Angold, A; Prendergast, M; Cox, A; Harrington, R; Simonoff, E; Rutter, M
Great advances have been made during the last 20 years in the development of structured and semi-structured interviews for use with psychiatric patients. However, in the field of child and adolescent psychiatry there have been weaknesses in the specification and definition of both symptoms and the psychosocial impairments resulting from psychiatric disorder. Furthermore, most of the available interviews for use with children have been tied to a single diagnostic system (DSM-III, DSM-III-R, or ICD-9). This has meant that symptom coverage has been limited and nosological comparisons have been inhibited. The Child and Adolescent Psychiatric Assessment (CAPA) represents an attempt to remedy some of these shortcomings. This paper outlines the principles adopted in the CAPA to improve the standardization, reliability and meaningfulness of symptom and diagnostic ratings. The CAPA is an interviewer-based diagnostic interview with versions for use with children and their parents, focused on symptoms occurring during the preceding 3 month period, adapted for assessments in both clinical and epidemiological research. PMID:7480451
Journal of the American Academy of Child & Adolescent Psychiatry, 2009
An introduction for any medical health clinician on the knowledge and skills that are needed for the psychiatric assessment and management of physically ill children and adolescents is presented. These parameters are presented to assist clinicians in psychiatric decision making.
Cautin, Robin L.; Overholser, James C.; Goetz, Patricia
Evaluated internalized and externalized anger in adolescent psychiatric inpatients. Results indicated that internalized anger led to depression and feelings of hopelessness and increased chances of suicide attempts. In contrast, externalized anger was related to alcohol-related problems. Thus, different modes of anger expression appear to be…
Whitbeck, Les B; 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
Brown, Kirk Warren; West, Angela Marie; Loverich, Tamara M.; Biegel, Gina M.
Interest in mindfulness-based interventions for children and adolescents is burgeoning, bringing with it the need for validated instruments to assess mindfulness in youths. The present studies were designed to validate among adolescents a measure of mindfulness previously validated for adults (e.g., Brown & Ryan, 2003), which we herein call the…
Jacobson, Carol Valera; Meyer, Tracy
This study investigated the effectiveness of the Child and Adolescent Functional Assessment Scale (CAFAS) for assessing the functioning of youth with mental disorders. The CAFAS is a multidimensional tool used to record the extent to which a youth's mental health disorder is disruptive of functioning in each of five psycho-social areas: role…
Angold, Adrian; Erkanli, Alaattin; Copeland, William; Goodman, Robert; Fisher, Prudence W.; Costello, E. Jane
Objective: To compare examples of three styles of psychiatric interviews for youth: the Diagnostic Interview Schedule for Children (DISC) ("respondent-based"), the Child and Adolescent Psychiatric Assessment (CAPA) ("interviewer-based"), and the Development and Well-Being Assessment (DAWBA) ("expert judgment"). Method: Roughly equal numbers of…
Aichhorn, Wolfgang; Santeler, Stefan; Stelzig-Schöler, Renate; Kemmler, Georg; Steinmayr-Gensluckner, Maria; Hinterhuber, Hartmann
Various studies show a high prevalence of mental disorders among homeless people. So far most of these studies deal solely with single men, mainly affected by homelessness. Few data exist for women, children, adolescents and whole families that are more and more affected by poverty and homelessness. This study, conducted in Innsbruck/Austria, determined the prevalence of psychiatric disorders among homeless adolescents. The adolescents were recruited in a counselling centre and homeless shelter specifically founded for homeless youth. Mental disorders were diagnosed with the Structured Clinical Interview for DSM-IV (SKID-I). 40 adolescents and young adults ranging from 14-23 years (mean 17.9 years) were included in the study. The results show that 58% of the homeless adolescents were exposed to continuous violence in their families and that violence was a major reason for them to leave home. The overall prevalence of diagnosed psychiatric disorders was 80% in the whole sample; the leading disorder was substance abuse/dependence (65%), followed by mood disorders (42.5%), anxiety disorders (17.5%) and eating disorders (17.5%). 57.5% of the adolescents had a history of self-harm and 25% reported at least one suicide attempt. Duration of homelessness had the greatest influence on the prevalence of mental disorders. Longer duration of homelessness was associated with a higher risk of psychiatric disorder or self-harm. These results demonstrate the urgent need for early psychosocial and psychiatric help for homeless adolescents. PMID:18826872
Imran, Nazish; Azeem, Muhammad Waqar; Chaudhry, Mansoor R.; Butt, Zeeshan
Aims and method To assess adolescents' perceptions of their psychiatric illness and the role of various demographic factors in a Pakistani setting. Adolescents with various psychiatric diagnoses were interviewed using a structured questionnaire including the Illness Perceptions Questionnaire–Revised (IPQ-R). Results Fifty-two adolescents with various psychiatric illnesses were interviewed; their mean age was 12.7 years and the majority (67%) were female. Males had significantly higher scores on timeline and emotional representation (P<0.05), suggesting strongly held beliefs about chronicity of their illness and anger and worry about their condition. Adolescents' own emotional state, stress, family problems and bad luck were endorsed by participants as some of the causal factors in their mental illness. Clinical implications Despite the importance of early intervention in psychiatric problems, engaging youth in the treatment process in Pakistan remains difficult. Better understanding of how adolescents perceive their psychiatric difficulties may play a significant role in developing culturally sensitive interventions and better utilisation of services. PMID:26755949
Hughes, P P; Meize-Grochowski, R; Harris, C N
Seven hospitalized, adolescent psychiatric patients who received a total of 31 Therapeutic Touch treatments over two 2-week periods were interviewed about their experience. Findings from the interviews were categorized within 2 overarching themes-the therapeutic relationship and the body/mind connection. The study participants enjoyed the Therapeutic Touch, and in fact, they wanted more of it. This research shows the possibility of Therapeutic Touch as a nursing intervention with adolescent psychiatric patients if all care is taken to obtain their consent and to provide them with a safe environment for touch therapy. PMID:8698982
Rosenstein, Diana S.; Horowitz, Harvey A.
This study examined the role of attachment in adolescent psychopathology among psychiatrically hospitalized adolescents. Subjects consisted of 60 adolescents and 27 of their mothers. Measures included the Adult Attachment Interview classification for both the adolescents and their mothers, and a battery of diagnostic and personality assessment of…
Ditchburn, K. Marie; Sellman, J. Douglas
Three main aims of this study were to ascertain the prevalence rate of smoking among adolescent psychiatric outpatients; estimate smokers' degree of nicotine dependence; and investigate the relationship between smoking and common mental health disorders. Face-to-face interviews were conducted on 93 patients ages 13-18 presenting to an adolescent…
de Vries, Annelou L. C.; Doreleijers, Theo A. H.; Steensma, Thomas D.; Cohen-Kettenis, Peggy T.
Background: This study examined psychiatric comorbidity in adolescents with a gender identity disorder (GID). We focused on its relation to gender, type of GID diagnosis and eligibility for medical interventions (puberty suppression and cross-sex hormones). Methods: To ascertain DSM-IV diagnoses, the Diagnostic Interview Schedule for Children…
Indredavik, Marit S; Brubakk, Ann-Mari; Romundstad, Pål; Vik, Torstein
Aim Explore associations between smoking in pregnancy and psychiatric symptoms in the adolescent offspring. Design/subjects A prospective population based follow-up of 84 adolescents at 14 years of age, of whom 32 of the mothers reported smoking during pregnancy. Main outcome measures The Achenbach System of Empirically Based Assessment (ASEBA), ADHD-Rating Scale IV, Autism Spectrum Screening Questionnaire (ASSQ), Children's Global Assessment Scale (CGAS), estimated IQ based on four subscales of WISC-III. Results Adolescents who were born by smokers had significantly more rule-breaking and aggressive behaviour, externalizing and total problems on the ASEBA than adolescents of non-smokers (p < 0.01), when reported by mothers, fathers and teachers. ADHD symptoms were reported more frequently (p < 0.05), and mothers also reported more internalizing symptoms (p < 0.05) and social problems (p < 0.001). The ASSQ sum score was higher (p < 0.001), and overall function as measured by the CGAS was lower (p < 0.01) for the smoking-exposed group. Associations were still present after controlling for possible confounding factors. Conclusion Adolescents exposed to prenatal smoking had higher scores for both externalizing and internalizing psychiatric symptoms, which could not be explained by a broad range of possible psychosocial confounders. Thus, smoking in pregnancy may be a marker for increased risk of psychiatric symptoms in the offspring. PMID:17407460
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. PMID:26113643
Background Adults who suffer from psychiatric disorders report low levels of physical activity and the activity levels differ between disorders. Less is known regarding physical activity across psychiatric disorders in adolescence. We investigate the frequency and type of physical activity in adolescent psychiatric patients, compared with adolescents in the general population. Methods A total of 566 adolescent psychiatric patients aged 13–18 years who participated in the CAP survey, Norway, were compared to 8173 adolescents aged 13–19 years who participated in the Nord-Trøndelag Health Study, Young-HUNT 3, Norway. All adolescents completed a questionnaire, including questions about physical activity and participation in team and individual sports. Results Approximately 50% of adolescents with psychiatric disorders and 25% of the population sample reported low levels of physical activity. Within the clinical sample, those with mood disorders (62%) and autism spectrum disorders (56%) were the most inactive and those with eating disorders (36%) the most active. This pattern was the same in individual and team sports. After multivariable adjustment, adolescents with a psychiatric disorder had a three-fold increased risk of lower levels of physical activity, and a corresponding risk of not participating in team and individual sports compared with adolescents in the general population. Conclusions Levels of physical activity were low in adolescent psychiatric patients compared with the general population, yet activity levels differed considerably between various disorders. The findings underscore the importance of assessing physical activity in adolescents with psychiatric disorders and providing early intervention to promote mental as well as physical health in this early stage of life. PMID:24450542
Goldston, David B.; Daniel, Stephanie Sergent; Erkanli, Alaattin; Reboussin, Beth A.; Mayfield, Andrew; Frazier, Patricia H.; Treadway, Sarah L.
The purpose of this prospective, naturalistic study was to examine the relationships between suicide attempts and contemporaneous psychiatric disorders, and developmental changes in these relationships from adolescence to young adulthood. The sample consisted of 180 adolescents, 12-19 years of age at hospitalization, repeatedly assessed for up to…
Malhotra, Savita; Biswas, Parthasarathy; Sharan, Pratap; Grover, Sandeep
Aim: To study the sociodemographic and clinical profile of patients, who presented to the child and adolescent psychiatric services of a tertiary care centre over a 26-year period (1980-2005). Methodology: Data were abstracted retrospectively from detailed work up files of all subjects assessed in the Child and Adolescent Psychiatry (CAP) Clinic…
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
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…
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
Kanbur, Nuray; Tüzün, Zeynep; Derman, Orhan
This study compared male adolescents in an orphanage with adolescents raised by their families in terms of psychiatric symptoms, using the Brief Symptom Inventory. Anxiety, depression, negative self, hostility, and Global Severity Index points were significantly higher in adolescents in the orphanage, although they did not reach pathological levels except with respect to hostility. Adolescents reared in orphanages scored high points for hostility, reaching pathological levels. PMID:21980809
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. PMID:25454118
Matali, José Luis; Andión, Oscar; Pardo, Marta; Iniesta, Raquel; Serrano, Eduard; San, Luis
In recent years, both the prevalence of drug use and related child and adolescent psychiatric emergencies have risen sharply. There are few studies about the impact on child and adolescent emergency services. This study has a twofold aim. The first is to describe the prevalence of substance use disorders, mental disorders and dual diagnosis (substance use problems plus mental disorder) in adolescents in psychiatric emergency service. The second is to analyze clinical and healthcare differences between patients with dual diagnosis and patients with a mental disorder without substance use disorder.We retrospectively reviewed 4012 discharge forms for emergencies treated at the psychiatric emergency department during the period 2007-2009. We obtained a sample of 1795 visits. This sample was divided into two groups: the dual diagnosis group (n = 477) and the psychiatric disorder group (n = 1318).The dual diagnosis group accounted for 26.5% of psychiatric emergencies analyzed. Compared to the psychiatric disorder group,the dual diagnosis group had significantly more conduct disorders, social problems, involuntariness in the visit, less hospital admissions and less connection with the healthcare network.Adolescents with a dual diagnosis account for a high percentage of visits at child and adolescent psychiatric emergency services. This patient group requires specialized care both at emergency services and in specific units. Accordingly, these units should play a triple role when handling dual diagnosis: detection, brief treatment and referral to a specialised unit. PMID:26990268
Kashani, J H; Beck, N C; Hoeper, E W; Fallahi, C; Corcoran, C M; McAllister, J A; Rosenberg, T K; Reid, J C
The prevalence of psychiatric disorders diagnosed according to DSM-III in adolescents in the general population is not known. The authors address this issue in a community sample of 150 adolescents 14-16 years of age. Structured interviews as well as other instruments were used to collect data. Twenty-eight (18.7%) of the 150 adolescents were identified as having a psychiatric disorder. These 28 adolescents viewed their parents as less caring, had lower self-esteem, and resolved their conflicts through verbal aggression and physical violence more often than did the adolescents who did not have a psychiatric disorder. The authors make recommendations regarding the use of structured interviews in future research. PMID:3495187
Salbach-Andrae, Harriet; Lenz, Klaus; Simmendinger, Nicole; Klinkowski, Nora; Lehmkuhl, Ulrike; Pfeiffer, Ernst
This study investigated current comorbid Axis I diagnoses associated with Anorexia Nervosa (AN) in adolescents. The sample included 101 female adolescents treated at a psychiatric unit for primary DSM-IV diagnoses of AN. 73.3% of the AN patients were diagnosed as having a current comorbidity of at least one comorbid Axis I diagnosis, with no…
Steer, Robert A.; And Others
Administered Beck Scale for Suicide Ideation (BSI) to 108 adolescent inpatients diagnosed with mixed psychiatric disorders. Examined relationships of Beck Depression Inventory, Anxiety Inventory, and Hopelessness Scale with BSI. Results support use of BSI with adolescent inpatients. Findings indicated that hopelessness was related to suicidal…
Kumar, Geetha; Steer, Robert A.; Gulab, Nazli A.
To ascertain whether children and adolescents whose ages ranged from 9 to 17 years described distinct profiles of personal resiliency, the Resiliency Scales for Children and Adolescents (RSCA) were administered to 100 youth who were admitted to an inpatient psychiatric unit and were diagnosed with various "DSM-IV-TR" disorders along with the Beck…
Marttunen, Mauri J.; Henriksson, Markus M.; Isometsa, Erkki T.; Heikkinen, Martti E.; Aro, Hillevi M.; Lonnqvist, Jouko K.
The characteristics of male adolescent suicide victims with (N=84) and without (N=8) diagnosable psychiatric disorder were compared. Psychological autopsy data were collected on all adolescent suicides in one year. Communication of suicidal intent and problems with discipline just before the suicide are among the few clinical warning signs found.…
Dew, Rachel Elizabeth; Daniel, Stephanie S.; Armstrong, Tonya D.; Goldston, David B.; Triplett, Mary Frances; Koenig, Harold G.
The aim of the current article is to review the literature on religion and spirituality as it pertains to adolescent psychiatric symptoms. One hundred and fifteen articles were reviewed that examined relationships between religion/spirituality and adolescent substance use, delinquency, depression, suicidality, and anxiety. Ninety-two percent of…
Mustanoja, Susanna; Luukkonen, Anu-Helmi; Hakko, Helina; Rasanen, Pirkko; Saavala, Hannu; Riala, Kaisa
We examined the relationship of exposure to domestic violence and violence occurring outside home to bullying behaviour in a sample (508; 40.9% males, 59.1% females) of underage psychiatric inpatient adolescents. Participants were interviewed using K-SADS-PL to assess DSM-IV psychiatric diagnoses and to gather information about domestic and other…
Johnson, Jeffrey G.; Cohen, Patricia; Kasen, Stephanie; Brook, Judith S.
Data from a community-based longitudinal study were used to investigate the associations of parental psychiatric disorders evident by early adulthood with child-rearing behavior during middle adulthood. A series of psychiatric assessments was conducted during the adolescence (mean ages 14 and 16) and early adulthood (mean age 22) of 153 males and…
Catthoor, Kirsten; Feenstra, Dine J; Hutsebaut, Joost; Schrijvers, Didier; Sabbe, Bernard
Background The aim of the study is to assess the severity of psychiatric stigma in a sample of personality disordered adolescents in order to evaluate whether differences in stigma can be found in adolescents with different types and severity of personality disorders (PDs). Not only adults but children and adolescents with mental health problems suffer from psychiatric stigma. In contrast to the abundance of research in adult psychiatric samples, stigma in children and adolescents has hardly been investigated. Personality disordered adolescents with fragile identities and self-esteem might be especially prone to feeling stigmatized, an experience which might further shape their identity throughout this critical developmental phase. Materials and methods One hundred thirty-one adolescent patients underwent a standard assessment with Axis I and Axis II diagnostic interviews and two stigma instruments, Stigma Consciousness Questionnaire (SCQ) and Perceived Devaluation–Discrimination Questionnaire (PDDQ). Independent sample t-tests were used to investigate differences in the mean SCQ and PDDQ total scores for patients with and without a PD. Multiple regression main effect analyses were conducted to explore the impact of the different PDs on level of stigma, as well as comorbid Axis I disorders. Age and sex were also entered in the regression models. Results and conclusions Adolescents with severe mental health problems experience a burden of stigma. Personality disordered patients experience more stigma than adolescents with other severe psychiatric Axis I disorders. Borderline PD is the strongest predictor of experiences of stigma. More severely personality disordered adolescents tend to experience the highest level of stigma. PMID:25999774
Swenson, Lance P.; Esposito-Smythers, Christianne; Hunt, Jeffrey I.; Hollander, Beth L. G.; Dyl, Jennifer; Rizzo, Christie J.; Steinley, Douglas L.; Spirito, Anthony
A study was conducted to examine the concurrent validity of the Children's Interview for Psychiatric Syndromes (ChIPS) for adolescent inpatients aged 12 to 18. The results reveal moderate agreement between ChIPS diagnoses and Schedule for Affective Disorder sand Schizophrenia for School-Age Children-Present and Lifetime version diagnoses.
Capetillo-Ventura, Nelly; Baeza, Inmaculada
The hypothalamic-pituitary-thyroid axis is involved in the production of thyroid hormone which is needed to maintain the normal functioning of various organs and systems, including the central nervous system. This study reports a case of hypothyroidism in a fifteen-year-old female adolescent who was attended for psychiatric symptoms. This case reveals the importance of evaluating thyroid function in children and adolescents with neuropsychiatric symptoms. PMID:25436160
Kahila, K; Kilkku, N; Kaltiala-Heino, R
Finland does not have a history of providing forensic adolescent psychiatric units although the need for this kind of service has been established. According to legislation patients who are minors have to be treated separately from adults, however, this has not been possible in practice. Also, adolescent psychiatric wards have not always been able to admit the most severely ill patients, those with impulsive and aggressive behaviours, because of lack of staff resources, problems associated with protecting other vulnerable patients and a shortage of secure environments. A previous report demonstrated the significant increase in adolescent's involuntary treatment within adult psychiatric wards. Data from this report were acknowledged as an important starting point in the planning process for the psychiatric treatment and research unit for adolescent intensive care. This paper describes the background, development process, plan of action, tailor-made education programme and supporting evidence for the first Finnish adolescent forensic service opened in April 2003 in the Department of Psychiatry, Tampere University Hospital. The tool used for planning the unit's activities and staff education programme was the Balanced Score Card approach, the structure and development of which is also outlined within the paper. PMID:15009502
Jang, Keum Seong; Hwang, Seon Young; Choi, Ja Yun
Background: The aims of this study were to identify the independent factors associated with intermittent addiction and addiction to the Internet and to examine the psychiatric symptoms in Korean adolescents when the demographic and Internet-related factors were controlled. Methods: Male and female students (N = 912) in the 7th-12th grades were…
Moseley, David S.; Tonge, Bruce J.; Brereton, Avril V.; Einfeld, Stewart L.
This article reports the findings of a study investigating rates and types of comorbid mental disorder evident in adolescents and young adults with autism. A sample of 84 young people (M = 19.5 years, SD = 4.6) with "Diagnostic and Statistical Manual of Mental Disorders," 4th Edition, Text Revision (DSM-IV-TR; American Psychiatric Association,…
Eltz, Michael; Evans, Allison Schettini; Celio, Mark; Dyl, Jennifer; Hunt, Jeffrey; Armstrong, Laura; Spirito, Anthony
This study examined the factor structure, reliability, and validity of the Suicide Probability Scale (SPS) in a sample of 226 (80 male, 146 female) adolescent psychiatric inpatients. Confirmatory factor analyses provided only some support for the original subscales. Exploratory factor analyses revealed some overlap with the original scales, but…
Estroff, T W; Schwartz, R H; Hoffmann, N G
Four hundred seventy-nine drug abusing adolescent patients enrolled in seven Straight, Inc. Adolescent Drug-Abuse Treatment Programs in five geographic regions across the United States were studied to determine the severity and patterns of cocaine abuse. Of these, 341 admitted to cocaine use and became part of this survey. Cocaine use was categorized as heavy, intermediate, or light. Areas examined were the addictive spectrum, psychosocial dysfunction, and psychiatric symptoms. Intermediate and heavy users of cocaine abused significantly less marijuana and inhalants than light cocaine abusers. Heavy and intermediate users were more likely to use cocaine intravenously and to use crack. They developed tachyphylaxis more frequently, progressed to weekly use in less than 3 months more frequently, and became preoccupied with obtaining and using cocaine significantly more frequently. They used more sedative hypnotics to calm themselves and engaged in more criminal behavior, such as stealing from parents and stores and passing bad checks. They had more arrests for possession of drugs, stole more cars, sold more drugs, and were more likely to trade sexual favors to obtain the drug. Heavy and intermediate users were significantly more psychiatrically disturbed than light users, becoming more suspicious, nervous, aggressive, and demonstrating increased symptoms of fatigue, sleeplessness, decreased appetite, and increasing cocaine dysphoria. All of these symptoms could be mistaken for psychiatric disorders. This study suggests that cocaine is as addictive in adolescents as in adults; possibly more so. It also causes psychosocial dysfunction and psychiatric symptoms. Further research into cocaine addiction among adolescents is indicated. PMID:2582695
Thurber, Steven; Hollingsworth, David K.
Because of recent developments in measurements, investigated possible covariation between hyperactivity and cerebral deficits in adolescent psychiatric inpatients. Used several different measures on 45 patients (32 boys, 13 girls). The limited amount of covariation found suggests that neuropsychological deficits may be a diffuse problem that…
Salbach-Andrae, Harriet; Lenz, Klaus; Simmendinger, Nicole; Klinkowski, Nora; Lehmkuhl, Ulrike; Pfeiffer, Ernst
This study investigated current comorbid Axis I diagnoses associated with Anorexia Nervosa (AN) in adolescents. The sample included 101 female adolescents treated at a psychiatric unit for primary DSM-IV diagnoses of AN. 73.3% of the AN patients were diagnosed as having a current comorbidity of at least one comorbid Axis I diagnosis, with no differences across AN subtypes. Mood disorders (60.4%) were most commonly identified, followed by the category anxiety disorders without obsessive-compulsive disorders (OCD) (25.7%), OCD (16.8%) and substance use disorders (7.9%). Two specific diagnoses differed across the two subtypes of AN. Substance use disorder was 18 times, and the category anxiety disorder without OCD was three times as likely to co-occur with AN binge-eating disorder and purging type than with AN restricting type. Clinicians should be alerted to the particularly high rate of psychiatric comorbidities in adolescents suffering from AN. PMID:17987378
Leventhal, Adam M; Strong, David R; Sussman, Steve; Kirkpatrick, Matthew G; Unger, Jennifer B; Barrington-Trimis, Jessica L; Audrain-McGovern, Janet
The popularity of electronic (e-) cigarettes has greatly increased recently, particularly in adolescents. However, the extent of psychiatric comorbidity with adolescent e-cigarette use and dual use of conventional (combustible) and e-cigarettes is unknown. This study characterized psychiatric comorbidity in adolescent conventional and e-cigarette use. Ninth grade students attending high schools in Los Angeles, CA (M age = 14) completed self-report measures of conventional/e-cigarette use, emotional disorders, substance use/problems, and transdiagnostic psychiatric phenotypes consistent with the NIMH-Research Domain Criteria Initiative. Outcomes were compared by lifetime use of: (1) neither conventional nor e-cigarettes (non-use; N = 2557, 77.3%); (2) e-cigarettes only (N = 412, 12.4%); (3) conventional cigarettes only (N = 152, 4.6%); and (4) conventional and e-cigarettes (dual use; N = 189, 5.6%). In comparison to adolescents who used conventional cigarettes only, e-cigarette only users reported lower levels of internalizing syndromes (depression, generalized anxiety, panic, social phobia, and obsessive-compulsive disorder) and transdiagnostic phenotypes (i.e., distress intolerance, anxiety sensitivity, rash action during negative affect). Depression, panic disorder, and anhedonia were higher in e-cigarette only vs. non-users. For several externalizing outcomes (mania, rash action during positive affect, alcohol drug use/abuse) and anhedonia, an ordered pattern was observed, whereby comorbidity was lowest in non-users, moderate in single product users (conventional or e-cigarette), and highest in dual users. These findings: (1) raise question of whether emotionally-healthier ('lower-risk') adolescents who are not interested in conventional cigarettes are being attracted to e-cigarettes; (2) indicate that research, intervention, and policy dedicated to adolescent tobacco-psychiatric comorbidity should distinguish conventional cigarette, e-cigarette, and dual use
In adolescents with chronic illnesses, the rate of behavioral disorders is 10% to 20% higher than that in their well peers. Rheumatoid arthritis, chronic renal disease, cystic fibrosis, cancer, and many other chronic illnesses constitute risk factors for behavioral disorders in adolescents. Because they are now living longer, more productive lives, adolescents with chronic illnesses are more often seen by their primary care physicians with behavioral disorders that can interfere with disease control. Risk-taking behaviors, difficulties with parents, noncompliance, depression, and isolation may all be manifestations of behavioral disorders. Parents and siblings may also be at risk for disorder. Particular constellations of family and individual characteristics may be associated with behavior disorder. So that these behaviors may be discovered as early as possible, it is important that the primary care physician conceptualize chronically ill adolescents and their families as "at risk." PMID:2190958
Trautman, P D; Rotheram-Borus, M J; Dopkins, S; Lewin, N
Psychiatric diagnoses were examined using the Schedule for Affective Disorders and Schizophrenia for School-Aged Children semistructured interview among three groups of minority adolescent females aged 12 to 17:61 suicide attempters, 31 psychiatrically disturbed nonattempters, and 23 nonattempting, nondisturbed girls. Major or minor depressive disorder was found in 42% of the suicide attempters; conduct disorder in 46%; multiple diagnoses in 38%, no diagnosis in 13%. These rates were very similar to those found in disturbed nonattempters. Only one symptom, suicidal ideation, distinguished attempters from disturbed nonattempters, while many symptoms distinguished these two groups from nondisturbed nonattempters. PMID:1890096
Liberatore, Katia A; Rosario, Katyna; Colón-De Martí, Luz N; Martínez, Karen G
Internet addiction (IA) is particularly relevant in the adolescent population. The aim of this study was to describe the prevalence of IA in a clinical sample of Latino adolescents receiving ambulatory psychiatric treatment. The correlation between their pattern of Internet use and their respective psychiatric diagnosis was also studied. Adolescent patients from the Psychiatric Ambulatory Clinic at the Pediatric University Hospital (N=71) completed the Internet Addiction Test (IAT) and a questionnaire about Internet use. Information regarding demographic and diagnostic data was retrieved from their clinical records. None of the subjects presented severe IA. A total of 71.8% (n=51) of the adolescents obtained scores reflecting no problem related to IA. Only 11.6% (n=5) of subjects have discussed Internet use with their therapist. Mood disorders showed a statistically significant (p=0.044) correlation with a higher score on the IAT. Mental health care practitioners must consider questions on Internet use as an essential part of the patients' evaluation given its significant correlation with diagnosis of a mood disorder. PMID:21114410
Havens, Jennifer F.; Gudiño, Omar G.; Biggs, Emily A.; Diamond, Ursula N.; Weis, J. Rebecca; Cloitre, Marylene
Trauma exposure and posttraumatic stress disorder (PTSD), though prevalent among adolescent psychiatric inpatients, are under-identified in standard clinical practice. In a retrospective chart review of 140 adolescents admitted to a psychiatric inpatient unit, we examine associations between probable PTSD identified through the Child PTSD Symptom Scale and adolescents' service use and clinical characteristics. Results suggest a large discrepancy between rates of probable PTSD identified through standardized assessment and during the emergency room psychiatric evaluation (28.6% vs. 2.2%). Adolescents with probable PTSD had greater clinical severity and service utilization, an increased likelihood of being diagnosed with bipolar disorder (27.5% vs. 9.2%) and being prescribed antipsychotic medications (47.5% vs. 27.6%), and were prescribed more psychotropic medications. Upon discharge, those with probable PTSD were more likely to be assigned a diagnosis of PTSD (45% vs. 7.1%), a comorbid diagnoses of major depressive disorder (30% vs. 14.3%), to be prescribed an antidepressant medication (52.5% vs. 33.7%), and they continued to be prescribed more medications. The under-identification of trauma exposure and PTSD have important implications for the care of adolescents given that accurate diagnosis is a prerequisite for providing effective care. Improved methods for identifying trauma-related problems in standard clinical practice are needed. PMID:22522731
Abrantes, Ana M.; Strong, David R.; Ramsey, Susan E.; Lewinsohn, Peter M.; Brown, Richard A.
The clinical and psychosocial characteristics of 239 dieting and nondieting adolescents (61% female; mean age=15.3) recruited from an inpatient psychiatric setting were examined. Dieting adolescents were compared to nondieting adolescents on exercise frequency, weight control behaviors, risky behaviors, psychiatric comorbidity and distress, eating…
Alavi, Nazanin; Roberts, Nasreen; Sutton, Chloe; Axas, Nicholas; Repetti, Leanne
Objective: To examine the prevalence of bullying victimization among adolescents referred for urgent psychiatric consultation, to study the association between bullying victimization and suicidality, and to examine the relation between different types of bullying and suicidality. Method: A retrospective chart review was conducted for all adolescents referred to a hospital-based urgent consultation clinic. Our study sample consisted of adolescents with a history of bullying victimization. The Research Ethics Board of Queen’s University provided approval. Data analysis was conducted using SPSS (IBM SPSS Inc, Armonk, NY). Chi-square tests were used for sex, suicidal ideation, history of physical and sexual abuse, and time and type of bullying, and an independent sample t test was used for age. Results: The prevalence of bullying victimization was 48.5% (182 of 375). There was a significant association between being bullied and suicidal ideation (P = 0.01), and between sex and suicidal ideation (P ≤ 0.001). Victims of cyberbullying reported more suicidal ideation than those who experienced physical or verbal bullying (P = 0.04). Conclusions: Bullying victimization, especially cyberbullying, is associated with increased risk of suicidal ideation among adolescents referred for psychiatric risk assessment. The detailed history of the type and duration of bullying experienced by the victims should be considered when conducting a psychiatric risk assessment. PMID:26720189
Hill, Simon A.; Riordan-Eva, Elliott; Bhandari, Bharathi; Ferdinandez, Uresh
Objective: The objective of the study was to use routinely collected data on vitamin D levels of adolescents detained in a secure psychiatric hospital to see if this at-risk group for vitamin D deficiency do in fact have low vitamin D levels. Methods: Vitamin D blood levels were collated from clinical records of inpatients admitted to Bluebird House, a medium secure adolescent unit, since 2012. Corresponding data were gathered to include gender, ethnic status and age. Blood levels were assessed on admission to the unit and after treatment with vitamin D supplementation, if indicated. Results: Only 3 out of the 35 patients (8.6%) had adequate vitamin D levels (serum 25-hydroxyvitamin D [25-OHD] > 50 nmol/l). A total of 23 patients (65.7%) had levels consistent with deficiency (25-OHD < 30 nmol/l) with the remaining 9 patients (25.7%) showing levels indicating possible deficiency (25-OHD 30–50 nmol/l. Conclusions: Vitamin D levels were low in our sample of young people admitted to a secure psychiatric hospital. This is the first published study of vitamin D levels in a secure adolescent psychiatric hospital. The results point to the need for routine prescription of vitamin D to adolescents held in secure conditions such as hospitals, secure children’s homes and youth offender institutes. PMID:27536343
Jesmin, Akhter; Rahman, Khan Muhammad Zillur; Muntasir, Maruf Mohammad
Objectives Psychiatric disorders are increasingly recognized among children and adolescents in Bangladesh. Psychiatric disorders are more common in children with chronic and acute pediatric disorders. Our study was designed to determine the psychiatric disorders among children and adolescents attending pediatric outpatient departments of tertiary care hospitals. Methods This cross-sectional study was carried out from July 2012 to February 2013 in pediatric outpatient departments of three prime tertiary level hospitals of Dhaka, Bangladesh. A purposive sampling technique was used. A total of 240 male and female children aged 5 to 16 years old were included in the study. We used a semi-structured questionnaire to obtain sociodemographic and other relevant clinical information about the children and their families from their parents or caregivers and a validated parent version of the Bangla Development and Well-Being Assessment (DAWBA) for measuring psychopathology. Results The mean age of the children was 9.0± 2.6 years. The majority (71%) of children were in the 5–10 year age group. The male/female ratio was 1.2:1. Among the respondents, 18% were found to have a psychiatric disorder. Behavioral disorders, emotional disorders, and developmental disorders were found in 9.0%, 15.0% and 0.4% respectively. Hyperkinetic disorder was the single most frequent (5.0%) psychiatric disorder. Conclusions A significant number of children were found to have psychiatric disorders. Our study indicates the importance of identification and subsequent management of psychiatric conditions among the pediatric population. PMID:27403237
Lavan, Hannah; Johnson, Jeffrey G
This study was conducted to investigate the association between psychiatric disorders and high-risk sexual behavior among adolescent primary care patients. Interviews assessing anxiety, conduct, depressive, eating, substance use, and personality disorders (PDs), as well as histories of sexual behavior were administered to 119 male and 284 female adolescent primary care patients. Results indicated that, after co-occurring psychiatric disorders were controlled statistically, adolescents with elevated PD symptom levels were more likely than adolescents without elevated PD symptom levels to report a high number of sexual partners during the past year and during their lifetime. Adolescents with a history of conduct disorder were more likely than adolescents without such a history to report a high number of lifetime unsafe sexual partners. Elevated antisocial, dependent, and paranoid PD symptom levels were associated with high-risk sexual behavior after co-occurring psychiatric disorders were controlled. Further, certain specific antisocial, borderline, dependent, histrionic, narcissistic, obsessive-compulsive, paranoid, and schizotypal PD symptoms were independently associated with high-risk sexual behavior after co-occurring psychiatric disorders and overall PD symptom levels were controlled. The association between overall PD symptom levels and the number of sexual partners was significantly stronger among the females than among the males in the sample. Increased recognition and treatment of PDs, coupled with increased recognition of high-risk sexual behavior may facilitate the prevention of sexually transmitted diseases and teenage pregnancy among adolescents. PMID:11881162
Comasco, Erika; Gustafsson, Per A; Sydsjö, Gunilla; Agnafors, Sara; Aho, Nikolas; Svedin, Carl Göran
Psychiatric disorders are multi-factorial and their symptoms overlap. Constitutional and environmental factors influence each other, and this contributes to risk and resilience in mental ill-health. We investigated functional genetic variation of stress responsiveness, assessed as FKBP5 genotype, in relation to early life adversity and mental health in two samples of adolescents. One population-based sample of 909 12-year-old adolescents was assessed using the Life Incidence of Traumatic Events scale and the Strengths and Difficulties Questionnaire. One sample of 398 17-year-old adolescents, enriched for poly-victimized individuals (USSS), was assessed using the Juvenile Victimization Questionnaire and the Trauma Symptom Checklist for Children (TSCC). The FKBP5 rs1360780 and rs3800373 polymorphisms were genotyped using a fluorescence-based competitive allele-specific PCR. Most prominently among poly-victimized older male adolescents, the least common alleles of the polymorphisms, in interaction with adverse life events, were associated with psychiatric symptoms, after controlling for ethno-socio-economic factors. The interaction effect between rs3800373 and adverse life events on the TSCC sub-scales-anxiety, depression, anger, and dissociation-and with the rs1360780 on dissociation in the USSS cohort remained significant after Bonferroni correction. This pattern of association is in line with the findings of clinical and neuroimaging studies, and implies interactive effects of FKBP5 polymorphisms and early life environment on several psychiatric symptoms. These correlates add up to provide constructs that are relevant to several psychiatric symptoms, and to identify early predictors of mental ill-health. PMID:26424511
Chadwick, Benjamin; Miller, Michael L.; Hurd, Yasmin L.
Cannabis use is increasingly pervasive among adolescents today, even more common than cigarette smoking. The evolving policy surrounding the legalization of cannabis reaffirms the need to understand the relationship between cannabis exposure early in life and psychiatric illnesses. cannabis contains psychoactive components, notably Δ9-tetrahydrocannabinol (THC), that interfere with the brain’s endogenous endocannabinoid system, which is critically involved in both pre- and post-natal neurodevelopment. Consequently, THC and related compounds could potentially usurp normal adolescent neurodevelopment, shifting the brain’s developmental trajectory toward a disease-vulnerable state, predisposing early cannabis users to motivational, affective, and psychotic disorders. Numerous human studies, including prospective longitudinal studies, demonstrate that early cannabis use is associated with major depressive disorder and drug addiction. A strong association between schizophrenia and cannabis use is also apparent, especially when considering genetic factors that interact with this environmental exposure. These human studies set a foundation for carefully controlled animal studies which demonstrate similar patterns following early cannabinoid exposure. Given the vulnerable nature of adolescent neurodevelopment and the persistent changes that follow early cannabis exposure, the experimental findings outlined should be carefully considered by policymakers. In order to fully address the growing issues of psychiatric illnesses and to ensure a healthy future, measures should be taken to reduce cannabis use among teens. PMID:24133461
Chadwick, Benjamin; Miller, Michael L; Hurd, Yasmin L
Cannabis use is increasingly pervasive among adolescents today, even more common than cigarette smoking. The evolving policy surrounding the legalization of cannabis reaffirms the need to understand the relationship between cannabis exposure early in life and psychiatric illnesses. cannabis contains psychoactive components, notably Δ(9)-tetrahydrocannabinol (THC), that interfere with the brain's endogenous endocannabinoid system, which is critically involved in both pre- and post-natal neurodevelopment. Consequently, THC and related compounds could potentially usurp normal adolescent neurodevelopment, shifting the brain's developmental trajectory toward a disease-vulnerable state, predisposing early cannabis users to motivational, affective, and psychotic disorders. Numerous human studies, including prospective longitudinal studies, demonstrate that early cannabis use is associated with major depressive disorder and drug addiction. A strong association between schizophrenia and cannabis use is also apparent, especially when considering genetic factors that interact with this environmental exposure. These human studies set a foundation for carefully controlled animal studies which demonstrate similar patterns following early cannabinoid exposure. Given the vulnerable nature of adolescent neurodevelopment and the persistent changes that follow early cannabis exposure, the experimental findings outlined should be carefully considered by policymakers. In order to fully address the growing issues of psychiatric illnesses and to ensure a healthy future, measures should be taken to reduce cannabis use among teens. PMID:24133461
Fabrega, H; Ulrich, R; Mezzich, J E
A large sample of adolescents brought for psychiatric evaluation to a public University based facility are the subjects of the study. Material incorporated in a DSM-III multiaxial formulation plus symptoms constituted the dependent variables. Analyses concentrated on ethnic differences, with variation associated with gender and social class controlled statistically. Caucasians showed comparatively greater clinical morbidity: higher number of Axis I definite diagnoses and level of symptoms. Eating disorder diagnoses were more common in Caucasians. There were no significant differences pertaining to level of stress or social impairment. Blacks showed higher levels of symptoms scored as "social aggression" and diagnosed as conduct disorders. The pattern of results raised the question of a possible referral bias, with blacks shunted to the psychiatric facility with lower levels of standard clinical psychopathology, but higher levels of social oppositional behavior. Further research is needed to verify if such a bias does exist. PMID:8444771
Brand, Serge; Kirov, Roumen
Restoring sleep is strongly associated with a better physical, cognitive, and psychological well-being. By contrast, poor or disordered sleep is related to impairment of cognitive and psychological functioning and worsened physical health. These associations are well documented not only in adults but also in children and adolescents. Importantly, adolescence is hallmarked by dramatic maturational changes in sleep and its neurobiological regulation, hormonal status, and many psychosocial and physical processes. Thus, the role of sleep in mental and physical health during adolescence and in adolescent patients is complex. However, it has so far received little attention. This review first presents contemporary views about the complex neurobiology of sleep and its functions with important implications for adolescence. Second, existing complex relationships between common adolescent somatic/organic, sleep-related, and psychiatric disorders and certain sleep alterations are discussed. It is concluded that poor or altered sleep in adolescent patients may trigger and maintain many psychiatric and physical disorders or combinations of these conditions, which presumably hinder recovery and may cross into later stages of life. Therefore, timely diagnosis and management of sleep problems appear critical for growth and development in adolescent patients. PMID:21731894
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. PMID
Griesler, Pamela C.; Hu, Mei-Chen; Schaffram, Christine; Kandel, Denise B.
The relationship between nicotine dependence and DSM-IV psychiatric disorders in 1,039 adolescents is examined. Findings revealed that psychiatric disorders most usually predicted the onset of the first basis of nicotine dependence while nicotine dependence does not appear to have an influence on the onset of psychiatric disorders. Other…
Swenson, Lance P.; Spirito, Anthony; Dyl, Jennifer; Kittler, Jennifer; Hunt, Jeffrey I.
This archival study of 288 adolescent psychiatric inpatients examined the psychiatric correlates of cutting behavior. Participants were categorized into Threshold cutters (n = 61), Subthreshold cutters (n = 43), and Noncutters (n = 184). Groups were compared on psychiatric diagnoses, suicidality, and self-reported impairment. Results demonstrated…
Psychiatric reports in German civil law cases are required if questions are raised of legal capacity, capacity to express a testamentary will, ability to sue or be sued, capacity to marry, ability of mentally disordered patients to consent to treatment, and when custody or hospital orders of these patients is considered or compensation is due for mental disorders resulting from accidents. Many reports must decide whether the ability to decide using sound reason or motives is or was impaired by a mental disorder. This capability is attributed to every adult person; only if incapability is claimed must it be proven by psychiatric assessment. As in most psychiatric court reports, such assessments must be structured in several steps. First a clinical diagnosis has to be established which must then be translated into legal terminology. After this has been accomplished, the psychiatrist must describe the functional impairments caused by the disorder and define the probability with which these impairments might affect the legal act in question. Most reports are prepared in the context of custody law, which centers on helping those patients who, due to a mental disorder, cannot manage their own legal matters. PMID:19159913
Tolou-Shams, Marina; Feldstein Ewing, Sarah W. Tarantino, Nicholas; Brown, Larry K.
Crack and cocaine use among adults has been associated with co-occurring psychiatric disorders as well as other drug use and unprotected sex. However, this issue is relatively unstudied in adolescents. This study collected data from 282 adolescents (mean age = 14.9 years) treated in intensive psychiatric treatment settings to understand the…
Valevski, Avi; Ratzoni, Gideon; Sever, Jonathan; Apter, Alan; Zalsman, Gil; Shiloh, Roni; Weizman, Abraham; Tyano, Sam
Outcome according to diagnosis and stability of diagnosis were investigated in a follow-back study, with a duration of 15-19 years, of 351 adolescents with various psychiatric disorders hospitalized in a closed psychiatric ward. Findings indicated that transient adolescent psychosis is associated with a relatively good prognosis and should…
Hoefnagels, Cees; Meesters, Cor; Simenon, Joke
The potential role of social support for the adolescent offspring of psychiatric patients has hitherto not been examined. We examined whether the adolescent's level of psychiatric symptoms is dependent on the content and the function of social support (whether direct or moderating), controlling for perceived stress. In a cross-sectional design, 40…
Simons, J.; Capio, C. M.; Adriaenssens, P.; Delbroek, H.; Vandenbussche, I.
Self-concept is a widely examined construct in the area of psychiatric disorders. This study compared the Physical Self-Description Questionnaire (PSDQ) scores of adolescents with psychiatric disorders (N=103) with the results of a matched group of non-clinical adolescents (N=103). Self-concept and Physical self-concept were lower in the clinical…
Angle, Hugh V.; Ellinwood, Everett H.; Carroll, Judith
Behavioral Assessment information, a more general form of Problem- Oriented Record data, appears to have many useful clinical qualities and was selected to be the information content for a computer interview system. This interview system was designed to assess problematic behaviors of psychiatric patients. The computer interview covered 29 life problem areas and took patients from four to eight hours to complete. In two reliability studies, the computer interview was compared to human interviews. A greater number of general and specific patient problems were identified in the computer interview than in the human interviews. The attitudes of computer patients and clinicians receiving the computer reports were surveyed.
Background The aims of this prospective study are to clarify the outcomes of child psychiatric inpatient treatment and to identify factors associated with patient improvement. Methods The attending psychiatrist used the Children's Global Assessment Scale (CGAS) to assess youths at admission to and discharge from a child and adolescent psychiatric unit in Japan(N = 126, mean age = 12.8, SD = 1.9). Hospital records gathered sociodemographic and clinical variables. In addition, youths and their primary caregivers assessed themselves using the Youth Self Report (YSR) and the Child Behavior Checklist (CBCL), respectively. Longitudinal analyses compared each scales' baseline and discharge scores. We also examined factors associated with changes in functioning (CGAS). Results Longitudinal comparisons revealed that CGAS, CBCL and YSR scores showed improvement over time (CGAS: t = -14.40, p = 0.00; CBCL: t = 3.80, p = 0.00; YSR: t = 2.40, p = 0.02). Linear regressions determined that the factors associated with improvement in CGAS included age, lower CGAS scores at admission, frequency of group therapy and psychiatric diagnosis. Conclusions This evaluation of children and adolescents in an inpatient unit demonstrated clinical improvement over time and identified factors associated with said improvement. PMID:21453481
Background Two school shootings with altogether 18 victims took place in Finland in November 2007 and September 2008. Homicides and suicides are both associated with the copycat phenomenon. The aim of the present study was to characterize adolescent copycats who had threatened to carry out a school massacre. Methods The nation-wide study evaluated 77 13- to 18-year-old adolescents who were sent for adolescent psychiatric evaluations between 8.11.2007 and 30.6.2009, one of the reasons for evaluation being a threat of massacre at school. The medical files of the copycats were retrospectively analysed using a special data collection form. Data on demographics, family- and school-related issues, previous psychiatric treatment and previous delinquency, current symptoms, family adversities and psychiatric diagnoses were collected. The severity of the threat expressed and the risk posed by the adolescent in question were evaluated. The Psychopathy Checklist Youth Version was used to assess psychopathic traits. Results All of the copycats were native Finns with a mean age of 15.0 years. Almost two thirds of them had a history of previous mental health treatment before the index threat. Almost two thirds of the copycats suffered from anxiety and depressive symptoms, and almost half of the sample expressed either suicidal ideation or suicidal plans. Behavioural problems including impulse control problems, aggressive outbursts, the destruction of property as well as non-physical and physical violence against other persons were common. The diagnosis groups highlighted were behavioural and emotional disorders, mood disorders as well as schizophrenia-related disorders. The prevalence of pervasive developmental disorders was high. Only one of the copycats was assessed as expressing high traits of psychopathy. Conclusion The copycats with school massacre threats were characterized with a high prevalence of mental and behavioural disorders. Like actual school shooters, they
Harford, Thomas C.; Yi, Hsiao-ye; Chen, Chiung M.; Grant, Bridget F.
Background Few epidemiologic studies have examined a full range of adolescent psychiatric disorders in the general population. The association between psychiatric symptom clusters (PSCs) and DSM-IV alcohol use disorders (AUDs) among adolescents is not well understood. Methods This study draws upon the public-use data from the 2000 National Household Survey on Drug Abuse, including a study sample of 19,430 respondents ages 12 to 17. Logistic regression and exploratory structural equation modeling assess the associations between PSCs and DSM-IV AUDs by gender. The PSCs are based on brief screening scales devised from the Diagnostic Interview Schedule for Children Predictive Scales. Results Several PSCs were found to be significantly associated with DSM-IV AUDs, including separation anxiety, generalized anxiety, depression, oppositional defiant disorder, and conduct disorder among both genders, and panic disorder and obsessive compulsive disorder among females. Consistent with the literature, the analysis of PSCs yields three factors identical for both genders—two internalizing factors (fear and anxiety–misery) and one externalizing factor. Adolescents who scored higher on the externalizing factor tended to have higher levels of the AUD factor. Female adolescents who scored higher on the internalizing misery factor and lower on the internalizing fear factor also tended to have higher levels of the AUD factor. Conclusion The associations that we found between PSCs and AUDs among adolescents in this study are consistent with those found among adults in other studies, although gender may moderate associations between internalizing PSCs and AUDs. Our findings lend support to previous findings on the developmentally stable associations between disruptive behaviors and AUDs among adolescents as well as adults in the general population. PMID:26110378
Kaplan, Sebastian G; Ali, Shahzad K; Simpson, Brittany; Britt, Victoria; McCall, W Vaughn
The goals of our study were to: 1) describe the incidence of disturbances in sleep quality, sleep hygiene, sleep-related cognitions and nightmares; and 2) investigate the association between these sleep-related disturbances and suicidal ideation (SI), in adolescents admitted to a psychiatric inpatient unit. Our sample consisted of 50 adolescents between the ages of 12 and 17 years (32 females and 18 males; 41 Caucasian and nine African American). Our cross-sectional design involved the administration of the Adolescent Sleep Wake Scale (ASWS), the Adolescent Sleep Hygiene Scale (ASHS), the Dysfunctional Beliefs and Attitudes about Sleep-Short version for use with children (DBAS-C10), the Disturbing Dreams and Nightmare Scale (DDNSI), and the Suicidal Ideation Questionnaire Jr (SIQ-JR). Analyses were conducted using Pearson correlations, as well as univariate and multivariate regression. Results indicated that our sample experienced sleep disturbances and SI to a greater degree than non-clinical samples. Sleep quality was correlated with nightmares, while sleep quality and nightmares were each correlated with SI. Sleep quality, dysfunctional beliefs, and nightmares each independently predicted SI. Our study was the first to use the four sleep measures with an adolescent psychiatric inpatient sample. It is important to develop sleep-related assessment tools in high-risk populations given the link between sleep disturbances and suicidality. Furthermore, a better understanding of the relationships between SI and sleep quality, sleep-related cognitions, and nightmares is needed to develop potential prevention and treatment options for suicidality in adolescents. PMID:24356389
Amr, Mostafa Abdel-Monhem; Amin, Tarek Tawfik; Hablas, Hatem Refaat
The objectives of this study were to determine the magnitude of psychiatric disorders and to define socio-demographic and disease-related risk factors in a sample of adolescents with SCD in Al-Hassa, Saudi Arabia. The sample consisted of 110 adolescents with SCD and a convenient sample of 202 adolescents without SCD as controls. Psychiatric…
Goldston, David B.; Walsh, Adam; Mayfield Arnold, Elizabeth; Reboussin, Beth; Sergent Daniel, Stephanie; Erkanli, Alaattin; Nutter, Dennis; Hickman, Enith; Palmes, Guy; Snider, Erica; Wood, Frank B.
