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Sample records for adolescent psychiatric services

  1. Adolescents and Dual Diagnosis in a Psychiatric Emergency Service.

    PubMed

    Matali, José Luis; Andión, Oscar; Pardo, Marta; Iniesta, Raquel; Serrano, Eduard; San, Luis

    2016-03-02

    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.

  2. A brief intervention is sufficient for many adolescents seeking help from low threshold adolescent psychiatric services

    PubMed Central

    2010-01-01

    Background There has been a considerable increase in the need for psychiatric services for adolescents. Primary health care practitioners have a major role in detecting, screening and helping these adolescents. An intervention entitled SCREEN is described in this article. The SCREEN intervention was developed to help practitioners to detect and screen adolescent needs, to care for adolescents at the primary health care level and to facilitate the referral of adolescents to secondary care services in collaboration between primary and secondary health care. Secondly, the article presents the background and clinical characteristics of youths seeking help from the SCREEN services, and compares the background factors and clinical characteristics of those patients referred and not referred to secondary care services. Methods The SCREEN intervention consisted of 1 to 5 sessions, including assessment by a semi-structured anamnesis interview, the structured Global Assessment Scale, and by a structured priority rating scale, as well as a brief intervention for each adolescent's chosen problem. Parents took part in the assessment in 39% of cases involving girls and 50% involving boys. During 34 months, 2071 adolescents (69% females) entered the intervention and 70% completed it. The mean age was 17.1 years for boys and 17.3 years for girls. Results For 69% of adolescents, this was the first contact with psychiatric services. The most common reasons for seeking services were depressive symptoms (31%). Self-harming behaviour had occurred in 25% of girls and 16% of boys. The intervention was sufficient for 37% of those who completed it. Psychosocial functioning improved during the intervention. Factors associated with referral for further treatment were female gender, anxiety as the main complaint, previous psychiatric treatment, self-harming behaviour, a previous need for child welfare services, poor psychosocial functioning and a high score in the priority rating scale

  3. Emergency Presentations to an Inner-City Psychiatric Service for Children and Adolescents

    ERIC Educational Resources Information Center

    Dil, L. M.; Vuijk, P. J.

    2012-01-01

    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…

  4. [A university department as a psychiatric service centre for children and adolescents].

    PubMed

    Remschmidt, Helmut; Walter, Reinhard; Theisen, Frank; Ulbrich, Rainer; Martin, Matthias

    2006-11-01

    The article reports on a system of care for psychiatrically ill children and adolescents that has been designed, established and expanded since 1980 by a university department in a rural region. The department is responsible for the mental health care of three counties with altogether 807 000 inhabitants. The development of this system of care was due in great part to the model program of the German Federal Government for the reform of mental health care that comprised 14 model regions, out of which the region of Marburg and its surrounding counties was the only one with a focus on the situation of psychiatrically ill children and adolescents. With the aid of this model program, a comprehensive evaluation of existing psychiatric services was carried out and at the same time, new services for this clientele were established such as a mobile child and adolescent psychiatric service and a day hospital. A particular focus was laid on the development of a complete network of psychiatric services with manifold, and over the years well proven, cooperation measures. Finally, the quality of mental health care was significantly increased by a continuous evaluation of services and the implementation of two institutes for psychotherapeutic training. Several research initiatives in the field of social psychiatry have contributed to this amelioration and at the same time, to a successful integration of mental health care and research.

  5. Eight-year incidence of psychiatric disorders and service use from adolescence to early adulthood: longitudinal follow-up of the Mexican Adolescent Mental Health Survey.

    PubMed

    Benjet, Corina; Borges, Guilherme; Méndez, Enrique; Albor, Yesica; Casanova, Leticia; Orozco, Ricardo; Curiel, Teresa; Fleiz, Clara; Medina-Mora, María Elena

    2016-02-01

    Half of mental disorders have their first onset before adulthood when the presence of a disorder may be particularly disruptive to developmental milestones. Retrospective prevalence estimates have been shown to underestimate the burden of mental illness and scarce data are available on the incidence of disorders throughout the adolescent period, especially in developing countries. Thus, the objective was to determine the incidence of mental disorders in an 8-year period from adolescence to young adulthood, onset of service use and their predictors in a Mexican cohort. 1071 respondents from a representative two-wave panel sample participated in the Mexican Adolescent Mental Health Survey in 2005 and in the follow-up survey in 2013. Disorders were evaluated with the World Mental Health Composite International Diagnostic Interview. 37.9% experienced the onset of a psychiatric disorder and 28.4% sought services for the first time. Substance use disorders had the greatest incidence, followed by mood and behavior disorders, anxiety disorders and lastly eating disorders. Sex, age, school dropout, childhood adversities and prior mental disorders predicted the onset of new disorders. Being female, having more educated parents and most classes of disorder predicted first time service use. These findings contribute to a paradigm shift in conceptions of mental disorder similar to how we think of common physical afflictions as near universal experiences across the life course, but less frequent at any given moment. Adolescents are particularly vulnerable. Therefore, public health policy should focus on early universal promotion of positive mental health and structural determinants of mental health.

  6. Child and Adolescent Psychiatric Epidemiology in India

    PubMed Central

    Bhola, Poornima; Kapur, Malavika

    2003-01-01

    The increasing focus on child mental health in developing countries like India points to the importance of epidemiological data in developing training, service and research paradigms.This review attempts to synthesise and evaluate the available research on the prevalence of child and adolescent psychiatric disorders in India and highlight significant conceptual and methodological trends. It identified 55 epidemiological studies conducted between 1964 and 2002 in the community and school settings. Despite considerable progress, various methodological lacunae continue to limit the value of the epidemiological surveys. These include issues related to sampling, case definition methods, tools, multi-informant data and data analysis. The importance of a socio-culturally relevant research framework has been highlighted. The review suggests directions for future research to guide planning of services that meet the mental health needs of vulnerable children and adolescents PMID:21206860

  7. Ayahuasca in adolescence: a preliminary psychiatric assessment.

    PubMed

    Da Silveira, Dartiu Xavier; Grob, Charles S; de Rios, Marlene Dobkin; Lopez, Enrique; Alonso, Luisa K; Tacla, Cristiane; Doering-Silveira, Evelyn

    2005-06-01

    Ayahuasca is believed to be harmless for those (including adolescents) drinking it within a religious setting. Nevertheless controlled studies on the mental/ psychiatric status of ritual hallucinogenic ayahuasca concoction consumers are still lacking. In this study, 40 adolescents from a Brazilian ayahuasca sect were compared with 40 controls matched on sex, age, and educational background for psychiatric symptomatology. Screening scales for depression, anxiety, alcohol consumption patterns (abuse), attentional problems, and body dysmorphic disorders were used. It was found that, compared to controls, considerable lower frequencies of positive scoring for anxiety, body dismorphism, and attentional problems were detected among ayahuasca-using adolescents despite overall similar psychopathological profiles displayed by both study groups. Low frequencies of psychiatric symptoms detected among adolescents consuming ayahuasca within a religious context may reflect a protective effect due to their religious affiliation. However further studies on the possible interference of other variables in the outcome are necessary.

  8. Psychiatric Disorders in Iranian Children and Adolescents

    PubMed Central

    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

    2016-01-01

    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

  9. Tobacco Smoking in Adolescent Psychiatric Outpatients

    ERIC Educational Resources Information Center

    Ditchburn, K. Marie; Sellman, J. Douglas

    2013-01-01

    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…

  10. Psychiatric Comorbidity in Gender Dysphoric Adolescents

    ERIC Educational Resources Information Center

    de Vries, Annelou L. C.; Doreleijers, Theo A. H.; Steensma, Thomas D.; Cohen-Kettenis, Peggy T.

    2011-01-01

    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…

  11. [Social psychiatric service as a cornerstone of psychiatric community care].

    PubMed

    Hoffmann, P; Tiggemann, H G

    1991-12-01

    Psychiatric care has gradually been shifting in Germany from its original inpatient basis to outpatient and complementary treatment. This shift of emphasis resulted in a transfer of psychiatry-political responsibility to communal bodies and hence also to communal public health services. Sociopsychiatric service ranks high in communal psychiatric care setups, since it promotes cooperation and helps to coordinate efforts in individual cases in respect of focal points on which such care is centered. For the future, an expert commission has suggested that the various institutions actively engaged in community psychiatric care should team up in each region. This applies in particular to mobile services visiting the patients in their homes, and to the offices providing contracts to sociopsychiatric services of public health offices. Despite positive outlooks there are also quite a few negative aspects of present-day practice. One of them is poor definition of tasks and functions of communal sociopsychiatric services, whereas another one are the unsatisfactory quantitative and qualitative means at their disposal. It is also too often overlooked that psychiatric patients and disabled persons are entitled to compensation insurance payments to promote their rehabilitation, as provided for by individual legislation in the various German laender. To tap these sources sufficiently well, sociopsychiatric services must be better equipped in every respect. The professional competence of social workers and physicians, as well as of the relevant staff, must be safeguarded by continuing education and specialist training measures.

  12. Gestational Risks and Psychiatric Disorders Among Indigenous Adolescents

    PubMed Central

    Crawford, Devan M.

    2009-01-01

    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

  13. Characteristics of Patients Visiting the Child & Adolescent Psychiatric Clinic: A 26-Year Study from North India

    ERIC Educational Resources Information Center

    Malhotra, Savita; Biswas, Parthasarathy; Sharan, Pratap; Grover, Sandeep

    2007-01-01

    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…

  14. Psychiatric Syndromes in Adolescents with Marijuana Abuse and Dependency in Outpatient Treatment

    ERIC Educational Resources Information Center

    Diamond, Guy; Panichelli-Mindel, Susan M.; Shera, David; Dennis, Mike; Tims, Frank; Ungemack, Jane

    2006-01-01

    Objective: The purpose of the current study to assist in understanding the prevalence and clinical correlates of psychiatric distress in adolescents seeking outpatient services for marijuana abuse or dependency. Methods: In a multi-site randomized clinical trial, 600 adolescents and their parents were assessed at intake using the Global Appraisals…

  15. Service dogs, psychiatric hospitalization, and the ADA.

    PubMed

    Muramatsu, Russ S; Thomas, Kelly Jones; Leong, Stephanie L; Ragukonis, Frank

    2015-01-01

    A service dog is defined as "any dog that is individually trained to do work or perform tasks for the benefit of an individual with a disability, including a physical, sensory, psychiatric, intellectual, or other mental disability." Some psychiatric patients may depend on a service dog for day-to-day functioning. The Americans with Disabilities Act (ADA) established certain rights and responsibilities for individuals with disabilities and health care providers. Psychiatric hospitalization of a patient with a service dog may pose a problem and involves balancing the requirement to provide safe and appropriate psychiatric care with the rights of individuals with disabilities. This Open Forum examines issues that arise in such circumstances, reviews the literature, and provides a foundation for the development of policies and procedures.

  16. Histories of Child Maltreatment and Psychiatric Disorder in Pregnant Adolescents

    ERIC Educational Resources Information Center

    Romano, Elisa; Zoccolillo, Mark; Paquette, Daniel

    2006-01-01

    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…

  17. Adolescents' Perceptions of Their Consent to Psychiatric Mental Health Treatment

    PubMed Central

    Roberson, Anthony James; Kjervik, Diane K.

    2012-01-01

    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

  18. Educational Functioning and Self-Esteem of Psychiatrically Hospitalized Adolescents.

    ERIC Educational Resources Information Center

    Bley, Georganne R.; And Others

    A topic of much national concern is the mental health of youth. Adolescents often enter psychiatric treatment with poor school performance, having attended numerous schools, and have very negative attitudes toward the school environment. In order to facilitate more effective psychiatric functioning, this study sought to learn more about two groups…

  19. Psychiatric Diagnostic Interviews for Children and Adolescents: A Comparative Study

    ERIC Educational Resources Information Center

    Angold, Adrian; Erkanli, Alaattin; Copeland, William; Goodman, Robert; Fisher, Prudence W.; Costello, E. Jane

    2012-01-01

    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…

  20. Religion/Spirituality and Adolescent Psychiatric Symptoms: A Review

    ERIC Educational Resources Information Center

    Dew, Rachel Elizabeth; Daniel, Stephanie S.; Armstrong, Tonya D.; Goldston, David B.; Triplett, Mary Frances; Koenig, Harold G.

    2008-01-01

    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…

  1. Psychiatric Comorbidities among Female Adolescents with Anorexia Nervosa

    ERIC Educational Resources Information Center

    Salbach-Andrae, Harriet; Lenz, Klaus; Simmendinger, Nicole; Klinkowski, Nora; Lehmkuhl, Ulrike; Pfeiffer, Ernst

    2008-01-01

    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…

  2. Adolescent Inpatient Psychiatric Admission Rates and Subsequent One-Year Mortality in England: 1998-2004

    ERIC Educational Resources Information Center

    James, Anthony; Clacey, Joe; Seagroatt, Valerie; Goldacre, Michael

    2010-01-01

    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…

  3. Psychiatric Symptoms due to Thyroid Disease in a Female Adolescent

    PubMed Central

    Capetillo-Ventura, Nelly; Baeza, Inmaculada

    2014-01-01

    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

  4. Validation of the Children's Interview for Psychiatric Syndromes (ChIPS) with Psychiatrically Hospitalized Adolescents

    ERIC Educational Resources Information Center

    Swenson, Lance P.; Esposito-Smythers, Christianne; Hunt, Jeffrey I.; Hollander, Beth L. G.; Dyl, Jennifer; Rizzo, Christie J.; Steinley, Douglas L.; Spirito, Anthony

    2007-01-01

    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.

  5. An acute in-patient psychiatric service for 16- to 17-year-old adolescents in the UK: a descriptive evaluation

    PubMed Central

    Duddu, Venu; Rhouma, Abdulhakim; Qureshi, Masood; Chaudhry, Imran Bashir; Drake, Terry; Sumra, Altaf; Husain, Nusrat

    2016-01-01

    Aims and method The need for an age-appropriate in-patient service for 16- to 17-year-olds led to the development of a 6-bed acute admissions unit in a non-metropolitan county in the UK. We provide a descriptive evaluation of the first 2 years of its operation. All admissions from April 2010 to March 2012 were reviewed, clinical details systematically recorded and descriptively analysed. Results Ninety-seven young people were admitted during this period (a third were compulsorily detained under the Mental Health Act 1983). The average length of stay was 3–4 weeks. The most common presenting complaints were self-harm and low mood, usually in the context of life events and childhood adversity. Nearly half had substance misuse and other risk-taking behaviours. A third presented with psychotic symptoms. Adjustment and anxiety disorders were most common, followed by alcohol/substance use disorders, depressive illnesses and psychotic illnesses. Comorbidity was the rule rather than the exception. Most patients improved by the time of discharge. Clinical implications The unit provides an accessible and effective age-appropriate service and is likely to constitute an important component of the comprehensive child and adolescent mental health service strategy in the county. PMID:27752345

  6. Adolescent cocaine abuse. Addictive potential, behavioral and psychiatric effects.

    PubMed

    Estroff, T W; Schwartz, R H; Hoffmann, N G

    1989-12-01

    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.

  7. Internet Addiction and Psychiatric Symptoms among Korean Adolescents

    ERIC Educational Resources Information Center

    Jang, Keum Seong; Hwang, Seon Young; Choi, Ja Yun

    2008-01-01

    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…

  8. The Psychiatric Consequences of Child and Adolescent Sexual Abuse

    PubMed Central

    YÜCE, Murat; KARABEKİROĞLU, Koray; YILDIRIM, Zeynep; ŞAHİN, Serkan; SAPMAZ, Dicle; BABADAĞI, Zehra; TURLA, Ahmet; AYDIN, Berna

    2015-01-01

    Introduction The purpose of this study was to investigate the psychiatric consequences of sexual abuse and its associated factors in children and adolescents referred to our child and adolescent psychiatry clinic from official medico–legal units. Methods All victims of sexual abuse (n=590) aged 1–18 (mean: 13.56±3.38) referred from forensic units to Ondokuz Mayis University Child and Adolescent Psychiatry Clinic over a period of 2 years [boys: 83 (14.1%); girls: 507 (85.9%)] were included. Child and adolescent psychiatry and forensic medicine specialists evaluated all the cases. The Wechsler Intelligence Scale for Children-Revised Form (WISC-R) and the Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version-Turkish Version (K-SADS-PL-T) were applied. Results Abuse-related psychiatric diagnoses (of which 45.9% were major depressive disorder and 31.7% were post-traumatic stress disorder cases) were made in 75.2% of the cases. In 80.3% of the cases, the perpetrators were known to their victims [incest, n=91 (15.1%)], and intercourse took place in 48.8%. Although gender and age were not significantly associated with the appearance of any psychiatric disorders, severity of abuse (e.g., intercourse; p=.006), additional physical assault (p<.001), and incest (p<.001) had a significant correlation with psychiatric disorders. To explore the predictive value of multiple factors in the appearance of any sexual assault-related psychiatric disorder, a logistic regression model was used to determine the best linear combination of age, gender, abuse severity, incest, involvement of any other victim, additional physical assault, and length of time from first abuse to first psychiatric evaluation. This combination of variables (occurrence of incest, additional physical assault, and a long duration from first abuse to first psychiatric evaluation) significantly predicted the appearance of a psychiatric disorder of any kind (χ2

  9. Psychiatric considerations in children and adolescents with HIV/AIDS.

    PubMed

    Benton, Tami D

    2011-08-01

    The psychosocial impact of human immunodeficiency virus (HIV) disease has been recognized since the beginning of the epidemic for affected adults, but there has been less focus on the impact of HIV on young people. Among HIV-positive (HIV+) adults, high levels of distress, psychiatric symptoms, and their associations with worse health outcomes were recognized early in the epidemic. Subsequently, many studies have focused on understanding the prevalence of psychiatric symptoms among HIV+ adults and on identifying effective treatments for these symptoms. Fewer studies have examined these symptoms and their treatments among HIV+ children and adolescents. This article reviews what is known about psychiatric syndromes among HIV+ youths, their treatments, and other psychosocial factors of concern to the psychiatrist when treating children and adolescents with HIV disease.

  10. Psychiatric considerations in children and adolescents with HIV/AIDS.

    PubMed

    Benton, Tami D

    2010-04-01

    The psychosocial impact of human immunodeficiency virus (HIV) disease has been recognized since the beginning of the epidemic for affected adults, but there has been less focus on the impact of HIV on young people. Among HIV-positive (HIV+) adults, high levels of distress, psychiatric symptoms, and their associations with worse health outcomes were recognized early in the epidemic. Subsequently, many studies have focused on understanding the prevalence of psychiatric symptoms among HIV+ adults and on identifying effective treatments for these symptoms. Fewer studies have examined these symptoms and their treatments among HIV+ children and adolescents. This article reviews what is known about psychiatric syndromes among HIV+ youths, their treatments, and other psychosocial factors of concern to the psychiatrist when treating children and adolescents with HIV disease.

  11. Psychiatric comorbidity in adolescent electronic and conventional cigarette use.

    PubMed

    Leventhal, Adam M; Strong, David R; Sussman, Steve; Kirkpatrick, Matthew G; Unger, Jennifer B; Barrington-Trimis, Jessica L; Audrain-McGovern, Janet

    2016-02-01

    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.

  12. Childhood- versus Adolescent-Onset Antisocial Youth with Conduct Disorder: Psychiatric Illness, Neuropsychological and Psychosocial Function

    PubMed Central

    Johnson, Vicki A.; Kemp, Andrew H.; Heard, Robert; Lennings, Christopher J.; Hickie, Ian B.

    2015-01-01

    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

  13. Prevalence of Internet addiction in Latino adolescents with psychiatric diagnosis.

    PubMed

    Liberatore, Katia A; Rosario, Katyna; Colón-De Martí, Luz N; Martínez, Karen G

    2011-06-01

    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.

  14. Characteristics of Dieting and Nondieting Adolescents in a Psychiatric Inpatient Setting

    ERIC Educational Resources Information Center

    Abrantes, Ana M.; Strong, David R.; Ramsey, Susan E.; Lewinsohn, Peter M.; Brown, Richard A.

    2006-01-01

    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…

  15. Psychiatric adjustment to leaving school in adolescents with intellectual disability: a pilot study.

    PubMed

    Hepper, F; Garralda, M E

    2001-12-01

    The negotiation of stressful life cycle transitions may contribute to the higher prevalence of psychiatric disorders amongst people with intellectual disability (ID). It is possible that leaving school at the age of 16 years might place particular psychological demands on adolescents, increasing the risk of psychiatric morbidity at a time when they are vulnerable as a result of losing the links with health services sustained through school attendance. The present pilot study was designed as a prospective cohort study to investigate whether there is an increase of psychiatric morbidity [rated with the Strengths and Difficulties Questionnaire (SDQ), and through semi-structured interviews with parents] in adolescents with ID at the time of their transition from school to adult education and services. Although there was a high frequency (eight out of 10 subjects) of reported emotional and behavioural problems prior to transition, there was no increase or decrease in psychiatric morbidity for the group as a whole during the 6 months after leaving school. However, there were marked individual differences in scores on the SDQ, which may be worth investigating in a larger study.

  16. Practice Parameter for the Psychiatric Assessment and Management of Physically Ill Children and Adolescents

    ERIC Educational Resources Information Center

    Journal of the American Academy of Child & Adolescent Psychiatry, 2009

    2009-01-01

    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.

  17. Economic Impact of Childhood Psychiatric Disorder on Public Sector Services in Britain: Estimates from National Survey Data

    ERIC Educational Resources Information Center

    Snell, Tom; Knapp, Martin; Healey, Andrew; Guglani, Sacha; Evans-Lacko, Sara; Fernandez, Jose-Luis; Meltzer, Howard; Ford, Tamsin

    2013-01-01

    Background: Approximately one in ten children aged 5-15 in Britain has a conduct, hyperactivity or emotional disorder. Methods: The British Child and Adolescent Mental Health Surveys (BCAMHS) identified children aged 5-15 with a psychiatric disorder, and their use of health, education and social care services. Service costs were estimated for each…

  18. Readiness to change smoking behavior in adolescents with psychiatric disorders.

    PubMed

    Apodaca, Timothy R; Abrantes, Ana M; Strong, David R; Ramsey, Susan E; Brown, Richard A

    2007-06-01

    There has been recent increased interest in utilizing motivational interviewing (MI) to increase adolescent readiness to quit smoking, but attempts to impact quit rates have thus far been discouraging. A better understanding of factors associated with adolescent readiness to quit smoking prior to receiving any intervention may provide guidance when tailoring future MI interventions in order to increase their effectiveness with this population. Adolescent smokers (N=191) who had been admitted to a psychiatric hospital and enrolled in a clinical trial evaluating MI completed questionnaires that assessed smoking behavior and variables thought to be related to smoking. Confidence to quit smoking and negative beliefs about smoking were significant predictors of adolescents' baseline readiness to quit smoking. The failure to demonstrate relationships between health consequences and readiness suggest that caution may be warranted in the use of feedback, a common component of MI-based interventions. Such feedback tends to focus on health consequences, which was unrelated to adolescent baseline readiness to change smoking behavior in the current study. Parallels between current results and the Theory of Planned Behavior are discussed in consideration of developing more effective MI-based interventions for adolescent smokers.

