, David R.; Demyttenaere, Koen; Kovess-Masfety, Viviane; Matschinger, Herbert; Levinson, Daphna; de Girolamo, Giovanni; Ono, Yutaka; de Graaf, Ron; Browne, Mark Oakley; Bunting, Brendan; Xavier, Miguel; Haro, Josep Maria; Kessler, Ronald C.
Background Previous research suggests that many people receiving mental health treatment do not meet criteria for a mental disorder but are rather ‘the worried well’. Aims To examine the association of past-year mental health treatment with DSM-IV disorders. Method The World Health Organization’s World Mental Health (WMH) Surveys interviewed community samples of adults in 23 countries (n = 62 305) about DSM-IV disorders and treatment in the past 12 months for problems with emotions, alcohol or drugs. Results Roughly half (52%) of people who received treatment met criteria for a past-year DSM-IV disorder, an additional 18% for a lifetime disorder and an additional 13% for other indicators of need (multiple subthreshold disorders, recent stressors or suicidal behaviours). Dose-response associations were found between number of indicators of need and treatment. Conclusions The vast majority of treatment in the WMH countries goes to patients with mental disorders or other problems expected to benefit from treatment. PMID:25395690
Briegel, Wolfgang; Schimek, Martina; Kamp-Becker, Inge; Hofmann, Christina; Schwab, K Otfried
Moebius sequence is a rare congenital disorder usually defined as a combination of facial weakness with impairment of ocular abduction. A strong association of Moebius sequence with autism spectrum disorders (ASDs) has been suggested in earlier studies with heterogenous age groups. The primary caregivers of all children and adolescents with Moebius sequence aged 6-17 years known to the German Moebius foundation were anonymously asked to complete two screening measures of ASD [Behavior and Communication Questionnaire (VSK); Marburger Asperger's Syndrome Rating Scale (MBAS)]. For those who reached the cut-off for ASD, well standardized diagnostic instruments (Autism Diagnostic Interview-Revised, Autism Diagnostic Observation Schedule, WISC-III, and Kinder-DIPS) should be administered. Minimal diagnostic criteria for Moebius sequence were congenital facial weakness (uni- or bilateral) and impairment of ocular abduction (uni- or bilateral). Familiar cases should be excluded. The primary caregivers of 35/46 children and adolescents (18 males, 17 females, mean age 11.5 years) sent back completed questionnaires, but only 27 subjects met inclusion criteria. According to the primary caregivers, none of these subjects showed mental retardation. Two probands (both males 9 and 16 years old) reached the cut-off of the MBAS whereas the results of the VSK did not indicate ASDs in any of the patients. The 9 year old boy could be examined personally and did not meet diagnostic criteria of ASD. ASDs might be not as frequent as reported in previous studies on patients with Moebius sequence, at least not in patients without mental retardation.
Silveira, José; Rockman, Patricia; Fulford, Casey; Hunter, Jon
Abstract Objective To provide primary care physicians with a novel approach to risk identification and related clinical decision making in the management of undifferentiated mental disorders. Sources of information We conducted a review of the literature in PubMed, CINAHL, PsycINFO, and Google Scholar using the search terms diagnostic uncertainty, diagnosis, risk identification, risk assessment/methods, risk, risk factors, risk management/methods, cognitive biases and psychiatry, decision making, mental disorders/diagnosis, clinical competence, evidence-based medicine, interviews as topic, psychiatry/education, psychiatry/methods, documentation/methods, forensic psychiatry/education, forensic psychiatry/methods, mental disorders/classification, mental disorders/psychology, violence/prevention and control, and violence/psychology. Main message Mental disorders are a large component of practice in primary care and often present in an undifferentiated manner, remaining so for prolonged periods. The challenging search for a diagnosis can divert attention from risk identification, as diagnosis is commonly presumed to be necessary before treatment can begin. This might inadvertently contribute to preventable adverse events. Focusing on salient aspects of the patient presentation related to risk should be prioritized. This article presents a novel approach to organizing patient information to assist risk identification and decision making in the management of patients with undifferentiated mental disorders. Conclusion A structured approach can help physicians to manage the clinical uncertainty common to risk identification in patients with mental disorders and cope with the common anxiety and cognitive biases that affect priorities in risk-related decision making. By focusing on risk, functional impairments, and related symptoms using a novel framework, physicians can meet their patients’ immediate needs while continuing the search for diagnostic clarity and long
Buchanan, Alec; Zonana, Howard
An offender's punishment can be reduced when a court decides that his mental disorder reduces his responsibility for what he did. Courts have sought to establish whether a mentally disordered offender's responsibility is reduced by asking whether his disorder caused the crime. Acceptance of this "causation by mental disorder" criterion has fluctuated, however. This may be because causal explanations are not the types of explanations we are accustomed to offering for the kinds of acts that bring defendants, and psychiatric witnesses, to court. More often, we offer what philosophers have called "possibility" explanations for these acts. The application of psychiatry to possibility explanations has not been widely explored. It offers the potential for the improved use of psychiatric evidence in criminal proceedings.
Stylianidis, S; Pantelidou, S; Chondros, P; Roelandt, J L; Barbato, A
In Greece, the need for epidemiological data became evident at the beginning of the mental health reform during 1983 with the emergence of the necessity to develop community-based mental health services. This survey was conducted in 2005 by the Association for Regional Development and Mental Health (EPAPSY), supported by the local authorities. It followed the methodology of the survey "Mental Health in the General Population: Images and Realities" (MHGP), a large scale multisite epidemiological research conducted by the World Health Organization Collaborative Centre of Lille in France and other countries. The aim of this study was to assess prevalence, sociodemographic and comorbidity patterns of mental disorders in the general adult population of Evia Island, Greece. This was a cross-sectional survey investigating point, period and lifetime prevalence of mental disorders. The target population was the non-institutionalized adult population of island of Evia (population 230,000 people). The Mini International Neuropsychiatric Interview and a sociodemographic data questionnaire were administered by trained interviewers to 900 residents of Evia. The quota sampling method was used to obtain a sample representative of the target population. Lifetime prevalence of any disorder, as identified by the MINI, was 29%. The prevalence of depression was high, with 17.5% of women and 14.6% of men currently meeting the criteria for diagnosis. Affective and anxiety disorders were found to be more frequent in women than men, except for dysthymia, social phobia and post-traumatic stress disorder which were slightly more frequent in men. The prevalence of psychiatric disorders in Evia was much higher than the prevalence found by other epidemiological studies in Greece and among the highest in Southern Europe. The high prevalence of mental disorders found in Evia means that almost one third of the population will suffer from a clinically significant disorder in their lifetime
Yahata, Noriaki; Kasai, Kiyoto; Kawato, Mitsuo
Psychiatry research has long experienced a stagnation stemming from a lack of understanding of the neurobiological underpinnings of phenomenologically defined mental disorders. Recently, the application of computational neuroscience to psychiatry research has shown great promise in establishing a link between phenomenological and pathophysiological aspects of mental disorders, thereby recasting current nosology in more biologically meaningful dimensions. In this review, we highlight recent investigations into computational neuroscience that have undertaken either theory- or data-driven approaches to quantitatively delineate the mechanisms of mental disorders. The theory-driven approach, including reinforcement learning models, plays an integrative role in this process by enabling correspondence between behavior and disorder-specific alterations at multiple levels of brain organization, ranging from molecules to cells to circuits. Previous studies have explicated a plethora of defining symptoms of mental disorders, including anhedonia, inattention, and poor executive function. The data-driven approach, on the other hand, is an emerging field in computational neuroscience seeking to identify disorder-specific features among high-dimensional big data. Remarkably, various machine-learning techniques have been applied to neuroimaging data, and the extracted disorder-specific features have been used for automatic case-control classification. For many disorders, the reported accuracies have reached 90% or more. However, we note that rigorous tests on independent cohorts are critically required to translate this research into clinical applications. Finally, we discuss the utility of the disorder-specific features found by the data-driven approach to psychiatric therapies, including neurofeedback. Such developments will allow simultaneous diagnosis and treatment of mental disorders using neuroimaging, thereby establishing 'theranostics' for the first time in clinical
Kelly, Sarah; Anderson, Debra; Hall, Lynne; Peden, Ann; Cerel, Julie
Gang violence is a growing public health concern in the United States, and adolescents are influenced by exposure to gang violence. This study explored the influence of exposure to gang violence on adolescent boys' mental health using a multi-method design. A semi-structured interview guide and the Trauma Symptom Checklist for Children were used to collect data from adolescents. Parents, primary caregivers, and community center employees completed the Child Behavior Checklist or Teacher Report Form. Ten adolescent boys, their parents or primary caregivers, and six community center employees participated in the study. Exposure to gang violence was common among these adolescents and they had a variety of reactions. Parents, primary caregivers, and community center employees had differing perceptions of adolescents' exposure to violence and their mental health. Adolescent boys' exposure to gang violence in the community is alarming. These adolescents encountered situations with violence that influenced their mental health.
Jopling, Ellen N; Khalid-Khan, Sarosh; Chandrakumar, Shivani F; Segal, Shira C
With an estimated lifetime prevalence as high as 5.9% in the general population, borderline personality disorder (BPD) is a psychiatric disorder characterized by marked impulsivity as well as difficulties in interpersonal relationships, self-image, and affects. The burden on the health care system is immense with BPD patients accounting for 10%-20% of the patients in mental health outpatient facilities and 15%-40% in mental health inpatient facilities. Further, while 75%-80% of BPD patients attempt to commit suicide, 10% succeed; this mortality rate exceeds even that of anorexia nervosa which, with a weighted mortality rate of 5.1%, has often been considered to have the highest mortality rate of any mental disorder. In order to provide treatment and to implement preventative measures, a risk profile as well as clinical features must be identified within the adolescent population. This is presently crucial, as the current criteria for BPD are not developmentally focused, and as a result, criteria initially developed for the adult population are being applied in diagnoses of adolescents. A population of adolescents (n=80) between 16 and 19 years of age meeting the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) criteria either for BPD traits (n=46) or for BPD (n=36) were included in a retrospective chart review; a control group consisting of n=30 mood and anxiety control subjects were included to allow for further comparisons. Complex significant differences were discovered between the three groups in the following areas: history of sexual abuse, suicidal ideation, internalizing/externalizing symptoms, interpersonal difficulties, impulsivity, pre-perinatal stress, bullying, substance abuse, anxiety disorders, disruptive disorders, and finally, learning disorders.
Minoletti, Alberto; Galea, Sandro; Susser, Ezra
Mental disorders are highly prevalent in Latin American countries and exact a serious emotional toll, yet investment in public mental health remains insufficient. Most countries of the region have developed national and local initiatives to improve delivery of mental health services over the last 22 years, following the technical leadership of the Pan American Health Organization/World Health Organization (PAHO/WHO). It is especially notable that PAHO/WHO facilitated the development of national policies and plans, as well as local programs, to deliver specialized community care for persons with severe mental disorders. Nevertheless, at present, the majority of Latin American countries maintain a model of services for severe mental disorders based primarily on psychiatric hospitals that consume most of the national mental health budget. To accelerate the pace of change, this article emphasizes the need to develop cross-country regional initiatives that promote mental health service development, focusing on severe mental disorders. As one specific example, the authors describe work with RedeAmericas, which has brought together an interdisciplinary group of international investigators to research regional approaches and train a new generation of leaders in public mental health. More generally, four regional strategies are proposed to complement the work of PAHO/ WHO in Latin America: 1) to develop multi-country studies on community services, 2) to study new strategies and interventions in countries with more advanced mental health services, 3) to strengthen advocacy groups by cross-country interchange, and 4) to develop a network of well-trained leaders to catalyze progress across the region. PMID:25339792
Sivertsen, Børge; Harvey, Allison G; Pallesen, Ståle; Hysing, Mari
The aim of the current study was to compare mental health problems, resilience and family characteristics in adolescents with and without delayed sleep phase (DSP) in a population-based sample. Data were taken from the youth@hordaland-survey, a large population-based study in Hordaland County in Norway conducted in 2012. In all, 9338 adolescents aged 16-19 years (53.5% girls) provided self-reported data on a wide range of instruments assessing mental health symptoms, including depression, anxiety, obsessive-compulsive behaviours, attention deficit hyperactive disorder (ADHD) symptoms, perfectionism, resilience and sleep. Measures of socioeconomic status were also included. Three hundred and six adolescents (prevalence 3.3%) were classified as having DSP [according to the International Classification of Sleep Disorders-2 (ICSD-2)] criteria. Adolescents with DSP reported higher levels of depression, anxiety and ADHD symptoms. Adolescents with DSP also exhibited significantly lower levels of resilience. The Cohen's d effect sizes ranged from small [obsessive-compulsive disorder (OCD): d = 0.15] to moderate (inattention: d = 0.71). In the fully adjusted model, the significant predictors of DSP included inattention [odds ratio (OR): 2.11], lack of personal structure (OR: 2.07), low (OR: 1.85) and high (OR: 1.91) paternal education, parents not living together (OR: 1.81), hyperactivity/inattention (OR: 1.71) and poorer family economy (OR: 1.59). In conclusion, the high symptom load across a range of mental health measures suggests that a broad and thorough clinical approach is warranted when adolescents present with DSP.
Masi, Gabriele; Millepiedi, Stefania; Mucci, Maria; Poli, Paola; Bertini, Nicoletta; Milantoni, Luca
Objective: There are insufficient data on generalized anxiety disorder in children and adolescents. Symptoms and comorbidity of generalized anxiety disorder are described as a function of age, gender, and comorbidity in a consecutive series of referred children and adolescents. Method: One hundred fifty-seven outpatients (97 males and 60 females,…
Doerfler, Leonard A.; Connor, Daniel F.; Volungis, Adam M.; Toscano, Peter F., Jr.
The present study examined the frequency and characteristics of panic disorder in children and adolescents who had been referred to a pediatric psychopharmacology clinic. Of the 280 children and adolescents evaluated in this clinic, 35 were diagnosed with panic disorder using a semi-structured clinical interview (K-SADS) and other objective…
Kasen, Stephanie; Cohen, Patricia; Chen, Henian; Johnson, Jeffrey G.; Crawford, Thomas N.
Background: Schools are key social contexts for shaping development and behavior in youths; yet, little is known of their influence on adolescent personality disturbance. Method: A community-based sample of 592 adolescents was assessed for family and school experiences, Axis I psychiatric disorders, and Axis II personality disorder (PD) symptoms,…
Bonne, O; Canetti, L; Bachar, E; De-Nour, A K; Shalev, A
An imaginary companion (IC) is a frequently encountered childhood fantasy, invisible to anyone but the child, who may be named, addressed or played with. Whether the presence of an IC is a normal developmental feature has not been determined. We examined psychometric measures and the presence/absence of childhood IC in a sample of 850 mentally healthy adolescents. 17.6% of our subjects, more often females, reported having had such a companion. Subjects who reported having had an IC in childhood exhibited higher levels of distress and emotional discontrol, displayed prolonged transitional object attachment and immature modes of coping with stress. Thus, although childhood imaginary companionship is not indicative of psychopathology, it may denote a vulnerability for adolescent perturbation and difficulty in coping with emotionally laden situations.
Wills, Cheryl D
Although juveniles have developmental, educational, healthcare, and rehabilitation needs that differ from adults, thousands of them have been confined in adult corrections facilities in the past 30 years. This manuscript will review how and why juveniles end up in adult corrections facilities, who they are, their rehabilitative needs, and how they differ from adults in corrections facilities and youths in the juvenile justice system. The importance of providing developmentally-informed mental health services to youths in adult corrections facilities is examined, along with barriers to traditional adolescent psychiatric practice. Recommendations for future directions in adolescent psychiatric care are presented.
Giedd, Jay N.; Keshavan, Matcheri; Paus, Tomáš
What do we know about the maturation of the human brain during adolescence? Do structural changes in cerebral cortex reflect synaptic pruning? Are increases in white-matter volume driven by myelination? Is the adolescent brain more or less sensitive to reward? These are but a few questions we ask in this review while attempting to indicate how findings obtained in the healthy brain help in furthering our understanding of mental health during adolescence. PMID:19002191
Shafran, Naama; Shahar, Golan; Berant, Ety; Gilboa-Schechtman, Eva
Negative perceptions of self and others have lately become one of the criteria for Posttraumatic Stress Disorder (PTSD) among adults and adolescents. Drawing from theories of mental representations in psychopathology, this study examined self-reported negative cognitions, self and parental representations, and relationship themes among adolescents with and without PTSD. Thirty one adolescents with PTSD (11 boys, mean age = 14.06, SD = 2.24) were matched with 29 adolescents who had no psychiatric diagnosis (11 boys, mean age = 14.96, SD = 1.78). Adolescents completed self-report measures, wrote a description of self, mother and father, and were interviewed about positive and negative relationship episodes with mother, father, and peers. Adolescents with PTSD reported more self-criticism and performance evaluation than did controls. Their self-representation exhibited a lower sense of agency, which was related to structural variables (i.e., less integrative description). Although parental representations of adolescents with PTSD were not generally less benevolent or more punitive than those of controls, their relationship themes revealed a higher proportion of the wish to be distant from others. Adolescents with PTSD exhibited more passive responses and perceived more dominant or controlling responses from their parents. Findings point out to a serious impairment in representations of self and relationship patterns in adolescent PTSD.