Objective: To examine psychiatric morbidity and functional impairment of adolescents with and without poor reading skills during mid- to late adolescence. Method: The sample consisted of 188 adolescents, 94 with poor reading skills and 94 with typical reading skills, screened from a larger sample in the public schools at age 15. To assess…
Background Bullying is quite prevalent in the school setting and has been associated with the socioeconomic position and psychiatric morbidity of the pupils. The aim of the study was to investigate the association between bullying and socioeconomic status in a sample of Greek adolescents and to examine whether this is confounded by the presence of psychiatric morbidity, including sub-threshold forms of illness. Methods 5,614 adolescents aged 16-18 years old and attending 25 senior high schools were screened and a stratified random sample of 2,427 were selected for a detailed interview. Psychiatric morbidity was assessed with a fully structured psychiatric interview, the revised Clinical Interview Schedule (CIS-R), while bullying was assessed with the revised Olweus bully/victim questionnaire. The following socio-economic variables were assessed: parental educational level and employment status, financial difficulties of the family and adolescents' school performance. The associations were investigated using multinomial logit models. Results 26.4% of the pupils were involved in bullying-related behaviours at least once monthly either as victims, perpetrators or both, while more frequent involvement (at least once weekly) was reported by 4.1%. Psychiatric morbidity was associated with all types of bullying-related behaviours. No socioeconomic associations were reported for victimization. A lower school performance and unemployment of the father were significantly more likely among perpetrators, while economic inactivity of the mother was more likely in pupils who were both victims and perpetrators. These results were largely confirmed when we focused on high frequency behaviours only. In addition, being overweight increased the risk of frequent victimization. Conclusions The prevalence of bullying among Greek pupils is substantial. Perpetration was associated with some dimensions of adolescents' socioeconomic status, while victimization showed no socioeconomic
Vadlin, Sofia; Åslund, Cecilia; Hellström, Charlotta; Nilsson, Kent W
The aim of the present study was to investigate associations between problematic gaming and psychiatric symptoms among adolescents. Data from adolescents in the SALVe cohort, including adolescents in Västmanland who were born in 1997 and 1999 (N=1868; 1034 girls), and data from consecutive adolescent psychiatric outpatients in Västmanland (N=242; 169 girls) were analyzed. Adolescents self-rated on the Gaming Addiction Identification Test (GAIT), Adult ADHD Self-Report Scale Adolescent version (ASRS-A), Depression Self-Rating Scale Adolescent version (DSRS-A), Spence Children's Anxiety Scale (SCAS), and psychotic-like experiences (PLEs). Multivariable logistic regression analyses were performed, and adjusted for sex, age, study population, school bullying, family maltreatment, and interactions by sex, with two-way interactions between psychiatric measurements. Boys had higher self-rated problematic gaming in both samples, whereas girls self-rated higher in all psychiatric domains. Boys had more than eight times the probability, odds ratio (OR), of having problematic gaming. Symptoms of ADHD, depression and anxiety were associated with ORs of 2.43 (95% CI 1.44-4.11), 2.47 (95% CI 1.44-4.25), and 2.06 (95% CI 1.27-3.33), respectively, in relation to coexisting problematic gaming. Problematic gaming was associated with psychiatric symptoms in adolescents; when problematic gaming is considered, the probability of coexisting psychiatric symptoms should also be considered, and vice versa. PMID:27203825
Starr, Lisa R.; Donenberg, Geri R.; Emerson, Erin
Objective The current study examines longitudinal associations between light and heavy sexual experiences and psychiatric symptoms in African-American girls receiving mental health care. Research supports bidirectional associations between adolescent romantic and sexual behaviors and depression and other mental health problems, but this finding has not been examined among African-American youth or in clinical samples. African-American girls in psychiatric treatment suffer disparities in HIV/AIDS vulnerability, and understanding the context of girls’ risk-taking (and how psychological symptoms contribute) may aid prevention efforts. Method 265 African-American girls seeking psychiatric care were assessed for mental health symptoms and light and heavy sexual behaviors. Participants completed a six-month follow-up. Results Baseline light sexual activity predicted increased internalizing and externalizing symptoms and substance use at follow-up. Internalizing and externalizing symptoms predicted increased heavy sexual behaviors over time, including HIV-risk behaviors. Conclusions Results support the association between romantic involvement and depression. Psychological symptoms may play a key role in the emergence of risky sexual behaviors among African-American girls in psychiatric care, and should be considered in prevention program development. PMID:22742458
Vicari, Stefano; Pontillo, Maria; Armando, Marco
Down's syndrome (DS) is the most frequent genetic cause of intellectual disability and patients with DS show significant psychopathology (18-23%). Moreover, individuals with DS often show a cognitive decline associated with ageing characterized by a deterioration in memory, language and cognitive functioning. According to these relevant findings, an overview is presented of state-of-the-art knowledge of the neurocognitive, neurobiological and psychopathological profile, assessment and treatment of patients with DS. The linguistic characteristics of DS develop differently along distinct developmental trajectories. Thus, for example, morphosyntax deficit, especially in production, is more evident in adolescence than in early childhood and lexicon is usually better preserved in all ages (at least in comprehension). So far, rehabilitation is the only effective approach for improving cognitive and linguistic abilities. However, ongoing preliminary reports on other approaches such as transmagnetic stimulation or drugs suggest alternative or integrative treatment for the future. Individuals with DS show typical organization of brain structures related to some cognitive abilities, such as reduced volume in frontal and prefrontal areas, which is related to poor executive and linguistic abilities. They also frequently show psychiatric disorders such as externalizing disorders as well as depression, anxiety and obsessive-compulsive disorder. Nevertheless, as for other genetic syndrome with intellectual disability, there is a significant lack of research specifically focused on treatments of psychiatric and behavioural problems in DS. This is true both for psychosocial and for pharmacological interventions. PMID:23492931
Malhotra, Savita; Chakrabarti, Subho; Shah, Ruchita; Mehta, Anurati; Gupta, Aarzoo; Sharma, Minali
Background: A diagnostic tool designed as part of a telepsychiatry application for diagnosis and management of child and adolescent psychiatric disorders in India was developed considering the paucity of trained child psychiatrists and mental health professionals in India. Materials and Methods: The diagnostic tool consisted of screening and 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) criteria-based diagnostic algorithms for 18 psychiatric disorders seen in childhood and adolescence. Accuracy of diagnoses and feasibility of use of the tool was examined by comparing it with detailed semi-structured clinical evaluations by a qualified psychiatrist with 50 psychiatric patients (children and adolescents). Statistical Analysis: Descriptive analyses and paired t-tests were conducted to compare the mean number of diagnosis generated by the two interviews. Sensitivity, specificity, positive and negative predictive values were computed for the screening and the diagnostic sub-modules of the tool, compared to the clinical diagnoses. Kappa coefficients were computed to assess agreement between the diagnoses generated by the diagnostic sub-module and the clinical diagnoses. Results: The screening sub-module had high sensitivity, high specificity and negative predictive values for all disorders. For the diagnostic sub-module, there was moderate (kappa-0.4–0.6) to substantial agreement (kappa > 0.6) for all the disorders, (except psychosis) and high sensitivity (barring a few disorders) and specificity for almost all the disorders. Positive predictive values were found to be acceptable to high for most disorders, with consistently high negative predictive values. Conclusion: The new tool was found to be comprehensive, reasonably short and feasible. Results showed acceptable level of accuracy in diagnosis generated by the tool. PMID:26424901
Dil, L. M.; Vuijk, P. J.
Psychiatric emergency services for children and adolescents vary in process, structure and outcome. There are few systematic studies on the type and prevalence of psychiatric problems encountered, related circumstances or resulting interventions. Evidence in these areas is important in evaluation of the function of mental health services in the…
Psychiatric rehabilitation differs from traditional approaches to mental health, because it places much greater emphasis on the importance of the person's relationship with the environment. In psychiatric rehabilitation, the importance is not placed on finding a cure for the client's mental illness; rather, what matters is the ability to hold a…
Mazefsky, Carla A.; Oswald, Donald P.; Day, Taylor N.; Eack, Shaun M.; Minshew, Nancy J.; Lainhart, Janet E.
Varied presentations of emotion dysregulation in autism complicate diagnostic decision making and may lead to inaccurate psychiatric diagnoses or delayed autism diagnosis for high-functioning children. This pilot study aimed to determine the concordance between prior psychiatric diagnoses and the results of an autism-specific psychiatric interview…
Dodangi, Nasrin; Habibi Ashtiani, Nastaran; Valadbeigi, Burhanoddin
Background: Epidemiology, the study of patterns of disease distribution in time and space, can help to improve mental health services for children and adolescents by increasing understanding of causes, development, and course of psychiatric disorders. Objectives: To describe the prevalence of DSM-IV TR psychiatric disorders and comorbidities in students of Paveh, one of the western cities in Iran. Materials and Methods: The participants of this cross sectional survey were 379 children and adolescents aged 6-18 years old that were selected by multistage cluster sampling method. They were screened in the first phase of the study by two screening tools. In the second phase, 141 students were assessed by K-SADS-PL psychiatric interview. Results: The overall prevalence of DSM-IV TR disorders in this population according to psychiatric interview was 24.4%. The most common disorder was attention deficit hyperactivity disorder (11.9%) and then generalized anxiety disorder (11.3%), social phobia (6.2%), and separation anxiety disorder (6.2%). There was no significant difference between two sex and age groups except enuresis. Conclusions: The prevalence of psychiatric disorders in Paveh is comparable to other areas of Iran and the world. The high prevalence of attention deficit hyperactivity disorder needs more consideration and treatment plans. PMID:25237571
Starr, Lisa R.; Donenberg, Geri R.; Emerson, Erin
The current study examines longitudinal associations between light and heavy sexual experiences and psychiatric symptoms in African American adolescent girls receiving mental health care. Research supports bidirectional associations between adolescent romantic and sexual behaviors and depression and other mental health problems, but this finding…
Adams, Zachary W.; McCart, Michael R.; Zajac, Kristyn; Danielson, Carla Kmett; Sawyer, Genelle K.; Saunders, Benjamin E.; Kilpatrick, Dean G.
This study examined the prevalence of and associations between specific psychiatric disorders, substance use problems, and trauma exposure in a sample of delinquent and nondelinquent adolescents. A nationally representative sample of adolescents ("n" = 3,614; "M" age = 14.5 years, "SD" = 1.7; 51% male; 71% White,…
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…
Roberts, Robert E.; Roberts, Catherine R.; Chan, Wenyaw
Background: We have few data on incidence of psychiatric disorders among adolescents. This study examined first incidence of disorders among adolescents and baseline factors which increased or decreased risk of new onset cases a year later. Methods: Data were analyzed from Teen Health 2000 (TH2K), a probability sample of 4,175 youths 11-17 and…
Tillman, Rebecca; Geller, Barbara; Frazier, Jeanne; Beringer, Linda; Zimerman, Betsy; Klages, Tricia; Bolhofner, Kristine
Objective: To examine characteristics between subjects with a prepubertal and early adolescent bipolar disorder phenotype from pediatric versus psychiatric venues. Method: Subjects (N = 93) with a prepubertal and early adolescent bipolar disorder phenotype were obtained through consecutive new case ascertainment from designated pediatric and…
Halfon, O; Laget, J; Ekbatani, A; Barbaux, J J
The present prospective study, with a five-year follow-up, presents an extensive psychiatric and educational assessment of an adolescent population (N = 30) in the age range 14-20, suffering from several psychiatric disorders, though apt to follow a normal academic program. The residential settings where the study took place provide both psychiatric and schooling facilities. In this environment, what is the effectiveness of long-term hospitalization? Are there any criteria for predicting results? After discharge, could social adjustments difficulties be prevented? Assessment instruments are described and the results of one preliminary study are presented. The actual data seems to confirm the impact of the special treatment facilities combining schooling and psychiatric settings on the long term outcome of adolescents. PMID:1342658
Harju, Outi; Luukkonen, Anu-Helmi; Hakko, Helinä; Räsänen, Pirkko; Riala, Kaisa
The Internet plays a major role in adolescents' free time activities and communication nowadays. The aim here was to investigate the possibility of an association of computers and video games or sports (team, individual) with psychiatric disorders among underage psychiatric inpatients. The series of adolescents (n = 508) had been diagnosed using semistructured interviews (K-SADS-PL). The results showed that an interest in computers and video games did not increase the risk of any specific psychiatric disorder among these adolescent inpatients, but the likelihood of a substance-related disorder was statistically significantly lower among the boys with computers as a hobby. Team sports were related to increased likelihood of conduct disorder among the boys, whereas the likelihood of an affective disorder was reduced. No such association was found in individual sports or among the girls. We conclude that social contacts and peers play an important role in preventing adolescent depression. PMID:21288072
Costello, E. Jane; He, Jian-ping; Sampson, Nancy A; Kessler, Ronald C.; Merikangas, Kathleen Ries
Objective This report examined data on 12-month rates of service use for adolescent mental, emotional, and behavioral disorders. Methods The National Comorbidity Survey Adolescent Supplement (NCS-A) is a national survey of DSM-IV mental, emotional, and behavioral disorders and service use among U.S. adolescents. Results In the 12 months up to the interview, 45% of adolescents with psychiatric disorders received some form of professional help. Youth with mood disorders were most likely to receive services (60.1%), and those with anxiety disorders least likely (41.4%). Services were more likely to be provided in a school setting (23.6% of those with disorders) or by specialty mental health providers (22.8%) than by general medical practitioners (10.1%). Juvenile justice (4.5%), complementary and alternative medicine (CAM) (5.3%), and human services (7.9%) also provided mental health care. Although pediatricians treated a higher proportion of youth with mood disorders than of those with behavior disorders, they were more likely to treat youth with behavior disorders because of the larger number of the latter (11.5% of 1,465 vs. 13.9% of 820). Black youth were significantly less likely than white youth to receive specialty mental health or pediatric services for mental disorders. Conclusions The 12-month findings from the NCS-A confirm those of earlier, smaller studies, that only a minority of youth with psychiatric disorders received recent treatment of any sort. Much of this treatment was provided in service settings in which few of the providers were likely to have specialist mental health training. PMID:24233052
Engqvist, Ulf; Rydelius, Per-Anders
Background Increased mortality rates among previous child and adolescent psychiatry (CAP) patients have been found in Scandinavian studies up to the 1980s. The suicide risk in this group has been estimated to be almost five times higher than expected. This article addresses two questions: Do Swedish CAP patients continue to risk premature death and what kind of information related to psychiatric symptoms and/or behavior problems can predict later suicide? Methods Hospital files, Sweden's census databases (including immigration and emigration) and administrative databases (including the Swedish Hospital Discharge register and the Persons Convicted of Offences register), and the Cause of Death register were examined to determine the mortality rate in a group of 1,400 former CAP inpatients and outpatients over a period of 12–33 years. Observed and expected numbers of deceased were calculated with the prospective method and the standardized mortality ratio (SMR) method. The relative risk or the risk ratio (RR) is presented with 95% confidence intervals (CIs). Significance level tests were made using two-by-two tables and chi-square tests. The Cox proportional-hazards regression model was used for survival analysis. Results Twenty-four males and 14 females died. Compared with the general population, the standardized mortality ratio in this group of CAP patients was significantly higher in both sexes. Behavioral problems, school problems, and co-morbid alcohol or drug abuse and criminality (including alcohol-related crimes) were found to be important predictors. Thirty-two deaths were attributed to suicide, intoxication, drug overdose, or accident; one patient died of an alcohol abuse-related disorder, and five patients died of natural causes. Suicide was the most common cause of death, but only 2 of these 19 cases were initially admitted for attempted suicide. Conclusion We suggest that suicide and death prevention among CAP patients may not be a psychiatric issue per
Nichols, Sara R.; Javdani, Shabnam; Emerson, Erin; Donenberg, Geri R.
Economic hardship and poor parenting behaviors are associated with increased risk for mental health problems in community adolescents. However, less is known about the impact of socioeconomic status (SES) and parenting behaviors on youth at elevated risk for mental health problems, such as teens seeking outpatient psychiatric care. This study examined whether family SES and parent positive communication were directly and indirectly associated with mental health symptoms six months later in urban teens seeking outpatient treatment, after accounting for baseline levels of symptoms. At baseline, adolescent participants (N = 346; 42% female; 61% African-American) ages 12 to 19 years old (M = 14.9; SD = 1.8) and their primary caregivers reported on SES and teen internalizing and externalizing symptoms and engaged in a videotaped discussion of a real-life conflict to assess parent positive communication. At 6-month follow-up, 81% (N = 279) of families were retained and teens and caregivers again reported internalizing and externalizing symptoms. Structural Equation Modeling (SEM) was used to test the hypothesized models with a sample of 338, using the full information likelihood method to adjust for missing data. For parent-reported externalizing symptoms, SEM revealed support for the indirect association of SES with follow-up externalizing symptoms via parent positive communication and externalizing symptoms at baseline. For parent reported internalizing symptoms, there was a direct association between SES and follow-up internalizing symptoms, but not an indirect effect via parent positive communication. Youth-reported symptoms were not associated with SES nor with parent positive communication. Current findings extend prior research on adolescent mental health in a diverse sample of urban youth seeking outpatient psychiatric care. These families may benefit from interventions that directly target SES-related difficulties and parent positive communication. PMID:25750502
Tremmery, S; Danckaerts, M; Bruckers, L; Molenberghs, G; De Hert, M; Wampers, M; De Varé, J; de Decker, A
Although aggression is part of daily life in psychiatric units for adolescents, empirical data on its prevalence are sparse. Only few studies have described prevalence of aggressive incidents in adolescent psychiatric wards, and data in forensic psychiatric care are even more limited. Available studies reported high prevalence rates of aggression, ranging from 0.4 to 2.4 incidents of aggression per day across (forensic) child and adolescent psychiatric units. Between 27 and 78 % of all admitted youth committed an aggressive act. In this study, we collected systematically registered data of all aggressive incidents from the first 2 years (2010-2012) on a newly established forensic adolescent psychiatric unit, which used a formal aggression management program embedded in the social competence model, which is based on early intervention in the 'chain of behavior' to prevent any further escalation. The inclusion of also minor aggressive incidents is unique in the literature and the clinical relevance is highlighted. A mean of one incident a day took place, with each adolescent involved in at least one incident. Notably, 1.7 aggressive incidents per month made seclusion of restraint use necessary. Based on the social competence theory, the aggression management model suggests intervening early in the cascade of aggression, in order to prevent further escalation and reduce the need for intrusive interventions. Evidence supported that aggression is a contextual event, as external factors clearly influence the incidence of aggression. Aggression management should be built on both relational and structural security. PMID:24682593
Tak, Hee-Jong; Ahn, Joon-Ho; Kim, Kun-Woo; Kim, Yeni; Choi, Sam-Wook; Lee, Kyung-Yeon; Park, Eun Jin
Objective Lamotrigine is a widely used medication for psychiatric disorders and epilepsy, but the adverse effects of this drug in adolescent Korean patients have not yet been investigated. In the present study, we sought to compare the incidence and impact of lamotrigine-induced skin rashes and different pattern of adverse events in psychiatric and nonpsychiatric adolescent patients. Methods Using a retrospective cohort design, all of the charts were reviewed for adolescents (13 to 20 years old), treated with lamotrigine during the previous 2 years in the Child and Adolescent Psychiatric Clinic and Pediatric Neurologic Clinic of the Ulsan University Hospital in South Korea. Results Of the 102 subjects, 23 patients developed a skin rash. All of these rashes were observed within 7 weeks of the initiation of the lamotrigine therapy. Only one subject developed a serious rash, which was diagnosed as Stevens-Johnson syndrome. Although the psychiatric subjects were administered statistically lower doses of lamotrigine during weeks 1 through 5 and at week 12, the likelihood of developing a rash was not significantly different between the psychiatric and nonpsychiatric patients. Conclusion Careful dose escalation and close observation of side effects for the first 7 weeks of treatment is important. The present study reveals the tolerability of lamotrigine in an adolescent population, although a double-blind, controlled trial is needed to confirm these findings. PMID:22707969
Brown, Richard A; Abrantes, Ana M; Minami, Haruka; Prince, Mark A; Bloom, Erika Litvin; Apodaca, Timothy R; Strong, David R; Picotte, Dawn M; Monti, Peter M; MacPherson, Laura; Matsko, Stephen V; Hunt, Jeffrey I
Substance use among adolescents with one or more psychiatric disorders is a significant public health concern. In this study, 151 psychiatrically hospitalized adolescents, ages 13-17 with comorbid psychiatric and substance use disorders, were randomized to a two-session Motivational Interviewing intervention to reduce substance use plus treatment as usual (MI) vs. treatment as usual only (TAU). Results indicated that the MI group had a longer latency to first use of any substance following hospital discharge relative to TAU (36 days versus 11 days). Adolescents who received MI also reported less total use of substances and less use of marijuana during the first 6 months post-discharge, although this effect was not significant across 12 months. Finally, MI was associated with a significant reduction in rule-breaking behaviors at 6-month follow-up. Future directions are discussed, including means of extending effects beyond 6 months and dissemination of the intervention to community-based settings. PMID:26362000
Groschwitz, Rebecca C; Kaess, Michael; Fischer, Gloria; Ameis, Nina; Schulze, Ulrike M E; Brunner, Romuald; Koelch, Michael; Plener, Paul L
Non-suicidal self-injury (NSSI) and suicidal behaviors frequently occur among adolescent psychiatric patients. Although those behaviors are distinct with regards to intent, NSSI has been shown to be an important risk-factor for suicide attempts. However, the association of NSSI and Suicidal Behavior Disorder (SBD) according to DSM-5 criteria has not yet been investigated. For investigating distinctive features and mutual risk-factors of NSSI-disorder and SBD, adolescent psychiatric inpatients (N=111, aged 12-19 years; 65.8% females) were interviewed using the Self-Injurious-Thoughts-And-Behaviors-Interview-German (SITBI-G). NSSI started significantly earlier in life (M=12.5 years, SD=2.2) than first suicide attempts (M=14.1 years, SD=2.0). Patients meeting NSSI-disorder and/or SBD were significantly more likely to be female and to be diagnosed with an affective disorder. NSSI-disorder and SBD seem to have several distinctive features (i.e. age of onset or frequency), but also seem to share certain mutual risk-factors (i.e. affective disorders, female gender). While both NSSI and SBD seem to be maintained by mainly automatic negative reinforcement, positive automatic and social functions were rated significantly higher for NSSI. Most importantly, NSSI seems to be a strong risk factor for the occurrence of SBD (even when controlling for suicidal ideation) and should therefore always be assessed when dealing with psychiatric adolescent patients. PMID:26144578
Leininger, Michele; Stephenson, Laura A.
Length of stay in psychiatric inpatient units has received increasing attention with the external pressures for treatment cost-effectiveness and evidence that longer hospital stays do not appear to have significant advantages over shorter hospital stays. This study examined the relationship between length of psychiatric hospital stay and…
Sundquist, Jan; Li, Xinjun; Ohlsson, Henrik; Råstam, Maria; Winkleby, Marilyn; Sundquist, Kristina; Kendler, Kenneth S.; Crump, Casey
Background More knowledge is needed on potential associations between individual-, family-, and neighborhood-level factors and psychiatric disorders in children and adolescents. Aims To examine associations between, individual-, family-, and neighborhood-level factors and incident internalizing (anxiety and mood) disorders and externalizing (ADHD and conduct) disorders in children and adolescents, and to estimate the relative contributions of family and neighborhood to individual variation in these disorders. Method We performed a three-level logistic regression on all 542,195 children born in Sweden in 1992 to 1996, nested in 427,954 families, which in turn were nested in 8,475 neighborhoods. The children were followed from 2000 to 2010 for incident internalizing and externalizing psychiatric disorders, assessed from medical records. Results 26,514 children (4.8%) were diagnosed with internalizing or externalizing psychiatric disorders. Approximately 29% of the total individual variance in internalizing disorders could be attributed to the family level, which includes both genetic and family environmental effects, and 5% to the neighborhood level. The corresponding figures for externalizing disorders were 43.5% and 5.5%, respectively. After adjustment for individual-level sociodemographic factors, high neighborhood deprivation was associated with increased risks of externalizing and internalizing psychiatric disorders (odds ratio [OR]=1.37, 95% credible interval [CI]=1.25–1.50 and OR=1.34, 95% CI=1.25–1.45, respectively), including conduct disorder (OR=2.01, 95% CI=1.58–2.55), anxiety disorders (OR=1.40, 95% CI=1.29–1.52), and mood disorders (OR=1.21, 95% CI, 1.09–1.35). The strongest association between neighborhood deprivation and ADHD was observed in moderately deprived neighborhoods (OR=1.31, 95% CI=1.19–1.44). Conclusions These findings call for policies to promote mental health that consider potential influences from children’s family and
Damme, Tine Van; Simons, Johan; Sabbe, Bernard; van West, Dirk
AIM: To summarize research regarding the motor abilities of children and adolescents who suffer from a common psychiatric condition. METHODS: In order to outline the current knowledge regarding the motor abilities of children and adolescents with autism spectrum disorders (ASD), attention deficit hyperactivity disorder (ADHD), disruptive behavior disorders (DBD) and depression, a comprehensive systematic literature search was carried out using PubMed, Medline and ERIC databases. The databases were searched for relevant English language articles published between January 1990 and April 2014. Only studies that conducted a quantitative evaluation of motor ability and concerned individuals aged 0-18 years were included. A separate search was conducted for each disorder (ASD, ADHD, DBD, depression) in conjunction with each of the following keywords: (psycho/perceptuo) motor/movement skill(s), (psycho/perceptuo) motor/movement abilities, (psycho/perceptuo) motor/movement impairment, (psycho/perceptuo) motor/movement problem(s), motor function, motor coordination, motor performance, motor deficit(s). To detect supplementary relevant literature, the reference lists of the retrieved articles were examined. RESULTS: The search strategy yielded 51 studies meeting the inclusion criteria. In total, 28 studies were included that examined the motor abilities of children and adolescents with ASD. All studies indicated that they performed below average on various standardized motor assessment instruments. The overall prevalence rate for impairment in motor abilities ranged from 33% to 100%. Twenty-seven studies examined the motor abilities of children and adolescents with ADHD. Depending on the type of motor assessment tool and the cut-off points used by different researchers, prevalence rates of impairment in motor abilities are highly variable and ranged from 8% to 73%. Remarkably, there is a paucity of research addressing the motor abilities of individuals with DBD or depression
Pitcher, Sharon M.; Albright, Lettie K.; DeLaney, Carol J.; Walker, Nancy T.; Seunarinesingh, Krishna; Mogge, Stephen; Headley, Kathy N.; Ridgeway, Victoria Gentry; Peck, Sharon; Hunt, Rebecca; Dunston, Pamela J.
A team of researchers revised the Motivation to Read Profile for use with adolescents. Instruments to assess adolescents' in- and out-of-school reading motivations were administered. A survey adapted for adolescents was administered to 384 teens at eight sites throughout the United States and Trinidad, and 100 students were interviewed using a…
Slone, Michelle; Shoshani, Anat
This cross-sectional study investigated relations between conflict exposure and psychiatric symptoms among 8,727 Jewish Israeli adolescents aged 12-17 years from 1998-2011. This 14-year span included periods of terrorism, missile attacks, wars, relocations, military operations, and relative quiet, reflecting a dynamically changing, primarily violent climate. Annual samples from the same cities, geographical regions, and schools throughout the country were assessed for personal political life events (PLE) exposure and for psychiatric symptoms using the Brief Symptom Inventory (BSI; Derogatis & Spencer, ). Data were divided into 8 exposure periods: (a) pre-Intifada 1998-2000, (b) Intifada peak 2001-2003, (c) Intifada recession 2004, (d) evacuation 2005, (e) missiles and the 2006 Lebanon war, (f) peak missiles 2006-2007, (g) Operation Cast Lead 2008-2009, and (h) global terrorism 2010-2011. Results confirmed a relation between type of exposure period, PLE exposure, and psychiatric symptoms. In addition, PLE exposure was positively correlated with psychiatric symptoms (β = .49). A moderating effect of gender on the relationship between PLE exposure and the psychiatric index was found, with elevated symptoms among females (β = .30). PMID:24948538
Jones, Heather A; Bilge-Johnson, Sumru; Rabinovitch, Annie E; Fishel, Hazel
The current study investigated relationships among self-reported peer victimization, suicidality, and depression in adolescent psychiatric inpatients. Sixty-seven adolescent psychiatric inpatients at a Midwestern children's hospital completed measures of bullying and peer victimization, suicidal ideation, and depression during their inpatient stay. Analyses indicated significant moderate correlations among victimization, suicidal ideation, and depression in adolescents. Results from mediational analyses found that negative self-esteem mediated the relationship between peer victimization and suicidal ideation. To date, this study is the first to directly examine the mechanisms underlying the relationship between peer victimization and suicidal ideation in adolescent psychiatric inpatients. PMID:23827938
Cole, James H.; Filippetti, Maria Laura; Allin, Matthew P. G.; Walshe, Muriel; Nam, Kie Woo; Gutman, Boris A.; Murray, Robin M.; Rifkin, Larry; Thompson, Paul M.; Nosarti, Chiara
Background The hippocampus has been reported to be structurally and functionally altered as a sequel of very preterm birth (<33 weeks gestation), possibly due its vulnerability to hypoxic–ischemic damage in the neonatal period. We examined hippocampal volumes and subregional morphology in very preterm born individuals in mid- and late adolescence and their association with psychiatric outcome. Methods Structural brain magnetic resonance images were acquired at two time points (baseline and follow-up) from 65 ex-preterm adolescents (mean age = 15.5 and 19.6 years) and 36 term-born controls (mean age=15.0 and 19.0 years). Hippocampal volumes and subregional morphometric differences were measured from manual tracings and with three-dimensional shape analysis. Psychiatric outcome was assessed with the Rutter Parents’ Scale at baseline, the General Health Questionnaire at follow-up and the Peters Delusional Inventory at both time points. Results In contrast to previous studies we did not find significant difference in the cross-sectional or longitudinal hippocampal volumes between individuals born preterm and controls, despite preterm individual having significantly smaller whole brain volumes. Shape analysis at baseline revealed subregional deformations in 28% of total bilateral hippocampal surface, reflecting atrophy, in ex-preterm individuals compared to controls, and in 22% at follow-up. In ex-preterm individuals, longitudinal changes in hippocampal shape accounted for 11% of the total surface, while in controls they reached 20%. In the whole sample (both groups) larger right hippocampal volume and bilateral anterior surface deformations at baseline were associated with delusional ideation scores at follow-up. Conclusions This study suggests a dynamic association between cross-sectional hippocampal volumes, longitudinal changes and surface deformations and psychosis proneness. PMID:26091104
An 18-year follow-up of 66 aggressive and disturbed adolescents admitted to the children's unit of a large mental hospital in 1960 reveals a high degree of antisocial and criminal behavior persisting into adulthood, with lessening psychiatric involvement as the subjects matured. Factors contributing to this pattern of continuing antisocial behavior are identified, and implications for treatment programs are considered. PMID:7258309
Benton, Tami D; Boyd, Rhonda; Ifeagwu, Judith; Feldtmose, Emily; Smith-Whitley, Kim
Sickle cell disease (SCD), the most common genetic hemoglobin disorder, affects more than 70,000 Americans, primarily those of African and Mediterranean descent. SCD, characterized by chronic hemolytic anemia; recurrent, episodic painful episodes; vaso-occlusive complications affecting multiple organ systems; and increased risk of infections, is associated with a shortened life span for affected individuals. However, recent medical advances have significantly increased survivability and quality of life for individuals with SCD. Despite these advances, adolescents with SCD continue to face many challenges of living with a chronic condition that requires lifelong medical management that may place them at risk of psychiatric symptoms and disorders. Studies focusing on children and adolescents with SCD suggest greater risks for psychosocial difficulties and depressive and anxiety symptoms. This article describes findings from a structured psychiatric interview administered to 40 adolescents and their parents. The rates of reported psychiatric diagnosis were significantly higher than those reported for the general population. Awareness of risks for psychiatric disorders in SCD could lead to increased identification and interventions that may improve medical and psychiatric outcomes. PMID:21312010
Lynch, Fionnuala; Mills, Carla; Daly, Irenee; Fitzpatrick, Carol
Purpose: Against a background of a lack of systematic epidemiological research in Ireland in the area, this study set out to determine prevalence rates of psychiatric disorders, suicidal ideation and intent, and parasuicide in a population of Irish adolescents aged 12-15 years in a defined geographical area. Method: All 12-15-year olds attending…
Jacobson, Colleen M.; Muehlenkamp, Jennifer J.; Miller, Alec L.; Turner, J. Blake
This retrospective chart review study of 227 participants examined the psychiatric profiles of outpatient adolescents ages 12 to 19 years (M = 15.08 years, SD = 1.72 years) engaging in different types of deliberate self-harm (DSH) behaviors. Participants were divided into four groups: no deliberate self-harm (NoDSH; n = 119), nonsuicidal…
Zametkin, Alan J.; Zoon, Christine K.; Klein, Hannah W.; Munson, Suzanne
Objective: To review the past 10 years of published research on psychiatric aspects of child and adolescent obesity and highlight information mental health professionals need for preventing obesity in youths and diagnosing and treating it. Method: Researchers performed computerized and manual searches of the literature and summarized the most…
Backman, M. L.; Santavuori, P. R.; Aberg, L. E.; Aronen, E. T.
Juvenile neuronal ceroid lipofuscinosis (JNCL) is one of the most common neurodegenerative disorders in childhood and adolescence. The clinical picture includes diverse and complex psychiatric symptoms that are difficult to treat. Only symptomatic treatment is available. To improve symptomatic therapy, it is important to recognize the symptoms.…
Witman, Jeffrey P.
The purpose of this study was to determine the impact of adventure program participation upon adolescents in psychiatric treatment. All adventure programs included goal setting, awareness, cooperative and trust activities, and group and individual problem-solving. Participants' total hours of program participation ranged from 8-22 hours. A random…
This manual is a programed learning tool for mental health professionals which teaches child and adolescent patient management skills to be used in a residential psychiatric care setting. The introduction to the paper describes the basic differences between adult and child psychiatry; behaviors that are abnormal for adults, such as having…
Townsend, Lisa; Floersch, Jerry; Findling, Robert L.
Background: Despite the effectiveness of psychotropic treatment for alleviating symptoms of psychiatric disorders, youth adherence to psychotropic medication regimens is low. Adolescent adherence rates range from 10-80% (Swanson, 2003; Cromer & Tarnowski, 1989; Lloyd et al., 1998; Brown, Borden, and Clingerman, 1985; Sleator, 1985) depending on…
Mc Manama O'Brien, Kimberly H.; Berzin, Stephanie C.
Specific psychiatric diagnoses and comorbidity patterns were examined to determine if they were related to the medical lethality of "suicide attempts" among adolescents presenting to an urban general hospital (N = 375). Bivariate analysis showed that attempters with substance abuse disorders had higher levels of lethality than attempters without…
James, Anthony; Clacey, Joe; Seagroatt, Valerie; Goldacre, Michael
Background: Adolescence is a time of very rapid change not only in physical but also psychological development. During the teenage years there is a reported rise in the prevalence of psychiatric disorders. The aim of this study was to investigate age- and sex-specific National Health Service (NHS) hospital inpatient admission rates for psychiatric…
Buckle, Sarah K.; Lancaster, Sandra; Powell, Martin B.; Higgins, Daryl J.
Objectives: To examine the relationship between sexual abuse and academic achievement in an adolescent inpatient psychiatric population. Individual factors expected to influence this relationship were measured to explore the way they each interacted with sexual abuse and its relationship to academic achievement. Method: Eighty-one adolescent…
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
Holzer, Laurent; Pihet, Sandrine; Passini, Christina Moses; Feijo, Isabelle; Camus, Didier; Eap, Chin
Purpose: To determine the prevalence of substance use among adolescent psychiatric outpatients using a variety of data sources. Method: Using a questionnaire, 3-month prevalence of substance use data were obtained from 50 adolescents and their health care providers. Adolescents' self-reports and providers' clinical impressions were…
Kumar, Geetha; Steer, Robert A.
Beck Scale for Suicide Ideation (BSI) was administered to 121 adolescent inpatients. Twelve characteristics found to be associated with adolescent suicide ideation were entered into multiple regression to estimate BSI scores, along with Beck inventories for anxiety, depression (BDI), and hopelessness (BHS), and Youth Self Report. BHS and BDI were…
Johnson, Vicki A.; Kemp, Andrew H.; Heard, Robert; Lennings, Christopher J.; Hickie, Ian B.
Objective The present study investigates whether youths with childhood-onset antisocial behavior have higher rates of psychiatric illness, neuropsychological and psychosocial dysfunction than youths who engage in antisocial behavior for the first time in adolescence. Prior studies have generally focused on single domains of function in heterogeneous samples. The present study also examined the extent to which adolescent-onset antisocial behavior can be considered normative, an assumption of Moffitt’s dual taxonomy model. Method Forty-three subjects (34 males, 9 females, mean age = 15.31, age range 12–21) with a diagnosis of conduct disorder (CD) were recruited through Headspace Services and the Juvenile Justice Community Centre. We compared childhood-onset antisocial youths (n = 23) with adolescent-onset antisocial youths (n = 20) with a conduct disorder, across a battery of psychiatric, neuropsychological and psychosocial measures. Neuropsychological function of both groups was also compared with normative scores from control samples. Results The childhood-onset group displayed deficits in verbal learning and memory, higher rates of psychosis, childhood maltreatment and more serious violent behavior, all effects associated with a large effect size. Both groups had impaired executive function, falling within the extremely low range (severely impaired). Conclusions Childhood-onset CD displayed greater cognitive impairment, more psychiatric symptoms and committed more serious violent offences. The finding of severe executive impairment in both childhood- and adolescent-onset groupings challenges the assumption that adolescent-onset antisocial behavior is a normative process. PMID:25835393
Bhui, K; Bhugra, D
We live in an increasingly multicultural society and thus the cross-cultural application of assessment procedures is likely to become more common. However, little attention has been directed to the limitations of such unconditional application of what are essentially ethnocentric procedures. This article outlines the limitations of the psychiatric assessment when applied across cultures and presents the template for a culture sensitive assessment. PMID:9329996
Davies, Allison; And Others
Investigated sensitivity of Personality Inventory for Children (PIC) and Minnesota Multiphasic Personality Inventory (MMPI) in assessing psychotic states in adolescents. Results from comparison of 29 psychotic and 58 nonpsychotic adolescent psychiatric inpatients suggest the need for a profile-analytic approach to PIC and MMPI interpretation in…
Buckholdt, Kelly E; Weiss, Nicole H; Young, John; Gratz, Kim L
Exposure to violence during adolescence is a highly prevalent phenomenon associated with a range of deleterious outcomes. Theoretical literature suggests that emotion dysregulation is one consequence of exposure to violence associated with the manifestation of posttraumatic stress symptoms (PTSS) and borderline personality (BP) pathology. Thus, the goal of the present study was to examine the mediating role of emotion dysregulation in the relation between exposure to violence and both PTSS and BP pathology in a sample of 144 adolescents (age 10- to 17-years; 51% male; 55% African American) admitted to a psychiatric residential treatment center. Exposure to violence was associated with greater emotion dysregulation, which, in turn, was associated with greater PTSS and BP pathology. Furthermore, emotion dysregulation mediated the associations between exposure to violence and both PTSS and BP pathology. Findings suggest the importance of assessing and treating emotion dysregulation among violence-exposed adolescents in psychiatric residential treatment. PMID:25500759
Fein, George; Greenstein, David; Cardenas, Valerie A.; Cuzen, Natalie L.; Foucheb, Jean-Paul; Ferrett, Helen; Thomas, Keven; Stein, Dan J.
Most prior studies of the effects of excessive alcohol intake on the adolescent brain examined alcohol use dependent samples with comorbid psychiatric and substance use disorders. In the Cape Town region, we identified a sizeable cohort of adolescents with alcohol use disorders (AUD) without externalizing or other psychiatric disorders. We examined brain morphology in 64 such adolescents compared to age and gender matched healthy controls. Magnetic resonance imaging data were analyzed using FSL’s FIRST software for subcortical volumes, and cortical gray matter (GM) was analyzed using voxel based morphometry (VBM) and regions of interest (ROI) analysis. AUD boys had smaller thalamic and putamen volumes compared to non-drinking boys, while AUD girls had larger thalamic and putamen volumes compared to non-drinking girls. VBM revealed a large region of decreased GM density in AUDs compared to controls located in the left lateral frontal, temporal, and parietal lobes, extending medially deep into the parietal lobe. Smaller GM volume in this region was also present when examined using ROI analysis. Our lack of findings in other brain regions, particularly hippocampus, suggests that reports of smaller brain volumes in adolescent AUDs in the literature are a consequence of psychiatric and substance abuse comorbidities. PMID:23916536
Valentino, Kristin; Bridgett, David J; Hayden, Lisa C; Nuttall, Amy K
Prior research has established the independent associations of depressive symptoms and childhood trauma to overgeneral memory (OGM); the present study addresses the potentially interactive effects between these two risk factors on OGM. In addition, the current study comprehensively evaluates whether executive functions (EF) mediate the relation between depressive symptoms and/or abuse to OGM in a child and adolescent sample. OGM was assessed among an inpatient-psychiatric sample of 49 youth (ages 7-17) with, and without, child abuse histories and depressive symptomatology. EF was assessed with standardized neuropsychological measures of verbal fluency, inhibition, and cognitive flexibility. There was a significant interaction of depressive symptoms and abuse in predicting OGM; the effect of depression on OGM was less pronounced among youth with abuse histories, who had elevated OGM at both low and high depressive symptoms relative to those with no abuse and low depressive symptoms. Among the EF measures, only category fluency was associated with OGM. An additive, rather than mediational, model was supported, whereby category fluency accounted for a significant proportion of variance in OGM above child abuse and depressive symptoms. The meaning of these findings for models of OGM and clinical practice are emphasized. PMID:22432507
Xiaoli, Yang; Chao, Jiang; Wen, Pan; Wenming, Xu; Fang, Liang; Ning, Li; Huijuan, Mu; Jun, Na; Ming, Lv; Xiaoxia, An; Chuanyou, Yu; Zenguo, Fu; Lili, Li; Lianzheng, Yu; Lijuan, Tong; Guowei, Pan
Background To describe the prevalence of DSM-IV disorders and comorbidity in a large school-based sample of 6–17 year old children and adolescents in northeast China. Methods A two-phase cross-sectional study was conducted on 9,806 children. During the screening phase, 8848 children (90.23%) and their mothers and teachers were interviewed using the Strengths and Difficulties Questionnaire (SDQ). During the diagnostic phase, 1129 children with a positive SDQ and 804 randomly selected children with a negative SDQ (11%), and their mothers and teachers, were interviewed using the Development and Well-Being Assessment (DAWBA). Results The overall prevalence of DSM-IV disorders was 9.49% (95% CI = 8.10–11.10%). Anxiety disorders were the most common (6.06%, 95% CI = 4.92–7.40), followed by depression (1.32%, 95% CI = 0.91–1.92%), oppositional defiant disorder (1.21%, 95%CI = 0.77–1.87) and attention-deficit hyperactivity disorder (0.84%, 95% CI = 0.52–1.36%). Of the 805 children with a psychiatric disorder, 15.2% had two or more comorbid disorders. Conclusions Approximately one in ten Chinese school children has psychiatric disorders involving a level of distress or social impairment likely to warrant treatment. Prevention, early identification and treatment of these disorders are urgently needed and pose a serious challenge in China. PMID:25360718
Kim, Kerri L; Galvan, Thania; Puzia, Megan E; Cushman, Grace K; Seymour, Karen E; Vanmali, Roshani; Jones, Richard N; Spirito, Anthony; Dickstein, Daniel P
To better delineate the unique correlates of self-injurious behaviors (SIB), psychiatric profiles of mutually exclusive groups of adolescents who made a suicide attempt (SA) versus those engaged in nonsuicidal self-injury (NSSI) were examined. Contrary to hypotheses, the NSSI group endorsed earlier onsets of SIB and suicidal ideation (SI), as well as higher rates of depression and anxiety compared with their SA counterparts. Future work is warranted to understand the role of SI, including duration of SI and anxiety in the development of NSSI, and to identify risk and resiliency factors useful in predicting an adolescent's SIB status. PMID:25060743
Puskar, Kathryn; Grabiak, Beth R; Bernardo, Lisa Marie; Ren, Dianxu
This article compares rural adolescents' coping responses before and after the behavioral intervention Teaching Kids to Cope with Anger (TKC-A). A quasi-experimental design was used, that included 94 (intervention) and 85 (control) students who were enrolled in three high schools in rural southwestern Pennsylvania. Results showed no statistically significant differences between the intervention and control groups' coping responses following the TKC- A intervention. The majority of youth in this study demonstrated healthy coping skills. In the future, the TKC-A needs to be integrated into the high school curriculum as a health promotion effort that is tailored to adolescents. PMID:19657872
Monuteaux, Michael C.; Mick, Eric; Faraone, Stephen V.; Biederman, Joseph
Background: Little is known about the influence of sex on the course of attention-deficit/hyperactivity disorder (ADHD) and its comorbid psychiatric conditions. The purpose of this study was to examine the effect of sex on the course and psychiatric correlates of ADHD from childhood into adolescence. Methods: Two identically designed,…
McReynolds, Larkin S.; Wasserman, Gail A.; DeComo, Robert E.; John, Reni; Keating, Joseph M.; Nolen, Scott
Juvenile assessment centers (JACs) were developed to address service fragmentation and promote the sharing of information among agencies providing services to youth involved with the juvenile justice system. To date, there are no reports that describe the diagnostic profiles of the youth served by such centers. The authors hypothesize that the…
Theesen, Karen A.
A compilation of literature and clinical wisdom, this handbook provides the reader with current information on the safety and efficacy of the psychotropic agents in the pediatric population. It lists information on the pharmacokinetics, adverse effects, dosing, and suggested monitoring guidelines for children and adolescents. The guide may also be…
Williams, Carolyn L.; Westermeyer, Joseph
Presenting complaints and problems of 28 Southeast Asian adolescent refugees who were seen by therapists at a U.S. hospital psychiatry department are described. Journal Availability: Subscription Department, The Williams Wilkins Co., 428 East Preston St., Baltimore, MD 21202. (SEW)
Jenkins, Janis H
Drawing on data from a longitudinal study of 47 adolescents of diverse ethnic backgrounds hospitalized for psychiatric disorder in New Mexico, the article critically examines the relevance of post-traumatic stress disorder (PTSD) to address anthropological questions of how to define the problem. Factors include the utility/limitation of psychiatric diagnostic categories, the lived experience of severe distress, the socioeconomic and political conditions of suffering, and reciprocal relations between immediate and remote social institutions. I discuss the mental health care system for adolescents and present two case studies of young inpatients, emphasizing the need for dual specification of the conditions of trauma and the structure of experience. I argue for understanding patterns of abandonment that shape the raw existence of young people at both the personal and collective levels to apprehend their depth and durability. PMID:24942649
Kanamüller, Juha; Riala, Kaisa; Nivala, Maija; Hakko, Helinä; Räsänen, Pirkko
We examined correlations of child sexual abuse among 300 adolescent girls in psychiatric inpatient treatment. Diagnostic and Statistical Manual of Mental Disorders (4th ed.)-based psychiatric diagnoses were obtained from the Schedule for Affective Disorder and Schizophrenia for School-Age Children-Present and Lifetime and from data on family and behavioral characteristics from the European Addiction Severity Index (EuropASI). A total of 79 girls (26.3%) had experienced child sexual abuse during their lifetime. Child sexual abuse was associated with an adolescent's home environment, sibling status, smoking, posttraumatic stress disorder diagnosis, self-mutilating behavior, and suicidal behavior. At least 62% of the perpetrators were acquaintances of the victims. Correlates of child sexual abuse can be used to identify child sexual abuse victims and persons at heightened risk for child sexual abuse. PMID:25101753
Blanco, Carlos; Wall, Melanie M.; He, Jian-Ping; Krueger, Robert F.; Olfson, Mark; Jin, Chelsea J.; Burstein, Marcy; Merikangas, Kathleen R.