  19. Improving services for parents with psychiatric disabilities: three new opportunities in the field of psychiatric rehabilitation.

    PubMed

    Cook, Judith A; Mueser, Kim T

    2014-03-01

    Despite many challenges, recent developments in the field of psychiatric rehabilitation offer opportunities for an increased focus on serving parents with psychiatric disabilities and their children. One such trend is the growth of psychosocial rehabilitation (PSR) programs that serve children and youth. The new Certificate in Children's Psychiatric Rehabilitation program offers practitioners education and training to meet the needs of children and families. Another opportunity can be found in the recent growth of family services in PSR programs for veterans with serious mental health problems. The Veterans Administration's new Psychosocial Rehabilitation and Recovery Services model explicitly includes family members in supporting veterans and acknowledges the need to deliver direct services to their spouses, children, and parents. A third relevant trend is the emergence of a new generation of recovery-oriented PSR services for mothers and fathers. Opportunities for enhanced services are provided in particular by self-help, peer support programs for parents with lived experience.

  20. Cannabis Use during Adolescent Development: Susceptibility to Psychiatric Illness.

    PubMed

    Chadwick, Benjamin; Miller, Michael L; Hurd, Yasmin L

    2013-10-14

    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.

  1. Working Models of Attachment in Psychiatrically Hospitalized Adolescents: Relation to Psychopathology and Personality.

    ERIC Educational Resources Information Center

    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…

  2. Sleep and its importance in adolescence and in common adolescent somatic and psychiatric conditions

    PubMed Central

    Brand, Serge; Kirov, Roumen

    2011-01-01

    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

  3. The psychiatric treatment of 'behavioural problems' in adolescence: Between coercion and socialisation.

    PubMed

    Coutant, Isabelle

    2016-12-01

    A 2005 report from the French Institute for Medical Research highlighted factors likely to prompt 'behavioural problems' in children and adolescents, and recommended early identification of at-risk families. A number of mental health professionals rose up against such medicalisation of social issues. This ethnographic study was conducted in this climate, in a psychiatric unit, located in a disadvantaged area in the outskirts of Paris, that specialises in adolescents with such problems. The research emphasised how professionals resist being instrumentalised by juvenile counselling services and the justice system, the observed practices bearing traces of critiques of psychiatric institutions since the 1960s. Psychiatrists thus try to justify and legitimate their interventions, which are co-constructed by relevant counselling and mental health professionals and, as much as possible, adolescents and their parents. Consequently, full understanding of institutionalisation, beyond its aspects of constraint and subjection, also requires consideration of its potential as a step in the socialisation process, especially for adolescents from working class backgrounds bereft of social and cultural capital. Contact with professionals may confer a kind of power, 'the power to speak'. At least, that is what the professionals try to give them using the 'pedagogy of reflexivity'.

  4. Dissociative and Sexual Behaviors in Children and Adolescents with Sexual Abuse and Psychiatric Histories.

    ERIC Educational Resources Information Center

    Friedrich, William N.; Jaworski, Theresa M.; Huxsahl, John E.; Bengtson, Brad S.

    1997-01-01

    Evaluated children (N=350) to assess the degree to which dissociation and sexual behavior discriminated sexually abused children and adolescents from nonpsychiatric and psychiatric comparison groups. Results show that psychiatric and nonpsychiatric samples differed in their reports of sexual concerns and dissociation, whereas psychiatric abused…

  5. Psychosocial and Psychiatric Factors Associated with Adolescent Suicide: A Case-Control Psychological Autopsy Study

    ERIC Educational Resources Information Center

    Portzky, Gwendolyn; Audenaert, Kurt; van Heeringen, Kees

    2009-01-01

    This study aimed at the investigation of psychosocial and psychiatric risk factors of adolescent suicide by means of a case-control psychological autopsy study. Relatives and other informants of 19 suicide victims and 19 matched psychiatric controls were interviewed by means of a semi-structured interview schedule. Psychiatric controls included…

  6. Comorbidity of Psychiatric Disorders and Nicotine Dependence among Adolescents: Findings from a Prospective, Longitudinal Study

    ERIC Educational Resources Information Center

    Griesler, Pamela C.; Hu, Mei-Chen; Schaffram, Christine; Kandel, Denise B.

    2008-01-01

    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…

  7. Psychiatric Correlates of Nonsuicidal Cutting Behaviors in an Adolescent Inpatient Sample

    ERIC Educational Resources Information Center

    Swenson, Lance P.; Spirito, Anthony; Dyl, Jennifer; Kittler, Jennifer; Hunt, Jeffrey I.

    2008-01-01

    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…

  8. Reliability and Validity of the Beck Depression Inventory--II with Adolescent Psychiatric Inpatients

    ERIC Educational Resources Information Center

    Osman, Augustine; Kopper, Beverly A; Barrios, Frank; Gutierrez, Peter M.; Bagge, Courtney L.

    2004-01-01

    This investigation was conducted to validate the Beck Depression Inventory--II (BDI-II; A. T. Beck, R. A. Steer, & G. K. Brown, 1996) in samples of adolescent psychiatric inpatients. The sample in each substudy was primarily Caucasian. In Study 1, expert raters (N=7) and adolescent psychiatric inpatients (N=13) evaluated the BDI-II items to assess…

  9. Crack and Cocaine Use among Adolescents in Psychiatric Treatment: Associations with HIV Risk

    ERIC Educational Resources Information Center

    Tolou-Shams, Marina; Feldstein Ewing, Sarah W. Tarantino, Nicholas; Brown, Larry K.

    2010-01-01

    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…

  10. Stability of Diagnosis: A 20-Year Retrospective Cohort Study of Israeli Psychiatric Adolescent Inpatients.

    ERIC Educational Resources Information Center

    Valevski, Avi; Ratzoni, Gideon; Sever, Jonathan; Apter, Alan; Zalsman, Gil; Shiloh, Roni; Weizman, Abraham; Tyano, Sam

    2001-01-01

    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…

  11. The Prevalence and Characteristics of Psychiatric Disorders among Adolescent Bedouin with Mild to Moderate Intellectual Disability

    ERIC Educational Resources Information Center

    Manor-Binyamini, Iris

    2010-01-01

    The aim of this study was to examine the prevalence and types of psychiatric disorders among Bedouin adolescents with mild to moderate intellectual disability. This is the first study ever conducted on this topic within the Bedouin community in the Negev in Israel. The issue of psychiatric disorders among adolescents with intellectual disability…

  12. Self-Concept and Physical Self-Concept in Psychiatric Children and Adolescents

    ERIC Educational Resources Information Center

    Simons, J.; Capio, C. M.; Adriaenssens, P.; Delbroek, H.; Vandenbussche, I.

    2012-01-01

    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…

  13. Religion/Spirituality and adolescent psychiatric symptoms: a review.

    PubMed

    Dew, Rachel Elizabeth; Daniel, Stephanie S; Armstrong, Tonya D; Goldston, David B; Triplett, Mary Frances; Koenig, Harold G

    2008-12-01

    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 articles reviewed found at least one significant (p < .05) relationship between religiousness and better mental health. Evidence for relationships between greater religiousness and less psychopathology was strongest in the area of teenage substance use. Methods of measuring religion/spirituality were highly heterogeneous. Further research on the relationship of religion/spirituality to delinquency, depression, suicidality, and anxiety is warranted. Measurement recommendations, research priorities, and clinical implications are discussed.

  14. Religion, spirituality, and depression in adolescent psychiatric outpatients.

    PubMed

    Dew, Rachel E; Daniel, Stephanie S; Goldston, David B; Koenig, Harold G

    2008-03-01

    This study examines in a preliminary manner the relationship between multiple facets of religion/spirituality and depression in treatment-seeking adolescents. One hundred seventeen psychiatric outpatients aged 12 to 18 completed the brief multidimensional measure of religiousness/spirituality, the Beck Depression Inventory (BDI), a substance abuse inventory. Controlling for substance abuse and demographic variables, depression was related to feeling abandoned or punished by God (p < 0.0001), feeling unsupported by one's religious community (p = 0.0158), and lack of forgiveness (p < 0.001). These preliminary results suggest that clinicians should assess religious beliefs and perceptions of support from the religious community as factors intertwined with the experience of depression, and consider the most appropriate ways of addressing these factors that are sensitive to adolescents' and families' religious values and beliefs.

  15. A 5-year retrospective study of demographic, anamnestic, and clinical factors related to psychiatric hospitalizations of adolescent patients

    PubMed Central

    Di Lorenzo, Rosaria; Cimino, Nina; Di Pietro, Elena; Pollutri, Gabriella; Neviani, Vittoria; Ferri, Paola

    2016-01-01

    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

  16. Psychiatric Services in Dubai (A Short Descriptive Report)

    ERIC Educational Resources Information Center

    Al Mualla, Saoud

    2011-01-01

    The paper gives an account of psychiatric services in Dubai (U.A.E). It describes the unique demographic constitution of Dubai and its complex health system. It also discusses the reasons behind the primitiveness of psychiatry in comparison to other medical specialties and services, especially considering the wealth of Dubai. The paper then goes…

  17. Curriculum development: Preparing trainees to care for children and adolescents with psychiatric disorders.

    PubMed

    Foley, Kimberly P; Haggerty, Treah S; Harrison, Natasha

    2015-01-01

    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.

  18. 42 CFR 424.14 - Requirements for inpatient services of inpatient psychiatric facilities.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... psychiatric facilities. 424.14 Section 424.14 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... psychiatric facilities. (a) Requirements for certification and recertification: General considerations... other hospitals because the care furnished in inpatient psychiatric facilities is often purely...

  19. 42 CFR 424.14 - Requirements for inpatient services of inpatient psychiatric facilities.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... psychiatric facilities. 424.14 Section 424.14 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... psychiatric facilities. (a) Requirements for certification and recertification: General considerations... other hospitals because the care furnished in inpatient psychiatric facilities is often purely...

  20. Reading Problems, Psychiatric Disorders, and Functional Impairment from Mid- To Late Adolescence.

    ERIC Educational Resources Information Center

    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.

    2007-01-01

    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…

  1. Psychiatric Disorders in a Sample of Saudi Arabian Adolescents with Sickle Cell Disease

    ERIC Educational Resources Information Center

    Amr, Mostafa Abdel-Monhem; Amin, Tarek Tawfik; Hablas, Hatem Refaat

    2010-01-01

    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…

  2. Associations between problematic gaming and psychiatric symptoms among adolescents in two samples.

    PubMed

    Vadlin, Sofia; Åslund, Cecilia; Hellström, Charlotta; Nilsson, Kent W

    2016-10-01

    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.

  3. Tics and psychiatric comorbidity in children and adolescents.

    PubMed

    Gadow, Kenneth D; Nolan, Edith E; Sprafkin, Joyce; Schwartz, Joseph

    2002-05-01

    This study examined comorbid psychiatric symptoms in a large, community-based sample of children and adolescents. The study sample comprised a total of 3006 school children: 413 preschool (3 to 5 years; 237 males, 176 females; mean age 4 years 2 months, SD 8 months), 1520 elementary school (5 to 12 years; 787 males, 733 females; mean age 8 years 2 months, SD 1 year 11 months), and 1073 secondary school children (12 to 18 years; 573 males, 500 females; mean age 14 years 4 months, SD 1 year 10 months), all of whom were attending regular education programs. Children were evaluated with a teacher-completed DSM-IV-referenced rating scale. The sample was divided into four groups: attention-deficit-hyperactivity disorder with tics (ADHD+tics), ADHD without tics (ADHD), tics without ADHD (T), and a comparison group i.e. neither ADHD nor tics (Non). The percentage of children with tic behaviors varied with age: preschool children (22.3%), elementary school children (7.8%), and adolescents (3.4%). Tic behaviors were more common in males than females, regardless of comorbid ADHD symptoms. For many psychiatric symptoms, screening prevalence rates were highest for the ADHD groups (ADHD+tics>ADHD>T>Non). However, obsessive-compulsive and simple and social phobia symptoms were more common in the groups with tic behavior. Findings for a community-based sample show many similarities with studies of clinically referred samples suggesting that teacher-completed ratings of DSM-IV symptoms may be a useful methodology for investigating the phenomenology of tic disorders.

  4. 42 CFR 415.184 - Psychiatric services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS Physician Services in Teaching Settings..., including documentation, except that the requirement for the presence of the teaching physician during...

  5. 42 CFR 415.184 - Psychiatric services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS Physician Services in Teaching Settings..., including documentation, except that the requirement for the presence of the teaching physician during...

  6. 42 CFR 415.184 - Psychiatric services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS Physician Services in Teaching Settings..., including documentation, except that the requirement for the presence of the teaching physician during...

  7. Managing Bipolar Youths in a Psychiatric Inpatient Emergency Service

    ERIC Educational Resources Information Center

    Masi, Gabriele; Mucci, Maria; Pias, Paola; Muratori, Filippo

    2011-01-01

    Among the youths referred to our Psychiatric Inpatient Emergency Service, we focused on bipolar disorder (BD), to explore predictive elements for the outcome. Fifty-one patients (30 males, 21 females, age range 8-18 years, mean age 14.2 plus or minus 3.1 years) received a diagnosis of BD, according to historical information, prolonged…

  8. Emergency Psychiatric Services for Individuals with Intellectual Disabilities: Caregivers' Perspectives

    ERIC Educational Resources Information Center

    Weiss, Jonathan A.; Lunsky, Yona; Gracey, Carolyn; Canrinus, Maaike; Morris, Susan

    2009-01-01

    Background: Strains on the mental health system and inaccessible services for individuals with intellectual disabilities (ID) often force caregivers to bring individuals with ID to the emergency department (ED) when in psychiatric crisis. The purpose of this study was to understand the experience of caregivers and adults with ID and mental health…

  9. Placebo effect in child and adolescent psychiatric trials.

    PubMed

    Parellada, Mara; Moreno, Carmen; Moreno, Miguel; Espliego, Ana; de Portugal, Enrique; Arango, Celso

    2012-11-01

    Much literature has been written in the field of child psychiatry regarding the placebo as a tool to test drug efficacy in clinical trials, but quite little regarding the placebo effect itself or its clinical use in child psychiatry. In this article, we aim to critically review the literature regarding the placebo effect in children and adolescents with mental disorders, focusing especially on factors influencing the placebo effect and how they may influence the interpretation of clinical trials. The placebo effect seems to be more marked in children than adults, and particularly in children and adolescents with depression, although it is pervasive across ages and is present in non-psychiatric conditions as well. The use of a placebo in clinical trials as a comparator with drugs that have moderate efficacy at most makes it difficult to obtain positive results, and much effort is needed to design very high quality clinical trials that may overcome the limitations of using a placebo. In addition, the placebo effect across ages and clinical conditions must be tested directly (compared with no treatment whenever possible), in order to characterise which placebos work for what and to determine their use in clinical settings.

  10. Perceived Dangerousness as Related to Psychiatric Symptoms and Psychiatric Service Use – a Vignette Based Representative Population Survey

    PubMed Central

    Sowislo, Julia F.; Gonet-Wirz, Franca; Borgwardt, Stefan; Lang, Undine E.; Huber, Christian G.

    2017-01-01

    Perceptions of dangerousness are an influential component of mental health stigma and can be driven by the display of psychiatric symptoms and the use of psychiatric service institutions. Yet, no previous study compared symptoms and service use associated perceptions of dangerousness. Therefore, we conducted a representative survey (N = 2,207) in the canton of Basel-Stadt, Switzerland. Participants were asked to answer the perceived dangerousness scale with respect to a vignette that either depicted psychiatric symptoms of a fictitious character or a psychiatric service institution the fictitious character had been admitted to. Between the vignettes, type of symptoms, type of psychiatric service, dangerousness, and gender were systematically varied. Perceived dangerousness was significantly lower as related to psychiatric service use than related to psychiatric symptoms. Overall, symptoms of alcohol dependency, behavior endangering others, and male gender of the fictitious character tend to increase perceived dangerousness. Furthermore, being hospitalized in a psychiatric unit at a general hospital or the rater being familiar with psychiatric services tends to decrease perceived dangerousness. Effective anti-stigma initiatives should integrate education about dangerousness as well as methods to increase familiarity with psychiatry. Additionally, an integration of modern psychiatry in somato-medical care institutions might decrease stigmatization. PMID:28367993

  11. Survey of stakeholders' opinions of community psychiatric nursing services.

    PubMed

    Shanley, E; Watson, G; Cole, A

    2001-06-01

    The paper describes a telephone survey of the views of representatives of users, purchasers and providers of community psychiatric nursing services on services in Scotland. The telephone interview protocol was based on seven themes derived from interviewing 63 users, purchasers and providers throughout the UK. Descriptive statistics were used to present the responses in the survey to the forced choice questions. Responses to the open ended questions were coded, categorized and computed. The paper describes the responses by the major stakeholders to each of the themes. Overall, the quality of the existing services was placed in the 'good' category. However, criticism was directed at the insufficient numbers of Community Psychiatric Nurses in the service, the inadequate amount of time spent with clients and their poorly organized method of working. Other findings and stakeholders' recommendations are discussed.

  12. Implementing routine outcome measurement in psychiatric rehabilitation services in Israel.

    PubMed

    Roe, David; Gelkopf, Marc; Gornemann, Miriam Isolde; Baloush-Kleinman, Vered; Shadmi, Efrat

    2015-01-01

    In this article we present the design, development and implementation of the Psychiatric Rehabilitation Routine Outcome Measurement (PR-ROM) project, the first systematic effort to implement mental health routine outcome measures in Israel. The goal of the PR-ROM is to provide updated information about the process and impact of psychiatric rehabilitation services in Israel and to establish a sustainable infrastructure and foundation for routine outcome monitoring of rehabilitation services to improve care, inform policy, generate incentives for service improvement, increase informed decision-making and provide data for research purposes. The rehabilitation services evaluated and the characteristics of the population being served are described and the methods and nature of the collected data as well as some preliminary findings are presented. We discuss the major barriers encountered, our efforts to deal with them and lessons learned during the process. We conclude with a description of the current state of the initiative and plans for the future.

  13. 42 CFR 415.184 - Psychiatric services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS Physician Services in Teaching Settings § 415.184..., including documentation, except that the requirement for the presence of the teaching physician during...

  14. 42 CFR 415.184 - Psychiatric services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS Physician Services in Teaching Settings § 415.184..., including documentation, except that the requirement for the presence of the teaching physician during...

  15. Inpatient Opioid Withdrawal Management of Street Children and Adolescents Admitted to Child and Adolescent Psychiatric Ward: A Preliminary Case Series

    PubMed Central

    Firouzkouhi Moghadam, Mahboubeh; Hashemian, Seyed-Sepehr; Pishjoo, Masoud; Ghasemi, Sanaz; Hajebi, Ahmad; Noroozi, Alireza

    2016-01-01

    Background About 10 million children worldwide live or work on the street. International reports estimate the prevalence of substance use among street children to be between 25% - 90%, which is who were referredntal disorders and high-risk behaviors. Objectives The objective of this study was to report the outcomes of assisted withdrawal of opioid-dependent vulnerable children and adolescents who were referred to child and adolescent psychiatric ward of Ali Ebne Abitaleb hospital, an academic hospital in Zahedan city. Methods Clinical chart abstractions were performed on a convenience sample of 40 serial opioid-dependent street children and adolescents (mean age: 11.14 ± 3.6 years) who were referred to child and adolescent psychiatric ward of Ali Ebne Abitaleb treatment and research center from November 2014 to May 2015. The demographic data, drug use history, comorbid physical and psychiatric conditions, symptomatology of opioid withdrawal syndrome, pharmacotherapies and psychosocial services, length of hospital stay, and any adverse events were extracted from the patients’ files using a checklist developed by the authors. Results Twenty-four (60%) patients were male, and 16 (40%) were female. The main drug used by all patients was opioids. Heroin Kerack (which has a street name of crystal in southeast Iran) was the most common (75%) drug of use, followed by opium (10%) and opium residue (7.5%). None of the participants self-reported using injected drugs. The high rate of a lack of eligibility for guardianship was documented among parents (87.5%) mainly due to their use of illegal drugs. Musculoskeletal pain and diarrhea were the most common withdrawal symptoms of the patients upon admission. The mean length of stay was 10.8 (± 7.30) days, and no significant adverse events were reported during the symptomatic treatment of opioid withdrawal syndrome. Conclusions To our knowledge, this is the first study to report on the safety and feasibility of inpatient

  16. Psychiatric Disorders and Sexual Risk among Adolescents in Mental Health Treatment

    PubMed Central

    Brown, Larry K.; Hadley, Wendy; Stewart, Angela; Lescano, Celia; Whiteley, Laura; Donenberg, Geri; DiClemente, Ralph

    2010-01-01

    Objective To examine the relationship between psychiatric disorders and sexual behaviors among adolescents receiving mental health treatment. Adolescents in mental health treatment have been found to have higher rates of HIV risk behavior than their peers, but data concerning the relationship between psychopathology and risk are inconsistent and limited. Method Eight hundred and forty adolescents (56% female, 58% African American, mean age 14.9 years) and their parents completed computerized assessments of psychiatric symptoms via the Computerized Diagnostic Interview Schedule for Children (C-DISC). Adolescents also reported on sexual risk behaviors (vaginal/anal sex, condom use at last sex) and completed urine screens for a sexually transmitted infection (STI). Results Adolescents meeting criteria for Mania, externalizing disorder (Oppositional Defiant, Conduct, and Attention Deficit Hyperactivity Disorders) or comorbid internalizing (Major Depressive, Generalized Anxiety, and Post-Traumatic Stress Disorders) and externalizing disorders were significantly more likely to report a lifetime history of vaginal or anal sex than those who did not meet criteria for any psychiatric disorder (OR = 2.0, 2.3 and 1.9, respectively). Adolescents meeting criteria for Mania were significantly more likely to have two or more partners in the past 90 days (OR= 3.2) and test positive for a STI (OR = 4.3) relative to adolescents who did not meet criteria for a psychiatric disorder. Conclusions The presence of internalizing and externalizing disorders, especially Mania, suggests the need for careful screening and targeting of adolescent sexual behavior during psychiatric treatment. PMID:20658815

  17. 42 CFR 440.160 - Inpatient psychiatric services for individuals under age 21.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Definitions § 440.160 Inpatient psychiatric services for individuals under age 21. “Inpatient psychiatric... 42 Public Health 4 2010-10-01 2010-10-01 false Inpatient psychiatric services for individuals under age 21. 440.160 Section 440.160 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES,...

  18. ASD, a Psychiatric Disorder, or Both? Psychiatric Diagnoses in Adolescents with High-Functioning ASD

    ERIC Educational Resources Information Center

    Mazefsky, Carla A.; Oswald, Donald P.; Day, Taylor N.; Eack, Shaun M.; Minshew, Nancy J.; Lainhart, Janet E.

    2012-01-01

    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…

  19. Psychiatric Diagnoses as Contemporaneous Risk Factors for Suicide Attempts among Adolescents and Young Adults: Developmental Changes

    ERIC Educational Resources Information Center

    Goldston, David B.; Daniel, Stephanie Sergent; Erkanli, Alaattin; Reboussin, Beth A.; Mayfield, Andrew; Frazier, Patricia H.; Treadway, Sarah L.