Guillem, E; Pelissolo, A; Lepine, J P
Epidemiologic studies in the general population, taking into account certain bias inherent to the clinical observation have confirmed the clinical impression reporting a higher psychiatric comorbidity with persons suffering from migraine than in persons without migraine. Persons with migraine are at increased risk for affective and anxiety disorders, personality traits disorders (neuroticism), suicide attempts, but not for alcohol or illicit drug abuse. The comorbidity is more important in migraine with aura than in migraine without aura. Concerning affective disorders, the lifetime prevalence of major depression is 34.4% in persons with migraine and 10.4% in persons without migraine. For bipolar I disorder, prevalence is 6.8% in migraine with aura versus 0.9% when no migraine. Compared to no migraine, the lifetime prevalence of anxiety disorders in migraine is significantly increased in: panic disorder (10.9% vs 1.8%); generalized anxiety disorder (10.2% vs 1.9%); obsessive-compulsive disorder (8.6% vs 1.8%); phobic disorder (39.8% vs 20.6%). In addition, no psychopathological, biological or genetic explanation seems to be meaningful for the comprehension of this comorbidity pattern. These results remain primarily descriptive but they justify a clinical investigation of affective and anxiety disorders, and suicide attempts, in all person with migraine, and it also justifies the treatment of pain associated with the treatment of eventual affective or anxiety disorders.
Recent reports of functional and anatomical studies have provided evidence that aberrant neural connectivity lies at the heart of many mental disorders. Information related to neural networks has elucidated the nonlinear dynamical complexity in brain signals over a range of temporal scales. The recent advent of nonlinear analytic methods, which have served for the quantitative description of the brain signal complexity, has provided new insights into aberrant neural connectivity in many mental disorders. Although many studies have underpinned aberrant neural connectivity, findings related to complexity behavior are still inconsistent. This inconsistency might result from (i) heterogeneity in mental disorders, (ii) analytical issues, (iii) interference of typical development and aging. First, most mental disorders are heterogeneous in their clinical feature or intrinsic pathological mechanisms. Second, neurophysiologic output signals from complex brain connectivity might be characterized with multiple time scales or frequencies. Finally, age-related brain complexity changes must be considered when investigating pathological brain because typical brain complexity is not constant across generations. Future systematic studies addressing these issues will greatly expand our knowledge of neural connections and dynamics related to mental disorders.
Mcshane, Gerard; Bazzano, Cheryl; Walter, Garry; Barton, Giles
The purpose of this study was to evaluate the outcome of adolescents with anxiety-based school attendance problems enrolled in a specialist adolescent educational and mental health program that provides educational assistance and social skills development, and to suggest key elements that may account for its apparent effectiveness. Young people attending the Sulman Program in Sydney, Australia, between March 2003 and December 2004 were identified. Baseline information was gathered from the medical records, pre and postintervention personal development questionnaires were given to students, and pre and postratings of function were made. Those attending the program showed improvement in their general level of functioning indicated by completion of a year-long course of study (17 of 24), preparation for employment (17), increased independent travel (5), and self-rated improvement in social skills, stress tolerance and emotional literacy. Pre and poststaff ratings on the Health of the Nation Outcomes Scales Child and Adolescent (HoNOSCA), Children's Global Assessment Scale (CGAS) and Global Assessment of Functioning (GAF) indicated improvement in personal and social functioning. Parental satisfaction was rated as high. The findings confirm the effectiveness of, and need for, flexible programs to support adolescents with social anxiety disorder and other longer-term mental health problems to offset the adverse consequences of early withdrawal from educational and social environments. Several elements may help to explain the program's effectiveness and provide guidance for similar programs elsewhere.
McLaughlin, Katie A.; Gadermann, Anne M.; Hwang, Irving; Sampson, Nancy A.; Al-Hamzawi, Ali; Andrade, Laura Helena; Angermeyer, Matthias C.; Benjet, Corina; Bromet, Evelyn J.; Bruffaerts, Ronny; Caldas-de-Almeida, José Miguel; de Girolamo, Giovanni; de Graaf, Ron; Florescu, Silvia; Gureje, Oye; Haro, Josep Maria; Hinkov, Hristo Ruskov; Horiguchi, Itsuko; Hu, Chiyi; Karam, Aimee Nasser; Kovess-Masfety, Viviane; Lee, Sing; Murphy, Samuel D.; Nizamie, S. Haque; Posada-Villa, José; Williams, David R.; Kessler, Ronald C.
Background Associations between specific parent and offspring mental disorders are likely to have been overestimated in studies that have failed to control for parent comorbidity. Aims To examine the associations of parent with respondent disorders. Method Data come from the World Health Organization (WHO) World Mental Health Surveys (n = 51 507). Respondent disorders were assessed with the Composite International Diagnostic Interview and parent disorders with informant-based Family History Research Diagnostic Criteria interviews. Results Although virtually all parent disorders examined (major depressive, generalised anxiety, panic, substance and antisocial behaviour disorders and suicidality) were significantly associated with offspring disorders in multivariate analyses, little specificity was found. Comorbid parent disorders had significant sub-additive associations with offspring disorders. Population-attributable risk proportions for parent disorders were 12.4% across all offspring disorders, generally higher in high- and upper-middle- than low-/lower-middle-income countries, and consistently higher for behaviour (11.0-19.9%) than other (7.1-14.0%) disorders. Conclusions Parent psychopathology is a robust non-specific predictor associated with a substantial proportion of offspring disorders. PMID:22403085
National Center for Education in Maternal and Child Health, Arlington, VA.
Items in this annotated bibliography deal with the mental health of adolescents and include materials for adolescents, parents, health educators, and health professionals. Resources cited include 11 videotapes and 64 publications dealing with the following topics: (1) teenage suicide; (2) mental illness in the family; (3) coping; (4) teenage…
Lund, Crick; Boyce, Gerard; Flisher, Alan J.; Kafaar, Zuhayr; Dawes, Andrew
Background: Children and adolescents with mental health problems have poor service cover in low- and middle-income countries. Little is known about the resources that would be required to provide child and adolescent mental health services (CAMHS) in these countries. The purpose of this study was to calculate the human resources and associated…
Hassiotis, A.; Turk, J.
Background: Little research has been conducted on the mental health needs of adolescents with intellectual disability, despite the severity and rates of such needs being high throughout childhood and in adulthood. We have investigated the prevalence and predictors of mental health needs and service use in adolescents with intellectual…
Elbedour, S.; Bart, William; Hektner, Joel
Previous studies of polygamy and child mental health have primarily focused on younger children. The present studies are among the first to focus on adolescents. The first study involved 210 randomly selected Bedouin Arab adolescents (mean age 15.9), who were administered instruments assessing their family environment and mental health. The second…
Samargia, Luzette A.; Saewyc, Elizabeth M.; Elliott, Barbara A.
Adolescents forego mental health care in spite of self-perceived needs for services; this presents a significant public health problem. Using data from the 2001 Adolescent Health Care Access Survey of 16-year-olds in Saint Louis County, Minnesota, we assessed barriers to mental health care among the 878 respondents who reported ever needing…
Walcott, Christy M.; Music, Ajlana
Extensive research suggests that adolescence is a critical developmental period, especially when it comes to factors that influence mental health problems. Systematic efforts to promote adolescent help-seeking are essential for improving long-term mental health outcomes. Defined as a "behavior of actively seeking help from other people,"…
Hagen, Beverly Hartung
Reviews relevant literature on the subject of rural adolescent mental health. Discusses demographics, unique situations, and problems of rural youth. Presents impact of the rural economic crisis. Suggests treatment strategies to deal with mental health problems of rural adolescents: individual therapy, family therapy, and peer group programs. (NEC)
Hanson, Mark D.; Johnson, Samantha; Niec, Anne; Pietrantonio, Anna Marie; High, Bradley; MacMillan, Harriet; Eva, Kevin W.
Objective: Adolescent mental illness stigma-related factors may contribute to adolescent standardized patients' (ASP) discomfort with simulations of psychiatric conditions/adverse psychosocial experiences. Paradoxically, however, ASP involvement may provide a stigma-reduction strategy. This article reports an investigation of this hypothetical…
Lake, Johanna K.
Adolescents and adults with an autism spectrum disorder (ASD) who do not have an intellectual impairment or disability (ID), described here as individuals with high-functioning autism spectrum disorder (HFASD), represent a complex and underserved psychiatric population. While there is an emerging literature on the mental health needs of children with ASD with normal intelligence, we know less about these issues in adults. Of the few studies of adolescents and adults with HFASD completed to date, findings suggest that they face a multitude of cooccurring psychiatric (e.g., anxiety, depression), psychosocial, and functional issues, all of which occur in addition to their ASD symptomatology. Despite this, traditional mental health services and supports are falling short of meeting the needs of these adults. This review highlights the service needs and the corresponding gaps in care for this population. It also provides an overview of the literature on psychiatric risk factors, identifies areas requiring further study, and makes recommendations for how existing mental health services could include adults with HFASD. PMID:25276425
Benjet, Corina; Borges, Guilherme; Medina-Mora, Maria Elena; Zambrano, Joaquin; Aguilar-Gaxiola, Sergio
Background: Because the epidemiologic data available for adolescents from the developing world is scarce, the objective is to estimate the prevalence and severity of psychiatric disorders among Mexico City adolescents, the socio-demographic correlates associated with these disorders and service utilization patterns. Methods: This is a multistage…
De Block, Andreas
Mental disorders are often thought to be harmful dysfunctions. Jerome Wakefield has argued that such dysfunctions should be understood as failures of naturally selected functions. This suggests, implicitly, that evolutionary biology and other Darwinian disciplines hold important information for anyone working on answering the philosophical question, 'what is a mental disorder?'. In this article, the author argues that Darwinian theory is not only relevant to the understanding of the disrupted functions, but it also sheds light on the disruption itself, as well as on the harm that attends the disruption. The arguments advanced here are partially based on the view that a core feature of Darwinism is that it stresses the environmental relativity of functions and dysfunctions. These arguments show a very close empirical connection between social judgments (values) and dysfunctions (psychopathology), which is of interest for psychiatric theory. Philosophically, they lead to the conclusion that the concept of mental disorder is identical to the concept of mental dysfunction. Consequently, it is both misleading and redundant to conceptualize mental disorders as 'harmful dysfunctions', and not simply as 'mental dysfunctions'.
Przedworski, Julia M.; VanKim, Nicole A.; Eisenberg, Marla E.; McAlpine, Donna D.; Lust, Katherine A.; Laska, Melissa N.
Introduction Sexual minority college students (i.e., those not identifying as heterosexual, or those reporting same-sex sexual activity) may be at increased risk of poor mental health, given factors such as minority stress, stigma, and discrimination. Such disparities could have important implications for students’ academic achievement, future health, and social functioning. This study compares reports of mental disorder diagnoses, stressful life events, and frequent mental distress across five gender-stratified sexual orientation categories. Methods Data were from the 2007–2011 College Student Health Survey, which surveyed a random sample of college students (N=34,324) at 40 Minnesota institutions. Data analysis was conducted in 2013–2014. The prevalence of mental disorder diagnoses, frequent mental distress, and stressful life events were calculated for heterosexual, discordant heterosexual, gay or lesbian, bisexual, and unsure students. Logistic regression models were fit to estimate the association between sexual orientation and mental health outcomes. Results Lesbian, gay, and bisexual students were more likely to report any mental health disorder diagnosis than heterosexual students (p<0.05). Lesbian, gay, bisexual, and unsure students were significantly more likely to report frequent mental distress compared to heterosexual students (OR range, 1.6–2.7). All sexual minority groups, with the exception of unsure men, had significantly greater odds of experiencing two or more stressful life events (OR range, 1.3–2.8). Conclusions Sexual minority college students experience worse mental health than their heterosexual peers. These students may benefit from interventions that target the structural and social causes of these disparities, and individual-level interventions that consider their unique life experiences. PMID:25997903
Hemayattalab, Rasool; Movahedi, Ahmadreza
The purpose of this study was to investigate the effect of five variations of imagery and physical practice on learning of Basketball free throws in adolescents with mental retardation (AWMR). Forty AWMR were randomly assigned to five groups and performed a variation of practice: physical practice, mental practice, physical practice followed by…
Laghi, Fiorenzo; Lonigro, Antonia; Levanto, Simona; Ferraro, Maurizio; Baumgartner, Emma; Baiocco, Roberto
The study aimed at verifying if nice and nasty theory of mind behaviors, in association with teachers' peer buddy nomination, could be used to correctly select peer models for adolescents with autism spectrum disorder. Mentalizing abilities and emotional and behavioral characteristics of 601 adolescents were assessed. Results suggest that teachers…
Takeuchi, David T.; Hong, Seunghye; Gile, Krista; Alegría, Margarita
In this article, we use age of immigration as a proxy for the developmental context for understanding the association between immigration experiences and mental health. Generation defines the context under which immigrants arrive in the United States. We drew data from the National Latino and Asian American Study (N = 2,095), the first ever study conducted on the mental health of a national sample of Asian Americans. Our findings reveal that age of immigration is linked to lifetime and 12-month rates of psychiatric disorder: Immigrants who arrive earlier in life are more likely to have both lifetime and 12-month disorders. U.S. born and immigrants who arrive as children are much more likely to have a mental disorder in their lifetimes than other immigrant generations. PMID:20150976
Golden, Neville H
Eating disorders are prevalent in adolescents and are associated with significant medical and psychiatric morbidity. Amenorrhoea, one of the cardinal features of anorexia nervosa, is the most likely reason for consulting the gynaecologist. Amenorrhoea in a young woman should alert the gynaecologist to the possibility of an underlying eating disorder. Osteopenia is a potentially irreversible complication of prolonged amenorrhoea and a low oestrogen state. Eating disorders are best managed by a team approach, with the team comprising a physician, nutritionist and therapist. Oestrogen replacement therapy has not been shown to be an effective treatment for osteopenia in anorexia nervosa and the gynaecologist should avoid simply prescribing oestrogen replacement therapy without referring the patient for comprehensive treatment of the eating disorder. Nutritional rehabilitation, weight restoration and resumption of spontaneous menses are the mainstay of medical management. Calcium and vitamin D supplementation and moderate weight-bearing exercise should be prescribed where indicated. Newer therapeutic options for the treatment of osteopenia include DHEA, IGF-1 and alendronate.
Andrade, Laura Helena; Wang, Yuan-Pang; Andreoni, Solange; Silveira, Camila Magalhães; Alexandrino-Silva, Clovis; Siu, Erica Rosanna; Nishimura, Raphael; Anthony, James C.; Gattaz, Wagner Farid; Kessler, Ronald C.; Viana, Maria Carmen
Background World population growth is projected to be concentrated in megacities, with increases in social inequality and urbanization-associated stress. São Paulo Metropolitan Area (SPMA) provides a forewarning of the burden of mental disorders in urban settings in developing world. The aim of this study is to estimate prevalence, severity, and treatment of recently active DSM-IV mental disorders. We examined socio-demographic correlates, aspects of urban living such as internal migration, exposure to violence, and neighborhood-level social deprivation with 12-month mental disorders. Methods and Results A representative cross-sectional household sample of 5,037 adults was interviewed face-to-face using the WHO Composite International Diagnostic Interview (CIDI), to generate diagnoses of DSM-IV mental disorders within 12 months of interview, disorder severity, and treatment. Administrative data on neighborhood social deprivation were gathered. Multiple logistic regression was used to evaluate individual and contextual correlates of disorders, severity, and treatment. Around thirty percent of respondents reported a 12-month disorder, with an even distribution across severity levels. Anxiety disorders were the most common disorders (affecting 19.9%), followed by mood (11%), impulse-control (4.3%), and substance use (3.6%) disorders. Exposure to crime was associated with all four types of disorder. Migrants had low prevalence of all four types compared to stable residents. High urbanicity was associated with impulse-control disorders and high social deprivation with substance use disorders. Vulnerable subgroups were observed: women and migrant men living in most deprived areas. Only one-third of serious cases had received treatment in the previous year. Discussion Adults living in São Paulo megacity had prevalence of mental disorders at greater levels than similar surveys conducted in other areas of the world. Integration of mental health promotion and care into the
Williams, Marian E.; Haranin, Emily C.
Up to 70% of children with autism spectrum disorders (ASD) have a co-occurring mental health disorder; however, many clinicians feel unprepared to serve children with complex co-occurring conditions. This study surveyed 64 mental health clinicians working in 21 publically-funded mental health agencies in a large urban setting to explore their…
Tromp, Noor B; Koot, Hans M
The aim of the present study was to relate and compare two approaches to personality pathology in adolescents. Dimensions of personality pathology, assessed by the Dimensional Assessment of Personality Pathology-Basic Questionnaire for Adolescents (DAPP-BQ-A; Tromp & Koot, 2008), were related to DSM-IV personality disorder (PD) symptoms in 168 adolescents referred for mental health services. Correlational analyses revealed that the DAPP-BQ-A higher- and lower-order dimensions were related to PD symptoms in predictable ways. Regression analyses showed that for all but three PDs (Schizoid, Schizotypal, and Passive-Aggressive), lower-order dimensions accounted for unique variance, after controlling for gender, age, and co-occurring PD symptoms. It is concluded that dimensional assessment may provide valuable information on adolescent personality pathology, and facilitate the study of developmental antecedents of adult personality pathology.