Objective To construct a virtual space of common adolescent psychiatric disorders, spanned by factors reflecting major psychopathological dimensions, and locate psychiatric disorders in that space; examine whether the major psychopathological dimensions can be hierarchically organized; and determine the distribution of the latent scores of individuals in the space spanned by those dimensions. Method Exploratory factor analyses of data from the National Comorbidity Survey Adolescent Supplement (NCS-A) using the psychiatric diagnoses as indicators were used to identify the latent major psychopathological dimensions. The loadings of the disorders on those dimensions were used as coordinates to calculate the distance among disorders. The distribution of individuals in the space was based on the latent scores on the factors reflecting the major psychopathological conditions. Results A model with three correlated factors provided an excellent fit (Comparative Fit Index [CFI]=0.97, Tucker-Lewis Index [TLI]=0.95, the root mean squared error of approximation [RMSEA]=0.008) for the structure of disorders and a 4-factor model could be hierarchically organized, ultimately yielding a general psychopathology factor. Distances between disorders ranged from 0.079 (between social phobia and generalized anxiety disorder [GAD]) and 1.173 (between specific phobia and conduct disorder [CD]). At the individual level, there were 546 distinct liabilities observed (22% of all 2,455 potential liabilities). Conclusion A novel way of understanding psychiatric disorders in adolescents is as existing in a space with a limited number of dimensions with no disorder aligning along one single dimension. These dimensions are hierarchically organized, allowing for analyses at different levels of organization. Furthermore, individuals with psychiatric disorders present with a broad range of liabilities, reflecting the diversity of their clinical presentations. PMID:25524789
Ikaheimo, Olli; Laukkanen, Matti; Hakko, Helina; Rasanen, Pirkko
The influence of family structure on criminality in adolescents is well acknowledged in population based studies of delinquents, but not regarding adolescent psychiatric inpatients. The association of family structure to criminality was examined among 508 adolescents receiving psychiatric inpatient treatment between 2001 and 2006. Family structure…
Scomparini, Luciana Burim; dos Santos, Bernardo; Rosenheck, Robert Alan; Scivoletto, Sandra
OBJECTIVES: The objective of this study was to evaluate the association between different types of child maltreatment and the presence of psychiatric disorders in highly vulnerable children and adolescents served by a multidisciplinary program. METHODS: In total, 351 patients with a mean age of 12.47, of whom 68.7% were male and 82.1% lived in shelters, underwent psychiatric evaluations based on the Kiddie-Sads-Present and Lifetime Version. Two different methods were used to evaluate maltreatment: medical records were reviewed to identify previous diagnoses related to socioeconomic and psychosocial circumstances, and the Childhood Trauma Questionnaire was used to obtain a structured history of trauma. Bivariate associations were evaluated between psychiatric disorders and evidence of each type and the frequency of abuse. RESULTS: The most frequent psychiatric diagnoses were substance use disorders, affective disorders and specific disorders of early childhood, whereas 13.67% of the sample had no psychiatric diagnosis. All patients suffered neglect, and 58.4% experienced physical or sexual abuse. The presence of a history of multiple traumas was only associated with a diagnosis of substance use disorder. Mental retardation showed a strong positive association with reported physical abuse and emotional neglect. However, a negative correlation was found when we analyzed the presence of a history of multiple traumas and mental retardation. CONCLUSION: All children living in adverse conditions deserve careful assistance, but we found that physical abuse and emotional neglect were most strongly associated with mental retardation and multiple traumas with substance abuse. PMID:24037004
Kring, Sheilah R.; Greenberg, Jan S.; Seltzer, Marsha Mailick
This study investigated the associations between the characteristics of adolescents and adults with autism spectrum disorders (ASD) and maternal well-being. Two groups were compared: mothers of adolescents and adults with ASD and co-morbid psychiatric disorders (n = 142) and mothers whose sons or daughters had a single diagnosis of ASD (n = 130).…
Mustanoja, Susanna; Luukkonen, Anu-Helmi; Hakko, Helinä; Räsänen, Pirkko; Säävälä, Hannu; Riala, Kaisa
We examined the relationship of exposure to domestic violence and violence occurring outside home to bullying behaviour in a sample (508; 40.9% males, 59.1% females) of underage psychiatric inpatient adolescents. Participants were interviewed using K-SADS-PL to assess DSM-IV psychiatric diagnoses and to gather information about domestic and other violence and bullying behaviour. Witnessing interparental violence increased the risk of being a victim of bullying up to 2.5-fold among boys. For girls, being a victim of a violent crime was an over 10-fold risk factor for being a bully-victim. Gender differences were seen in witnessing of a violent crime; girls were more likely to be bullies than boys. Further, as regards being a victim of a violent crime outside home and physical abuse by parents at home, girls were significantly more often bully-victims than boys. When interfering and preventing bullying behaviour, it is important to screen adolescents' earlier experiences of violence. PMID:21479513
Gudiño, Omar G; Weis, J Rebecca; Havens, Jennifer F; Biggs, Emily A; Diamond, Ursula N; Marr, Mollie; Jackson, Christie; Cloitre, Marylene
Despite high rates of trauma exposure (46%-96%) and significant posttraumatic stress disorder (PTSD; 21%-29%) symptoms in adolescent psychiatric inpatients, there is a dearth of research on effective interventions delivered in inpatient settings. The current report describes the development of Brief STAIR-A, a repeatable 3-module version of skills training in affective and interpersonal regulation (STAIR) developed for adolescents in inpatient care. An uncontrolled design was used to conduct a preliminary examination of the group intervention's effectiveness. Adolescent psychiatric inpatients (N = 38; ages 12 years-17 years) admitted to a public hospital participated in Brief STAIR-A and attended a median of 6 sessions (range 3-36). They completed measures of PTSD and depressive symptom severity, coping skill use, and coping efficacy upon admission and again prior to discharge. Participants reported significant reductions in symptom severity (d = 0.65-0.67), no change in the absolute level of coping skills used (d = 0.16), but greater coping efficacy when discharged from care (d = 0.75). Results from this pilot study suggest that this brief group treatment shows promise for treating adolescents' trauma-related difficulties in inpatient psychiatry settings, but additional research examining its effectiveness is essential. PMID:25070927
Schwenck, Christina; Schneider, Wolfgang; Reichert, Andreas
Parent trainings constitute an effective method to target aspects of parenting in child and adolescent psychiatric and psychotherapeutic care. Past research has mainly been conducted in outpatient contexts, with parents of children with externalizing disorders and often included only small sample sizes. The aim of the current study was first to assess the effectiveness of a novel parent training which is characterized by a universal approach, an open group concept, and short duration, and second to identify variables that have an influence on the effectiveness. A sample of n = 151 parent-child dyads treated in an inpatient clinic was included in the study and randomly assigned to a treatment group and a waiting-list control group. As dependent measures served child behavior problems, dysfunctional parenting, parental mental health, and parental self-efficacy measured with parent-rated questionnaires prior to the training, post training and 3 months after discharge of the clinic. Additionally, a parent-child-interaction observation was conducted and rated by blind raters. Results indicated a general inpatient treatment effect on all dependent measures assessed with questionnaires. An additional effect of the parent training was only shown for parenting and parental mental health with the treatment group revealing better outcomes post training and at follow-up. No effects were found for the measures assessed by interaction observation. Out of a number of variables, only a low monthly income was associated with a higher reduction of dysfunctional parenting. Results indicate that parent training does not contribute additionally to standard inpatient care with respect to child behavior, but does have an influence on parental well-being, which might have a positive effect on the long run. PMID:26707493
Kimhy, David; Vakhrusheva, Julia; Liu, Ying; Wang, Yuanjia
Mobile electronic devices (i.e., PDAs, cellphones) have been used successfully as part of research studies of individuals with severe mental illness living in the community. More recently, efforts have been made to incorporate such technologies into outpatient treatments. However, few attempts have been made to date to employ such mobile devices among hospitalized psychiatric patients. In this article, we evaluate the potential use of such devices in inpatient psychiatric settings using 33 hospitalized patients with schizophrenia. Employing an Experience Sampling Method approach, we provide support for the feasibility of using such devices, along with examples of potentially clinically-relevant information that can be obtained using such technologies, including assessment of fluctuations in the severity of psychotic symptoms and negative mood in relation to social context, unit location, and time of day. Following these examples, we discuss issues related to the potential use of mobile electronic devices by patients hospitalized at inpatient psychiatric settings including issues related to patients' compliance, assessment schedules, questionnaire development, confidentiality issues, as well as selection of appropriate software/hardware. Finally, we delineate some issues and areas of inquiry requiring additional research and development. PMID:25042959
Chi, Felicia W; Sterling, Stacy; Campbell, Cynthia I; Weisner, Constance
This study examines the associations between 12-step participation and outcomes over 7 years among 419 adolescent substance use patients with and without psychiatric comorbidities. Although level of participation decreased over time for both groups, comorbid adolescents participated in 12-step groups at comparable or higher levels across time points. Results from mixed-effects logistic regression models indicated that for both groups, 12-step participation was associated with both alcohol and drug abstinence at follow-ups, increasing the likelihood of either by at least 3 times. Findings highlight the potential benefits of 12-step participation in maintaining long-term recovery for adolescents with and without psychiatric disorders. PMID:23327502
Jakobsen, Klaus Damgaard; Bruhn, Christina Hedegaard; Pagsberg, Anne-Katrine; Fink-Jensen, Anders; Nielsen, Jimmi
Aripiprazole is a partial dopamine agonist with only minor neurological and psychiatric adverse effects, making it a potential first-line drug for the treatment of psychiatric disorders. However, the evidence of its use in children and adolescents is rather sparse. The aim of this case study is to discuss adverse drug reaction (ADR) reports concerning aripiprazole-associated neurological and psychiatric events in children and adolescents. The ADR report database at Danish Medicines Agency was searched for all ADRs involving children and adolescents (<18 years) reported by the search term [aripiprazole] AND all spontaneous reports since the introduction of aripiprazole in 2003 until December 31, 2015. Nineteen case reports were included in the study and included both patients with psychotic disorders (PS group) and nonpsychotic disorders (non-PS group). The PS group consisted of 5 patients with schizophrenia and psychoses, not otherwise specified; and the non-PS group consisted of fourteen cases including autism spectrum disorders, attention deficit and hyperactivity disorder, obsessive-compulsive disorder, and Tourette syndrome. The main reported adverse effects in the non-PS group were chronic insomnia, Parkinsonism, behavioral changes psychoses, and weight gain, whereas the adverse effects in the PS group was predominantly anxiety, convulsions, and neuroleptic malignant syndrome. Although aripiprazole is considered safe and well tolerated in children and adolescents, severe adverse events as neuroleptic malignant syndrome, extreme insomnia, and suicidal behavior has been reported to health authorities. Clinicians should pay attention to these possible hazards when prescribing aripiprazole to this vulnerable group of patients. PMID:27504593
Colins, Olivier; Vermeiren, Robert; Schuyten, Gilberte; Broekaert, Eric
This study examines the past year prevalence rate of psychiatric disorders in detained male adolescents and the relation between psychiatric disorders and type of offending. The Diagnostic Interview Schedule for Children (DISC-IV) was administered in a sample (N = 245) of male detained adolescents aged 12 to 17 years. Based on lifetime official criminal history, participants were classified into property, violent, and versatile subgroups. High rates of psychiatric disorders were found in all groups. In addition, property offenders reported significantly higher rates of depression, disruptive behavior disorders, substance use disorders and comorbidity than violent and versatile offenders. Overall, versatile offenders did not differ from violent offenders, with the exception of more marijuana use disorder found in violent offenders. This study once more emphasizes that detained boys have substantial mental health needs, a finding that is generalizable across countries. In addition, the current study suggests that classifying detained juveniles by offense subgroups may carry clinical relevance. The long-term impact of these differences, and the possible effects of intervention, should be subject of further research. PMID:19290723
Aebi, Marcel; Linhart, Susanne; Thun-Hohenstein, Leonhard; Bessler, Cornelia; Steinhausen, Hans-Christoph; Plattner, Belinda
The objective of the present study was to analyse patterns of emotional, physical and sexual maltreatment in detained male juvenile offenders using latent class analysis (LCA). The association of maltreatment related LCA profiles with psychopathology and criminal behaviors was also studied. LCA based on the items of the Child Trauma Questionnaire (CTQ) assessing childhood emotional, physical, and sexual abuse was performed in a sample of 260 male adolescent offenders (mean age = 16.5 years, SD = 1.29 years). Chi square tests and general linear models were performed to assess the associations of CTQ profiles with categorical interview-based psychiatric disorders, dimensional Youth Self-Report problem scales, and officially registered offenses. LCA suggested a three class solution: (1) a no/mild trauma (NM; 76 %) (2) emotional and physical trauma (EP; 18 %) and (3) emotional, physical, and sexual trauma (EPS; 8 %). The classes EP and EPS were related to a variety of psychiatric disorders and self-reported mental health problems. Furthermore, EPS showed higher presence of a subsequent re-incarceration compared to NM. A majority of sexually abused juveniles also experienced emotional and physical abuse reflecting gravely disturbed family systems. Multiple abuse in childhood was associated with a broad variety of disorders including externalizing disorders and repeated criminal offending. Such findings indicate that trauma assessment is also relevant in externalizing youth. A comprehensive treatment approach for detained boys with multiple abuse experiences is required targeting both mental health needs and the reduction of criminal behaviors. PMID:25418616
Bolton, Jim; Palmer, Lucy; Cawdron, Rohanna
Aims and method We aimed to estimate the proportion of UK emergency departments with a psychiatric assessment room and to determine whether such rooms met criteria for conducting high-risk assessments. Liaison psychiatry services were asked whether their hospital had such a room, whether it met the criteria and whether respondents judged it to be sufficiently safe and private. Results Of the 60 emergency departments included in the survey, 23% had a psychiatric assessment room that met all the safety criteria and was judged to be safe and private. Barriers to the establishment of an appropriate facility included it being a low priority for hospital management, a room being used for other purposes, and balancing safety requirements with the creation of a calming environment. Clinical implications Mental illness is a common reason for presentation to emergency departments. Despite national recommendations, this survey indicates that many departments lack a sufficiently safe and private assessment room, which compromises the safety and privacy of patient care. PMID:27087987
Engelmann, G; Erhard, D; Petersen, M; Parzer, P; Schlarb, A A; Resch, F; Brunner, R; Hoffmann, G F; Lenhartz, H; Richterich, A
Adolescent patients with inflammatory bowel disease (IBD) show an increased risk for behavioral and emotional dysfunction. Health-related quality of life (HRQoL) is influenced by medical illnesses, as well as by psychiatric disorders, but for adolescents with IBD, the extent to which HRQoL is influenced by these two factors is unclear. For 47 adolescent IBD patients, we analyzed disease activity, HRQoL and whether or not a psychiatric disorder was present. Disease activity was estimated using pediatric Ulcerative Colitis Activity Index and pediatric Crohn's Disease Activity Index. The IMPACT-III and the EQ-5D were used to measure HRQoL and QoL, respectively. In addition, patient and parent diagnostic interviews were performed. 55.3 % patients fulfilled DSM-IV criteria for one or more psychiatric disorders. In all patients, psychiatric comorbidity together with disease activity contributed to a reduction in quality of life. Adolescents with IBD are at a high risk for clinically relevant emotional or behavioral problems resulting in significantly lower HRQoL. We conclude that accessible, optimally structured psychotherapeutic and/or psychiatric help is needed in adolescent patients with IBD. PMID:24838299
Pullen, Samuel J.; Wall, Christopher A.; Angstman, Elizabeth R.; Munitz, Gillian E.; Kotagal, Suresh
Objective: Children and adolescents with restless legs syndrome (RLS) are commonly diagnosed with comorbid attention deficit hyperactivity disorder and behavioral disturbances. Uncertainty exists over the significance of other co-occurring psychiatric disorders and their pharmacologic management in children with RLS. The purpose of this study was to determine the prevalence and nature of psychiatric disorders in children with RLS and to describe the use of psychotropic medications in our study cohort. Methods: The electronic medical records of children younger than 18 years of age who had been diagnosed with RLS between January 1, 2003, and December 31, 2009, were reviewed. Only those patients whose findings were consistent with the 2003 NIH workshop diagnostic criteria for probable or definite restless legs syndrome were included in this study. The medical records were cross-referenced for encounters with a child psychiatrist or psychologist. Likewise, only psychiatric diagnoses whose medical records explicitly reflected DSM-IV diagnostic criteria for psychiatric disorder(s) were included. Demographic data, serum ferritin, psychotropic medications, and in some cases, the results of pharmacogenomic testing were included in the data analysis in an ad hoc fashion. Results: We found 374/922 patients who met diagnostic criteria for childhood onset RLS. The mean age of the subjects was 10.6 years (range 0 to 18) and the male to female ratio was approximately 1:1. Overall, 239/374 (64%) patients with RLS had one or more comorbid psychiatric disorders. Attention deficit hyperactivity disorder was found in 94/374 (25%) patients, mood disturbances were found in 109/374 (29.1%) patients, anxiety disorders in 43/374 (11.5%) patients, and behavioral disturbances in 40/374 (10.9%) patients. Attention deficit hyperactivity disorder and disruptive behavior disorders were more common in males (OR = 1.94 for both), whereas mood disturbances and anxiety disorders were more common in
Ivarsson, Tord; Broberg, Anders G; Arvidsson, Tomas; Gillberg, Christopher
Adolescents in junior high school (n = 237), completed a questionnaire on bullying as it relates to victim and to perpetrator status, suicidality and biographical data. Psychological symptoms were assessed by the Youth Self Report (YSR) and the Depression Self-Rating Scale (DSRS) supplemented by school health officers blind assessments. Bullying was common: bully only (18%), victim only (10%) and victim and bully (9%). Bullies had mainly externalizing symptoms (delinquency and aggression) and those of the victim and bully group both externalizing and internalizing symptoms as well as high levels of suicidality. Adolescents in the bully only group were more likely to be boys and to have attention problems. Moreover, a substantial proportion of the adolescents in the victim only group were judged by school health officer to have psychiatric symptoms and to function socially less well. PMID:16757465
Kirkcaldy, Bruce; Furnham, Adrian; Siefen, Georg
A sample of around 2,500 adolescents in a child and adolescent psychiatry clinic in the region of Munster, Germany had their intelligence assessed. Family size (total number of siblings within a family) was significantly correlated with intelligence score categories (-0.08 and -0.19 for males and females). First borns and only children displayed…
Adewuya, Abiodun O; Oseni, Saheed B A
Despite the prevalence of anxiety and depressive disorders in children and adolescents with epilepsy, their impact on the quality of life has not been sufficiently studied. Adolescents with epilepsy (n=90) aged 12 to 18 were assessed for anxiety and depressive disorders with the Diagnostic Interview Schedule for Children, Version IV (DISC-IV), and their quality of life was assessed with the parent-rated Impact of Childhood Illness Scale (ICIS). Sociodemographic and illness variables were also obtained. Predictors of poor quality of life in adolescents with epilepsy include anxiety disorders, depressive disorders, frequency of seizures, and side effects of antiepileptic drugs. Depressive and anxiety disorders impacted on both the adolescents and the family. Programs designed to improve the overall quality of life of these adolescents should include the evaluation and treatment of possible comorbid anxiety and depressive disorders and involve the family. PMID:16143568
Fontanella, Cynthia A.
This study examined predictors of readmission for a sample of 522 adolescents enrolled in Medicaid and admitted to three inpatient psychiatric hospitals in Maryland. Comprehensive data on clinical, treatment, and health care system characteristics were collected from archival sources (medical records, Medicaid claims, and Area Resource File). Predictors of readmission were examined with bivariate (Kaplan Meier) and multivariate (Cox Regression) survival techniques. One year readmission rates were 38% with the majority occurring within 3 months after discharge. Adolescent demographic (age and gender), clinical (severity of symptoms, comorbidity, suicidality) and family characteristics (level of family risk) were associated with readmission. However, treatment factors including type of aftercare, post-discharge living environment, medication noncompliance, and hospital provider were among the strongest predictors of readmission. Study findings underscore the importance of careful discharge planning and linkage to appropriate aftercare. The differing rates of readmission across hospitals also suggest that organizational level factors may play a vital role in determining treatment outcomes. PMID:18954182
Di Lorenzo, Rosaria; Cimino, Nina; Di Pietro, Elena; Pollutri, Gabriella; Neviani, Vittoria; Ferri, Paola
Background Psychiatric emergencies of children and adolescents have greatly increased during the last years, but this phenomenon has not been studied in detail. The aim of this study was to analyze the correlation between acute psychiatric hospitalizations of adolescents and selected variables to highlight risk factors for psychiatric emergencies. Methods This retrospective research was conducted in the acute psychiatric public ward, Service of Psychiatric Diagnosis and Treatment (SPDT), and in the residential facility for adolescents, “The Medlar”, located in Modena. The sample was constituted by all adolescent patients (n=101, age range 14–18) who had acute hospitalizations (n=140) in SPDT and had been successively transferred to “The Medlar” (n=83), from February 2, 2010 to January 31, 2015. From clinical charts, we extracted demographic and anamnestic characteristics of patients and clinical variables related to hospitalizations. Data were statistically analyzed. Results Sixty-one percent of our patients lived with one divorced parent, with adoptive or immigrant family, or in institutions; 51% had experienced stressful events during childhood; 81% had a normal intellective level, but only 6% presented regular school performance. Parental psychiatric illness was negatively related, in a statistically significantly way, with onset age of adolescent mental disorders (coefficient −2.28, 95% confidence interval [CI]: −3.53 to 1.01, P<0.001, single linear regression; odds ratio: 4.39, 95% CI: 1.43–13.47, P<0.010, single logistic regression). The most frequent reasons for admission were aggressive behavior in males and suicide risk in females (P=0.002). The most frequent psychiatric diagnosis at SPDT discharge was “conduct disorder”, more frequent in males, followed by “adjustment disorder”, more frequent in females (P=0.001). In SPDT, the adolescent hospitalizations progressively increased fivefold at the end of the observation period
Background Several countries have established or are planning acute psychiatric in-patient services that accept around-the-clock emergency admission of adolescents. Our aim was to investigate the characteristics and clinical outcomes of a cohort of patients at four Norwegian units. Methods We used a prospective pre-post observational design. Four units implemented a clinician-rated outcome measure, the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA), which measures mental health problems and their severity. We collected also data about the diagnoses, suicidal problems, family situations, and the involvement of the Child Protection Service. Predictions of outcome (change in HoNOSCA total score) were analysed with a regression model. Results The sample comprised 192 adolescents admitted during one year (response rate 87%). Mean age was 15.7 years (range 10-18) and 70% were girls. Fifty-eight per cent had suicidal problems at intake and the mean intake HoNOSCA total score was 18.5 (SD 6.4). The largest groups of main diagnostic conditions were affective (28%) and externalizing (26%) disorders. Diagnoses and other patient characteristics at intake did not differ between units. Clinical psychiatric disorders and developmental disorders were associated with severity (on HoNOSCA) at intake but not with outcome. Of adolescents ≥ 16 years, 33% were compulsorily admitted. Median length of stay was 8.5 days and 75% of patients stayed less than a month. Compulsory admissions and length of stay varied between units. Mean change (improvement) in the HoNOSCA total score was 5.1 (SD 6.2), with considerable variation between units. Mean discharge score was close to the often-reported outpatient level, and self-injury and emotional symptoms were the most reduced symptoms during the stay. In a regression model, unit, high HoNOSCA total score at intake, or involvement of the Child Protection Service predicted improvement during admission. Conclusions Acute
McManama O'Brien, Kimberly H.
Adolescents psychiatrically hospitalized following a suicide attempt are at high risk for a repeat attempt or suicide completion, and substance use is consistently implicated as a risk factor for continued suicidal behavior in adolescents. Despite this knowledge, there have been few studies that have investigated the effectiveness of combined suicidality and substance use interventions within acute psychiatric care settings for suicidal youth with substance use problems. While social workers are well-positioned to deliver such interventions, greater emphasis on teaching integrated therapeutic techniques in social work curriculum and professional training is needed to ensure their implementation. PMID:26674510
Barber, M E; Marzuk, P M; Leon, A C; Portera, L
Gate questions are commonly used to shorten structured interviews, by not probing negative responses with more detailed questions. This study quantified cases of aborted suicide attempts that would have been missed, if we had skipped detailed questions following a gate. To accomplish this, we interviewed a random sample of 135 adult psychiatric inpatients concerning their past suicidal behavior. Using our structured interview, subjects were asked a general question about aborted suicide attempts, and then asked method-specific questions regardless of their response to the general "gate" question. Of the seventy subjects who were found to have histories of aborted attempts, 44.3% answered "no" to the gate question. Comparing these "false negative" subjects to "true positives," who had answered "yes" to the gate question and reported bona fide aborted attempts yielded no significant associations with demographics, psychiatric diagnoses, or reported histories of actual suicide attempts. Thus, a large number of subjects with aborted attempts would have been missed if a negative response to the gate question had not been probed. Clinical and reasearch implications generally, as well as implications for suicide assessment, are discussed. PMID:11287058
Pitta, Ana Maria Fernandes
The article takes a look at Brazilian Psychiatric Reform over the past decade, after the approval of Federal Law 10.216/2001 and seeks to elicit long overdue discussion about the pressing challenges that Brazilian Psychiatric Reform needs to tackle to promote or review the long-desired utopia of "full citizenship for all in a society without asylums." Is the Reform showing signs of exhaustion? The redirection of the care model for Mental Health in Brazil from the hospital to the community over the past decade is an undeniable achievement. Taking the use of psychoactive substances as the scope of policy and intervention, this incorporates complex demands that the current Crack drama makes it more urgent to question its history, its limits, its power. What will keep the flame alight of a successful movement that, surprisingly, has resisted the force of time and stigma in the ten years since the Law was enacted? These and other questions need to be worked on. It is time to recycle the focus of assessment and analysis in order to identify what threatens its vitality. This is the challenge to which the writer and debaters will be enjoined to contribute. PMID:22124894
Margret, Cecilia Patrica; Ries, Richard K
Alcohol drinking in childhood and adolescence is a serious public health concern. Adolescence is a vulnerable period for risk-taking tendencies. Understanding the influences of problematic alcohol use is important for evolving interventions. Alcohol use in early years foreshadows a lifetime risk for psychiatric and substance use disorders. Early screening and assessment can alter tragic sequelae. We discuss clinical aspects such as confidentiality, differential levels of care, and criteria for best fitting treatments. Given the prevalence of drinking and its impact on psychiatric and substance use disorders, the need for further study and prevention are emphasized. PMID:27338964
Laukkanen, Matti; Hakko, Helinä; Riala, Kaisa; Räsänen, Pirkko
This study investigated whether adolescent's family type was associated with regular smoking or the use of illicit substances (cannabis or hard drugs) among underage adolescent psychiatric in-patients. The sample consisted of 471 adolescents aged 12-17 years admitted to psychiatric hospital between April 2001 and March 2006 at Oulu University Hospital, Finland. The information on family factors and substance use was based on the Schedule for Affective Disorder and Schizophrenia for School-Age Children, Present and Lifetime interview and the European modification of the Addiction Severity Index questionnaire. Compared to adolescent boys from two-parent families, those from child welfare placement were more likely to regularly use both cannabis (odds ratio [OR]=4.4; 95%confidence interval [CI]=1.4-13.7; P=.012) and hard drugs (OR=8.4; 95% CI=1.7-42.1; P=.01).Among girls, no association was found between family type and the use of illicit substances. Two-parent or foster family units may protect adolescents from involvement with illicit substances. In clinical adolescent psychiatric practice more attention should be paid to family interventions and parental support. PMID:19062350
Luukkonen, Anu-Helmi; Räsänen, Pirkko; Hakko, Helinä; Riala, Kaisa
The aim was to investigate the association of bullying behavior with psychiatric disorders and physical health in a sample of adolescent psychiatric patients, as there have to our knowledge been no previous studies using actual psychiatric diagnoses examining this relationship in boys and girls. We studied 508 Finnish adolescents (age 12-17) admitted to psychiatric inpatient care between April 2001 and March 2006 from the geographically large area of Northern Finland. The Schedule for Affective Disorder and Schizophrenia for School-Age Children, Present and Lifetime (K-SADS-PL) was used to obtain psychiatric diagnoses of adolescents according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and information on bullying behavior. Logistic regression analyses showed that having an externalizing disorder increased the likelihood of being a bully or a bully-victim (i.e. a person who is both a bully and a victim of bullying) among both the boys (odds ratio, OR=14.4, P=0.001) and the girls (OR=10.0, P<0.001). In addition, having an internalizing disorder increased the likelihood of being a victim of bullying among the boys (OR=3.4, P=0.008), but not the girls. Chronic somatic diseases were also significantly associated with being bullied among the boys (OR=2.5, P=0.041). Our results suggest that adolescents who are involved in bullying behavior should be evaluated psychiatrically, as this might be an early marker of psychiatric disorders. PMID:20471097
Montgomery, Gregory P. J.; Crockford, David N.; Hecker, Kent
Objective: The Coordinators of Psychiatric Education (COPE) Residency In-Training Exam is a formative exam for Canadian psychiatric residents that was reconstructed using assessment best practices. An assessment of psychometric properties was subsequently performed on the exam to ensure preliminary validity and reliability. Methods: An exam…
How parents give meaning to the problems of adolescents diagnosed with mental disorders and receiving treatment is likely related to important outcomes including parental well-being and commitment to treatment, as well as their own behaviors and reactions to their child. The aim of this cross-sectional, mixed-method study of 70 parents of adolescents receiving wraparound mental health services is to examine: (1) how parents conceptualize their child's MH problems; (2) factors related to parents' conceptualization of youths' problems using medical model terms; and (3) associations between parents' problem conceptualization and their emotional or coping responses to their child having psychiatric problem(s). Content analysis indicated that 54.3% of parents definitively conceptualized adolescents' problems using psychiatric terms, 37.1% reported uncertainty about the nature of their child's problems, and 8.6% gave alternative, non-psychiatric explanations for their child's problems. We found significant relationships between parents' problem conceptualization and their attitudes and experience with MH treatment, demographics, as well as with adolescents' clinical characteristics. Parents who conceptualized problems using psychiatric terminology were more likely to express sadness and pessimism relative to other parents, though there were no differences in expressions of worry, guilt, pragmatism and optimism by problem conceptualization. PMID:19847647
Christodoulides, T. E.; Richardson, G.; Graham, F.; Kennedy, P. J.; Kelly, T. P.
The paper describes an evaluation of a risk assessment tool's effectiveness in distinguishing adolescent sexual offenders who had committed further sexual offences from those who had not. The sample consisted of 50 male adolescent sexual offenders referred to a forensic outpatient service within a healthcare setting. The adolescents within the…
Copeland, William E.; Wolke, Dieter; Angold, Adrian; Costello, E. Jane
Context Both bullies and victims of bullying are at risk for psychiatric problems in childhood, but it is unclear if this elevated risk extends into early adulthood. Objective To test whether bullying and being bullied in childhood predicts psychiatric and suicidality in young adulthood after accounting for childhood psychiatric problems and family hardships. Design Prospective, population-based study of 1420 subjects with being bullied and bullying assessed four to six times between ages 9 and 16. Subjects were categorized as bullies only, victims only, bullies and victims (bully-victims), or neither. Setting and population Community sample Main Outcome Measure Psychiatric outcomes included depression, anxiety, antisocial personality disorder, substance disorders, and suicidality (including recurrent thoughts of death, suicidal ideation, or a suicide attempt) were assessed in young adulthood (ages 19, 21, and 24/25/26) by structured diagnostic interviews. Results Victims and bully-victims had elevated rates of young adult psychiatric disorder, but also elevated rates of childhood psychiatric disorders and family hardships. After controlling for childhood psychiatric problems or family hardship, victims continued to have higher prevalence of agoraphobia (odds ratio (OR), 4.6; 95% confidence interval (CI), 1.7–12.5, p <0.01), generalized anxiety (OR, 2.7; 95% CI, 1.1–6.3, p <0.001), and panic disorder (OR, 3.1; 95% CI, 1.5–6.5, p <0.01), and bully-victims were at increased risk of young adult depression (OR, 4.8; 95% CI, 1.2–19.4, p <0.05), panic disorder (OR, 14.5; 95% CI, 5.7–36.6, p <0.001), agoraphobia (females only; OR, 26.7; 95% CI, 4.3–52.5, p <0.001), and suicidality (males only: OR, 18.5; 95% CI, 6.2–55.1, p <0.0001). Bullies were at risk for antisocial personality disorder only (OR, 4.1; 95% CI, 1.1–15.8, p < 0.04). Conclusion The effects of being bullied are direct, pleiotropic and long- lasting with the worst effects for those who are
Johnson, Daniel C.
The purpose of this study was to examine the etiology and cultural underpinnings of adolescent violence as collective case study analysis of three inter-related groups: psychiatrically hospitalized rural adolescents, their parent/guardian, and various hospital staff. Violence among adolescents is a serious societal issue that has had varying…
Wolff, Jennifer; Esposito-Smythers, Christianne; Becker, Sara; Seaboyer, Lourah; Rizzo, Christie; Lichtenstein, David; Spirito, Anthony
Peer victimization among children and adolescents is a major public health concern, given its widespread individual and societal ramifications. Victims of peer aggression often face significant levels of psychological distress and social difficulties, such as depression, suicidal ideation, suicide attempts, and social rejection. The purpose of the present study was to examine whether cognitive distortions and perceptions of social support moderate the association between peer victimization and suicidal thoughts among psychiatrically hospitalized adolescents. Participants included 183 psychiatrically hospitalized adolescents (ages 13–18). In multiple regression analyses that controlled for gender, social and cognitive factors served as significant resources factors. Cognitive factors also moderated the relationship between peer victimization and suicidal ideation. PMID:25125940
Gutierrez, Peter M; Freedenthal, Stacey; Wong, Jane L; Osman, Augustine; Norizuki, Tamami
Resilience has been associated with a markedly decreased chance for risky behaviors following a trauma or other negative life event. This study examined the factor structure and psychometric properties of a self-report measure of resilience, the Suicide Resilience Inventory-25 (SRI-25; Osman et al., 2004 ), among psychiatric inpatient adolescents. In Study 1, we conducted confirmatory factor analysis to provide additional empirical support for the structure and invariance of the 3-factor model of the SRI-25 in youth samples, ages 14 to 17 years (N = 152 boys, 220 girls). Scale reliability analyses provided good evidence for internal consistency reliability of scores on the SRI-25 total and scales. In Study 2 (N = 30 boys, 40 girls), we presented data in support for the concurrent validity (i.e., known groups) of scores on the SRI-25. Additionally, we identified potential correlates for the SRI-25 total scale scores. PMID:22176266
Olié, Jean-Pierre; Gourion, David; Canceil, Olivier; Lôo, Henri
The uncertainties of looming adulthood, nostalgia for childhood, and a general malaise explain the crisis of adolescence. Rebellion, conflict, occasional failure at school or in society, and at-risk behaviors are not always signs of future psychiatric illness. In contrast, the physician must be in a position to identify tell-tale signs such as dysmorphophobia, existential anxiety, a feeling of emptiness, and school or social breakdown. Most psychiatric disorders that begin in adolescence are only diagnosed several years after onset. Yet early diagnosis is of utmost importance, as treatment becomes less effective and the long-term prognosis worsens with time. Suicide is the second cause of death during adolescence. All signs of suicidal behavior require hospitalization and evaluation in a psychiatric unit. Antidepressants may be necessary in adolescence. The recent controversy concerning a possible increase in the suicidal risk during antidepressant treatment should not mask the fact that the real public health issue is depression, and not antidepressants. Eating disorders are especially frequent among adolescent girls; it is important to identify psychiatric comorbidities such as schizophrenia, depression and obsessive-compulsive disorders, and to assess the vital risk. Illicit drug and alcohol consumption are frequent during adolescence; for example, close to half of all French adolescents have tried cannabis at least once. Once again, it is important to detect psychiatric comorbidities in substance-abusing adolescents. Phobia is an underdiagnosed anxiety disorder among adolescents; it may become chronic if proper treatment is not implemented, leading to suffering and disability. Finally, two major psychiatric disorders--schizophrenia and bipolar disorder--generally begin in adolescence. Treatment efficacy and the long-term prognosis both depend on early diagnosis. Treatment must be tailored to the individual patient. "Borderline" states are over
Arola, Riikka; Antila, Henna; Riipinen, Pirkko; Hakko, Helinä; Riala, Kaisa; Kantojärvi, Liisa
Various psychiatric problems in adolescence and early adulthood have been shown to associate with criminal behaviour. In this study the association of personality disorders (PDs) with criminal behaviour was examined in adolescents treated in psychiatric hospitals. The study sample consisted of 508 adolescents (age 13-17) admitted to acute psychiatric impatient care between April 2001 and March 2006. Crime data was obtained from the Finnish Legal Register Centre on September 2013. The Schedule for Affective Disorder and Schizophrenia for School-Age Children Present and Lifetime (K-SADS-PL) was used to assess psychiatric diagnoses in adolescence. The information on PDs in early adulthood was based on follow-up information on psychiatric treatments in either out- or inpatient settings until the end of 2012, and was extracted from the National Care Register for Health Care provided by the Finnish National Institute for Health and Welfare. A total of 22 (39%) of the 57 subjects with PD had committed a crime. In women, the likelihood for violent criminality was significantly increased in those with Borderline PD (OR 6.09, CI 1.24-29.84, p=0.009) and was also associated with conduct disorder (OR 4.26, CI 1.38-13.19, p=0.012), child welfare placement (OR 11.82, CI 3.61-38.76, p<0.001) and parent's substance use disorder (OR 7.74, CI 2.30-26.10, p=0.001). In men, no association was observed between PD and any kind of criminal behaviour. Significant predictors for violent criminality in males were conduct disorder (OR 4.05, CI 1.75-9.38, p=0.001), substance use disorder (OR 2.51, CI 1.22-5.17, p=0.012) and special services at school (OR 2.58, CI 1.16-5.76, p=0.021). Females with Borderline PD showed an increased risk for violent offending. This suggests Borderline PD as a potential explanatory factor for violent assaults by females and highlights the importance of recognizing the risk for violence in young women with a Borderline PD. PMID:27399875
Sander, Christian; Hensch, Tilman; Wittekind, Dirk Alexander; Böttger, Daniel; Hegerl, Ulrich
During the last few decades, much knowledge has been gained about sleep being a heterogeneous condition with several distinct sleep stages that represent fundamentally different physiological states. The same applies for the wake state which also comprises distinct global functional states (called vigilance stages). However, various terms and concepts have been introduced describing different aspects of wakefulness, and accordingly several methods of assessment exist, e.g. sleep laboratory assessments (Multiple Sleep Latency Test, Maintenance of Wakefulness Test), questionnaires (Epworth Sleepiness Scale, Karolinska Sleepiness Scale), behavioural tasks (Psychomotor Vigilance Test) or electroencephalography (EEG)-based assessments (Alpha Attenuation Test, Karolinska Drowsiness Test). Furthermore, several theoretical concepts about the regulation of sleep and wakefulness have been put forward, and physiological correlates have been identified. Most relevant for healthy functioning is the regulation of brain arousal and the adaption of wakefulness to the environmental and situational needs so that the optimal balance between energy conservation and responsiveness can be obtained. Since one approach to the assessment of brain arousal regulation is the classification of EEG vigilance stages, a computer-based algorithm (Vigilance Algorithm Leipzig) has been introduced, allowing classification of EEG vigilance stages in EEG recordings under resting conditions. The time course of EEG vigilance stages in EEGs of 15-20 min duration allows estimation of the individual arousal regulation (hyperstable, adaptive, or unstable vigilance pattern). The vigilance model of affective disorders and attention-deficit/hyperactivity disorder links a disturbed arousal regulation to the pathogenesis of psychiatric disorders and accordingly helps to explain and possibly also predict treatment effects of pharmacological and non-pharmacological interventions for these conditions. PMID:26901462
Egger, Helen Link; Erkanli, Alaattin; Keeler, Gordon; Potts, Edward; Walter, Barbara Keith; Angold, Adrian
Objective: To examine the test-retest reliability of a new interviewer-based psychiatric diagnostic measure (the Preschool Age Psychiatric Assessment) for use with parents of preschoolers 2 to 5 years old. Method: A total of 1,073 parents of children attending a large pediatric clinic completed the Child Behavior Checklist 1 1/2-5. For 18 months,…
Dougherty, Lea R.; Bufferd, Sara J.; Carlson, Gabrielle A.; Dyson, Margaret; Olino, Thomas M.; Durbin, C. Emily; Klein, Daniel N.
Evidence supports the role of temperament in the origins of psychiatric disorders. However, there are few data on associations between temperament and psychiatric disorders in early childhood. A community sample of 541 three-year-old preschoolers participated in a laboratory temperament assessment, and caregivers were administered a structured…
Pfeiffer, Ernst; Hansen, Berit; Korte, Alexander; Lehmkuhl, Ulrike
The paper presents--in the sense of clinical guidelines--reality of clinical care in a child and adolescence university hospital specialised on eating disorders. Need of a multimodal therapeutic approach is emphasized, including normalisation of weight and eating behaviour, nursing and pedagogical measures, individual, group and family therapy, completed by body therapy, art and music therapy and in case psychopharmacotherapy. Recommendations for overcoming weak spots are made. PMID:15918540
Udo, Itoro; Mohammed, Zeid; Gash, Amanda
Issues surrounding capacity to consent to or refuse treatment are increasingly receiving clinical and legal attention. Through the use of 3 case vignettes that involve different aspects of mental health care in palliative care settings, mental capacity issues are discussed. The vignettes tackle capacity in a patient with newly developed mental illness consequent to physical illness, capacity in a patient with mental illness but without delirium and capacity in a patient with known impairment of the mind. These discussions give credence to best practice position where physicians act in the best interests of their patients at all times. It is important to emphasize that capacity decisions have to be made on a case by case basis, within the remit of legal protection. This is a fundamental requirement of the Mental Capacity Act 2005, England & Wales (MCA). The later is used as the legal basis for these discussions. The psychiatric liaison service is a useful resource to provide consultation, advice and or joint assessment to clinicians encountering complex dilemmas involving decision-making capacity. PMID:25278761
Biegel, Gina M.; Brown, Kirk Warren; Shapiro, Shauna L.; Schubert, Christine M.
Research has shown that mindfulness-based treatment interventions may be effective for a range of mental and physical health disorders in adult populations, but little is known about the effectiveness of such interventions for treating adolescent conditions. The present randomized clinical trial was designed to assess the effect of the…
Wang, Sheng-Min; Hwang, Sunyoung; Yeon, Bora; Choi, Kyoung Ho; Oh, Youngmin; Lee, Hae-Kook; Kweon, Yong-Sil; Lee, Chung Tai
Objective Patients visiting the emergency department (ED) after a suicide attempt are generally assessed for suicide risk by psychiatric residents. Psychiatric residents' competence in evaluating the risk posed by the patients who attempted suicide is critical to preventing suicide. Methods We investigated factors considered important by psychiatric residents when evaluating suicide risk. This study included 140 patients admitted to the ED after attempting suicide. Psychiatric residents rated patients' severity of current and future suicide risk as low/moderate/high using the Brief Emergency Room Suicide Risk Assessment (BESRA). The association between each BESRA variable and level of suicide risk was analyzed. Results Many factors were commonly considered important in evaluating the severity of current and future suicide risk. However, the following factors were only associated with future suicide risk: female gender, having no religion, family psychiatric history, history of axis I disorders, having a will, harboring no regrets, and social isolation. Conclusion Psychiatric residents use diverse factors when assessing suicide risk. Psychiatric residents might put more emphasis on non-modifiable demographic and clinical factors, concrete evidence showing suicide determination, and social isolation to assess the risk of future suicide. PMID:26207124
Strong, David R; Brown, Richard A; Ramsey, Susan E; Myers, Mark G
Using methods based in item response theory, we examined a structured interview assessment of Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) nicotine dependence and the Modified Fagerström Tolerance Questionnaire (mFTQ) symptoms to explore the expression of particular symptoms as a function of level of nicotine involvement in a sample of 191 adolescents with psychiatric disorders. Despite our attempts to capture a broad range of smokers, 64% of teens were daily smokers and 68% met DSM-IV criteria for nicotine dependence. This paper describes the relative severity of DSM-IV and mFTQ items, as well as each item's ability to discriminate among individuals at various levels of nicotine involvement. Comparisons across measures revealed that the mFTQ was not particularly sensitive to individual variation in DSM-IV symptom counts, suggesting the physiological components were not strongly related to the predominantly cognitive and behavioral components of the DSM-IV nicotine dependence syndrome. However, the mFTQ relative to the DSM-IV consistently showed stronger relationships to the immediate consequences of nicotine deprivation (urge, craving), supporting the conceptualization of the mFTQ as measuring nicotine exposure. These analyses provide us with some preliminary understanding of the severity of particular symptoms and the order in which symptoms are likely to be expressed across levels of nicotine dependence. PMID:14577990
Park, Subin; Kim, Jae-Won; Kim, Bung-Nyun; Bae, Jeong-Hoon; Shin, Min-Sup; Yoo, Hee-Jeong
Objective We aimed to examine the rates, correlates, methods, and precipitating factors of suicide attempts among adolescent patients admitted for psychiatric inpatient care from 1999 to 2010 in a university hospital in Korea. Methods The subjects consisted of 728 patients who were admitted for psychiatric inpatient care in a university hospital over a 12-year period and who were aged 10-19 years at the time of admission. We retrospectively investigated the information on suicidal behaviors and other clinical information by reviewing the subjects' electronic medical records. Whether these patients had completed their suicide on 31 December 2010 was determined by a link to the database of the National Statistical Office. Results Among 728 subjects, 21.7% had suicidal ideation at admission, and 10.7% admitted for suicidal attempts. Female gender, divorced/widowed parents, and the presence of mood disorders were associated with a significantly increased likelihood of suicide attempts. Most common method of suicide attempts was cutting, and most common reason for suicide attempts was relationship problems within the primary support group. A diagnosis of schizophrenia was associated with increased risk of death by suicide after discharge. Conclusion These results highlight the role of specific psychosocial factor (e.g., relational problems) and psychiatric disorders (e.g., mood disorders) in the suicide attempts of Korean adolescents, and the need for effective prevention strategies for adolescents at risk for suicide. PMID:25670943
Lindberg, Nina; Sailas, Eila; Kaltiala-Heino, Riittakerttu
School massacres have increased pressure on health-care authorities for assessing risk for severe violence. In acute situations, threat analysis focuses at thought processes and actions of adolescents presenting threat of violence, in order to assess to which extent the adolescent has progressed from thoughts to actions. Because of great variability in aggressive behavior, separate interventions for individual, family and other developmental surroundings are often needed. Structured risk-assessment in special health care is aimed for conducting decision making towards risk reduction and adequate help for adolescents at risk. PMID:24069639
Mason, Michael J; Aplasca, Alexis; Morales-Theodore, Rosa; Zaharakis, Nikola; Linker, Julie
This article highlights the prevalence of co-occurring disorders among adolescents and underscores the complexity and opportunities of treating these patients in a systematic, comprehensive approach. As evidenced by this review, the need exists to develop and test models of care that integrate co-occurring disorders into both psychiatric and substance abuse treatment settings. The challenge for pediatric practitioners is to provide detailed assessments linked to evidence-based treatment plans to account for the variations in adolescent development and the unique risk factor profile of each patient. The issues related to co-morbidity are vast and continue to grow with rapidly increasing research literature. PMID:27338972
Jacobson, Colleen M; Muehlenkamp, Jennifer J; Miller, Alec L; Turner, J Blake
This retrospective chart review study of 227 participants examined the psychiatric profiles of outpatient adolescents ages 12 to 19 years (M = 15.08 years, SD = 1.72 years) engaging in different types of deliberate self-harm (DSH) behaviors. Participants were divided into four groups: no deliberate self-harm (NoDSH; n = 119), nonsuicidal self-injury only (NSSI only; n = 30), suicide attempt only (n = 38), and suicide attempt plus NSSI (n = 40). Those who attempted suicide were more likely to have major depressive disorder and/or posttraumatic stress disorder than those who engaged in NSSI only. Those who engaged in any type of DSH were more likely to have features of borderline personality disorder than those who did not engage in DSH. The suicidal ideation levels of those in the NSSI group were similar to those in the NoDSH group. Findings offer empirical support for the importance of distinguishing between suicidal and nonsuicidal self-harm behaviors. PMID:18470773
Wang, Peng-Wei; Cheng, Cheng-Chung; Chou, Frank Huang-Chih; Tsang, Hin-Yeung; Chang, Yu-San; Huang, Mei-Feng; Yen, Cheng-Fang
Background: No single assessment method can successfully evaluate the clinical ability of medical students in psychiatric clerkships; however, few studies have examined the efficacy of multiple assessments, especially in psychiatry. The aim of this study was to examine the relationship among different types of assessments of medical students'…
Louwerse, A; Eussen, M L J M; Van der Ende, J; de Nijs, P F A; Van Gool, A R; Dekker, L P; Verheij, C; Verheij, F; Verhulst, F C; Greaves-Lord, K
The current 7-year follow-up study investigated: (1) the stability of ASD severity, and (2) associations of ASD severity in adolescence with (a) childhood and concurrent psychiatric comorbidity, and (b) concurrent societal functioning. The Autism Diagnostic Observation Schedule (ADOS) and the Diagnostic Interview Schedule for Children were administered in childhood (ages 6-12) and in adolescence (ages 12-20) to 72 individuals with a pervasive developmental disorder-not otherwise specified (PDD-NOS). ADOS calibrated severity scores showed a large stability (r = .51). Psychiatric comorbidity in childhood and adolescence were not associated with ASD severity in adolescence. Mental health care use (87 %) and special education needs were high (71 %). Reevaluation of ASD severity and psychiatric comorbidity later in life seem useful when PDD-NOS is diagnosed in childhood. PMID:26395112
McLaughlin, Katie A.; Green, Jennifer Greif; Gruber, Michael J.; Sampson, Nancy A.; Zaslavsky, Alan M.; Kessler, Ronald C.