    2009-01-01

    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…

  20. Family Trauma and Dysfunction in Sexually Abused Female Adolescent Psychiatric Control Groups.

    ERIC Educational Resources Information Center

    Wherry, Jeffrey N.; And Others

    1994-01-01

    Differences in family trauma, stressors, and dysfunction among adolescent psychiatric inpatients grouped by sexual abuse self-reports were investigated. Family trauma/dysfunction was determined from a composite score derived from the Traumatic Antecedents Scale. The results indicated that sexually abused adolescents reported more family…

  1. Psychiatric Consequences for Israeli Adolescents of Protracted Political Violence: 1998-2004

    ERIC Educational Resources Information Center

    Slone, Michelle; Shechner, Tomer

    2009-01-01

    Background: This study examined relations between Israeli adolescents' political violence exposure and psychiatric consequences over seven years around the second Intifada and possible differential effects according to age and gender. Methods: Cross-sectional data was collected from 3667 adolescents aged 10-18, constituting two age groups of early…

  2. Children with a Prepubertal and Early Adolescent Bipolar Disorder Phenotype from Pediatric Versus Psychiatric Facilities

    ERIC Educational Resources Information Center

    Tillman, Rebecca; Geller, Barbara; Frazier, Jeanne; Beringer, Linda; Zimerman, Betsy; Klages, Tricia; Bolhofner, Kristine

    2005-01-01

    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…

  3. Utility of the Minnesota Multiphasic Personality Inventory Personality Disorder Scales with Adolescent Psychiatric Inpatients.

    ERIC Educational Resources Information Center

    Freiheit, Stacy R.; And Others

    1996-01-01

    The utility of Minnesota Multiphasic Personality Inventory personality disorder scales was studied with 217 male adolescent psychiatric inpatients. Analyses of variance found patterns consistent with research on adult samples in spite of differences in factor structure. These similarities suggest that adolescent assessment may provide information…

  4. Psychiatric Problems and Trauma Exposure in Nondetained Delinquent and Nondelinquent Adolescents

    ERIC Educational Resources Information Center

    Adams, Zachary W.; McCart, Michael R.; Zajac, Kristyn; Danielson, Carla Kmett; Sawyer, Genelle K.; Saunders, Benjamin E.; Kilpatrick, Dean G.

    2013-01-01

    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,…

  5. Psychiatric Disorders and Sexual Risk among Adolescents in Mental Health Treatment

    ERIC Educational Resources Information Center

    Brown, Larry K.; Hadley, Wendy; Stewart, Angela; Lescano, Celia; Whiteley, Laura; Donenberg, Geri; DiClemente, Ralph

    2010-01-01

    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…

  6. Behavioral Management Leads to Reduction in Aggression in a Child and Adolescent Psychiatric Inpatient Unit

    ERIC Educational Resources Information Center

    Dean, Angela J.; Duke, Suzanne G.; George, Michelle; Scott, James

    2007-01-01

    Objective: Aggression is common in children and adolescents admitted to psychiatric inpatient units. Few interventions for reducing aggressive behaviors have been identified. This study aimed to evaluate the impact of a milieu-based behavioral management program on the frequency of aggressive behaviors in a child and adolescent mental health…

  7. Bidirectional Linkages between Psychological Symptoms and Sexual Activities among African American Adolescent Girls in Psychiatric Care

    ERIC Educational Resources Information Center

    Starr, Lisa R.; Donenberg, Geri R.; Emerson, Erin

    2012-01-01

    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…

  8. Fiscally challenged. Psychiatric industry's hope is in consolidation, focusing services.

    PubMed

    Saphir, A

    2000-03-27

    Psychiatric hospitals are closing in droves. Last year alone, at least 75 were shuttered, up sharply from the previous year. And psych hospitals collectively lost $254 million in 1998. To reverse the sector's fortunes, providers are focusing on consolidation and specialty services. "Mental health isn't glamorous," says David Moulthrop (left), CEO of a Wisconsin psych hospital. "But there is a future, though the pie has shrunk."

  9. Gender differences in psychiatric disorders and clusters of self-esteem among detained adolescents.

    PubMed

    Van Damme, Lore; Colins, Olivier F; Vanderplasschen, Wouter

    2014-12-30

    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.

  10. 42 CFR 412.405 - Preadmission services as inpatient operating costs under the inpatient psychiatric facility...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... under the inpatient psychiatric facility prospective payment system. 412.405 Section 412.405 Public... Services of Inpatient Psychiatric Facilities § 412.405 Preadmission services as inpatient operating costs under the inpatient psychiatric facility prospective payment system. The prospective payment...

  11. 42 CFR 412.405 - Preadmission services as inpatient operating costs under the inpatient psychiatric facility...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... under the inpatient psychiatric facility prospective payment system. 412.405 Section 412.405 Public... Services of Inpatient Psychiatric Facilities § 412.405 Preadmission services as inpatient operating costs under the inpatient psychiatric facility prospective payment system. The prospective payment...

  12. 42 CFR 412.405 - Preadmission services as inpatient operating costs under the inpatient psychiatric facility...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... under the inpatient psychiatric facility prospective payment system. 412.405 Section 412.405 Public... Services of Inpatient Psychiatric Facilities § 412.405 Preadmission services as inpatient operating costs under the inpatient psychiatric facility prospective payment system. The prospective payment...

  13. 42 CFR 424.14 - Requirements for inpatient services of inpatient psychiatric facilities.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... psychiatric facilities. 424.14 Section 424.14 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... Certification and Plan Requirements § 424.14 Requirements for inpatient services of inpatient psychiatric... requirements differ from those for other hospitals because the care furnished in psychiatric hospitals is...

  14. 42 CFR 424.14 - Requirements for inpatient services of inpatient psychiatric facilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... psychiatric facilities. 424.14 Section 424.14 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... Certification and Plan Requirements § 424.14 Requirements for inpatient services of inpatient psychiatric... requirements differ from those for other hospitals because the care furnished in psychiatric hospitals is...

  15. 42 CFR 412.405 - Preadmission services as inpatient operating costs under the inpatient psychiatric facility...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... under the inpatient psychiatric facility prospective payment system. 412.405 Section 412.405 Public... Services of Inpatient Psychiatric Facilities § 412.405 Preadmission services as inpatient operating costs under the inpatient psychiatric facility prospective payment system. The prospective payment...

  16. 42 CFR 412.405 - Preadmission services as inpatient operating costs under the inpatient psychiatric facility...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... under the inpatient psychiatric facility prospective payment system. 412.405 Section 412.405 Public... Services of Inpatient Psychiatric Facilities § 412.405 Preadmission services as inpatient operating costs under the inpatient psychiatric facility prospective payment system. The prospective payment...

  17. The Evaluation of Elderly Patients by a Psychiatric Emergency Service

    PubMed Central

    Baker, F. M.; Scholhamer, Nanne

    1988-01-01

    A retrospective descriptive study of older patients evaluated by the psychiatric emergency service (PES) of a general hospital was implemented. The medical records of all patients aged 65 years and older evaluated by the PES during the 1980 calendar year were reviewed. Seventy-four patients were identified, 38 male and 36 female. Forty-three percent of the sample had no medical problems, 59 percent had a prior psychiatric history, and 38 percent had a diagnosis of organic brain syndrome. After their evaluation, 43 percent of these older patients were discharged home with a referral for outpatient treatment. In contrast to prior studies, only 35 percent of the sample were taking two or more psychoactive medications. Only two patients were referred for evaluation from skilled nursing homes. PMID:3404560

  18. Registration of aggressive incidents in an adolescent forensic psychiatric unit and implications for further practice.

    PubMed

    Tremmery, S; Danckaerts, M; Bruckers, L; Molenberghs, G; De Hert, M; Wampers, M; De Varé, J; de Decker, A

    2014-09-01

    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.

  19. Intimate relationship involvement, intimate relationship quality, and psychiatric disorders in adolescents.

    PubMed

    Whisman, Mark A; Johnson, Daniel P; Li, Angela; Robustelli, Briana L

    2014-12-01

    Prior research has shown that poor relationship quality in marriage and other intimate relationships demonstrates cross-sectional and longitudinal associations with a variety of psychiatric disorders in adults. In comparison, there has been less research on the covariation between relationship quality and psychiatric disorders in adolescents, a developmental period that is associated with elevated risk of incidence of several disorders and that is important for the acquisition and maintenance of intimate relationships. The present study was conducted to examine the associations between intimate relationship involvement, intimate relationship quality, and psychiatric disorders in a population-based sample of adolescents. The associations between relationship involvement, positive and negative relationship quality, and 12-month prevalence of mood, anxiety, and substance use disorders were evaluated in adolescents from the National Comorbidity Survey-Adolescent Supplement. Participants completed an interview-based assessment of psychiatric disorders and a self-report measure of relationship quality. Results indicated that the prevalence of broad categories of mood, anxiety, and substance use disorders, and several specific disorders were significantly associated with (a) being married, cohabiting, or involved in a serious relationship; and (b) reporting more negative (but not less positive) relationship quality. For several disorders, the association between the disorder and relationship involvement was moderated by age, wherein the strength of the association decreased in magnitude with increasing age. Findings suggest that being in an intimate relationship and reporting higher levels of negative relationship quality are associated with the prevalence of several common psychiatric disorders in adolescents.

  20. Child and adolescent psychiatric patients and later criminality

    PubMed Central

    Engqvist, Ulf; Rydelius, Per-Anders

    2007-01-01

    Background Sweden has an extensive child and adolescent psychiatric (CAP) research tradition in which longitudinal methods are used to study juvenile delinquency. Up to the 1980s, results from descriptions and follow-ups of cohorts of CAP patients showed that children's behavioural disturbances or disorders and school problems, together with dysfunctional family situations, were the main reasons for families, children, and youth to seek help from CAP units. Such factors were also related to registered criminality and registered alcohol and drug abuse in former CAP patients as adults. This study investigated the risk for patients treated 1975–1990 to be registered as criminals until the end of 2003. Methods A regional sample of 1,400 former CAP patients, whose treatment occurred between 1975 and 1990, was followed to 2003, using database-record links to the Register of Persons Convicted of Offences at the National Council for Crime Prevention (NCCP). Results Every third CAP patient treated between 1975 and 1990 (every second man and every fifth woman) had entered the Register of Persons Convicted of Offences during the observation period, which is a significantly higher rate than the general population. Conclusion Results were compared to published results for CAP patients who were treated between 1953 and 1955 and followed over 20 years. Compared to the group of CAP patients from the 1950s, the results indicate that the risk for boys to enter the register for criminality has doubled and for girls, the risk seems to have increased sevenfold. The reasons for this change are discussed. Although hypothetical and perhaps speculative this higher risk of later criminality may be the result of lack of social control due to (1) rising consumption of alcohol, (2) changes in organisation of child social welfare work, (3) the school system, and (4) CAP methods that were implemented since 1970. PMID:17727714

  1. Psychiatric Worker and Family Members: Pathways Towards Co-Operation Networks within Psychiatric Assistance Services.

    PubMed

    Carbone, Silvia

    2014-03-04

    The family's role in patient care was greatly altered by Law 180. This law, introduced in Italy in 1978, led to a gradual phasing out of custodial treatment for psychiatric patients. This different mindset, which views the family as an alternative to institutionalization, leads to it being seen as an essential entity in the setting up of community service dynamics. We interviewed health professionals in order to understand obstacles of collaboration between family members and mental health care workers. The goal was to uncover actions that promote collaboration and help build alliances between families and psychiatric workers. Results showed that health professionals view the family as a therapeutic resource. Despite this view, family members were rarely included in patient treatment. The reasons is: the structures have a theoretical orientation of collaboration with the family but, for nurses not are organized a few meeting spaces with family members. Services should create moments, such as multi-family groups or groups of information, managed by nurses and not only by doctors. These occasions it might facilitate the knowledge between professionals and family members.

  2. Predictors of self-esteem in adolescents with a psychiatric referral.

    PubMed

    Akdemir, Devrim; Çak, Tuna; Aslan, Cihan; Aydos, Büşra Sultan; Nalbant, Kevser; Çuhadaroğlu-Çetin, Füsun

    2016-01-01

    In the literature self-esteem is found to be lower in clinically referred adolescents compared to adolescents without any psychiatric disorder. The aim of this study is to examine self-esteem and associated socio-demographical and psychological factors in clinically referred adolescents in Turkey. Three hundred forty-nine adolescents aged between 12 and 18 years admitted to the Department of Child and Adolescent Psychiatry with a psychiatric complaint were enrolled. Rosenberg Self-Esteem Scale (RSES), Brief Symptom Inventory (BSI), Parenting Style Scale (PSS) and Sense of Identity Assessment Form (SIAF) were used for the evaluation. Self-esteem was lower in: girls, adolescents without siblings, living in non-nuclear families, with a past suicide attempt, and with history of a non-suicidal self-injurious behavior (NSSI). Self-esteem was negatively correlated with identity confusion on SIAF and positively correlated with acceptance/involvement on PSS. Significant predictors of self-esteem were gender, presence of a sibling, history of a NSSI and SIAF scores. Interactions between self-esteem and gender, psychiatric symptoms, parenting and identity development are complex in clinically referred adolescents. Further elucidation of the mechanisms through which these characteristics modify self-esteem will be necessary to guide families and clinicians to help adolescents to maintain high self-esteem levels.

  3. Motivational Interviewing to Reduce Substance Use in Adolescents with Psychiatric Comorbidity

    PubMed Central

    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.

    2016-01-01

    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

  4. Characteristics and staff resources of child and adolescent psychiatric hospital wards in Finland.

    PubMed

    Ellilä, H; Sourander, A; Välimäki, M; Piha, J

    2005-04-01

    The aim of this study is to describe structural characteristics and staff resources of child psychiatric and adolescent psychiatric hospital wards in Finland. The target group of the survey consisted of 69 child and adolescent psychiatric hospital units in Finland. Information was obtained from 64 units (93%). Most of the wards were based on 24-h-a-day provision. There were only 7-day-treatment programmes including two family wards. When compared internationally, the numbers of units, beds and staff levels were high in Finland, with all members of staff qualified. The nurse-patient ratio and psychiatrist resources were rather satisfactory. However, in many units there was a lack of psychologists, social workers and occupational therapists. General recommendations and guidelines for staff resources in child and adolescent hospital treatment wards are warranted.

  5. Predicting Length of Psychiatric Hospital Stay in Children and Adolescents.

    ERIC Educational Resources Information Center

    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…

  6. [Emergency Psychiatric Service in general hospitals: a retrospective study].

    PubMed

    de Sousa, Fernando Sérgio Pereira; da Silva, Cezar Augusto Ferreira; Oliveira, Eliany Nazaré

    2010-09-01

    The Emergency Psychiatric Service in General Hospitals (SEPHG, acronym in Portuguese) is a service included in the psychiatric reform movement. The purpose of the present study was to characterize patients with psychological distress treated at the Dr. Estevam SEPHG, located in Sobral, Cear state. This exploratory study was performed using documental analyses with a quantitative approach, and involved 191 clients treated at the referred SEPHG from January to December 2007. Data collection was performed using a client register book, which contained information obtained from the patients' medical record. There was a predominance of male patients (70.15%), aged 30-49 years (48.71%) and single (74.86%). Most patients were from the city of Sobral (69.64%). In 42.40% of cases, the diagnosis was of alcohol use/abuse. Most clients (66.50%) sought the service voluntarily. After being evaluated at the SEPHG, 43.45% of patients were referred to the local Center for Psychosocial Care-Alcohol and other Drugs. The results emphasize the importance of mental health.

  7. Sleep problems in children and adolescents with epilepsy: Associations with psychiatric comorbidity.

    PubMed

    Hansen, Berit Hjelde; Alfstad, Kristin Å; van Roy, Betty; Henning, Oliver; Lossius, Morten I

    2016-09-01

    Sleep problems are common in pediatric epilepsy and may influence seizure control, daytime functioning, and overall quality of life. Knowledge of factors contributing to sleep problems is likely to improve treatment. The aim of this study was to investigate associations between psychiatric comorbidity and parent-reported and self-reported sleep problems in a sample of children and adolescents with epilepsy. Participants were children and adolescents (N=94), aged 10-19years, with generalized or focal epilepsy who had been referred to a tertiary epilepsy treatment center in Norway. Participants underwent a thorough clinical assessment and 24h of EEG registration. Information on sleep problems was obtained from parents using the Children's Sleep Habit Questionnaire (CSHQ) and from self-reporting using the Sleep Self-Report (SSR) questionnaire. Psychiatric diagnoses were established using the semistructured psychiatric interview Schedule for Affective Disorders and Schizophrenia - Present and Lifetime Version (Kiddie-SADS-PL). Both the total and subdomain CSHQ and SSR scores were high in comparison with scores from population-based samples. Having one or more psychiatric disorder(s) was significantly associated with elevated scores on both the CSHQ and the SSR. With the exception of parent-reported parasomnias, associations between sleep problems and psychiatric disorders remained significant after adjusting for relevant epilepsy variables. Psychiatric comorbidity explained about one-third of the variance of the reported sleep problems in children and adolescents with epilepsy.

  8. Remote Psychiatric and Psychological Services via the Communications Technology Satellite (CTS).

    ERIC Educational Resources Information Center

    Covvey, H. Dominic; And Others

    To provide remote psychiatric services to a population in Moose Factory, Ontario, via satellite, digital data links will be used to provide 24-hour access to the psychiatric medical file system and the psychiatric patient register at University Hospital, London, Ontario, and to permit scoring and interpretation of standard psychological tests. The…

  9. 42 CFR 424.14 - Requirements for inpatient services of inpatient psychiatric facilities.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... psychiatric facilities. 424.14 Section 424.14 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... psychiatric facilities. (a) Content of certification and recertification: General considerations. The content requirements differ from those for other hospitals because the care furnished in psychiatric hospitals is...

  10. Self-reported peer victimization and suicidal ideation in adolescent psychiatric inpatients: the mediating role of negative self-esteem.

    PubMed

    Jones, Heather A; Bilge-Johnson, Sumru; Rabinovitch, Annie E; Fishel, Hazel

    2014-10-01

    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.

  11. Adolescent Services & the TC. Chapter 6.

    ERIC Educational Resources Information Center

    Acampora, Alfonso P., Ed.; Nebelkopf, Ethan, Ed.

    This document contains seven papers from the ninth World Conference of Therapeutic Communities (TCs) that deal with adolescent clients and TCs. Papers include: (1) Preliminary Consideration on "Adolescence and the TC" (David Deitch); (2) "Daytop's Full Service Adolescent Treatment Program" (Charles Devlin and Lois Morris); (3)…

  12. [Autonomy, care and justice: ethical aspects of the psychiatric treatment of adolescents].

    PubMed

    Höger, Christoph

    2010-11-01

    What is the right and good action in dealing with young patients in child and adolescent psychiatry? To answer this question, we have to consider professional standards, legal rules, and ethical reflections. With reference to the latter, four bioethical principles were proposed by Beauchamp and Childress to identify and to deal with ethical problems and conflicts. On the basis of this scheme we reflect on the legal aspects and discuss the following topics: (1) self-determination of adolescents concerning their own psychiatric treatment, (2) conflicts between autonomy and care, which occur relatively often, whenever restrictions to personal liberty are indicated, and (3) admission of adolescents in adult psychiatric wards. The bioethical principles facilitate a reliable decision-making process in individual cases. The standards of right and good action have to be implemented in the field of distributive justice. We find evidence that prioritization decisions for inpatient admission are already established in German child and adolescent psychiatry.

  13. Implementing psychiatric advance directives: service provider issues and answers.

    PubMed

    Srebnik, Debra; Brodoff, Lisa

    2003-01-01

    Psychiatric advance directives (PADs) are an emerging method for adults with serious and persistent mental illness to document treatment preferences in advance of periods of incapacity. This article presents and responds to issues most frequently raised by service providers when planning for implementation of PADs. Issues discussed include access to PADs; competency to execute PADs; the relationship of PADs to standards of care, resource availability, and involuntary treatment; roles of service providers and others in execution of PADs; timeliness and redundancy of PAD information; consumer expectations of PADs; complexity of PADs; revocation and "activation"; legal enforceability of PADs; the role and powers of agents; liability for honoring and not honoring PADs; and use of PADs to consent for release of health care information. Recommendations are made for training staff and consumers, consideration of statute development, and methods to reduce logistical, attitudinal, and system barriers to effective use of PADs.

  14. 42 CFR 440.160 - Inpatient psychiatric services for individuals under age 21.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... psychiatric facility which is accredited by the Joint Commission on Accreditation of Healthcare Organizations, the Council on Accreditation of Services for Families and Children, the Commission on Accreditation...

  15. 42 CFR 440.160 - Inpatient psychiatric services for individuals under age 21.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... psychiatric facility which is accredited by the Joint Commission on Accreditation of Healthcare Organizations, the Council on Accreditation of Services for Families and Children, the Commission on Accreditation...

  16. 42 CFR 440.160 - Inpatient psychiatric services for individuals under age 21.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... psychiatric facility which is accredited by the Joint Commission on Accreditation of Healthcare Organizations, the Council on Accreditation of Services for Families and Children, the Commission on Accreditation...

  17. 42 CFR 440.160 - Inpatient psychiatric services for individuals under age 21.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... psychiatric facility which is accredited by the Joint Commission on Accreditation of Healthcare Organizations, the Council on Accreditation of Services for Families and Children, the Commission on Accreditation...

  18. Why do many psychiatric disorders emerge during adolescence?

    PubMed Central

    Giedd, Jay N.; Keshavan, Matcheri; Paus, Tomáš

    2008-01-01

    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

  19. Crime and Psychiatric Disorders Among Youth in the US Population: An Analysis of National Comorbidity Survey-Adolescent Supplement

    PubMed Central

    Coker, Kendell L.; Smith, Philip H.; Westphal, Alexander; Zonana, Howard V.; McKee, Sherry A.

    2014-01-01

    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

  20. Psychiatric Aspects of Child and Adolescent Obesity: A Review of the Past 10 Years

    ERIC Educational Resources Information Center

    Zametkin, Alan J.; Zoon, Christine K.; Klein, Hannah W.; Munson, Suzanne

    2004-01-01

    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…

  1. Adolescent Dress, Part I: Dress and Body Markings of Psychiatric Outpatients and Inpatients.

    ERIC Educational Resources Information Center

    Michelman, John D.; And Others

    1991-01-01

    Investigated dress and body markings of 100 hospitalized and never-hospitalized adolescent psychiatric patients using in-depth interviews. Found that hospitalized patients had higher incidence of self-scarring, but other individual expressions of appearance did not differentiate two groups. Suggests that dress and appearance observations,…

  2. Examining the Impact of Psychiatric Diagnosis and Comorbidity on the Medical Lethality of Adolescent "Suicide Attempts"

    ERIC Educational Resources Information Center

    Mc Manama O'Brien, Kimberly H.; Berzin, Stephanie C.