ÇAKIN MEMİK, Nursu; KARAKAYA, Işık; YILDIZ, Özlem; ŞIŞMANLAR, Şahika; ÇAĞLAYAN, Çiğdem; AĞAOĞLU, Belma
Introduction In this study, we aimed to determine the changes in quality of life of children/adolescents with anxiety disorders during six months of sertraline treatment, to investigate parent-child/adolescent concordance in perception of quality of life and to examine the effect of treatment on children/adolescents. Methods In this study, 30 patients with anxiety disorders according to criteria specified in Diagnostic and Statistical Manual of Mental Disorders, 4th. Edition (DSM-IV) were assigned to sertraline treatment. The patients were evaluated using the Pediatric Quality of Life Inventory (PedsQL), State-Trait Anxiety Inventory for Children, Clinical Global Impression Scale (CGI) and the Children’s Global Assessment Scale (CGAS) at 0th, 2nd and 6th months. Results PedsQL total scores increased significantly with the treatment in children and adolescents (p<.001), however, no differences were observed in parent proxy report (p=.326). The mean CGAS score was 59.85±7.73 at the beginning of treatment and 73.70±7.01 at the end of treatment (p<.001). The average CGI score decreased from 4.68±.96 to 2.27±.84. Conclusion It was observed that perception of quality of life in children and adolescents with anxiety disorders increased with the treatment.
Nooner, Kate B; Linares, L Oriana; Batinjane, Jessica; Kramer, Rachel A; Silva, Raul; Cloitre, Marylene
Studies of posttraumatic stress disorder (PTSD) in adolescence published from 2000 to 2011 indicate that adolescents are at greater risk of experiencing trauma than either adults or children, and that the prevalence of PTSD among adolescents is 3-57%. Age, gender, type of trauma, and repeated trauma are discussed as factors related to the increased rates of adolescent PTSD. PTSD in adolescence is also associated with suicide, substance abuse, poor social support, academic problems, and poor physical health. PTSD may disrupt biological maturational processes and contribute to the long-term emotion and behavior regulation problems that are often evident in adolescents with the disorder. Recommendations are presented for practice and research regarding the promotion of targeted prevention and intervention services to maximize adolescents' strengths and minimize vulnerabilities. Public policy implications are discussed.
Salles, Fanny Helena Martins; Soares, Pedro San Martin; Wiener, Carolina David; Mondin, Thaise Campos; da Silva, Paula Moraes; Jansen, Karen; de Mattos Souza, Luciano Dias; da Silva, Ricardo Azevedo; Oses, Jean Pierre
Nerve growth factor (NGF) is an important member of the neurotrophin family and its alteration has been associated with psychiatric disorders. Functionality consists of the activities that an individual can perform, as well as their social participation, which is an important factor in analyzing the carrier living conditions of subjects with psychiatric suffering. Several studies have evaluated functionality in bipolar disorder; however, no studies have evaluated the functionality in other mental disorders. There are also few studies investigating the association between functionality and the biological bases of mental disorders. This study aimed to evaluate the serum NGF levels in psychiatric patients and to verify a possible association between the serum neurotrophic levels and functionality. This was a cross-sectional study with a convenient sample obtained from the Public Mental Health Service from the south of Brazil. The final sample was composed of 286 patients enrolled from July 2013 to October 2014. Data was collected using a sociodemographic questionnaire, and the diagnosis was confirmed using the Mini International Neuropsychiatric Interview (M.I.N.I) and a Functioning Assessment Short Test. The serum NGF levels were determined using the enzyme-linked immunosorbent assay method. Statistical analyses were performed using IBM SPSS Statistic 21.0 software. NGF serum levels were increased significantly in patients with obsessive–compulsive disorder compared with patients with no obsessive–compulsive disorder (P=0.015). An increase in serum NGF levels in generalized anxiety disorder patients was observed compared with patients with no generalized anxiety disorder (P=0.047). NGF was negatively associated with autonomy (P=0.024, r=−0.136), work (P=0.040, r=−0.124), and cognition (P=0.024, r=−0.137), thereby showing that changes in serum levels of NGF are associated with functionality in mental disorders. PMID:28053561
Forensic mental health services exist in a nebulous space at the intersection of two different systems-criminal justice and mental health-and the entanglement of these systems poses intricate problems for psychiatrists. This article discusses the present circumstances of forensic mental health services in Japan, focusing on trends in prison psychiatry. In the traditional Japanese system, offenders with mental disorders were treated within general psychiatry as involuntarily admitted patients, or within the prison system as mentally ill inmates. As a consequence of recent legal reform, however, this situation has radically changed. The Medical Treatment and Supervision Act of 2005 aimed to provide intensive psychiatric treatment to offenders with mental disorders, attaching great importance to their reintegration into society. Under the new system, a person who commits a serious criminal offense in a state of insanity or diminished capacity shall be referred by the public prosecutor to the district court; following a treatment order of the court, the person shall be treated in psychiatric facilities established by the law. While the new system is expected to play a role in the context of specialist forensic psychiatry, its distinction from general psychiatry remains unclear. For example, persons who commit serious crimes, such as assault, in an acute psychotic state are occasionally admitted to general psychiatric hospitals, even if they meet the criteria for a treatment order under the Medical Treatment and Supervision Act. The relationship between prison psychiatry and specialist forensic psychiatry is still more problematic. Compared to the intensive, rehabilitation-oriented care provided under the Medical Treatment and Supervision Act, mental health services in penal institutions have a number of disadvantages, and it is unlikely that mentally ill prisoners have benefited from the recent progress in forensic psychiatry. Statistics show that the number of
Essau, Cecilia A.; Lewinsohn, Peter M.; Olaya, Beatriz; Seeley, John R.
Background Anxiety disorders are associated with adverse psychosocial functioning, and are predictive of a wide range of psychiatric disorders in adulthood. Objective The present study examined the associations between anxiety disorders during childhood and adolescence and psychosocial outcomes at age 30, and sought to address the extent to which psychopathology after age 19 mediated these relations. Method Eight hundred and sixteen participants from a large community sample were interviewed twice during adolescence, at age 24, and at age 30. They completed self-report measures of psychosocial functioning and semi-structured diagnostic interviews during adolescence and young adulthood. Results Childhood anxiety only predicted less years of completed education at age 30, whereas adolescent anxiety predicted income, unemployment, maladjustment, poor coping skills, more chronic stress and life events. Adult major depressive disorder (MDD) was the only disorder predicted by childhood anxiety, whereas adolescent anxiety predicted MDD, substance (SUD) and alcohol abuse/dependence (AUD) in adulthood. No adult psychopathology mediated the relationship between childhood anxiety disorders and psychosocial outcomes at age 30. Adult MDD, SUD and AUD partially or completely mediated the association between adolescent anxiety and most domains of psychosocial functioning at age 30. Limitations The participants are ethically and geographically homogenous, and changes in the diagnostic criteria and the interview schedules across the assessment periods. Conclusion Adolescent anxiety, compared to childhood anxiety, is associated with more adverse psychosocial outcomes at age 30. Adolescent anxiety affects negative outcomes at age 30 directly and through MDD, SUD and AUD. PMID:24456837
Zimmermann, Peter; Iwanski, Alexandra; Çelik, Fatma
From an attachment perspective, insecure attachment patterns in both infancy and adolescence are risk factors for the development of anxiety disorders in adolescence. Dysfunctional emotion regulation and biased social information processing are possible mediating processes. This study examines differences in emotion regulation, emotional vulnerability, and behaviour inhibition in adolescents with clinical diagnosis of anxiety disorder and healthy controls. Adolescents with anxiety disorder reported more maladaptive emotion regulation depending on the specific emotion and a higher incidence of reporting hurt feelings in social interactions. In contrast, behaviour inhibition did not explain additional variance. The results suggest that adolescents with anxiety disorders show a bias in the interpretation of social interactions as frequently emotionally hurting, and the use of dysfunctional emotion regulation strategies that minimize the possibility for effective social emotion regulation by close others or therapists. The results are interpreted within attachment framework.
Pine, Daniel S; Fox, Nathan A
Progress in treating and preventing mental disorders may follow from research that integrates development, genetics, and neuroscience. This review first delineates how longitudinal research has identified three particular groups of disorders shown to differ on the basis of symptom trajectories and risk-factor profiles. In the next section, the review describes how research on genetic contributions to psychopathology has elucidated the nature of risk for two groups of disorders, the neurodevelopmental and psychotic disorders. In the third section, the review describes how research on environmental contributions to psychopathology has targeted early temperament, its associated perturbations in information-processing functions, and its relations to a third group of disorders, the emotional disorders. For all three groups of disorders, such integrative research has generated ideas about novel interventions. The hope is that over the coming decade such ideas will lead to novel treatments that alter the trajectory of risk in developmental psychopathology.
Chisholm, D; Flisher, A J; Lund, C; Patel, V; Saxena, S; Thornicroft, G; Tomlinson, M
We call for the global health community, governments, donors, multilateral agencies, and other mental health stakeholders, such as professional bodies and consumer groups, to scale up the coverage of services for mental disorders in all countries, but especially in low-income and middle-income countries. We argue that a basic, evidence-based package of services for core mental disorders should be scaled up, and that protection of the human rights of people with mental disorders and their families should be strengthened. Three questions are critical to the scaling-up process. What resources are needed? How can progress towards these goals be monitored? What should be the priorities for mental health research? To address these questions, we first estimated that the amount needed to provide services on the necessary scale would be US$2 per person per year in low-income countries and $3-4 in lower middle-income countries, which is modest compared with the requirements for scaling-up of services for other major contributors to the global burden of disease. Second, we identified a series of core and secondary indicators to track the progress that countries make toward achievement of mental health goals; many of these indicators are already routinely monitored in many countries. Third, we did a priority-setting exercise to identify gaps in the evidence base in global mental health for four categories of mental disorders. We show that funding should be given to research that develops and assesses interventions that can be delivered by people who are not mental health professionals, and that assesses how health systems can scale up such interventions across all routine-care settings. We discuss strategies to overcome the five main barriers to scaling-up of services for mental disorders; one major strategy will be sustained advocacy by diverse stakeholders, especially to target multilateral agencies, donors, and governments. This Series has provided the evidence for advocacy
Bagadia, V N; Shah, L P; Pradhan, P V; Gada, M T
1. Mental health gets a low priority all over the world but much more so in developing countries. 2. In India, modern psychiatric facilities are available only in the cities. Mental hospitals are becoming modernized but the backbone of psychiatry is the psychiatric department in the General Hospital where treatment is out-patient and family based except short admissions for crisis intervention. 3. Psychotropic drugs are preferred both by psychiatrists and patients, next being electroconvulsive therapy (ECT) and other physical treatments followed by psychotherapies. 4. In view of paucity of facilities, 80% of the population has to depend on indigenous treatments consisting of Ayurvedic and Unani systems of medicine, religious treatments consisting of prayers, fasting, etc. and various witchcraft and magical rituals.
Maurizi, Laura K; Gershoff, Elizabeth T; Aber, J Lawrence
The phenomenon of discordance between parents' and children's ratings of the child's mental health symptoms or of parenting behavior until recently has been treated as a problem of reliability. More recent work has sought to identify factors that may influence discordance, yet much remains to be learned about why informants' ratings of developmental phenomena are discordant and the meaning of such discordance. This study examined the extent to which discordance can be treated as a measure of the difference between two equally valid perceptions, and as such an indicator of the quality of the parent-adolescent relationship. One category of concordance and three patterns of discordance were derived from item-level differences in ratings of affection, control, and punitiveness provided by a diverse sample (53% female; 46% Hispanic-American, 35% African-American, 15% European-American, 4% another race/ethnicity) of 484 adolescents aged 12-20 years (M = 15.67, SD = 1.72) and their parents. Over and above adolescents' and parents' independent ratings of parenting, the discordance between these ratings was found to predict adolescent reports of anxiety and conduct disorder symptoms, as well as the quality of the parent-adolescent relationship. This was particularly true when adolescents and parents were discordant in their ratings of affection and when adolescents rated their parents higher on affection than did parents themselves. Implications of these findings and future research directions are discussed.
Fatemi, S Hossein; Folsom, Timothy D
Fragile X mental retardation protein (FMRP) is highly enriched in neurons and binds to approximately 4% of mRNAs in mammalian brain. Its loss is a hallmark of fragile X syndrome (FXS), the most common form of mental retardation. In this review we discuss the mutation in the fragile X mental retardation-1 gene (FMR1), that leads to FXS, the role FMRP plays in neuronal cells, experiments from our own laboratory that demonstrate reductions of FMRP in additional psychiatric disorders (autism, schizophrenia, bipolar disorder, and major depressive disorder), and potential therapies to ameliorate the loss of FMRP. This article is part of a Special Issue entitled 'Trends in neuropharmacology: in memory of Erminio Costa'.
Bartlett, Delwyn J; Biggs, Sarah N; Armstrong, Stuart M
Delayed sleep phase disorder (DSPD) - a circadian rhythm sleep disorder - is most commonly seen in adolescents. The differential diagnosis between DSPD and conventional psychophysiological insomnia is important for correct therapeutic intervention. Adolescent DSPD sleep duration is commonly 9 hours or more. Depression may be comorbid with DSPD. DSPD has a negative impact on adolescent academic performance. DSPD treatments include bright light therapy, chronotherapeutic regimens, and administration of melatonin as a chronobiotic (as distinct from a soporific). Attention to non-photic and extrinsic factors including healthy sleep parameters is also important to enable better sleep and mood outcomes in adolescents.
Sachdev, Perminder S.; Mohan, Adith; Taylor, Lauren; Jeste, Dilip V.
About every 20 years, the American Psychiatric Association revises its official classification of mental disorders. The fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was published in 2013, exciting considerable commentary, debate and criticism. This article briefly describes the process that led to the DSM-5 and the main changes from the previous version (DSM-IV) that would be of interest to a geriatric psychiatrist. While there have been a number of changes in the areas of schizophrenia, bipolar disorder, depressive disorders and anxiety disorders, the majority of these changes are minor and unlikely to have major treatment implications. The classification of neurocognitive disorders has however seen a major revision and elaboration in comparison with DSM-IV, with the introduction of Mild and Major Neurocognitive Disorders, the latter equated with dementia. A common language is introduced for the criteria of the various etiological subtypes of neurocognitive disorders. All physicians treating patients with neurocognitive disorders should familiarize themselves with these criteria. Their use in research has the potential to harmonize the field. PMID:26332215
Betancourt, Theresa Stichick; Rubin-Smith, Julia E.; Beardslee, William R.; Stulac, Sara N.; Fayida, Ildephonse; Safren, Steven
In assessing the mental health of HIV/AIDS-affected children and adolescents in Sub-Saharan Africa, researchers often employ mental health measures developed in other settings. However, measures derived from standard Western psychiatric criteria are frequently based on conceptual models of illness or terminology that may or may not be an appropriate for diverse populations. Understanding local perceptions of mental health problems can aid in the selection or creation of appropriate measures. This study used qualitative methodologies (Free Listing [FL], Key Informant [KI] interviews, and Clinician Interviews [C-KIs]) to understand local perceptions of mental health problems facing HIV/AIDS-affected youth in Rwinkwavu, Rwanda. Several syndrome terms were identified by participants: agahinda kenshi, kwiheba, guhangayika, ihahamuka, umushiha and uburara. While these local syndromes share some similarities with Western mood, anxiety, and conduct disorders, they also contain important culture-specific features and gradations of severity. Our findings underscore the importance of understanding local manifestations of mental health syndromes when conducting mental health assessments and when planning interventions for HIV/AIDS-affected children and adolescents in diverse settings. PMID:21271393
Hayes, Joseph F; Maughan, Daniel L; Grant-Peterkin, Hugh
Summary To date there have been few peer-reviewed studies on the feasibility, acceptability and effectiveness of digital technologies for mental health promotion and disorder prevention. Any evaluation of these evolving technologies is complicated by a lack of understanding about the specific risks and possible benefits of the many forms of internet use on mental health. In order to adequately meet the mental health needs of today’s society, psychiatry must engage in rigorous assessment of the impact of digital technologies. PMID:26932479
Martin, Laurie; Milot, Alyssa
Mental health problems can develop at any point in life and may be influenced by a variety of factors, including genetics or family history of a disorder, chemical imbalances in the brain, or stressors in the environment. Adolescence is a time of great change and transition, when youth are starting to make decisions about career paths, further…
Gahr, M; Connemann, B J; Freudenmann, R W; Kölle, M A; Schönfeldt-Lecuona, C J
Animal hoarding (AH) is a mental disorder that is characterised by an excessive number of kept animals, inability to maintain minimal standards of animal care and hygiene, and deficient insight into the thereby developing failures and problems. Although AH as a disease concept is neither represented in the DSM-5 nor the ICD-10, it may be classified as a subform of the hoarding disorder (DSM-5 300.3) that was implemented in the DSM-5 as an obsessive-compulsive disorder. Due to the hygienic deficiencies of the living spaces and the insufficient keeping of animals there is an increased risk of epizootic diseases and zoonoses. Specific epidemiological studies do not exist, however, women seem to be affected more frequently. AH is diagnosed mostly in late adulthood. Besides thorough somatic and psychiatric medical diagnostics, cooperation with the veterinary offices and authorities is usually necessary. Comorbid mental disorders (particularly depressive, obsessive-compulsive and personality disorders) are frequent. Currently, no evidence-based therapies exist. Social therapy and cognitive-behavioural psychotherapeutic interventions as well as sufficient treatment of comorbid mental disorders are recommended.