Context Although childhood adversities (CAs) are known to be highly co-occurring, most research examines their associations with mental disorders one at a time. Recent evidence from adult studies suggests, though, that the associations of multiple CAs with mental disorders are non-additive, arguing for the importance of multivariate analysis of multiple CAs. No attempt has yet been made to carry out a similar kind of analysis among children or adolescents. Objective To examine the multivariate associations of 12 CAs with first onset of mental disorders in a national sample of US adolescents. Design US national survey of adolescents (ages 13–17) assessing DSM-IV anxiety, mood, behavior, and substance disorders and CAs. The CAs include parental loss (death, divorce, other separations), maltreatment (physical, sexual, and emotional abuse, neglect), parental maladjustment (psychopathology, substance abuse, criminality, violence) and economic adversity. Setting Dual-frame household-school samples. Participants 6,483 adolescents-parent pairs. Main outcome measure Lifetime DSM-IV disorders assessed with the WHO Composite International Diagnostic Interview. Results 58.3% of adolescents reported at least one CA, among whom 59.7% reported multiple CAs. CAs reflecting maladaptive family functioning (MFF) were more strongly associated than other CAs with disorder onsets. The best-fitting model included terms for type and number of CAs and distinguished between MFF and Other CAs. CAs predicted behavior disorders most strongly and fear disorders least strongly. The joint associations of multiple CAs were sub-additive. The population-attributable risk proportions for disorder classes ranged from 15.7% for fear disorders to 40.7% for behavior disorders. CAs were associated with 28.2% of all onsets. Conclusions CAs are common, highly co-occurring, and strongly associated with onset of mental disorders among US adolescents. The sub-additive multivariate associations of CAs with
Heshmat, Ramin; Qorbani, Mostafa; Ghoreshi, Behnaz; Djalalinia, Shirin; Tabatabaie, Omid Reza; Safiri, Saeid; Noroozi, Mehdi; Motlagh, Mohammad-Esmaeil; Ahadi, Zeinab; Asayesh, Hamid; Kelishadi, Roya
Objectives The aim of the present study was to evaluate the association between socioeconomic status (SES) and psychiatric problems and violent behaviours in a nationally representative sample of Iranian children and adolescents, based on nationwide surveillance programme data, 2011–2012. Methods Overall, 14 880 students, aged 6–18 years, were selected using a multistage cluster sampling method from rural and urban areas of 30 provinces in Iran. SES was estimated based on a main summarised component, extracted from principle component analysis of family assets and parents' jobs and education. For statistical analysis, SES was classified as ‘low’, ‘middle’ and ‘high’. The WHO-Global School Based Student Health Survey (WHO-GSHS) questionnaire was used to assess psychiatric problems and violent behaviours. Results In total, 13 486 students (participation rate 90.6%) completed the study: 50.8% were boys and 75.6% were urban residents, with a mean age of 12.47±3.36 years. In the multivariate model, the ORs of depression, anxiety, feeling worthless, anger, insomnia, confusion and physical fights were lower in students with high SES compared with those with low SES (p<0.05) but physical fights was lower in the high SES group than in the low SES group (p<0.05). No significant relationship was documented between SES and other variables, including getting worried, history of bullying and being victimised. Conclusions Children and adolescents with low SES were at higher risk for psychiatric problems and violent behaviours. Mental health policies and public interventional strategies should be considered at the public level, notably for low SES families. PMID:27531729
Stratton, Kelcey Jane; Edwards, Alexis Christine; Overstreet, Cassie; Richardson, Lisa; Tran, Trinh Luong; Trung, Lam Tu; Tam, Nguyen Thanh; Tuan, Tran; Buoi, La Thi; Ha, Tran Thu; Thach, Tran Duc; Amstadter, Ananda Beth
Little is known about risk factors for adolescent mental health in Vietnam. The present study investigated the relationship between caretaker mental health and adolescent mental health in a cross-sectional Vietnamese sample. Primary caretakers completed measures of their own mental distress and general health status using the Self-Reporting Questionnaire-20 (SRQ-20) as well as reports of adolescent mental health using the parent version of the Strengths and Difficulties Questionnaire (SDQ). Multivariate regression models were used to examine the relationships between the caretaker and adolescent health variables. The demographic factors of age, sex, ethnicity, religious affiliation, and household wealth status demonstrated significant relationships with SDQ subscale scores. Caretaker mental health was positively associated with adolescent mental health, and this association remained significant even after accounting for other relevant demographic variables and caretaker general health status. Understanding correlates of adolescent mental health difficulties may help identify youth and families at risk for developing psychiatric problems and inform mental health interventions in Vietnam. PMID:25204862
Stratton, Kelcey Jane; Edwards, Alexis Christine; Overstreet, Cassie; Richardson, Lisa; Tran, Trinh Luong; Trung, Lam Tu; Tam, Nguyen Thanh; Tuan, Tran; Buoi, La Thi; Ha, Tran Thu; Thach, Tran Duc; Amstadter, Ananda Beth
Little is known about risk factors for adolescent mental health in Vietnam. The present study investigated the relationship between caretaker mental health and adolescent mental health in a cross-sectional Vietnamese sample. Primary caretakers completed measures of their own mental distress and general health status using the Self-Reporting Questionnaire-20 (SRQ-20) as well as reports of adolescent mental health using the parent version of the Strengths and Difficulties Questionnaire (SDQ). Multivariate regression models were used to examine the relationships between the caretaker and adolescent health variables. The demographic factors of age, sex, ethnicity, religious affiliation, and household wealth status demonstrated significant relationships with SDQ subscale scores. Caretaker mental health was positively associated with adolescent mental health, and this association remained significant even after accounting for other relevant demographic variables and caretaker general health status. Understanding correlates of adolescent mental health difficulties may help identify youth and families at risk for developing psychiatric problems and inform mental health interventions in Vietnam. PMID:25204862
Coker, Kendell L.; Smith, Philip H.; Westphal, Alexander; Zonana, Howard V.; McKee, Sherry A.
Objective Current knowledge regarding psychiatric disorders and crime in youth is limited to juvenile justice and community samples. This study examined relationships between psychiatric disorders and self-reported crime involvement in a sample of youth representative of the US population. Method The National Comorbidity Survey-Adolescent Supplement (N=10,123; ages 13–17; 2001–2004) was used to examine the relationship between lifetime DSM-IV-based diagnoses, reported crime (property, violent, other), and arrest history. Logistic regression compared the odds of reported crime involvement with specific psychiatric disorders to those without any diagnoses, and examined the odds of crime by psychiatric comorbidity. Results Prevalence of crime was 18.4%. Youth with lifetime psychiatric disorders, compared to no disorders, had significantly greater odds of crime, including violent crime. For violent crime resulting in arrest, conduct disorder (CD; OR=57.5; 95% CI=30.4,108.8), alcohol use disorders (OR=19.5; 95% CI=8.8,43.2), and drug use disorders (OR=16.1; 95% CI=9.3,27.7) had the greatest odds with similar findings for violent crime with no arrest. Psychiatric comorbidity increased the odds of crime. Youth with 3 or more diagnoses (16.0% of population) accounted for 54.1% of those reporting arrest for violent crime. Youth with at least 1 diagnosis committed 85.8% of crime, which was reduced to 67.9% by removing those with CD. Importantly, 88.2% of youth with mental illness report never committing any crime. Conclusion Our findings highlight the importance of improving access to mental health services for youthful offenders in community settings given the substantial associations found between mental illness and crime in this nationally representative epidemiological sample. PMID:25062596
Jensen, Peter S; Buitelaar, Jan; Pandina, Gahan J; Binder, Carin; Haas, Magali
We aimed to provide a descriptive review of treatment studies of atypical antipsychotics in paediatric psychiatric disorders. A systematic review of the literature used Medline and EMBASE databases to identify clinical trials of atypical antipsychotics in children and adolescents between 1994 and 2006. Trials were limited to double-blind studies and open-label studies of > or = 8 weeks duration that included > or = 20 patients. Nineteen double-blind and 22 open-label studies were identified. Studies included use of clozapine, olanzapine, quetiapine, risperidone, and ziprasidone in the treatment of disruptive behavioural disorders (DBDs), pervasive developmental disorders (PDDs), tic disorder, psychotic disorders, and mania. These medications generally reduced the severity of a variety of psychiatric symptoms in children and adolescents. Less frequent adverse events included extrapyramidal symptoms, hyperglycaemia and diabetes, and endocrine effects. The review of published scientific data suggests that most of the atypical antipsychotics, excluding clozapine, have a favourable risk/benefit profile and effectively reduce disabling behaviours in paediatric psychiatric patients. While there is a body of evidence published of treatment of DBDs and PDDs, there is a lack of controlled data to guide clinical practice for the use of atypical antipsychotics for paediatric psychotic disorders and bipolar disorder. While there have been studies with duration up to 2 years, no definitive data are available that suggest long-term safety; additional studies are warranted. PMID:17075688
Zaitsoff, Shannon L.; Grilo, Carlos M.
Objective To examine psychosocial correlates of specific aspects of eating disorder (ED) psychopathology (i.e., dietary restriction, body dissatisfaction, binge eating, and self-induced vomiting) in psychiatrically-hospitalized adolescent girls and boys. Method Four hundred and ninety-two psychiatric inpatients (286 girls and 206 boys), aged 12 to 19 years, completed self-report measures of psychosocial and behavioral functioning including measures of suicide risk and ED psychopathology. Associations between ED psychopathology and psychosocial functioning were examined separately by sex and after controlling for depressive/negative affect using Beck Depression Inventory scores. Results Among boys and girls, after controlling for depressive/negative affect, ED psychopathology was significantly associated with anxiety, low self-esteem, and current distress regarding childhood abuse. Among girls, after controlling for depressive/negative affect, ED psychopathology was significantly related to hopelessness and suicidality. Among boys, after controlling for depressive/negative affect, ED psychopathology was positively related to self-reported history of sexual abuse and various externalizing problems (drug abuse, violence, and impulsivity). Conclusion In psychiatrically hospitalized adolescents, ED psychopathology may be an important marker of broad psychosocial distress and behavioral problems among girls and boys although the nature of the specific associations differs by sex. PMID:20152294
Forensic psychiatry is frequently defined as the branch of psychiatry that deals with issues arising in the interface between psychiatry and the law. Psychiatrists are called on by the legal system to provide testimony in a wide variety of cases, criminal and civil. In criminal cases, forensic psychiatrists may be asked to comment on the competence of a person to make decisions throughout all the phases of criminal investigation, trial, and punishment. These include the competence to stand trial, to plead guilty, to be sentenced, to waive appeal, and to be executed. In civil cases, forensic psychiatric experts are asked to evaluate a number of civil competences, including competence to make a will or contract or to make decisions about one's person and property. Psychiatrists are also called on to testify about many other issues related to civil cases. Forensic psychiatrists who work with children and adolescents are frequently involved in evaluations and testimonies concerning juvenile delinquency, child custody, termination of parental rights, and other issues. As such, forensic psychiatric experts have now developed into a reputable and well-known group of professionals. Forensic evaluation methods, ethical issues related to forensic psychiatric practice, and some common criminal and civil forensic psychiatric evaluations are discussed in this overview. PMID:25411982
Dyl, Jennifer; Kittler, Jennifer; Phillips, Katharine A.; Hunt, Jeffrey I.
Background: This study assessed prevalence and clinical correlates of body dysmorphic disorder (BDD), eating disorders (ED), and other clinically significant body image concerns in 208 consecutively admitted adolescent inpatients. It was hypothesized that adolescents with BDD would have higher levels of depression, anxiety, and suicidality.…
Creswell, Cathy; Waite, Polly; Cooper, Peter J
Anxiety disorders in childhood and adolescence are extremely common and are often associated with lifelong psychiatric disturbance. Consistent with DSM-5 and the extant literature, this review concerns the assessment and treatment of specific phobias, separation anxiety disorder, generalised anxiety disorder, social anxiety disorder, panic disorder and agoraphobia. Evidence-based psychological treatments (cognitive behaviour therapy; CBT) for these disorders have been developed and investigated, and in recent years promising low-intensity versions of CBT interventions have been proposed that offer a means to increase access to evidence-based treatments. There is some evidence of effectiveness of pharmacological treatments for anxiety disorders in children and young people, however, routine prescription is not recommended due to concerns about potential harm. PMID:24636957
Clark, C M
Satanism is a destructive religion that promises power, dominance, and gratification to its practitioners. Unfortunately, some adolescents are seduced by these promises, often because they feel alienated, alone, angry, and desperate. This article explores the psychosocial needs of adolescents that are often met by participation in Satanic worship. Gratification of these needs, when met, may make leaving the cult a difficult and lengthy process. Included is a method for determining the adolescents' level of involvement and an assessment strategy for the therapeutic evaluation process. A brief overview of clinical intervention is also discussed. PMID:8085495
West, M; Rose, S; Spreng, S; Adam, K
This article reports on the Adolescent Unresolved Attachment Questionnaire (AUAQ), a brief questionnaire that assesses the caregiving experiences of unresolved adolescents (as recipients of caregiving). The AUAQ was developed and validated in a large normative sample (n = 691) and a sample of 133 adolescents in psychiatric treatment. It is a self-report questionnaire consisting of 3 scales with Likert-type responses ranging from strongly disagree to strongly agree. The Aloneness/Failed Protection Scale assesses the adolescent's perception of the care provided by the attachment figure. The Fear Scale taps the fear generated by the adolescent's appraisal of failed attachment figure care. The Anger/Dysregulation Scale assesses negative affective responses to the perceived lack of care from the attachment figure. All scales demonstrated satisfactory internal reliability and agreement between scores for adolescents (n = 91) from the normative sample who completed the AUAQ twice. Adolescents in the clinical sample also completed the Adult Attachment Interview (AAI; C. George, N. Kaplan, & M. Main, 1984/1985/1996); the AUAQ demonstrated high convergent validity with the AAI. PMID:11117104
Witwer, Andrea N.; Lecavalier, Luc; Norris, Megan
The "Children's Interview for Psychiatric Syndromes-Parent Version" (P-ChIPS) is a structured psychiatric interview designed to assess the presence of psychiatric disorders in children and adolescents. This study examined the reliability and validity of the P-ChIPS in 61 youngsters (6- to 17-years-old) with Autism Spectrum Disorders. Reliability…
Jin, Run; Ge, Xiaojia; Brody, Gene H.; Simons, Ronald L.; Cutrona, Carolyn E.; Gibbons, Frederick X.
This study included three waves of data, collected from approximately 890 African-American children and their families. Antecedents and consequences of psychiatric disorders among this population were examined. Children's temperament, pubertal timing, and experience of stressful life events were tested as antecedents of psychiatric disorders.…
Simonoff, Emily; Jones, Catherine R. G.; Baird, Gillian; Pickles, Andrew; Happe, Francesca; Charman, Tony
Background: Psychiatric problems are common in autism spectrum disorders (ASDs), but the reasons are poorly understood. We use a longitudinal population-representative cohort to examine for the first time the persistence of psychiatric problems and to identify risk factors for their occurrence and stability. Methods: Eighty-one 16-year olds (75…
Diomšina, Beata; Rasmussen, Pernille Darling; Danilevičiütė, Vita
The aim of this paper is to share the clinical experience of the treatment of aripiprazole (Abilify) in children and adolescents. The authors have done a cross-sectional study about Abilify's treatment in children and adolescents with severe conduct problems (high impulsivity, aggression, outward reaction, physical cross-border behavior), high restlessness with ADHD, psychotic and psychosis-like symptoms with autistic disorders, psychosis, and intensive tics with Tourette's syndrome. The authors studied and described patients at the Child and Adolescent Psychiatric Clinic 1 in Roskilde, Denmark, who were treated with Abilify and were patients of the clinic in June 2013. The target group consisted of 33 patients, aged 9-18 years, which were in Abilify treatment during this time. Indications for the treatment and effectiveness of Abilify, Abilify's common doses used in children and adolescents, and the most common adverse effects of Abilify are presented. Abilify was found to be effective, well tolerated and safe for children and adolescents. The dose depends on the complexity of diagnosis (higher doses used in cases of complex diagnosis), on the age (higher doses used in older children, but only in the case of noncomplex diagnoses). Statistical analysis shows that in cases of complex diagnoses, dosage does not depend on age but depends on other factors. It also shows that the effect of treatment is better for those who did not gain weight. PMID:26642668
Srebnicki, Tomasz; Bryńska, Anita
First applications of computer-assisted technologies (CAT) in the rehabilitation of cognitive deficits, including child and adolescent psychiatric disorders date back to the 80's last century. Recent developments in computer technologies, wide access to the Internet and vast expansion of electronic devices resulted in dynamic increase in therapeutic software as well as supporting devices. The aim of computer assisted technologies is the improvement in the comfort and quality of life as well as the rehabilitation of impaired functions. The goal of the article is the presentation of most common computer-assisted technologies used in the therapy of children and adolescents with cognitive deficits as well as the literature review of their effectiveness including the challenges and limitations in regard to the implementation of such interventions. PMID:27556116
Metraux, Stephen; Caplan, Joel M.; Klugman, Dutch; Hadley, Trevor R.
This study assesses the extent of residential segregation among 15,246 people diagnosed with psychiatric disabilities and receiving Medicaid (MA) in Philadelphia, and an identically sized group of MA recipients serving as matched controls. Results indicate that overall levels of residential segregation among this group were modest at their most…
Zeilinger, E. L.; Nader, I. W.; Brehmer-Rinderer, B.; Koller, I.; Weber, G.
Background: Assessment of psychiatric disorders in persons with an intellectual developmental disorder (IDD) can be performed with a variety of greatly differing instruments. This makes the choice of an instrument best suited for the intended purpose challenging. In this study, we developed a comprehensive set of characteristics for the evaluation…
Stark, Kate H.; Barnes, Julia C.; Young, Nicholas D.; Gabriels, Robin L.
Children and adolescents with autism spectrum disorder (ASD) are at risk for emotional dysregulation and behavior problems that can escalate to levels requiring psychiatric hospitalization. Evaluating the etiology of such behaviors can be challenging for health care providers, as individuals with ASD can have difficulty self-reporting concerns.…
Groholt, Berit; Ekeberg, Oivind
The prevalence of mental health and suicidal behavior was examined 8 to 10 years after an adolescent suicide attempt. Of 71 persons, 79% had at least one psychiatric disorder (mean 1.7) at follow-up, most commonly depression (46%), personality disorder (46%), and anxiety disorder (42%). The stability of diagnoses was moderate. The suicide…
Amitai, Maya; Sachs, Ephi; Zivony, Amir; Remez, Roei; Ben Baruch, Reut; Amit, Ben H; Kronenberg, Sefi; Apter, Alan; Shoval, Gal; Weizman, Abraham; Zalsman, Gil
The objective of this study was to determine the long-term hematological and biochemical side effects of valproic acid (VPA) in psychiatric adolescent inpatients. A retrospective naturalistic study design was used. Participants were psychiatric inpatients treated with VPA, alone or in combination with other medications. Electronic medical files were reviewed for changes in hematological and biochemical parameters following a course of VPA treatment. One hundred and four adolescents aged 12-18 (mean 15.76±1.58) years fulfilled the study criteria. The mean blood level and duration of VPA treatment were 65.81±22.18 mcg/ml and 98.57±135.94 days, respectively. The mean levels of thyroid-stimulating hormones and triglyceride levels increased significantly from the first to the last measurement. Platelet count decreased significantly following VPA treatment. No correlation was observed between these parameters and age, duration of treatment, or VPA levels. No serious adverse events were reported. Long-term VPA treatment in adolescents with psychiatric disorders is associated with significant increases in triglyceride levels. Moreover, VPA-treated adolescent psychiatric inpatients may be at risk of developing pituitary-thyroid axis dysregulation and decreased platelet count. Therefore, baseline measurement of thyroid functions and metabolic and hematological parameters and monitoring throughout the treatment are recommended. PMID:26020713
Louwerse, A.; Eussen, M. L. J. M.; Van der Ende, J.; de Nijs, P. F. A.; Van Gool, A. R.; Dekker, L. P.; Verheij, C.; Verheij, F.; Verhulst, F. C.; Greaves-Lord, K.
The current 7-year follow-up study investigated: (1) the stability of ASD severity, and (2) associations of ASD severity in adolescence with (a) childhood and concurrent psychiatric comorbidity, and (b) concurrent societal functioning. The Autism Diagnostic Observation Schedule (ADOS) and the Diagnostic Interview Schedule for Children were…
Max, Jeffrey E.; Friedman, Keren; Wilde, Elisabeth A.; Bigler, Erin D.; Hanten, Gerri; Schachar, Russell J.; Saunders, Ann E.; Dennis, Maureen; Ewing-Cobbs, Linda; Chapman, Sandra B.; Yang, Tony T.; Levin, Harvey S.
This study aimed to better understand the occurrence of novel psychiatric disorders (NPDs) in children with mild traumatic brain injury (mTBI) in relation to preinjury variables, injury-related variables, and concurrent neurocognitive outcome. Eighty-seven children aged 5–14 years who had experienced mTBI were studied from consecutive hospital admissions with semistructured psychiatric interviews soon after injury (baseline). Fifty-four children were reassessed 24 months postinjury. Standardized instruments were used to evaluate injury severity, lesion characteristics, preinjury variables (lifetime psychiatric disorder, family psychiatric history, family function, socioeconomic status, psychosocial adversity, adaptive function, and academic function), and finally, postinjury neurocognitive and adaptive function. At 24 months postinjury, NPDs had occurred in 17 of 54 (31%) participants. NPD at 24 months was related to frontal white matter lesions and was associated with estimated preinjury reading, preinjury adaptive function, and concurrent deficits in reading, processing speed, and adaptive function. These findings extend earlier reports that the psychiatric morbidity after mTBI in children is more common than previously thought, and moreover, it is linked to preinjury individual variables and injury characteristics and is associated with postinjury adaptive and neurocognitive functioning. PMID:25923850
Chan, Oliver; Chow, Kavin Kit-wan
Institutional aggression in forensic psychiatric setting is an under-researched subject, despite the magnitude of the problem. No studies have been conducted on the assessment of risk and the examination of predictors of aggression among the Chinese forensic psychiatric population. Our study aimed to examine the determinants of aggression in the only forensic psychiatric institution in Hong Kong, and to test the psychometric properties of a risk-assessment instrument, the Dynamic Appraisal of Situational Aggression (DASA). We recruited a representative sample of 530 consecutively admitted detainees. Qualified nurses completed two risk-assessment instruments, the DASA and the Brøset Violence Checklist (BVC), once daily during the participants׳ first 14 days of admission. Aggressive incidents were recorded using the revised Staff Observation Aggression Scale (SOAS-R), and participants׳ data were collected for multivariate analyses. We showed that female gender, diagnoses of personality disorder and substance-related disorder, and admission at other correctional institutions were associated with institutional aggression. Aggression was perpetrated by 17.7% of the participants, and the DASA was demonstrated to have good psychometric properties in assessing and predicting aggressive incidents. Our findings preliminarily support the use of daily in-patient risk-assessment and affirm the role of dynamic factors in institutional aggression. PMID:25175913
Connor, Jennifer; Rueter, Martha
Adolescent suicidality is a serious problem among American youth. Common risk factors for adolescent suicidality include depression and conduct problems but there is little agreement on the best means to assess these factors. We compared multiple informants (mothers, fathers, the adolescent and a sibling) and multiple assessment techniques using a…
Lester, Mindy Chaky
There is a growing need for the measurement of therapeutic outcomes and the therapeutic alliance in inpatient mental health services with the adolescent population. This dissertation extends the literature on the use of client feedback measures with adolescents by investigating the use of the Outcome Rating Scale (ORS) and the Session Rating Scale…
Freiheit, Stacy R.; Overholser, James C.; Lehnert, Kim L.
This study examined relationship between a sense of humor and symptoms of depression among adolescents. Findings on measures of humor and depression for 140 adolescents revealed that a sense of humor can be reliably measured and may be inversely related to symptoms of depression. (LBT)
Evansm, Allison Schettini; Spirito, Anthony; Celio, Mark; Dyl, Jennifer; Hunt, Jeffrey
Substance abuse is one of the most problematic health risk behaviors among adolescents. Given that research consistently finds increased levels of substance use among adolescents with conduct problems as well as trauma-related symptoms, it is important that substance abuse be examined to better understand its role in Conduct Disorder (CD) and…
Czyz, Ewa K.; Liu, Zhuqing; King, Cheryl A.
This study examined the extent to which posthospitalization "change" in connectedness with family, peers, and nonfamily adults predicted suicide attempts, severity of suicidal ideation, and depressive symptoms across a 12-month follow-up period among inpatient suicidal adolescents. Participants were 338 inpatient suicidal adolescents, ages 13 to…
Liu, Mingli; Ming, Qingsen; Yi, Jinyao; Wang, Xiang; Yao, Shuqiao
Objective: To investigate associations of television and of video game or non-educational computer use (VG/CU) exposure volumes in a typical school day with psychiatric symptoms and suicidal ideation/self-injurious behavior (self-harm), in mainland Chinese adolescents. Methods: Secondary school pupils (N = 13,659; mean age: 15.18 ± 1.89) from 10 urban areas sampled from different regions of mainland China were recruited. The subjects were divided into the following four screen exposure volume groups for television and VG/CU respectively based on a self-administered questionnaire: 0 h/day, >0 to ≤1 h/day, >1 to ≤2 h/day, and >2 h/day. Demographic and psychiatric symptoms were recorded for each respondent. Odds ratios (ORs) and 95% confidence intervals (CIs) for several types of psychological problems and self-harm were calculated. Results: More than 2 h per school day television watching was associated with higher risk of depression in both boys (OR = 1.33, 95%CI: 1.02–1.73) and girls (OR = 1.62, 95%CI: 1.19–2.21), of anxiety in boys (OR = 1.43, 95%CI: 1.05–1.95), of general emotional, behavioral, and social problems (GEBSPs; OR = 1.55, 95%CI: 1.01–2.39), and of oppositional defiant problems (OR = 1.65, 95% CI: 1.09–2.50) in girls, compared with no television exposure. Conversely, television exposure of no more than 1 h per school day was associated with lower self-harm risk in boys (OR = 0.81, 95%CI: 0.67–0.99) compared with no television exposure. High school day VG/CU time (>2 h) compared with no VG/CU were associated with higher risks of anxiety (OR = 1.40, 95%CI: 1.06–1.86) and of attention deficit/hyperactivity problems (ADHPs; OR = 1.56, 95%CI: 1.02–2.38) in boys. And any school day VG/CU exposure was associated with higher risks of self-harm and all other psychiatric problems in boys and all psychiatric problems (including anxiety and ADHPs) in girls (ORs, 1.44–3.69), compared to no VG/CU exposure. Conclusion: For secondary school
Cross-cultural assessment and care frequently involve cross-language communication via a translator, interpreter, or bilingual worker. A resurgence of immigration, legalization of former illegal migrants, and refugee flight to the United States has increased the need for such special means of communication. Psychiatrists and other mental health professionals should develop conceptual models, skills, and experience for conducting cross-language interviews. This article provides information, terminology, and models for one aspect of this special clinical task, i.e., working with translators. PMID:2246648
Michaud, Pierre-André; Blum, Robert Wm; Benaroyo, Lazare; Zermatten, Jean; Baltag, Valentina
The purpose of this article is to provide policy guidance on how to assess the capacity of minor adolescents for autonomous decision-making without a third party authorization, in the field of clinical care. In June 2014, a two-day meeting gathered 20 professionals from all continents, working in the field of adolescent medicine, neurosciences, developmental and clinical psychology, sociology, ethics, and law. Formal presentations and discussions were based on a literature search and the participants' experience. The assessment of adolescent decision-making capacity includes the following: (1) a review of the legal context consistent with the principles of the Convention on the Rights of the Child; (2) an empathetic relationship between the adolescent and the health care professional/team; (3) the respect of the adolescent's developmental stage and capacities; (4) the inclusion, if relevant, of relatives, peers, teachers, or social and mental health providers with the adolescent's consent; (5) the control of coercion and other social forces that influence decision-making; and (6) a deliberative stepwise appraisal of the adolescent's decision-making process. This stepwise approach, already used among adults with psychiatric disorders, includes understanding the different facets of the given situation, reasoning on the involved issues, appreciating the outcomes linked with the decision(s), and expressing a choice. Contextual and psychosocial factors play pivotal roles in the assessment of adolescents' decision-making capacity. The evaluation must be guided by a well-established procedure, and health professionals should be trained accordingly. These proposals are the first to have been developed by a multicultural, multidisciplinary expert panel. PMID:26281798
Wilcox, Holly C.; Kuramoto, Satoko J.; Lichtenstein, Paul; Langstrom, Niklas; Brent, David A.; Runeson, Bo
Objective: This retrospective cohort study examined the risk for suicide, psychiatric hospitalization, and violent criminal convictions among offspring of parents who died from suicide, accidents, and other causes. Method: Population-based data from multiple Swedish national registers were linked from 1969 to 2004. Participants were 44,397…
Ehrlich, Stefan; Noam, Gil G.; Lyoo, In Kyoon; Kwon, Bae J.; Clark, Megan A.; Renshaw, Perry F.
Objective: Increasingly, researchers and clinicians are recognizing that there may be biological markers associated with increased risk of suicide. The objective of this study was to compare white matter hyperintensities in psychiatrically hospitalized children and youth with and without a history of suicide attempt while controlling for other…
Joelsson, Petteri; Chudal, Roshan; Gyllenberg, David; Kesti, Anna-Kaisa; Hinkka-Yli-Salomäki, Susanna; Virtanen, Juha-Pekka; Huttunen, Jukka; Ristkari, Terja; Parkkola, Kai; Gissler, Mika; Sourander, Andre
Recent studies have shown an increasing incidence of attention-deficit/hyperactivity disorder (ADHD) among children diagnosed in specialized services. This study aims to describe children with ADHD in Finnish specialized healthcare by reporting the demographic characteristics, time trends in diagnosis, psychiatric comorbidity, and the validity of register-based diagnoses. All the singletons born in Finland between 1991 and 2005 and diagnosed with ADHD by 2011 were identified and their psychiatric comorbidity data was obtained from the Finnish Hospital Discharge Register (FHDR). Parents of 69 patients were interviewed via telephone for a diagnostic validation. A total of 10,409 children were identified with ADHD, with a male: female ratio of 5.3:1 and a psychiatric comorbidity rate of 76.7 %. Of the validation sample 88 % met the diagnostic criteria of ADHD for DSM-IV. There is an increasing trend of ADHD diagnosis among both males and females. Psychiatric comorbidity is common and includes a wide range of disorders among children with ADHD. There was an increase of ADHD diagnoses especially among boys. More attention is needed to detect ADHD among girls in health services. Diagnoses in the FHDR show diagnostic validity and their sociodemographic patterns are in line with previous studies. PMID:26399420
Korte, Alexander; Beier, Klaus M; Vukorepa, Julia; Mersmann, Maik; Albiez, Verena
Gender identity disorder (GID), gender dysphoria (GD) respectively, is considered a multifactorial disease whose etiology is subject to complex bio-psycho-social conditions, each with different weighting. As a result, therapists, who treat children and adolescents with GID/GD, have to deal with a very heterogeneous group with individually varying causes, differing psychopathology and varying disease progression. In addition to general psychiatric aspects of development, particularly psychiatric comorbidity, but also the different individual psychodynamics--i. e. the specific constellation of conflicts and possible ego deficits and structural deficits in the learning history of the person are of differential importance. In regard to the indication for gender reassignment measures this sometimes is relevant for the decision. The difficulties arising for decision making and the usefulness of a systematic evaluation of case reports as a basis for further optimization of the treatment recommendations are illustrated by two case reports. In the course of this, also the disadvantages and potential dangers of too early diagnostic definition and introduction of gender somato-medical and legal measures are shown exemplarily. PMID:25296512
Waters, Amanda; Sands, Natisha; Keppich-Arnold, Sandra; Henderson, Kathryn
Handover, or the communication of patient information between clinicians, is a fundamental component of health care. Psychiatric settings are dynamic environments relying on timely and accurate communication to plan care and manage risk. Crisis assessment and treatment teams are the primary interface between community and mental health services in many Australian and international health services, facilitating access to assessment, treatment, and admission to hospital. No previous research has investigated the handover between crisis assessment and treatment teams and inpatient psychiatric units, despite the importance of handover to care planning. The aim of the present study was to identify the nature and types of information transferred during these handovers, and to explore how these guides initial care planning. An observational, exploratory study design was used. A 20-item handover observation tool was used to observe 19 occasions of handover. A prospective audit was undertaken on clinical documentation arising from the admission. Clinical information, including psychiatric history and mental state, were handed over consistently; however, information about consumer preferences was reported less consistently. The present study identified a lack of attention to consumer preferences at handover, despite the current focus on recovery-oriented models for mental health care, and the centrality of respecting consumer preferences within the recovery paradigm. PMID:25438620
Fitzgibbon, Marian L.
This article is a brief review of child and adolescent obesity over the past ten years. The starting point for the review is the well-known fact that there has been a dramatic rise in the prevalence of obesity among children, adolescents, and adults in the United Sates (Ogden et al., 2002). The rise has occurred across all age and ethnic groups,…
Pumariega, Andrés J; Rothe, Eugenio; Mian, Ayesha; Carlisle, Lee; Toppelberg, Claudio; Harris, Toi; Gogineni, Rama Rao; Webb, Sala; Smith, Jacqueline
The United States faces a rapidly changing demographic and cultural landscape, with its population becoming increasingly multiracial and multicultural. In consequence, cultural and racial factors relating to mental illness and emotional disturbances deserve closer attention and consideration. This Practice Parameter outlines clinical applications of the principle of cultural competence that will enable child and adolescent mental health clinicians to better serve diverse children, adolescents, and their families. PMID:24074479
Goldstein, Tina R.; Bridge, Jeffrey A.; Brent, David A.
We examined sleep difficulties preceding death in a sample of adolescent suicide completers as compared with a matched sample of community control adolescents. Sleep disturbances were assessed in 140 adolescent suicide victims with a psychological autopsy protocol and in 131 controls with a similar semistructured psychiatric interview. Rates of…
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Roberts, Robert E; Roberts, Catherine Ramsay; Xing, Yun
We present prevalence data for adolescents in a large metropolitan area in the US and the association of DSM-IV diagnoses to functional impairment and selected demographic correlates. We sampled 4175 youths aged 11-17 years from households enrolled in large health maintenance organizations. Data were collected using questionnaires and the Diagnostic Interview Schedule for Children, Version IV (DISC-IV). Impairment was measured using the Child Global Assessment Scale and diagnostic specific impairment in the DISC-IV. 17.1% of the sample met DSM-IV criteria for one or more disorders in the past year; 11% when only DISC impairment was considered and 5.3% only using the CGAS. The most prevalent disorders were anxiety (6.9%), disruptive (6.5%), and substance use (5.3%) disorders. The most prevalent specific disorders were agoraphobia, conduct and marijuana abuse/dependence, then alcohol use and oppositional defiant disorder. Younger youths and females had lower odds for any disorder, as did youths from two parent homes. There was increased odds associated with lower family income. Females had greater odds of mood and anxiety disorders, males of disruptive and substance use disorders. There were greater odds of mood and disruptive disorders for older youths. Prevalences were highly comparable to recent studies using similar methods in diverse non-metropolitan populations. We found associations with age, gender, and to a lesser extent, socioeconomic status reported in previous studies. The inclusion of both diagnosis-specific impairment and global impairment reduced prevalence rates significantly. Our results suggest commonality of prevalences and associated factors in diverse study settings, including urban and rural areas. PMID:17107689
Hässler, F; Bohne, S; Buchmann, J
Based on the efforts by the legislator to standardize the law for disabled persons and to simplify the accesses to appropriate assistance, procedures of expert reports are exemplarily presented from the aspect of child and adolescent psychiatry. Obliged to the principle of the two aspects for constituting a claim (which is first to set up a diagnosis and then to evaluate the existent or imminent handicap, both serving as the basis for the claim), etiological models, diagnostic - including developmental psychological - and therapeutic approaches in underlying psychiatric disorders of learning difficulties such as attention deficit hyperactivity disorders, pervasive developmental disorders, specific developmental disorders in learning abilities, and mental retardation are described as the participation in social life is either at risk or already affected. With regard these descriptions it is readily recognizable that child and adolescent neuropsychiatry has not only to provide professional competence in cases of appraisal question formulations concerning special assistance in early childhood, determination of special educational needs, and creation of plans for auxilliary interventions, but should also be employed regularly. PMID:11713698
Newby, Amy; McGuinness, Teena M
Psychiatric nurses are in key positions to identify and stop human trafficking, as well as aid its survivors. The combination of emotional trauma, sexual violence, and physical injuries experienced by these victims leads to high rates of posttraumatic stress disorder, depression, and anxiety. To detect human trafficking, it is important to identify the salient risk factors of homelessness and runaway history. This article offers key questions to help identify victims, as well as web-based resources. PMID:22421012
Lynch, Fionnuala; Mills, Carla; Daly, Irenee; Fitzpatrick, Carol
Suicide rates in young Irish males have risen markedly in the past 10 years, and suicide is now the leading cause of death in young men in the 15-24-year-old age range. This is the first large-scale study in Ireland that set out to identify young people at risk of psychiatric disorders, including depressive disorders, and suicidal ideation. Seven…
Penney, Stephanie R; Marshall, Lisa A; Simpson, Alexander I F
Individuals with serious mental illness (SMI; i.e., psychotic or major mood disorders) are vulnerable to experiencing multiple forms of adverse safety events in community settings, including violence perpetration and victimization. This study investigates the predictive validity and clinical utility of modifiable risk factors for violence in a sample of 87 forensic psychiatric patients found Not Criminally Responsible on Account of Mental Disorder (NCRMD) transitioning to the community. Using a repeated-measures prospective design, we assessed theoretically based dynamic risk factors (e.g., insight, psychiatric symptoms, negative affect, treatment compliance) before hospital discharge, and at 1 and 6 months postdischarge. Adverse outcomes relevant to this population (e.g., violence, victimization, hospital readmission) were measured at each community follow-up, and at 12 months postdischarge. The base rate of violence (23%) was similar to prior studies of discharged psychiatric patients, but results also highlighted elevated rates of victimization (29%) and hospital readmission (28%) characterizing this sample. Many of the dynamic risk indicators exhibited significant change across time and this change was related to clinically relevant outcomes. Specifically, while controlling for baseline level of risk, fluctuations in dynamic risk factors predicted the likelihood of violence and hospital readmission most consistently (hazard ratios [HR] = 1.35-1.84). Results provide direct support for the utility of dynamic factors in the assessment of violence risk and other adverse community outcomes, and emphasize the importance of incorporating time-sensitive methodologies into predictive models examining dynamic risk. (PsycINFO Database Record PMID:26914860
Jakobsen, Marianne; Demott, Melinda A M; Heir, Trond
Unaccompanied asylum-seeking children (UASC) are known to be subjected to several potentially traumatic life events, risking more mental health problems than other populations of same age. In this study, we aimed to explore the prevalence of psychiatric morbidity at an early stage after arrival to the host country. We performed structured clinical interviews (CIDI) with 160 male UASC from different countries (Afghanistan, Somalia, Iran), after four months in Norway. Most of the participants had experienced life threatening events (82%), physical abuse (78%), or loss of a close relative (78%) in their former life. Altogether 41.9% of the participants fulfilled diagnostic criteria for a current psychiatric disorder. The most prevalent diagnosis was PTSD (30, 6%), followed by MDD (9, 4%), Agoraphobia (4, 4%) and GAD (3, 8%). Implications of this vulnerability call for more mental health resources in the early stages of the asylum process. Increased awareness of psychiatric morbidity in UASC may improve the prognosis, give more appropriate care, and ease the integration process on all levels of society. PMID:25006343
Jakobsen, Marianne; Demott, Melinda A. M; Heir, Trond
Unaccompanied asylum-seeking children (UASC) are known to be subjected to several potentially traumatic life events, risking more mental health problems than other populations of same age. In this study, we aimed to explore the prevalence of psychiatric morbidity at an early stage after arrival to the host country. We performed structured clinical interviews (CIDI) with 160 male UASC from different countries (Afghanistan, Somalia, Iran), after four months in Norway. Most of the participants had experienced life threatening events (82%), physical abuse (78%), or loss of a close relative (78%) in their former life. Altogether 41.9% of the participants fulfilled diagnostic criteria for a current psychiatric disorder. The most prevalent diagnosis was PTSD (30, 6%), followed by MDD (9, 4%), Agoraphobia (4, 4%) and GAD (3, 8%). Implications of this vulnerability call for more mental health resources in the early stages of the asylum process. Increased awareness of psychiatric morbidity in UASC may improve the prognosis, give more appropriate care, and ease the integration process on all levels of society. PMID:25006343
Flint, Jonathan; Timpson, Nicholas; Munafò, Marcus
Intermediate phenotypes are traits positioned somewhere between genetic variation and disease. They represent a target for attempts to find disease-associated genetic variants and elucidation of mechanisms. Psychiatry has been particularly enamored with intermediate phenotypes, due to uncertainty about disease etiology, inconclusive results in early psychiatric genetic studies, and their appeal relative to traditional diagnostic categories. Here, we argue that new genetic findings are relevant to the question of the utility of these constructs. In particular, results from genome-wide association studies of psychiatric disorders now allow an assessment of the potential role of particular intermediate phenotypes. Based on such an analysis, as well as other recent results, we conclude that intermediate phenotypes are likely to be most valuable in understanding mechanism. PMID:25216981
Vandevoorde, Jérémie; Baudoin, Thierry; Chabert, Béatrice; Baudoin, Emmanuelle; Sanchez Valero, Ambre
The epidemiological literature shows that the population going through general or psychiatric emergencies indicates a high suicide risk. Suicide is classified as an avoidable mortality by the WHO. Therefore, suicidal potential must be assessed at different stages of hospitalization: when the patient comes to the emergency, during hospitalization, after hospitalization in the context of prevention and regularly monitoring. The authors present a simple approach to the investigation of suicidal activity through a semi-structured clinical interview and propose a fast and convenient grid report, experienced at psychiatric emergencies. A real and concrete case illustrates the method whereas are reminded the suicide warning signs and indices of increase about risk of acting out at the hospital. PMID:26071030
Blázquez, Ana; Castro-Fornieles, Josefina; Baeza, Inmaculada; Morer, Astrid; Martínez, Esteban; Lázaro, Luisa
It has been postulated that immigrant children are at increased risk of mental health problems. This study examined differences in psychopathology between immigrant and non-immigrant adolescents admitted for the first time to a child and adolescent inpatient psychiatry unit. Participants were 234 adolescents (191 non-immigrants and 43 immigrants). There were significant differences between the two groups in relation to certain stressors: parental separation, family breakdown, being under state custody, physical and/or psychological maltreatment and sexual abuse. Differences between the main diagnoses of the two groups were found in relation to schizophrenia and anorexia nervosa. There are differences between immigrants and natives in terms of diagnosis, and these differences are influenced by ethnicity and stressors. Future studies should seek to identify protective factors in order to prevent mental health disorders in the immigrant population. PMID:25476167
Grech, Anton; Axiak, Sally
This paper reports on a patient record survey that was undertaken with the central aim of establishing reliable, baseline information to inform strategic planning and organisation of future CAMHS in Malta. The records of the total population of children and adolescents admitted into the psychatric hospital over a five year period were surveyed. Results showed that the characteristics and circumstances of children and adolescents with mental disorder and comorbid substance misuse in Malta are similar to those described in international studies. The survey emphasised the pressing need for further research into this sub group and also highlighted gaps in reliable data systems locally. PMID:26417795
Schwartz, Robert C.; Smith, Shannon D.
Adolescent substance abuse is an increasing problem in U. S. society. This article provides an overview of adolescent substance abuse, screening, and assessment strategies; contact information related to specific assessment instruments; and information regarding ethic important to consider during the assessment process. (Contains 16 references and…
Nappi, Carla M; Thakral, Charu; Kapungu, Chisina; Donenberg, Geri R; DiClemente, Ralph; Brown, Larry
Authors examined if parental monitoring moderated effects of family sexual communication on sexual risk behavior among adolescents in psychiatric care. Seven hundred and eighteen parents reported upon quality of family discussions about sex-related topics and degree to which they monitor teen behavior. Adolescents reported the frequency of their own safe sex practices. Parental monitoring moderated the family communication quality-sexual risk behavior relationship among African American families. African American parents who perceived themselves as capable of open family sexual communication and frequent monitoring had adolescents who reported decreased sexual risk behavior. The moderator model was not supported among Caucasian and Hispanic families and findings did not depend upon gender. For African Americans, findings support the influential role of family processes in development of teen sexual risk behavior and suggest, for parents of teens receiving mental health services, learning communication and monitoring skills may be critical to their adolescent's sexual health. PMID:19085102
Zaninotto, Ana Luiza; Vicentini, Jessica Elias; Fregni, Felipe; Rodrigues, Priscila Aparecida; Botelho, Cibele; de Lucia, Mara Cristina Souza; Paiva, Wellingson Silva
Neuropsychological and psychiatric disorders represent a major concern and cause of disabilities after the trauma, contributing to worse recovery after traumatic brain injury (TBI). However, the lack of well-defined parameters to evaluate patient’s psychiatric disorders leads to a wide range of diagnoses and symptoms. The aim of this study was to perform a review of literature in order to gather data of the most common scales and inventories used to assess and diagnose depression, anxiety, and posttraumatic stress disorder (PTSD) after TBI. We conducted a literature search via MEDLINE, PubMed, and Web of Science. We included reviews, systematic reviews, and meta-analysis studies, and we used the following keywords: “traumatic brain injury OR TBI,” “depression OR depressive disorder,” “anxiety,” and “posttraumatic stress disorder OR PTSD.” From 610 titles, a total of 68 systematic reviews or meta-analysis were included in the section “Results” of this review: depression (n = 32), anxiety (n = 9), and PTSD (n = 27). Depression after TBI is a more established condition, with more homogeneous studies. Anxiety and PTSD disorders have been studied in a heterogeneous way, usually as comorbidity with other psychiatric disorders. Some scales and inventories designed for the general community may not be appropriate for patients with TBI. PMID:27378949
Zaninotto, Ana Luiza; Vicentini, Jessica Elias; Fregni, Felipe; Rodrigues, Priscila Aparecida; Botelho, Cibele; de Lucia, Mara Cristina Souza; Paiva, Wellingson Silva
Neuropsychological and psychiatric disorders represent a major concern and cause of disabilities after the trauma, contributing to worse recovery after traumatic brain injury (TBI). However, the lack of well-defined parameters to evaluate patient's psychiatric disorders leads to a wide range of diagnoses and symptoms. The aim of this study was to perform a review of literature in order to gather data of the most common scales and inventories used to assess and diagnose depression, anxiety, and posttraumatic stress disorder (PTSD) after TBI. We conducted a literature search via MEDLINE, PubMed, and Web of Science. We included reviews, systematic reviews, and meta-analysis studies, and we used the following keywords: "traumatic brain injury OR TBI," "depression OR depressive disorder," "anxiety," and "posttraumatic stress disorder OR PTSD." From 610 titles, a total of 68 systematic reviews or meta-analysis were included in the section "Results" of this review: depression (n = 32), anxiety (n = 9), and PTSD (n = 27). Depression after TBI is a more established condition, with more homogeneous studies. Anxiety and PTSD disorders have been studied in a heterogeneous way, usually as comorbidity with other psychiatric disorders. Some scales and inventories designed for the general community may not be appropriate for patients with TBI. PMID:27378949
Small, David Marc; Simons, Anne D.; Yovanoff, Paul; Silva, Susan G.; Lewis, Cara C.; Murakami, Jessica L.; March, John
Patterns and correlates of comorbidity, as well as differences in manifest depressive profiles were investigated in a sample of depressed adolescents. A sub-sample of the youth were characterized as belonging to either a "Pure" depression group, an "Internalizing" group (depression and co-occurring internalizing disorders), or an "Externalizing"…
Shanahan, Lilly; Copeland, William; Costello, E. Jane; Angold, Adrian
Background: Most psychosocial risk factors appear to have general rather than specific patterns of association with common childhood and adolescence disorders. However, previous research has typically failed to 1) control for comorbidity among disorders, 2) include a wide range of risk factors, and 3) examine sex by developmental stage effects on…
Brown, Adrienne; Cosgrave, Elizabeth; Killackey, Eoin; Purcell, Rosemary; Buckby, Joe; Yung, Alison R.
While the prevalence, correlates and mental health impacts of intimate partner violence are well documented in adolescents and young adults, fewer studies have considered physical dating violence among clinical samples of help-seeking young people. In a sample of 98 young people aged 15-24 years (54% females) referred to a specialist public youth…
do Prado, Carine Hartmann; Grassi-Oliveira, Rodrigo; Wieck, Andréa; Zaparte, Aline; Filho, Ledo Daruy; da Silva Morrone, Maurilio; Moreira, José C; Bauer, Moisés Evandro
Early life stress (ELS) has been associated with biological and psychosocial alterations due to developmental reprogramming. Here, we investigated whether childhood maltreatment is associated with an imbalance between the production of oxidative markers and antioxidant defenses. Thirty adolescents with no psychiatric disorder but reporting childhood maltreatment and twenty-seven adolescents with no psychiatric disorder and no history of ELS were recruited for the study. Childhood maltreatment was investigated by the Childhood Trauma Questionnaire (CTQ). Redox state was estimated by plasma levels of protein carbonylation, total thiol content (SH), superoxide dismutase (SOD), glutathione peroxidase (GPx), as well as total reactive antioxidant potential (TRAP). Childhood maltreatment was associated with oxidative stress as shown by increased protein carbonylation. Interestingly, adolescents exposed to maltreatment also displayed higher SOD levels, TRAP kinetics and reduced GPx levels when compared with adolescents who had not undergone childhood maltreatment. No significant differences were observed for SH levels. Taken together, we provide novel evidence indicating that childhood maltreatment is associated with increased oxidative stress markers in otherwise healthy adolescents. PMID:26845563
Nedopil, N; Blümcke, I; Bock, H; Bogerts, B; Born, C; Stübner, S
This article reviews current developments in psychiatric assessment of sex offenders for criminal courts. These developments are characterized by constantly changing laws and increasing neurobiological findings about paraphilias. Psychiatrists must prepare their reports taking into account the tension between psychopathological, neurobiological, and normative aspects of their judgement. The complexity of such assessments can best be demonstrated by narratives. This narrative concerns a 47-year-old patient who killed eight women after strangling them and masturbating or having intercourse with the unconscious victims. He explained in detail six of these crimes and gave ample information about his history, sexual development, fantasies, and a number of other sexual crimes he had committed. From this information a plausible explanation of his development to sexual fetishism and from there to sadism could be derived. Brain MRI displayed gliotic scars in the frontal lobe and right hippocampus. Consequences of the various findings on psychiatric assessment of legal culpability are discussed in this paper, concluding that a differentiated approach to the assessment is possible only from a psychopathological point of view in which behaviour, clinical features, and motivations are analysed. PMID:18806981
Zhou, Jiansong; Witt, Katrina; Xiang, Yutao; Zhu, Xiaomin; Wang, Xiaoping; Fazel, Seena
Objectives: The aim of this study was to undertake a systematic review on violence risk assessment instruments used for psychiatric patients in China. Methods: A systematic search was conducted from 1980 until 2014 to identify studies that used psychometric tools or structured instruments to assess aggression and violence risk. Information from primary studies was extracted, including demographic characteristics of the samples used, study design characteristics, and reliability and validity estimates. Results: A total of 30 primary studies were identified that investigated aggression or violence; 6 reported on tools assessing aggression while an additional 24 studies reported on structured instruments designed to predict violence. Although measures of reliability were typically good, estimates of predictive validity were mostly in the range of poor to moderate, with only 1 study finding good validity. These estimates were typically lower than that found in previous work for Western samples. Conclusion: There is currently little evidence to support the use of current violence risk assessment instruments in psychiatric patients in China. Developing more accurate and scalable approaches are research priorities. PMID:25991764
Landsberger, Sarah A; Diaz, David R; Spring, Noah Z; Sheward, Jerry; Sculley, Charleen
Deaf youth may be more vulnerable to psychiatric disorders but very little research data is available. The current study identified prevalence rates of psychiatric disorders and examined the psychosocial needs and strengths of deaf youth aged 4-17 receiving specialized outpatient mental health services for the deaf. Compared to hearing peers, deaf youth had greater rates of attention deficit hyperactivity disorder, conduct, autism-spectrum and bipolar disorders and spent three times longer in treatment than their hearing peers. In the deaf subsample, moderate-severe risk was found in social functioning (33.3 %) and suicidal behavior (14 %). Deaf youth had moderate to severe impairment in social relationships (54.8 %), school functioning (42.9 %). Over one-third of deaf youth had impaired family relationships, living situation, communication, judgment and physical health. Deaf youth present with higher rates of certain clinical disorders and have deficits in multiple life domains that may impact functioning and create a longer treatment course. PMID:23504290
Leccese, M; Waldron, H B
A variety of instruments are currently available to screen for and assess adolescent substance abuse and aid in planning appropriate interventions. Assessment practices in treatment facilities for adolescents have tended to rely on the use of unstandardized, local measures or on measures developed for adults with unknown reliability and validity for adolescents. This review is designed to serve as a resource for health professionals regarding the issues involved in assessing adolescent substance involvement and the types of instruments that are available for use. Conceptual issues relevant to the evaluation of adolescent substance use are discussed. Then, standardized, adolescent-specific assessment tools are briefly summarized, including screening questionnaires, comprehensive instruments, and several other substance-related instruments. PMID:7884839
Morán-Sánchez, Inés; Luna, Aurelio; Pérez-Cárceles, Maria D
Mental capacity is an emerging ethical legal concept in psychiatric settings but its relation to clinical parameters remains yet uncertain. The aim of this study is to evaluate the association between capacity to consent research and different psychiatric disorders and to characterize predictors of impairments in research decision-making capacity across diagnostic groups in a cross-sectional study. 139 consecutively referred outpatients with DSM-IV TR diagnoses of psychotic, mood and anxiety disorders were interviewed and a binary judgment of incapacity was made guided by the MacArthur competence assessment tool for consent research (MacCAT-CR). Demographics and clinical information were assessed by cases notes. Patients with anxiety disorders performed the best on the MacCAT-CR, and patients with psychotic disorders had the worst performance, however, there was considerable heterogeneity within each group. Cognitive impairment and global functioning were strongly correlated with MacCAT-CR subscales scores. 30.6% participants lacked research-related decisional capacity. Low Understanding score OR 0.07 (IC 95% 0.01-0.32) and Low Reasoning score OR 0.30 (IC 95% 0.11-0.82) were the factors most closely associated with lack of capacity. No absolute statements about decisional capacity can be driven merely due to the diagnosis. We found several risk factors which may be considered to decide which populations may require more thorough capacity assessments. The issues under consideration in the present study are by no means unique to people with psychiatric conditions. Ignoring this caveat, risks further inappropriate stigmatization of those with serious mental illness. PMID:25952945
In order to avoid threatening social disintegration, it is important for children and adolescents with chronic mental disorders and also for physically disabled children to diagnose disturbances of social participation in an early stage and to commence rehabilitation measures. The need for rehabilitation, the ability to rehabilitate and the rehabilitation prognosis are important for identifying the individual rehabilitation goals. A multi-axial diagnosis according to the ICF with a determination of adaptability, a behavioural analysis, skills, activity and participation is required. For disabled children, there are only a few ICF check lists for diagnosing social participation. Because of this, the ICF check list CASP (Child & Adolescent Scale of Participation) for measuring social participation according to Bedell was translated, which is shown in the appendix. PMID:19739060
Völkl-Kernstock, Sabine; Huemer, Julia; Jandl-Jager, Elisabeth; Abensberg-Traun, Marihan; Marecek, Sonja; Pellegrini, Elisabeth; Plattner, Belinda; Skala, Katrin
The experience of cumulative childhood adversities, such as exposure to domestic violence or abuse by caregivers, has been described as risk factor for poor mental health outcomes in adolescence and adulthood. We performed an investigation of experience of violence in all patients aged 6 to 20 years who had consulted the Department of Child and Adolescent Psychiatry, Medical University of Vienna, as outpatients during the period of one year. We were using the Childhood Trauma Interview (CTI) in order to obtain information on the kind of violence. Seventy-five percent of all patients had reported experiences of violence. These youth were significantly more often involved in acts of school violence, thus a significant correlation between experience of domestic violence and violence at school could be revealed. The results of our study emphasize the need for interventions preventing violence both in domestic and in school environments. PMID:26487648
Angle, Hugh V.; Ellinwood, Everett H.