    2012-01-01

    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…

  3. Adolescent Attitudes toward Psychiatric Medication: The Utility of the Drug Attitude Inventory

    ERIC Educational Resources Information Center

    Townsend, Lisa; Floersch, Jerry; Findling, Robert L.

    2009-01-01

    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…

  4. Psychiatric Impairment among Adolescents Engaging in Different Types of Deliberate Self-Harm

    ERIC Educational Resources Information Center

    Jacobson, Colleen M.; Muehlenkamp, Jennifer J.; Miller, Alec L.; Turner, J. Blake

    2008-01-01

    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…

  5. The Multi-Attitude Suicide Tendency Scale: Further Validation with Adolescent Psychiatric Inpatients.

    ERIC Educational Resources Information Center

    Osman, Augustine; Gilpin, Andrew R.; Panak, William F.; Kopper, Beverly A.; Barrios, Francisco X.; Gutierrez, Peter M.; Chiros, Christine E.

    2000-01-01

    Examines construct validity and psychometric properties of the Multi-Attitude Suicide Tendency Scale in adolescent psychiatric inpatients. Confirmatory factor analysis provides support for the fit of the 28-item, four-factor model. Results of regression analyses reveal that high scores on the repulsion by life and the attraction to death subscales…

  6. Gender and Disorder Specific Criminal Career Profiles in Former Adolescent Psychiatric In-Patients.

    ERIC Educational Resources Information Center

    Kjelsberg, Ellen

    2004-01-01

    A Norwegian nation-wide sample of 1087 former adolescent psychiatric in-patients, 584 males and 503 females, were followed up 15-33 years after first hospitalization. On the basis of detailed hospital records from index hospitalization all were rediagnosed according to DSM-IV. The patient list was linked to the national criminal register and the…

  7. Multi-informant reports of psychiatric symptoms among high-functioning adolescents with Asperger syndrome or autism.

    PubMed

    Hurtig, Tuula; Kuusikko, Sanna; Mattila, Marja-Leena; Haapsamo, Helena; Ebeling, Hanna; Jussila, Katja; Joskitt, Leena; Pauls, David; Moilanen, Irma

    2009-11-01

    The aim of the study was to examine psychiatric symptoms in high-functioning adolescents with autism spectrum disorders reported by multiple informants. Forty-three 11- to 17-year-old adolescents with Asperger syndrome (AS) or high-functioning autism (HFA) and 217 typically developed adolescents completed the Youth Self-Report (YSR), while their parents completed the Child Behavior Checklist (CBCL). Teachers of adolescents with AS/HFA completed the Teacher Report Form (TRF). The informants reported significantly more psychiatric symptoms, especially withdrawn, anxious/depressed, social and attention problems, in adolescents with AS/HFA than in controls. In contrast to findings in the general population, the psychiatric problems of adolescents with AS/HFA are well acknowledged by multiple informants, including self-reports. However, anxiety and depressive symptoms were more commonly reported by adolescents with AS/HFA and their teachers than their parents, indicating that some emotional distress may be hidden from their parents.

  8. Psychosocial Correlates of Suicidal Ideation in Adolescent Psychiatric Inpatients.

    ERIC Educational Resources Information Center

    Kumar, Geetha; Steer, Robert A.

    1995-01-01

    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…

  9. Substance Use in Adolescent Psychiatric Outpatients: Self-Report, Health Care Providers' Clinical Impressions, and Urine Screening

    ERIC Educational Resources Information Center

    Holzer, Laurent; Pihet, Sandrine; Passini, Christina Moses; Feijo, Isabelle; Camus, Didier; Eap, Chin

    2014-01-01

    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 compared with…

  10. Psychiatric and Cognitive Functioning in Adolescent Inpatients with Histories of Dating Violence Victimization

    PubMed Central

    Rizzo, Christie J.; Esposito-Smythers, Christianne; Spirito, Anthony; Thompson, Ariel

    2010-01-01

    The presence of dating violence victimization as well as its relation to psychiatric diagnosis and cognitive processes was examined in a sample of 155 adolescents hospitalized in a psychiatric facility. Participants and their parents completed semi-structured diagnostic interviews. Participants also completed self-report measures of dating violence victimization and cognitive functioning. Seventy-seven percent of adolescents who had initiated dating reported psychological, physical, and/or sexual abuse by a dating partner over the past year. Victims of psychological abuse alone as well as physical and/or sexual violence endorsed higher rates of major depressive disorder compared to non-victims. Physical/sexual dating violence victims also endorsed significantly higher rates of PTSD and alcohol use disorders, more frequent co-occurrence of externalizing and internalizing disorders, and more frequent negative cognitive biases, relative to non-victimized adolescents. Findings suggest that psychiatrically hospitalized adolescents with dating violence histories represent a subgroup of adolescent inpatients with a particularly serious clinical picture. PMID:20824193

  11. Ethnic Disparities in School-Based Behavioral Health Service Use for Children with Psychiatric Disorders

    ERIC Educational Resources Information Center

    Locke, Jill; Kang-Yi, Christina D.; Pellecchia, Melanie; Marcus, Steven; Hadley, Trevor; Mandell, David S.

    2017-01-01

    Background: We examined racial/ethnic disparities in school-based behavioral health service use for children with psychiatric disorders. Methods: Medicaid claims data were used to compare the behavioral healthcare service use of 23,601 children aged 5-17 years by psychiatric disorder (autism, attention deficit hyperactivity disorder [ADHD],…

  12. [Service expectations facing Saxony's newly established social psychiatric services. Attitudes of established neurologists, physicians in psychiatric clinics and social psychiatry service staff].

    PubMed

    Kallert, T W; Leisse, M; Kreiner, B; Bach, O

    1998-11-01

    In the wake of the disintegration of the policlinical system which had prevailed in the former German Democratic Republic, far-reaching restructuring has become necessary in the "new" German laender in the field of complementary psychiatric care. Establishment throughout the state of Saxony of a uniform outreach-based ambulatory service ranks as a first component towards building regionalized community psychiatric networks. In light of some twenty years of experience in the old laender, this function is considered a task of the Social Psychiatric Services ("Sozialpsychiatrische Dienste", SPDIs). The present study had been directed at a state-wide investigation of the expectations community-practice psychiatrists (n = 165), physicians in psychiatric clinics (n = 95) and staff working in SPDIs (n = 138) in Saxony hold regarding service programmes and operating methods of these newly established service delivery structures. Given the high return rates in this anonymous postal questionnaire study, the findings presented are considered near-representative. A concurrent finding for all of the groups interviewed, expectations concerning the client population to be serviced by the SPDIs focus on the group of persons with chronic mental illness. Also, the expectations expressed concerning major care/therapeutic services to be rendered by the SPDIs concur in their emphasis on a core area of immediately client-oriented SPDI activities. Between the two medical groups, a major difference found is that community-practice psychiatrists more frequently expect high SPDI commitment regarding sociotherapeutic programmes at an institutional level, whereas clinical physicians expect them to focus on taking over medical therapies in the narrower sense. The expectations SPDI staff hold relative to the therapeutic services to be rendered by themselves go beyond the scope of what has so far been implemented in their current activity, and qualitative content analyses are presented in the

  13. Bidirectional linkages between psychological symptoms and sexual activities among African American adolescent girls in psychiatric care.

    PubMed

    Starr, Lisa R; Donenberg, Geri R; Emerson, Erin

    2012-01-01

    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 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. Two-hundred-sixty-five African American girls seeking psychiatric care were assessed for mental health symptoms and light and heavy sexual behaviors. Participants completed a 6-month follow-up. 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. 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 adolescent girls in psychiatric care and should be considered in prevention program development.

  14. Associations between sleep disturbance and suicidal ideation in adolescents admitted to an inpatient psychiatric unit.

    PubMed

    Kaplan, Sebastian G; Ali, Shahzad K; Simpson, Brittany; Britt, Victoria; McCall, W Vaughn

    2014-01-01

    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.

  15. [Issues in psychiatric evaluation of children and adolescents with visual impairment].

    PubMed

    Saisky, Yaniv; Hasid, Soli; Ebert, Tanya; Kosov, Irene

    2014-02-01

    Approximately 8% from those who are defined as blind in Israel are children and adolescents. Visual impairment is correlated with a high rate of psychopathology. However, some of these children and adolescents do not receive appropriate diagnosis and treatment. Often, the clinicians and those who treat the children/adolescents lack the proper professional knowledge related to the unique diagnosis and treatment of children/ adolescents who are visually impaired. Visual impairment might influence different aspects of the psychiatric diagnosis. These aspects include the influence of the impairment on different developmental axes; the reciprocal relationship between the child and his/her environment; the clinical presentation of different psychopathologies; and the different treatment modalities. In this review we discuss these issues. Moreover, we raise the question as to whether there is a need to adapt the psychiatric evaluation and the treatment specifically to the visually impaired child. The review is based on the existing literature in addition to our clinical experience, which stems from our work with children and adolescents who are at the "Jewish Institute for the Blind", an institute for children and adolescents with visual impairment in Israel.

  16. Psychiatric Disorders in Children and Adolescents Attending Pediatric Out Patient Departments of Tertiary Hospitals

    PubMed Central

    Jesmin, Akhter; Rahman, Khan Muhammad Zillur; Muntasir, Maruf Mohammad

    2016-01-01

    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

  17. The association of chronic adversity with psychiatric disorder and disorder severity in adolescents.

    PubMed

    Benjet, Corina; Borges, Guilherme; Méndez, Enrique; Fleiz, Clara; Medina-Mora, Maria Elena

    2011-09-01

    The purpose of this paper is to estimate the impact of chronic adversity on psychopathology in adolescents, taking into account the type of adversity, number of adversities experienced and type of psychiatric disorder, as well as to estimate the impact on severity of the disorder. A total of 3,005 male and female adolescents from the Mexican Adolescent Mental Health Survey aged 12-17 years were interviewed in a stratified multistage general population probability survey. Assessment of 20 DSM-IV disorders, disorder severity and 12 chronic childhood adversities were assessed with the adolescent version of the World Mental Health Composite International Diagnostic Interview (WMH-CIDI-A). Family dysfunction adversities including abuse presented the most consistent associations between chronic adversity and psychopathology and their impact was generally non-specific with regard to the type of disorder. Parental divorce, parental death and economic adversity were not individually associated with psychopathology. Among those with a psychiatric disorder, sexual abuse and family violence were associated with having a seriously impairing disorder. The odds of having a psychiatric disorder and a serious disorder increased with increasing numbers of adversities; however, each additional adversity increased the odds at a decreasing rate. While the study design does not allow for conclusions regarding causality, these findings suggest general pathways from family dysfunction to psychopathology rather than specific associations between particular adversities and particular disorders, and provide further evidence for the importance of family-focused intervention and prevention efforts.

  18. Crack and Cocaine Use among Adolescents in Psychiatric Treatment: Associations with HIV Risk

    PubMed Central

    Tolou-Shams, Marina; Ewing, Sarah W. Feldstein; Tarantino, Nicholas; Brown, Larry K.

    2011-01-01

    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 relationship between crack/cocaine use and HIV risk. Thirteen percent of youth reported ever using crack or cocaine. Use was not associated with age, gender, race/ethnicity or SES. After controlling for known factors that influence unprotected sex, the odds that those with a history of crack/cocaine use engaged in inconsistent condom use was six times greater than that for those youth who did not ever use. Thus, crack/cocaine use is prevalent even among younger adolescents with psychiatric disorders who are not in drug treatment. Its use is associated with high rates of sexual and other risk behaviors. A history of use should alert clinicians to a wide variety of possible behavioral risks. These results can also inform future adolescent HIV prevention intervention development. PMID:22224066

  19. Bullying Victimization (Being Bullied) Among Adolescents Referred for Urgent Psychiatric Consultation: Prevalence and Association With Suicidality

    PubMed Central

    Alavi, Nazanin; Roberts, Nasreen; Sutton, Chloe; Axas, Nicholas; Repetti, Leanne

    2015-01-01

    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

  20. Neurological, Metabolic, and Psychiatric Adverse Events in Children and Adolescents Treated With Aripiprazole.

    PubMed

    Jakobsen, Klaus Damgaard; Bruhn, Christina Hedegaard; Pagsberg, Anne-Katrine; Fink-Jensen, Anders; Nielsen, Jimmi

    2016-10-01

    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.

  1. Overweight in adolescent, psychiatric inpatients: A problem of general or food-specific impulsivity?

    PubMed

    Deux, Natalie; Schlarb, Angelika A; Martin, Franziska; Holtmann, Martin; Hebebrand, Johannes; Legenbauer, Tanja

    2017-05-01

    Adolescent psychiatric patients are vulnerable to weight problems and show an overrepresentation of overweight compared to the healthy population. One potential factor that can contribute to the etiology of overweight is higher impulsivity. As of yet, it is unclear whether it is a general impulse control deficit or weight-related aspects such as lower impulse control in response to food that have an impact on body weight. As this may have therapeutic implications, the current study investigated differences between overweight and non-overweight adolescent psychiatric inpatients (N = 98; aged 12-20) in relation to trait impulsivity and behavioral inhibition performance. The Barratt Impulsiveness Scale and two go/no-go paradigms with neutral and food-related stimulus materials were applied. Results indicated no significant differences concerning trait impulsivity, but revealed that overweight inpatients had significantly more difficulties in inhibition performance (i.e. they reacted more impulsively) in response to both food and neutral stimuli compared to non-overweight inpatients. Furthermore, no specific inhibition deficit for high-caloric vs. low-caloric food cues emerged in overweight inpatients, whereas non-overweight participants showed significantly lower inhibition skills in response to high-caloric than low-caloric food stimuli. The results highlight a rather general, non-food-specific reduced inhibition performance in an overweight adolescent psychiatric population. Further research is necessary to enhance the understanding of the role of impulsivity in terms of body weight status in this high-risk group of adolescent inpatients.

  2. Cultural considerations in child and adolescent psychiatric emergencies and crises.

    PubMed

    Pumariega, Andres J; Rothe, Eugenio

    2003-10-01

    The United States is a country of immigrants. With the exception of Native Americans, every other American is, or descends from, an immigrant. First- and second-generation immigrant children are the most rapidly growing segment of the American population. The future of American society is ultimately related to the adaptation of these children. Addressing psychiatric emergencies in these populations requires attention to their cultural differences and needs.

  3. Predicting Future Suicide Attempts Among Adolescent and Emerging Adult Psychiatric Emergency Patients.

    PubMed

    Horwitz, Adam G; Czyz, Ewa K; King, Cheryl A

    2015-01-01

    The purpose of this study was to longitudinally examine specific characteristics of suicidal ideation in combination with histories of suicide attempts and non-suicidal self-injury (NSSI) to best evaluate risk for a future attempt among high-risk adolescents and emerging adults. Participants in this retrospective medical record review study were 473 (53% female; 69% Caucasian) consecutive patients, ages 15 to 24 years (M=19.4 years) who presented for psychiatric emergency services during a 9-month period. These patients' medical records, including a clinician-administered Columbia-Suicide Severity Rating Scale, were coded at the index visit and at future visits occurring within the next 18 months. Logistic regression models were used to predict suicide attempts during this period. Socioeconomic status, suicidal ideation severity (i.e., intent, method), suicidal ideation intensity (i.e., frequency, controllability), a lifetime history of suicide attempt, and a lifetime history of NSSI were significant independent predictors of a future suicide attempt. Suicidal ideation added incremental validity to the prediction of future suicide attempts above and beyond the influence of a past suicide attempt, whereas a lifetime history of NSSI did not. Sex moderated the relationship between the duration of suicidal thoughts and future attempts (predictive for male patients but not female). Results suggest value in incorporating both past behaviors and current thoughts into suicide risk formulation. Furthermore, suicidal ideation duration warrants additional examination as a potential critical factor for screening assessments evaluating suicide risk among high-risk samples, particularly for male patients.

  4. Pathways to Psychiatric Care for Children and Adolescents at a Tertiary Facility in Northern Nigeria.

    PubMed

    Abdulmalik, Jibril O; Sale, Shehu

    2012-03-07

    There is limited availability of mental health services in Nigeria, and indeed most of Africa. Available services are also often under-utilized because of widespread ignorance and supernatural beliefs about the etiology of mental illnesses. The consequence, therefore, is a long and tedious pathway to care for the mentally ill, especially children and adolescents. This was a study of all new patients, aged 18 years and below, presenting over a 6 month period in 2009 (January - June) at the outpatient clinic of a tertiary psychiatric facility in northern Nigeria. A socio-demographic questionnaire was utilized, along with a record of the clinician's assessment of diagnosis for 242 patients. Subjects who had been withdrawn from school, or any previously engaged-in activity for longer than 4 weeks on account of the illness, were recorded as having disability from the illness. The children were aged 1-18 years (mean=12.3; SD=5.2) with males accounting for 51.7% (125) while 14.5% of the females (n=117) were married. Two thirds (64.5%) of the patients had been ill for longer than 6 months prior to presentation. One hundred and forty four subjects (59.5%) had received no care at all, while 36.4% had received treatment from traditional/religious healers prior to presentation. The most disabling conditions were ADHD (80%), mental retardation (77.8%), epilepsy (64.1%) and psychotic disorders (50%). There is urgent need for extending mental health services into the community in order to improve access to care and increase awareness about effective and affordable treatments.

  5. Pathways to Psychiatric Care for Children and Adolescents at a Tertiary Facility in Northern Nigeria

    PubMed Central

    Sale, Shehu

    2012-01-01

    There is limited availability of mental health services in Nigeria, and indeed most of Africa. Available services are also often under-utilized because of widespread ignorance and supernatural beliefs about the etiology of mental illnesses. The consequence, therefore, is a long and tedious pathway to care for the mentally ill, especially children and adolescents. This was a study of all new patients, aged 18 years and below, presenting over a 6 month period in 2009 (January – June) at the outpatient clinic of a tertiary psychiatric facility in northern Nigeria. A socio-demographic questionnaire was utilized, along with a record of the clinician’s assessment of diagnosis for 242 patients. Subjects who had been withdrawn from school, or any previously engaged-in activity for longer than 4 weeks on account of the illness, were recorded as having disability from the illness. The children were aged 1-18 years (mean=12.3; SD=5.2) with males accounting for 51.7% (125) while 14.5% of the females (n=117) were married. Two thirds (64.5%) of the patients had been ill for longer than 6 months prior to presentation. One hundred and forty four subjects (59.5%) had received no care at all, while 36.4% had received treatment from traditional/religious healers prior to presentation. The most disabling conditions were ADHD (80%), mental retardation (77.8%), epilepsy (64.1%) and psychotic disorders (50%). There is urgent need for extending mental health services into the community in order to improve access to care and increase awareness about effective and affordable treatments. PMID:28299078

  6. Psychiatric Disorders in Adolescence and Early Adulthood and Risk for Child-Rearing Difficulties during Middle Adulthood

    ERIC Educational Resources Information Center

    Johnson, Jeffrey G.; Cohen, Patricia; Kasen, Stephanie; Brook, Judith S.

    2008-01-01

    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…

  7. The Influence of Sex on the Course and Psychiatric Correlates of ADHD from Childhood to Adolescence: A Longitudinal Study

    ERIC Educational Resources Information Center

    Monuteaux, Michael C.; Mick, Eric; Faraone, Stephen V.; Biederman, Joseph

    2010-01-01

    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,…

  8. Is Exposure to Domestic Violence and Violent Crime Associated with Bullying Behaviour among Underage Adolescent Psychiatric Inpatients?

    ERIC Educational Resources Information Center

    Mustanoja, Susanna; Luukkonen, Anu-Helmi; Hakko, Helina; Rasanen, Pirkko; Saavala, Hannu; Riala, Kaisa

    2011-01-01

    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…

  9. Psychiatric Comorbidity in Adolescents and Young Adults with Autism

    ERIC Educational Resources Information Center

    Moseley, David S.; Tonge, Bruce J.; Brereton, Avril V.; Einfeld, Stewart L.

    2011-01-01

    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…

  10. The Handbook of Psychiatric Drug Therapy for Children and Adolescents.

    ERIC Educational Resources Information Center

    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…

  11. Which skills boost service provider confidence when managing people presenting with psychiatric emergencies?

    PubMed

    Poremski, Daniel; Lim, Xin Ya; Kunjithapatham, Ganesh; Koh, Doris; Alexander, Mark; Cheng, Lee

    2016-12-01

    The way service seekers interact with the staff at emergency services has been shown to influence the standard of care, especially in the case of certain psychiatric manifestations. Staff reactions to psychiatric complaints have been linked to their comfort dealing with these types of service users as well as their competencies understanding the illness. It is therefore vital to understand which skills increase confidence in treating psychiatric emergencies. Twenty-six open-ended convergent interviews were conducted with staff working in a psychiatric emergency department. Thematic analysis was used to analyze the data. Participants reported several non-technical skills which developed from exclusively serving people with psychiatric emergencies: 1) Vigilance allowed staff to be sensitive to minor changes in behavior which precede psychiatric emergencies. 2) The ability to negotiate and find tangible solutions was particularly important when dealing with psychiatric complaints which may not have tangible resolutions. 3) The ability to appraise social support networks allowed staff to plan follow-up actions and ensure continuity of care when support was available. 4) The ability to self-reflect allowed participants to learn from their experience and avoid burnout, frustration, and fatigue. Participants also reported several other clinical skills which they gained during training, including teamwork, de-escalating techniques and risk assessment. Tentatively speaking, these skills improve staff's confidence when treating psychiatric emergencies. Certain skills may be generalized to staff working in medical emergency departments who frequently encounter psychiatric complaints.

  12. Psychiatric symptom typology in a sample of youth receiving substance abuse treatment services: associations with self-reported child maltreatment and sexual risk behaviors.

    PubMed

    Oshri, Assaf; Tubman, Jonathan G; Jaccard, James

    2011-11-01

    Latent profile analysis (LPA) was used to classify 394 adolescents undergoing substance use treatment, based on past year psychiatric symptoms. Relations between profile membership and (a) self-reported childhood maltreatment experiences and (b) current sexual risk behavior were examined. LPA generated three psychiatric symptom profiles: Low-, High- Alcohol-, and High- Internalizing Symptoms profiles. Analyses identified significant associations between profile membership and childhood sexual abuse and emotional neglect ratings, as well as co-occurring sex with substance use and unprotected intercourse. Profiles with elevated psychiatric symptom scores (e.g., internalizing problems, alcohol abuse and dependence symptoms) and more severe maltreatment histories reported higher scores for behavioral risk factors for HIV/STI exposure. Heterogeneity in psychiatric symptom patterns among youth receiving substance use treatment services, and prior histories of childhood maltreatment, have significant implications for the design and delivery of HIV/STI prevention programs to this population.

  13. [Psychometric properties of the Beck depression inventory-II (BDI-II) among adolescent psychiatric patients].