Stanton, A; Kennedy, M; Spingarn, R; Rotheram-Borus, M J
Models of program development have primarily focused on the internal organizational processes needed to plan, implement, and evaluate new service programs. However, creating an external demand for new programs by policy makers, administrative bureaucracies, public health officials, and funders is critical to establishing new programs. A series of deaths of seropositive youth and an absence of local service settings with staff trained to address the needs of youth living with HIV provided the impetus for Larkin Street Youth Center. In particular, the agency had to overcome stigma associated with having both substance use and mental health disorders to establish service programs to recruit and mobilize staff within the agency and the local community and to establish a comprehensive housing program for symptomatic HIV-infected adolescents. This article examines how a residential assisted care facility for HIV-seropositive adolescents was established using organizational strategic planning processes, problem solving, and social marketing frameworks.
Kessler, Ronald C.; Avenevoli, Shelli; Costello, Jane; Green, Jennifer Greif; Gruber, Michael J.; McLaughlin, Katie A.; Petukhova, Maria; Sampson, Nancy A.; Zaslavsky, Alan M.; Merikangas, Kathleen Ries
Context Estimates of DSM-IV disorder prevalence are high; stringent criteria to define need for services are desired. Objective To present US national data on the prevalence and sociodemographic correlates of 12-month serious emotional disturbance (SED), defined by the US Substance Abuse and Mental Health Services Administration, from the National Comorbidity Survey Replication Adolescent Supplement. Design The National Comorbidity Survey Replication Adolescent Supplement is a national survey of DSM-IV anxiety, mood, behavior, and substance disorders among US adolescents. Setting Dual-frame household and school samples of US adolescents. Participants Total of 6483 pairs of adolescents aged 13 to 17 (interviews) and parents (questionnaires). Main Outcome Measures The DSM-IV disorders were assessed with the World Health Organization Composite International Diagnostic Interview and validated with blinded clinical interviews based on the Schedule for Affective Disorders and Schizophrenia for School-Age Children. Serious emotional disturbance was operationalized as a DSM-IV/Composite International Diagnostic Interview disorder with a score of 50 or less on the Children’s Global Assessment Scale (ie, moderate impairment in most areas of functioning or severe impairment in at least 1 area). Concordance of Composite International Diagnostic Interview SED diagnoses with blinded Schedule for Affective Disorders and Schizophrenia for School-Age Children diagnoses was good. Results The estimated prevalence of SED was 8.0%. Most SEDs were due to behavior (54.5%) or mood (31.4%) disorders. Although respondents with 3 or more disorders made up only 29.0% of those with 12-month DSM-IV/Composite International Diagnostic Interview disorders, they constituted 63.5% of SEDs. Predictive effects of high comorbidity were significantly greater than the product of their disorder-specific odds ratios and consistent across disorder types. Associations of sociodemographic variables with SED
Cramer, Phebe; Kelly, Francis D
The use of defense mechanisms by male and female adolescents with a diagnosis of conduct disorder was compared with the defense use of adolescents with a diagnosis of adjustment reaction. Because conduct disorder has been shown to be associated with a developmental lag in several areas of psychological functioning, we expected that these adolescents would show immaturity in the use of defenses. This expectation was confirmed. As compared with adjustment reaction, conduct disordered youths were more likely to use the immature defense of denial and less likely to use the mature defense of identification.
Kebede, D; Alem, A
This report examines the prevalence and socio-demographic correlates of affective disorders based on a survey conducted in Addis Ababa between September and December of 1994. An Amharic version of the CIDI was used to collect data from a random community sample of 1420 individuals aged 15 and above. The lifetime prevalence for specific affective disorders was as follows: bipolar disorders 0.3%, depressive episodes 2.7%, recurrent depressive episodes 0.2%, and persistent mood disorders 1.6%. The weighted lifetime prevalence of affective disorders was 5.0% (women 7.7% and men 3.2%). One-month prevalence was 3.8% (women 5.9% and men 2.3%). After adjusting for several potential confounders, the risk of affective disorders was only 29% higher in women compared to men. This difference in risk was not statistically significant. Age was also not associated with risk of affective disorders. On the other hand, education was associated with the risk of disorder, the risk decreasing with increasing educational attainment. This inverse trend was statistically significant (P for trend = 0.02). The risk was also 37% lower in the employed than the unemployed: Odds Ratio (OR), 95% confidence interval (95% CI) = 0.63 (0.39, 1.01). There were no statistically significant associations between affective disorders and marital status or ethnicity.
Ringeisen, Heather; Aldworth, Jeremy; Colpe, Lisa J; Pringle, Beverly; Simile, Catherine
This study investigates whether the six-item Strengths and Difficulties Questionnaire SDQ (five symptoms and one impact item) included in the National Health Interview Survey (NHIS) can be used to construct models that accurately estimate the prevalence of any impairing mental disorder among children 4-17 years old as measured by a shortened Child/Adolescent or Preschool Age Psychiatric Assessment (CAPA or PAPA). A subsample of 217 NHIS respondents completed a follow-up CAPA or PAPA interview. Logistic regression models were developed to model presence of any child mental disorder with impairment (MDI) or with severe impairment (MDSI). Models containing only the SDQ impact item exhibited highly biased prevalence estimates. The best-performing model included information from both the five symptom SDQ items and the impact item, where absolute bias was reduced and sensitivity and concordance were increased. This study illustrates the importance of using all available information from the six-item SDQ to accurately estimate the prevalence of any impairing childhood mental disorder from the NHIS. Copyright © 2015 John Wiley & Sons, Ltd.
Savage, Hannah; Murray, Joanna; Hatch, Stephani L; Hotopf, Matthew; Evans-Lacko, Sara; Brown, June S L
Only a third of people with mental disorders seek professional help. In this study, we aimed to investigate attitudes toward help-seeking among non-help-seekers drawn from a community survey in South London. We conducted qualitative interviews with 24 participants with symptoms of mental disorders. We analyzed data using thematic analysis. Participants' reasons for not seeking professional help included perceiving their problems as normal or unsuitable for professional help, negative expectations of professional help, believing informal strategies were sufficient, fearing being stigmatized for having a mental disorder and help-seeking, and self-perceptions of being strong and/or self-reliant. A small number (n = 4) had resolved their problems. Participants with unresolved mental disorders (n = 20) had more chronic stressors, particularly about finances and family relationships, and greater concerns about professional help and stigma than other participants. Potential targets for interventions to encourage help-seeking could be focused around stigma about help-seeking as well as the self-perception of being strong.
Svennerlind, Christer; Nilsson, Thomas; Kerekes, Nóra; Andiné, Peter; Lagerkvist, Margareta; Forsman, Anders; Anckarsäter, Henrik; Malmgren, Helge
Historically, the Swedish criminal justice system conformed to other Western penal law systems, exempting severely mentally disordered offenders considered to be unaccountable. However, in 1965 Sweden enforced a radical penal law abolishing exceptions based on unaccountability. Mentally disordered offenders have since then been subjected to various forms of sanctions motivated by the offender's need for care and aimed at general prevention. Until 2008, a prison sentence was not allowed for offenders found to have committed a crime under the influence of a severe mental disorder, leaving forensic psychiatric care the most common sanction in this group. Such offenders are nevertheless held criminally responsible, liable for damages, and encumbered with a criminal record. In most cases, such offenders must not be discharged without the approval of an administrative court. Two essentially modern principles may be discerned behind the "Swedish model": first, an attempted abolishment of moral responsibility, omitting concepts such as guilt, accountability, atonement, and retribution, and, second, the integration of psychiatric care into the societal reaction and control systems. The model has been much criticized, and several governmental committees have suggested a re-introduction of a system involving the concept of accountability. This review describes the Swedish special criminal justice provisions on mentally disordered offenders including the legislative changes in 1965 along with current proposals to return to a pre-1965 system, presents current Swedish forensic psychiatric practice and research, and discusses some of the ethical, political, and metaphysical presumptions that underlie the current system.
Wolff, Nancy; Bjerklie, J. R.; Maschi, Tina
Correctional facilities are under increasing pressure to respond to the treatment needs of mentally disordered offenders during their incarceration and to arrange for treatment post release through reentry planning. This paper constructs cost estimates for three different reentry investments using data on the population (n = 2715) of male mentally…
The behavior disorders of 54 Japanese individuals with mental retardation receiving antipsychotic medication were compared to 52 subjects receiving anticonvulsants and 202 subjects without medication. Results found the problem behaviors of subjects receiving antipsychotic drugs were more severe and severity of disability was associated with higher…
CENTERWALL, WILLARD R.; CENTERWALL, SIEGRIED A.
ADDRESSED TO PUBLIC HEALTH WORKERS AND PHYSICIANS IN GENERAL PRACTICE, THE PAMPHLET INTRODUCES METHODS OF DETECTING AND MANAGING PHENYLKETONURIA, AN INHERITED METABOLIC DISORDER ASSOCIATED WITH MENTAL RETARDATION. INFORMATION, UPDATED FROM THE 1961 EDITION, IS INCLUDED ON THE INCIDENCE AND GENETICS, BIOCHEMISTRY, AND CLINICAL COURSE OF THE…
Smith, David T.
This paper reviews literature and clinical experiences on the neurobiological and psychological aspects of sleep in children with mental retardation. The lack of a universal, operational definition of sleep disorders is noted, and a study is cited in which 61% of a group of 20 children (ages 2-13) with developmental disabilities were found to have…
Colins, Olivier F; Grisso, Thomas; Mulder, Eva; Vermeiren, Robert
Having an effective triage tool is an important step toward a careful use of the restricted time and qualified personnel to perform comprehensive psychiatric assessment in juvenile justice settings. The aims of this study were to examine the construct validity of the Massachusetts Youth Screening Inventory-second version (MAYSI-2), and its likelihood to identify youths who might have a psychiatric disorder. Data from up to 781 male adolescents (mean age = 16.73 years) were gathered as part of the standardized mental health screening and assessment in two all-male Youth Detention Centers in the Netherlands. Categorical assessments were based on two structured diagnostic interviews. Sensitivity, specificity, positive and negative predictive values, and the area under the curve were calculated to evaluate the likelihood of the MAYSI-2 to identify youths with a psychiatric disorder. Youths with a disorder scored significantly higher on the corresponding MAYSI-2 subscale than youths without a disorder. In the total sample, 70 % of the youths with a disorder met the Caution cut-off criteria on at least one MAYSI-2 scale, while youths without a psychiatric disorder were very unlikely to meet cut-off criteria for multiple MAYSI-2 scales. Overall, the sensitivity was slightly better when analyses were repeated in groups of youths from various ethnic origins. The findings supported the construct validity of the Dutch MAYSI-2 and suggested that the MAYSI-2 is a valid mental health screening tool that may serve relatively well as a triage tool. Its effectiveness, however, may differ between ethnic groups.
Bechtold, Jordan; Simpson, Theresa; White, Helene R.; Pardini, Dustin
Some evidence suggests that youth who use marijuana heavily during adolescence may be particularly prone to health problems in later adulthood (e.g., respiratory illnesses, psychotic symptoms). However, relatively few longitudinal studies have prospectively examined the long-term physical and mental health consequences associated with chronic adolescent marijuana use. The present study used data from a longitudinal sample of Black and White young men to determine whether different developmental patterns of marijuana use, assessed annually from early adolescence to the mid-20s, were associated with adverse physical (e.g., asthma, high blood pressure) and mental (e.g., psychosis, anxiety disorders) health outcomes in the mid-30s. Analyses also examined whether chronic marijuana use was more strongly associated with later health problems in Black men relative to White men. Findings from latent class growth curve analysis identified four distinct subgroups of marijuana users: early-onset chronic users, late increasing users, adolescence-limited users, and low/nonusers. Results indicated that the four marijuana use trajectory groups were not significantly different in terms of their physical and mental health problems assessed in the mid-30s. The associations between marijuana group membership and later health problems did not vary significantly by race. Findings are discussed within the context of a larger body of work investigating the potential long-term health consequences of early-onset chronic marijuana use, as well as the complications inherent in studying the possible link between marijuana use and health effects. PMID:26237286
Fazel, Mina; Garcia, Jo; Stein, Alan
Access to needed mental health services can be particularly difficult for newly arrived refugee and asylum-seeking adolescents, although many attend school. This study examined young refugees' impressions and experience of mental health services integrated within the school system. Semi-structured interviews were conducted with 40 adolescent refugees discharged by three school-based mental health services across the United Kingdom. Two-thirds preferred to be seen at school. Rumination and worry about insecurity in the asylum process had a negative impact particularly on the adolescents' social functioning and ability to focus at school. The important role played by teachers in supporting and mediating contact with mental health services was valued by those interviewed. The study confirms that schools offer an important location for mental health services for adolescent refugees and provide an important portal for integration of services.
War, Firdous Ahmad; Ved, Rifat Saroosh; Paul, Mohammad Altaf
The primary purpose of this paper was to compare the epidemiology of mental health problems and self-esteem of conflict hit adolescents living in charitable seminaries with their counterparts brought up in natural homes. Substantive body of the literature illustrates the emotional and behavioral issues experienced by these adolescents. In this study, 27 adolescents from a charitable Muslim seminary and 30 adolescents from a regular school were recruited. Self-report measures and clinical interview were used to measure mental health and self-esteem. The findings indicate that adolescents in institution setting may not be having mental health and self-esteem-related issues when compared to adolescents living in intact by parent homes. While the authors acknowledge the limitations of the study, these findings need further research to examine the causes for these differences.
Kawakami, Norito; Abdulghani, Emad Abdulrazaq; Alonso, Jordi; Bromet, Evelyn; Bruffaerts, Ronny; de Almeida, Jose Miguel Caldas; Chiu, Wai Tat; de Girolamo, Giovanni; de Graaf, Ron; Fayyad, John; Ferry, Finola; Florescu, Silvia; Gureje, Oye; Hu, Chiyi; Lakoma, Matthew D.; LeBlanc, William; Lee, Sing; Levinson, Daphna; Malhotra, Savita; Matschinger, Herbert; Medina-Mora, Maria Elena; Nakamura, Yosikazu; Browne, Mark A. Oakley; Okoliyski, Michail; Posada-Villa, Jose; Sampson, Nancy A.; Viana, Maria Carmen; Kessler, Ronald C.
Background Better information on the human capital costs of early-onset mental disorders could increase sensitivity of policy-makers to the value of expanding initiatives for early detection-treatment. Data are presented on one important aspect of these costs: the associations of early-onset mental disorders with adult household income. Methods Data come from the WHO World Mental Health (WMH) Surveys in eleven high income, five upper-middle income, and six low/lower-middle income countries. Information about 15 lifetime DSM-IV mental disorders as of age of completing education, retrospectively assessed with the WHO Composite International Diagnostic Interview, was used to predict current household income among respondents ages 18-64 (n = 37,741) controlling for level of education. Gross associations were decomposed to evaluate mediating effects through major components of household income. Results Early-onset mental disorders are associated with significantly reduced household income in high and upper-middle income countries but not low/lower-middle income countries, with associations consistently stronger among women than men. Total associations are largely due to low personal earnings (increased unemployment, decreased earnings among the employed) and spouse earnings (decreased probabilities of marriage and, if married, spouse employment and low earnings of employed spouses). Individual-level effect sizes are equivalent to 16-33% of median within-country household income, while population-level effect sizes are in the range 1.0-1.4% of Gross Household Income. Conclusions Early mental disorders are associated with substantial decrements in income net of education at both individual and societal levels. Policy-makers should take these associations into consideration in making healthcare research and treatment resource allocation decisions. PMID:22521149
Describes Kleine-Levin syndrome, rare disorder characterized by excessive sleep and abnormal hunger. Notes that, in its pure form, disorder can only be diagnosed in adolescent males. Presents case study of 15-year-old male with disease. Presents evidence which suggests link between Kleine-Levin syndrome and cyclic affective disorders. (Author/ABL)
Sullivan, Aimee E.; Judd, Charles M.; Axelson, David A.; Miklowitz, David J.
The symptoms of bipolar disorder affect and are affected by the functioning of family environments. Little is known, however, about the stability of family functioning among youth with bipolar disorder as they cycle in and out of mood episodes. This study examined family functioning and its relationship to symptoms of adolescent bipolar disorder,…
Bryla, Karen Y.