The prediction of treatment outcome will require a clinically dedicated and comprehensive information system to gather a sizable data file on each individual, covering patient assessment, treatment and treatment outcome. The computer interview represents an information system capable of routinely gathering a large portion of this information. However, current methods of data analysis cannot adequately handle the information complexity associated with psychiatric treatment. Computer simulation is a method ideally suited to the investigation of complex subject matter and is proposed as a means to forecast the treatment outcome of actual patients under various conditions of treatment.
Anderson, Rhydonia H.; And Others
Verbal interactions between adolescents and their parents may affect adolescents' self-esteem and self-concept. The current development of an instrument, the Verbal Interaction Questionnaire (VIQ), was designed to measure adolescents' perceptions of their parents verbal interactions with them. Noting that the relationship between adolescents'…
Goulette, Carol A.
Adolescent suicide has tripled in the past two decades and is considered to be a leading cause of death among America's youths. This increase has prompted much research on the assessment and prevention of adolescent suicide. Suicidologists have agreed there are no scientifically proven methods to assess which individual might attempt suicide.…
Does the use of health care and special school services, prior to admission for psychiatric inpatient treatment, differ between adolescents housed by child welfare services and those living with their biological parent(s)?
Laukkanen, Matti; Hakko, Helinä; Räsänen, Pirkko; Riala, Kaisa
We examined whether the use of health care and special school services, prior to admission for psychiatric inpatient treatment, differed between adolescents from child welfare units and those living at their parental home. 208 boys and 300 girls aged 12-17 years were admitted for psychiatric hospital between 2001 and 2006. Child welfare adolescents had used more health services/treatments prior to psychiatric hospital admission than adolescents living with their biological family. The best discriminating factors between study groups for both genders, were previous psychiatric hospitalizations, unemployed parents, use of special school services and self-perceived serious anxiety/tension or trouble controlling violent behavior. Repeated school grades and previous use of psychotropic medications were discriminating factors only in girls. Adolescents in child welfare deserve adequate mental health evaluations at an early stage, with referral to appropriate adolescent psychiatric services if required. Appropriate service provision and properly planned treatments may reduce the amount of intensive and sometimes unnecessary psychiatric inpatient treatments. PMID:23392732
Walker, Elizabeth Reisinger; Berry, Frank W; Citron, Tod; Fitzgerald, Judy; Rapaport, Mark H; Stephens, Bryan; Druss, Benjamin G
Similar to other states, Georgia is facing workforce challenges within its community mental health system. These issues may be exacerbated as implementation of the Affordable Care Act expands demand for behavioral health services. Georgia's Department of Behavioral Health and Developmental Disabilities commissioned a needs assessment to examine the shortage of prescribing providers (psychiatrists, advanced practice registered nurses, and physician assistants) in the state's public mental health system. A unique partnership of key stakeholders developed and conducted the mixed-methods needs assessment at six of Georgia's 27 community mental health centers serving more than 40,000 patients annually. The assessment documented challenges in recruiting and retaining psychiatrists and workforce shortages for all prescriber groups. The authors describe opportunities for optimizing the psychiatric workforce and training the next generation of community psychiatrists. PMID:25642608
Cham, Heining; Hughes, Jan N; West, Stephen G; Im, Myung Hee
The Adolescent Motivation for Educational Attainment Questionnaire is a 32-item questionnaire (we drew 20 items from 3 subscales of the Educational Motivation Questionnaire; Murdock, 1999) that was developed to measure multiple potential dimensions of adolescents' motivation to complete high school and enroll in post-secondary education, including competence and effort beliefs; perceived value of education; and peer, teacher, and parent support for educational attainment. We assessed a multiethnic sample (N = 569) of low-achieving students who started 1st grade together in 1 urban and 2 small city school districts. Participants were assessed over 2 consecutive years (Grades 8 and 9 given prior grade retention, or Grades 9 and 10 if not retained). Exploratory factor analyses identified 4 correlated dimensions underlying the questionnaire responses. Subsequent confirmatory factor analyses provided support for a bifactor model, which includes a general factor of students' basic educational motivation, and specific factors of (a) teacher educational expectations, (b) peer aspirations, and (c) value of education. Measurement invariance of the bifactor model was established across students' gender and ethnicity (Caucasian, African American, and Hispanic) and year of testing. Criterion-related validity of the general and specific factors with students' school belonging, student-teacher warmth and conflict, disciplinary practices, letter grade, conduct problems, and behavioral engagement was examined. Practical implications of the measure are discussed. PMID:24588748
Soylu, Nusret; Alpaslan, Ahmet Hamdi; Ayaz, Muhammed; Esenyel, Selcen; Oruç, Mücahit
The purpose of this study was to compare sexually abused children and adolescents, with and without intellectual disabilities (ID), in terms of post-abuse psychiatric disorders, features of the sexual abuse, and sociodemographic characteristics. The study included sexually abused children aged 6-16 years, who were sent to three different child mental health units for forensic evaluation; there were 102 cases (69 girls and 33 boys) with ID and 154 cases (126 girls and 28 boys) without ID. Researchers retrospectively examined the files, social examination reports, and the judicial reports of the cases. It was determined that in the group with ID, sexual abuse types including penetration and contact had higher rates, they were exposed to more frequent repeated abuses, the abuses were revealed with their own reports at a later period and lower rates, and post-abuse pregnancies were more frequent. It was also determined that the abuser was a familiar person and a family member at lower rates and more than one abuser was encountered more frequently, compared to the group without ID. While no difference was determined between the two groups in terms of the frequency of post-abuse post-traumatic stress disorder (PTSD) and major depressive disorder (MDD), conduct disorder (CD) was observed more frequently in the group with ID. This study emphasizes that sexual abuse, which is an important problem in individuals with ID, has different features and effects. PMID:24161460
Fenton, G W; O'Gorman, E C
Sixty final-year medical students had their clinical performance in psychiatry assessed by the following three methods: a multiple choice questionnaire based on a series of short videotaped interviews with psychiatric patients; the examination of a traditional long 'case' with presentation of the history, mental state findings and formulation about diagnosis and management to a panel of three examiners; and a conventional oral examination about the principles and practice of psychiatry with a different trio of examiners. The total mark on the videotape session correlated significantly with the combined clinical and oral marks. There was also a significant positive correlation between the total video marks and the individual clinical marks, but none between the marks obtained during the video and oral components of the examination. However, the significant positive correlations between the video marks and those of the clinical examination were modest and only accounted for not more than 14% of the variance. Inspection of the distribution of correct answers to the videotape questions shows that students do best in identifying mental state symptoms and signs and in choosing the correct diagnosis. They do less well in the areas of aetiology and treatment. Indeed, optimal performance in the latter distinguishes those who do well in the clinical/oral examination from those whose performance is mediocre. The significance of these findings to the teaching and assessment of psychiatric skills in medical students is discussed. PMID:6472143
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. PMID:25116035
The assessment process can be integrated with treatment and evaluation for helping teenage suicide attempters and families in short term psychiatric hospitalization programs. The method is an extremely efficient way for the therapist to work within a given time constraint. During family assessment sufficient information can be gathered to…
Mackaronis, Julia E; Byrne, Peter M; Strassberg, Donald S
Adolescents who have sexually offended have unique treatment needs. For mental health professionals to adequately address these unique needs, further research is necessary. To that end, we explored the assessment of sexual interest (which may play an integral role in understanding potential for sexual reoffending) in a sample of 103 male adolescents who have sexually offended. We compared results from a physiological assessment (MONARCH 21 penile plethysmography [PPG]) and an actuarial assessment (Screening Scale for Pedophilic Interest [SSPI]), plus data from an unobstrusive assessment (Affinity, a viewing time measure) in a smaller subsample of 16 male adolescents. One finding that has particular relevance for clinical assessment is that the SSPI may have limited utility with adolescents. We also found evidence for some overlap between data from PPG and viewing time assessments, although whether or not PPG data are ipsatized may affect relationships with other assessment modalities. PMID:24879092
Smith, Teri; Sharp, Susan; Manzardo, Ann M; Butler, Merlin G
Advances made in genetic testing and tools applied to pharmacogenetics are increasingly being used to inform clinicians in fields such as oncology, hematology, diabetes (endocrinology), cardiology and expanding into psychiatry by examining the influences of genetics on drug efficacy and metabolism. We present a clinical case example of an adolescent male with anxiety, attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder who did not tolerate numerous medications and dosages over several years in attempts to manage his symptoms. Pharmacogenetics testing was performed and DNA results on this individual elucidated the potential pitfalls in medication use because of specific pharmacodynamic and pharmacokinetic differences specifically involving polymorphisms of genes in the cytochrome p450 enzyme system. Future studies and reports are needed to further illustrate and determine the type of individualized medicine approach required to treat individuals based on their specific gene patterns. Growing evidence supports this biological approach for standard of care in psychiatry. PMID:25710722
Smith, Teri; Sharp, Susan; Manzardo, Ann M.; Butler, Merlin G.
Advances made in genetic testing and tools applied to pharmacogenetics are increasingly being used to inform clinicians in fields such as oncology, hematology, diabetes (endocrinology), cardiology and expanding into psychiatry by examining the influences of genetics on drug efficacy and metabolism. We present a clinical case example of an adolescent male with anxiety, attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder who did not tolerate numerous medications and dosages over several years in attempts to manage his symptoms. Pharmacogenetics testing was performed and DNA results on this individual elucidated the potential pitfalls in medication use because of specific pharmacodynamic and pharmacokinetic differences specifically involving polymorphisms of genes in the cytochrome p450 enzyme system. Future studies and reports are needed to further illustrate and determine the type of individualized medicine approach required to treat individuals based on their specific gene patterns. Growing evidence supports this biological approach for standard of care in psychiatry. PMID:25710722
Scivoletto, Sandra; Silva, Thiago F.; Cunha, Paulo Jannuzzi; Rosenheck, Robert A.
OBJECTIVE: Despite the high prevalence of substance abuse and mood disorders among victimized children and adolescents, few studies have investigated the association of these disorders with treatment adherence, represented by numbers of visits per month and treatment duration. We aimed to investigate the effects of substance abuse and mood disorders on treatment adherence and duration in a special program for victimized children in São Paulo, Brazil. METHODS: A total of 351 participants were evaluated for psychiatric disorders and classified into one of five groups: mood disorders alone; substance abuse disorders alone; mood and substance abuse disorders; other psychiatric disorders; no psychiatric disorders. The associations between diagnostic classification and adherence to treatment and the duration of program participation were tested with logistic regression and survival analysis, respectively. RESULTS: Children with mood disorders alone had the highest rate of adherence (79.5%); those with substance abuse disorders alone had the lowest (40%); and those with both disorders had an intermediate rate of adherence (50%). Those with other psychiatric disorders and no psychiatric disorders also had high rates of adherence (75.6% and 72.9%, respectively). Living with family significantly increased adherence for children with substance abuse disorders but decreased adherence for those with no psychiatric disorders. The diagnostic correlates of duration of participation were similar to those for adherence. CONCLUSIONS: Mood and substance abuse disorders were strong predictive factors for treatment adherence and duration, albeit in opposite directions. Living with family seems to have a positive effect on treatment adherence for patients with substance abuse disorders. More effective treatment is needed for victimized substance-abusing youth. PMID:22249474
Franzoni, Emilo; Monti, Morena; Pellicciari, Alessandro; Muratore, Carlo; Verrotti, Alberto; Garone, Caterina; Cecconi, Ilaria; Iero, Luisa; Gualandi, Stefano; Savarino, Francesca; Gualandi, Paola
In order to evaluate the psychiatric symptoms associated with a diagnosis of eating disorders (ED) we have administered a new psychometric instrument: the Self Administrated Psychiatric Scales for Children and Adolescents (SAFA) test. SAFA was administered to a cohort of 97 patients, aged from 8.8 to 18, with an ED diagnosis. Age, body mass index (BMI) and BMI standard deviation score were analyzed. Furthermore, while looking for linkable risk factors, we evaluated other data that took an influence over the SAFA profile, like parental separation and family components’ number. Compared to the range of statistical normality (based on Italian population), patients with bulimia nervosa or binge-eating disorder showed higher and pathologic values in specific subscales. When analyzing sex, males showed more pathologic values in most anxiety-related, obsessiveness–compulsiveness-related and insecurity subscales. A correlation among age, BMI and specific subscales (low self esteem, psychological aspects) emerged in participants with anorexia nervosa. In order to plan more appropriate diagnostic and therapeutic approaches in children or adolescents suffering from ED, the SAFA test can be an important instrument to evaluate psychiatric symptoms. Therefore, we propose to include this useful, simple self-administered test as a new screening tool for ED diagnosis. PMID:19557115
Franzoni, Emilo; Monti, Morena; Pellicciari, Alessandro; Muratore, Carlo; Verrotti, Alberto; Garone, Caterina; Cecconi, Ilaria; Iero, Luisa; Gualandi, Stefano; Savarino, Francesca; Gualandi, Paola
In order to evaluate the psychiatric symptoms associated with a diagnosis of eating disorders (ED) we have administered a new psychometric instument: the Self Administrated Psychiatric Scales for Children and Adolescents (SAFA) test. SAFA was administered to a cohort of 97 patients, aged from 8.8 to 18, with an ED diagnosis. Age, body mass index (BMI) and BMI standard deviation score were analyzed. Furthermore, while looking for linkable risk factors, we evaluated other data that took an influence over the SAFA profile, like parental separation and family components' number. Compared to the range of statistical normality (based on Italian population), patients with bulimia nervosa or binge-eating disorder showed higher and pathologic values in specific subscales. When analyzing sex, males showed more pathologic values in most anxiety-related, obsessiveness-compulsiveness-related and insecurity subscales. A correlation among age, BMI and specific subscales (low self esteem, psychological aspects) emerged in participants with anorexia nervosa. In order to plan more appropriate diagnostic and therapeutic approaches in children or adolescents suffering from ED, the SAFA test can be an important instrument to evaluate psychiatric symptoms. Therefore, we propose to include this useful, simple self-administered test as a new screening tool for ED diagnosis. PMID:19557115
Clark, Cynthia M.
Describes Satanism as destructive religion that promises power, dominance, and gratification and that may seduce adolescents who feel alienated, alone, angry, and desperate. Explores psychosocial needs of adolescents that are met by participation in Satanic worship. Includes method for determining adolescents' level of involvement and assessment…
Micali, Nadia; Solmi, Francesca; Horton, Nicholas J.; Crosby, Ross D.; Eddy, Kamryn T.; Calzo, Jerel P.; Sonneville, Kendrin R.; Swanson, Sonja A.; Field, Alison E.
Objective To investigate whether anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and other specified feeding and eating disorders (OSFED), including purging disorder (PD), subthreshold BN, and BED at ages 14 and 16, are prospectively associated with later depression, anxiety disorders, alcohol and substance use, and self-harm. Method Eating disorders were ascertained at 14 and 16 years of age in 6,140 youth at age 14 (58% of those eligible) and 5,069 at age 16 (52% of those eligible) as part of the prospective Avon Longitudinal Study of Parents and Children (ALSPAC). Outcomes (depression, anxiety disorders, binge drinking, drug use, deliberate self-harm, weight status) were measured using interviews and questionnaires about 2 years following predictors. Generalized estimating equation models adjusting for gender, socio-demographic variables, and prior outcome were used to examine prospective associations between eating disorders and each outcome. Results All eating disorders were predictive of later anxiety disorders. AN, BN, BED, PD, and OSFED were prospectively associated with depression (respectively AN: odds ratio [OR]=1.39 [95% CIs: 1.00-1.94]; BN: OR=3.39[1.25-9.20]; BED: OR=2.00 [1.06-3.75]; PD: OR=2.56 [1.38-4.74]). All eating disorders but AN predicted drug use and deliberate self-harm (BN: OR=5.72[2.22-14.72], PD: OR=4.88[2.78-8.57], subthreshold BN: OR=3.97[1.44-10.98], subthreshold BED: OR=2.32[1.43-3.75]). Whilst BED and BN predicted obesity (respectively OR=3.58 [1.06-12.14] and OR=6.42 [1.69-24.30]), AN was prospectively associated with underweight. Conclusions Adolescent eating disorders, including subthreshold presentations, predict negative outcomes, including mental health disorders, substance use, deliberate self-harm, and weight outcomes. This study highlights the high public health and clinical burden of eating disorders among adolescents. PMID:26210334
The Adolescent Behavior Checklist: normative data and sensitivity and specificity of a screening tool for diagnosable psychiatric disorders in adolescents with mental retardation and other development disabilities.
Demb, H B; Brier, N; Huron, R; Tomor, E
Individuals with mental retardation are almost twice as likely to demonstrate severe behavioral problems or symptoms of mental illness as are nonmentally retarded individuals. At present, however, the ability to diagnose a mental disorder in an individual with mental retardation is difficult, and instruments are needed to help facilitate this process. The Adolescent Behavior Checklist was developed with this purpose in mind. This self-report scale is used to assess the likelihood that an adolescent with mild mental retardation or borderline intelligence has a diagnosable mental illness. The 86-item yes/no self-report scale renders scores on eight subscales derived from DSM III-R. The checklist has been found to have good criterion and congruent validity and good test-retest reliability. Data regarding interrater reliability and the sensitivity and specificity of the scale are presented, as are implications for future research. PMID:8085031
The enormity of the problem of adolescent suicide-attempts and completions-mandates that each attempt be evaluated with the context of the adolescent's social, psychological, and biological history. The assessment of risk, including the mental status exam, and prevention and treatment are covered. PMID:10356165
Wheeler, Barbara R.; And Others
Provides therapeutic guidelines to social workers working with adolescents involved in Satanism. Describes common goals of therapy and recommends family involvement. Concludes there is a further need for study concerning at-risk and assessment factors, and intervention alternatives since more adolescents are becoming involved in Satanic…
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…
Over the past 25 years, there has been a gradual recognition that counseling children and adolescents is much different than counseling adults. Because of this difference, numerous books, games, and articles have focused on what assessment and intervention strategies work with the child and adolescent population. However, many of these…
Silver, Eric; Piquero, Alex R; Jennings, Wesley G; Piquero, Nicole L; Leiber, Michael
Prior studies have documented linkages between mental disorder and both offending and victimization. However, few studies have examined the violent offending-violent victimization overlap among mentally disordered individuals and none have examined the factors that are jointly related to their covariation. Here, we assess this overlap during the first ten weeks following hospital discharge among a large sample of psychiatric patients from three large cities. Findings indicate that: (1) violent offending and violent victimization show substantial covariation; (2) although each of the two outcomes were predicted by a few unique risk factors, several risk factors were similarly predictive of both outcomes; and (3) even after adjusting for demographic, clinical, and social risk factors, the correlation between violent offending and violent victimization remained robust. Implications for theory, research, and policy are highlighted. PMID:20145985
Selim, Abeer A; Dawood, Eman
In the current study, the Objective Structured Video Examination (OSVE) was conducted to assess undergraduate nursing students' knowledge, observation, and clinical reasoning related to clinical psychiatric nursing competencies. The OSVE showed acceptable reliability and validity (Cronbach's α = 0.714, r = 0.6, respectively). Students highly appraised the OSVE because it covered a wide area of knowledge and clinical skills; the examination instructions were clear, concrete, and easily understood; the sounds and pictures of the videos were clear; and the videos simulated real patients. The examination was fair, well-administered, well-structured, and well-sequenced. The OSVE reflected learned skills, it provided opportunities for learning, grades were clearly identified, and it eliminated personal bias. Overall, the OSVE provided a practical and useful experience. On the other hand, some students negatively perceived the OSVE as being stressful and requiring more time. PMID:25602587
Bråbäck, Lennart; Åström, Daniel Oudin; Strömgren, Magnus; Forsberg, Bertil
Objective To investigate associations between exposure to air pollution and child and adolescent mental health. Design Observational study. Setting Swedish National Register data on dispensed medications for a broad range of psychiatric disorders, including sedative medications, sleeping pills and antipsychotic medications, together with socioeconomic and demographic data and a national land use regression model for air pollution concentrations for NO2, PM10 and PM2.5. Participants The entire population under 18 years of age in 4 major counties. We excluded cohort members whose parents had dispensed a medication in the same medication group since the start date of the register. The cohort size was 552 221. Main outcome measures Cox proportional hazards models to estimate HRs and their 95% CIs for the outcomes, adjusted for individual-level and group-level characteristics. Results The average length of follow-up was 3.5 years, with an average number of events per 1000 cohort members of ∼21. The mean annual level of NO2 was 9.8 µg/m3. Children and adolescents living in areas with higher air pollution concentrations were more likely to have a dispensed medication for a psychiatric disorder during follow-up (HR=1.09, 95% CI 1.06 to 1.12, associated with a 10 µg/m3 increase in NO2). The association with NO2 was clearly present in 3 out of 4 counties in the study area; however, no statistically significant heterogeneity was detected. Conclusion There may be a link between exposure to air pollution and dispensed medications for certain psychiatric disorders in children and adolescents even at the relatively low levels of air pollution in the study regions. The findings should be corroborated by others. PMID:27259522
Dew, Rachel Elizabeth; Kramer, Stephen I.; McCall, W. Vaughn
Objective: Facility in psychopharmacology is a major goal of psychiatric residency. This study assesses the adequacy of pharmacotherapy provided to depressed patients in a resident clinic. Methods: Charts of all 285 patients seen in an outpatient triage clinic during 2000 were reviewed. One hundred twelve patients had diagnoses of major…
Gerber, F.; Carminati, G. Galli
Background: The lack of psychometric measures of psychopathology especially in intellectual disabilities (ID) population was addressed by creation of the Psychiatric Assessment Schedule for Adult with Developmental Disability (PAS-ADD-10) in Moss et?al. This schedule is a structured interview designed for professionals in psychopathology. The…
Treadwell-Deering, Diane; Evankovich, Karen; Lotze, Tim
We present the case of a 14-year-old Hispanic boy with a 6-month history of a psychotic disorder necessitating several hospitalizations who was incidentally found to have multiple sclerosis with no physical findings. Neuropsychological assessment has revealed impairments in word-finding, bilateral fine motor skills, and attention. Imaging and…
Brown, Elaine C.; Aman, Michael G.; Lecavalier, Luc
A quantitative method for typing psychopathology of youngsters with mental retardation was assessed. Parents of 601 students in special educational placements rated them with the ABC. The sample was randomly divided into two subgroups. We used Ward's hierarchical method of cluster analysis and derived eight clusters in Subsample 1 and satisfactory…
Sondheimer, Adrian N; Klykylo, William M
The American Psychiatric Association (APA) and the American Academy of Child and Adolescent Psychiatry (AACAP) are the primary organizational embodiments of the specialties of, respectively, general psychiatry and child and adolescent psychiatry in the United States. Professional organizations set guidelines and standards for the expected behaviors of their members. To those ends, ethics committees were established by both the APA and the AACAP. This article describes how each of these organizations, via their committees, produced codes of ethics, and continuously provide relevant educational materials and advocacy efforts. It also reviews the APA ethics committee's responsibility for the evaluation of ethical complaints lodged against members. In closing, the article examines ethical dilemmas lurking on the horizon, beginning to be faced by the specialties and thus likely to be addressed by the committees. PMID:18036488
Farmer, Richard F.; Seeley, John R.; Kosty, Derek B.; Lewinsohn, Peter M.
Research on hierarchical modeling of psychopathology has frequently identified two higher-order latent factors, “internalizing” and “externalizing.” When based on the comorbidity of psychiatric diagnoses, the externalizing domain has usually been modeled as a single latent factor. Multivariate studies of externalizing symptom features, however, suggest multidimensionality. To address this apparent contradiction, confirmatory factor analytic methods and information-theoretic criteria were used to evaluate four theoretically plausible measurement models based on lifetime comorbidity patterns of seven putative externalizing disorders. Diagnostic information was collected at four assessment waves from an age-based cohort of 816 persons between the ages of 14 and 33. A two-factor model that distinguished oppositional behavior disorders (attention–deficit/hyperactivity disorder, oppositional defiant disorder) from social norm violation disorders (conduct disorder, adult antisocial behavior, alcohol use disorder, cannabis use disorder, hard drug use disorder) demonstrated consistently good fit and superior approximating abilities. Analyses of psychosocial outcomes measured at the last assessment wave supported the validity of this two-factor model. Implications of this research for the theoretical understanding of domain-related disorders and the organization of classification systems are discussed. PMID:19899840
Lanyon, Richard I.; Thomas, Michael L.
The 3 Higher Order (HO) scales of the Minnesota Multiphasic Personality Inventory-2 Restructured Form and the 3 core clinical scales of the Psychological Screening Inventory/Psychological Screening Inventory-2 were developed to broadly represent the 3 traditional psychiatric categories of mental disorder: major psychiatric disorder ("psychotic"),…
Sonie, Sandrine; Kassai, Behrouz; Pirat, Elodie; Bain, Paul; Robinson, Janine; Gomot, Marie; Barthelemy, Catherine; Charvet, Dorothee; Rochet, Thierry; Tatou, Mohamed; Assouline, Brigitte; Cabrol, Stephane; Chabane, Nadia; Arnaud, Valerie; Faure, Patricia; Manificat, Sabine
We assessed the accuracy of the French version of the "Autism Spectrum Quotient" ("AQ") in adolescents with Asperger syndrome (AS) and high-functioning autism (HFA) compared to healthy controls and adolescents with psychiatric disorders (PDs). Three groups of adolescents, aged 11-18, were assessed: 116 with AS/HFA (93 with IQ [greater than or…
Hogan, Neil R; Olver, Mark E
The present study examined risk for inpatient aggression, including treatment-related changes in risk, using a battery of 5 forensic instruments. The relative contributions of different types of risk factors to the assessment of risk for inpatient outcomes were also assessed. The Historical-Clinical-Risk Management-20V3, Short-Term Assessment of Risk and Treatability, Violence Risk Scale, Violence Risk Appraisal Guide-Revised, and Psychopathy Checklist-Revised were rated from archival information sources on a sample of 99 adult forensic inpatients from a Canadian psychiatric hospital. Pretreatment and posttreatment ratings were obtained on all dynamic study measures; associations between risk and change ratings with inpatient aggression were examined. Significant pretreatment-posttreatment differences were found on the HCR-20V3, START, and VRS; pretreatment scores on these measures each demonstrated predictive accuracy for inpatient aggression (AUC = .68 to .76) whereas the PCL-R and VRAG-R did not. HCR-20V3, VRS, and START dynamic scores demonstrated incremental predictive validity for inpatient aggression to varying degrees after controlling for static risk factors. Dynamic change scores from these 3 measures also demonstrated incremental concurrent associations with reductions in inpatient aggression after controlling for baseline risk. Several instruments demonstrated predictive validity for inpatient aggression and clinical/dynamic risk and change scores had unique associations with this outcome. The present findings suggest that risk assessments using the HCR-20 V3, START, and VRS may inform the management and reduction of inpatient aggression, as well as assessments of dynamic risk more generally. (PsycINFO Database Record PMID:26828708
Dyl, Jennifer; Kittler, Jennifer; Phillips, Katharine A.; Hunt, Jeffrey I.
Background This study assessed prevalence and clinical correlates of body dysmorphic disorder (BDD), eating disorders (ED), and other clinically significant body image concerns in 208 consecutively admitted adolescent inpatients. It was hypothesized that adolescents with BDD would have higher levels of depression, anxiety, and suicidality. Adolescents with eating disorders were expected to have higher levels of depression, anxiety, and trauma-related symptoms. Trauma-related symptoms were also examined in relation to BDD, in the absence of specific hypotheses. Method Participants completed the Body Dysmorphic Disorder Questionnaire (BDDQ) and reliable and valid self-report measures of suicidality, depression, anxiety, post-traumatic stress disorder (PTSD), dissociation, and sexual preoccupation/distress. Prevalence of BDD, eating disorders, and other clinically significant body image concerns was determined, and clinical correlates were examined. Results 6.7% (n = 14) of participants met DSM-IV criteria for definite (n = 10) or probable (n = 4) DSM-IV BDD, 3.8% (n = 8) met criteria for an eating disorder, and 22.1% (n = 46) had clinically significant shape/weight concerns (SWC) that did not clearly meet criteria for BDD or an eating disorder. Both the BDD and SWC groups scored significantly higher than the group with no significant body image concerns (no BDD/ED/SWC group) on measures of anxiety and suicidality. The BDD, SWC, and ED groups all had significantly higher levels of depression than the no BDD/ED/SWC group. Only the SWC group scored significantly higher than the no BDD/ED/SWC group on measures of PTSD, dissociation, and sexual preoccupation/distress. Conclusions A high proportion of participants had clinically significant body image concerns or a body image disorder. These concerns/disorders were associated with higher levels of depression, anxiety, and suicidality. In addition, the group concerned with body shape or weight had significantly greater
Ravens-Sieberer, Ulrike; Karow, Anne; Barthel, Dana; Klasen, Fionna
This article provides an overview of the conceptual foundations of measuring health-related quality of life (HRQoL) in children and adolescents in child and adolescent psychiatry, and of the current state of research in this field. The available procedures for determining quality of life are presented according to their areas of use and their psychometric characteristics. The internationally available generic instruments for measuring HRQoL in children are identified and assessed in terms of their strengths and weaknesses with regard to selected criteria. As a result, seven generic HRQoL instruments and two utility procedures have been identified which satísfy the following criteria: (i) psychometric qualíty; (ii) age-appropriate measurement; (iii) versions for self-reporting and external rating; and (iv) cross-cultural measurement. The identified instruments satisfy the individual criteria to different degrees. They are increasingly being used in health services research, treatment studies, and epidemiological research; however, they are not yet widely used as part of the clinical routine in child and adolescent psychiatrics. PMID:25152654
Lazar, Christina M; Black, Anne C; McMahon, Thomas J; Rosenheck, Robert A; Ries, Richard; Ames, Donna; Rosen, Marc I
The goal of this project was to develop an evidence-based method to assess the ability of disabled persons to manage federal disability payments. This article describes the development of the Financial Incapability Structured Clinical Assessment done Longitudinally (FISCAL) measure of financial capability. The FISCAL was developed by an iterative process of literature review, pilot testing, and expert consultation. Independent assessors used the FISCAL to rate the financial capability of 118 participants (57% female, 58% Caucasian) who received Social Security disability payments, had recently been treated in acute care facilities for psychiatric disorders, and who did not have representative payees or conservators. Altogether, 48% of participants were determined financially incapable by the FISCAL, of whom 60% were incapable because of unmet basic needs, 91% were incapable because of spending that harmed them (e.g., on illicit drugs or alcohol), 56% were incapable because of both unmet needs and harmful spending, and 5% were incapable because of contextual factors. As expected, incapable individuals scored higher on a measure of money mismanagement (p < .001) compared with capable individuals. Interrater reliability for FISCAL capability determinations was very good (κ = .77) and interrater agreement was 89%. In this population, the FISCAL had construct validity; ratings demonstrated good reliability and correlated with a related measure. Potentially, the FISCAL can be used to validate other measures of capability and to help understand how people on limited incomes manage their funds. PMID:26146947
Zaider, Talia I.; Johnson, Jeffrey G.; Cockell, Sarah J.
Conducted a prospective longitudinal study to investigate whether anxiety, depressive, personality, or substance abuse disorders increase risk for onset of bulimia nervosa (BN) or binge eating disorder (BED) during adolescence. Findings for 201 adolescents suggest that adolescents with chronic depressive symptoms may be at elevated risk for the…
Burriss, F. Antoinette; Breland-Noble, Alfiee M.; Webster, Joe L.; Soto, Jose A.
TOPIC Juvenile mental health courts for adjudicated youth. PURPOSE To describe the role of psychiatric nurses in reducing mental health disparities for adjudicated youth via juvenile mental health courts. SOURCES ISI Web of Knowledge; Sage Journals Online; HighWire; PubMed; Google Scholar and Wiley Online Library and websites for psychiatric nursing organizations. Years included: 2000–2010. CONCLUSIONS Juvenile mental health courts may provide a positive and effective alternative to incarceration for youth with mental health problems with psychiatric nurses playing a key role in program implementation. PMID:21501288
Lescano, Celia M.; Hadley, Wendy S.; Beausoleil, Nancy I.; Brown, Larry K.; D'eramo, Domenic; Zimskind, Abigail
This study examined the factor structure and reliability of a brief but comprehensive measure, the adolescent risk inventory (ARI), designed to assess adolescent risk behaviors and attitudes. Measures assessing demographics and risk behaviors were administered to 134 youth (ages 12-19) in psychiatric treatment. A confirmatory factor analysis of…
Brittain, Philip James; Lobo, Sarah Elizabeth Margaret; Rucker, James; Amarasinghe, Myanthi; Anilkumar, Anantha Padmanabha Pillai; Baggaley, Martin; Banerjee, Pallavi; Bearn, Jenny; Broadbent, Matthew; Butler, Matthew; Campbell, Colin Donald; Cleare, Anthony James; Dratcu, Luiz; Frangou, Sophia; Gaughran, Fiona; Goldin, Matthew; Henke, Annika; Kern, Nikola; Krayem, Abdallah; Mufti, Faiza; McIvor, Ronan; Needham-Bennett, Humphrey; Newman, Stuart; Olajide, Dele; O’Flynn, David; Rao, Ranga; Rehman, Ijaz Ur; Seneviratne, Gertrude; Stahl, Daniel; Suleman, Sajid; Treasure, Janet; Tully, John; Veale, David; Stewart, Robert; McGuffin, Peter; Lovestone, Simon; Hotopf, Matthew; Schumann, Gunter
Progress in personalised psychiatry is dependent on researchers having access to systematic and accurately acquired symptom data across clinical diagnoses. We have developed a structured psychiatric assessment tool, OPCRIT+, that is being introduced into the electronic medical records system of the South London and Maudsley NHS Foundation Trust which can help to achieve this. In this report we examine the utility of the symptom data being collected with the tool. Cross-sectional mental state data from a mixed-diagnostic cohort of 876 inpatients was subjected to a principal components analysis (PCA). Six components, explaining 46% of the variance in recorded symptoms, were extracted. The components represented dimensions of mania, depression, positive symptoms, anxiety, negative symptoms and disorganization. As indicated by component scores, different clinical diagnoses demonstrated distinct symptom profiles characterized by wide-ranging levels of severity. When comparing the predictive value of symptoms against diagnosis for a variety of clinical outcome measures (e.g. ‘Overactive, aggressive behaviour’), symptoms proved superior in five instances (R2 range: 0.06–0.28) whereas diagnosis was best just once (R2∶0.25). This report demonstrates that symptom data being routinely gathered in an NHS trust, when documented on the appropriate tool, have considerable potential for onward use in a variety of clinical and research applications via representation as dimensions of psychopathology. PMID:23520532
Rabenschlag, Franziska; Hoffmann, Sven; Kozel, Bernd; Sprenger, Rosmarie
In the interdisciplinary treatment process nurses play an important role, assessing suicide risk. To cope with this responsibility, the use of assessment instruments is recommended. Although a lot of instruments exist to assess the risk of suicide, nurses do not use them consistently. This cross-sectional study seeks to answer the following questions: How do nurses assess the suicidality of patients of psychiatric hospitals in the German speaking part of Switzerland? Do they use assessment instruments and if so, which ones? Ward nurses in every psychiatric hospital (n = 32) were asked about the state of the nursing practice in assessing the suicide risk by means of an electronic questionnaire. The following results emerged: Nurses use instruments to assess suicide risk on about half of the wards (n = 119, 50.63%). 13% of the mentioned instruments are research-based. Nurses mostly assess suicide endangerment in the case of a presumed danger, less often at admission and least often during the discharge process. As suicidality is assessed mostly when nurses assume a danger in this study, and due to the fact that suicides most frequently occur shortly prior to or during the discharge process, an expansion of or the introduction of the assessment is recommended before the discharge process. PMID:23876661
Sinclair, Samuel J; Siefert, Caleb J; Shorey, Hal S; Antonius, Daniel; Shiva, Andrew; Kehl-Fie, Kendra; Blais, Mark A
Few studies have assessed the psychometric properties of the Personality Assessment Inventory short-form (PAI-SF) clinical scales, and none have conducted these evaluations using participants from psychiatric inpatient units. The present study evaluated item-level tests of scaling assumptions of the PAI-SF using a large (N=503) clinical sample of participants who completed the PAI during their admission to a psychiatric inpatient unit. Internal consistency reliability was high across scales, and tests of item-scale convergence and discrimination generally confirmed hypothesized item groupings. Scale-level correlations supported unique variance being measured by each scale. Finally, agreement between the PAI short- and full-form scales was found to be high. The results are discussed with regards to scale interpretation. PMID:19879654
von Auer, Anne Kristin; Kleindienst, Nikolaus; Ludewig, Sonia; Soyka, Oliver; Bohus, Martin; Ludäscher, Petra
In April 2004 the inpatient unit "Wellenreiter" at the Vorwerker Clinic for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy in Lubeck (Germany) opened its doors. Despite reservations by the therapeutic community, we implemented a specialized treatment for female adolescents with symptoms of borderline personality disorder - the I;>ialectical Behavior Therapy for Adolescents (DBT-A). In this article we present the concept, our experiences, and data from the past 10 years of clinical work in this specialized unit. PMID:26373383
Haggerty, Greg; Blanchard, Mark; Baity, Matthew R.; Defife, Jared A; Stein, Michelle B.; Siefert, Caleb J.; Sinclair, Samuel J.; Zodan, Jennifer
The Social Cognition and Object Relations Scale-Global Rating Method (SCORS-G) is a clinical rating system assessing eight domains of self and interpersonal relational experience which can be applied to narrative response data (e.g., Thematic Apperception Test [TAT; Murray, 1943]; early memories narratives) or oral data (e.g., psychotherapy narratives, Relationship Anecdotal Paradigms). In the current study, seventy-two psychiatrically hospitalized adolescents consented and were rated by their individual and group therapist using the SCORS-G. Clinicians also rated therapy engagement, personality functioning, quality of peer relationships, school functioning, global assessment of functioning (GAF), history of eating disordered behavior and history of nonsuicidal self-injury. SCORS-G composite ratings achieved an acceptable level of inter-rater reliability and were associated with theoretically predicted variables (e.g., engagement in therapy; history of nonsuicidal self-injury). SCORS-G ratings also incrementally improved the prediction of therapy engagement and global functioning beyond what was accounted for by GAF scores. This study further demonstrates the clinical utility of the SCORS-G with adolescents. PMID:25010080
Nguyen, Jacqueline; O'Brien, Casey; Schapp, Salena
Inhalant use refers to the use of substances such as gases, glues, and aerosols in order to achieve intoxication, while inhalant use disorder (IUD) encompasses both DSM-IV-TR criteria for inhalant abuse and dependence. Inhalant use among adolescents is an international public health concern considering the severe medical and cognitive consequences and biopsychosocial correlates. In this paper, we summarize the current state of the literature on inhalant use among adolescents focusing on social context, prevention, assessment, and treatment strategies. Psychoeducation, skills training, and environmental supply reduction are helpful strategies for preventing adolescent inhalant use, while parent and adolescent self-report as well as physician report of medical signs and symptoms can aid in assessment and diagnosis. Although research has only begun to explore the treatment of inhalant use, preliminary findings suggest that a multimodal approach involving individual counselling (i.e., CBT brief intervention), family therapy, and activity and engagement programs is the first-line treatment, with residential treatment programs indicated for more severe presentations. The limited nature of treatments developed specifically for inhalant use combined with high prevalence rates and potential for significant impairment within the adolescent population indicate the need for further research. Research should focus on understanding the social context of use, establishing the efficacy of current adolescent substance use treatments adapted for inhalant use, and exploring long-term outcomes. PMID:26969125
Fine, Adam; Steinberg, Laurence; Frick, Paul J; Cauffman, Elizabeth
Although low self-control is consistently related to adolescent offending, it is unknown whether self-report measures or laboratory behavior tasks yield better predictive utility, or if a combination yields incremental predictive power. This is particularly important because developmental theory indicates that self-control is related to adolescent offending and, consequently, risk assessments rely on self-control measures. The present study (a) examines relationships between self-reported self-control on the Weinberger Adjustment Inventory with Go/No-Go response inhibition, and (b) compares the predictive utility of both assessment strategies for short- and long-term adolescent reoffending. It uses longitudinal data from the Crossroads Study of male, first-time adolescent offenders ages 13-17 (N = 930; 46 % Hispanic/Latino, 37 % Black/African-American, 15 % non-Hispanic White, 2 % other race). The results of the study indicate that the measures are largely unrelated, and that the self-report measure is a better indicator of both short- and long-term reoffending. The laboratory task measure does not add value to what is already predicted by the self-report measure. Implications for assessing self-control during adolescence and consequences of assessment strategy are discussed. PMID:26792266
Hardwick, Peter J.; Rowton-Lee, Martyn A.
Reviews the mental health literature relevant to homicidal children and adolescents. Background and situational factors relevant to risk are described. Background factors include the witnessing of serious violence, both live and on the screen, as well as abuse through neglect and deprivation. Discusses other factors that contribute to homicidal…
Hargrave, T M; Arthur, M E
This article describes the workshop "Teaching Child Psychiatric Assessment Skills: Using Mental Health Screening Instruments," presented at the 35th Forum for Behavioral Sciences in Family Medicine on 20 September 2014. The goals of the presentation were (1) to teach family medicine behavioral health educators to use both general and problem-specific mental health screening tools (MHSTs) in their work with trainees to help satisfy the Accreditation Council for Graduate Medical Education (ACGME) mandate for behavioral and mental health experience during family medicine residency, (2) to reflect on how MHSTs might be integrated into the flow of family medicine teaching practices, and (3) to exemplify how evidence-based methods of adult education might be used in teaching such content. One general MHST, the Pediatric Symptom Checklist-17 and one problem-specific MHST for each of the four commonest pediatric mental health issues: for attention-deficit hyperactivity disorder, the Vanderbilt; for Anxiety, the Screen for Childhood Anxiety-Related Emotional Disorders; for Depression, the Patient Health Questionnaire-9 for teens; and for Aggression, the Retrospective-Modified Overt Aggression Scale, were practiced at least twice in the context of a clinical vignette. All of the selected MHSTs are free in the public domain and available for download from the website: www.CAPPCNY.org. Participants were asked to reflect on their own office practice characteristics and consider how MHSTs might be integrated into their systems of care. This workshop could be replicated by others wishing to teach the use of MHSTs in primary care settings or teaching programs. PMID:26116547
Ahmari, Susanne E.; Eich, Teal; Cebenoyan, Deniz; Smith, Edward E.; Simpson, H. Blair
It has been challenging to identify core neurocognitive deficits that are consistent across multiple studies in patients with Obsessive Compulsive Disorder (OCD). In turn, this leads to difficulty in translating findings from human studies into animal models to dissect pathophysiology. In this article, we use primary data from a working memory task in OCD patients to illustrate this issue. Working memory deficiencies have been proposed as an explanatory model for the evolution of checking compulsions in a subset of OCD patients. However, findings have been mixed due to variability in task design, examination of spatial vs. verbal working memory, and heterogeneity in patient populations. Two major questions therefore remain: first, do OCD patients have disturbances in working memory? Second, if there are working memory deficits in OCD, do they cause checking compulsions?. In order to investigate these questions, we tested 19 unmedicated OCD patients and 23 matched healthy controls using a verbal working memory task that has increased difficulty/task-load compared to classic digit-span tasks. OCD patients did not significantly differ in their performance on this task compared to healthy controls, regardless of the outcome measure used (i.e. reaction time or accuracy). Exploratory analyses suggest that a subset of patients with predominant doubt/checking symptoms may have decreased memory confidence despite normal performance on trials with the highest working memory load. These results suggest that other etiologic factors for checking compulsions should be considered. In addition, they serve as a touchstone for discussion, and therefore help us to generate a roadmap for increasing consensus in the assessment of neurocognitive function in psychiatric disorders. PMID:24994503
Background Non-suicidal self-injury (NSSI) is a common concern among hospitalized adolescents, and can have significant implications for short and long-term prognosis. Little research has been devoted on how personality features in severely ill adolescents interact with NSSI and "attitude toward life and death" as a dimension of suicidality. Developing more specific assessment methodologies for adolescents who engage in self-harm without suicidal intent is relevant given the recent proposal of a non-suicidal self-injury (NSSI) disorder and may be useful in predicting risk in psychiatrically impaired subjects. Methods Consecutively hospitalized adolescents in a psychiatric unit (N = 52; 71% females; age 12-19 years), reporting at least one recent episode of self-harm according to the Deliberate Self-harm Inventory, were administered the Structured Clinical Interview for DSM Mental Disorders and Personality Disorders (SCID I and II), the Children's Depression Inventory and the Multi-Attitude Suicide Tendency Scale (MAST). Results Mean age onset of NSSI in the sample was 12.3 years. All patients showed "repetitive" NSSI (high frequency of self-harm), covering different modalities. Results revealed that 63.5% of adolescents met criteria for Borderline Personality Disorder (BPD) and that the rest of the sample also met criteria for personality disorders with dysregulated traits. History of suicide attempts was present in 46.1% of cases. Elevated depressive traits were found in 53.8%. Results show a statistically significant negative correlation between the score on the "Attraction to Life" subscale of the MAST and the frequency and diversification of self-harming behaviors. Conclusions Most adolescent inpatients with NSSI met criteria for emotionally dysregulated personality disorders, and showed a reduced "attraction to life" disposition and significant depressive symptoms. This peculiar psychopathological configuration must be addressed in the treatment of adolescent
Ben-Zeev, Dror; Scherer, Emily A.; Wang, Rui; Xie, Haiyi; Campbell, Andrew T.
in loneliness were associated with sensor-derived kinesthetic activity (p<.01). Conclusions and implications for practice Smartphones can be harnessed as instruments for unobtrusive monitoring of several behavioral indicators of mental health. Creative leveraging of smartphone sensing will create novel opportunities for close-to-invisible psychiatric assessment at a scale and efficiency that far exceed what is currently feasible with existing assessment technologies. PMID:25844912
Kapfhammer, H P; Mayer, C; Neumeier, R; Scherer, J
The passage from adolescence to young adulthood is characterized by a series of decisive developmental tasks. The significance of the adaptational patterns established in these years derives from their long-lasting influences on the psychosocial development during adult life. The psychosocial development of psychiatrically ill and healthy young adults was compared in respect to self image (Offer), identity status (Adams) and level of ego functionality (Loevinger). Patients showed serious deficits in general psychosocial adaptation (self image) especially pronounced in the areas of private personality development and family life. They were significantly less able to respect a developmental logic of exploration and commitment in the formation of identity. And their level of ego functions was primarily unmature, preconformist. There were important differences in the adaptational patterns of patient subgroups indicating a remarkably unfavourable psychosocial development of the nonpsychotic patients. Subjective (self image) and objective criteria (premorbid adaptation, actual psychosocial competence) of psychosocial development corresponded well. PMID:8146268
McGarry, Denise; Cashin, Andrew; Fowler, Cathrine
Child and adolescent psychiatric nursing (CAPN) as a discipline has been remarkably slow in the uptake of high fidelity human patient simulation (HFHPS) as an education tool. Assuming HFHPS has potential use, and the issue is one of change management, this paper speculates about how Lewin's paradigm for Planned Change might provide guidance to the specialty discipline of CAPN in development of strategies to promote adoption of HFHPS to education of pre-registration nurses. Kurt Lewin (1890-1947) was a seminal theorist of change, whose pioneering work has had significant impact across many disciplines. His theory of Planned Change has four components - field theory, group dynamics, action research and the three-step model of change. Each component is considered briefly and then combined within an example of application. PMID:22800392
More than a half of patients with OCD are classified as early-onset. Early-onset OCD has been indicated to be associated with a greater OCD global severity and more frequently comorbid with tic disorders and other obsessive-compulsive (OC) spectrum disorders, compared with late-onset OCD. Early-onset OCD patients with severe impairment caused by both OC symptoms and comorbid OC spectrum disorders may be identified as being refractory. Tic disorders and autism spectrum disorder (ASD) are child and adolescent psychiatric disorders included in OC spectrum disorders. OCD comorbid with chronic tic disorders including Tourette syndrome (TS) is specified as tic-related OCD. Tic-related OCD is characterized by the high prevalence of early-onset and sensory phenomena including "just right" feeling. Self-injurious behaviors (SIB) such as head banging and body punching often occur in patients with TS. The patients' concern about SIB is likely to trigger them, suggesting that an impulse-control problem is a feature of TS. More than a half of patients with TS have OC symptoms. When OC symptoms in patients with TS were assessed with a dimensional approach, symmetry dimension symptoms were found most frequently over the lifetime. On the other hand, the severity of aggression dimension symptoms was the most stable during the course among all dimensions. Aggression dimension symptoms also exhibited a close relationship with impairment of global functioning and sensory phenomena. This tendency may be characteristic of tic-related OCD. It is sometimes difficult to differentiate between OC symptoms and restricted, repetitive behaviors which are core symptoms of ASD. Recently, ego-dystonia and insight are considered non-essential to diagnose OCD, whereas high-functioning and/or atypical ASD is recognized as being more prevalent than previously estimated. In this situation, attention to comorbidity of OCD and ASD is increasing, and the prevalence of OCD in children and adolescents with
Ferreira, Alcinéia Donizeti; Sponholz, Alcion; Mantovani, Célia; Pazin-Filho, Antônio; Passos, Afonso Dinis Costa; Botega, Neury José; Del-Ben, Cristina Marta
The objective of this study was to characterize admissions to an emergency hospital due to suicide attempts and verify outcomes in 2 years. Data were collected from medical records and were analyzed using descriptive statistics and logistic regression. The sample consisted of 412 patients (58.7% women; mean age = 32.6 years old, SD = 14.3). Self-poisoning was the most frequent method (84.0%), and they were diagnosed mainly as depressive (40.3%) and borderline personality disorders (19.1%). Previous suicide attempts and current psychiatric treatment were reported by, respectively, 32.0% and 28.4%. Fifteen patients (3.6%, 9 males) died during hospitalization. At discharge, 79.3% were referred to community-based psychiatric services. Being male (OR = 2.11; 95% CI = 1.25-3.55), using violent methods (i.e., hanging, firearms, and knives) (OR = 1.96; 95% CI = 1.02-3.75) and psychiatric treatment history (OR = 2.58; 95% CI = 1.53-4.36) were predictors for psychiatric hospitalization. Of 258 patients followed for 2 years, 10 (3.9%) died (3 suicide), and 24 (9.3%) undertook new suicide attempts. Patients with a history of psychiatric treatment had higher risks of new suicide attempts (OR = 2.46, 95% CI = 1.07-5.65). Suicide attempters admitted to emergency hospitals exhibit severe psychiatric disorders, and despite interventions, they continue to present high risks for suicide attempts and death. PMID:25961847
Dudley, Cheryl; O'Sullivan, Lucia F.; Moreau, Donna
A study examined the association between sexual risk behaviors of 110 psychiatrically referred Latino girls aged 13-18 and their HIV knowledge. Questionnaires completed by the girls indicated that girls engaging in higher levels of sexual activity had clearly acquired accurate knowledge concerning HIV transmission but had not integrated it into…
Joshi, Gagan; Petty, Carter; Wozniak, Janet; Henin, Aude; Fried, Ronna; Galdo, Maribel; Kotarski, Meghan; Walls, Sarah; Biederman, Joseph
The objective of the study was to systematically examine patterns of psychiatric comorbidity in referred youth with autism spectrum disorders (ASD) including autistic disorder and pervasive developmental disorder not otherwise specified. Consecutively referred children and adolescents to a pediatric psychopharmacology program were assessed with…
Journal of the American Academy of Child and Adolescent Psychiatry, 2007
Oppositional defiant disorder (ODD) is a common clinical problem in children and adolescents. Oppositionality and associated types of aggressive behavior are among the most common referral problems in child psychiatry. Grouped among the disruptive behavior disorders, ODD is frequently comorbid with other psychiatric conditions and often precedes…
Mlott, S R; Lira, F T; Campbell, P L
Forty in-patient adolescents and 40 non-hospitalized adolescents, comparable in age, sex, education, birth position and socioeconomic level, and their parents were administered the Rokeach Dogmatism Scale, Barksdale Self-Esteem Evaluation Scale, the Singer and Antrobus Imaginal Process Inventory, and the Elms Empathic Fantasy Scale. Distinct differences were found between the in-patient adolescent and his/her parents in aspects of fantasy, empathy, dogmatism, and self-esteem, while the non-hospitalized adolescents were very similar in fantasy with both parents. In addition, both parents of the nonhospitalized adolescents had greater levels of self-esteem with less dogmatism evident in the fathers. The results are discussed in terms of the identification process and modeling, the socialization process with its suppression or reduction of taboo drive manifestations and fantasy as a means of achieving unattainable drives. PMID:676838
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,…
Stoelb, Matt; Chiriboga, Jennifer
This comprehensive assessment process model includes primary, secondary, and situational risk factors and their combined implications and significance in determining an adolescent's level or risk for suicide. Empirical data and clinical intuition are integrated to form a working client model that guides the professional in continuously reassessing…
Van Horn, M. Lee; Hawkins, J. David; Arthur, Michael W.; Catalano, Richard F.