    PubMed

    Besier, Tanja; Goldbeck, Lutz; Keller, Ferdinand

    2008-02-01

    A revised version of the Beck depression inventory (BDI-II) has been translated into German. Until now the BDI-II has only been evaluated in several American studies with clinical and nonclinical samples of adolescents. 111 adolescent psychiatric patients (ages ranged from 15-18 years) participated in a study to evaluate reliability, construct and factorial validity, as well as the diagnostic discrimination of the BDI-II. Internal consistency was high (alpha=0.92), showing the homogeneity of the instrument. Associations with other clinical (parent and self report) instruments point in the expected direction and support the external validity of the BDI-II. A factor-analysis generated inconclusive results. The BDI-II differentiated very well between a subsample of depressed adolescents (n=46), a subsample of non-depressed adolescent patients (n=53) and a nonclinical sample (n=31). The results of this study support the use of the BDI-II as a severity measure of depressive symptoms among adolescent psychiatric patients.

  14. Association of Family Structure to Later Criminality: A Population-Based Follow-Up Study of Adolescent Psychiatric Inpatients in Northern Finland

    ERIC Educational Resources Information Center

    Ikaheimo, Olli; Laukkanen, Matti; Hakko, Helina; Rasanen, Pirkko

    2013-01-01

    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…

  15. World wide use of psychotropic drugs in child and adolescent psychiatric disorders.

    PubMed

    Simeon, J G; Wiggins, D M; Williams, E

    1995-05-01

    1. Questionnaires were mailed to child psychiatrists world wide to obtain more precise information on views and approaches to the diagnosis and treatment of childhood psychiatric disorders. 2. Results indicated important problems related to the management of child psychiatry practice both overseas and in Canada. 3. The choice of medication was frequently restricted by lack of availability, and political or social attitudes. 4. A consensus on diagnosis and treatment guidelines in child and adolescent psychiatry remains an important issue.

  16. Classifying child and adolescent psychiatric disorder by problem checklists and standardized interviews.

    PubMed

    Boyle, Michael H; Duncan, Laura; Georgiades, Kathy; Bennett, Kathryn; Gonzalez, Andrea; Van Lieshout, Ryan J; Szatmari, Peter; MacMillan, Harriet L; Kata, Anna; Ferro, Mark A; Lipman, Ellen L; Janus, Magdalena

    2016-11-14

    This paper discusses the need for research on the psychometric adequacy of self-completed problem checklists to classify child and adolescent psychiatric disorder based on proxy assessments by parents and self-assessments by adolescents. We put forward six theoretical arguments for expecting checklists to achieve comparable levels of reliability and validity with standardized diagnostic interviews for identifying child psychiatric disorder in epidemiological studies and clinical research. Empirically, the modest levels of test-retest reliability exhibited by standardized diagnostic interviews - 0.40 to 0.60 based on kappa - should be achievable by checklists when thresholds or cut-points are applied to scale scores to identify a child with disorder. The few studies to conduct head-to-head comparisons of checklists and interviews in the 1990s concurred that no construct validity differences existed between checklist and interview classifications of disorder, even though the classifications of youth with psychiatric disorder only partially overlapped across instruments. Demonstrating that self-completed problem checklists can classify disorder with similar reliability and validity as standardized diagnostic interviews would provide a simple, brief, flexible way to measuring psychiatric disorder as both a categorical or dimensional phenomenon as well as dramatically lowering the burden and cost of assessments in epidemiological studies and clinical research.

  17. Predictors of medication compliance after hospital discharge in adolescent psychiatric patients.

    PubMed

    Lloyd, A; Horan, W; Borgaro, S R; Stokes, J M; Pogge, D L; Harvey, P D

    1998-01-01

    Failure in medication compliance in adult psychiatric patients is often found to be due to side effects or associated with unawareness of illness. Little research has been conducted on medication compliance in adolescent psychiatric patients. In this study, 97 adolescent psychiatric patients, including 46 with substance abuse, were followed up an average of 14 months after their discharge from inpatient psychiatric care. Compliance with prescribed medications was examined and the association between several potential predictors and compliance was examined. The overall rate of medication compliance was only 38% at 14-month follow-up, whereas the rate of patients stopping their medications because of side effects was only 23%. Significant predictors of compliance failures were general noncompliance with the discharge plan, followed by postdischarge substance abuse. Side effects did not contribute any additional variance when these factors were considered. These data suggest that medication compliance may be adversely impacted by general tendencies toward noncompliance with treatment, which may be mediated by several possible factors. Interventions to increase awareness of the need for psychotropic medications as well as careful monitoring for substance abuse relapse in this population are suggested.

  18. Students with Psychiatric Disabilities on Campus: Examining Predictors of Enrollment with Disability Support Services

    ERIC Educational Resources Information Center

    Collins, Mary Elizabeth; Mowbray, Carol T.

    2008-01-01

    Because of advances in psychotropic medications, psychiatric rehabilitation methods, the implementation of civil rights legislation, and empowerment movement of consumers with psychiatric disabilities, students with mental illnesses are increasingly able to access and complete higher education. Disability services offices on college campuses can…

  19. The Role of Race in Diagnostic and Disposition Decision-making in a Pediatric Psychiatric Emergency Service (PES)

    PubMed Central

    Muroff, Jordana; Edelsohn, Gail A.; Joe, Sean; Ford, Briggett C.

    2008-01-01

    Objective We investigated the influence of race/ethnicity in diagnostic and disposition decision-making for children and adolescents presenting to an urban psychiatric emergency service (PES). Method Medical records were reviewed for 2991 child and adolescent African American, Hispanic/Latino, and White patients, treated in an urban PES between October 2001 and September 2002. A series of bivariate and binomial logistic regression analyses were employed to delineate the role of race in the patterns and correlates of psychiatric diagnostic and treatment disposition decisions. Results Binomial logistic regression analyses reveal that African American (OR=2.28, p<.001), and Hispanic/Latino (OR=2.35, p<.05) patients are more likely to receive a psychotic disorder and behavioral disorders diagnoses (African American:OR=1.66, p<.001; Hispanic/Latino:OR=1.36, p<.05) than White children/adolescents presenting to PES. African American youth compared to White youth are also less likely to receive depressive disorder (OR=0.78, p<.05), bipolar disorder (OR=.44, p<.001), and alcohol/substance abuse disorder (OR=.18, p<.01) diagnoses. African American pediatric PES patients are also more likely to be hospitalized (OR=1.50, p<.05), controlling for other socio-demographic and clinical factors (e.g., GAF). Conclusions The results highlight that non-clinical factors such as race/ethnicity are associated with clinical diagnostic decisions as early as childhood suggesting the pervasiveness of such disparities. PMID:18433660

  20. Dissociative identity disorder among adolescents: prevalence in a university psychiatric outpatient unit.

    PubMed

    Sar, Vedat; Onder, Canan; Kilincaslan, Ayse; Zoroglu, Süleyman S; Alyanak, Behiye

    2014-01-01

    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.

  1. Association of child maltreatment and psychiatric diagnosis in Brazilian children and adolescents

    PubMed Central

    Scomparini, Luciana Burim; dos Santos, Bernardo; Rosenheck, Robert Alan; Scivoletto, Sandra

    2013-01-01

    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

  2. Receipt of employment services among Veterans Health Administration users with psychiatric diagnoses.

    PubMed

    Abraham, Kristen M; Ganoczy, Dara; Yosef, Matheos; Resnick, Sandra G; Zivin, Kara

    2014-01-01

    This study examined the population-based reach of Veterans Health Administration (VHA) employment services to VHA patients with psychiatric diagnoses. Reach of services includes the percentage and characteristics of people who accessed services compared with those who did not. Using clinical administrative data, we identified patients with a psychiatric diagnosis among a random sample of all patients who received VHA services in 1 yr. Among VHA patients with psychiatric diagnoses, we examined their likelihood of receiving any VHA employment services and specific types of employment services, including supported employment, transitional work, incentive therapy, and vocational assistance. We identified clinical and demographic characteristics associated with receiving employment services. Results indicated that 4.2% of VHA patients with a psychiatric diagnosis received employment services. After adjusting for clinical and demographic characteristics, VHA patients with schizophrenia and bipolar disorder were more likely to receive any employment services and to receive supported employment than were patients with depression, PTSD, or other anxiety disorders. VHA patients with depression and PTSD were more likely to receive transitional work and vocational assistance than patients with schizophrenia. Future studies should examine system-level barriers to receiving employment services and identify types of employment services most appropriate for Veterans with different psychiatric diagnoses.

  3. Risk Factors of Acute Behavioral Regression in Psychiatrically Hospitalized Adolescents with Autism

    PubMed Central

    Périsse, Didier; Amiet, Claire; Consoli, Angèle; Thorel, Marie-Vincente; Gourfinkel-An, Isabelle; Bodeau, Nicolas; Guinchat, Vincent; Barthélémy, Catherine; Cohen, David

    2010-01-01

    Aim: During adolescence, some individuals with autism engage in severe disruptive behaviors, such as violence, agitation, tantrums, or self-injurious behaviors. We aimed to assess risk factors associated with very acute states and regression in adolescents with autism in an inpatient population. Method: Between 2001 and 2005, we reviewed the charts of all adolescents with autism (N=29, mean age=14.8 years, 79% male) hospitalized for severe disruptive behaviors in a psychiatric intensive care unit. We systematically collected data describing socio-demographic characteristics, clinical variables (severity, presence of language, cognitive level), associated organic conditions, etiologic diagnosis of the episode, and treatments. Results: All patients exhibited severe autistic symptoms and intellectual disability, and two-thirds had no functional verbal language. Fifteen subjects exhibited epilepsy, including three cases in which epilepsy was unknown before the acute episode. For six (21%) of the subjects, uncontrolled seizures were considered the main cause of the disruptive behaviors. Other suspected risk factors associated with disruptive behavior disorders included adjustment disorder (N=7), lack of adequate therapeutic or educational management (N=6), depression (N=2), catatonia (N=2), and painful comorbid organic conditions (N=3). Conclusion: Disruptive behaviors among adolescents with autism may stem from diverse risk factors, including environmental problems, comorbid acute psychiatric conditions, or somatic diseases such as epilepsy. The management of these behavioral changes requires a multidisciplinary functional approach. PMID:20467546

  4. Early detection of psychotic disorders in adolescents: specificity of basic symptoms in psychiatric patient samples.

    PubMed

    Resch, F; Koch, E; Möhler, E; Parzer, P; Brunner, R

    2002-01-01

    Based on the results of adult studies that have shown a subgroup of basic symptoms to have a predictive value for later schizophrenic disorder, a cross-sectional study on 36 schizophrenic and 75 nonschizophrenic adolescent psychiatric inpatients was performed to elucidate the specificity of prodromal signs in early age groups. The occurrence of any single basic symptom does not show schizophrenic specificity in adolescents, but the number of basic symptoms in the categories of the Bonn Scale for the Assessment of Basic Symptoms is increased in schizophrenic patients compared with subjects with other diagnoses. The interrelation between minus symptoms and cognitive symptoms exerts a higher amount of cognitive disturbances given a certain level of irritation in schizophrenic adolescents. With the help of odds ratios, the seven most discriminating cognitive items could be elucidated including perception, information processing and action tendency.

  5. Examining the impact of psychiatric diagnosis and comorbidity on the medical lethality of adolescent suicide attempts.

    PubMed

    McManama O'Brien, Kimberly H; Berzin, Stephanie C

    2012-08-01

    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 substance abuse. Regression results indicated having depression comorbid with any other diagnosis was not associated with medical lethality. However, having a substance abuse disorder was associated with higher suicide attempt lethality, highlighting the importance of substance abuse as a risk factor for lethal suicide attempts in adolescents. This finding stimulates critical thinking around the understanding of suicidal behavior in youth and the development and implementation of treatment strategies for suicidal adolescents with substance abuse disorders.

  6. Bullying behavior in relation to psychiatric disorders and physical health among adolescents: a clinical cohort of 508 underage inpatient adolescents in Northern Finland.

    PubMed

    Luukkonen, Anu-Helmi; Räsänen, Pirkko; Hakko, Helinä; Riala, Kaisa

    2010-06-30

    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.

  7. Music listening preferences and preadmission dysfunctional psychosocial behaviors of adolescents hospitalized on an in-patient psychiatric unit.

    PubMed

    Weidinger, C K; Demi, A S

    1991-01-01

    This study investigated the relationship between music listening preferences and preadmission, dysfunctional psychosocial behaviors (PDPB) of 60 adolescents who were hospitalized on an in-patient psychiatric unit. Findings were that hospitalized adolescents who primarily listened to music with negative lyrics/themes had a history of more PDPB than hospitalized adolescents who primarily listened to music that did not contain negative lyrics/themes; and hospitalized adolescents who primarily listened to heavy metal music had a history of more PDPB than hospitalized adolescents who primarily listened to other types of music.

  8. The copycat phenomenon after two Finnish school shootings: an adolescent psychiatric perspective

    PubMed Central

    2012-01-01

    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

  9. Effects of motivational interviewing on smoking cessation in adolescents with psychiatric disorders

    PubMed Central

    Brown, R; Ramsey, S; Strong, D; Myers, M; Kahler, C; Lejuez, C; Niaura, R; Pallonen, U; Kazura, A; Goldstein, M; Abrams, D

    2003-01-01

    Objective:To test the hypothesis that among adolescent smokers hospitalised for psychiatric and substance use disorders, motivational interviewing (MI) would lead to more and longer quit attempts, reduced smoking, and more abstinence from smoking over a 12 month follow up. Design:Randomised control trial of MI versus brief advice (BA) for smoking cessation, with pre- and post-intervention assessment of self efficacy and intentions to change, and smoking outcome variables assessed at one, three, six, nine, and 12 month follow ups. Setting:A private, university affiliated psychiatric hospital in Providence, Rhode Island, USA. Patients or other participants:Consecutive sample (n = 191) of 13–17 year olds, admitted for psychiatric hospitalisation, who smoked at least one cigarette per week for the past four weeks, had access to a telephone, and did not meet DSM-IV criteria for current psychotic disorder. Interventions:MI versus BA. MI consisted of two, 45 minute individual sessions, while BA consisted of 5–10 minutes of advice and information on how to quit smoking. Eligible participants in both conditions were offered an eight week regimen of transdermal nicotine patch upon hospital discharge. Main outcome measures:Point prevalence abstinence, quit attempts, changes in smoking rate and longest quit attempt. Proximal outcomes included intent to change smoking behaviour (upon hospital discharge), and self efficacy for smoking cessation. Results:MI did not lead to better smoking outcomes compared to BA. MI was more effective than BA for increasing self efficacy regarding ability to quit smoking. A significant interaction of treatment with baseline intention to quit smoking was also found. MI was more effective than BA for adolescents with little or no intention to change their smoking, but was actually less effective for adolescents with pre-existing intention to cut down or quit smoking. However, the effects on these variables were relatively modest and only

  10. Self-harm in Child and Adolescent Psychiatric Inpatients: A Retrospective Study

    PubMed Central

    Zhand, Naista; Matheson, Katherine; Courtney, Darren

    2016-01-01

    Objective This study presents a comprehensive report of children and adolescents who engaged in self-harm during their admission to a psychiatric inpatient unit. Method A chart review was conducted on all admissions to an acute care psychiatric inpatient unit in a Canadian children’s hospital over a one-year period. Details on patients with self-harm behaviour during the admission were recorded, including: demographics, presentation to hospital, self-harm behaviour and outcome. Baseline variables for patients with and without self-harm behaviour during admission were compared. Results Self-harm incidents were reported in 60 of 501 (12%) admissions during the one-year period of the study. Fourteen percent of patients (50 of 351) accounted for total number of 136 self-harm incidents. Half of these incidents (49%) occurred outside of the hospital setting, when patients were on passes. Using the Beck Lethality Scale (0–10), mean severity of the self-injury attempts was 0.33, and there were no serious negative outcomes. Conclusion Self-harm behaviour during inpatient psychiatric admission is a common issue among youth, despite safety strategies in place. While self-harm behaviour is one of the most common reasons for admission to psychiatric inpatient unit, our understanding of nature of these acts during the admission and contributing factors are limited. Further research is required to better understand these factors, and to develop strategies to better support these patients. PMID:27924147

  11. Health-related quality of life in adolescents with inflammatory bowel disease depends on disease activity and psychiatric comorbidity.

    PubMed

    Engelmann, G; Erhard, D; Petersen, M; Parzer, P; Schlarb, A A; Resch, F; Brunner, R; Hoffmann, G F; Lenhartz, H; Richterich, A

    2015-04-01

    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.

  12. Treatment of psychiatric disorders in children and adolescents with HIV/AIDS.

    PubMed

    Benton, Tami D

    2010-04-01

    We could not have predicted that HIV/AIDS would become one of our greatest public health challenges worldwide when the first cases were identified in the 1980s. More than 22 million people have died from the disease, and HIV is now the seventh-leading cause of death in the United States among 15- to 24-year-olds. At the beginning of this pandemic, most HIV infections of youth were acquired congenitally. Prenatal screening of pregnant women, early detection, and antiretroviral therapies have reduced mother-to-child transmission. Children born with HIV infections are now young adults living with HIV, while other adolescents are acquiring HIV primarily through high-risk behaviors. Associations between psychiatric symptoms and poor health outcomes have been recognized among adults. Few studies have examined these factors among youth. We review what is known about psychiatric syndromes among HIV-positive youth, and their treatments.

  13. Love and Service in Adolescent Addiction Recovery.

    PubMed

    Lee, Matthew T; Pagano, Maria E; Johnson, Byron R; Post, Stephen G

    This article is one of the first to examine the relationships among a specific combination of "spiritual virtues" (helping others and the experience of divine love) and outcomes related to criminal involvement, sobriety, and character development among adolescents. One-hundred ninety five adolescents with substance dependency court-referred to residential treatment were assessed at intake, discharge, and 6 months post-treatment. Higher service to others predicted reduced recidivism, reduced relapse, and greater character development. Experiencing divine love enhanced the effect of service on recidivism. Greater attention to spiritual virtues might improve treatment for youth involved with alcohol, drugs, and certain forms of crime.

  14. Love and Service in Adolescent Addiction Recovery

    PubMed Central

    Lee, Matthew T.; Pagano, Maria E.; Johnson, Byron R.; Post, Stephen G.

    2016-01-01

    This article is one of the first to examine the relationships among a specific combination of “spiritual virtues” (helping others and the experience of divine love) and outcomes related to criminal involvement, sobriety, and character development among adolescents. One-hundred ninety five adolescents with substance dependency court-referred to residential treatment were assessed at intake, discharge, and 6 months post-treatment. Higher service to others predicted reduced recidivism, reduced relapse, and greater character development. Experiencing divine love enhanced the effect of service on recidivism. Greater attention to spiritual virtues might improve treatment for youth involved with alcohol, drugs, and certain forms of crime. PMID:27482142

  15. Psychiatric Problems and Trauma Exposure in Non-detained Delinquent and Non-delinquent Adolescents

    PubMed Central

    Adams, Zachary W.; McCart, Michael R.; Zajac, Kristyn; Danielson, Carla Kmett; Sawyer, Genelle K.; Saunders, Benjamin E.; Kilpatrick, Dean G.

    2014-01-01

    Objective This study examined the prevalence of and associations between specific psychiatric disorders, substance use problems, and trauma exposure in a sample of delinquent and non-delinquent adolescents. Method A nationally representative sample of adolescents (n = 3,614; mean age = 14.5 years, SD = 1.7; 51% male; 71% White, non-Hispanic, 13.3% African American, non-Hispanic, 10.7% Hispanic) was interviewed via telephone about engagement in delinquent acts and their experience of posttraumatic stress disorder, major depressive episode, substance use, interpersonal violence, and other forms of trauma exposure. Results Delinquent adolescents were more likely than non-delinquent adolescents to experience trauma; they were also more likely to report past-year posttraumatic stress disorder, major depressive episode, alcohol abuse, and non-experimental drug use. After accounting for the effects of demographics and trauma exposure, delinquency was associated with increased likelihood of posttraumatic stress disorder and problematic substance use in both genders and increased likelihood of major depressive episode in girls. Conclusions Findings highlight substantial overlap among delinquency, trauma exposure, posttraumatic stress disorder, and major depressive episode in adolescents and the need for interventions that address these varied clinical problems. Future work should examine the factors underlying the development of these relations over time. PMID:23236966

  16. Childhood and adolescent onset psychiatric disorders, substance use, and failure to graduate high school on time.

    PubMed

    Breslau, Joshua; Miller, Elizabeth; Joanie Chung, W-J; Schweitzer, Julie B

    2011-03-01

    We examined the joint predictive effects of childhood and adolescent onset psychiatric and substance use disorders on failure to graduate high school (HS) on time. Structured diagnostic interviews were conducted with a US national sample of adults (18 and over). The analysis sample included respondents with at least 8 years of education who were born in the US or arrived in the US prior to age 13 (N = 29,662). Psychiatric disorders, substance use and substance use disorders were examined as predictors of termination or interruption of educational progress prior to HS graduation, with statistical adjustment for demographic characteristics and childhood adversities. Failure to graduate HS on time was more common among respondents with any of the psychiatric and substance use disorders examined, ranging from 18.1% (specific phobia) to 33.2% (ADHD-combined type), compared with respondents with no disorder (15.2%). After adjustment for co-occurring disorders, significant associations with failure to graduate on time remained only for conduct disorder (OR = 1.89, 95% CI 1.57-2.26) and the three ADHD subtypes (Inattentive OR = 1.78, 95% CI 1.44-2.20, Hyperactive-Impulsive OR = 1.38, 95% CI 1.14-1.67, and Combined OR = 2.06, 95% CI 1.66-2.56). Adjusting for prior disorders, tobacco use was associated with failure to graduate on time (OR = 1.97, 95% CI 1.80-2.16). Among substance users, substance use disorders were not associated with on-time graduation. The findings suggest that the adverse impact of childhood and adolescent onset psychiatric disorders on HS graduation is largely accounted for by problems of conduct and inattention. Adjusting for these disorders, smoking remains strongly associated with failure to graduate HS on time.

  17. A Novel Screening and Diagnostic Tool for Child and Adolescent Psychiatric Disorders for Telepsychiatry

    PubMed Central

    Malhotra, Savita; Chakrabarti, Subho; Shah, Ruchita; Mehta, Anurati; Gupta, Aarzoo; Sharma, Minali

    2015-01-01

    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

  18. Tripartite structure of positive and negative affect, depression, and anxiety in child and adolescent psychiatric inpatients.

    PubMed

    Joiner, T E; Catanzaro, S J; Laurent, J

    1996-08-01

    The tripartite model of depression and anxiety suggests that depression and anxiety have shared (generalized negative affect) and specific (anhedonia and physiological hyperarousal) components. In one of the 1st studies to examine the structure of mood-related symptoms in youngsters, this model was tested among 116 child and adolescent psychiatric inpatients, ages 8-16 (M = 12.46; SD = 2.33). Consistent with the tripartite model, a 3-factor (Depression, Anxiety, and Negative Affect) model represented the observed data well. Follow-up analyses suggested that a nonhierarchical arrangement of the 3 factors may be preferable to a hierarchical one.