Disordered eating among American adolescent females represents a significant health issue in our current cultural climate. Disordered eating receives insufficient attention, however, due to the public's unfamiliarity with symptoms and consequences, absence of treatment options, and unreliable instrumentation to detect disordered eating. Disordered…
Wakefield, Jerome C; First, Michael B
The In Review articles in this issue on normality and disorder by Dr Rachel Cooper and Dr Derek Bolton explore the importance of a value component of harm in the concept of mental disorder. They focus on the Diagnostic and Statistical Manual of Mental Disorder's clinical significance criterion, requiring that symptoms cause significant distress or role impairment, as the expression of the harm component. As Dr Bolton argues, harm in the form of distress or role impairment has always been intimately tied to the concept of disorder and treatment decisions; as Dr Cooper argues, without the harm requirement, any disliked anomaly may be labelled a disorder. Moreover, as Cooper argues, a harm requirement is not incompatible with a natural kinds approach to distinguishing among disorders or to a categorical approach to disorder; the lack of zones of rarity on the harm continuum does not preclude categorical underlying causal processes. However, neither paper systematically develops arguments regarding the other component of disorder, the requirement that the harm must be caused by underlying dysfunction. The dysfunction component distinguishes disorders from the many other negative conditions in life. Cooper's identification of dysfunction with symptom severity ignores the fact that normal suffering can be severe, and Bolton's attempt to encompass risk of harm within harm yields an implausibly expansive conception of disorder. While the harm component is essential, clarification of the dysfunction component of the concept of disorder, pursued in part 2 of this In Review in the December 2013 issue, is also essential to establishing a coherent and plausibly limited domain of psychiatric disorder within the broader arena of harmful conditions.
Schuppert, H Marieke; Bloo, Josephine; Minderaa, Ruud B; Emmelkamp, Paul M G; Nauta, Maaike H
The Borderline Personality Disorder Severity Index-IV-adolescent and parent versions (BPDSI-IV-ado/p) are DSM-IV based semi-structured interviews for the assessment of the severity of symptoms of borderline personality disorder (BPD) in adolescents. The present study evaluates the psychometric properties of the BPDSI-IV-ado/p. The interviews were administered to 122 adolescents, aged 14-19 years and their parents/caretakers who were referred to mental health centres for emotion regulation problems, and to 45 healthy controls. The interrater reliability and internal consistency of all nine subscales (following the nine BPD symptoms in DSM-IV) proved to be good to excellent. Discriminant, concurrent, and construct validity were satisfactory. Cut-off scores that optimize sensitivity and specificity were derived. Informant agreement between adolescents and parents/caretakers was modest. The results of this study suggest that the BPDSI-IV adolescent and parent versions are valid and reliable instruments for the assessment of BPD symptom severity in adolescents.
Chen, Wan-Yi; Corvo, Kenneth; Lee, Yookyong; Hahm, Hyeouk Chris
Research on the impact of exposure to community violence tends to define victimization as a single construct. This study differentiates between direct and indirect violence victimization in their association with mental health problems and mental health service use. This study includes 8947 individuals from four waves of the National Longitudinal Study of Adolescent to Adult Health and examines (1) whether sub-types of adolescent victimization are linked to depressive symptoms; (2) whether adolescent victimization is linked with mental health service use; and (3) the role of mental health service use in attenuating symptoms arising from victimizations. Adolescents witnessing community violence were more likely to experience depressive symptoms during adolescence but not during their young adulthood; direct exposure to violence during adolescence does not predict depressive symptoms in adolescence but does in adulthood. Use of mental health service mediates report of depressive symptoms for adolescent witnessing community violence.
..., poisons) 9327Organic mental disorder, other (including personality change due to a general medical... 9416Dissociative amnesia; dissociative fugue; dissociative identity disorder (multiple personality...
..., poisons) 9327Organic mental disorder, other (including personality change due to a general medical... 9416Dissociative amnesia; dissociative fugue; dissociative identity disorder (multiple personality...
..., poisons) 9327Organic mental disorder, other (including personality change due to a general medical... 9416Dissociative amnesia; dissociative fugue; dissociative identity disorder (multiple personality...
Zhou, D M; Tan, H Z; Li, S Q
Mental health status of 726 adolescents and their backgrounds were investigated with Symptom Check List(SCL-90) and self-designed questionnaire. The results showed that the prevalence rate of psychological problems ranged from 6.34% to 24.93%. Among these problems, obsession led all the others. Females had higher scores in interpersonal sensitivity, depression, anxiety, phobia than males. Logistic regression analysis indicated that the major factors contributed to mental health status of adolescents were the relationship between teacher and student, father's concern with his child, only child or not, parents' expectations, personality and sex. The study provides reference source for improving the mental health status of adolescents.
Kamenov, Kaloyan; Cabello, Maria; Caballero, Francisco Félix; Cieza, Alarcos; Sabariego, Carla; Raggi, Alberto; Anczewska, Marta; Pitkänen, Tuuli; Ayuso-Mateos, Jose Luis
Despite the huge body of research on social support, literature has been primarily focused on its beneficial role for both physical and mental health. It is still unclear why people with mental and neurological disorders experience low levels of social support. The main objective of this study was to explore what are the strongest factors related to social support and how do they interact with each other in neuropsychiatric disorders. The study used cross-sectional data from 722 persons suffering from dementia, depression, epilepsy, migraine, multiple sclerosis, Parkinson's disease, schizophrenia, stroke, and substance use disorders. Multiple linear regressions showed that disability was the strongest factor for social support. Extraversion and agreeableness were significant personality variables, but when the interaction terms between personality traits and disability were included, disability remained the only significant variable. Moreover, level of disability mediated the relationship between personality (extraversion and agreeableness) and level of social support. Moderation analysis revealed that people that had mental disorders experienced lower levels of support when being highly disabled compared to people with neurological disorders. Unlike previous literature, focused on increasing social support as the origin of improving disability, this study suggested that interventions improving day-to-day functioning or maladaptive personality styles might also have an effect on the way people perceive social support. Future longitudinal research, however, is warranted to explore causality.
Munkholm, Anja; Olsen, Else Marie; Rask, Charlotte Ulrikka; Clemmensen, Lars; Rimvall, Martin K; Jeppesen, Pia; Micali, Nadia; Skovgaard, Anne Mette
Preadolescence is a key period in the early stages of eating disorder development. The aim of the present study was, firstly, to investigate restrained, emotional and external eating in a general population-based sample of 11-12 year olds. Secondly, we sought to explore how these eating behaviours are associated with possible predictors of eating disorders, such as body dissatisfaction, weight status and mental disorders. A subsample of 1567 children (47.7% boys; 52.3% girls) from the Copenhagen Child Cohort (CCC2000) completed web-based questionnaires on eating behaviours and body dissatisfaction using The Eating Pattern Inventory for Children (EPI-C) and The Children's Figure Rating Scale. Mental disorders were assessed using the online version of the Development and Well-Being Assessment (DAWBA) based on parental replies with final DSM-IV diagnoses determined by experienced child- and adolescent psychiatrists. Height and weight were measured at a face-to-face assessment. The results showed that restrained eating was significantly associated with overweight, body dissatisfaction and emotional disorders in both genders. Emotional eating showed similar associations with overweight and body dissatisfaction in both genders, but was only associated with mental disorders in girls. External eating was significantly associated with body dissatisfaction and neurodevelopmental disorders in both genders, but was only associated with overweight in girls. Our findings show that problematic eating behaviours can be identified in preadolescence, and co-exist with weight problems and mental disorders. Thus restrained, emotional and external eating was, in different ways, associated with overweight, body dissatisfaction and mental disorders. Our findings point to significant eating behaviours in preadolescence, which could constitute potential predictors of later eating disorder risk.
Wu, Monica S; Hamblin, Rebecca J; Storch, Eric A
With many youth presenting to primary care settings for mental health difficulties, knowledge of the respective evidence-based psychotherapies is imperative in ensuring that these youth receive the appropriate interventions in a timely manner. Most frequently, children present with internalizing and/or externalizing disorders, which cover a broad range of common pediatric mental disorders. Treatments of these disorders generally incorporate cognitive and/or behavioral components, which are derived from theoretical underpinnings and empirical support. Although the interventions share common components, they are distinctive in nature and are further tailored toward the idiosyncratic needs of children and their families. Careful consideration of the apposite intervention and individual needs of youth are pertinent to the effective amelioration of symptomology.
Carter, Rebecca R.; Johnson, Shannon M.; Exline, Julie J.; Post, Stephen G.; Pagano, Maria E.
The purpose of this study is to explore narcissistic and prosocial behaviors as reported by adolescents with and without substance dependency disorder (SDD). This study employs a quasi-experimental design using SDD adolescents compared with two normative samples of adolescents. In comparison to normative adolescents, adolescents with SDD were…
Horner, R D; Keilitz, I
The need for self-care by retarded individuals in behaviors such as brushing teeth led to the development and evaluation of a comprehensive toothbrushing program that included a task analysis and training procedure specific to each component of the task analysis. Eight mentally retarded adolescents, in two groups, individually received acquisition training that included scheduled opportunities for independent performances, verbal instruction, modelling, demonstration, and physical assistance. The first group of four subjects received token plus social reinforcement; the second received only social reinforcement. All eight subjects showed improved toothbrushing behaviors when compared to baseline. Six of the eight subjects correctly performed all toothbrushing steps in two of three consecutive sessions. The study emphasizes the need for systematic program development and evaluation. PMID:1184494
Myers, Mark G.; Prochaska, Judith J.
Although tobacco use is reported by the majority of substance use disordered (SUD) youth, little work has examined tobacco focused interventions with this population. The present study is an initial investigation of the effect of a tobacco use intervention on adolescent SUD treatment outcomes. Participants were adolescents in SUD treatment taking…
Zacharias, Stephanie R. C.; Kelchner, Lisa N.; Creaghead, Nancy
Purpose: The purpose of this study was to explore teachers' attitudes toward, and perceptions of personality traits of, female adolescents who presented with voice disorders. Method: For this comparative study consisting of a 25-item web-based semantic differential survey, teachers rated voice recordings of 4 female adolescents (considered…
Pajer, Kathleen; Gardner, William
This study investigates the function of the hypothalamic-pituitary-adrenal (HPA) axis in adolescent antisocial girls. This question is important because disturbance of HPA functioning has been found in populations of violent adult males and antisocial adolescent males, suggesting that it may be a marker of a physiological disorder associated with…
Azar, Rima; Zoccolillo, Mark; Paquette, Daniel; Quiros, Elsa; Baltzer, Franziska; Tremblay, Richard E.
Objective: To examine the association between cortisol levels and conduct disorder (CD) in adolescent mothers. Past research has shown that low levels of cortisol were associated with CD, particularly with its aggressive symptoms. The authors tested the hypothesis that adolescent mothers with CD would show lower levels of salivary cortisol…
Mazurek, Micah O.; Kanne, Stephen M.; Wodka, Ericka L.
Aggression is a clinically significant problem for many children and adolescents with autism spectrum disorders (ASD). However, there have been few large-scale studies addressing this issue. The current study examined the prevalence and correlates of physical aggression in a sample of 1584 children and adolescents with ASD enrolled in the Autism…
Siegel, Rebecca S.; Freeman, Andrew J.; La Greca, Annette M.; Youngstrom, Eric A.
Background: Pediatric bipolar disorder (PBD) is associated with psychosocial impairment, but few studies have examined peer relationship functioning and PBD. Adolescence is a crucial developmental period when peers become increasingly salient. Objective: This study compared perceived friendship quality and peer victimization in adolescents with…
Winters, Ken C.; Kaminer, Yifrah
The different established screening methodologies and comprehensive assessment techniques used in evaluating adolescents suspected of or known to have substance abuse disorders are discussed. Recommendations and suggestions for establishing standards of training and professional efficiency are also highlighted to treat adolescents with substance…
Pinto-Foltz, Melissa Dawn; Logsdon, M Cynthia; Derrick, Ann
Little is known about recruiting and retaining adolescent mothers in research studies. Investigators who study adolescent mothers have been guided by trial and error, clinical experience, qualitative inquiry, literature of special populations, or the advice of stakeholders. This paper describes the challenges and lessons learned in engaging adolescent mothers in a longitudinal community-based mental health intervention study. Audio-recorded data that describes the circumstances of five adolescent mothers lost to attrition were extracted from a longitudinal mental health intervention study. Adolescent mothers described a chaotic home environment with multiple demands, family conflict, health issues, limited access to a telephone, transportation, financial, and social support. Utilizing a multidisciplinary community advisory group, dedicated telephone, and free electronic media may assist in overcoming modifiable barriers to recruitment and retention of adolescent mothers. Exploring a waiver of informed consent and the engagement of mothers of adolescents in research are indicated.
Tassone-Monchicourt, C; Daumerie, N; Caria, A; Benradia, I; Roelandt, J-L
Image of Madness was always strongly linked with the notion of "dangerousness", provoking fear and social exclusion, despite the evolution of psychiatric practices and organisation, and the emphasis on user's rights respect. Mediatization and politicization of this issue through news item combining crime and mental illness, reinforce and spread out this perception. This paper presents a review of the litterature on social perceptions associating "dangerousness", "Insanity" and "mental illness", available data about the link between "dangerous states" and "psychiatric disorders", as well as the notion of "dangerousness" and the assessment of "dangerous state" of people suffering or not from psychiatric disorders. MAPPING OF SOCIAL REPRESENTATIONS: The French Survey "Mental Health in General Population: Images and Realities (MHGP)" was carried out between 1999 and 2003, on a representative sample of 36.000 individuals over 18 years old. It aims at describing the social representations of the population about "insanity/insane" and "mental illness/mentally ill". The results show that about 75% of the people interviewed link "insanity" or "mental illness" with "criminal or violent acts". Young people and those with a high level of education more frequently categorize violent and dangerous behaviours in the field of Mental illness rather than in that of madness. CORRELATION BETWEEN DANGEROUS STATE AND PSYCHIATRIC DISORDERS: in the scientific literature, all experts reject the hypothesis of a direct link between violence and mental disorder. Besides, 2 tendencies appear in their conclusions: on one hand, some studies establish a significative link between violence and severe mental illness, compared with the general population. On the other hand, results show that 87 to 97% of des aggressors are not mentally ills. Therefore, the absence of scientific consensus feeds the confusion and reinforce the link of causality between psychiatric disorders and violence. OFFICIAL
... ADMINISTRATION 20 CFR Part 404 RIN 0960-AH62 Extension of Expiration Date for Mental Disorders Body System... date of the Mental Disorders body system in the Listing of Impairments (listings) in our regulations... Mental Disorders body system in the Listing of Impairments (listings) in our regulations. In this...
Fifteen epidemiological studies on psychiatric morbidity in India have been analysed. National all-India prevalence rates for ‘all mental disorders’ and five specific disorders have been worked out The national prevalence rates for ‘all mental disorders’ arrived at are 70.5 (rural), 73 (urban) and 73 (rural + urban) per 1000 population. Prevalence of schizophrenia is 2.5/1000 and this seems to be the only disorder whose prevalence is consistent across cultures and over time. Rates for depression, anxiety neurosis, hysteria and mental retardation are provided. Urban morbidity in India is 3.5 percent higher than the rural rate, but rural-urban differences are not consistent for different disease categories. In Hindi speaking north India, mental morbidity amongst factory workers is two and half times that of the non-industrial urban inhabitants and five times the rural morbidity. The present data are expected to serve as baseline rates for mental health planners and for psychiatrists interested in epidemiological studies. PMID:21407903
Teplin, Linda A.; Abram, Karen M.; McClelland, Gary M.; Washburn, Jason J.; Pikus, Ann K.
Objectives. We determined whether or not juvenile detainees with major mental disorders received treatment, and the variables that predicted who received services. Methods. Our sample was 1829 randomly selected juvenile detainees taking part in the Northwestern Juvenile Project. To determine need for mental health services, independent interviewers administered the Diagnostic Interview Schedule for Children and rated functional impairment using the Child Global Assessment Scale. Records on service provision were obtained from the juvenile justice and public health systems. Results. Among detainees who had major mental disorders and associated functional impairments, 15.4% received treatment in the detention center and 8.1% received treatment in the community by the time of case disposition or 6 months, whichever came first. Significantly more girls than boys were detected and treated. Receiving treatment was predicted by clinical variables (having a major mental disorder or reported treatment history or suicidal behavior) and demographic variables. Conclusions. The challenge to public health is to provide accessible, innovative, and effective treatments to juvenile detainees, a population that is often beyond the reach of traditional services. PMID:16186454
Kutcher, S.; Wei, Y.; McLuckie, A.; Bullock, L.
Mental disorders make up close to one-third of the global burden of disease experienced during adolescence. Schools can play an important role in the promotion of positive mental health as well as an integral role in the pathways into mental health care for adolescents. In order for schools to effectively address the mental health problems of…
Cyr, Katie; Chamberland, Claire; Clément, Marie-Ève; Wemmers, Jo-Anne; Collin-Vézina, Delphine; Lessard, Geneviève; Gagné, Marie-Hélène; Damant, Dominique
This study documents lifetime experiences of victimizations, polyvictimization, and trauma symptoms among 1,400 adolescents from the province of Québec. The vast majority (81%) of adolescents were victimized during their lifetime, with most victims (82%) being the target of more than one form of victimization. Polyvictimization accounted for most variability in scores of depression, posttraumatic stress disorder (PTSD), and anger/ aggression compared to individual victimization categories. Sexual victimization and maltreatment still made an independent contribution in predicting all trauma scores once polyvictimization was considered. Gender differences were found in the victimization experiences contributing to the prediction of mental health symptoms. Sexual victimization was a significant predictor of PTSD and anger/aggression symptoms for girls, whereas witnessing violence predicted anger and PTSD symptoms for boys, and assault predicted their anger. This study outlines the importance of assessing various types of victimization among adolescents. Systematic data and observation of trends on child victimization are needed in Canada and elsewhere.