This study investigates community-level prediction of adolescent substance use and problem behaviors using ratings by community leaders to assess the effects of four risk factors on levels of drug use and problem behaviors. Three questions are examined: (a) Can psychometrically sound measures of community leader perceptions of risk factors in…
Schmitz, Katharine E.; Hovell, Melbourne F.; Nichols, Jeanne F.; Irvin, Veronica L.; Keating, Kristen; Simon, Gayle M.; Gehrman, Christine; Jones, Kenneth Lee
This study aimed to determine whether self-assessed puberty is sufficiently reliable and valid to substitute for physician examination when feasibility of physician examination is low (e.g., behavioral research). Adolescents (convenience sample N = 178 endocrinology patients and N = 125 from educational trial; mean age 12.7 and 11.3 years,…
Gray, Barbara P; Dihigo, Sharolyn K
A significant number of adolescents experience depression and other mental health disorders that may put them at risk for suicide. Mental health assessment is an important component of primary healthcare. Depression and suicide risk screening can assist healthcare providers in preventing suicides. PMID:26262455
Kuhn, Brett R.; Mayfield, Joan W.; Kuhn, Robert H.
Provides guidelines for counselors interested in developing their own assessment procedure to evaluate child and adolescent sleep disturbance. Guidelines include reviewing the developmental and medical history, screening for parental psychopathology, obtaining a child behavior rating scale and sleep diary, and conducting a semistructured clinical…
Feasibility trials assess whether a behavior change program warrants a definite trial evaluation. This paper reports the feasibility of an intervention consisting of Self Determination Theory-informed text messages, pedometers, and goal prompts to increase adolescent physical activity. A 4-group ran...
King, H. Elizabeth; And Others
These papers on child and adolescent sexual abuse address the psychological consequences, psychological assessment techniques, and clinical issues in group therapy with sexually abused girls. In the first paper. H. Elizabeth King discusses the psychological consequences of sexual assault and incest on minors particularly in regard to family…
Accurate appropriate assessment of overweight and obesity in children and adolescents is a critical aspect of contemporary medical care. However, physicians and other health care professionals may find this a somewhat thorny field to enter. The BMI has become the standard as a reliable indicator of ...
Channaveerachari, Naveen Kumar; Raj, Aneel; Joshi, Suvarna; Paramita, Prajna; Somanathan, Revathi; Chandran, Dhanya; Kasi, Sekar; Bangalore, N. Roopesh; Math, Suresh Bada
Purpose: To present the descriptive data on the frequency of medical and psychiatric morbidity and also to discuss various pertinent issues relevant to the disaster management, the future challenges and psychosocial needs of the 2013 floods in Uttarakhand, India. Materials and Methods: Observation was undertaken by the disaster management team of National Institute of Mental Health and Neurosciences in the worst affected four districts of Uttarakhand. Qualified psychiatrists diagnosed the patients using the International Classification of Diseases-10 criteria. Data were collected by direct observation, interview of the survivors, group sessions, individual key-informant interview, individual session, and group interventions. Results: Patients with physical health problems formed the majority of treatment seekers (39.6%) in this report. Only about 2% had disaster induced psychiatric diagnoses. As was expected, minor mental disorders in the form of depressive disorders and anxiety disorders formed majority of the psychiatric morbidity. Substance use disorders appear to be very highly prevalent in the community; however, we were not able to assess the morbidity systematically. Conclusions: The mental health infrastructure and manpower is abysmally inadequate. There is an urgent need to implement the National Mental Health Program to increase the mental health infrastructure and services in the four major disaster-affected districts. PMID:25969596
Copeland, William E; Shanahan, Lilly; Davis, Maryann; Burns, Barbara; Angold, Adrian; Costello, E. Jane
Objective During the transition to young adulthood, youth face challenges that may limit their likelihood of obtaining service use for psychiatric problems. The goal of this analysis is to estimate changes in service use rates and untreated psychiatric cases during the transition from adolescence to adulthood. Methods In a prospective, population-based study, participants were assessed up to 4 times in adolescence (ages 13 to 16; 3983 observations of 1297 participants collected between 1993 and 2000) and 3 times in young adulthood (ages 19, 21, and 24–26; 3215 observations of 1273 participants collected between 1999 and 2010). Structured diagnostic interviews were used to assess service need (DSM-IV psychiatric status) and behavioral service use in 21 service settings. Results During young adulthood, only 28.9% of those meeting DSM-IV diagnostic criteria also received some treatment in the past 3 months. This compared to 50.9% for the same participants during adolescence. This includes a near-complete drop in use of educational/vocational services as well as declines in use of specialty behavioral services. Young adults most frequently accessed services in either specialty behavioral or general medical settings. Males, African-Americans, those with substance dependence and those living independently were least likely to get treatment. Insurance and poverty status were unrelated to likelihood of service use in young adult psychiatric cases. Conclusion Young adults with psychiatric problems are much less likely to receive treatment than when they were adolescents. Public policy needs to address the gap in service use during the transition to adulthood. PMID:25554854
Bolten, Margarete I
Infant mental health problems include difficulties to regulate emotions or attention, crying, sleeping or feeding problems as well as aggressive behavior. Early identifications of these problems help to change developmental trajectories and improve developmental outcomes. Psychiatric assessment and classification have to take into account the rapid processes of development as well as the inseparable linkage between symptoms of the infant, psychosocial risks in the family environment, and parent-child relations. The proposed DSM-5 classification system presents a systematic description of mental health disorders which are relevant for infant psychiatry. However, the proposal has provided rather limited attention to developmental differences and parent-infant relations. Therefore, additional classification systems, like the Zero-to-Three (DC: 0-3R), are strongly recommended. In terms of assessment and in accordance with the guidelines of the American Academy of Child and Adolescent Psychiatry, infant psychiatrists have to consider the close relation between somatic and mental health and the interplay between behaviors of the caregiver and the infant. Therefore, the assessment has to be multidisciplinary and relationship based. A standard assessment in infancy includes a clinical interview, behavior observations, caregiver questionnaires, and a pediatric screening. All assessments should pay attention to motor, cognitive, language, and social-emotional development. Because infant development is embedded in the family context, socio-economic factors, parents' mental problems, including drug abuse, domestic violence, and trauma history should be assessed. The treatment has to be oriented toward symptoms and development and has to address underlying medical conditions. The focus should be on parent-child interactions. Evidence-based interventions are based on attachment theory, use social-learning perspectives, and behavioral approaches. PMID:23229140
de Oliveira, Cristiane Franco; da Silveira, Carla Rosane; Beghetto, Mariur; de Mello, Paula Daniel; de Mello, Elza Daniel
OBJECTIVE: To evaluate the daily calcium intake of adolescents in schools from Chapecó, Santa Catarina, Southern Brazil, to check if calcium intake is in accordance with the Dietary Reference Intakes (DRI), and to investigate variables associated with daily calcium intake. METHODS: Cross-sectional study approved by the Institutional Review Board and developed in 2010. Students of the 8th grade completed questionnaires with personal data and questions about the calcium-rich foods intake frequency. In order to compare students with adequate (1300mg) or inadequate intake of calcium/day (<1300mg), parametric and nonparametric tests were used. RESULTS: A total of 214 students with a mean age of 14.3±1.0 years were enrolled. The median daily calcium intake was 540mg (interquartile range - IQ: 312-829mg) and only 25 students (11.7%) had calcium intake within the recommendations of the DRI for age. Soft drink consumption ≥3 times/week was associated with a lower intake of calcium. CONCLUSIONS: Few students ingested adequate levels of calcium for the age group. It is necessary to develop a program to encourage a greater intake of calcium-rich foods in adolescence. PMID:25119753
in their lives with varying and varied attempts to master, or cope with, the inevitable change in their existential status. Some try but fail and some fail to try, with resulting despair that can lead those adolescents to believe that suicide is the only choice they have to end their suffering. We described how psychodynamics can influence motivation, relationships, and behaviors, and how these may contribute to an outcome of suicide. Existing psychopathological conditions contribute. These include anxiety, dysthymia, posttraumatic stress disorders, acute reactive disorders, major affective disorders, severe conduct disorders, and psychotic disorders. We considered the possible lethal interplay between psychodynamic and psychopathological factors. This led to the crux of this report, a full discussion of prevention and treatment. The first and most important aspect of suicide prevention is early recognition of the adolescent at risk. It is of high priority to detect and treat those psychiatric disorders accompanied by greatest suicidal risk; depression, conduct disorders, substance abuse disorders, borderline conditions, and schizoaffective disorders. With all adolescents, threats of suicide must be taken seriously. There should be an immediate, complete psychiatric workup preferably before specific treatment begins. If crisis intervention must precede diagnostic study, the workup should not be delayed longer than necessary. Education of health care professionals, educators, families, and peers about warning signs can emphasize early intervention and thereby enable a skilled psychiatrist to assess suicidal thoughts, plans, means, and previous attempts, past and current life stresses, and available family and environmental support. All of this information will lead to a decision regarding hospitalization and treatment for the adolescent.(ABSTRACT TRUNCATED) PMID:8721288
Wong-Anuchit, Choochart; Mills, Andrew C; Schneider, Joanne Kraenzle; Rujkorakarn, Darunee; Kerdpongbunchote, Chusri; Panyayong, Benjaporn
This paper reports the translation of the English Internalized Stigma of Mental Illness scale into Thai and assessment of its psychometric properties. After forward- and backward-translation, Thai experts completed the content validity index with item agreements of .86 to 1.00. Data were collected from 390 psychiatric clinic patients in central Thailand using systematic random sampling. Unweighted least squares factor analysis with Promax rotation identified five subscales. Cronbach's alpha for scale reliability was .88, and correlations for construct validity ranged from r=.55 to .69. These findings support the validity and reliability of the Thai version of the scale. PMID:27455917
Milin, Robert; Manion, Ian; Dare, Glenda; Walker, Selena
A study to identify and assess the withdrawal symptoms in adolescents afflicted with cannabis dependence is conducted. Results conclude that withdrawal symptoms of cannabis were present in adolescents seeking treatment for this substance abuse.
Minden, Sarah L.; Feinstein, Anthony; Kalb, Rosalind C.; Miller, Deborah; Mohr, David C.; Patten, Scott B.; Bever, Christopher; Schiffer, Randolph B.; Gronseth, Gary S.; Narayanaswami, Pushpa
Objective: To make evidence-based recommendations for screening, diagnosing, and treating psychiatric disorders in individuals with multiple sclerosis (MS). Methods: We reviewed the literature (1950 to August 2011) and evaluated the available evidence. Results and recommendations: Clinicians may consider using the Center for Neurologic Study Emotional Lability Scale to screen for pseudobulbar affect (Level C). Clinicians may consider the Beck Depression Inventory and a 2-question tool to screen for depressive disorders and the General Health Questionnaire to screen for broadly defined emotional disturbances (Level C). Evidence is insufficient to support/refute the use of other screening tools, the possibility that somatic/neurovegetative symptoms affect these tools' accuracy, or the use of diagnostic instruments or clinical evaluation procedures for identifying psychiatric disorders in MS (Level U). Clinicians may consider a telephone-administered cognitive behavioral therapy program for treating depressive symptoms (Level C). Although pharmacologic and nonpharmacologic therapies are widely used to treat depressive and anxiety disorders in individuals with MS, evidence is insufficient to support/refute the use of the antidepressants and individual and group therapies reviewed herein (Level U). For pseudobulbar affect, a combination of dextromethorphan and quinidine may be considered (Level C). Evidence is insufficient to determine the psychiatric effects in individuals with MS of disease-modifying and symptomatic therapies and corticosteroids; risk factors for suicide; and treatment of psychotic disorders (Level U). Research is needed on the effectiveness in individuals with MS of pharmacologic and nonpharmacologic treatments frequently used in the non-MS population. PMID:24376275
During 1990-1993, 83,000 ethnic Nepalese fled from Bhutan to refugee camps in southeast Nepal after new citizenship policies were enacted by the Bhutanese government. Although annual nutrition surveys of children aged <5 years had been conducted by international agencies, no anthropometric assessment of adolescents had been performed since the refugees arrived in 1990. After withdrawal of a fortified cereal from their rations, the number of reported cases of angular stomatitis (AS) (i.e., thinning and/or fissuring at the angles of the mouth, a sign of possible vitamin deficiency) increased six-fold during December 1998-March 1999 (from 5.5 to 35.6 cases per 1000 refugees) (Santa Tamang, MD, Save the Children Fund, United Kingdom, personal communication, 1999). The highest rates of AS were found among children and adolescents. In October 1999, CDC was invited by the World Food Programme and the United Nations High Commissioner for Refugees to assess the health status of adolescent refugees. This report summarizes the investigation, which indicated a high prevalence of low body mass index (BMI), anemia, low vitamin A status, and signs of micronutrient deficiencies among adolescent refugees. PMID:11032093
Austin, Cynthia A; Krumholz, Lauren S; Tharinger, Deborah J
This case study provides an in-depth example of a comprehensive therapeutic assessment with an adolescent (TA-A) and his parents. The TA-A addressed parental concerns about their son's drug experimentation as well as the adolescent's own private questions about his distinctiveness from others, all set against a backdrop of ongoing parental conflict and poor communication. The TA-A process and how it is specifically tailored to balance the needs of adolescents and their parents is discussed. Subsequently, each step of TA-A is illustrated through the case study. Research findings at the conclusion of the assessment and at follow-up indicated significant decreases in internalizing symptomology and school problems, increases in self-esteem and self-reliance, and improved family functioning as reported by the adolescent. At follow-up, the father spoke of developing a more assertive parenting approach and successful follow-through on recommendations. This case study provides a template for clinicians interested in conducting TA-A. PMID:22475356
Dias, Philomena J
There are no gold-standard tests for evaluating a teen suspected of abusing substances. Awareness of the high prevalence of substance abuse in youth, a high index of suspicion, and a firm desire to be a part of the solution are all that is required to address the problem of substance abuse in youth. In an age of "dotcoms" and societal complexity that fosters an emotionally "disconnected" atmosphere by uniting adolescents only by what they buy, plug into, click on, or blast away, teens need trusted medical homes where caring pediatricians are available to give youth accurate and authoritative facts and care to help them build inner resilience and connect them to the pain and hurt of the people in their lives. Until now, the "three strikes and you're out" maxim has been applied in medical care. This maxim may work for baseball, Clintonomics, and practical office management strategies but is not recommended for addressing the needs of substance using or abusing youth who are prey to advertising strategies. The size of the marketing and advertising budgets of the alcohol and cigarette industries is an indication of the relentless marketing directed toward vulnerable youth. Pediatricians would be doing teens a disservice if they fail to countermand this marketing effect by not using the "rule of seven"--the "seven 'S' screen," seven education attempts, seven different ways over 7 years, and persistence over seven attempts of chemically dependent adolescents to quit. It has been said by Osler that "These are our methods--to carefully observe the phenomena of life in all its stages, to cultivate the reasoning of the faculty so as to be able to know the true from the false. This is our work--to prevent disease, to relieve suffering, to heal the sick," and provide HOPE always. PMID:11993283
Roberts, Robert E.; Roberts, Catherine Ramsay; Xing, Yun
Objective: The authors present prevalence data for adolescents in a large metropolitan area and examine the association of DSM-IV diagnoses with functional impairment and selected demographic correlates among European Americans (EA), African Americans (AA), and Mexican (MA) Americans. Method: The authors sampled 4,175 youths ages 11 to 17 years…
Andrade, Naleen N.; Hishinuma, Earl S.; McDermott, John F., Jr.; Johnson, Ronald C.; Goebert, Deborah A.; Makini, George K., Jr.; Nahulu, Linda B.; Yuen, Noelle Y. C.; McArdle, John J.; Bell, Cathy K.; Carlton, Barry S.; Miyamoto, Robin H.; Nishimura, Stephanie T.; Else, Iwalani R. N.; Guerrero, Anthony P. S.; Darmal, Arsalan; Yates, Alayne; Waldron, Jane A.
Objectives: The prevalence rates of disorders among a community-based sample of Hawaiian youths were determined and compared to previously published epidemiological studies. Method: Using a two-phase design, 7,317 adolescents were surveyed (60% participation rate), from which 619 were selected in a modified random sample during the 1992-1993 to…
Thurstone, Christian; Riggs, Paula D.; Klein, Constance; Mikulich-Gilbertson, Susan K.
Objective: To explore change in human immunodeficiency virus (HIV) risk among teens in outpatient treatment for substance use disorders (SUDs). Method: From December 2002 to August 2004, 50 adolescents (13-19 years) with major depressive disorder, conduct disorder, and one or more non-nicotine SUD completed the Teen Health Survey (THS) at the…
Akroyd, Mike; Jordan, Gary; Rowlands, Paul
People with serious mental illness have reduced life expectancy compared with a control population, much of which is accounted for by significant physical comorbidity. Frontline clinical staff in mental health often lack confidence in recognition, assessment and management of such 'medical' problems. Simulation provides one way for staff to practise these skills in a safe setting. We produced a multidisciplinary simulation course around recognition and assessment of medical problems in psychiatric settings. We describe an audit of strategic and design aspects of the recognition and assessment of medical problems in psychiatric settings course, using the Department of Health's 'Framework for Technology Enhanced Learning' as our audit standards. At the same time as highlighting areas where recognition and assessment of medical problems in psychiatric settings adheres to these identified principles, such as the strategic underpinning of the approach, and the means by which information is collected, reviewed and shared, it also helps us to identify areas where we can improve. PMID:25425630
Brunault, Paul; Gohier, Bénédicte; Ducluzeau, Pierre-Henri; Bourbao-Tournois, Céline; Frammery, Julie; Réveillère, Christian; Ballon, Nicolas
Bariatric surgery is indicated in obese patients with a BMI ≥ 40 kg/m(2) or ≥ 35 kg/m(2) with serious comorbidities, in second intention in patients who failed to achieve significant weight loss after a well-managed medical, nutritional and psychotherapeutic treatment for 6 to 12 months, and in patients who are aware of the consequences of bariatric surgery and who agree with a long term medical and surgical follow-up. Such a treatment requires a preoperative multidisciplinary assessment and management, which includes a mandatory consultation with a psychiatrist or a psychologist that should be member of the multidisciplinary staff and participate in these staffs. Although one of this consultation's aim is to screen for the few patients who for which surgery is contra-indicated, in most cases, the main aim of this assessment is to screen for and manage psychiatric and psychopathologic disorders that could be temporary contra-indication, because these disorders could lead to poorer postoperative outcome when untreated. By explaining to the patient how these disorders could affect postoperative outcome and which benefits he could retrieve from their management, the patient will increase his motivation for change and he will be more likely to seek professional help for these disorders. In all cases, a systematic examination of the patient's personality and his/her ability to understand the postoperative instructions is essential before surgery because clinicians should check that the patient is able to be adherent to postoperative instructions. In addition to clinical interview, use of self-administered questionnaires before the consultation might help to determine which psychiatric or psychopathologic factors should be more closely screened during the consultation. Psychiatric disorders and addictions are highly prevalent in this population (e.g., mood and anxiety disorders, binge eating disorder, attention deficit hyperactivity disorder, addictions, personality
Shoemaker, Erica Z; Tully, Laura M; Niendam, Tara A; Peterson, Bradley S
The last two decades have marked tremendous progress in our ability to prevent and intervene early in psychiatric illnesses. The interventions described in this article range from established, empirically-supported treatments to creative interventions early in their development and deployment. Some of these interventions are low-technology programs delivered in social settings (such as schools), and some rely on sophisticated emerging technologies such as neuroimaging. This article reviews 4 preventative interventions: 1) The use of structural brain imaging to identify children at risk for familial depression who are most likely to benefit from preventative cognitive behavioral therapy 2) The Good Behavior Game, a school based program that, when implemented in 1st grade classrooms, cut the incidence of substance use disorders in students in half when those students were 19 years old, 3) The SPARX video game, which has the potential to be an accessible, appealing, and cost-effective treatment for the thousands of teens affected by mild to moderate depressive disorders, and 4) Intensive psychosocial treatments which can reduce the progression of from the ultra high risk state to the first episode psychosis by 50% over 12 months. All of these interventions have tremendous potential to reduce the suffering and disability caused by psychiatric illness to both children and adults. PMID:26300034
Arjun, Torwane Nilesh; Sudhir, Hongal; Sahu, R. N.; Saxena, Vrinda; Saxena, Eshani; Jain, Shubham
Aim: The aim of the current cross-sectional study was to assess oral mucosal lesions among psychiatric jail patients residing in central jail, Bhopal, Madhya Pradesh, India. Materials and Methods: The study subjects consisted of prediagnosed psychiatric patients residing in central jail, Bhopal. A matched control consisting of cross section of the population, that is, jail inmates residing in the same central jail locality was also examined to compare the psychiatric subjects. The WHO oral health assessment proforma, 1997 along with 18-item questionnaire was used for the oral health examination. Results: A total number of subjects examined were 244, which comprised of 122 psychiatric inmates and 122 nonpsychiatric inmates. Among all psychiatric inmates, about 57.4% of inmates had a diagnosis of depression, 14.8% had psychotic disorders (like schizophrenia), and 12.3% had anxiety disorder. A total of 77% study inmates, which comprised of 87.7% psychiatrics and 66.4% nonpsychiatrics had a habit of tobacco consumption (smokeless or smoking). Overall prevalence of oral mucosal lesions among the inmates was 85 (34.8%), which comprised of 39.3% psychiatric inmates and 30.3% nonpsychiatric inmates. Conclusion: The information presented in this study adds to our understanding of the common oral mucosal lesions occurring in a psychiatric inmate population. Leukoplakia and oral submucous fibrosis were the most common types of oral mucosal lesions found. Efforts to increase patient awareness of the oral effects of tobacco use and to eliminate the habit are needed to improve oral and general health of the prison population. PMID:25316937
Rigoni, Davide; Pellegrini, Silvia; Mariotti, Veronica; Cozza, Arianna; Mechelli, Andrea; Ferrara, Santo Davide; Pietrini, Pietro; Sartori, Giuseppe
Despite the advances in the understanding of neural and genetic foundations of violence, the investigation of the biological bases of a mental disorder is rarely included in psychiatric evaluation of mental insanity. Here we report on a case in which cognitive neuroscience and behavioral genetics methods were applied to a psychiatric forensic evaluation conducted on a young woman, J.F., tried for a violent and impulsive murder. The defendant had a history of multidrug and alcohol abuse and non-forensic clinical evaluation concluded for a diagnosis of borderline personality disorder. We analyzed the defendant's brain structure in order to underlie possible brain structural abnormalities associated with pathological impulsivity. Voxel-based morphometry indexed a reduced gray matter volume in the left prefrontal cortex, in a region specifically associated with response inhibition. Furthermore, J.F.'s DNA was genotyped in order to identify genetic polymorphisms associated with various forms of violence and impulsive behavior. Five polymorphisms that are known to be associated with impulsivity, violence, and other severe psychiatric illnesses were identified in J.F.'s DNA. Taken together, these data provided evidence for the biological correlates of a mental disorder characterized by high impulsivity and aggressive tendencies. Our claim is that the use of neuroscience and behavioral genetics do not change the rationale underlying the determination of criminal liability, which must be based on a causal link between the mental disorder and the crime. Rather, their use is crucial in providing objective data on the biological bases of a defendant's mental disorder. PMID:21031162
Hadley, Wendy; Barker, David H.; Lescano, Celia M.; Stewart, Angela J.; Affleck, Katelyn; Donenberg, Geri; DiClemente, Ralph; Brown, Larry K.
Aims To assess the associations of sexual risk behavior with psychiatric impairment and individual, peer, and partner attitudes among adolescents receiving mental health treatment. Methods Adolescents (N=893, 56% female, 67% African American) completed assessments of psychiatric impairment, rejection sensitivity, peer norms, HIV knowledge, perceived vulnerability, self-efficacy and condom use intentions. Two structural equation models were used to test the study hypotheses; one for sexually active youth and one for non-active youth. Results For non-active youth, psychiatric impairment influenced self-efficacy and condom use intentions via peer norms, rejection sensitivity, and perceived vulnerability. Among the sexually active youth, sexual risk was related to impairment and previous condom use. Discussion These results suggest that individual, peer, and partner factors are related to impairment and to sexual risk attitudes, but depend on previous sexual experience. PMID:26023302
Crespi, Tony D.; Politikos, Natalie N.
Approximately 4.5 to 6.3 million youth experience serious emotional disturbances. Unfortunately, many of them have unmet mental health needs. Tools used in personality assessment can offer unparalleled assistance in diagnosis, and assist in designing appropriate interventions. Unfortunately, not all psychologists embrace personality assessment as…
Laird, Robert D.; Marrero, Matthew D.; Melching, Jessica; Kuhn, Emily S.
Studies of privacy invasion have relied on measures that combine items assessing adolescents' feelings of privacy invasion with items assessing parents' monitoring behaviors. Removing items assessing parents' monitoring behaviors may improve the validity of assessments of privacy invasion. Data were collected from 163 adolescents (M age 13 years,…
Okoniewski, Anastasia; Tiase, Victoria; Low, Alexander; Rodriguez, Martha; Kaplan, Steven
Background Use of mobile technology has made a huge impact on communication, access, and information/resource delivery to adolescents. Mobile technology is frequently used by adolescents. Objective The purpose of this study was to understand the health information needs of adolescents in the context of their everyday lives and to assess how they meet their information needs. Methods We gave 60 adolescents smartphones with unlimited text messaging and data for 30 days. Each smartphone had applications related to asthma, obesity, human immunodeficiency virus, and diet preinstalled on the phone. We sent text messages 3 times per week and asked the following questions: (1) What questions did you have about your health today? (2) Where did you look for an answer (mobile device, mobile application, online, friend, book, or parent)? (3) Was your question answered and how? (4) Anything else? Results Our participants ranged from 13-18 years of age, 37 (62%) participants were male and 22 (37%) were female. Of the 60 participants, 71% (42/60) participants identified themselves as Hispanic and 77% (46/60) were frequent users of mobile devices. We had a 90% (1935/2150) response rate to our text messages. Participants sent a total of 1935 text messages in response to the ecological momentary assessment questions. Adolescents sent a total of 421 text messages related to a health information needs, and 516 text messages related to the source of information to the answers of their questions, which were related to parents, friends, online, mobile apps, teachers, or coaches. Conclusions Text messaging technology is a useful tool for assessing adolescents’ health behavior in real-time. Adolescents are willing to use text messaging to report their health information. Findings from this study contribute to the evidence base on addressing the health information needs of adolescents. In particular, attention should be paid to issues related to diet and exercise. These findings may be
Goodman, Jarid; Marsh, Rachel; Peterson, Bradley S.; Packard, Mark G.
Extensive evidence indicates that mammalian memory is organized into multiple brains systems, including a “cognitive” memory system that depends upon the hippocampus and a stimulus-response “habit” memory system that depends upon the dorsolateral striatum. Dorsal striatal-dependent habit memory may in part influence the development and expression of some human psychopathologies, particularly those characterized by strong habit-like behavioral features. The present review considers this hypothesis as it pertains to psychopathologies that typically emerge during childhood and adolescence. These disorders include Tourette syndrome, attention-deficit/hyperactivity disorder, obsessive-compulsive disorder, eating disorders, and autism spectrum disorders. Human and nonhuman animal research shows that the typical development of memory systems comprises the early maturation of striatal-dependent habit memory and the relatively late maturation of hippocampal-dependent cognitive memory. We speculate that the differing rates of development of these memory systems may in part contribute to the early emergence of habit-like symptoms in childhood and adolescence. In addition, abnormalities in hippocampal and striatal brain regions have been observed consistently in youth with these disorders, suggesting that the aberrant development of memory systems may also contribute to the emergence of habit-like symptoms as core pathological features of these illnesses. Considering these disorders within the context of multiple memory systems may help elucidate the pathogenesis of habit-like symptoms in childhood and adolescence, and lead to novel treatments that lessen the habit-like behavioral features of these disorders. PMID:24286520
Neumann, Anna; van Lier, Pol A. C.; Gratz, Kim L.; Koot, Hans M.
The authors explored the utility of the Difficulties in Emotion Regulation Scale (DERS) in assessing adolescents' emotion regulation. Adolescents (11-17 years; N = 870) completed the DERS and measures of externalizing and internalizing problems. Confirmatory factor analysis suggested a similar factor structure in the adolescent sample of the…
Schap, T E; Zhu, F; Delp, E J; Boushey, C J
The use of image-based dietary assessment methods shows promise for improving dietary self-report among children. The Technology Assisted Dietary Assessment (TADA) food record application is a self-administered food record specifically designed to address the burden and human error associated with conventional methods of dietary assessment. Users would take images of foods and beverages at all eating occasions using a mobile telephone or mobile device with an integrated camera [e.g. Apple iPhone, Apple iPod Touch (Apple Inc., Cupertino, CA, USA); Nexus One (Google, Mountain View, CA, USA)]. Once the images are taken, the images are transferred to a back-end server for automated analysis. The first step in this process is image analysis (i.e. segmentation, feature extraction and classification), which allows for automated food identification. Portion size estimation is also automated via segmentation and geometric shape template modeling. The results of the automated food identification and volume estimation can be indexed with the Food and Nutrient Database for Dietary Studies to provide a detailed diet analysis for use in epidemiological or intervention studies. Data collected during controlled feeding studies in a camp-like setting have allowed for formative evaluation and validation of the TADA food record application. This review summarises the system design and the evidence-based development of image-based methods for dietary assessment among children. PMID:23489518
Abbey, Joan M.
The value of early identification of sexually aberrant behaviors and intervention with sexually deviant minors is obvious from a community safety perspective. Early intervention also appears to have value from the offender's perspective. A research review revealed several common themes with implications for both assessment and treatment. Most…
Lock, James; La Via, Maria C
This Practice Parameter reviews evidence-based practices for the evaluation and treatment of eating disorders in children and adolescents. Where empirical support is limited, clinical consensus opinion is used to supplement systematic data review. The Parameter focuses on the phenomenology of eating disorders, comorbidity of eating disorders with other psychiatric and medical disorders, and treatment in children and adolescents. Because the database related to eating disorders in younger patients is limited, relevant literature drawn from adult studies is included in the discussion. PMID:25901778
Manzardo, Ann M.; Poje, Albert B.; Penick, Elizabeth C.; Butler, Merlin G.
Chronic alcohol use alters adaptive immunity and cytokine activity influencing immunological and hormone responses, inflammation, and wound healing. Brain cytokine disturbances may impact neurological function, mood, cognition and traits related to alcoholism including impulsiveness. We examined the relationship between plasma cytokine levels and self-rated psychiatric symptoms in 40 adult males (mean age 51 ± 6 years; range 33–58 years) with current alcohol dependence and 30 control males (mean age 48 ± 6 years; range 40–58 years) with no history of alcoholism using multiplex sandwich immunoassays with the Luminex magnetic-bead based platform. Log-transformed cytokine levels were analyzed for their relationship with the Symptom Checklist-90R (SCL-90R), Barratt Impulsivity Scales (BIS) and Alcoholism Severity Scale (ASS). Inflammatory cytokines (interferon γ-induced protein-10 (IP-10); monocyte chemoattractant protein-1 (MCP1); regulated on activation, normal T cell expressed and secreted (RANTES)) were significantly elevated in alcoholism compared to controls while bone marrow-derived hematopoietic cytokines and chemokines (granulocyte-colony stimulating factor (GCSF); soluble CD40 ligand (sCD40L); growth-related oncogene (GRO)) were significantly reduced. GRO and RANTES levels were positively correlated with BIS scales; and macrophage-derived chemokine (MDC) levels were positively correlated with SCL-90R scale scores (p < 0.05). Elevated inflammatory mediators in alcoholism may influence brain function leading to increased impulsiveness and/or phobia. The novel association between RANTES and GRO and impulsivity phenotype in alcoholism should be further investigated in alcoholism and psychiatric conditions with core impulsivity and anxiety phenotypes lending support for therapeutic intervention. PMID:27043532
Manzardo, Ann M; Poje, Albert B; Penick, Elizabeth C; Butler, Merlin G
Chronic alcohol use alters adaptive immunity and cytokine activity influencing immunological and hormone responses, inflammation, and wound healing. Brain cytokine disturbances may impact neurological function, mood, cognition and traits related to alcoholism including impulsiveness. We examined the relationship between plasma cytokine levels and self-rated psychiatric symptoms in 40 adult males (mean age 51 ± 6 years; range 33-58 years) with current alcohol dependence and 30 control males (mean age 48 ± 6 years; range 40-58 years) with no history of alcoholism using multiplex sandwich immunoassays with the Luminex magnetic-bead based platform. Log-transformed cytokine levels were analyzed for their relationship with the Symptom Checklist-90R (SCL-90R), Barratt Impulsivity Scales (BIS) and Alcoholism Severity Scale (ASS). Inflammatory cytokines (interferon γ-induced protein-10 (IP-10); monocyte chemoattractant protein-1 (MCP1); regulated on activation, normal T cell expressed and secreted (RANTES)) were significantly elevated in alcoholism compared to controls while bone marrow-derived hematopoietic cytokines and chemokines (granulocyte-colony stimulating factor (GCSF); soluble CD40 ligand (sCD40L); growth-related oncogene (GRO)) were significantly reduced. GRO and RANTES levels were positively correlated with BIS scales; and macrophage-derived chemokine (MDC) levels were positively correlated with SCL-90R scale scores (p < 0.05). Elevated inflammatory mediators in alcoholism may influence brain function leading to increased impulsiveness and/or phobia. The novel association between RANTES and GRO and impulsivity phenotype in alcoholism should be further investigated in alcoholism and psychiatric conditions with core impulsivity and anxiety phenotypes lending support for therapeutic intervention. PMID:27043532
DeFife, Jared A; Goldberg, Melissa; Westen, Drew
Central to the proposed DSM-5 general definition of personality disorder (PD) are features of self- and interpersonal functioning. The Social Cognition and Object Relations Scale-Global Rating Method (SCORS-G) is a coding system that assesses eight dimensions of self- and relational experience that can be applied to narrative data or used by clinically experienced observers to quantify observations of patients in ongoing psychotherapy. This study aims to evaluate the relationship of SCORS-G dimensions to personality pathology in adolescents and their incremental validity for predicting multiple domains of adaptive functioning. A total of 294 randomly sampled doctoral-level clinical psychologists and psychiatrists described an adolescent patient in their care based on all available data. Individual SCORS-G variables demonstrated medium-to-large effect size differences for PD versus non-PD identified adolescents (d = .49-1.05). A summary SCORS-Composite rating was significantly related to composite measurements of global adaptive functioning (r = .66), school functioning (r = .47), externalizing behavior (r = -.49), and prior psychiatric history (r = -.31). The SCORS-Composite significantly predicted variance in domains of adaptive functioning above and beyond age and DSM-IV PD diagnosis (ΔR(2)s = .07-.32). As applied to adolescents, the SCORS-G offers a framework for a clinically meaningful and empirically sound dimensional assessment of self- and other representations and interpersonal functioning capacities. Our findings support the inclusion of self- and interpersonal capacities in the DSM-5 general definition of personality disorder as an improvement to existing PD diagnosis for capturing varied domains of adaptive functioning and psychopathology. PMID:23398103
Golubovic, Spela; Skrbic, Renata
Intellectual disability affects different aspects of functioning and quality of life, as well as the ability to independently assess the quality of life itself. The paper examines the agreement in the quality of life assessments made by adolescents with intellectual disability and their parents compared with assessments made by adolescents without…
The objective of this study was to assess the cross-culture validity and reliability of a standard psychiatric assessment instrument without the usual "gold standards." Normally criterion validity testing requires comparison with such a standard--usually another instrument or a professional diagnosis. Instead local informants identified persons with and without "agahinda gakabije" (a locally described grief syndrome) who were then asked if they thought they had this syndrome and also interviewed using the depression section of the Hopkins Symptom Checklist (DHSCL). To assess criterion validity, interviews where respondent and informant agreed on the presence or absence of agahinda gakabije were compared with depression diagnosis using the DHSCL. We also assessed construct validity (using factor analysis), internal reliability (Cronbach's alpha), and test-retest reliability using results from a subsequent community-based survey employing the DHSCL. We found a similar relationship between depression and agahinda gakabije as between depression and grief in western countries, which supports criterion validity. Construct validity and internal reliability were good (Cronbach's alpha = 0.87). Test-retest reliability of a DHSCL-based scale was less adequate (0.67). Although not replacing the usual gold standards for testing criterion validity, this approach may prove useful where these standards are unavailable. As this includes much of the developing world, this could result in more accurate mental health assessments among populations for whom this has hitherto not been possible. PMID:11339319
Aghanwa, H S; Morakinyo, O
This study explored factors associated with psychiatric morbidity in typhoid fever in a Nigerian general hospital. Information such as sociodemographic characteristics, symptom manifestations, results of investigations, neuropsychiatric symptoms, outcome and disposal were obtained from the case files of patients admitted for typhoid fever over a period of six years. The patients with psychiatric morbidity conspicuous enough to be documented by the attending physicians-mostly internists-were compared with those with no documented psychiatric morbidity on sociodemographic and clinical indices. Of the 136 cases, 26 (19.1%) had psychiatric morbidity. This included delirium (73.1%), generalized anxiety disorder (3.8%), depressive episode (3.8%), schizophrenia like disorder (3.8%) and monosymptomatic neuropychiatric manifestations such as apathy, hallucinations and irrelevant talking (15.5%). The clinical and sociodemographic indices that were significantly associated with psychiatric morbidity were diarrhea, blood biochemical imbalance and age (P<.05). Adolescents and young adults were more predisposed to developing psychiatric complications. Some factors potentially associated with psychiatric morbidity in typhoid fever have been identified. There is the need to prospectively assess the burden from psychiatric morbidity and identify interventions that may reduce it. PMID:11427249
Bhat, Amritha S.; Srinivasan, K.
Aim: To study the prevalence of psychiatric diagnosis and psychopathology in adolescent offspring of parents with panic disorder, depression and normal controls. Methods: Adolescent offspring (11-16 years) of parents with a diagnosis of panic disorder and major depression, and normal controls were interviewed using Missouri Assessment of Genetics…
Ghanizadeh, Ahmad; Mohammadi, Mohammad Reza; Moini, Rozita
Objective: To study the psychiatric comorbidity of a clinical sample of children with ADHD and the psychiatric disorders in their parents. Method: Structured psychiatric interviews assessing lifetime psychiatric disorders by "DSM-IV" criteria, using the Farsi version of the Schedule for Affective Disorders and Schizophrenia. Results: The mean age…
Davison, Martin J; David-West, S Kenneth; Duncan, Roderick
The most common cause of adolescent heel pain is calcaneal apophysitis also known as Sever's disease. The condition may occur in adolescent athletes, particularly those involved in running or jumping activities, during the pubertal growth spurt. The mean age of presentation in Sever's disease is ten, (range 7-15). It presents with posterior heel pain that is worse with activity and relieved by rest in most cases. Sever's disease, Osgood Schlatter's disease (tibial tuberosity) and Sinding-Larsen Johansson syndrome (distal patella) are all overuse syndromes brought about by repetitive submaximal loading and microtrauma. They are, however, entirely self-limiting and resolve at skeletal maturity or earlier. Careful assessment is required to differentiate them from other rare pathologies. Achilles tendinitis is rare under the age of 14. As in Sever's disease, it may occur in jumping athletes, those who suddenly increase their sporting activities and in individuals with relative gastrosoleus tightness. It may also occur in those with inflammatory arthropathies and merit rheumatological investigation if there are other suggestive signs or symptoms. Benign and malignant tumours of the adolescent calcaneus are extremely rare In a unilateral case, atypical features such as night pain or absence of a precipitating activity should raise the index of suspicion. There may be localised swelling and bony expansion. PMID:27382917
Rabbia, F; Grosso, T; Cat Genova, G; Conterno, A; De Vito, B; Mulatero, P; Chiandussi, L; Veglio, F
The aim of this study was to evaluate the distribution of resting heart rate and its biological and environmental determinants in adolescents. The study was cross- sectional and the population consisted of 2230 children and adolescents, age range 12-18 years, enrolled randomly from state schools in Turin, Italy. In all participants the following parameters were evaluated: heart rate, blood pressure (BP), weight, height, degree of sexual development, physical activity, parental socio-cultural level. Heart rate and BP were measured after 5, 10 and 15 min in a sitting position. Furthermore, to obtain regression equations to define heart rate as a function of the other variables available, a multiple regression analysis was performed. In both sexes BP, but not heart rate, declined significantly from the first to the last determination. Heart rate was positively and significantly correlated to BP level in both sexes; heart rate was higher in girls (3 bpm) and followed a progressive decreasing trend with age in both sexes, that was opposite to BP values. Age, sexual maturation, height, physical activity and parental socio-cultural level were independent determinants of resting heart rate. In conclusion, resting heart rate in adolescents is related to several methodological, constitutional and environmental factors that have to be taken into account when assessing heart rate values and constructing tables of normal values. PMID:12082493
Kalarchian, Melissa A; Marcus, Marsha D
The onset of psychiatric symptoms and disorders is relatively common in childhood, occurring among youths across the weight spectrum. However, available research suggests that certain psychiatric comorbidities are more prevalent in obese children and adolescents than in healthy weight youths. First, we review research on disordered eating, including evidence to suggest that loss of control eating is associated with weight gain and obesity in youths, as well as poor outcome in family-based treatment of paediatric obesity. Second, we highlight evidence on the relationship between depression and obesity, especially in girls. Third, we present data on attention deficit hyperactivity disorder (ADHD), particularly the symptoms of impulsivity and inattention, and childhood obesity. We also consider that some medical conditions and psychotropic medications contribute to weight gain and obesity in children and adolescents. Throughout the review, we emphasize that psychiatric comorbidity may be a cause or consequence of childhood obesity, or they may share common aetiological factors. PMID:22724645
Lindholm, Lars H; Koivukangas, Antti; Lassila, Antero; Kampman, Olli
This implementation study was part of the Ostrobothnia Depression Study, in Finland, which covered implementation of motivational interviewing (MI) and behavioral activation (BA) within regional public psychiatric secondary care. It aimed to evaluate the mid-term progress of implementation and related factors. Altogether, 80 therapists had been educated through the implementation program by the point of the mid-term evaluation. Eligible information for evaluation was gathered using two questionnaires (q1, q2) with a one-year interval. A total of 45 of the 80 therapists completed q1, 30 completed q2, and 24 completed both questionnaires. Professional education was the only background factor associated with adopting the interventions (q1: p=0.059, q2: p=0.023), with higher education indicating greater activity. On the basis of trends such as changes in overall usefulness score from q1 to q2, the most involved therapists were slightly more likely to adopt MI/BA. Our experience so far suggests that encouraging staff to begin using new interventions during education is very important. The Consolidated Framework for Implementation Research was found to be a useful tool for constructing the evaluation. PMID:26113263
Clemens, Elysia V.; Welfare, Laura E.; Williams, Amy M.
Psychiatric hospitalization is an intensive intervention designed to stabilize adolescents who are experiencing an acute mental health crisis. Reintegrating to school after discharge from psychiatric hospitalization can be overwhelming for many adolescents (E. V. Clemens, L. E. Welfare, & A. M. Williams, 2010). The authors used a consensual…
Kerr, David C. R.; Washburn, Jason J.; Feingold, Alan; Kramer, Anne C.; Ivey, Asha Z.; King, Cheryl A.