  19. Social and psychiatric functioning in adolescents with Asperger syndrome compared with conduct disorder.

    PubMed

    Green, J; Gilchrist, A; Burton, D; Cox, A

    2000-08-01

    Lack of standardized phenotypic definition has made outcome studies of Asperger syndrome (AS) difficult to interpret. This paper reports psychosocial functioning in 20 male adolescents with AS, defined according to current ICD-10 criteria, and a comparison group of 20 male adolescents with severe conduct disorder. Subjects were gathered from clinical referral. Evaluation used standardized interviewer rated assessments of social functioning and psychiatric morbidity. The AS group showed severe impairments in practical social functioning despite good cognitive ability and lack of significant early language delay. High levels of anxiety and obsessional disorders were found in AS; depression, suicidal ideation, tempers, and defiance in both groups. Results are compared with those from other studies. Relevance to clinical ascertainment and treatment is discussed.

  20. The Use of Psychiatric Service Dogs in the Treatment of Veterans with PTSD

    DTIC Science & Technology

    2012-10-01

    W81XWH-08-2-0572 TITLE: The Use of psychiatric Service Dogs in the Treatment of Veterans with PTSD PRINCIPAL INVESTIGATOR: Craig Love...The Use of Psychiatric Service Dogs in the Treatment 5a. CONTRACT NUMBER Of Veterans With PTSD 5b. GRANT NUMBER W81XWH-08-2-0572 5c. PROGRAM...concept of using service dogs to reduce the symptoms of PTSD among returning soldiers with severe cases of the disability. At this point the study is

  1. Psychiatric comorbidity distribution and diversities in children and adolescents with attention deficit/hyperactivity disorder: a study from Turkey

    PubMed Central

    Yüce, Murat; Zoroglu, Süleyman Salih; Ceylan, Mehmet Fatih; Kandemir, Hasan; Karabekiroglu, Koray

    2013-01-01

    Objective We aimed to determine distribution and diversities of psychiatric comorbidities in children and adolescents with attention deficit/hyperactivity disorder (ADHD) in terms of age groups, sex, and ADHD subtype. Materials and methods The sample included 6–18 year old children and adolescents from Turkey (N=108; 83 boys, 25 girls) diagnosed with ADHD. All comorbid diagnoses were determined based on the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version assessment. Results 96.3% of the cases were found to have at least one psychiatric comorbid diagnosis. The most frequent psychiatric comorbid disorder was oppositional defiant disorder (69.4%) followed by anxiety disorders (49%) and elimination disorders (27.8%). Disruptive behavior disorders were more common in ADHD-combined type. Depression and anxiety disorders were more common in girls. Separation anxiety disorder and elimination disorder were more common in children, whereas depression, bipolar disorder, obsessive–compulsive disorder, and social phobia were more common in the adolescents. Conclusion According to our results, when a diagnostic tool was used to assess the presence of comorbid psychiatric disorders in children and adolescents diagnosed with ADHD, almost all cases had at least one comorbid diagnosis. Therefore, especially in the clinical sample, ADHD cases should not be solely interpreted with ADHD symptom domains, instead they should be investigated properly in terms of accompanying psychiatric disorders. PMID:24265552

  2. Emergency Psychiatric Services for Individuals with Intellectual Disabilities: Perspectives of Hospital Staff

    ERIC Educational Resources Information Center

    Lunsky, Yona; Gracey, Carolyn; Gelfand, Sara

    2008-01-01

    Strains on the mainstream mental health system can result in inaccessible services that force individuals with intellectual disabilities into the emergency room (ER) when in psychiatric crisis. The purpose of this study was to identify clinical and systemic issues surrounding emergency psychiatry services for people with intellectual disabilities,…

  3. Non-Psychiatric Services Provided in a Mental Health Unit in a County Jail.

    ERIC Educational Resources Information Center

    Young, Diane S.

    2002-01-01

    Examines mental health service provision by social workers in a county jail through a retrospective review of 359 mentally ill jail inmates' health and mental health records. Of the non-psychiatric, mental health services provided beyond initial assessment, housing placement evaluations and follow-up sessions were the most frequent. Suggestions…

  4. Incorporating the Views of Service Users in the Development of an Integrated Psychiatric Service for People with Learning Disabilities

    ERIC Educational Resources Information Center

    Parkes, Charles; Samuels, Sarah; Hassiotis, Angela; Lynggaard, Henrik; Hall, Ian

    2007-01-01

    During the 1990s, a decision was made within the Learning Disabilities services of Camden & Islington to develop a local integrated service for people requiring an acute psychiatric admission. There had been little research at the time on the experiences of people with learning disabilities within the type of inner London acute mental health…

  5. Gender Differences in the Relationship Between Physical Activity and Smoking Among Psychiatrically Hospitalized Adolescents.

    PubMed

    Bloom, Erika Litvin; Abrantes, Ana M; Fokas, Kathryn F; Ramsey, Susan E; Brown, Richard A

    2012-12-01

    Physical activity has been identified as a protective factor with regard to tobacco use, such that physically active adolescents are less likely to initiate smoking, and smokers are less physically active than non-smokers. These findings, along with the well-documented benefits of exercise on mood and well-being in adults, have stimulated interest in exercise-based smoking cessation interventions. However, little research has explored the relationship between physical activity and smoking characteristics within adolescent smokers. Also, gender differences in adolescents' motives for smoking and exercise may have implications for intervention development, especially in clinical populations. The current study explored the relationship between physical activity and smoking in a sample of adolescent smokers (N = 191) and non-smokers (N = 48) receiving inpatient psychiatric treatment (61% female, mean age 15.3 years). Results indicated that smokers were less likely to be physically active than non-smokers. Additionally, there was a consistent pattern of gender differences in the relationship between smoking and physical activity within smokers. Specifically, physically active male smokers were less nicotine dependent and less prone to withdrawal, and had a trend toward greater motivation to quit, than their non-active counterparts. In contrast, physically active female smokers did not differ in dependence or withdrawal and were less motivated to quit than non-active female smokers. Taken together, these results suggest that within clinical populations of adolescent females, smoking and exercise may be used jointly as weight control strategies. Exercise-based interventions for smoking cessation for adolescent females, especially clinical populations, should address weight and body image concerns.

  6. Non-Suicidal Self-Injury Disorder: An Empirical Investigation in Adolescent Psychiatric Patients

    PubMed Central

    Glenn, Catherine R.; Klonsky, E. David

    2013-01-01

    Objective Non-suicidal self-injury (NSSI) is a growing public health concern, especially among adolescents. In the current edition of the Diagnostic and Statistical Manual of Mental Disorders, NSSI is classified as a criterion of borderline personality disorder (BPD). However, a distinct NSSI disorder will now be included in DSM-5 as a “condition requiring further study.” Importantly, at this time, there is little direct evidence supporting the DSM-5 proposal over the DSM-IV classification. To address this need, the current study examined the extent to which NSSI occurs independently of BPD, and has clinical significance beyond a diagnosis of BPD in adolescent psychiatric patients. Method NSSI disorder was assessed based on the proposed DSM-5 criteria in 198 adolescents ages 12 to 18 (74% female; 64% Caucasian, 14% Hispanic, 10% African American, and 12% mixed/other ethnicity) from a psychiatric hospital. Major Axis I disorders, Axis II BPD, and suicide ideation and attempts were assessed with structured clinical interviews; emotion dysregulation and loneliness were measured with validated self-report questionnaires. Results First, results indicate that NSSI disorder occurs independently of BPD. Specifically, although there was overlap between the occurrence of BPD and NSSI disorder, this overlap was no greater than that between BPD and other Axis I disorders (e.g., anxiety and mood disorders). Second, NSSI disorder demonstrated unique associations with clinical impairment – indexed by suicide ideation and attempts, emotion dysregulation, and loneliness – over and above a BPD diagnosis. Conclusions Taken together, findings support the classification of NSSI as a distinct and clinically significant diagnostic entity. PMID:23682597

  7. Explaining lifetime criminal arrests among clients of a psychiatric probation and parole service.

    PubMed

    Solomon, P; Draine, J

    1999-01-01

    This study examines the extent to which sociodemographic characteristics, clinical characteristics, substance abuse problems, and the array of lifetime criminal behavior may explain lifetime arrests among offenders supervised by the psychiatric probation and parole service. Three hundred twenty-five clients with new cases at a psychiatric probation and parole service in a large urban center were screened for major psychiatric disorders. They were also interviewed for socio-demographic characteristics, mental health treatment history, criminal behavior, and arrest history. Hierarchical block multiple regression analysis tested a model explaining lifetime arrests. After controlling for age and other demographic variables, the number of lifetime psychiatric hospitalizations and lifetime occurrences of mania diagnosis significantly explained lifetime arrests. The total model explained about 10 percent of the variance in lifetime arrests after controlling for opportunity variables, which explained 45 percent. The explanatory power of lifetime hospitalizations and mania support the contention that symptoms, rather than diagnosis, may be the most important clinical factor in explaining criminal arrest among persons with mental illness. Implications for psychiatric services include the development of effective jail diversion programs.

  8. Psychiatric and Substance Use Disorders as Risk Factors for Attempted Suicide among Adolescents: A Case Control Study.

    ERIC Educational Resources Information Center

    Kelly, Thomas M.; Cornelius, Jack R.; Lynch, Kevin G.

    2002-01-01

    Tests substance-related and non-substance-related psychiatric disorders as predictors of attempted suicide among adolescents. Bipolar disorder, cocaine use disorders, and conduct disorder were found to be predictive of attempted suicide in univariate testing. Higher rates of cocaine use disorder/conduct disorder, hallucinogen use disorder/conduct…

  9. Borderline personality disorder associates with violent criminality in women: A population based follow-up study of adolescent psychiatric inpatients in Northern Finland.

    PubMed

    Arola, Riikka; Antila, Henna; Riipinen, Pirkko; Hakko, Helinä; Riala, Kaisa; Kantojärvi, Liisa

    2016-09-01

    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.

  10. A Qualitative Analysis Exploring Explanatory Models of Aggression and Violence in a Small Cohort of Rural Psychiatrically Hospitalized Adolescents, Their Parents, and Selected Hospital Staff

    ERIC Educational Resources Information Center

    Johnson, Daniel C.

    2010-01-01

    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…

  11. Bullying behaviour in schools, socioeconomic position and psychiatric morbidity: a cross-sectional study in late adolescents in Greece

    PubMed Central

    2012-01-01

    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

  12. Psychiatric diagnoses and psychosocial needs of outpatient deaf children and adolescents.

    PubMed

    Landsberger, Sarah A; Diaz, David R; Spring, Noah Z; Sheward, Jerry; Sculley, Charleen

    2014-02-01

    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.

  13. The implementation of community-based crisis services for people with acute psychiatric illness.

    PubMed

    Finch, S J; Burgess, P M; Herrman, H E

    1991-06-01

    This article describes three recently established community-based crisis services for people with acute psychiatric illness. Data were obtained from local information systems developed in the early phase of service operation. Patterns of service were found to vary among the teams in terms of the frequency of contact with the client, the period of contact with the client and the overall numbers of contacts. Such diversification of services reflects, at least in part, the differences in the service networks within which the new services were Such diversification of services is inevitable and creative, and the evaluation of these services must consider not only the short-term impact of crisis services, but also the impact of the network of care services on longer term outcomes for the client.

  14. 75 FR 71441 - Universal Health Services, Inc. and Psychiatric Solutions, Inc.; Analysis of Agreement Containing...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-23

    ... contract management business accounted for the remaining 7%. Acute Inpatient Psychiatric Services UHS's... largest hospital management companies, with 2009 revenues totaling approximately $5.2 billion. In 2009... business, and includes all of the assets necessary for a Commission-approved buyer to independently...

  15. New Research into General Psychiatric Services for Adults with Intellectual Disability and Mental Illness

    ERIC Educational Resources Information Center

    Chaplin, R.

    2009-01-01

    Background: There are a variety of models for the mental health care of adults with comorbid intellectual disability (ID) and mental illness. There has been a long-running debate as to whether this should be provided by general psychiatric or specialised ID services. A previous review concluded that there was no clear evidence to support either…

  16. Psychiatric Diagnoses and Clinical Characteristics of Asian American Youth in Children's Services

    ERIC Educational Resources Information Center

    Nguyen, Ly; Arganza, Girlyn F.; Huang, Larke N.; Liao, Qinghong; Nguyen, Hoang T.; Santiago, Rolando

    2004-01-01

    This study examined the psychiatric diagnoses and clinical characteristics of the 981 Asian American children enrolled in the first phase of the Comprehensive Community Mental Health Services for Children and Their Families Program. Asian Americans were less likely than non-Asian Americans to receive diagnoses of depression and ADHD and more…

  17. Dating violence victimization, dispositional aggression, and nonsuicidal self-injury among psychiatrically hospitalized male and female adolescents.

    PubMed

    Rizzo, Christie J; Esposito-Smythers, Christianne; Swenson, Lance; Hower, Heather M; Wolff, Jennifer; Spirito, Anthony

    2014-06-01

    The objective of the current study was to characterize the association between dating violence victimization and dispositional aggression in predicting nonsuicidal self-injury (NSSI) among psychiatrically hospitalized male and female adolescents. One hundred fifty-five adolescents (ages 13-17) and their parents completed the Schedule for Affective Disorders and Schizophrenia for School-Age Children clinical interview to assess NSSI and child abuse; adolescents completed self-report measures of aggression and dating violence victimization (verbal, physical, and sexual). Dating violence victimization and NSSI were found to be highly prevalent among both males and females in this psychiatric inpatient sample. Two moderational models were supported, wherein dating violence was associated with NSSI in the context of elevated trait anger in males and indirect aggression in females. Findings suggest that helping victims of dating violence acquire skills to address certain forms of dispositional aggression may attenuate NSSI.

  18. Social-Cognitive Moderators of the Relationship between Peer Victimization and Suicidal Ideation among Psychiatrically Hospitalized Adolescents

    PubMed Central

    Wolff, Jennifer; Esposito-Smythers, Christianne; Becker, Sara; Seaboyer, Lourah; Rizzo, Christie; Lichtenstein, David; Spirito, Anthony

    2013-01-01

    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

  19. Motor abilities of children and adolescents with a psychiatric condition: A systematic literature review

    PubMed Central

    Damme, Tine Van; Simons, Johan; Sabbe, Bernard; van West, Dirk

    2015-01-01

    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

  20. Subregional Hippocampal Morphology and Psychiatric Outcome in Adolescents Who Were Born Very Preterm and at Term

    PubMed Central

    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

    2015-01-01

    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

  1. Immunization Services for Adolescents within Comprehensive School Health Programs.

    ERIC Educational Resources Information Center

    Vernon, Mary E.; Bryan, Gloria; Hunt, Pete; Allensworth, Diane; Bradley, Beverly

    1997-01-01

    Discusses school health services, adolescent immunization, current school immunization practices, and support for school-based immunization programs. Children and adolescents can receive preventive health services, including immunizations and monitoring of immunization levels. Expanding school health services could improve the immunization levels…

  2. Chronic Stress and Adolescents' Mental Health: Modifying Effects of Basal Cortisol and Parental Psychiatric History. The TRAILS Study.

    PubMed

    Zandstra, Anna Roos E; Hartman, Catharina A; Nederhof, Esther; van den Heuvel, Edwin R; Dietrich, Andrea; Hoekstra, Pieter J; Ormel, Johan

    2015-08-01

    Large individual differences in adolescent mental health following chronic psychosocial stress suggest moderating factors. We examined two established moderators, basal cortisol and parental psychiatric history, simultaneously. We hypothesized that individuals with high basal cortisol, assumed to indicate high context sensitivity, would show relatively high problem levels following chronic stress, especially in the presence of parental psychiatric history. With Linear Mixed Models, we investigated the hypotheses in 1917 Dutch adolescents (53.2% boys), assessed at ages 11, 13.5, and 16. Low basal cortisol combined with the absence of a parental psychiatric history increased the risk of externalizing but not internalizing problems following chronic stress. Conversely, low basal cortisol combined with a substantial parental psychiatric history increased the risk of internalizing but not externalizing problems following chronic stress. Thus, parental psychiatric history moderated stress- cortisol interactions in predicting psychopathology, but in a different direction than hypothesized. We conclude that the premise that basal cortisol indicates context sensitivity may be too crude. Context sensitivity may not be a general trait but may depend on the nature of the context (e.g., type or duration of stress exposure) and on the outcome of interest (e.g., internalizing vs. externalizing problems). Although consistent across informants, our findings need replication.

  3. The Dynamics and Correlates of Religious Service Attendance in Adolescence

    ERIC Educational Resources Information Center

    Hardie, Jessica Halliday; Pearce, Lisa D.; Denton, Melinda Lundquist

    2016-01-01

    This study examines changes in religious service attendance over time for a contemporary cohort of adolescents moving from middle to late adolescence. We use two waves of a nationally representative panel survey of youth from the National Study of Youth and Religion (NSYR) to examine the dynamics of religious involvement during adolescence. We…

  4. Understanding readmission to psychiatric hospital in Australia from the service users' perspective: a qualitative study.

    PubMed

    Duhig, Michael; Gunasekara, Imani; Patterson, Sue

    2017-01-01

    Inpatient care is integral to balanced mental health systems, contributing to containment of risk associated with psychiatric crises and affording opportunities for treatment. However, psychiatric wards are not always safe and service users are often dissatisfied with the experience. Hence, and because inpatient care is the most costly component of mental health systems, minimising duration of admission and reducing risk of readmission are clinical and strategic priorities internationally. With (primarily quantitative) research to date focused on explaining readmission in terms of characteristics of individuals and services, understanding of the 'revolving door phenomenon' remains limited. Considering verstehen critical to addressing this messy problem, we examined readmission from the service users' perspective. Using grounded theory techniques, we inductively analysed data from interviews with 13 people readmitted to inpatient care within 28 days of discharge. Participants, including eight men, were recruited in 2013 from three psychiatric wards at a metropolitan hospital in Australia. Analysis supported description of readmission as a process, fundamentally related to insufficiency of internal, interpersonal and/or environmental resources to maintain community tenure. For the people in this study, admission to hospital was either the default coping mechanism or the culmination of counter-productive attempts to manage stressful circumstances. Readmission can appropriately be understood as one representation of a fundamental social malaise and the struggle of some people to survive in an apparently inhospitable world. The findings indicate that neither locating the 'problem of readmission' within an individual and promoting self-governance/self-control/self-regulation, nor identifying failures of specific services or sectors are likely to support the economic and ethical imperative of reducing psychiatric admissions. The findings of the study and limitations

  5. Resource Guide to New Jersey Adolescent Substance Abuse Treatment Services.

    ERIC Educational Resources Information Center

    Molinari, Geralyn D.

    This guide was developed to assist treatment providers and school personnel to identify New Jersey drug and alcohol treatment programs providing services to adolescents. Geographical areas served, days and hours of operation, admission requirements, services available for adolescents, payment information, and the name of a contact person are…

  6. The association of non-suicidal self-injury and suicidal behavior according to DSM-5 in adolescent psychiatric inpatients.

    PubMed

    Groschwitz, Rebecca C; Kaess, Michael; Fischer, Gloria; Ameis, Nina; Schulze, Ulrike M E; Brunner, Romuald; Koelch, Michael; Plener, Paul L

    2015-08-30

    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.

  7. Predictors of non-drug psychiatric/psychotherapeutic treatment in children and adolescents with mental or behavioural disorders.

    PubMed

    Abbas, Sascha; Ihle, Peter; Adler, Jürgen-Bernhard; Engel, Susanne; Günster, Christian; Holtmann, Martin; Kortevoss, Axel; Linder, Roland; Maier, Werner; Lehmkuhl, Gerd; Schubert, Ingrid

    2017-04-01

    Children and adolescents with mental health problems need effective and safe therapies to support their emotional and social development and to avoid functional impairment and progress of social deficits. Though psychotropic drugs seem to be the preferential treatment, psychotherapy and psychosocial interventions are essential in mental health care. For Germany, current data on the utilization of psychotherapy and psychosocial interventions in children with mental health problems is lacking. To analyse why certain children and adolescents with mental or behavioural disorders do and others do not receive non-drug treatment, we assessed predictors associated with specific non-drug psychiatric/psychotherapeutic treatment including psychosocial interventions, psychotherapy and other non-drug treatments. The study is based on data of two large German health insurance funds, AOK and TK, comprising 30 % of the German child and adolescent population. Predictors of non-drug psychiatric/psychotherapeutic treatment were analysed for 23,795 cases and two controls for every case of the same age and sex in children aged 0-17 years following a new diagnosis of mental or behavioural disorder in 2010. Predictors were divided according to Andersen's behavioural model into predisposing, need and enabling factors. The most prominent and significant predictors positively associated with non-drug psychiatric/psychotherapeutic treatment were the residential region as predisposing factor; specific, both ex- and internalizing, mental and behavioural disorders, psychiatric co-morbidity and psychotropic drug use as need factors; and low area deprivation and high accessibility to outpatient physicians and inpatient institutions with non-drug psychiatric/psychotherapeutic department as enabling factors. In conclusion, the present study suggests that the residential region as proxy for supply of therapist and socioeconomic situation is an influencing factor for the use of psychotherapy. The

  8. EXPERIENCES OF PSYCHIATRIC CONSULTATION SERVICE IN TWO COALFIELD HOSPITALS OF BIHAR

    PubMed Central

    Sharma, L.N.; Khanna, R.; Chatterjee, S.

    1990-01-01

    SUMMARY The Central Institute of Psychiatry provides extension consultation services at two coalfield hospitals of Bihar, representing the intermediate and central level of health care delivery system. Analysis of data covering a period of one year, from September 1988 to August 1989, revealed significant differences in the utilization pattern of the two centres. The differences relate to the proportion of population observed, their demographic characteristics, diagnostic break-up, and follow-up pattern. The provision of psychiatric extension services at the intermediate level is recommended. PMID:21927441

  9. Use of Inpatient Psychiatric Services by Children and Youth under Age 18, United States, 1980. Mental Health Statistical Note No. 175.

    ERIC Educational Resources Information Center

    Milazzo-Sayre, Laura J.; And Others

    The report examines data from three sample surveys of admissions during 1980 to the inpatient psychiatric services of state and mental hospitals and private psychiatric hospitals and the separate inpatient psychiatric services of non-federal general hospitals. Findings revealed that an estimated 81,532 persons under 18 years were admitted to…

  10. Socioeconomic Status and Intelligence Quotient as Predictors of Psychiatric Disorders in Children and Adolescents with High-Functioning Autism Spectrum Disorder and in Their Siblings

    ERIC Educational Resources Information Center

    Rosa, Mireia; Puig, Olga; Lázaro, Luisa; Calvo, Rosa

    2016-01-01

    Previous studies have shown high rates of comorbid disorders in children and adolescents with autism spectrum disorder, but failed to compare them with general population and few of them have identified predictors of comorbidity. This study compared the rates of psychiatric disorders in 50 children and adolescents with autism spectrum disorder, 24…

  11. Interactive television for an urban adult mental health service: the Guy's Psychiatric Intensive Care Unit Telepsychiatry Project.

    PubMed

    Haslam, R; McLaren, P

    2000-01-01

    We carried out a feasibility study of an interactive television (IATV) system to enhance the provision of psychiatric intensive care services to a remote adult acute psychiatric ward in the same National Health Service mental health trust. The system used videoconferencing equipment connected by ISDN at 128 kbit/s. The system was used for patient referral, assessment and monitoring by staff at the remote site 8 km away.