Stikkelbroek, Yvonne; Bodden, Denise H M; Reitz, Ellen; Vollebergh, Wilma A M; van Baar, Anneloes L
The death of a parent or sibling (family bereavement) is associated with mental health problems in approximately, 25 % of the affected children. However, it is still unknown whether mental health problems of family-bereaved adolescents are predicted by pre-existing mental health problems, pre-loss family functioning, or multiple bereavements. In this study, a prospective longitudinal assessment of change in mental health following bereavement was done in a large representative sample from the 'Tracking Adolescents Individual Lives Survey' (TRAILS). This is a four-wave prospective cohort study of Dutch adolescents (n = 2230) of whom 131 (5.9 %) had experienced family bereavement at the last wave (T4). Family-bereaved adolescents reported more internalizing problems, within 2 years after family bereavement, compared to the non-bereaved peers, while taking into account the level of internalizing problems before the bereavement. A clinically relevant finding was that 22 % new cases were found in family-bereaved, in comparison to 5.5 % new cases in non-bereaved. Low SES predicted more internalizing problems in family-bereaved but not in non-bereaved adolescents. Family functioning, reported by the adolescent, did not predict mental health problems within 2 years. Multiple family bereavements predicted fewer externalizing problems. In conclusion, internalizing problems increase in adolescents after family bereavement in comparison to non-bereaved and these can be predicted by pre-loss factors. Awareness among professionals regarding the risks for aggravation of mental health problems after family loss is needed.
Infurna, Maria Rita; Fuchs, Anna; Fischer-Waldschmidt, Gloria; Reichl, Corinna; Holz, Birger; Resch, Franz; Brunner, Romuald; Kaess, Michael
Previous studies on borderline personality disorder (BPD) development suggest a transgenerational transmission of parent-child relationship quality, which may also be influenced by parents' mental health status. The aim of this study was twofold. First, we aimed to investigate the transgenerational effect of parental bonding experiences on the development of BPD in their offspring. Second, we examined the association between parents' mental health status and BPD in offspring. Ninety-one female adolescent psychiatric inpatients along with 87 mothers and 59 fathers were enrolled in the study. Adolescent BPD was assessed with the Structured Clinical Interview for DSM-IV-II, parental bonding with the Parental Bonding Instrument, and parents´ psychiatric symptoms with the Patient Health Questionnaire. We found that low parental care produced a transgenerational effect from mother to BPD in offspring. Further, significant associations were found between paternal psychiatric symptoms and adolescent BPD. High paternal stress levels mediated the association between maternal affect reported by fathers and BPD in daughters. There is evidence of a transgenerational effect of parental bonding specifically for female adolescents with BPD, compared with other clinical control subjects. Our findings highlight the importance of including both parents in future research and in early clinical treatment in adolescents with BPD.
Kloos, Angelica; Weller, Elizabeth B; Weller, Ronald A
Bipolar disorder is a serious and difficult-to-treat condition in any age group. In childhood and adolescence, diagnosis and treatment present specific challenges, as the disorder often manifests in atypical presentations, such as marked irritability and frequent alterations of mood states not typically seen in adults. The lack of double-blind, placebo-controlled studies in pediatric populations also leads to many difficult pharmacologic challenges. In this paper, we review available studies in neuroanatomy, neurochemistry, neurocognitive functioning, and genetics to further explore the underlying neurobiologic mechanisms of child and adolescent bipolar disorder. Future investigation should elicit distinct mechanisms for diagnosing and treating bipolar disorder from a neurobiologic perspective.
Reijonen, Jori H.; Pratt, Helen D.; Patel, Dilip R.; Greydanus, Donald E.
Selectively reviews the literature on the diagnostic criteria for eating disorders (anorexia nervosa, bulimia nervosa, and binge-eating disorder) as described in "Diagnostic and Statistical Manual of Mental Disorders" (4th ed.) and "International Classification of Diseases" (10th ed.). Discusses the prevalence and course of…
Seedat, Soraya; Scott, Kate Margaret; Angermeyer, Matthias C.; Berglund, Patricia; Bromet, Evelyn J.; Brugha, Traolach S.; Demyttenaere, Koen; de Girolamo, Giovanni; Haro, Josep Maria; Jin, Robert; Karam, Elie G.; Kovess-Masfety, Viviane; Levinson, Daphna; Mora, Maria Elena Medina; Ono, Yutaka; Ormel, Johan; Pennell, Beth-Ellen; Posada-Villa, Jose; Sampson, Nancy A.; Williams, David; Kessler, Ronald C.
Context Gender differences in mental disorders, including more anxiety-mood disorders among women and more externalizing disorders among men, are found consistently in epidemiological surveys. The “gender roles” hypothesis suggests that these differences should narrow as the roles of women and men become more equal. Objective To study time-space (i.e., cohort-country) variation in gender differences in lifetime DSM-IV mental disorders across cohorts in 15 countries in the WHO World Mental Health (WMH) Survey Initiative and determine if this variation is significantly related to time-space variation in female gender role traditionality (GRT) as measured by aggregate patterns of female education, employment, marital timing, and use of birth control. Design/Setting and Participants Face-to face household surveys of 72,933 community-dwelling adults in Africa, the Americas, Asia, Europe, the Middle East, and the Pacific. Main Outcomes The WHO Composite International Diagnostic Interview (CIDI) assessed lifetime prevalence and age-of-onset of 18 DSM-IV anxiety, mood, externalizing, and substance disorders. Survival analyses estimated time-space variation in Female:Male (F:M) odds-ratios (ORs) of these disorders across cohorts defined by age ranges 18–34, 35–49, 50–64, and 65+. Structural equation analysis examined predictive effects of variation in GRT on these ORs. Results Women had more anxiety-mood disorders than men and men more externalizing-substance disorders than women in all cohorts and countries. Although gender differences were generally consistent across cohorts, significant narrowing was found in recent cohorts for major depressive disorder (MDD) and substance disorders. This narrowing was significantly related to temporal (MDD) and spatial (substance disorders) variation in GRT. Conclusion While gender differences in most lifetime mental disorders were fairly stable over the time-space units studied, substantial inter-cohort narrowing of
Mnich, Eva E; Makowski, Anna C; Kofahl, Christopher; Lambert, Martin; Bock, Thomas; Angermeyer, Matthias C; von dem Knesebeck, Olaf
Public knowledge about and attitudes towards mental illness were analyzed. Furthermore, changes in knowledge and attitudes after an information and awareness campaign were examined. The basis were two telephone surveys in 2011 (t0) and 2014 (t1) in Hamburg (intervention) and Munich (control). In 2011, the public was relatively well informed about mental disorders. Regarding the level of information of the public before the campaign and inconsistent results of previous evaluation studies the anticipated impact of the awareness campaign at t1 are moderate.
Background Recent developments in Global Workspace theory suggest that human consciousness can suffer interpenetrating dysfunctions of mutual and reciprocal interaction with embedding environments which will have early onset and often insidious staged developmental progression, possibly according to a cancer model, in which a set of long-evolved control strategies progressively fails. Methods and results A rate distortion argument implies that, if an external information source carries a damaging 'message', then sufficient exposure to it, particularly during critical developmental periods, is sure to write a sufficiently accurate image of it on mind and body in a punctuated manner so as to initiate or promote similarly progressively punctuated developmental disorder, in essence either a staged failure affecting large-scale brain connectivity, which is the sine qua non of human consciousness, or else damaging the ability of embedding goal contexts to contain conscious dynamics. Conclusion The key intervention, at the population level, is clearly to limit exposure to factors triggering developmental disorders, a question of proper environmental sanitation, in a large sense, primarily a matter of social justice which has long been known to be determined almost entirely by the interactions of cultural trajectory, group power relations, and economic structure, with public policy. Intervention at the individual level appears limited to triggering or extending periods of remission, representing reestablishment of an extensive, but largely unexplored, spectrum of evolved control strategies, in contrast with the far better-understood case of cancer. PMID:16371149
Corbett, Chris; Armstrong, Matthew J; Parker, Richard; Webb, Kerry; Neuberger, James M
Depression affects up to 60% of solid-organ recipients and is independently associated with both mortality (hazard ratio for death of ~2) and de novo malignancy after transplantation, although the mechanism is not clear. Both pretransplantation psychosis and depression occurring more than 2 years after transplantation are associated with increased noncompliance and graft loss. It remains to be shown that effective treatment of depression is associated with improved outcomes and quality of life. Immunosuppressive drugs (especially corticosteroids and calcineurin inhibitors) and physiologic challenges can precipitate deterioration in mental health. All potential transplant candidates should be assessed for mental health problems and preexisting medical conditions that can mimic mental health problems, such as uremic, hepatic, or hypoxic encephalopathy, should be identified and treated appropriately. Expert mental health review of those with identified risk factors (such as previous suicide attempts, history of mental illness or noncompliance with medications) is advisable early in the transplant assessment process to mitigate risk and support the patient. Patients with mental health disorders, when adequately controlled and socially supported, have outcomes similar to the general transplant population. Therefore, exclusion from transplantation based on the diagnosis alone is neither ethically nor medically justified. However, it is ethically and clinically justifiable to deny access to transplantation to those who, despite full support, would have a quality of life that is unacceptable to the candidate or are likely to be noncompliant with treatment or follow-up, which would lead to graft loss.
Physical health investigations, such as blood tests, ECGs, and appropriate radiological tests, are essential in the assessment and management of many patients in inpatient mental health settings. This project took place in a 12-bed adolescent mental health unit in Swindon, UK, where on average at least two-thirds of patients have a diagnosed eating disorder. Multidisciplinary ward rounds provide an appropriate setting for discussion and documentation of physical investigations. Over a two-week period, 22 electronic ward round entries were audited for any documentation of five common investigations - blood tests, ECG, MRI head, DEXA, and ovarian ultrasound. Blood tests were documented in 2/22 (9.1%), ECG, MRI head, DEXA, and ovarian ultrasound were documented in 0/22 (0%). Modifications were made to an electronic ward round template, to include headings for each of these investigations, with free-text boxes as well as drop-down boxes for the radiological tests. Following this, re-audit of 22 ward round entries over a two-week period showed documentation had hugely improved - blood tests were documented in 21/22 (95.5%), with ECG, MRI head, DEXA, and pelvis US all documented in 22/22 (100%). A further audit a month later showed these results were largely sustained. In conclusion, use of a simple, structured ward round template can hugely improve documentation of important physical investigations within mental health settings. PMID:26734411
De Sanctis, Virginia A.; Trampush, Joey W.; Harty, Seth C.; Marks, David J.; Newcorn, Jeffrey H.; Miller, Carlin J.; Halperin, Jeffrey M.
Children with attention deficit/hyperactivity disorder (ADHD) are at heightened risk for maltreatment and later substance use disorders (SUDs). We investigated the relationship of childhood maltreatment and other risk factors to SUDs among adolescents diagnosed with ADHD in childhood. Eighty adolescents diagnosed with ADHD when they were 7 to 11…
López-Muñoz, F; Molina, J D; Rubio, G; Alamo, C
Since Classical Antiquity numerous authors have linked the origin of some mental disorders to physical and functional changes in the pineal gland because of its attributed role in humans as the connection between the material and the spiritual world. The pineal organ was seen as a valve-like structure that regulated the flow of animal spirits through the ventricular system, a hypothesis that took on more vigour during the Middle Ages and the Renaissance. The framework for this theory was "the three cells of the brain", in which the pineal gland was even called the "appendix of thought". The pineal gland could also be associated with the boom, during this period, of certain legends about the "stone of folly". But the most relevant psychopathological role of this organ arrived with Descartes, who proposed that it was the seat of the human soul and controlled communications between the physical body and its surroundings, including emotions. After a period of decline during which it was considered as a mere vestigial remnant of evolution, the link between the pineal gland and psychiatric disorders was definitively highlighted in the 20th century, first with the use of glandular extracts in patients with mental deficiency, and finally with the discovery of melatonin in 1958. The physiological properties of melatonin reawakened interest in the relationship between the pineal gland and mental disorders, fundamentally the affective and sleep disorders, which culminated in the development of new pharmacological agents acting through melatonergic receptors (ramelteon and agomelatine).
Nevels, Robert M; Dehon, Erin E; Alexander, Katrina; Gontkovsky, Samuel T
Research examining the role of pharmacological therapy in the treatment of children and adolescents with clinical disorders is growing. Clinical disorders that present with comorbid aggression can add a challenge to treatment. Child and adolescent neuropsychiatric disorders associated with aggression include attention-deficit hyperactivity disorder, various mood disorders and in particular bipolar disorders/pediatric mania, schizophrenia, mental retardation, oppositional defiant disorder, conduct disorder, and autism spectrum disorders. This review describes the psychopharmacy to treat these disorders and the aggression that often appears comorbidly. Existing literature regarding the efficacy and safety of psychotropics for youth with neuropsychiatric disorders also is discussed. In addition, general guidelines for psychopharmacy of aggression in children and adolescents are presented. Studies reviewed in this article provide evidence for the use of psychostimulants, alpha-2 agonists, beta blockers, lithium, anticonvulsant mood-stabilizers, atypical antipsychotics, traditional antipsychotics, and selective serotonin reuptake inhibitors in treating pediatric aggression with the choice of medication dependent on symptomology. Despite increased support for pediatric psychotropic use, there is a need for more long-term safety and efficacy studies of existing medications and newer, safer, and more effective agents with fewer side effects for the pharmacological treatment of all childhood disorders in which aggression is prominent.
Makanjuola, R O
Twenty Yoruba traditional healers specializing in mental disorders were studied. Two main groups of mental disorders were identified, asinwin (psychotic disorders) and ode ori (a less severe disorder with prominent somatic symptoms). The further sub-categorization of mental disorders was largely on an aetiological basis. The most important aetiological factors identified were: the actions of enemies with major emphasis on the deployment of supernatural forces; self-induced disorders, of which cannabis abuse was the most frequently quoted example; soponna (small-pox) and 'hereditary' factors. The healers' beliefs regarding mode of hereditary transmission of mental disorders were very different from those of modern medicine.
Wang, Dongming; Li, Wenzhen; Xiao, Yang; He, Wulong; Wei, Weiquan; Yang, Longyu; Yu, Jincong; Song, Fujian; Wang, Zengzhen
Abstract Introduction: New-type drugs are popular with adolescents and could lead to psychiatry disorders, but no medications have been proven to be effective for these disorders of new-type drug dependence. We aimed to evaluate the efficacy of tryptophan on sleeping disorders and mental symptoms in detoxified individuals with new-type drug dependence. Methods: This randomized, placebo-controlled trial included 80 detoxified individuals with new-type drug dependence, recruited successively from a Compulsory Residential Drug Abstinence Institution in Wuhan, China, from April 2012 to November 2012. Eligible participants were randomly allocated to be treated with tryptophan (1000 mg/d, n = 40) or placebo (n = 40) for 2 weeks. The sleeping disorders and mental symptoms were assessed using Athens Insomnia Scale and Symptom Check-List-90 at baseline and 2 weeks. Results were analyzed according to the “intention-to-treat” approach. Results: Forty-five participants completed the 2-week study, 24 in the tryptophan group and 21 in the placebo group. There were no statistically significant differences in baseline characteristics between groups and the treatment adherence was similar between groups. The reduction in the Athens Insomnia Scale score in the tryptophan group was significantly greater than that in the placebo group (P = 0.017). However, no significant differences were found in Symptom Check-List-90 scores (either by individual dimension or the overall score) between groups (all P > 0.05). The frequency of adverse events was similar and no serious adverse events were reported during the study. Conclusion: Tryptophan was unlikely to be effective for mental symptoms, but could alleviate sleep disorders in short term among detoxified individuals with new-type drug dependence. Future large-scale trials are required to confirm findings from this study. PMID:27428201
Hilmani, Said; Houass, Yassine; El Azhari, Abdessamad
Background: Ventricular meningioma constitutes 2% of intracranial meningioma, representing a challenging disease for neurosurgeons. Although cognitive impairment is one of the major symptoms of ventricular tumors, few studies have reported the details of cognitive impairment before and after their surgical removal. The expected effects on cognitive function should also be considered when choosing a surgical approach. Case Descriptions: We report the case of a large lateral ventricle meningioma revealed by cognitive dysfunction and moderate intellectual disability. The patient underwent subtotal resection of the tumor which had partial improvement in cognitive disorders. It is important to precisely assess neuropsychological function in patients with large brain tumors, and judicious preoperative plan, adequate knowledge of anatomy, and use of correct microsurgical techniques are fundamental in achieving complete resection of paraventricular meningioma with low morbidity. Conclusion: Pre and postoperative precise neuropsychological examinations may identify the potential cognitive impairment and beneficial effects of surgery in patients with large lateral ventricle meningiomas. PMID:28144473
Mar, Harvey H.; Glidden, Laraine Masters
Investigated were the abilities of 98 educable mentally retarded adolescents to encode and retrieve words using semantic and acoustic cues in a free and cued recall task. Available from: Ablex Publishing Corporation, 355 Chestnut Street, Norwood, New Jersey 07648. (CL)
Jordan, Amy B; Kramer-Golinkoff, Emily K; Strasburger, Victor C
In this article we examine media use and its relationship to adolescent overweight/obesity and adolescent eating disorders. We consider the potential mechanisms through which exposure to media during adolescence (both amount of time and choice of content) might exacerbate unhealthy eating and physical activity patterns. We consider strategies that health care providers can use to identify problematic media use and suggestions they might offer to adolescents and their parents for ways to make media a more positive agent in young people's healthy development.