The consequences of aggression on problem course and suicide risk were examined in 270 acutely suicidal adolescents (ages 12-17 years; 184 girls). Participants were assessed during psychiatric hospitalization (T1), 6-months post-hospitalization (T2), and 15 or more months post-hospitalization (T3). Study variables included self- and…
Ayirolimeethal, Anithakumari; Ragesh, G.; Ramanujam, Jayanthi M.; George, Biju
Background: There is a considerable lack of scientific estimate of psychiatric morbidity among Indian prisoners. Objective: The objective of the following study is to study the prevalence of psychiatric morbidity among prisoners. Settings and Design: A cross-sectional study at District Jail, Kozhikode, Kerala. Materials and Methods: A total of 255 prisoners who were inmates during the period from mid-April to mid-July 2011 participated in the study. The study subjects included both male and female remand or convict prisoners. Socio-demographic data, clinical history and criminological history were collected from each individual. Psychiatric morbidity was assessed using MINI-Plus. Statistical Analysis: Done by using SPSS version 16 (SPSS Inc, Chicago, USA). Results: A total of 175 subjects (68.6%) had a current mental illness. Substance use disorder was the most common diagnosis (47.1%). Antisocial personality disorder was diagnosed in 19.2%, adjustment disorder in 13.7%, mood disorder in 4.3% and psychosis in another 6.3% of prisoners. A high rate of a current psychiatric disorder was seen in male (69.7%) prisoners. A significant association was noticed for the different nature of crimes with psychiatric diagnoses and previous imprisonment. Nearly 4% of prisoners reported a moderate to high suicide risk. Conclusion: Mental health problems among prisoners were quite high. Mentally ill prisoners are at high risk for repeated incarceration. The increased rate of psychiatric disorders should be a concern for mental health professionals and the policy makers. PMID:24891702
De Germond-Burquier, Véronique; Narring, Françoise; Entremont, Cécile; Basset, Lytta
Spirituality affects adolescents' as well as adults' daily life. It is usually considered to be a protective factor in physical and psychological health outcomes, but might also be a cause of suffering. In the perspective of an holistic approach, health professional should assess this subject with tact and sensitivity. Until there is a suitable instrument adapted to this age group and European culture, the exploration of spirituality and religious practices can be evaluated while taking the clinical history. Nevertheless, resistance which is common in health professionals, could be overcome by appropriate training. PMID:27451512
Yalch, Matthew M; Hopwood, Christopher J; Fehon, Dwain C; Grilo, Carlos M
Suicide is a leading cause of death among adolescents and suicidal behavior is one of the primary risk factors for youth psychiatric hospitalizations. A number of studies indicate that depression and substance abuse are associated with suicide risk in this population, but less is known about the role of borderline personality features or their incremental influence over other known risk factors in indicating suicidal behavior among adolescents. This study examined whether borderline features were associated with suicide risk when controlling for symptoms of depression and substance abuse in a sample of adolescents hospitalized in an inpatient psychiatric facility. Self-report data from 477 adolescent psychiatric inpatients were used to test hypotheses about the association of borderline features with suicide risk after controlling for other common risk factors. Borderline features were significantly related to suicide risk even after accounting for symptoms of depression and substance abuse. These findings underscore the clinical value of routinely assessing borderline features among adolescents. PMID:24128121
Price, Maggi; Higa-McMillan, Charmaine; Kim, Sunyoung; Frueh, B Christopher
The psychiatric sequelae associated with childhood experience(s) of trauma is complex and distinguishable from that of adult trauma exposure. Categories of impairment associated with experiences of early trauma include internalizing and externalizing emotional and behavioral problems, posttraumatic stress symptomatology, and dissociation. The present study assessed the relationship between the type of trauma experience (i.e., non-interpersonal or interpersonal) and the manifestation of a wide range of psychiatric symptomatology using prospective longitudinal data from a community sample of ethnically diverse children and adolescents (N=1676; ages 4-18). The study also examined the relationship between different types of trauma experiences (e.g., direct, vicarious, interpersonal) and levels of various symptom domains (e.g., anxiety, posttraumatic stress, conduct problems). A number of factors relevant to the relationship between early trauma experience and subsequent impairment including temperament, socioeconomic status, sex, and age were included in the analyses. Results indicated that interpersonal traumas involving significant interpersonal proximity were associated with externalizing problems (i.e., oppositional defiant and conduct problems). Direct trauma experiences and emotionality were positively associated with almost all symptom domains. Implications for the relationship between trauma and developmental psychopathology are discussed. PMID:24064334
Suárez-Pinto, Tatiana A; Blanco-Gómez, Argénida; Díaz-Martínez, Luis A
Seventy percent of adolescent morbidity and mortality is related to six risky behaviors. The Rapid Assessment for Adolescent Preventive Services is a screening questionnaire consisting of 21 questions but there is not a validated Spanish-language version. The obj ective of this study was to validate the Spanish-language version of the Rapid Assessment for Adolescent Preventive Services in two Colombian cities: Bucaramanga and Medellin. The questionnaire was administered to 270 randomly selected adolescent students aged between 11 and 19 years old. Its internal consistency measured using Cronbach's alpha was 0.7207. The factor analysis showed that two factors accounted for 84.5% of variance, but factor loading indicates that only one of these is valid in Colombia: substance use (tobacco, alcohol, narcotics, and psychoactive substances). PMID:27606643
Mazefsky, Carla A; Borue, Xenia; Day, Taylor N; Minshew, Nancy J
Autism spectrum disorder (ASD) is often associated with poor emotional control and psychopathology, such as anxiety and depression; however, little is known about the underlying mechanisms. Emotion regulation (ER) is a potential contributing factor, but there has been limited research on ER and its role in comorbid psychopathology in ASD. In this study, we compared self-reported ER with self- and parent reports of psychopathology in 25 high-functioning adolescents with ASD and 23 age- and Intelligence Quotient (IQ)-matched typically developing controls. Contrary to expectations, both groups reported similar levels of adaptive, voluntary forms of ER (problem solving, acceptance, etc.). However, the ASD group reported significantly greater use of involuntary forms of ER that are typically maladaptive, including remaining focused on the stressor (e.g. rumination and emotional arousal) and shutting down (e.g. emotional numbing and being unable to think or act). Associations between ER and psychopathology were generally more robust using self-report rather than parent report. For both groups, greater endorsement of involuntary ER strategies was associated with higher ratings of psychopathology, whereas voluntary ER strategies focused on changing or adapting to the situation were significantly associated with lower levels of psychopathology. The magnitude and direction of association between ER types and psychopathology were similar for measures of depression and anxiety. These findings can help guide the development of psychosocial treatments targeting dysfunctional ER in adolescents with ASD. Interventions focused on ER as a transdiagnostic process may be a more robust method to improve emotional control and decrease emotional distress in ASD than disorder-specific interventions. PMID:24610869
Welsh, Jennifer L.; Schmidt, Fred; McKinnon, Lauren; Chattha, H. K.; Meyers, Joanna R.
Promising new adolescent risk assessment tools are being incorporated into clinical practice but currently possess limited evidence of predictive validity regarding their individual and/or combined use in risk assessments. The current study compares three structured adolescent risk instruments, Youth Level of Service/Case Management Inventory…
Stösser, D; Klosinski, G
This study investigates 77 families i.e. their children, aged 7-17, and their parents, who attended the out-patient clinic of the child psychiatric department for the first time. It was intended to examine and outline the subjective situation on entering the clinic. A structured verbal interview was conducted with the children before the start of the actual examination procedure, while a written questionnaire was submitted to the parents. Among the questioned items were modes of referral, references, sources of information, knowledge and preparedness, ideas, expectations and apprehensions about the institution and its treatments. The answer that were obtained reflected a lack of self-determination on the part of the children and the strength of influence exerted by the parents along with other relevant authorities. The children were often taken to the clinic without any active consent on their part. When asked about hopes of improvement they did not often confirm. Similarly fears about the impending examination were at first denied by most children but subsequently conceded, when concrete suggestions were made. Strikingly the better informed and prepared, children were able to admit to their fears more often. The results of the parental questionnaire illustrate an extensive lack of information about the institution that the families were actually attending. It may be concluded that the parents had also been little assertive when preparing their children for the examination. When asked about their expectations the parents primarily quoted "help" and "advice". Scepticism about the examination came only at the bottom of the list.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7784354
Farrell, A D; Ampy, L A; Meyer, A L
Identified and developed a scale to assess problematic interpersonal situations among urban adolescents. In Study 1, problematic situations were identified by focus groups of 6th graders (N = 43). Their relevance was verified in Study 2 by assessing their reported frequency and difficulty in a sample of 6th graders (N = 457) that included mostly African American youth from low-income families. Scales representing 3 dimensions, peer provocation, perceived injustice, and environmental stressors were verified by confirmatory factor analyses. In Study 3, the internal consistency and structure of these scales were cross-validated in a sample of 7th graders (N = 459). All 3 scales were correlated with self-reported violent behavior, drug use, and anxiety and uniquely accounted for 11% to 19% of the variance. These findings have implications for identifying youth at risk for emotional and behavioral problems and for designing more relevant interventions. PMID:9789189
Costello, H; Moss, S; Prosser, H; Hatton, C
The Psychiatric Assessment Schedule for Adults with Developmental Disability (PAS-ADD) is a semi-structured clinical interview designed for use with respondents who have learning disability. The first version was based on the Present State Examination. The revised version was derived from the Schedules for Clinical Assessment in Neuropsychiatry (SCAN), and makes ICD 10 diagnoses using the SCAN diagnostic program. This current version has a 4-point scale of severity, compared with the 3-point scale of the first version. It also has a new module relating to psychotic disorders. The sample consisted of 40 individuals representing a spectrum of neurotic, depressive and psychotic disorders. Videotapes of 40 PAS-ADD interviews were re-rated by trained interviewers who had not been involved in the original study in which the videotapes were produced. The mean Kappa across all individual item codes was 0.65, ranging from 0.94 to 0.35. The mean Kappa agreement on item groups was 0.66. Correlation between total symptom scores was 0.74. Agreement on index of definition was Kappa 0.70. We concluded that, agreement was generally lower than for the ICD 9 version. This was probably due mainly to the increase in the severity categories from three to four. However, the new items (most of which related to psychosis) were of comparable reliability to other items. PMID:9299928
Birmaher, Boris; Williamson, Douglas E.; Dahl, Ronald E.; Axelson, David A.; Kaufman, Joan; Dorn, Lorah D.; Ryan, Neal D.
Objective: To simultaneously and prospectively compare the clinical presentation, course, and parental psychiatric history between children and adolescents with major depressive disorder. Method: A group of prepubertal children (n = 46) and postpubertal adolescents (n = 22) were assessed with structured interviews for psychopathology and parental…
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…
Dorn, Lorah D.; Dahl, Ronald E.; Woodward, Hermi Rojahn; Biro, Frank
This article addresses pragmatic issues regarding the assessment of puberty in research on adolescent health and development. Because pubertal processes have a major effect on physical, psychological, and social development, we posit that the assessment of pubertal status is at least as important as the specification of age for characterizing…
The author presents a brief account of the development of psychiatric rehabilitation during the past two centuries. He draws attention to new trends in rehabilitation of the mentally sick during the post-war period and at present. He describes the system of rehabilitation in the Soviet Union which began to develop as a results of efforts in the Bekhterev Institute in Leningrad. In our country the law on social security in 1964 created conditions for protected workshop and protected work places. In 1973 methodical instructions of the Ministry of Labour and Social Affairs issued instructions which specified the principles of planning, establishment and operation of these facilities. At the end of 1986 the Ministry of Health CSR issued an amendment to the concept of psychiatry which contains the organization of psychiatric rehabilitation not only in in-patient but in particular in out-patient psychiatric facilities. PMID:2194684
Bradley, Elspeth A.; Summers, Jane A.; Wood, Hayley L.; Bryson, Susan E.
Eight males and four females with an Autism Diagnostic Interview-Revised (ADI-R) diagnosis of autism (mean age of 16.3 years) and severe intellectual disability (IQ < 40) were individually matched to controls on the basis of chronological age, gender, and nonverbal IQ. The dependent measure was the Diagnostic Assessment for the Severely…
Lehnert, Kim L.; And Others
The Cognition Rating Form (CRF), a scoring measure for the Rotter Incomplete Sentences Blank, was evaluated with 56 adolescent psychiatric patients and 102 high school controls. Concurrent validities and sensitivity rates indicated that the CRF shows promise as a thought sampling scoring measure. (SLD)
Pearce, Patsy; Johnson, Carolyn; Manly, Patricia; Locke, Jake
A large proportion of child psychiatry patients have undiagnosed language disorders. Adequately developed language is critical for psychotherapy and cognitive-behavioral therapies. This study investigated (1) whether assessment of oral narratives would identify language impairments in this population undetected by assessment of only core language abilities, and (2) the extent to which measures of cognition, working memory, emotional distress, and social function differentially predict core language and narrative development. Results showed that (1) more than twice as many children were identified with language impairment when both narrative and core language assessment were used, and (2) core language comprehension and complex verbal working memory were the strongest predictors of narrative production, while core language comprehension, a less complex working-memory task, and social skills best predicted narrative comprehension. Emotional distress did not predict either. The results emphasize the importance of evaluating child psychiatry patients' language, using both core language and narrative measures. PMID:23689481
Martinerie, L; Le Heuzey, M-F; Delorme, R; Carel, J-C; Bargiacchi, A
Gender dysphoria, originally called gender identity disorder, is characterized by the dissociation between one's expressed gender and the gender of rearing as assigned at birth, which generates significant clinical distress and social, academic, and other important forms of isolation. This state is also known as transgender or transsexualism and is recognized as a medical disease. Adults with gender dysphoria can benefit from psychological, medical, and surgical care. However, gender dysphoria rarely occurs in adulthood but rather emerges in childhood or adolescence, generating deep social and academic difficulties, especially at puberty. For the last 10years, the management of gender dysphoria in children and adolescents has developed in several countries, specifically in Europe, but remains under-recognized in France. Since 2013, several pediatric psychiatry and endocrinology departments have initiated a multidisciplinary evaluation and management approach for these patients. This article reviews the clinical criteria helping diagnose gender dysphoria and presents the different steps in the assessment and management of these patients in accordance with international guidelines. PMID:27117996
Dike, Charles C; Nicholson, Elizabeth; Young, John L
Patients in a forensic psychiatric facility often require escorted transport to medical facilities for investigations or treatments of physical health ailments. Transporting these patients presents significant safety and custody challenges because of the nature of patients housed in forensic psychiatric facilities. A significant proportion of these patients may be transfers from the Department of Corrections (DOC) under legal mandates for psychiatric evaluation and treatment better provided in a hospital setting, and most of them will return to the DOC. Although departments of correction have protocols for escorting these potentially dangerous individuals, it is unclear whether receiving psychiatric hospitals have established procedures for maintaining the safety of others and custody of these individuals during transportation outside the hospital facility. The literature is sparse on precautions to be observed when transporting dangerous forensic psychiatric patients, including those with high escape risk. In this article, we describe one forensic inpatient facility's procedure for determining the appropriate level needed to transport these individuals outside of the forensic facility. We also describe the risk assessment procedure for determining level of transport. These are quality improvement measures resulting from a critical review of an incident of escape from the forensic facility several years ago. PMID:26668224
Brière, Frédéric N.; Rohde, Paul; Seeley, John R.; Klein, Daniel; Lewinsohn, Peter M.
Background Adolescent suicide attempts are disproportionally prevalent and frequently of low severity, raising questions regarding their long-term prognostic implications. In this study, we examined whether adolescent attempts were associated with impairments related to suicidality, psychopathology, and psychosocial functioning in adulthood (objective 1) and whether these impairments were better accounted for by concurrent adolescent confounders (objective 2). Method 816 adolescents were assessed using interviews and questionnaires at four time points from adolescence to adulthood. We examined whether lifetime suicide attempts in adolescence (by T2, mean age 17) predicted adult outcomes (by T4, mean age 30) using linear and logistic regressions in unadjusted models (objective 1) and adjusting for sociodemographic background, adolescent psychopathology, and family risk factors (objective 2). Results In unadjusted analyses, adolescent suicide attempts predicted poorer adjustment on all outcomes, except those related to social role status. After adjustment, adolescent attempts remained predictive of axis I and II psychopathology (anxiety disorder, antisocial and borderline personality disorder symptoms), global and social adjustment, risky sex, and psychiatric treatment utilization. However, adolescent attempts no longer predicted most adult outcomes, notably suicide attempts and major depressive disorder. Secondary analyses indicated that associations did not differ by sex and attempt characteristics (intent, lethality, recurrence). Conclusions Adolescent suicide attempters are at high risk of protracted and wide-ranging impairments, regardless of the characteristics of their attempt. Although attempts specifically predict (and possibly influence) several outcomes, results suggest that most impairments reflect the confounding contributions of other individual and family problems or vulnerabilites in adolescent attempters. PMID:25421360
Kessler, R. C.
Reviewed in this article are selected recent advances and future challenges for psychiatric epidemiology. Major advances in descriptive psychiatric epidemiology in recent years include the development of reliable and valid fully structured diagnostic interviews, the implementation of parallel cross-national surveys of the prevalences and correlates of mental disorders, and the initiation of research in clinical epidemiology. Remaining challenges include the refinement of diagnostic categories and criteria, recognition and evaluation of systematic underreporting bias in surveys of mental disorders, creation and use of accurate assessment tools for studying disorders of children, adolescents, the elderly, and people in less developed countries, and setting up systems to carry out small area estimations for needs assessment and programme planning. Advances in analytical and experimental epidemiology have been more modest. A major challenge is for psychiatric epidemiologists to increase the relevance of their analytical research to their colleagues in preventative psychiatry as well as to social policy analysts. Another challenge is to develop interventions aimed at increasing the proportion of people with mental disorders who receive treatment. Despite encouraging advances, much work still needs to be conducted before psychiatric epidemiology can realize its potential to improve the mental health of populations. PMID:10885165
Singh, Ranbir; Verdolini, Norma; Agius, Mark; Moretti, Patrizia; Quartesan, Roberto
The risk of suicide is one of the most important risk factors looked into for acute psychiatric assessments that influences the management plan. The prevalence of suicide is on a rise across European countries; as a consequence, the different countries have created specific guidelines and policies in order to prevent suicides in the acute settings. These guidelines are based on both different cultural aspects as well as the different organization of the mental health system in the different countries. This paper wants to present the comparison between the guidelines of two European countries, England and Italy, in order to evaluate the systems, understand differences and common contact points. The different European countries could learn one from the other and a European shared point of view may be a way forward to create better understanding and preventing the risk of suicide across the population. PMID:26417782
Fraidakis, M J
Cerebrotendinous xanthomatosis (CTX) is a rare and severe, but treatable, inborn disorder of bile acid biosynthesis and sterol storage with autosomal recessive inheritance and variable clinical presentation. CTX treatment consists of chenodeoxycholic acid and must be started as early as possible to prevent permanent disability. Psychiatric manifestations are rare and non-specific, and often lead to significant diagnostic and treatment delay. Therefore, better recognition of the gamut of psychiatric manifestations in CTX can diminish the risk of misdiagnosis and irreversible neurological deterioration. We hereby describe the psychiatric features in CTX. A complete review of all published cases of CTX in the medical literature was undertaken and the case reports with psychiatric presentation were collected and analyzed. We also describe the psychiatric features in relation to the neurological semeiology in six patients with CTX diagnosed at the La Salpêtrière Hospital. We conclude that psychiatric manifestations in CTX follow a bimodal/bitemporal pattern, appearing early in the disease course in the form of a behavioral/personality disorder associated with learning difficulties or mental retardation, or manifesting in advanced disease in the setting of dementia as rich neuropsychiatric syndromes, such as frontal, orbitofrontal or frontotemporal syndromes of cortico-subcortical dementia encompassing behavioral/personality disturbance, affective/mood disorders or psychotic disorders. Behavioral/personality disturbance in childhood or adolescence, especially when accompanied by learning difficulties, should therefore lead to further investigation to exclude CTX, as early diagnosis and treatment is critical for prognosis. PMID:24002088
Journal of the American Academy of Child & Adolescent Psychiatry, 2012
Research in etiology, neurobiology, genetics, clinical correlates, and evidence-based treatments in children and adolescents with obsessive-compulsive disorder indicate a need for the revision of the Practice Parameters for the Assessment and Treatment of Children and Adolescents with Obsessive-Compulsive Disorder first published a decade ago. The…
Huang, Bin; Hillman, Jennifer; Biro, Frank M.; Ding, Lili; Dorn, Lorah D.; Susman, Elizabeth J.
Adolescent sexual maturation is staged using Tanner criteria assessed by clinicians, parents, or adolescents. The physiology of sexual maturation is driven by gonadal hormones. We investigate Tanner stage progression as a function of increasing gonadal hormone concentration and compare performances of different raters. Fifty-six boys (mean age,…
Perepletchikova, Francheska; Krystal, John H.; Kaufman, Joan
Background: Alcohol use disorders in adolescents are associated with significant morbidity and mortality. Over the past decade, there has been a burgeoning of research on adolescent alcohol use disorders. Methods: A summary of the alcohol assessment tools is provided, and randomized studies reviewed and synthesized to provide an overview of state…
The purpose of this study was to operationalise a model of time orientation and investigate the variability of its factors based on preparation for assessment and perceived academic performance. Responses from 113 male adolescents (mean age = 16.46 years) and 115 female adolescents (mean age = 16.42 years) to items operationalising an expanded…
Silver, Rawley; Ellison, JoAnne
Examines assumption that art therapists can objectively identify self-images in drawings by troubled adolescents without talking to these youth. Findings suggest that discussion, though preferable, is not required for identifying self-images. Analysis of adolescents' drawings indicates that structured art assessment can be useful in evaluating…
Phelps, LeAdelle; Bajorek, Ellen
Literature on the prevalence, symptomatology, and etiology of anorexia nervosa and bulimia in adolescents is reviewed. The school psychologist is in an essential position to help the adolescent and family. Assessment, consultation, and intervention strategies are discussed for the school psychologist, and psychological and pharmacological…
Musick, Kelly; Meier, Ann
Adolescents who share meals with their parents score better on a range of well-being indicators. Using 3 waves of the National Longitudinal Survey of Adolescent Health (N = 17,977), the authors assessed the causal nature of these associations and the extent to which they persist into adulthood. They examined links between family dinners and…
Rosenthal, Natalie L.; Kobak, Roger
Adolescents' attachment hierarchies were assessed in a sample of 212 high school and 198 college students. The Important People Interview (IPI) differentiated attachment bonds from other supportive or affiliative relationships and indicated that adolescents show a hierarchical ordering of preferences for multiple attachment figures. Differences in…
Hackman, Daniel T.; Greene, Marion S.; Fernandes, Taya J.; Brown, Ashley M.; Wright, Eric R.; Chambers, R. Andrew
Objective An epidemic of prescription drug abuse is disproportionately impacting the mentally ill. We examined the utility of a state prescription drug monitoring database for assessing recent controlled substance prescribing to patients presenting for dual diagnosis treatment. Method In a community mental health center that provides integrated dual diagnosis care, we queried the Indiana Scheduled Prescription Electronic Collection and Tracking (INSPECT) system for all cases that were open as of August 2, 2011, and had been practitioner-diagnosed (per DSM-IV criteria) by January 2, 2012. INSPECT provided a record of controlled substance dispensations to each patient; diagnostic evaluation was conducted blind from prescription data compilation covering the prior 12 months. Demographic data, insurance status, and DSM-IV diagnoses were compiled from the clinic's electronic medical record. Results The sample (N = 201) was 51% female, 56% white, and two-thirds uninsured. Over 80% were dually diagnosed with substance use disorders and psychotic, mood, or anxiety disorders. Nicotine and alcohol disorders were identified in most, with about a third diagnosed with cannabis, cocaine, or opioid disorders. A majority of patients (n = 115) had been prescribed opioids in the prior year, with nearly 1 in 5 prescribed an opioid and benzodiazepine simultaneously. Patients were dispensed a mean of 4 opioid prescriptions and 213 opioid pills. More opioid prescriptions correlated with opioid dependence (OR = 1.08; 95% CI, 1.016–1.145), and more prescribers correlated with personality disorder diagnoses (OR = 1.112; 95% CI, 1.001–1.235). Higher rates and riskier patterns of controlled substance prescribing were identified in patients with Medicaid/Medicare insurance compared to uninsured patients. Conclusions Prescription drug monitoring is a powerful tool for assessing addictions and high frequencies of patient exposures to prescribed opioids in a dual diagnosis clinic. Improved
Cavanaugh, S V
Psychiatric disorders are common in medical inpatient and outpatient populations. As a result, internists commonly are the first to see psychiatric emergencies. As with all medical problems, a good history, including a collateral history from relatives and friends, physical and mental status examination, and appropriate laboratory tests help establish a preliminary diagnosis and treatment plan. Patients with suicidal ideation usually have multiple stressors in the environment and/or a psychiatric disorder (i.e., a major affective disorder, dysthymic disorder, anxiety or panic disorder, psychotic disorder, alcohol or drug abuse, a personality disorder, and/or an adjustment disorder). Of all patients who commit suicide, 70% have a major depressive disorder, schizophrenia, psychotic organic mental disorder, alcoholism, drug abuse, and borderline personality disorder. Patients who are at great risk have minimal supports, a history of previous suicide attempts, a plan with high lethality, hopelessness, psychosis, paranoia, and/or command self-destructive hallucinations. Treatment is directed toward placing the patient in a protected environment and providing psychotropic medication and/or psychotherapy for the underlying psychiatric problem. Other psychiatric emergencies include psychotic and violent patients. Psychotic disorders fall into two categories etiologically: those that have an identifiable organic factor causing the psychosis and those that have an underlying psychiatric disorder. Initially, it is essential to rule out organic pathology that is life-threatening or could cause irreversible brain damage. After such organic causes are ruled out, neuroleptic medication is indicated. If the patient is not agitated or combative, he or she may be placed on oral divided doses of neuroleptics in the antipsychotic range. Patients who are agitated or psychotic need rapid tranquilization with an intramuscular neuroleptic every half hour to 1 hour until the agitation and
A liaison approach to psychiatric consultation increases the patient population who can benefit from psychiatric assessment during hospitalization for medical or surgical conditions. It also broadens the scope of the psychiatric investigation of the individual patient. The meaning of the illness to the patient, and the patient's present methods of adapting to his or her illness are important considerations. Unconscious concerns, which interfere with the patient's compliance to medical treatment, may be sufficiently clarified and resolved so that medical progress is expedited. Psychiatric consultation can be used to prevent an untoward psychological reaction to illness, if this is foreseen. This preventive consultation, which is often possible only because of the family physician's awareness of the psychological vulnerability of some of her or his patients, can result in reduced medical and psychiatric morbidity. PMID:21263836
Viswanathan, S; Datta, SS; Sheridan, PB; Lax-Pericall, T
Background: Interpersonal violence amongst youth is on the rise world-wide and London is no exception. The resulting injuries can be very serious and even result in death. This is a difficult to engage subgroup of patients and there is likely to be significant unmet social and mental health needs. Aim: The current paper discusses the results of immediate psychiatric and social assessment of young people following a serious physical assault as assessed by a pediatric liaison Child and Adolescent Mental Health Service (CAMHS). CAMHS in Kings College Hospital, London in one calendar year and also the help seeking behavior of the young people following the assault. Subjects and Methods: The Department of Pediatric Liaison Psychiatry is based within the Kings College Hospital and has a multidisciplinary team comprising of nurses, consultant child and adolescent psychiatrists and social workers who reviewed all patients who were referred to them following an episode of assault. All young people who were referred to the department of pediatric liaison psychiatry based within Kings College Hospital over one calendar year were included in the analysis. Results: 83% (29/35) of the victims were male and 83% (29/35) were from minority ethnic backgrounds. Although 70% (25/35) of the young people included in this study had significant safe guarding concerns, only 17% (6/35) turned up for their follow-up appointments with child mental health teams. Conclusions: Innovative models of service delivery are required to cater to the unique needs of this group of extremely vulnerable young people. PMID:24669337
Significant time and resources are devoted to the monitoring of social climate in secure settings. However, if these efforts are to help (rather than hinder) attempts to improve the functioning of such units, the monitoring of social climate must be based on sound psychometric methods. The aim of this review was to determine what questionnaires exist to measure the social climate in secure settings and what evidence exists regarding their psychometric properties. Twelve questionnaire-based measures of social climate were identified. The Essen Climate Evaluation Schema has received the most consistent empirical support, but this questionnaire does not provide as much of an in-depth, detailed insight into social climate as that provided by other social climate questionnaires. Although more extensive measures of climate exist, they have not yet received sufficient validation to justify their routine use in practice. Nevertheless, there is growing evidence that some questionnaire-based measures can provide a reliable and valid assessment of the social climate in secure settings, which has important clinical and theoretical implications. PMID:25850103
Schiavenato, Martin; Alvarez, Ofelia
Pain assessment of the child and adolescent with sickle cell disease is complex and challenging. We present a paradigm of pain assessment during a vaso-occlusive crisis in children and adolescents based on the Pain Assessment as a Social Transaction model. Using this model, the assessment of pain severity in sickle cell disease is uniquely highlighted as comprising at least 4 key factors: the limitations of current pain assessment tools, the existence of acute pain of various origins and the emergence and coexistence of chronic pain, the prevalence of cognitive deficits, and the sociocultural dynamics in America. Improved tools for pain assessment and targeted practitioner education are warranted. PMID:23850944
Spear, Linda Patia
This introduction to the special issue of Neurotoxicology and Teratology on “Risk of neurobehavioral toxicity in adolescence” begins by broadly considering the ontogeny and phylogeny of adolescence, and the potential value of animal models of adolescence. Major findings from the emerging neuroscience of adolescence are then highlighted to establish the importance of studies of adolescent neurotoxicity. A variety of methodological issues that are of particular relevance to adolescent exposures are then discussed. These include consideration of pharmacokinetic factors, inclusion of other-aged comparison group(s), and issues involving timing, route of administration, and exposure-induced alterations in growth rate. Despite such methodological challenges, research to determine whether adolescence is a time of increased vulnerability (or greater resiliency) to specific drugs and environmental toxicants is progressing rapidly, as exemplified by the work presented in the articles of this special issue. PMID:17222532
Honkanen, Meri; Meri, Honkanen; Hurtig, Tuula; Tuula, Hurtig; Taanila, Anja; Anja, Taanila; Moilanen, Irma; Irma, Moilanen; Koponen, Hannu; Hannu, Koponen; Mäki, Pirjo; Pirjo, Mäki; Veijola, Juha; Juha, Veijola; Puustjärvi, Anita; Anita, Puustjärvi; Ebeling, Hanna; Hanna, Ebeling; Koivumaa-Honkanen, Heli; Heli, Koivumaa-Honkanen
The objective was to investigate how teachers' assessments of children predict life satisfaction in adolescence. This is a prospective cohort study on the population-based Northern Finland Birth Cohort 1986 (n = 8,959). Information was gathered from parents, teachers and adolescents using questionnaires at the age of 7, 8 and 15. Response rates were 80-90%. Emotional and behavioural problems were assessed with Rutter Children's Behavioural Questionnaires for teachers (RB2) and parents (RA2) during the first grade at age 8. At adolescence, self-reported life satisfaction was measured with a question including five response alternatives. According to teachers' assessments, 13.9% of the children had high emotional or behavioural problems (RB2 ≥9). These assessments predicted life dissatisfaction in adolescence (OR(crude) = 1.77; 95% CI 1.43-2.20) in several models including also health behaviour and use of psychotropic medicine. However, introducing all the significant variables in the same model, RB2 lost its significance (OR = 1.28; 0.96-1.70), but good school achievement assessed by teachers was still a significant predictor. Life satisfaction in adolescence was associated with a variety of favourable concurrent factors. In conclusion teachers' assessments of children during the first school year predicted life satisfaction in adolescence. In mental health promotion, teachers' early assessments should be utilized for the benefit of children. PMID:21789735
Winner, Joel G.; Goebert, Deborah; Matsu, Courtenay; Mrazek, David A.
Objective: The authors ascertained the amount of training in psychiatric genomics that is provided in North American psychiatric residency programs. Methods: A sample of 217 chief residents in psychiatric residency programs in the United States and Canada were identified by e-mail and surveyed to assess their training in psychiatric genetics and…
Adam, Kenneth S.; And Others
Adolescents in psychiatric treatment (N=133) participated in a case-comparison study investigating the association of attachment patterns with a history of suicidal behaviors. Attachment patterns were assessed using the Adult Attachment Interview. In accordance with definitions provided in the scoring system, 86% of case and 78% of comparison…
Scott, Stewart W.; Powell, John C.
Examined referral for psychiatric assessment of 17 adolescent self-mutilators attending Accident and Emergency Department for treatment of self-inflicted injuries and their previous attendance at casualty department in 5 years preceding the event. Findings suggest that repeated attendance at casualty department for apparently trivial or no…
Emslie, Graham; Kratochvil, Christopher; Vitiello, Benedetto; Silva, Susan; Mayes, Taryn; McNulty, Steven; Weller, Elizabeth; Waslick, Bruce; Casat, Charles; Walkup, John; Pathak, Sanjeev; Rohde, Paul; Posner, Kelly; March, John
Objective: To compare the rates of physical, psychiatric, and suicide-related events in adolescents with MDD treated with fluoxetine alone (FLX), cognitive-behavioral therapy (CBT), combination treatment (COMB), or placebo (PBO). Method: Safety assessments included adverse events (AEs) collected by spontaneous report, as well as systematic…
Oldehinkel, Albertine J; Ormel, Johan
It is well-known that childhood adversities can have long-term effects on mental health, but a lot remains to be learned about the risk they bring about for a first onset of various psychiatric disorders, and how this risk develops over time. In the present study, which was based on a Dutch longitudinal population survey of adolescents TRAILS (N = 1,584), we investigated whether and how childhood adversities, as assessed with three different measures, affected the risk of developing an incident depressive, anxiety, or disruptive behavior in childhood and adolescence. In addition, we tested gender differences in any of the effects under study. The results indicated that depressive, anxiety and disruptive behavior disorders each had their own, characteristic, pattern of associations with childhood adversities across childhood and adolescence, which was maintained after adjustment for comorbid disorders. For depressive disorders, the overall pattern suggested a high excess risk of incidence during childhood, which decreased during adolescence. Anxiety disorders were characterized by a moderately increased incident risk during childhood, which remained approximately stable over time. Disruptive behavior disorders took an intermediate position. Of the three childhood adversities tested, an overall rating of the stressfulness of the childhood appeared to predict onset of psychiatric disorders best. To conclude, the risk of developing a psychiatric disorder after exposure to adversities early in life depends on the nature of the adversities, the nature of the outcome, and the time that has passed since the adversities without disorder onset. PMID:24723042
Fritz, Gregory; Rockney, Randy
Enuresis is a symptom that is frequently encountered in child psychiatric evaluations. Careful assessment is required to identify specific urologic, developmental, psychosocial, and sleep-related etiologies. For most children with enuresis, however, a specific etiology cannot be determined. Treatment then involves supportive approaches,…
Fritz, Gregory; Rockney, Randy
Enuresis is a symptom that is frequently encountered in child psychiatric evaluations. Careful assessment is required to identify specific urologic, developmental, psychosocial, and sleep-related etiologies. For most children with enuresis, however, a specific etiology cannot be determined. Treatment then involves supportive approaches,…
Compas, Bruce E.; And Others
Conducted four studies to develop Adolescent Perceived Events Scale (APES), measure of major and daily stressful events during adolescence. Describes test construction, test-retest reliability, and concurrent validity of APES. Summarizes subsequent research showing APES to be significantly related to behavior problems and psychological…
Dilallo, John J.; Weiss, Gony
The use of motivational interviewing strategies in the practice of adolescent psychopharmacology is described. Motivational interviewing is an efficient and collaborative style of clinical interaction and this helps adolescent patients to integrate their psychiatric difficulties into a more resilient identity.
Cornell, Dewey G.
There are many practical difficulties in conducting forensic evaluations of adolescents charged with serious crimes. This paper addresses some of the reasons why adolescent forensic evaluations are problematic and suggests four strategies for establishing and maintaining rapport, based on a practitioner's experience in evaluating adolescents…
Lyon, Maureen E.; Benoit, Marilyn; O'Donnell, Regina M.; Getson, Pamela R.; Silber, Tomas; Walsh, Thomas
Evaluates risk factors in African American adolescent suicide attempters (n=51) and nonsuicidal (n=124) adolescents. Results show that threat of separation from a parental figure, insomnia, neglect, substance abuse, suicidal ideation, and failing grades were the strongest predictors of suicide attempt. Unexpected findings include high levels of…
Obradovic, Jelena; van Dulmen, Manfred H. M.; Yates, Tuppett M.; Carlson, Eilzabeth A.; Egeland, Byron
This study represents a developmentally informed, empirically validated examination of competence across multiple domains (Social, Cognitive, Emotional well-being), gender and age (early childhood, middle childhood, early adolescence, middle adolescence). Competence indicators were created and the structure of these domains was tested using…
Wheat, Santina; Dschida, Dorothy; Talen, Mary R
Psychiatric emergencies are acute disturbances in thought, behavior, mood, or social relationship that require immediate intervention as defined by the patient, family, or social unit to save the patient and/or others from imminent danger. Ensuring the safety of the patient, surrounding persons, and the medical team is the first step of evaluation. Treatment focuses on stabilization of the patient, then on specific symptoms and ultimately the cause of symptoms. There are important legal considerations, particularly regarding involuntary admissions. It is important to debrief with the patient, surrounding family, and the health care team to ensure a continued therapeutic alliance and the emotional health of all involved. PMID:27262012
Gullino, A; Coggiola, M; Accomazzo, V; Baracco, A; De Marzi, G P; Occhipinti, R; Perrelli, F; Romano, C
Problems at workplace with psychiatric subjects are increasing and the role of occupational physicians is basic to achieve a suitable job role. The purpose of this study is to assess the main occupational factors and to evaluate the judgement of fitness to work in 1109 patients with psychiatric diseases examined in our outpatients department during the period 2000-2012. These subjects were sent to our service by family doctors or, more frequently, by the companies seeking for judgement of the working residual capacities. The psychiatric diseases were classified according to the DSM IV; for each group considered, we evaluated the production sector, the specific job role, the pharmacological therapy as compared to the final judgement. The most frequent diagnoses were depressive and anxious disorders. The pharmacological therapy does not seem to be related to the final judgement but the small number of subjects defined as unfit to work does not allow a final evaluation. The study suggests the relevance of team work among the different actors of prevention to achieve a successful management of these workers in a specific job role. PMID:23405627
Gorlin, Eugenia I; Dalrymple, Kristy; Chelminski, Iwona; Zimmerman, Mark
Despite growing recognition that the symptoms and functional impairments of Attention Deficit/Hyperactivity Disorder (ADHD) persist into adulthood, only a few psychometrically sound diagnostic measures have been developed for the assessment of ADHD in adults, and none have been validated for use in a broad treatment-seeking psychiatric sample. The current study presents the reliability and validity of a semi-structured DSM-based diagnostic interview module for ADHD, which was administered to 1194 adults presenting to an outpatient psychiatric practice. The module showed excellent internal consistency and interrater reliability, good convergent and discriminant validity (as indexed by relatively high correlations with self-report measures of ADHD and ADHD-related constructs and little or no correlation with other, non-ADHD symptom domains), and good construct validity (as indexed by significantly higher rates of psychosocial impairment and self-reported family history of ADHD in individuals who meet criteria for an ADHD diagnosis). This instrument is thus a reliable and valid diagnostic tool for the detection of ADHD in adults presenting for psychiatric evaluation and treatment. PMID:27259136
Bickle, Andy; Stankard, Paul
The Criminal Justice Act 2003 ('the Act') introduced significant changes to the sentencing of violent and sexual offenders. The Act brought in a statutory assessment of dangerousness which includes a statutory assumption of dangerousness ('SAD') for certain repeat offenders. Previously, expert psychiatric witnesses have commented on whether a defendant demonstrated sufficient mental instability to warrant a discretionary life sentence. Under this regime, psychiatric evidence is adduced to the assessment of dangerousness, especially for the purpose of supporting or undermining a rebuttal of the statutory assumption. This study investigated how legal referrers are instructing psychiatrists in cases where on conviction there will be an automatic assumption that the offender is dangerous. The aim was to determine whether the requirements of the new law are being outlined to expert witnesses and how much notice is being given for the production of evidence. All referrals to a medium secure unit were surveyed over two years. Fifty-one referrals concerned defendants liable to the SAD on conviction. The majority of the SAD referrals (40 referrals = 78.4%) included no request to comment on risk or dangerousness. This figure did not fall over time as the Act became established. Only a small minority (5.9%) of instructions directed the psychiatrist to the relevant statutory provisions. On average, adequate notice appeared to be given for the production of evidence (45.6 days). In the authors' view, legal referrers should make more explicit the requirements of psychiatric evidence in such cases. New legislation currently before Parliament would amend further the sentencing of such offenders, but there would remain a statutory assessment of dangerousness as the basis of sentencing violent and sexual offenders. Psychiatrists wishing to act as expert witnesses should be aware of the contents of the statutory assessment and be prepared to liaise with legal counsel to clarify
Mosconi, Matthew W; Lejuez, Carl W
Adolescence represents a period of vulnerability to psychiatric problems due to a range of factors, including advances in social and cognitive abilities, increased levels of autonomy in decision-making and behavioral governance, and greater exposure to opportunities for risk-taking behavior. Adding to these psychological and social challenges, adolescence also is marked by robust maturational changes affecting both the microcircuitry and connectivity between widely distributed brain systems. These changes alter the communication among parallel, distributed brain networks, have implications for one's vulnerability to engage in risk behavior and make the brain particularly susceptible to external perturbations, such as exposure to neurotoxic substances. PMID:26889899
Rosenstein, Diana S.; Horowitz, Harvey A.
In relationships among attachment classification, psychopathology, and personality, traits were examined in a group of 60 psychiatrically hospitalized adolescents. Attachment was examined in 27 adolescent-mother pairs. Both adolescent and maternal attachment status were overwhelmingly insecure and were highly concordant. Results support a model of…
Di Maggio, Ilaria; Ginevra, Maria Cristina; Nota, Laura; Soresi, Salvatore
The study is aimed at providing the development and initial validation of the Design My Future (DMF), which may be administered in career counseling and research activities to assess adolescents' future orientation and resilience. Two studies with two independent samples of Italian adolescents were conducted to examine psychometric requisites of DMF. Specifically, in the first study, after developing items and examined the content validity, the factorial structure, reliability and discriminant validity of the DMF were tested. In the second study, the measurement invariance across gender, conducing a sequence of nested CFA models, was evaluated. Results showed good psychometric support for the instrument with Italian adolescents. PMID:27348551
Costello, E. Jane; Copeland, William; Angold, Adrian
Background: Little is known about changes in the prevalence of psychiatric disorders between childhood and adolescence, and adolescence and adulthood. Methods: We reviewed papers reporting prevalence rates of psychiatric disorders separately for childhood, adolescence, and early adulthood. Both longitudinal and cross-sectional papers published in…
Mazefsky, C. A.; Kao, J.; Oswald, D. P.
This study investigated the utility of self-report measures to screen for psychiatric comorbidities in autism spectrum disorders (ASDs). Thirty-eight 10-17 year olds with an ASD and without mental retardation completed: the "Children's Depression Inventory-Short version (CDI-S)", "Revised Children's Manifest Anxiety Scale (RCMAS)", "Conners-Wells…
Yoshimasu, Kouichi; Barbaresi, William J.; Colligan, Robert C.; Voigt, Robert G.; Killian, Jill M.; Weaver, Amy L.; Katusic, Slavica K.
Background: To evaluate associations between attention-deficit/hyperactivity disorder (ADHD) and comorbid psychiatric disorders using research-identified incident cases of ADHD and population-based controls. Methods: Subjects included a birth cohort of all children born 1976-1982 remaining in Rochester, MN after age five (n = 5,718). Among them we…
Nugent, Katie L; Spahr, Erin; Toroney, Jaimie; Mojtabai, Ramin; Nettles, Carrie; Turner, Lydia W; Fenton, Ashley; Spivak, Amethyst; Cullen, Bernadette A; Everett, Anita; Eaton, William W
The assessment of adverse effects of psychiatric medications is important in clinical and research settings because they are often associated with medication discontinuation, symptom exacerbation, and reduced quality of life. Currently available assessment tools are either limited with regard to the number and variety of included adverse effects or are not practical for use in most clinical or research settings owing to specialized rater training required and administration length. This report describes a modification of the Monitoring of Side Effects Scale (MOSES), an established adverse effect rating scale, by adding severity anchors to improve its reliability and ease of use. Interrater reliability was good for 7 of the 8 bodily adverse effects assessed, with intraclass correlation coefficients ranging from 0.76 to 0.91 in a sample of patients with severe mental illness. This modified version of the Monitoring of Side Effects Scale holds promise as a useful tool for assessing medication adverse effects in clinical and research settings. PMID:25928700
Höglund, Pontus; Levander, Sten; Anckarsäter, Henrik; Radovic, Susanna
Swedish penal law does not exculpate on the grounds of diminished accountability; persons judged to suffer from severe mental disorder are sentenced to forensic psychiatric care instead of prison. Re-introduction of accountability as a condition for legal responsibility has been advocated, not least by forensic psychiatric professionals. To investigate how professionals in forensic psychiatry would assess degree of accountability based on psychiatric diagnoses and case vignettes, 30 psychiatrists, 30 psychologists, 45 nurses, and 45 ward attendants from five forensic psychiatric clinics were interviewed. They were asked (i) to judge to which degree (on a dimensional scale from 1 to 5) each of 12 psychiatric diagnoses might affect accountability, (ii) to assess accountability from five case vignettes, and (iii) to list further factors they regarded as relevant for their assessment of accountability. All informants accepted to provide a dimensional assessment of accountability on this basis and consistently found most types of mental disorders to reduce accountability, especially psychotic disorders and dementia. Other factors thought to be relevant were substance abuse, social network, personality traits, social stress, and level of education. PMID:19811835
Albrecht, S A; Cornelius, M D; Braxter, B; Reynolds, M D; Stone, C; Cassidy, B
Studies have reported that between 28 and 62% of pregnant teenagers smoke (Cornelius, Taylor, Geva, & Day, 1995; Trollestrup, Frost, & Starzyk, 1992). Because smoking is prevalent among pregnant teenagers, the purpose of this research is to assess nicotine dependence in this high-risk group. This study analyzed baseline data from a sample of pregnant teen smokers who had volunteered to participate in a smoking cessation study (N = 94). Nicotine dependence was measured by adapting the Fagerstrom Tolerance Questionnaire (FTQ; Prokhorov, Pallonen, Fava, Ding, & Niaura, 1996), and by a 6-item withdrawal symptom scale. The overall FTQ score found among pregnant adolescents was 3.10 (SD = 2.3) compared to the mean overall FTQ score among vocational-technical students of 4.27 (SD = 2.2) (Prokhorov et al., 1996). Duration of smoking in years was significantly correlated with the overall FTQ score (r = 0.43, p < .01). Quantity of smoking, as measured by average number of cigarettes smoked, significantly correlated with overall FTQ scores (r = 0.67, p < .01). Lighter smokers were more likely to have previously attempted to quit, however, among the quit attempters, those who smoked 10+ cigarettes per day reported greater severity of withdrawal symptoms than those who smoked less per day. Prenatal education and smoking cessation programs for pregnant teenagers, and pregnant women in general, need to consider that nicotine dependence is an important issue. Early pregnancy may be an opportune time to intervene among pregnant smokers; incentives may be necessary to attract those women who are the heaviest smokers, and possibly the most dependent on nicotine. PMID:10349607
Singh, Jay P.; Desmarais, Sarah L.; Sellers, Brian G.; Hylton, Tatiana; Tirotti, Melissa; Van Dorn, Richard A.
Though considerable research has examined the validity of risk assessment tools in predicting adverse outcomes in justice-involved adolescents, the extent to which risk assessments are translated into risk management strategies and, importantly, the association between this link and adverse outcomes has gone largely unexamined. To address these shortcomings, the Risk-Need-Responsivity (RNR) model was used to examine associations between identified strengths and vulnerabilities, interventions, and institutional outcomes for justice-involved youth. Data were collected from risk assessments completed using the Short-Term Assessment of Risk and Treatability: Adolescent Version (START:AV) for 120 adolescent offenders (96 boys and 24 girls). Interventions and outcomes were extracted from institutional records. Mixed evidence of adherence to RNR principles was found. Accordant to the risk principle, adolescent offenders judged to have more strengths had more strength-based interventions in their service plans, though adolescent offenders with more vulnerabilities did not have more interventions targeting their vulnerabilities. With respect to the need and responsivity principles, vulnerabilities and strengths identified as particularly relevant to the individual youth's risk of adverse outcomes were addressed in the service plans about half and a quarter of the time, respectively. Greater adherence to the risk and need principles was found to predict significantly the likelihood of externalizing outcomes. Findings suggest some gaps between risk assessment and risk management and highlight the potential usefulness of strength-based approaches to intervention. PMID:25346561
Whitcomb, Sara A.; Merrell, Kenneth W.
Generally recognized as the standard work in its field, "Behavioral, Social, and Emotional Assessment of Children and Adolescents" provides a comprehensive foundation and guide for conducting conceptually sound, culturally responsive, and ecologically oriented assessments of student social and emotional behavior. It is aimed at graduate…
Kaminer, Yifrah; Burleson, Joseph A.; Burke, Rebecca H.
The objectives of this paper are two-fold: to examine first, if the change from positive to negative alcohol and any other substance use status from baseline assessment to the onset of the first session (i.e., pre-treatment phase) occurs in adolescents, that is, Assessment Reactivity (AR); second, whether AR predicts treatment outcome.…
Cosden, Merith; Panteleakos, Frances; Gutierrez, Lisa; Barazani, Sivan; Gottheil, Elisa
Strength-based assessments were designed to assess more completely the outcomes for youth having academic and behavioral problems in the schools. This approach has gained appeal among those working with adolescents who have serious behavior problems, such as those involved in drug use and related delinquent behavior. Traditional assessment…
Rudd, M. David; Joiner, Thomas E., Jr.
An integrative conceptual framework is provided for ongoing assessment and day-to-day treatment of suicidal adolescents. Goals are to provide a summary of therapeutic and assessment tasks consistent with existing standards of care and supported by empirical findings and to emphasize the roles, tasks, demands, and limitations of psychotherapy with…
Flanagan, Dawn P.; Alfonso, Vincent C.; Flanagan, Rosemary
Reviews Kaufman Adolescent and Adult Intelligence Test (KAIT), a new assessment of cognitive function for technical qualities such as reliability, validity, and standardization characters. Concludes that KAIT represents advancements in cognitive assessment but cannot be regarded as superior to existing intelligence measures until data is available…
Wichstrom, Lars; Berg-Nielsen, Turid Suzanne; Angold, Adrian; Egger, Helen Link; Solheim, Elisabet; Sveen, Trude Hamre
Background: Many disorders in childhood and adolescence were already present in the preschool years. However, there is little empirical research on the prevalence of psychiatric disorders in young children. A true community study using structured diagnostic tools has yet to be published. Methods: All children born in 2003 or 2004 in the city of…
Dvir, Yael; Ford, Julian D.; Hill, Michael; Frazier, Jean A.
Affect dysregulation, defined as the impaired ability to regulate and/or tolerate negative emotional states, and has been associated with interpersonal trauma and post-traumatic stress. Affect regulation difficulties also play a role in many other psychiatric conditions, including anxiety disorders and mood disorders, specifically major depression in youth and bipolar disorder throughout the life span. Exposure to traumatic events and interpersonal trauma in childhood is associated with a wide range of psychosocial, developmental, and medical impairments in children, adolescents and adults, with emotional dysregulation being a core feature that may help to account for this heightened risk. In order to understand how the developmental effects of childhood maltreatment contribute to emotional dysregulation and psychiatric sequelae, we review emotional regulation and its developmental neurobiology, and examine the research evidence of associations between childhood traumatization, emotional dysregulation, and psychiatric co-morbidities in children, adolescents and adults. PMID:24704784
Dvir, Yael; Ford, Julian D; Hill, Michael; Frazier, Jean A
Affect dysregulation, defined as the impaired ability to regulate or tolerate negative emotional states, has been associated with interpersonal trauma and posttraumatic stress. Affect-regulation difficulties play a role in many psychiatric conditions, including anxiety and mood disorders, and especially major depression in youth and bipolar disorder throughout the life span. Exposure to traumatic events and interpersonal trauma in childhood is associated with wide-ranging psychosocial, developmental, and medical impairments in children, adolescents, and adults, with emotional dysregulation being a core feature that may help to account for this heightened risk. In order to understand how the developmental effects of childhood maltreatment contribute to emotional dysregulation and psychiatric sequelae, we review emotional regulation and its developmental neurobiology, and examine the research evidence of associations between childhood trauma, emotional dysregulation, and psychiatric comorbidities in children, adolescents, and adults. PMID:24704784
Rende, Richard; Birmaher, Boris; Axelson, David; Strober, Michael; Gill, Mary Kay; Valeri, Sylvia; Chiappetta, Laurel; Ryan, Neal; Leonard, Henrietta; Hunt, Jeffrey; Iyengar, Satish; Keller, Martin
Objective: To determine whether childhood-onset bipolar disorder (BP) is associated with an increased psychiatric family history compared with adolescent-onset BP. Method: Semistructured psychiatric interviews were conducted for 438 youth with BP spectrum disorders. To evaluate the effects of age at onset and psychiatric family history, the sample…
Hawke, Josephine M.; Kaminer, Yifrah; Burke, Rebecca; Burleson, Joseph A.