  12. Cognitive and Social Factors Associated with NSSI and Suicide Attempts in Psychiatrically Hospitalized Adolescents

    PubMed Central

    Wolff, Jennifer; Frazier, Elisabeth A.; Esposito-Smythers, Christianne; Burke, Taylor; Sloan, Emma; Spirito, Anthony

    2013-01-01

    Although non-suicidal self-injury (NSSI) and suicide attempts (SA) frequently co-occur among youth, there is increasing evidence that both the risk factors and the phenomenology of the behaviors are distinct. This study examined how individuals who engage in NSSI only, individuals who attempt suicide only, and those who have histories of both NSSI and at least one suicide attempt may differ in terms of cognitions and perceived social support. Participants were 185 adolescents (78.1% female) between the ages of 13 and 18 recruited from a psychiatric inpatient facility in the northeastern United States. One hundred forty-eight teens were identified with a history of self-injurious behavior and divided into three groups: NSSI only (n=45), SA only (n=24) or both NSSI and SA (NSSI+SA; n=79). Analyses showed that the NSSI+SA group exhibited more cognitive errors, negative self-statements, and negative views of self, world, and future, as well as less perceived familial support than either the NSSI or SA only groups. There were no differences between groups on perceived support from teachers or peers. No significant demographic or diagnostic differences were found between the NSSI and SA groups. Limitations and clinical implications of the current research are discussed. PMID:23588400

  13. Cognitive and social factors associated with NSSI and suicide attempts in psychiatrically hospitalized adolescents.

    PubMed

    Wolff, Jennifer; Frazier, Elisabeth A; Esposito-Smythers, Christianne; Burke, Taylor; Sloan, Emma; Spirito, Anthony

    2013-08-01

    Although non-suicidal self-injury (NSSI) and suicide attempts (SA) frequently co-occur among youth, there is increasing evidence that both the risk factors and the phenomenology of the behaviors are distinct. This study examined how individuals who engage in NSSI only, individuals who attempt suicide only, and those who have histories of both NSSI and at least one suicide attempt may differ in terms of cognitions and perceived social support. Participants were 185 adolescents (78.1 % female) between the ages of 13 and 18 recruited from a psychiatric inpatient facility in the northeastern United States. One hundred forty-eight teens were identified with a history of self-injurious behavior and divided into three groups: NSSI only (n = 45), SA only (n = 24) or both NSSI and SA (NSSI+SA; n = 79). Analyses showed that the NSSI+SA group exhibited more cognitive errors, negative self-statements, and negative views of self, world, and future, as well as less perceived familial support than either the NSSI or SA only groups. There were no differences between groups on perceived support from teachers or peers. No significant demographic or diagnostic differences were found between the NSSI and SA groups. Limitations and clinical implications of the current research are discussed.

  14. Abuse, depressive symptoms, executive functioning, and overgeneral memory among a psychiatric sample of children and adolescents.

    PubMed

    Valentino, Kristin; Bridgett, David J; Hayden, Lisa C; Nuttall, Amy K

    2012-01-01

    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.

  15. Which factors may play a pivotal role on determining the type of psychiatric disorder in children and adolescents with epilepsy?

    PubMed

    Thome-Souza, Sigride; Kuczynski, Evelyn; Assumpção, Francisco; Rzezak, Patricia; Fuentes, Daniel; Fiore, Lia; Valente, Kette D

    2004-12-01

    Physicians have become aware of the high prevalence of psychiatric disorders (PDs) in children and adolescents with epilepsy; however, there are many controversies as to which factors may have an important role in the different types of PD. This study was designed to assess the main PD; verify the age of onset compared with the age of diagnosis of the PD; and determine which factors may be correlated with the type of PD described. For this purpose, a multidisciplinary team evaluated children and adolescents (4-18 years) with epilepsy and analyzed patient-related factors such as age (grouped according to Piaget's cognitive scale: <6 years, 7-13 years, >13 years), sex, family history of PDs, and cognitive status. With respect to epilepsy features, we considered age of onset, duration, seizure control at the time of psychiatric evaluation, refractoriness, antiepileptic drugs (mono- vs polytherapy), seizure type (generalized vs focal), and epilepsy type (idiopathic vs symptomatic/probably symptomatic). Depression occurred in 36.4% and attention-deficit hyperactivity disorder (ADHD) in 29.1%, these being the most frequent PDs in this series. Focal epilepsy was significantly more frequent in children and adolescents with PDs. As to the type of PD, age was an important factor, with a predominance of ADHD in children and depression in adolescents (P<0.0001). Family history was contributory for depression, but not for others PDs (P<0.0001). Depression remained underdiagnosed and untreated for a longer period. Impact of early diagnosis and treatment remains unknown.

  16. An analysis of paramilitary referrals to psychiatric services at a tertiary care center

    PubMed Central

    Verma, Rohit; Mina, Shaily; Deshpande, Smita N.

    2013-01-01

    Background: There is a dearth of specialized mental health services for Indian paramilitary service personnel. Those requiring psychiatric evaluation are referred to government psychiatric services often with minimal information. Hence, major diagnostic and decision making relies on the psychiatrist's clinical evaluation and judgment. The aim of the present study was to quantitatively evaluate the paramilitary referrals to psychiatric services at a tertiary care referral center. Materials and Methods: A retrospective chart analysis of all consecutive referrals by various Indian paramilitary services to a tertiary care hospital (2008-2010) was carried out. Results: Among the sample of 18 referrals, all were males (mean age: 37 years ± standard deviation (SD) =7.79). Various reasons for referral included: Evaluation of fitness for duty (83.3%), fitness to handle firearms (16.7%), and for disability certification (5.6%). There were no informants at all in 22.2%, and family members were available in only 11.1%. Hence, most referrals were admitted to the psychiatry ward for observation for various lengths of time. The mean duration of assessment (outpatient and inpatient) was 17.89 days (SD = 20.74) and final reported diagnoses were schizophrenia, depression, and bipolar disorder in 16.7, 11.1, and 11.1%, respectively. There was concurrent history of alcohol and nicotine dependence (40%). A large group (40%) was diagnosed not to suffer from a major mental illness, while a firm and final diagnosis could not be arrived at in 16.7% subjects. Only one subject was given the fitness to handle firearms, fitness for duty was refused in three (16.7%) subjects, and one subject was referred to neurology after being diagnosed as a case of seizure disorder. Conclusion: There is an urgent need for intensive training both to paramilitary physicians as well as to general hospital psychiatrists regarding proper assessment of paramilitary personnel, as there are frequent chances of the

  17. Psychiatric hospital treatment of children and adolescents in New South Wales, Australia: 12-year trends

    PubMed Central

    Sprague, Titia; Sharpe, Joanne

    2016-01-01

    Background It is preferable that children and adolescents requiring in-patient care for mental health problems are managed in age-appropriate facilities. To achieve this, nine specialist Child and Adolescent Mental Health Services (CAMHS) in-patient units have been commissioned in New South Wales (NSW) since 2002. Aims To examine trends in child and adolescent in-patient admissions since the opening of these CAMHS units. Method Analysis of separation data for under 18-year-olds to CAMHS, adult mental health and paediatric units for the period 2002 to 2013 in NSW, comparing districts with and without specialist CAMHS units. Results Separations from CAMHS, adult and paediatric units rose with time, but there was no interaction between time and health district type (with/without CAMHS unit). Five of eight health districts experienced increased separations of under 18-year-olds from adult units in the year of opening a CAMHS unit. Separations from related paediatric units increased in three of seven health districts. Conclusions Opening CAMHS units may be followed by a temporary increase in separations of young people from adult units, but it does not influence the flow of patients to non-CAMHS facilities in the longer term. Declaration of interest None. Copyright and usage © The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence. PMID:27703746

  18. Psychiatric Emergencies

    PubMed Central

    Bayrakal, Sadi

    1972-01-01

    Dr. Bayrakal believes that the time has come for the family physician to deal with minor psychiatric disturbances in his office as well as psychiatric emergencies in the emergency department. The newly emerging medico-social philosophy of both the federal and provincial governments, he says, is giving greater responsibility and authority to the family physician in every area of medicine, including psychiatry. The author discusses major psychiatric emergencies (suicide, suicidal attempt, homicide, social scandal, as well as other psychiatric emergencies) on the ward including adolescent psychiatry. (The descriptions and treatment procedures are given on a concrete clinical level without theoretical overload.) In the family physician's work, psychological understanding is of profound importance. Giving him the added scope of psychiatric consideration to see the patient in bio-psycho-social totality will enable him to practice a more humanized form of medicine. PMID:20468779

  19. HOLDING THE LINE WITH A WATCHFUL EYE: THE IMPACT OF PERCEIVED PARENTAL PERMISSIVENESS AND PARENTAL MONITORING ON RISKY SEXUAL BEHAVIOR AMONG ADOLESCENTS IN PSYCHIATRIC CARE

    PubMed Central

    Donenberg, Geri R.; Wilson, Helen W.; Emerson, Erin; Bryant, Fred B.

    2005-01-01

    Adolescents in psychiatric care are at increased risk of HIV, yet little is known about the family factors related to sexual risk taking among these youth. We explored whether perceived parental monitoring and perceived parental permissiveness were linked to high-risk sexual behavior in 169 ethnically diverse urban youth seeking mental health services in Chicago, and we tested whether adolescent gender moderated these associations. We evaluated sexual risk taking at a global level and for specific risk behaviors (e.g., sex without a condom, sex while using drugs and alcohol). Girls reported more risky sex overall than boys, and girls were more likely than boys to report having sex without a condom. At low levels of parental permissiveness, rates of risky sex among boys and girls’ did not differ, but at high levels of permissiveness girls reported more sexual risk taking than boys, and girls were more likely than boys to report having sex while using drugs and alcohol and having sex without a condom. Findings highlight the complexity of adolescent sexual behavior and the need for multilevel assessment of risk taking. Results suggest that parental monitoring and permissiveness are more strongly associated with sexual risk taking in troubled girls than troubled boys, and they underscore a need for gender-sensitive, family-focused HIV-prevention programs. PMID:12000232

  20. Satisfaction and associated factors of outpatient psychiatric service consumers in Ethiopia

    PubMed Central

    Yimer, Solomon; Yohannis, Zegeye; Getinet, Wondale; Mekonen, Tesfa; Fekadu, Wubalem; Belete, Habte; Menberu, Melak; Getnet, Asmamaw; Belete, Amsalu

    2016-01-01

    Purpose The purpose of this study was to assess the level of patient satisfaction and associated factors with psychiatric outpatient services in Ethiopia. Patients and methods A cross-sectional study was performed from May 2015 to June 2015. A total of 454 participants selected by systematic random sampling were included in this study. Pretested and interviewer-administered questionnaire was used to collect the data. Patient satisfaction was measured using Charleston Psychiatric Outpatient Satisfaction Scale, and other validated tools were used to assess the associated variables. Multivariate logistic regressions with 95% confidence interval (CI) were used to assess the strength, and P-value <0.05 was used to indicate significance of association. Results A total of 441 respondents were enrolled, with a response rate of 97.1% and magnitude of satisfaction of 61.2%. Being male (adjusted odds ratio [AOR] =0.612, 95% CI: 0.39, 0.94), being widowed (AOR =0.13, 95% CI: 0.05, 0.36), urban residence (AOR =0.49, 95% CI: 0.31, 0.78), diagnosed with schizophrenia (AOR =0.48, 95% CI: 0.28, 0.81), unfavorable attitude (AOR =0.49, 95% CI: 0.28, 0.86), and poor social functioning (AOR =0.52, 95% CI: 0.34, 0.80) were significantly associated with satisfaction. Conclusion More than one-third of psychiatric service consumers were dissatisfied with the service they received. Integrating patients to their own treatment plan and regular service evaluation are important to improve satisfaction. PMID:27703333

  1. Teaching Trainees to Deliver Adolescent Reproductive Health Services

    PubMed Central

    Shah, Brandi; Chan, Serena H.; Perriera, Lisa; Gold, Melanie A.; Akers, Aletha Y.

    2015-01-01

    OBJECTIVE Delivery of reproductive services to adolescents varies by specialty and has been linked to differences in clinical training. Few studies have explored how different specialties’ graduate medical education (GME) programs prepare providers to deliver adolescent reproductive services. We explored the perceptions of resident physicians regarding their training in delivering adolescent reproductive health services. DESIGN Between November 2008 and February 2009, nine focus groups were conducted with graduate medical trainees in three specialties that routinely care for adolescents. The semi-structured discussions were audio-recorded, transcribed and analyzed using an inductive approach to content analysis. SETTING Large, urban academic medical center in Pittsburgh, Pennsylvania PARTICIPANTS 54 resident trainees in pediatrics, family medicine and obstetrics/gynecology INTERVENTIONS None MAIN OUTCOMES Trainees’ perspectives regarding the didactic teaching and clinical training in providing adolescent reproductive services RESULTS Five themes emerged reflecting trainees’ beliefs regarding the best practices GME programs can engage in to ensure that trainees graduate feeling competent and comfortable delivering adolescent reproductive services. Trainees believed programs need to: 1) Provide both didactic lectures as well as diverse inpatient and outpatient clinical experiences; 2) Have faculty preceptors skilled in providing and supervising adolescent reproductive services; 3) Teach skills for engaging adolescents in clinical assessments and decision-making; 4) Train providers to navigate confidentiality issues with adolescents and caregivers; and 5) Provide infrastructure and resources for delivering adolescent reproductive services. CONCLUSIONS The three specialties differed in how well each of the five best practices were reportedly addressed during GME training. Policy recommendations are provided. PMID:26542014

  2. Reproductive health services for adolescents. Critical legal issues.

    PubMed

    English, A

    2000-03-01

    The contemporary legal and policy environment has increased the challenges associated with providing health care services to the adolescent population. The issue of reproductive health care services is particularly intense because of the controversial nature of services for contraception and abortion. As the debates continue, one must remember the background against which they are occurring. The current legal framework, developed over nearly 40 years, enables adolescents who are minors to give their own consent for care in numerous circumstances and provides them with a significant level of confidentiality protection, particularly for reproductive health services. Laws have been enacted to expand adolescents' financial access to health care, through targeted publicly funded service programs and expanded health insurance coverage. This background provides the foundation for addressing the current challenges and for protecting and expanding adolescents' access to care.

  3. Factors Contributing to the Utilization of Adult Mental Health Services in Children and Adolescents Diagnosed with Hyperkinetic Disorder

    PubMed Central

    Blasco-Fontecilla, Hilario; Carballo, Juan J.; Garcia-Nieto, Rebeca; Lopez-Castroman, Jorge; Alegria, Analucia A.; Basurte-Villamor, Ignacio; Sevilla-Vicente, Juncal; Navarro-Jimenez, Rocio; Legido-Gil, Teresa; Morant-Ginestar, Consuelo; Jimenez-Arriero, Miguel Angel; Saiz-Ruiz, Jeronimo; Baca-Garcia, Enrique

    2012-01-01

    Objectives. To examine whether age of First diagnosis, gender, psychiatric comorbidity, and treatment modalities (pharmacotherapy or psychotherapy) at Child and Adolescent Mental Health Services (CAMHS) moderate the risk of Adult Mental Health Services (AMHS) utilization in patients diagnosed with hyperkinetic disorder at CAMHS. Methods. Data were derived from the Madrid Psychiatric Cumulative Register Study. The target population comprised 32,183 patients who had 3 or more visits at CAMHS. Kaplan-Meier curves were used to assess survival data. A series of logistic regression analyses were performed to study the role of age of diagnosis, gender, psychiatric comorbidity, and treatment modalities. Results. 7.1% of patients presented with hyperkinetic disorder at CAMHS. Compared to preschool children, children and adolescents first diagnosed with hyperkinetic disorder at CAMHS were more likely to use AMHS. Female gender and comorbidity with affective disorders, schizophrenia, schizotypal and delusional disorders increased the risk of use of AMHS. Pharmacological or combined treatment of hyperkinetic disorder diagnosed at CAMHS was associated with increased risk of use at AMHS. Conclusions. Older age of first diagnosis, female gender, psychiatric comorbidity, and pharmacological treatment at CAMHS are markers of risk for the transition from CAMHS to AMHS in patients with hyperkinetic disorder diagnosed at CAMHS. PMID:22654608

  4. The Dynamics and Correlates of Religious Service Attendance in Adolescence.

    PubMed

    Hardie, Jessica Halliday; Pearce, Lisa D; Denton, Melinda Lundquist

    2016-03-01

    This study examines changes in religious service attendance over time for a contemporary cohort of adolescents moving from middle to late adolescence. We use two waves of a nationally representative panel survey of youth from the National Study of Youth and Religion (NSYR) to examine the dynamics of religious involvement during adolescence. We then follow with an analysis of how demographic characteristics, family background, and life course transitions relate to changes in religious service attendance during adolescence. Our findings suggest that, on average, adolescent religious service attendance declines over time, related to major life course transitions such as becoming employed, leaving home, and initiating sexual activity. Parents' affiliation and attendance, on the other hand, are protective factors against decreasing attendance.

  5. [Foreign patients in inpatient treatment in a psychiatric university clinic with community service].

    PubMed

    Holzmann, T H; Volk, S; Georgi, K; Pflug, B

    1994-05-01

    About one third (29.5%) of the population living within the area of Frankfurt, for which the psychiatric university clinic provides psychiatric service, are foreigners. For the better understanding of our foreign psychiatric inpatients treated in our clinic in in 1992, the diagnostic spectrum and the nationalities of these patients were analysed. More than half of them (58%) were raised up in former Yugoslavia, Turkey, Italy, Poland and Marocco. The other foreign patients came from 36 different countries. The diagnostic spectrum comparing german and foreign patients showed marked differences. Paranoid schizophrenia was more common in foreigners (31.5%) compared with german patients (16.8%), as well as female foreigners were admitted to the clinic because of psychoreactive disorders (65.2% of all turkish females) more often. The language barrier limited the treatment in many patients. In addition treatment was also hampered by family induced pressure on our patients. This was mainly due to differences and misunderstanding concerning the nature and treatment strategies. In spite of these difficulties, engagement of the therapeutic teams and treatment outcome did not differ between german and foreign patients. In order to improve treatment modalities, we quote for an increasing number of psychiatrists, who are capable of serbocroatic, turkish, italian, polish or arab language and culture, to work in clinical psychiatry.

  6. Mental health recovery for psychiatric inpatient services: perceived importance of the elements of recovery.

    PubMed

    Siu, B W M; Ng, B F L; Li, V C K; Yeung, Y M; Lee, M K L; Leung, A Y H

    2012-06-01

    OBJECTIVES. To develop a questionnaire for measuring the perceived importance of the elements of mental health recovery in psychiatric inpatients in Hong Kong and to test the psychometric properties of the questionnaire. METHODS. Thematic content analysis of identified literature on mental health recovery was performed to identify the elements related to mental health recovery. A questionnaire was developed to assess the perceived importance of the identified elements. An expert panel was set up to evaluate the content validity and patient focus group's face validity of the questionnaire. Participants were recruited from medium-stay and rehabilitation wards of Castle Peak Hospital. RESULTS. A total of 101 psychiatric inpatients completed the questionnaire, the majority of whom suffered from schizophrenia (75%). Having meaning in life was rated by 91% of the participants as an important element of recovery, followed by hope (86%) and general health and wellness (85%). Cronbach's alpha for internal consistency was 0.91. Explorative factor analysis yielded 7 factors and intraclass correlation coefficients revealed a fair-to-good test-retest reliability. CONCLUSIONS. The results supported the psychometric properties of the questionnaire for measurement of mental health recovery and serve as a basis for the future development of recovery-oriented services in the psychiatric inpatient settings in this locality.

  7. The use of psychiatric services before imprisonment: a survey and case register linkage of sentenced prisoners in Melbourne.

    PubMed

    Herrman, H; Mills, J; Doidge, G; McGorry, P; Singh, B

    1994-02-01

    Information about contact with psychiatric services before imprisonment was obtained for a stratified random sample of sentenced prisoners, who were not receiving prison psychiatric care, in Melbourne's three metropolitan prisons. The sample of 158 men and 31 women was matched with the longitudinal person-linked records of state psychiatric service use in the Victorian Psychiatric Case Register (VPCR). Records of contact with the state services were found for 54 men (34%) and 19 women (61%), including records of in-patient treatment for 25 men (16%) and 15 women (48%). For 64% of individuals with a positive match, the case-note diagnoses were substance use disorders only. Diagnoses of psychotic disorders were recorded for four prisoners, and mood disorders for another six. In addition, clinicians conducted standardized diagnostic interviews and enquired about treatment and personal history. A further 24 prisoners reported specialist psychiatric treatment outside the state treatment sector. This study links the findings from an interview survey of psychiatric morbidity in prisoners with the records available in the VPCR, and emphasizes a number of matters important to the public health. The high rates of previous treatment for substance abuse disorders, the apparent pool of prisoners with largely untreated major depression, and the service needs of those with chronic psychotic disorders are discussed.

  8. An evaluation of the use of interactive television in an acute psychiatric service.

    PubMed

    McLaren, P; Ball, C J; Summerfield, A B; Watson, J P; Lipsedge, M

    1995-01-01

    This study reports the results of the use of a low-cost videoconferencing system (LCVC) for communication in an acute psychiatric service. Qualitative research methodology was used to examine the use of the LCVC in interactions between psychiatrists, patients and nursing staff, including information on refusals. One hundred and five clinical interactions were studied over four months. The LCVC proved technically reliable and compatible with the performance of a wide range of clinical tasks. However, the results suggest the need for better understanding of the nature and origins of the attitudes that users bring to the use of such communications technology. A framework is presented for the classification of user responses in terms of preexisting attitudes of the users, technological limitations of the system and the mental state of the users. The study demonstrated the potential for interactive television to support many of the communication tasks necessary in a dispersed psychiatric service and for telepsychiatry to become a major method of service provision.

  9. Universal parent training as a supplement to inpatient psychiatric treatment for children and adolescents.

    PubMed

    Schwenck, Christina; Schneider, Wolfgang; Reichert, Andreas

    2016-08-01

    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.

  10. Integrating interactive television-based psychiatric consultation into an urban community mental health service.

    PubMed

    McLaren, P; Mohammedali, A; Riley, A; Gaughran, F

    1999-01-01

    We conducted a pilot study of urban telepsychiatry employing interactive television (IATV) over ISDN links for psychiatric consultation to support a primary-care mental health team. During the six months of the pilot phase, 30 consultations were arranged by the general practitioners for 14 different patients. Of these, 24 were completed by IATV and one by telephone when the IATV link failed. The system was used to manage patients with complex problems, many of whom were difficult to engage in standard services. The results showed high levels of user acceptance. Various problems for the further implementation of such systems were also identified.