Dewinter, Jeroen; Vermeiren, Robert; Vanwesenbeeck, Ine; Lobbestael, Jill; Van Nieuwenhuizen, Chijs
Differences in sexual functioning of adolescents with and without autism spectrum disorder (ASD) are understudied. In the current study, self-reported sexual behaviours, interests and attitudes of 50 adolescent boys, aged 15-18, with at least average intelligence and diagnosed with ASD, were compared with a matched general population control group of 90 boys. Results demonstrated substantial similarity between the groups in terms of sexual behaviours. The only significant difference was that boys with ASD reacted more tolerant towards homosexuality compared to the control group. Results reveal that sexuality is a normative part of adolescent development in high-functioning boys with ASD. Hence, attention should be given to this topic in education and mental health care.
Newbury-Helps, John; Feigenbaum, Janet; Fonagy, Peter
This study was designed to test the hypothesis that individuals with antisocial, particularly violent, histories of offending behavior have specific problems in social cognition, notably in relation to accurately envisioning mental states. Eighty-three male offenders on community license, 65% of whom met the threshold for antisocial personality disorder (ASPD), completed a battery of computerized mentalizing tests requiring perspective taking (Perspectives Taking Test), mental state recognition from facial expression (Reading the Mind in the Eyes Test), and identification of mental states in the context of social interaction (Movie for the Assessment of Social Cognition). The results were compared with a partially matched sample of 42 nonoffending controls. The offender group showed impaired mentalizing on all of the tasks when compared with the control group for this study when controlling for demographic and clinical variables, and the offending group performed poorly in comparisons with participants in published studies, suggesting that limited capacity to mentalize may be part of the picture presented by individuals with histories of offending behavior. Offenders with ASPD demonstrated greater difficulty with mentalizing than non-ASPD offenders. Mentalization subscales were able to predict offender status and those with ASPD, indicating that specific impairments in perspective taking, social cognition, and social sensitivity, as well as tendencies toward hypomentalizing and nonmentalizing, are more marked in individuals who meet criteria for a diagnosis of ASPD. Awareness of these deficits may be helpful to professionals working with offenders, and specifically addressing these deficits may be a productive aspect of therapy for this "hard to reach" clinical group.
Chinawa, J. M.; Manyike, P. C.; Obu, H. A.; Odetunde, O. I.; Aniwada, E. C.; Ndu, I. K.; Chinawa, A. T.
Background. Adolescents are prone to various forms of behavioral problems. These behavioral issues in adolescents can have serious consequences for the adolescents. Objectives. The objectives of the study are to determine the causative factors of adolescent problems and specific manifestations. Methods. Behavioral problems were investigated using a random sampling of adolescents from secondary schools in southeast Nigeria from February to April, 2014. A self-administered questionnaire was developed from Health Kids Colorado Questionnaire. Results. A total of 763 subjects completed the questionnaire. Adolescents who reported to have used tobacco 3 to 5 and 6 to 9 times during the last 30 days are just 3.14% and 3.4%, respectively. Nineteen (2.49%) adolescents claimed that they have had sex before but not in the last 3 months. Adolescents who attempted suicide are from 15 years and peaked at 18. Eighty-three (11%) adolescents who are 15 years old attempted suicide in a year; this peaks at 17 years where 235 (30.8%) committed suicide. Majority of adolescents with behavioral disorder are from the upper class family. Conclusion. This study revealed that adolescents exhibit several forms of behavioral problems. PMID:25276048
Forsberg, Sarah; Lock, James
Best-practice guidelines for the treatment of child and adolescent eating disorders recommend the inclusion of parents. Family-based treatment (FBT) posits that families are not only important in supporting their children but are critical change agents in the recovery process. As originally developed for anorexia nervosa, parents take a central role in managing and disrupting eating disorder symptoms. The most evidence-based treatment model for adolescent anorexia nervosa, FBT has also recently been found to be useful in the treatment of adolescent bulimia nervosa. This article provides a summary of the theoretic model, evidence base, and application of FBT.
Adherence to self-management and medication regimens is required to achieve optimal blood glucose control in adolescents with type 1 diabetes mellitus. Non-adherence places adolescents at serious risk of short and long-term health complications. Adherence difficulties may be exacerbated by concurrent eating disorders. Diabulimia is a term used to describe the deliberate administration of insufficient insulin to maintain glycaemic control for the purpose of causing weight loss. This article explores the concept of diabulimia and the compounding complications of an eating disorder on maintaining self-management regimens in adolescents with diabetes.
Becker, Stephen P.; Luebbe, Aaron M.; Langberg, Joshua M.
It is well established that children and adolescents with attention-deficit/hyperactivity disorder (ADHD) frequently experience co-occurring mental health problems in addition to difficulties in their peer relationships. Although substantial research has focused on the extent to which peer functioning contributes to subsequent co-occurring mental…
Heflinger, Craig Anne; Brannan, Ana Maria
This study examined caregiver strain (i.e., burden of care, caregiver burden) among families of adolescents in treatment for substance abuse disorders compared to youth with mental health problems. We used descriptive and regression analyses to compare groups and to examine the youth and family variables associated with caregiver strain across the…
Glenn, Catherine R.; Klonsky, E. David
Objective Non-suicidal self-injury (NSSI) is a growing public health concern, especially among adolescents. In the current edition of the Diagnostic and Statistical Manual of Mental Disorders, NSSI is classified as a criterion of borderline personality disorder (BPD). However, a distinct NSSI disorder will now be included in DSM-5 as a “condition requiring further study.” Importantly, at this time, there is little direct evidence supporting the DSM-5 proposal over the DSM-IV classification. To address this need, the current study examined the extent to which NSSI occurs independently of BPD, and has clinical significance beyond a diagnosis of BPD in adolescent psychiatric patients. Method NSSI disorder was assessed based on the proposed DSM-5 criteria in 198 adolescents ages 12 to 18 (74% female; 64% Caucasian, 14% Hispanic, 10% African American, and 12% mixed/other ethnicity) from a psychiatric hospital. Major Axis I disorders, Axis II BPD, and suicide ideation and attempts were assessed with structured clinical interviews; emotion dysregulation and loneliness were measured with validated self-report questionnaires. Results First, results indicate that NSSI disorder occurs independently of BPD. Specifically, although there was overlap between the occurrence of BPD and NSSI disorder, this overlap was no greater than that between BPD and other Axis I disorders (e.g., anxiety and mood disorders). Second, NSSI disorder demonstrated unique associations with clinical impairment – indexed by suicide ideation and attempts, emotion dysregulation, and loneliness – over and above a BPD diagnosis. Conclusions Taken together, findings support the classification of NSSI as a distinct and clinically significant diagnostic entity. PMID:23682597
Stewart, Angela J.; Theodore-Oklota, Christina; Hadley, Wendy; Brown, Larry K.; Donenberg, Geri; DiClemente, Ralph
This study explored whether adolescents with elevated symptoms of mania (ESM+) engage in more HIV risk behaviors than those with other psychiatric disorders and examined factors associated with HIV risk behavior among ESM+ adolescents. Eight hundred forty adolescents (56% female, 58% African American, "M" age = 14.9 years) who received mental…
Ahmad, NoorAni; MuhdYusoff, Fadhli; Ratnasingam, Selva; Mohamed, Fauziah; Nasir, Nazrila Hairizan; MohdSallehuddin, Syafinaz; MahadirNaidu, Balkish; Ismail, Rohana; Aris, Tahir
Studying trends in mental health morbidity will guide the planning of future interventions for mental and public health services. To assess the trends in mental health problems among children and adolescents aged 5 through 15 years in Malaysia from 1996 to 2011, data from the children's mental health component of three population-based surveys was analysed using a two-stage stratified sampling design. Mental health problems were assessed using the Reporting Questionnaire for Children. The prevalence of mental health problems among children and adolescents aged 5 through 15 years showed an increasing trend from 13.0% (95% Confidence Interval [CI]: 11.5–14.6) in 1996 to 19.4% (95% CI: 18.5–20.3) in 2006 and 20.0% (95% CI: 18.8–21.3) in 2011. In 2011, male children and adolescents and those who were in less affluent families were significantly associated with mental health problems. The findings indicate that even though mental health problems among children and adolescents in Malaysia are increasing, the rate of increase has decreased in the past five years. Socially and economically disadvantaged groups were most vulnerable to mental health problems. PMID:26000035
Ahmad, NoorAni; MuhdYusoff, Fadhli; Ratnasingam, Selva; Mohamed, Fauziah; Nasir, Nazrila Hairizan; MohdSallehuddin, Syafinaz; MahadirNaidu, Balkish; Ismail, Rohana; Aris, Tahir
Studying trends in mental health morbidity will guide the planning of future interventions for mental and public health services. To assess the trends in mental health problems among children and adolescents aged 5 through 15 years in Malaysia from 1996 to 2011, data from the children's mental health component of three population-based surveys was analysed using a two-stage stratified sampling design. Mental health problems were assessed using the Reporting Questionnaire for Children. The prevalence of mental health problems among children and adolescents aged 5 through 15 years showed an increasing trend from 13.0% (95% Confidence Interval [CI]: 11.5-14.6) in 1996 to 19.4% (95% CI: 18.5-20.3) in 2006 and 20.0% (95% CI: 18.8-21.3) in 2011. In 2011, male children and adolescents and those who were in less affluent families were significantly associated with mental health problems. The findings indicate that even though mental health problems among children and adolescents in Malaysia are increasing, the rate of increase has decreased in the past five years. Socially and economically disadvantaged groups were most vulnerable to mental health problems.
Shochet, Ian M; Saggers, Beth R; Carrington, Suzanne B; Orr, Jayne A; Wurfl, Astrid M; Duncan, Bonnie M; Smith, Coral L
Despite an increased risk of mental health problems in adolescents with autism spectrum disorder (ASD), there is limited research on effective prevention approaches for this population. Funded by the Cooperative Research Centre for Living with Autism, a theoretically and empirically supported school-based preventative model has been developed to alter the negative trajectory and promote wellbeing and positive mental health in adolescents with ASD. This conceptual paper provides the rationale, theoretical, empirical and methodological framework of a multilayered intervention targeting the school, parents and adolescents on the spectrum. Two important interrelated protective factors have been identified in community adolescent samples, namely the sense of belonging (connectedness) to school and the capacity for self and affect regulation in the face of stress (i.e. resilience). We describe how a confluence of theories from social psychology, developmental psychology and family systems theory, along with empirical evidence (including emerging neurobiological evidence), supports the interrelationships between these protective factors and many indices of wellbeing. However, the characteristics of ASD (including social and communication difficulties, and frequently difficulties with changes and transitions, and diminished optimism and self-esteem) impair access to these vital protective factors. The paper describes how evidence-based interventions at the school level for promoting inclusive schools (using the Index for Inclusion) and interventions for adolescents and parents to promote resilience and belonging [using the Resourceful Adolescent Program (RAP)] are adapted and integrated for adolescents with ASD. This multisite proof-of-concept study will confirm whether this multilevel school-based intervention is promising, feasible and sustainable.
Schmidt, Ricarda; Tetzlaff, Anne; Hilbert, Anja
A sizeable body of research has documented Expressed Emotion (EE) to predict clinical outcomes in various psychiatric disorders, including eating disorders. Patients' perceptions of relative's EE, however, were found to play an important role in the processing of EE. This study aimed to examine the level of perceived EE in adolescent binge-eating disorder (BED) and its impact on eating disorder psychopathology. Adolescents (12-20 years) seeking treatment for BED (n = 40) were compared to adolescents without current or lifetime eating disorder (CG; n = 40). Both groups were stratified according to age, sex, body mass index (BMI, kg/m(2)), and socio-economic status. The Five Minute Speech Sample (FMSS) and the Brief Dyadic Scale of EE were administered to assess patients' perceived maternal EE. Additionally, adolescents and mothers completed questionnaires on eating disorder and general psychopathology. On the FMSS, 37.5 % of patients with BED perceived their mothers as high EE (vs. 12.5 % in the CG). On the Brief Dyadic Scale of EE, patients with BED reported significantly higher levels of perceived maternal criticism, emotional overinvolvement, and lower levels of perceived warmth than controls. After controlling for the diagnosis of BED, perceived criticism and warmth, as assessed by questionnaire, significantly explained adolescents' global eating disorder psychopathology. Negative perceptions of maternal behavior and emotional atmosphere towards the child are characteristic of adolescent BED. As documented for other eating disorders, family factors are likely to have substantial implications for the maintenance and treatment of adolescent BED.
Kukla, Urszula; Łabuzek, Krzysztof; Chronowska, Justyna; Krzystanek, Marek; Okopień, BogusŁaw
Mental disorders accompanying digestive system diseases constitute interdisciplinary yet scarcely acknowledged both diagnostic and therapeutic problem. One of the mostly recognized examples is coeliac disease where patients endure the large spectrum of psychopathological symptoms, starting with attention deficit all the way down to the intellectual disability in extreme cases. It has not been fully explained how the pathomechanism of digestive system diseases affects patient's mental health, however one of the hypothesis suggests that it is due to serotonergic or opioid neurotransmission imbalance caused by gluten and gluten metabolites effect on central nervous system. Behavioral changes can also be invoked by liver or pancreatic diseases, which causes life-threatening abnormalities within a brain. It occurs that these abnormalities reflexively exacerbate the symptoms of primary somatic disease and aggravate its course, which worsens prognosis. The dominant mental disease mentioned in this article is depression which because of its effect on a hypothalamuspituitary- adrenal axis and on an autonomic nervous system, not only aggravates the symptoms of inflammatory bowel diseases but may accelerate their onset in genetically predisposed patients. Depression is known to negatively affects patients' ability to function in a society and a quality of their lives. Moreover, as far as children are concerned, the occurrence of digestive system diseases accompanied by mental disorders, may adversely affect their further physical and psychological development, which merely results in worse school performance. All those aspects of mental disorders indicate the desirability of the psychological care for patients with recognized digestive system disease. The psychological assistance should be provided immediately after diagnosis of a primary disease and be continued throughout the whole course of treatment.
This research uses the tools of modern medical science to study ancient descriptions of the symptoms suffered by King David. Biblical texts were examined, with a close study of verses relating to the mental disorder that afflicted King David, the second and greatest King of Israel, who ruled more than 3525 years ago. We include no commentaries, but refer only to the words of the Bible exactly as written. Evaluation of the passages referring to King David indicated that he was afflicted by some mental disorder, and among the many possibilities major depression, dysthymia and minor depression are the most likely. Of these diagnoses, major depression seems the most acceptable. This report suggests that the roots of contemporary psychiatry can be traced back to Biblical times.
Catanesi, Roberto; Carabellese, Felice; La Tegola, Donatella; Alfarano, Egle
There are few studies of female stalkers in literature addressing different study populations. There appears to be a high incidence of mental disease among female stalkers, having an important role in inducing the harassment. We present a woman affected by a bipolar disorder who had a long affair with her victim, broken off in 2007. Stalking began in January 2009 and continued for 6 months, during which time she was not taking drugs and was in a decompensated clinical phase. In July 2009, she was denounced for harassment; the authorities demanded a psychiatric examination. The woman then resumed taking the medication regularly. In December 2009, although she was in complete remission, she began stalking once more. This case shows that even when there seems to be an evident relation between psychopathology and crime, it is always necessary to evaluate to what extent the mental disorder is responsible for the criminal behavior.
Prior, Pauline M
Mentally disordered offenders find themselves at the intersection of the healthcare system and the criminal justice system in most European countries. Decisions on their care often involve lengthy discussions in relation to care versus control in society. In this article, the focus is on one aspect of this debate - that of human rights. An analysis of cases, taken to the European Court of Human Rights by mentally disordered offenders, demonstrates the difficulties inherent in ensuring appropriate care to individuals and safeguards to the public at the same time. The issues raised include the problems raised by indeterminate sentences, the use of detention for preventive purposes, and debates about treatment. The countries represented in this selection of cases are Belgium, Norway, Poland, the Netherlands, Russia and the United Kingdom.
Viinamäki, Anni; Marttunen, Mauri; Fröjd, Sari; Ruuska, Jaana; Kaltiala-Heino, Riittakerttu
This study investigates the comorbidity and longitudinal associations between self-reported conduct disorder and subclinical bulimia in a community-based sample of Finnish adolescents in a 2-year prospective follow-up study. There are 2070 adolescents who participated in the survey as ninth graders (mean age 15.5) and followed-up 2 years later. The Youth Self-Report Externalizing scale was used to measure conduct disorder and DSM-IV-based questionnaire to measure bulimia. Co-occurrence of female conduct disorder and subclinical bulimia was found at ages 15 and 17. Subclinical bulimia among girls at age 15 was a risk factor for conduct disorder at age 17, but conduct disorder at age 15 was not predictive of subclinical bulimia at age 17. The pathway from bulimia to conduct disorder may be suggestive of an association with future borderline personality disorder among girls.