Objectives: To examine the stability of comorbid psychiatric diagnoses among a sample of 50 adolescents in cognitive-behaviorally-based treatment for alcohol and other substance use disorders (AOSUD). Methods: A standardized psychiatric interview was administered at baseline and 12 month later to obtain current comorbid psychiatric disorders. Chi…
Clemens, Elysia V.; Welfare, Laura E.; Williams, Amy M.
Psychiatric reasons are among the most common causes of hospitalization for adolescents. A Consensual Qualitative Research approach was used to explore mental health professionals' perceptions of the needs of adolescents as they transition from psychiatric hospital to school. Academic, social, and emotional domains emerged as important areas of…
de Faria, Eliane Rodrigues; Franceschini, Sylvia do Carmo C.; Peluzio, Maria do Carmo G.; Sant'Ana, Luciana Ferreira da R.; Priore, Silvia Eloiza
OBJECTIVE To analyze methodological and ethical aspects in the sexual maturation assessment of adolescents. DATA SOURCES Books and theses, articles and legislations on the Medline, SciELO, Science Direct databases, besides institutional documents of the World Health Organization and the Pediatric Societies of Brazil and São Paulo, considering the period from 1962 to 2012. The following keywords were used in Portuguese and English: "sexual maturation", "self-assessment", "ethics", "OBJECTIVE assessment of sexual maturation", "puberty", "adolescent", and "adolescentdevelopment". DATA SYNTHESIS The sexual maturation assessment is used in populatinal studies and in clinical daily care. The direct evaluation is performed by a specialized physician, whereas the self-assessment is carried out by the adolescent. This evaluation should be carefully performed in the appropriate place, taking into account the ethical aspects. The patient should not be constrained and the physician must respect the privacy and the confidentiality. Before this evaluation and independently of the used method, the adolescent should receive information and explanation about the procedure and the tools that will be applied. Furthermore, the patient has the right to want or not an adult close to him. CONCLUSIONS Validation studies showed that self-assessment is inferior to clinical assessment and should, therefore, be performed only when the direct examination by physicians is not possible. PMID:24142325
Musick, Kelly; Meier, Ann
Adolescents who share meals with their parents score better on a range of well-being indicators. Using three waves of the National Longitudinal Survey of Adolescent Health (N = 17,977), we assessed the causal nature of these associations and the extent to which they persist into adulthood. We examined links between family dinners and adolescent mental health, substance use, and delinquency at wave 1, accounting for detailed measures of the family environment to test whether family meals simply proxy for other family processes. As a more stringent test of causality, we estimated fixed effects models from waves 1 and 2, and we used wave 3 to explore persistence in the influence of family dinners. Associations between family dinners and adolescent well-being remained significant, net of controls, and some held up to stricter tests of causality. Beyond indirect benefits via earlier well-being, however, family dinners associations did not persist into adulthood. PMID:23794750
Forensic psychiatric evaluators of adolescent defendants are often asked to address open-ended questions that affect what court an adolescent will be tried in and what sentence he might receive. Such questions often involve the extent to which the adolescent should be considered less culpable than an adult who has committed a similar offense. Assessing partial or diminished culpability in an adolescent is difficult because the concept of partial culpability is complex, assessment methods are inexact, and the implications for legal disposition are often not clear. This article suggests 10 factors a forensic evaluator may wish to consider in reaching opinions about an adolescent's culpability: appreciation of wrongfulness, ability to conform to law, developmental course of aggression and impulsivity, psychosocial immaturity (including time sense, susceptibility to peer pressure, risk-taking, and ability to empathize), environmental circumstances, peer group norms, out-of-character action, incomplete personality development, mental illness, and reactive attitudes toward the offense. PMID:22396338
Lugasi, Tziona; Achille, Marie; Blydt-Hansen, Tom; Clermont, Marie-José; Geoffroy, Louis; Legault, Laurent; Phan, Véronique; Bell, Lorraine E
Identity development represents a central task of adolescence. Identity achievement is characterized by a coherent sense of who one is following a period of exploration and can help navigate the challenges of adulthood. This study examined identity within a quality of life (QOL) context in 85 adolescents with a renal transplant or with Type 1 diabetes in comparison to 90 healthy controls. Results revealed significant differences in ideological identity, with patients showing higher levels of diffusion and controls showing higher levels of foreclosure. No differences with respect to interpersonal identity, QOL, perceived control over the QOL domains, and perceived opportunities for growth and development were found. Future research should assess identity and QOL over a longer period of time to determine whether differences between chronically ill and healthy young adults can be detected. PMID:23645186
The last decade, the number of health economic evaluations has increased substantially in the field of child psychiatry. The objective of the present paper is to offer an overview of economic evaluations of child psychiatric drug treatment. Major electronic databases, as well as abstract booklets from international clinical and health economics conferences with an external peer review process, were examined to search for comparative economic evaluations of child and adolescent psychiatric drug treatment. Most studies of pharmacotreatment were cost effectiveness analyses (CEAs) concerned with attention-deficit/hyperactivity disorder (ADHD). Three evaluations were done by or on behalf of agencies as part of ADHD-related health technology assessments. A number of economic studies used patient-level data from specific randomized clinical trials, especially the NIMH-initiated MTA (in childhood ADHD) and TADS (in adolescent major depression) studies. Almost all studies relied on narrow scale symptom scales to assess effects of treatment, even when quality-adjusted life years (QALYs) were reported. In many cases, effectiveness data came from short-term studies, and extrapolation to a one-year time horizon was usually based on assumptions. Even those evaluations attempting to address longer time horizons by way of modeling did not include the impact of treatment on long-term sequelae of the conditions studied, mainly due to a paucity of robust clinical data. Nevertheless, currently available health economic evaluations broadly suggest an acceptable to attractive cost effectiveness of medication management of ADHD, whereas there is no such evidence for child psychiatric disorders other than ADHD. PMID:20513230
Khor, Angela S; Gray, Kylie M; Reid, Sophie C; Melvin, Glenn A
Ecological Momentary Assessment (EMA) may increase accuracy of data compared with retrospective questionnaires by assessing behaviours as they occur, hence decreasing recall biases and increasing ecological validity. This study examined the feasibility and concurrent validity of an EMA tool for adolescents with High-Functioning Autism Spectrum Disorders (HFASD). Thirty-one adolescents with HFASD completed a mobile phone EMA application that assessed stressors and coping for two weeks. Parents and adolescents also completed retrospective measures of the adolescent's coping/stressors. Moderate compliance with the EMA tool was achieved and some concurrent validity was established with the retrospective measure of coping. Concordance was found between the types of stressors reported by parents and adolescents but not the quantity. The results suggest adolescents with HFASD are capable of reporting on their stressors and coping via EMA. EMA has the potential to be a valuable research tool in this population. PMID:24331303
Martin, Gary L.; Newman, Ian M.
Compared adolescent cigarette smoking rates determined by traditional questionnaire, random response questionnaire, and carbon monoxide test. Results from 1,160 ninth graders in 40 classrooms in 7 schools indicated that random response questionnaire elicited statistically larger proportion of smokers than did traditional questionnaire. Neither…
Hayes-Bohn, Rachel; Neumark-Sztainer, Dianne; Mellin, Alison; Patterson, Joan
This study explored opinions, concerns, and recommendations regarding care of Type 1 diabetes in schools. Thirty adolescent females and their parents participated in semi- structured, individual interviews that were audiotaped, transcribed, coded, and qualitatively analyzed. Responses emerged in three categories: (1) knowledge/training of school…
Perez, Juan; del Sol Fortea Sevilla, Maria
This study compared scores of 17 children with autism and mental retardation on the Psychoeducational Profile with scores on the Adolescent and Adult Psychoeducational Profile 5 years later. Eye-hand coordination predicted scores in vocational skills, independent functioning, and vocational behavior; imitation predicted interpersonal behavior;…
Fahlman, Mariane; McCaughtry, Nate; Martin, Jeffrey; Garn, Alex C.; Shen, Bo
Background: There is a need for instruments that can accurately determine the effectiveness of nutrition interventions targeting low-income, inner-city adolescents. Purpose: To examine the development of a valid and reliable eating behavior scale (EBS) for use in school-based nutrition interventions in urban, inner-city communities dominated by…
Hadley, Wendy; Hunter, Heather L; Tolou-Shams, Marina; Lescano, Celia; Thompson, Ariel; Donenberg, Geri; DiClemente, Ralph; Brown, Larry K
The present study sought to examine associations between maternal psychopathology, parental monitoring, and adolescent sexual activity among adolescents in mental health treatment. Seven hundred ninety mother-adolescent dyads recruited from adolescent mental health treatment settings completed audio computer-assisted structured interview assessments examining parent psychiatric symptoms, parental monitoring, and adolescent sexual risk behavior. Path analysis was used to examine the associations between variables of interest. Maternal caregivers who reported more mental health symptoms were more likely to have adolescents who reported recent sex and this relationship was mediated by less parental monitoring. These findings suggest that maternal caregivers with mental health symptoms may need specific interventions that provide assistance and support in monitoring their teens in order to reduce sexual risk taking among adolescents in mental health treatment. PMID:21417519
Eklund, Mona; Bäckström, Martin
A self-report instrument assessing work-related factors among people with psychiatric disabilities would be useful when trying to match possible employment or prevocational opportunities with people's desires and capacities. The aim of this study was to explore the factor structure, internal consistency, and construct and criterion validity of the Worker Role Self-Assessment (WRS) in this group as well as possible floor and ceiling effects. The participants were 283 clients from day centers for people with psychiatric disabilities and from outpatient units for people with psychosis. They completed the WRS and instruments selected to assess construct validity in terms of convergent (motivation for work and current activity level as reference variables) and discriminant validity (quality of life and self-rated health as reference variables). Two factors were identified, one tapping beliefs in a future worker role and one reflecting current capacities and routines. The internal consistency for the scale as a whole was good at 0.84. The factor reflecting a future worker role correlated as expected with the reference variables used to assess convergent and discriminant validity, whereas current capacities and routines showed a moderate association with quality of life and self-rated health, assumed to indicate discriminant validity. Criterion validity was shown in that those who had recent work experiences scored higher than the others on WRS. No floor or ceiling effects were identified. The findings indicate acceptable psychometric properties of the WRS. Further development is still warranted, however; the factor solution needs to be replicated and the construct validity should be further established. PMID:27103638
Riggs, Paula; Levin, Frances; Green, Alan I; Vocci, Frank
Psychiatric comorbidity is defined as the co-occurrence of a psychiatric disorder in a patient with a substance use disorder. Psychiatric disorders in substance abuse patients can antedate the substance use disorder or be a consequence of the substance abuse. There is emerging evidence that drug use in adolescence may alter the onset of certain psychiatric disorders in vulnerable individuals. Patients with concurrent comorbid disorders present special challenges for the substance abuse treatment system in terms of diagnosis and management because each disorder has the capability of exacerbating the other. This manuscript is a summary of an ISAM symposium that featured three speakers who discussed the following topics: 1. Etiology and treatment of comorbid psychiatric and substance use disorders in adolescents; 2. Treatment of ADHD and substance use disorders in adults; 3. Effects of substance abuse on the onset, severity, and treatment of schizophrenia. Recommendations for further research will be presented. PMID:19042206
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. PMID:26275772
Sarajlic Vukovic, Iris; Boricevic Maršanic, Vlatka; Aukst Margetic, Branka; Paradžik, Ljubica; Vidovic, Domagoj; Buljan Flander, Gordana
Background: Posttraumatic stress disorder (PTSD) in male veterans has been linked with impaired family relationships and psychopathology in their children. Less is known about symptoms in children of veterans with partial PTSD. Objective: To compare mental health problems, family functioning and parent-child bonding among adolescent offspring of…
Bauer, Katherine W.; Friend, Sarah; Graham, Daniel J.; Neumark-Sztainer, Dianne
Most studies of sedentary behavior have focused on television use or screen time. This study aims to examine adolescent girls' participation in a variety of recreational sedentary behaviors (e.g., talking on the phone and hanging around), and their association with physical activity (PA), dietary behaviors, and body mass index. Data were from a sample of 283 adolescent girls. Recreational sedentary behavior, PA, and dietary behaviors were self-reported, and girls' height and weight were measured. Over 95% of girls engaged in at least one recreational sedentary behavior during the recall period. Watching television and hanging around were the most common behaviors. Watching television, using the Internet, and hanging around were associated with less PA; watching television, hanging around, and talking on the phone were associated with less healthful dietary behaviors. No associations were found with body mass index. Interventions may benefit from capitalizing on and intervening upon girls' common recreational sedentary behaviors. PMID:22013514
Djordjevic, Jelena; Pirttiniemi, Pertti; Harila, Virpi; Heikkinen, Tuomo; Toma, Arshed M; Zhurov, Alexei I; Richmond, Stephen
Recent advances in laser scanning technology provide the opportunity to examine faces in three dimensions. The aim of this prospective clinical study was to explore facial symmetry in healthy growing individuals and determine whether asymmetric changes occur during adolescent growth. Non-invasive laser surface scanning was performed to capture facial images of 60 Caucasian Finnish adolescents (30 males and 30 females, mean 11.5 years). Facial symmetry was analysed on images obtained at the initial scanning (T₁), 2.5 (T₂), and 4.5 (T₃) years thereafter. The final sample consisted of 39 adolescents (19 males and 20 females, mean 16 years). Three-dimensional images were processed and analysed using an in-house developed subroutine for commercial software. A mirror image was generated and superimposed on the original image to create a symmetric face and establish the midsagittal plane. The surface matching of the original face and the mirror face (amount of symmetry) was measured for the whole face, upper, middle, and lower thirds at tolerance level 0.5 mm and presented with colour maps. Three angular and 14 linear measurements were made based on 21 soft tissue landmarks, which have proven to be reliable. The results of the Friedman test showed that facial symmetry parameters did not significantly differ over time (P > 0.05). Mann-Whitney U-test did not reveal statistically significant differences between genders at any time point (P > 0.05). Facial growth of healthy individuals during adolescence is symmetric, although further investigation on larger randomized sample is suggested. PMID:21300725
Wehry, Anna M.; Beesdo-Baum, Katja; Hennelly, Meghann M.; Connolly, Sucheta D.; Strawn, Jeffrey R.
Recent advances in the developmental epidemiology, neurobiology and treatment of pediatric anxiety disorders have increased our understanding of these conditions and herald improved outcomes for affected children and adolescents. This article reviews the current epidemiology, longitudinal trajectory, and neurobiology of anxiety disorders in youth. Additionally, we summarize the current evidence for both psychotherapeutic and psychopharmacologic treatments of fear-based anxiety disorders (e.g., generalized, social and separation anxiety disorders) in children and adolescents. Current data suggest that these disorders begin in childhood and adolescence, exhibit homotypic continuity and increase the risk of secondary anxiety and mood disorders. Psychopharmacologic trials involving selective serotonin reuptake inhibitors (SSRIs) and selective serotonin norepinephrine reuptake inhibitors (SSNRIs) are effective in pediatric patients with anxiety disorders and have generally demonstrated moderate effect sizes. Additionally, current data support cognitive-behavioral therapy (CBT) are efficacious in the treatment of these conditions in youth and that combination of CBT + an SSRI may be associated with greater improvement than would be expected with either treatment as monotherapy. PMID:25980507
Wehry, Anna M; Beesdo-Baum, Katja; Hennelly, Meghann M; Connolly, Sucheta D; Strawn, Jeffrey R
Recent advances in the developmental epidemiology, neurobiology, and treatment of pediatric anxiety disorders have increased our understanding of these conditions and herald improved outcomes for affected children and adolescents. This article reviews the current epidemiology, longitudinal trajectory, and neurobiology of anxiety disorders in youth. Additionally, we summarize the current evidence for both psychotherapeutic and psychopharmacologic treatments of fear-based anxiety disorders (e.g., generalized, social, and separation anxiety disorders) in children and adolescents. Current data suggest that these disorders begin in childhood and adolescence, exhibit homotypic continuity, and increase the risk of secondary anxiety and mood disorders. Psychopharmacologic trials involving selective serotonin reuptake inhibitors (SSRIs) and selective serotonin norepinephrine reuptake inhibitors (SSNRIs) are effective in pediatric patients with anxiety disorders and have generally demonstrated moderate effect sizes. Additionally, current data support cognitive behavioral therapy (CBT) for the treatment of these conditions in youth and suggest that the combination of psychotherapy + an SSRI may be associated with greater improvement than would be expected with either treatment as monotherapy. PMID:25980507
HIV Patient care should include psychological and psychiatric care, which is necessary for early detection thereof. Should suicidal ideation occur, refer the patient to a psychiatric unit. Pharmacological treatment is recommended when there is comorbidity with moderate or severe depression. You should look for the aetiology of neuropsychiatric disorder before using psychoactive drugs in HIV patients. The overall management of the health of HIV adolescents should include an assessment of mental health, environmental stressors and support systems. Training in the management of the patient both own emotions is critical to getting to provide optimal care. These new guidelines updated previous recommendations regarding psychiatric and psychological disorders, including the most common pathologies in adults and children. PMID:26409724
Moore, Louise E.; And Others
This review examines evaluation and treatment of adjustment problems in adolescents with visual impairments and describes a behavioral family treatment program. It considers the impact of the child on the family and the family on the child; assessment (psychopathology, social skills competence, family adjustment, and marital functioning); and…
Sink, Christopher A.; Bultsma, Shawn A.
The psychometric properties of the Life Perspectives Inventory (LPI-English language version), a new instrument designed to assess characteristics associated with nonreligious spirituality in high school-age adolescents, were examined in two phases. Phase 1 demonstrated the survey's factorial validity and internal consistency and the…
Dilley, Joseph B.; Weiner, Dana A.; Lyons, John S.; Martinovich, Zoran
The Child and Adolescent Needs and Strengths (CANS) is a functional assessment used in approximately 27 states to evaluate youth service outcomes. The CANS purports to measure both the youth's risk and protective factors, but its validity is largely un-researched. This study compares ratings of 304 delinquent youth on the CANS and ratings on a…
Mello, Zena R.; Finan, Laura J.; Worrell, Frank C.
We report on two studies that examine new instruments that assess time orientation and time relation in adolescents. These concepts refer to how individuals think about the past, the present, and the future, with time orientation defined as the emphasis one gives toward each time period and time relation defined as the degree one perceives that…
Grondhuis, Sabrina N.; Aman, Michael G.
Anxiety disorders are among the most common comorbid conditions in children and adolescents with autism spectrum disorders (ASDs), although assessment presents unique challenges. Many symptoms of anxiety appear to overlap with common presentations of autism. Furthermore, deficits in language and cognitive functioning make it difficult for such…
Chapin, John; Chirico, JoAnn
This study sought to document optimistic bias among older adolescents in the context of numerous hazards. It was among the first studies to triangulate quantitative and qualitative measures to investigate how individuals make personal risk assessments within the optimistic bias literature. Results from a small-scale survey and follow-up interviews…
Miller, Jon F.; Andriacchi, Karen; Nockerts, Ann
Purpose: This tutorial discusses the importance of language sample analysis and how Systematic Analysis of Language Transcripts (SALT) software can be used to simplify the process and effectively assess the spoken language production of adolescents. Method: Over the past 30 years, thousands of language samples have been collected from typical…
Journal of the American Academy of Child and Adolescent Psychiatry, 2007
This practice parameter reviews the literature on the assessment and treatment of children and adolescents with bipolar disorder. The parameter focuses primarily on bipolar 1 disorder because that is the type most often studied in juveniles. The presentation of bipolar disorder in youth, especially children, is often considered atypical compared…
Wu, Ya-Ping; Mirenda, Pat; Wang, Hwa-Pey; Chen, Ming-Chung
This case study describes the processes of functional analysis and modality assessment that were utilized to design a communication intervention for an adolescent with autism who engaged in loud and disruptive vocalizations for most of the school day. The functional analysis suggested that the vocalizations served both tangible and escape…
Pristas, Erica V.; Rosenberg, Harold
The Adolescent Responses to Alcohol and Drug Offers Scale (ARADOS) is a self-report questionnaire designed to assess a respondent's anticipated emotional reactions and intended use of cognitive-behavioral refusal skills in response to an offer of alcohol or other drug. A sample of 267 students enrolled in the 11th and 12th grades of four public…
Khubchandani, Jagdish; Telljohann, Susan K.; Price, James H.; Dake, Joseph A.; Hendershot, Candace
Background: This study assessed the perceptions and practices of school nurses regarding adolescent dating violence (ADV). Methods: The membership list of the National Association of School Nurses was used to identify a national random cross-sectional sample of high school nurses in the United States (N?=?750). A valid and reliable survey…
van Steensel, Roel; Oostdam, Ron; van Gelderen, Amos
On the basis of a validation study of a new test for assessing low-achieving adolescents' reading comprehension skills--the SALT-reading--we analyzed two issues relevant to the field of reading test development. Using the test results of 200 seventh graders, we examined the possibility of identifying reading comprehension subskills and the effects…
Mobile technologies are emerging as a valuable tool to collect and assess dietary intake. Adolescents readily accept and adopt new technologies, hence, a food record application (FRapp) may provide an accurate mechanism to monitor dietary intake. We examined the usability of a FRapp in 17 free-livin...
Wolf, Abraham W.; And Others
Examined the frequency and associations of multiple diagnoses in 205 psychiatric inpatients, assessing past and current episodes of illness. Over one-half of the sample received more than one diagnosis. Alcoholism, antisocial personality, and drug dependence formed one group; primary depression, primary mania, and secondary affective disorder,…
Struble, Laura M; Sullivan, Barbara J; Hartman, Laurie S
An astounding 30% to 50% of older patients who are hospitalized for a medical condition also have a psychiatric disorder. The intent of this article is to prepare acute care nurses to meet the mental health needs of older adults with a critical illness and prevent untoward sequelae of medical events. The authors discuss the importance of baseline assessment data, issues related to informed consent, manifestations of common psychiatric disorders that may be seen in older adults in the acute care setting, as well as strategies to improve patient outcomes. PMID:24484928
Silverman, Wendy K; Ollendick, Thomas H
We provide an overview of where the field currently stands when it comes to having evidence-based methods and instruments available for use in assessing anxiety and its disorders in children and adolescents. Methods covered include diagnostic interview schedules, rating scales, observations, and self-monitoring forms. We also discuss the main purposes or goals of assessment and indicate which methods and instruments have the most evidence for accomplishing these goals. We also focus on several specific issues that need continued research attention for the field to move forward toward an evidence-based assessment approach. Finally, tentative recommendations are made for conducting an evidence-based assessment for anxiety and its disorders in children and adolescents. Directions for future research also are discussed. PMID:16026211
Background In the continuing revision of Diagnostic and Statistical Manual (DSM-V) “identity” is integrated as a central diagnostic criterion for personality disorders (self-related personality functioning). According to Kernberg, identity diffusion is one of the core elements of borderline personality organization. As there is no elaborated self-rating inventory to assess identity development in healthy and disturbed adolescents, we developed the AIDA (Assessment of Identity Development in Adolescence) questionnaire to assess this complex dimension, varying from “Identity Integration” to “Identity Diffusion”, in a broad and substructured way and evaluated its psychometric properties in a mixed school and clinical sample. Methods Test construction was deductive, referring to psychodynamic as well as social-cognitive theories, and led to a special item pool, with consideration for clarity and ease of comprehension. Participants were 305 students aged 12–18 attending a public school and 52 adolescent psychiatric inpatients and outpatients with diagnoses of personality disorders (N = 20) or other mental disorders (N = 32). Convergent validity was evaluated by covariations with personality development (JTCI 12–18 R scales), criterion validity by differences in identity development (AIDA scales) between patients and controls. Results AIDA showed excellent total score (Diffusion: α = .94), scale (Discontinuity: α = .86; Incoherence: α = .92) and subscale (α = .73-.86) reliabilities. High levels of Discontinuity and Incoherence were associated with low levels in Self Directedness, an indicator of maladaptive personality functioning. Both AIDA scales were significantly different between PD-patients and controls with remarkable effect sizes (d) of 2.17 and 1.94 standard deviations. Conclusion AIDA is a reliable and valid instrument to assess normal and disturbed identity in adolescents. Studies for further validation and for
Hayes-Bohn, Rachel; Neumark-Sztainer, Dianne; Mellin, Alison; Patterson, Joan
This study explored opinions, concerns, and recommendations regarding care of Type 1 diabetes in schools. Thirty adolescent females and their parents participated in semi- structured, individual interviews that were audiotaped, transcribed, coded, and qualitatively analyzed. Responses emerged in three categories: knowledge/training of school staff; foods offered/available at school; and school rules. Participants expressed concerns that school personnel, particularly classroom teachers, possess limited knowledge of diabetes; that healthy food/beverage options are limited in the cafeteria, vending machines, and classrooms; and that school rules impede self-care of diabetes. Implications for enhancing diabetes management at school are noted. PMID:15283497
Scott, Ronald L; Knoth, Russell L; Beltran-Quiones, Monica; Gomez, Nelson
The earthquake that hit Armenia, Colombia, on January 25, 1999, dramatically impacted the lives of thousands of people, including children and adolescents. This study used the Hispanic MMPI-A to clinically assess for ongoing psychopathology in a group of 59 adolescent earthquake victims. Their scores on the basic, content, and supplementary scales of the instrument were compared to those of a control group of 62 Colombian adolescents with similar socioeconomic, educational, and ethnic backgrounds. The results showed no clinically significant elevations for the earthquake victims indicating that the disaster had not resulted in diagnosable psychopathology. When compared to controls, earthquake victims showed significant elevations on D, Pt, and Sc indicating that they were mildly affected (but within the normal range) by the earthquake. The results are discussed in the context of cultural factors and the contemporary disaster and resiliency literature. PMID:12602652
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 health treatment completed private, computer-based assessments of psychiatric disorders and of sexual and substance use behaviors and provided urine to screen for sexually transmitted infections (STI). 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 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). 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
Parra, Gilbert R.; Olsen, James P.; Buckholdt, Kelly E.; Jobe-Shields, Lisa; Davis, Genevieve L.
We conducted a pilot study of the initial development of a self-report measure assessing how adolescents react when parents respond in a helpful manner to their sad emotional experiences. Participants were late adolescents (ages 18-20) attending a large, racially diverse urban university (N = 86; 75% women; 46% racial/ethnic minority). A broad…
Brumm, V L; Bilder, D; Waisbren, S E
Psychological and psychiatric problems are well documented across the lifespan of individuals with early-treated phenylketonuria (PKU). Early-treated children and adolescents tend to display attentional problems, school problems, lower achievement motivation, decreased social competence, decreased autonomy, and low-self-esteem. As they enter adulthood, early-treated individuals may carry forward low self-esteem and lack of autonomy but also tend to develop depressed mood, generalized anxiety, phobias, decreased positive emotions, social maturity deficits, and social isolation. The correlation between level of metabolic control and severity of symptoms suggests a biological basis of psychiatric dysfunction. Additionally, psychosocial factors such as the burden of living with a chronic illness may contribute to psychological and psychiatric outcomes in PKU. The lack of a PKU-specific psychiatric phenotype combined with the observation that not everyone with PKU is affected highlights the complexity of the problem. More research on psychiatric and psychological outcomes in PKU is required. Of particular importance is the routine monitoring of emotional, behavioral, and psychosocial symptoms in individuals with this metabolic disorder. Longitudinal studies are required to evaluate the impact of new and emerging therapies on psychiatric and psychosocial functioning in PKU. Unidentified or untreated emotional and behavioral symptoms may have a significant, lifelong impact on the quality of life and social status of patients. PMID:20123472
de Andrade, Maria Izabel Siqueira; Oliveira, Juliana Souza; Leal, Vanessa Sá; da Lima, Niedja Maria Silva; Costa, Emília Chagas; de Aquino, Nathalia Barbosa; de Lira, Pedro Israel Cabral
Abstract Objective: To identify cutoff points of the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) index established for adolescents and discuss their applicability for the diagnosis of insulin resistance in Brazilian adolescents. Data source: A systematic review was performed in the PubMed, Lilacs and SciELO databases, using the following descriptors: "adolescents", "insulin resistance" and "Receiver Operating Characteristics Curve". Original articles carried out with adolescents published between 2005 and 2015 in Portuguese, English or Spanish languages, which included the statistical analysis using Receiver Operating Characteristics Curve to determine the index cutoff (HOMA-IR) were included. Data synthesis: A total of 184 articles were identified and after the study phases were applied, seven articles were selected for the review. All selected studies established their cutoffs using a Receiver Operating Characteristics Curve, with the lowest observed cutoff of 1.65 for girls and 1.95 for boys and the highest of 3.82 for girls and 5.22 for boys. Of the studies analyzed, one proposed external validity, recommending the use of the HOMA-IR cutoff>2.5 for both genders. Conclusions: The HOMA-IR index constitutes a reliable method for the detection of insulin resistance in adolescents, as long as it uses cutoffs that are more adequate for the reality of the study population, allowing early diagnosis of insulin resistance and enabling multidisciplinary interventions aiming at health promotion of this population. PMID:26559605
Knight, Adam C; Holmes, Megan E; Chander, Harish; Kimble, Amari; Stewart, Joshua Ty
Track and field events place different demands on athletes and may have an effect on balance. This study investigated the effects of event specialty, gender, and leg dominance on balance among adolescent track and field athletes. Forty healthy adolescent track and field athletes (male = 23, female = 17) categorised into three different groups (sprinter = 20, distance runners = 13, throwers = 7) had their single leg static balance measured with the eyes open and the eyes closed using an AMTI force platform. Dependent variables included average displacement (cm) of the centre of pressure (COP) in the anterior/posterior direction and medial/lateral directions, the average velocity of the COP (cm/s) and the 95% ellipse area (cm(2)). Variables were analysed using a 3 (event specialty) × 2 (gender) × 2 (leg) ANOVA with repeated measures on the leg variable (p < 0.05). There was a significant difference (p < 0.05) in the average displacement of the COP in the medial/lateral direction for both the eyes open and closed condition, with the non-dominant leg demonstrating greater displacement than the dominant leg. This might increase the risk of injury for the non-dominant leg, but additional data should be collected and analysed on both dynamic balance and performance. PMID:27111401
Hamann, Christoph; Schultze-Lutter, Frauke
Background The ever-increasing use of the Internet among adolescents represents an emerging opportunity for researchers to gain access to larger samples, which can be queried over several years longitudinally. Among adolescents, young adolescents (ages 11 to 13 years) are of particular interest to clinicians as this is a transitional stage, during which depressive and anxiety symptoms often emerge. However, it remains unclear whether these youngest adolescents can accurately answer questions about their mental well-being using a Web-based platform. Objective The aim of the study was to examine the accuracy of responses obtained from Web-based questionnaires by comparing Web-based with paper-and-pencil versions of depression and anxiety questionnaires. Methods The primary outcome was the score on the depression and anxiety questionnaires under two conditions: (1) paper-and-pencil and (2) Web-based versions. Twenty-eight adolescents (aged 11-13 years, mean age 12.78 years and SD 0.78; 18 females, 64%) were randomly assigned to complete either the paper-and-pencil or the Web-based questionnaire first. Intraclass correlation coefficients (ICCs) were calculated to measure intrarater reliability. Intraclass correlation coefficients were calculated separately for depression (Children’s Depression Inventory, CDI) and anxiety (Spence Children’s Anxiety Scale, SCAS) questionnaires. Results On average, it took participants 17 minutes (SD 6) to answer 116 questions online. Intraclass correlation coefficient analysis revealed high intrarater reliability when comparing Web-based with paper-and-pencil responses for both CDI (ICC=.88; P<.001) and the SCAS (ICC=.95; P<.001). According to published criteria, both of these values are in the “almost perfect” category indicating the highest degree of reliability. Conclusions The results of the study show an excellent reliability of Web-based assessment in 11- to 13-year-old children as compared with the standard paper
Ghanbarzadeh, Mohsen; Habibi, Abdolhamid; Shakeriyan, Said
Background Overweight and obese children are at increased risk of a wide range of health conditions including respiratory diseases. In addition, inactivity can decrease pulmonary function. This study assessed the effect of obesity and inactivity on pulmonary function impairment in adolescents. Materials and Methods This study was conducted on 80 adolescents. Subjects were divided into two groups. Group I included 40 untrained (VO2max= 29.30±4.20) fat adolescents (UO). Group II included 40 healthy trained (VO2max= 58.11±2.23) normal weight adolescents (TN). Body mass index (BMI), body fat percentage and waist to hip ratio (WHR) were calculated and pulmonary function tests were carried out according to the standard protocols. Data were analyzed using student's “t” test and Pearson's correlation coefficient. Results UO had significantly lower pulmonary function values than the TN group. They also showed lower FEV1/FVC ratio when compared to TN group (P < 0.05). In UO group, BMI, body fat percentage and WHR had a significant negative correlation with pulmonary function whereas in TN group only BMI had significant negative correlation with pulmonary function. A significant decrease in FEV1 was observed in the two groups, which led to a decrease in FEV1/FVC% after the exercise compared to before. Thus, exercise test induced airway resistance in both groups. Conclusion untrained obese adolescents have more respiratory symptoms than their normal weight trained peers, and these factors are recommended to be used as a predictor of pulmonary function in assessment of obese children in epidemiological studies. In addition, obesity and inactivity can surcharge pulmonary function abnormalities in adolescents. PMID:25191449
Background Few studies have examined how common physicians assess various weight-related variables and patient characteristics that predict such assessments based on adolescents’ reports. We aimed to examine how common adolescents received weight-related physical measurements and lifestyle enquiries (dietary habits and physical activity) from private practitioners and to identify factors associated with these assessments. Methods In the Hong Kong Student Obesity Surveillance (HKSOS) project, 33692 students (44.9% boys; mean age 14.8, SD 1.9 years, age range 11–18) from 42 randomly selected schools completed an anonymous questionnaire. The students were asked “In the past 12 months, has any private practitioners (or their nurses) measured or asked about these items?” Response options included height, weight, waist circumference (WC), blood pressure (BP), BMI, diet, and physical activity. Weight status was based on self-reported weight and height. Logistic regression was used to identify student characteristics associated with each assessment. Analyses were conducted using STATA 10.0. Results Among 13283 students who had doctor consultations in the past 12 months, 37.9% received physical measurements or lifestyle enquiries, with weight (20.8%), height (16.8%) and blood pressure (11.5%) being the most common, followed by diet (8.1%), BMI (6.3%), WC and physical activity (both 4.6%). In general, adolescents who were female, older, underweight or overweight/obese, had parents with higher education level, and had actively asked private practitioners for advice about weight were more likely to receive assessments of weight-related factors. Conclusions Weight-related factors in adolescents were infrequently assessed by private practitioners in Hong Kong. Generally, unhealthy weight, higher parental education and advice-seeking by adolescents predicted these assessments. PMID:24070145
Munzer, Jane; And Others
Suicide attempts and suicidal ideation among adolescents have been increasing faster than those for adults. This study addresses three questions on adolescent suicidal behavior: (1) Why do some adolescents with psychiatric disorders have a history of suicidal behaviors and some do not?; (2) How do intrapsychic and interpersonal underpinnings of…
Leibowitz, Scott; de Vries, Annelou L C
Adolescents presenting with gender-related concerns are increasingly seeking support from providers from a variety of disciplines within health care settings across the world. For those treating young people who meet the criteria for the DSM 5 diagnosis of gender dysphoria (GD), complex decisions in clinical care are common. Defining best practice with this population with respect to interventions that span mental health, physical, and surgical domains can be challenging, given a relative dearth of empirical data available; yet practice guidelines have emerged from different professional organizations which can aid with this. For this review paper, a broad literature search was performed to identify relevant studies pertaining to the care of adolescents with GD. In addition, an overview of trends in clinical practice, including shifts in conceptualization of how clinicians and patients define care that is considered affirming when working with this population, is described. This paper explores the characteristics of referral patterns to specialized clinics, provides a brief overview of gender identity development in adolescence, and then describes the phenomenology of known aetiological factors and co-occurring psychiatric issues in adolescents with GD. Additionally, clinical management considerations that detail assessment aims and common treatment interventions across disciplines will be explored. PMID:26828376
Jellinek, Michael S.; Henderson, Schuyler W.
The U.S. faces a changing demographic landscape that is increasingly multiracial. The application of a cultural competence model for assessing and treating the psychiatric disorders of minority youths in light of this demographic change is discussed.
Voineskos, G.; Denault, S.
Undue emphasis has been placed on rising rates of readmission to psychiatric facilities. After a decade of preoccupation with discharge rates, readmission statistics have been singled out in the last 15 years as the key factor for assessing hospital effectiveness. A study of a group of patients at high risk for recurrent hospitalization revealed that these patients were characterized more by features relating to environmental supports than by diagnosis. The operational definition for recurrent hospitalization (five or more admissions during the 2-year period preceding the latest admission) was effective in identifying this group; this is the first reported instance in which the definition has specified a certain number of admissions within a time-limited period. The findings of this study, as well as of an analysis of case histories and consumer opinion, led to the design of a pilot program for persons undergoing recurrent hospitalization. Readmission statistics are useless or misleading as measures of hospital effectiveness and efficiency; what matters is the way the former patients function in the community after discharge. Rather than simply trying to reduce the readmission rate psychiatric facilities should be examining the types of persons who are hospitalized recurrently to develop programs aimed at improving the functioning of these people in the community. PMID:630483
Su, Tung-Ping; Lien, Te-Cheng; Yang, Chih-Yi; Su, Yiet Ling; Wang, Jia-Horng; Tsai, Sing-Ling; Yin, Jeo-Chen
To assess the rapidly changing psychological status of nurses during the acute phase of the 2003 SARS outbreak, we conducted a prospective and periodic evaluation of psychiatric morbidity and psychological adaptation among nurses in SARS units and non-SARS units. Nurse participants were from two SARS units (regular SARS [N=44] and SARS ICU [N=26]) and two non-SARS units (Neurology [N=15] and CCU [N=17]). Participants periodically self-evaluated their depression, anxiety, post-traumatic stress symptoms, sleep disturbance, attitude towards SARS and family support. Results showed that depression (38.5% vs. 3.1%) and insomnia (37% vs. 9.7%) were, respectively, greater in the SARS unit nurses than the non-SARS unit nurses. No difference between these two groups was found in the prevalence of post-traumatic stress symptoms (33% vs. 18.7%), yet, three unit subjects (SARS ICU, SARS regular and Neurology) had significantly higher rate than those in CCU (29.7% vs. 11.8%, respectively) (p<0.05). For the SARS unit nurses, significant reduction in mood ratings, insomnia rate and perceived negative feelings as well as increasing knowledge and understanding of SARS at the end of the study (all p<0.001) indicated that a gradual psychological adaptation had occurred. The adjustment of nurses in the more structured SARS ICU environment, where nurses care for even more severely ill patients, may have been as good or better than that of nurses in the regular SARS unit. Occurrence of psychiatric symptoms was linked to direct exposure to SARS patient care, previous mood disorder history, younger age and perceived negative feelings. Positive coping attitude and strong social and family support may have protected against acute stress. In conclusion, the psychological impact on the caring staffs facing future bio-disaster will be minimized with lowered risk factors and a safer and more structured work environment. PMID:16460760
Rohlman, D S; Bailey, S R; Anger, W K; McCauley, L
In recent years there has been heightened concern over the potential of occupational or environmental exposures to affect neurological function in children and adolescents. The current study was designed to develop computerized tests to effectively assess neurobehavioral function in Hispanic adolescents working in agriculture and to evaluate those tests in Hispanic youths working in agriculture and in a non-agricultural group. After exclusions, 96 adolescents currently working in agriculture (AG) and 51 adolescents currently non-migratory and not working in agriculture (Non-AG) were tested. Neurobehavioral tests were selected from the computerized Behavioral Assessment and Research System. AG test performance was significantly below Non-AG performance on the cognitive tests. However, educational and cultural differences between the AG and Non-AG groups may explain this difference. Repeat testing of the AG group revealed substantially improved performance, further supporting educational or cultural differences as an explanation for the group differences. Together, these results expose the limitations in case-control or cross-sectional designs for testing migrant worker populations in the United States. Longitudinal or cross-sectional designs with repeat testing offer more promise and may be essential for drawing accurate conclusions in migrant worker groups where there are no truly equivalent comparison or control groups. PMID:11161647
Farrell, Albert D; Sullivan, Terri N; Goncy, Elizabeth A; Le, Anh-Thuy H
This study evaluated the Problem Behavior Frequency Scale (PBFS), a self-report measure designed to assess adolescents' frequency of victimization, aggression, and other problem behaviors. Analyses were conducted on a sample of 5,532 adolescents from 37 schools at 4 sites. About half (49%) of participants were male; 48% self-identified as Black non-Hispanic; 21% as Hispanic, 18% as White non-Hispanic. Adolescents completed the PBFS and measures of beliefs and values related to aggression, and delinquent peer associations at the start of the 6th grade and over 2 years later. Ratings of participants' behavior were also obtained from teachers on the Behavioral Assessment System for Children. Confirmatory factor analyses supported a 7-factor model that differentiated among 3 forms of aggression (physical, verbal, and relational), 2 forms of victimization (overt and relational), drug use, and other delinquent behavior. Support was found for strong measurement invariance across gender, sites, and time. The PBFS factors generally showed the expected pattern of correlations with teacher ratings of adolescents' behavior and self-report measures of relevant constructs. (PsycINFO Database Record PMID:26372261
Tringone, Robert; Bockian, Neil
Theodore Millon was one of the most influential personality theorists of the 20th century. His theory was originally rooted in biosocial learning models and later reconceptualized as an evolutionary model. This foundation of Millon's work encompasses the entire life span. He had a genuine concern for humankind, especially children. His theory encompasses a comprehensive understanding of the relationship among childhood experiences, parenting styles, and recurring events throughout the life span in shaping the personality. Notable contributions to child and adolescent assessment are the Millon Adolescent Personality Inventory (Millon, Green, & Meagher, 1982 ), the Millon Adolescent Clinical Inventory (Millon, Millon, & Davis, 1993 ), and the Millon Pre-Adolescent Clinical Inventory (M-PACI; Millon, Tringone, Millon, & Grossman, 2005 ). Given Millon's influence on the personality disorders section of the Diagnostic and Statistical Manual of Mental Disorders (DSM), the aforementioned instruments have personality constructs tied to familiar DSM categories, and among them, cover the age range of 9 to 18 years old. His development of the Millon Inventories revolutionized personality assessment in the United States and abroad. Millon's legacies will live on through his works and through the respect and compassion he demonstrated toward others. PMID:26226175
Rhondali, Wadih; Freyer, Gilles; Adam, Virginie; Filbet, Marilène; Derzelle, Martine; Abgrall-Barbry, Gaelle; Bourcelot, Sophie; Machavoine, Jean-Louis; Chomat-Neyraud, Muriel; Gisserot, Olivier; Largillier, Rémi; Le Rol, Annick; Priou, Frank; Saltel, Pierre; Falandry, Claire
Background Depression, a major outcome in cancer patients, is often evaluated by physicians relying on their clinical impressions rather than patient self-report. Our aim was to assess agreement between patient self-reported depression, oncologist assessment (OA), and psychiatric clinical interview (PCI) in elderly patients with advanced ovarian cancer (AOC). Methods This analysis was a secondary endpoint of the Elderly Women AOC Trial 3 (EWOT3), designed to assess the impact of geriatric covariates, notably depression, on survival in patients older than 70 years of age. Depression was assessed using the Geriatric Depression Scale-30 (GDS), the Hospital Anxiety Depression Scale, the distress thermometer, the mood thermometer, and OA. The interview guide for PCI was constructed from three validated scales: the GDS, the Hamilton Depression Rating Scale, and the Montgomery Asberg Depression Rating Scale (MADRS). The Diagnostic and Statistical Manual of Mental Disorders, fourth edition, revised (DSM) criteria for depression were used as a gold standard. Results Out of 109 patients enrolled at 21 centers, 99 (91%) completed all the assessments. Patient characteristics were: mean age 78, performance status ≥2: 47 (47%). Thirty six patients (36%) were identified as depressed by the PCI versus 15 (15%) identified by DSM. We found moderate agreement for depression identification between DSM and GDS (κ=0.508) and PCI (κ=0.431) and high agreement with MADRS (κ=0.663). We found low or no agreement between DSM with the other assessment strategies, including OA (κ=−0.043). Identification according to OA (yes/no) resulted in a false-negative rate of 87%. As a screening tool, GDS had the best sensitivity and specificity (94% and 80%, respectively). Conclusion The use of validated tools, such as GDS, and collaboration between psychologists and oncologists are warranted to better identify emotional disorders in elderly women with AOC. PMID:26203235
Zivin, Kara; Ganoczy, Dara; Pfeiffer, Paul N.; Miller, Erin M.; Valenstein, Marcia
Objective Depressed patients discharged from psychiatric hospitalizations face increased risks for adverse outcomes including suicide, yet antidepressant adherence rates during this high-risk period are unknown. Using Veterans Affairs (VA) data, we assessed antidepressant adherence and predictors of poor adherence among depressed veterans following psychiatric hospitalization. Method We identified VA patients nationwide with depressive disorders who had a psychiatric hospitalization between April 1, 1999 and September 30, 2003, received antidepressant medication, and had an outpatient appointment following discharge. We calculated medication possession ratios (MPRs), a measure of medication adherence, within three and six months following discharge. We assessed patient factors associated with having lower levels of adherence (MPRs <0.8) after discharge. Results 20,931 and 23,182 patients met criteria for three and six month MPRs. The mean three month MPR was 0.79 (s.d.=0.37). The mean six month MPR was 0.66 (s.d.=0.40). Patients with poorer adherence were male, younger, non-white, and had a substance abuse disorder, but were less likely to have PTSD or other anxiety disorders. Conclusion Poor antidepressant adherence is common among depressed patients after psychiatric hospitalization. Efforts to improve adherence at this time may be critical in improving the outcomes of these high-risk patients. PMID:19609666
Kapfhammer, H P; Neumeier, R; Scherer, J
The psychosocial development of psychiatrically ill and mentally healthy young adults is being explored in a series of comparative studies based on developmental tasks typical of this age. In a first study a patient group was compared with a control group with the Offer Self-Image Questionnaire as an indicator of patterns of psychosocial adaptation thus far. The patients showed significantly poorer adaptation on 10 dimensions of psychosocial life. In relation to a representative sample of young adults they especially reported disturbances in their own personality development and in family relations, but judged their adaptation to norms for behavior in public as less impaired. The nonpsychotic patients had a significantly less favorable pattern of self-concepts than the psychotic patients. The patients with affective disorders had a relatively healthy profile of psychosocial development compared with the schizophrenic patients. There was no significant difference between patients with schizophrenia of the disorganized type and other schizophrenic patients. There was a close relationship between subjective measures of self-concept and objective measures of psychosocial development, e.g. premorbid adaptation and current psychosocial development, e.g. premorbid adaptation and current psychosocial competence, in the different subgroups. The findings on self-concept seemed to be largely independent of the present severity of psychopathology. PMID:8342335
Mack, Avram H; Frances, Richard J
The treatment of alcohol use disorders (AUDs) in adolescents is a very important issue in the field of substance use disorders; however, it is a complex and understudied area in which there are limited data concerning evidence-based treatment. The authors first briefly review the epidemiology of AUDs in adolescents, describe existing guidelines for the treatment of such disorders in adolescent patients, and consider differences between AUDs as they present in adolescents and adults. In the next section of the paper, the authors review the assessment and diagnosis of AUDs in adolescents and consider how findings from such assessments will influence subsequent treatment planning. They also describe prognostic factors (e.g., family issues, socioeconomic factors, psychiatric comorbidity, gender, ability to form a therapeutic alliance) that may affect treatment outcome and need to be considered in treatment selection. The various settings in which adolescent AUDs may be treated and the types of patients and situations for which each is most appropriate are described. The second half of the article focuses on the treatment of adolescents with AUDs. The authors describe techniques for establishing abstinence and then preventing subsequent relapse. Although there is an interest in the use of medications (e.g., naltrexone) to treat AUDs in this population, there are unfortunately few if any data concerning the use of these agents in adolescent patients. More data are available concerning psychosocial treatments. The authors describe a variety of psychosocial modalities that have been tested in adolescents, including individual psychotherapy (e.g., interpersonal therapy, cognitive-behavioral therapy, motivational enhancement therapy), group therapies, 12 step/self-help programs, family therapy, skills training for parents, and psychoeducation. The authors then consider the importance of targeting comorbid psychiatric conditions, especially anxiety and depression, in the
Hooper, Stephen R.; Curtiss, Kathleen; Schoch, Kelly; Keshavan, Matcheri S.; Allen, Andrew; Shashi, Vandana
The present study sought to examine the longitudinal psychoeducational, neurocognitive, and psychiatric outcomes of children and adolescents with chromosome 22q11.2 deletion syndrome (22q11DS), a population with a high incidence of major psychiatric illnesses appearing in late adolescence/early adulthood. Little is known of the developmental…
Janssen, R.; Maes, B.
Background: People with intellectual disabilities (ID) have an increased vulnerability to develop psychiatric problems. Moreover, the early recognition and the accurate diagnosis of psychiatric disorders in the population of persons with ID are challenging. Method: A Dutch version of the Mini PAS-ADD, which is a screening instrument for…
Lord, Sarah E; Trudeau, Kimberlee J; Black, Ryan A; Lorin, Lucy; Cooney, Elizabeth; Villapiano, Albert; Butler, Stephen F
The current study was conducted to construct and validate a computer-delivered, multimedia, substance use self-assessment for adolescents. Reliability and validity of six problem dimensions were evaluated in two studies, conducted from 2003 to 2008. Study 1 included 192 adolescents from five treatment settings throughout the United States (N = 142) and two high schools from Greater Boston, Massachusetts (N = 50). Study 2 included 356 adolescents (treatment: N = 260; school: N = 94). The final version of Comprehensive Health Assessment for Teens (CHAT) demonstrated relatively strong psychometric properties. The limitations and implications of this study are noted. This study was supported by an SBIR grant. PMID:21174498