Wolraich, Mark L; Wibbelsman, Charles J; Brown, Thomas E; Evans, Steven W; Gotlieb, Edward M; Knight, John R; Ross, E Clarke; Shubiner, Howard H; Wender, Esther H; Wilens, Timothy
Attention-deficit/hyperactivity disorder (ADHD) is the most common mental disorder in childhood, and primary care clinicians provide a major component of the care for children with ADHD. However, because of limited available evidence, the American Academy of Pediatrics guidelines did not include adolescents and young adults. Contrary to previous beliefs, it has become clear that, in most cases, ADHD does not resolve once children enter puberty. This article reviews the current evidence about the diagnosis and treatment of adolescents and young adults with ADHD and describes how the information informs practice. It describes some of the unique characteristics observed among adolescents, as well as how the core symptoms change with maturity. The diagnostic process is discussed, as well as approaches to the care of adolescents to improve adherences. Both psychosocial and pharmacologic interventions are reviewed, and there is a discussion of these patients' transition into young adulthood. The article also indicates that research is needed to identify the unique adolescent characteristics of ADHD and effective psychosocial and pharmacologic treatments.
Coleman, William Lord
Friendship formation (making friends, keeping friends, and having successful interactions with peers and adults) constitutes a critical developmental-social milestone for adolescents. This process can be especially challenging for adolescents with attention-deficit/hyperactivity disorder, whose attentional problems may negatively affect their social skills (verbal and nonverbal language) and who fail to appreciate the complexity and nuances of adolescent communication. They often do not respond to feedback cues. They may be perceived as "immature," lacking empathy, and loners and losers, they may endure a "reputational bias," and they often experience coexisting challenges (eg, language problems, learning disabilities, or obesity). Successful and gratifying interactions, or the lack thereof, deeply and broadly affect adolescents: their self-esteem, self-image, confidence, school-learning, lifestyle, behavior, sexual activity, intimacy formation, mental-emotional well-being, and physical health. Successful achievement of this ever-evolving milestone has lifelong implications. This article describes various social-interactional skills, other components of social competence, and the dysfunctions that may cause social failure and suffering and describes how to evaluate and help manage problems in adolescents with attention-deficit/hyperactivity disorder.
The debate about the relevance of values for the concept of a mental disorder has quite a long history. In the light of newer insights into neuroscience and molecular biology it is necessary to re-evaluate this issue. Since the medical model in previous decades was more of a confession rather than evidence based, one could assume that it is-due to scientific progress-currently becoming the one and only bedrock of psychiatry. This article argues that this would be a misapprehension of the normative constitution of the assessment of human behavior. The claim made here is twofold: First, whether something is a mental disease can only be determined on the mental level. This is so because we can only call behavior deviant by comparing it to non-deviant behavior, i.e., by using norms regarding behavior. Second, from this it follows that psychiatric disorders cannot be completely reduced to the physical level even if mental processes and states as such might be completely reducible to brain functions.
Moed, Anat; Gershoff, Elizabeth T; Bringewatt, Elizabeth H
For youth exposed to community violence, parenting has been found to play a significant role in protecting adolescents from associated mental health symptoms. Yet little is known about the potential of parenting to prevent such exposure in the first place and thereby reduce the likelihood of adolescents' mental health symptoms. This study examined two parental practices that have often been examined as moderators, but not yet as predictors, of youth exposure to community violence associations with adolescent mental health, namely parental control and parental harshness. Analyses of self-reported data from 908 adolescents (M age = 16.5, SD = 1.71; 52 % girls; 13 % non-Hispanic White) revealed that harsh parenting was indirectly associated with youth mental health symptoms through higher levels of exposure to community violence, whereas links between controlling parenting and mental health symptoms were either non-significant or mediated through lower levels of adolescent violence exposure. These findings highlight the potential positive role parental control may play by preventing adolescents from exposure to potentially dangerous situations. Conversely, our results suggest that harsh parenting appears to pose a risk for adolescents by driving youth away from the home environment and potentially into places where violence may be more prevalent.
Strandholm, Thea; Kiviruusu, Olli; Karlsson, Linnea; Miettunen, Jouko; Marttunen, Mauri
Our study examines whether defense styles and separate defenses in depressed adolescent outpatients predict adult personality disorders (PDs). We obtained data from consecutive adolescent outpatients who participated in the Adolescent Depression Study at baseline and at the 8-year follow-up (N = 140). Defense styles were divided into mature, neurotic, image-distorting, and immature and a secondary set of analyses were made with separate defenses as predictors of a PD diagnosis. Neurotic, image-distorting, and immature defense styles in adolescence were associated with adulthood PDs. Neurotic defense style associated with cluster B diagnosis and image-distorting defense style associated with cluster A diagnosis. Separate defenses of displacement, isolation, and reaction formation were independent predictors of adult PD diagnosis even after adjusting for PD diagnosis in adolescence. Defense styles and separate defenses predict later PDs and could be used in the focusing of treatment interventions for adolescents.
Glozah, Franklin N; Pevalin, David J
Little is known about the role of age and gender in the association between psychosomatic symptoms and common mental illness in Ghanaian adolescents. This cross-sectional study examined age and gender as moderators between psychosomatic symptoms and common mental illness using data from a school-based survey (N = 770). Males reported higher psychosomatic symptoms and common mental illness, while younger adolescents reported higher common mental illness only. Psychosomatic symptoms were positively associated with common mental illness, but age and gender did not moderate this association. Interventions aimed at reducing the prevalence rate in psychosomatic symptoms are crucial in decreasing common mental illness in Ghanaian adolescents.
Gu, Simeng; Wang, Wei; Huang, Jason H.
Affective disorders are a leading cause of disabilities worldwide, and the etiology of these many affective disorders such as depression and posttraumatic stress disorder is due to hormone changes, which includes hypothalamus-pituitary-adrenal axis in the peripheral nervous system and neuromodulators in the central nervous system. Consistent with pharmacological studies indicating that medical treatment acts by increasing the concentration of catecholamine, the locus coeruleus (LC)/norepinephrine (NE) system is regarded as a critical part of the central “stress circuitry,” whose major function is to induce “fight or flight” behavior and fear and anger emotion. Despite the intensive studies, there is still controversy about NE with fear and anger. For example, the rats with LC ablation were more reluctant to leave a familiar place and took longer to consume the food pellets in an unfamiliar place (neophobia, i.e., fear in response to novelty). The reason for this discrepancy might be that NE is not only for flight (fear), but also for fight (anger). Here, we try to review recent literatures about NE with stress induced emotions and their relations with mental disorders. We propose that stress induced NE release can induce both fear and anger. “Adrenaline rush or norepinephrine rush” and fear and anger emotion might act as biomarkers for mental disorders. PMID:27051536
Mela, Mansfield; Depiang, Gu
Mental disorder is associated with criminal reoffending, especially violent acts of offending. Features of mental disorder, psychosocial stresses, substance use disorder, and personality disorder combine to increase the risk of criminal recidivism. Clozapine, an atypical antipsychotic, is indicated in the treatment of patients with psychotic disorders. This article is the report of a community follow-up study of a matched control of those treated with clozapine (n = 41) and those treated with other antipsychotics (n = 21). Rates of reoffending behavior in the general, nonviolent, violent, and sexual categories were calculated after two years of follow-up. Although not statistically significant, the two-year criminal conviction rates of those treated with other antipsychotics in all offense categories except sexual reoffending were two-fold higher than in those treated with clozapine. The time from release to the first offense and crime-free time in the community were significantly longer in the clozapine group. By prolonging the time it takes from release to first offense, clozapine confers additional crime-reduction advantages.
Lai, D W
This study explores the impact of violence exposure on the mental health of the adolescents in a rural small town. A structured questionnaire was used to survey 347 adolescents. Violence experienced and witnessed by the adolescents at school, in the neighbourhood, and at home was measured. Mental health was represented by the psychiatric symptoms, depression level, and self-esteem. The level of violence perpetrated by the adolescents was also explored. Results of the multiple regression analysis show that adolescents who have been exposed to more violence, either as a victim or as a witness, report more psychiatric symptoms, higher levels of depression, and more problems of self-esteem. Being a witness of violence also contributes significantly to the variance of violence committed by the adolescents. The implications of the findings to violence prevention are discussed in the conclusion.
Joppa, Meredith C.; Rizzo, Christie J.; Brown, Larry K.; Hadley, Wendy; Dattadeen, Jodi-Ann; Donenberg, Geri; DiClemente, Ralph
Little is known about why some adolescents with internalizing symptoms engage in sexual behaviors that increase their risk for HIV. This study tested a mediation model of internalizing symptoms and safe sex intentions among adolescents receiving mental health treatment. Self-efficacy for HIV prevention, HIV knowledge, and worry about HIV were hypothesized to mediate associations between internalizing symptoms and safe sex intentions among sexually active and non-active adolescents receiving mental health treatment (N = 893, M age = 14.9). Significant indirect effects from internalizing symptoms to safe sex intentions varied according sexual experience: for sexually non-active adolescents, HIV worry and knowledge mediated this link, whereas for sexually active adolescents, HIV self-efficacy was the significant mediator. Increasing both HIV knowledge and self-efficacy for HIV prevention are important targets for HIV prevention with adolescents with internalizing symptoms, and careful attention should be paid towards targeting these interventions to sexually experienced and inexperienced youth. PMID:25284921
Nicolas, C; Chawky, N; Jourdan-Ionescu, C; Drouin, M-S; Page, C; Houlfort, N; Beauchamp, G; Séguin, M
According to the World Health Organization, depression has become the leading cause of disability in the world, contributing significantly to the burden of health issues especially in the industrialized countries. This is a major public health problem, with potential impact on work climates, productivity at work and the continued existence of the organizations. Some recent studies have examined potential links between professional factors and common mental health disorders, but none have demonstrated a direct causal link.
Heinz, Andreas; Schlagenhauf, Florian; Beck, Anne; Wackerhagen, Carolin
It has been questioned that the more than 300 mental disorders currently listed in international disease classification systems all have a distinct neurobiological correlate. Here, we support the idea that basic dimensions of mental dysfunctions, such as alterations in reinforcement learning, can be identified, which interact with individual vulnerability and psychosocial stress factors and, thus, contribute to syndromes of distress across traditional nosological boundaries. We further suggest that computational modeling of learning behavior can help to identify specific alterations in reinforcement-based decision-making and their associated neurobiological correlates. For example, attribution of salience to drug-related cues associated with dopamine dysfunction in addiction can increase habitual decision-making via promotion of Pavlovian-to-instrumental transfer as indicated by computational modeling of the effect of Pavlovian-conditioned stimuli (here affectively positive or alcohol-related cues) on instrumental approach and avoidance behavior. In schizophrenia, reward prediction errors can be modeled computationally and associated with functional brain activation, thus revealing reduced encoding of such learning signals in the ventral striatum and compensatory activation in the frontal cortex. With respect to negative mood states, it has been shown that both reduced functional activation of the ventral striatum elicited by reward-predicting stimuli and stress-associated activation of the hypothalamic-pituitary-adrenal axis in interaction with reduced serotonin transporter availability and increased amygdala activation by aversive cues contribute to clinical depression; altogether these observations support the notion that basic learning mechanisms, such as Pavlovian and instrumental conditioning and Pavlovian-to-instrumental transfer, represent a basic dimension of mental disorders that can be mechanistically characterized using computational modeling and
Bruffaerts, Ronny; Vilagut, Gemma; Demyttenaere, Koen; Alonso, Jordi; AlHamzawi, Ali; Andrade, Laura Helena; Benjet, Corina; Bromet, Evelyn; Bunting, Brendan; de Girolamo, Giovanni; Florescu, Silvia; Gureje, Oye; Haro, Josep Maria; He, Yanling; Hinkov, Hristo; Hu, Chiyi; Karam, Elie G.; Lepine, Jean-Pierre; Levinson, Daphna; Matschinger, Herbert; Nakane, Yoshibumi; Ormel, Johan; Posada-Villa, Jose; Scott, Kate M.; Varghese, Matthew; Williams, David R.; Xavier, Miguel; Kessler, Ronald C.
Background Mental and physical disorders are associated with total disability, but their effects on days with partial disability (i.e. the ability to perform some, but not full-role, functioning in daily life) are not well understood. Aims To estimate individual (i.e. the consequences for an individual with a disorder) and societal effects (i.e. the avoidable partial disability in the society due to disorders) of mental and physical disorders on days with partial disability around the world. Method Respondents from 26 nationally representative samples (n = 61 259, age 18+) were interviewed regarding mental and physical disorders, and day-to-day functioning. The Composite International Diagnostic Interview, version 3.0 (CIDI 3.0) was used to assess mental disorders; partial disability (expressed in full day equivalents) was assessed with the World Health Organization Disability Assessment Schedule in the CIDI 3.0. Results Respondents with disorders reported about 1.58 additional disability days per month compared with respondents without disorders. At the individual level, mental disorders (especially post-traumatic stress disorder, depression and bipolar disorder) yielded a higher number of days with disability than physical disorders. At the societal level, the population attributable risk proportion due to physical and mental disorders was 49% and 15% respectively. Conclusions Mental and physical disorders have a considerable impact on partial disability, at both the individual and at the societal level. Physical disorders yielded higher effects on partial disability than mental disorders. PMID:22539779
Bannink, Rienke; Broeren, Suzanne; van de Looij – Jansen, Petra M.; de Waart, Frouwkje G.; Raat, Hein
Purpose To examine whether traditional and cyber bullying victimization were associated with adolescent's mental health problems and suicidal ideation at two-year follow-up. Gender differences were explored to determine whether bullying affects boys and girls differently. Methods A two-year longitudinal study was conducted among first-year secondary school students (N = 3181). Traditional and cyber bullying victimization were assessed at baseline, whereas mental health status and suicidal ideation were assessed at baseline and follow-up by means of self-report questionnaires. Logistic regression analyses were conducted to assess associations between these variables while controlling for baseline problems. Additionally, we tested whether gender differences in mental health and suicidal ideation were present for the two types of bullying. Results There was a significant interaction between gender and traditional bullying victimization and between gender and cyber bullying victimization on mental health problems. Among boys, traditional and cyber bullying victimization were not related to mental health problems after controlling for baseline mental health. Among girls, both traditional and cyber bullying victimization were associated with mental health problems after controlling for baseline mental health. No significant interaction between gender and traditional or cyber bullying victimization on suicidal ideation was found. Traditional bullying victimization was associated with suicidal ideation, whereas cyber bullying victimization was not associated with suicidal ideation after controlling for baseline suicidal ideation. Conclusions Traditional bullying victimization is associated with an increased risk of suicidal ideation, whereas traditional, as well as cyber bullying victimization is associated with an increased risk of mental health problems among girls. These findings stress the importance of programs aimed at reducing bullying behavior, especially
Ruffolo, Mary C.; Sarri, Rosemary; Goodkind, Sara
This study examines risk and protective factors for delinquent, diverted, and high-risk adolescent girls to inform the development of effective mental health prevention and intervention programs. Delinquent, diverted, and high-risk adolescent girls (N = 159) involved or at risk of involvement with the juvenile justice system, who were receiving…
Jakobsson, Niklas; Persson, Mattias; Svensson, Mikael
This paper analyzes whether class size has an effect on the prevalence of mental health problems and well-being among adolescents in Swedish schools. We use cross-sectional data collected in year 2008 covering 2755 Swedish adolescents in ninth grade from 40 schools and 159 classes. We utilize different econometric approaches to address potential…
Yuan, Anastasia S. Vogt
Although sibling structure influences some aspects of adolescents' well-being, including deviance and educational achievement, little research has explored the association between sibling structure and adolescents' mental health. This study explores how sibling structure (the number of siblings, full versus step- or half-siblings, the relative age…
Copeland-Linder, Nikeea; Lambert, Sharon F.; Ialongo, Nicholas S.
This study examined interrelationships among community violence exposure, protective factors, and mental health in a sample of urban, predominantly African American adolescents (N = 504). Latent Profile Analysis was conducted to identify profiles of adolescents based on a combination of community violence exposure, self-worth, parental monitoring,…
Ellis, B. Heidi; MacDonald, Helen Z.; Lincoln, Alisa K.; Cabral, Howard J.
The primary purpose of this study was to examine relations between trauma exposure, post-resettlement stressors, perceived discrimination, and mental health symptoms in Somali adolescent refugees resettled in the U.S. Participants were English-speaking Somali adolescent refugees between the ages of 11 and 20 (N = 135) who had resettled in the U.S.…
Walley, Cynthia T.; Grothaus, Tim
Given the prevalence of adolescent mental health issues and the impact they have on adolescent development and school success, school counselors are challenged to provide appropriate prevention and intervention services. Yet the sufficiency of school counselor training for these challenges is unclear. Qualitative procedures were used to examine…