  11. Service Users' Experiences of a Brief Intervention Service for Children and Adolescents: A Service Evaluation

    ERIC Educational Resources Information Center

    Gallagher, Jen; Schlösser, Annette

    2015-01-01

    Ten per cent of young people experience mental health difficulties at any one time. Prevention and early intervention leads to better prognosis for young people's mental well-being in the short and long term. Child and Adolescent Mental Health Services (CAMHS) must be able to provide swift and effective interventions for a range of difficulties to…

  12. Service user and clinical perspectives of psychiatric advance directives in New Zealand.

    PubMed

    Thom, Katey; O'Brien, Anthony John; Tellez, Juan Jose

    2015-12-01

    Advance care planning is becoming an increasingly important feature of health service provision. Although the New Zealand Mental Health Commission has advocated strongly for the provision of advance directives in mental health services, little is known about clinician or service user views on advance directives. The aim of the study was to survey the perspectives of service users and clinicians on the use of psychiatric advance directives. The study used an anonymous online survey to collect data from 110 mental health service users and 175 clinicians. Survey items included existing knowledge, preferred content and potential benefits of advance directives. Descriptive statistics and intergroup comparisons were conducted. Over 90% of service users and clinicians agreed that they support advance directives in mental health. There were similarities in the preferred content of an advance directive across the two groups, particularly regarding the notification of support persons, cultural support and preferred methods of de-escalation. Significant differences in opinion were found regarding the use of coercive measures and the ability of mental health legislation to override advance directives. The results indicate strong support for the use of advance directives within New Zealand mental health services, as well as for further research in the area.

  13. Language disorders and attention deficit disorders in young children referred for psychiatric services: analysis of prevalence and a conceptual synthesis.

    PubMed

    Love, A J; Thompson, M G

    1988-01-01

    Nearly two-thirds of a group of preschool children referred for psychiatric outpatient services were found to have language disorders when assessed by standardized procedures, a higher number than reported in previous studies. Significant interrelationships between language disorders and attention deficit disorders were found. Analyses of prevalence rates, gender ratios, and selected psychosocial factors led to reformulation of approaches to assessment and treatment of young children with severe psychiatric problems.

  14. The culture of care within psychiatric services: tackling inequalities and improving clinical and organisational capabilities

    PubMed Central

    2012-01-01

    Introduction Cultural Consultation is a clinical process that emerged from anthropological critiques of mental healthcare. It includes attention to therapeutic communication, research observations and research methods that capture cultural practices and narratives in mental healthcare. This essay describes the work of a Cultural Consultation Service (ToCCS) that improves service user outcomes by offering cultural consultation to mental health practitioners. The setting is a psychiatric service with complex and challenging work located in an ethnically diverse inner city urban area. Following a period of 18 months of cultural consultation, we gather the dominant narratives that emerged during our evaluation of our service. Results These narratives highlight how culture is conceptualized and acted upon in the day-to-day practices of individual health and social care professionals, specialist psychiatric teams and in care systems. The findings reveal common narratives and themes about culture, ethnicity, race and their perceived place and meaningfulness in clinical care. These narratives express underlying assumptions and covert rules for managing, and sometimes negating, dilemmas and difficulties when considering “culture” in the presentation and expression of mental distress. The narratives reveal an overall “culture of understanding cultural issues” and specific “cultures of care”. These emerged as necessary foci of intervention to improve service user outcomes. Conclusion Understanding the cultures of care showed that clinical and managerial over-structuring of care prioritises organisational proficiency, but it leads to inflexibility. Consequently, the care provided is less personalised and less accommodating of cultural issues, therefore, professionals are unable to see or consider cultural influences in recovery. PMID:23020856

  15. Recovery-Oriented Vocational Rehabilitation Services for Individuals with Co-Occurring Psychiatric Disabilities and Substance Use Disorders

    ERIC Educational Resources Information Center

    Lusk, Stephanie L.; Koch, Lynn C.; Paul, Teresia M.

    2016-01-01

    Purpose: In this article, we examined how individuals with co-occurring psychiatric disabilities and substance use disorders encounter numerous challenges when it comes to the vocational rehabilitation (VR) process. Method: A comprehensive review of the literature demonstrated barriers to service delivery (e.g., access to services, exclusionary…

  16. Community Reintegration for People with Psychiatric Disabilities: Challenging Systemic Barriers to Service Provision and Public Policy through Participatory Action Research

    ERIC Educational Resources Information Center

    Mirza, Mansha; Gossett, Andrea; Chan, Nathan Kai-Cheong; Burford, Larry; Hammel, Joy

    2008-01-01

    People with psychiatric disabilities represent a growing group within the population of nursing home residents in the USA. Despite a preference for living in community-based settings, the availability of supportive services for community living is hindered by barriers at both the service provision and public policy levels. Therefore, understanding…

  17. The Persistence and Stability of Psychiatric Problems in Adolescents with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Simonoff, Emily; Jones, Catherine R. G.; Baird, Gillian; Pickles, Andrew; Happe, Francesca; Charman, Tony

    2013-01-01

    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…

  18. Interactive Family Dynamics and Non-suicidal Self-Injury in Psychiatric Adolescent Patients: A Single Case Study

    PubMed Central

    Gatta, Michela; Miscioscia, Marina; Sisti, Marta; Comis, Ilaria; Battistella, Pier Antonio

    2017-01-01

    Non-Suicidal Self-Injury (NSSI) is a common, multifaceted phenomenon among adolescents. Recent researchers have shown that a number of psychological and psychiatric correlates are implicated in the onset/repetition of NSSI, but those previous studies did not directly observe the family interaction patterns of this clinical population. In this paper, the quality of family interactions was observed using the Lausanne Trilogue Play procedure to deepen the specific interactive dimensions associated with NSSI in adolescents. The results of a single case study showed a lack of positive emotional exchanges, a parenting style expressing hostility, a high level of control and difficulties in triangulation. Through this method, the authors show that a better understanding of the role of family interactions is crucial and could improve the assessment and treatment of Non-Suicidal Self-Injurious behaviors. Research and clinical implications are discussed. PMID:28220084

  19. Interactive Family Dynamics and Non-suicidal Self-Injury in Psychiatric Adolescent Patients: A Single Case Study.

    PubMed

    Gatta, Michela; Miscioscia, Marina; Sisti, Marta; Comis, Ilaria; Battistella, Pier Antonio

    2017-01-01

    Non-Suicidal Self-Injury (NSSI) is a common, multifaceted phenomenon among adolescents. Recent researchers have shown that a number of psychological and psychiatric correlates are implicated in the onset/repetition of NSSI, but those previous studies did not directly observe the family interaction patterns of this clinical population. In this paper, the quality of family interactions was observed using the Lausanne Trilogue Play procedure to deepen the specific interactive dimensions associated with NSSI in adolescents. The results of a single case study showed a lack of positive emotional exchanges, a parenting style expressing hostility, a high level of control and difficulties in triangulation. Through this method, the authors show that a better understanding of the role of family interactions is crucial and could improve the assessment and treatment of Non-Suicidal Self-Injurious behaviors. Research and clinical implications are discussed.

  20. Risk Factors for Psychiatric Hospital Admission for Participants in California's Full-Service Partnership Program.

    PubMed

    Penkunas, Michael J; Hahn-Smith, Stephen

    2016-08-01

    This study investigated the demographic and clinical predictors of psychiatric hospitalization during the first 2 years of treatment for adults participating in the full-service partnership (FSP) program, based on Assertive Community Treatment, in a large county in northern California. Clinical and demographic characteristics, data on prior hospitalizations, length of enrollment, and living situation for 328 FSP participants were collected from the county's internal billing system and the California Department of Health Care Services. In univariate models, the probability of hospitalization varied by diagnosis, age, and hospitalization history. In the multivariate model, younger age and frequent hospitalization prior to enrollment predicted hospitalization during enrollment. Findings support prior research on hospital recidivism and may be beneficial in refining future strategies for meeting the needs of adults with serious mental illness.

  1. Inpatient forensic-psychiatric care: Legal frameworks and service provision in three European countries.

    PubMed

    Edworthy, Rachel; Sampson, Stephanie; Völlm, Birgit

    2016-01-01

    Laws governing the detention and treatment of mentally disordered offenders (MDOs) vary widely across Europe, yet little information is available about the features of these laws and their comparative advantages and disadvantages. The purpose of this article is to compare the legal framework governing detention in forensic psychiatric care in three European countries with long-established services for MDOs, England, Germany and the Netherlands. A literature review was conducted alongside consultation with experts from each country. We found that the three countries differ in several areas, including criteria for admission, review of detention, discharge process, the concept of criminal responsibility, service provision and treatment philosophy. Our findings suggest a profound difference in how each country relates to MDOs, with each approach contributing to different pathways and potentially different outcomes for the individual. Hopefully making these comparisons will stimulate debate and knowledge exchange on an international level to aid future research and the development of best practice in managing this population.

  2. Adolescents perception of reproductive health care services in Sri Lanka

    PubMed Central

    Agampodi, Suneth B; Agampodi, Thilini C; UKD, Piyaseeli

    2008-01-01

    Background Adolescent health needs, behaviours and expectations are unique and routine health care services are not well geared to provide these services. The purpose of this study was to explore the perceived reproductive health problems, health seeking behaviors, knowledge about available services and barriers to reach services among a group of adolescents in Sri Lanka in order to improve reproductive health service delivery. Methods This qualitative study was conducted in a semi urban setting in Sri Lanka. A convenient sample of 32 adolescents between 17–19 years of age participated in four focus group discussions. Participants were selected from four midwife areas. A pre-tested focus group guide was used for data collection. Male and female facilitators conducted discussions separately with young males and females. All tape-recorded data was fully transcribed and thematic analysis was done. Results Psychological distresses due to various reasons and problems regarding menstrual cycle and masturbation were reported as the commonest health problems. Knowledge on existing services was very poor and boys were totally unaware of youth health services available through the public health system. On reproductive Health Matters, girls mainly sought help from friends whereas boys did not want to discuss their problems with anyone. Lack of availability of services was pointed out as the most important barrier in reaching the adolescent needs. Lack of access to reproductive health knowledge was an important reason for poor self-confidence among adolescents to discuss these matters. Lack of confidentiality, youth friendliness and accessibility of available services were other barriers discussed. Adolescents were happy to accept available services through public clinics and other health infrastructure for their services rather than other organizations. A demand was made for separate youth friendly services through medical practitioners. Conclusions and recommendations

  3. Associations of the Dopamine D4 Receptor Gene VNTR Polymorphism with Drug Use in Adolescent Psychiatric Inpatients

    PubMed Central

    McGeary, John E.; Esposito-Smythers, Christianne; Spirito, Anthony; Monti, Peter M.

    2007-01-01

    Background The VNTR polymorphism in the Dopamine D4 receptor gene (DRD4) has been associated with differential urge for substances across multiple methodologies ranging from neuroimaging to assessment in the natural environment. It is unclear whether the DRD4 gene is a marker for an underlying propensity for greater urge or whether the DRD4 gene differentially moderates the neuroadaptive effects of extended substance use on urge. Examination of the DRD4 in an adolescent sample may provide evidence of a mechanism of this putative relationship. Method Data from a subset of 77 participants in a larger assessment study characterized adolescents for substance-related behaviors by DRD4 genotype. The psychiatrically admitted adolescents were genotyped for the variable number of tandem repeats polymorphism in the DRD4 gene (L ≥ 7 [n = 25], S = < 7 [n = 52]). Associations of the DRD4 with scores on the SASSI, and ADI were examined as well as selected individual items thought to be most related to the intermediate phenotype of urge. Results The DRD4 gene was not associated with any DSM-IV substance misuse diagnostic classification. Individual items related to urge were also nonsignificantly related to DRD4 status. Carriers of the long variant of the DRD4 polymorphism were more likely to have used hard drugs within the previous 6 months and scored higher on the self-medication subscale of the ADI compared to short variant homozygotes. Discussion Preliminary results provide little evidence for the DRD4 VNTR polymorphism to be related to urge-related phenomena in hospitalized adolescents on a psychiatric inpatient unit. The association of the DRD4 gene with hard drug use may support literature linking this gene to impulsivity. Subscale findings may suggest a role of negative affect in previous DRD4 urge findings. PMID:17175015

  4. Association of family structure to later criminality: a population-based follow-up study of adolescent psychiatric inpatients in Northern Finland.

    PubMed

    Ikäheimo, Olli; Laukkanen, Matti; Hakko, Helinä; Räsänen, Pirkko

    2013-04-01

    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 and DSM-IV based psychiatric diagnoses were based on the K-SADS-PL-interview and criminality on criminal records provided by the Finnish Legal Register Centre. After adjusting for socio-demographic, clinical and family factors, the adolescents from single parent families, child welfare placements and those not living with their biological parents showed an increased risk of committing crimes at an earlier age than adolescents from two parent families. Lack of a safe and stable family environment has important implications for adolescents with severe mental disorder. When these adolescents are discharged from hospital, special attention should be focused on organizing stable and long term psychosocial support which compensates for the lack of stable family environment and seeks to prevent future adversities.

  5. Comprehensive Adolescent Pregnancy Services: A Resource Guide.

    ERIC Educational Resources Information Center

    Holt, K. A., Ed.; Langlykke, K., Ed.

    This resource guide was compiled to assist state, county, and community personnel in developing comprehensive adolescent health programs which address adolescent pregnancy, prevention, and care. It includes a broad range of topics with materials suitable for both professionals and consumers and for use by regional, state, and local government…

  6. Integration of computer and Internet-based programmes into psychiatric out-patient care of adolescents with depression.

    PubMed

    Kurki, Marjo; Hätönen, Heli; Koivunen, Marita; Anttila, Minna; Välimäki, Maritta

    2013-03-01

    The aim of this explorative study was to describe nurses' opportunities to integrate computer and Internet-based programmes in psychiatric out-patient care among adolescents with depression. Therefore, nurses' daily computer use and possible problems related to it were investigated. The data were collected by conducting focus group interviews with Finnish registered nurses (n =12) working at the out-patient clinics of two university central hospitals. The data were analysed using inductive content analysis. The analysis showed that nurses used the computer and Internet in their daily work for data transmission and informal interaction with adolescents. Findings revealed that nurses have good computer skills, a positive attitude towards using the computer and Internet and were motivated to make use of both on a daily basis. Problems faced in daily computer use were a lack of instructions and education, and lack of help and support. We can conclude that nurses have good opportunities to implement computer and Internet-based programmes in adolescent out-patient care. These results are encouraging keeping in mind that adolescents are the most active Internet users in society.

  7. Relational stressors as predictors for repeat aggressive and self-harming incidents in child and adolescent psychiatric inpatient settings.

    PubMed

    Ulke, Christine; Klein, Annette M; von Klitzing, Kai

    2014-01-01

    This study examined whether relational stressors such as psychosocial stressors, the therapist's absence and a change of therapist are associated with repeat aggressive or self-harming incidents in child and adolescent psychiatric inpatient care. The study data were derived from critical incident reports and chart reviews of 107 inpatients. In multinomial regression analysis, patients with repeat aggressive or self-harming incidents were compared with patients with single incidents. Results suggested that a higher number of psychosocial stressors and a change of therapist, but not the therapist's absence are predictors for repeat aggressive and self-harming incidents. There was a high prevalence of therapist's absence during both, single and repeat, incidents. Repeat aggressive incidents were common in male children and adolescents with disruptive behavior disorders. Repeat self-harming incidents were common in adolescent females with trauma-related disorders. Patients with repeat aggressive or self-harming incidents had a higher number of abnormal intrafamilial relationships and acute life events than patients with single incidents. Interventions to reduce a change of therapist should in particular target children and adolescents with a higher number of psychosocial stressors and/or a known history of traumatic relational experiences. After a first incident, patients should have a psychosocial assessment to evaluate whether additional relational support is needed.

  8. Effects of eliminating psychiatric rehabilitation from the secure levels of a mental-health service system.

    PubMed

    Tarasenko, Melissa; Sullivan, Mary; Ritchie, A Jocelyn; Spaulding, William D

    2013-11-01

    Psychiatric rehabilitation (PR) is widely recognized as a treatment approach and an array of evidence-based practices effective for promoting the recovery of people with serious mental illness (SMI). However, its use in institutional settings is not widespread for unclear reasons. Policymakers may sometimes believe the superiority of PR in controlled research does not apply in the real world, for various reasons. This study exploits an unusual set of real-world circumstances surrounding the closure of a well-developed PR program in a state hospital. The program was closed after a period of mental-health services reform that significantly augmented the surrounding community-service system. The PR program was converted to conventional medical-institutional model-treatment units with no reduction in beds or funding within the state hospital. A database composed of public documents was used to analyze the consequences of the closing. Within the institution, the consequences included a persistent presence of long-term difficult-to-discharge patients, a slowed discharge rate, a net increase in the hospital's per capita treatment costs, and higher use of restraint/seclusion. Effects were also detectable in the surrounding mental-health service system, including degraded outcome of community-based step-down services and increased pressure on emergency/crisis services. The consequences of closing the program are consistent with expectations based on research, and demonstrate danger in assuming that real world exigencies obviate research findings.

  9. Service use among Mexico City adolescents with suicidality

    PubMed Central

    Borges, Guilherme; Benjet, Corina; Medina-Mora, Maria Elena; Orozco, Ricardo; Familiar, Itziar; Nock, Matthew K.; Wang, Philip S.

    2009-01-01

    Background We report the lifetime and 12-month prevalence and associations of mental health treatment among Mexican adolescents with suicide-related outcomes (SROs; including ideation, plans, gestures and attempts). Methods A representative multistage probability household survey of 3005 adolescents aged 12 to 17 years residing in the Mexico City Metropolitan Area was carried out in 2005. Discrete time survival analyses were used to assess the relationships between SROs and receiving treatment for emotional, alcohol, or drug problems. Results The prevalence of lifetime service use among respondents with SROs was 35% for those with ideation only, 44% for those with ideation and plan, 49% for those with gesture and 50% for those with attempt; the prevalence of 12-month service use was 10%, 24%, 6% and 21%, respectively. Timing between onset of SRO and receiving treatment for emotional, alcohol, or drug problems showed that about 50% of adolescents will have contact with a service provider before developing any SRO. Healthcare professionals were the most likely to be consulted, followed by school-based programs. Limitations This survey was limited to adolescents living in one of the largest metropolitan areas in the world and the analyses used data on retrospectively reported ages of onset that are subject to recall errors. Conclusions Most suicidal adolescents do not receive treatment, and many adolescents develop their suicidality in spite of prior contacts with service providers. Interventions to increase treatment, prevention, and monitoring are sorely needed for this vulnerable population. PMID:19411113

  10. The development of a psychiatric rehabilitation service: a two year pilot project.

    PubMed

    Moss, E; Davidson, S

    1980-01-01

    In the history of psychiatry, one can discern conflicting trends with regard to hospitalization of people suffering from severe mental disturbances. From the beginning of the 19th century, the standard method for dealing with such people has been to take them away from their homes and work and put them in hospitals. However, since the discovery of antipsychotic drugs in the 1950's, there has developed a new movement to treat mentally disturbed people in their communities, either avoiding hospitalization altogether, or at least greatly shortening it. In many hospitals there has been a synthesis of these two trends, reflected in an upgrading of the importance of the rehabilitation function. In Shalvata Psychiatric Center, a medium-sized psychiatric hospital in Hod Hasharon, Israel, a two-year pilot project to introduce a centralized Rehabilitation Service was recently completed. The present Rehabilitation Service is based on the rehabilitation/activity therapy model in which the hospital is conceptualized as a setting in which patients may develop or recover social and vocational skills needed to function adequately in the community. It has drawn on existing, motivated staff from all mental health professions represented at the hospital, and works closely with all in-hospital wards and the day hospital. The authors discuss six areas of vocational and social rehabilitation with which the Rehabilitation Service has attempted to deal: 1. activity therapy/rehabilitation groups, 2. vocational guidance unit, 3. after-care therapeutic social club, 4. in-hospital rehabilitation consultation, 5. liaison activities with community-based facilities, 6. job placement.

  11. Adolescent Help-Seeking from the Internet

    ERIC Educational Resources Information Center

    Gould, Madelyn S.; Munfakh, Jimmie Lou Harris; Lubell, Keri; Kleinman, Marjorie; Parker, Sarah

    2003-01-01

    During the past decade there has been increased interest in help-seeking behavior among adolescents. This reflects the recognition that while many psychiatric problems increase markedly during adolescence, the majority of disturbed teenagers do not receive mental health services. Nearly half of all adolescents have reported using the Internet to…

  12. EXTENSION OF MENTAL HEALTH SERVICE THROUGH PSYCHIATRIC CAMPS : A NEW APPROACH

    PubMed Central

    Kapur, R.L.; Chandrashekar, C.R.; Shamasundar, C.; Isaac, Mohan K.; Parthasarathy, R.; Shetty, Shalini

    1982-01-01

    SUMMARY Psychiatric camps in the manner they are usually conducted serve no useful purpose in the long run, except to identify cases and to increase people's awareness about mental illnesses. The main drawback is poor follow up of the cases detected. To overcome these drawbacks and to make these camps more useful in delivering mental health services to the community, a new approach is being worked out. Screening and selection of the patients for the camp by the local doctors with the help of symptom check-list, a good propaganda well in advance incorporating the cardinal symptoms through mass media, training of the local doctors to gain basic skills and knowledge to manage cases during follow up, periodic visits by the psychiatrists to help these doctors in this job for some time, mental health exhibition during the camp were some of the strategies adopted in Kollegal Neuropsychiatric camp by community psychiatry unit of NIMHANS. It was a three days' camp. 312 cases were registered after screening. Only 6.7% cases were non-psychiatric. 30% epileptics, 30% neurotics, 12% Headache, 9% MR, 9% neurological cases, 5% psychoses. 25 doctors participated in training programme and camp patients were allotted to them for follow up. Monthly follow up is in progress. Findings and experiences are discussed. PMID:21965918

  13. Frequency of contact with community-based psychiatric services and the lunar cycle: a 10-year case-register study.

    PubMed

    Amaddeo, F; Bisoffi, G; Micciolo, R; Piccinelli, M; Tansella, M

    1997-08-01

    The relationship between the lunar cycle and the frequency of contact with community-based psychiatric services was assessed using the South Verona Psychiatric Case Register data. For each day of the study period (January 1982-December 1991) we recorded the number of contacts made by South Verona residents with psychiatric services and the corresponding day of the lunar cycle. First, the synodic month was divided into four interval phases (usually called new moon, first quarter, full moon and third quarter), and interphase differences in the mean number of contacts were tested using one-way analysis of variance. Second. the null hypothesis of no relationship between the lunar cycle and the frequency of contact with psychiatric services was tested against the alternative hypothesis of a sinusoidal distribution according to the lunar phase. The average number of contacts with psychiatric services on each day of the lunar cycle over the 10-year period was obtained and a sine-wave curve was fitted to the data. Both for total and drop-in contacts, no significant differences in mean number of contacts were found between the four interval phases of the synodic month (new moon, first quarter, full moon and third quarter). Similarly, no significant results were found by setting the expected surge in consultations at 1-3 days after the full moon and the period of the sine-wave curve equal to 30 days. When the period of the sine-wave curve was allowed to vary in order to fit the data best, none of the statistical tests reached the level of significance required to dismiss the possibility of false-positive results. These findings did not support the theory that a relationship exists between the lunar cycle and the frequency of contact with community-based psychiatric services.

  14. Adolescents' and parents' views of Child and Adolescent Mental Health Services (CAMHS) in Ireland.

    PubMed

    Coyne, I; McNamara, N; Healy, M; Gower, C; Sarkar, M; McNicholas, F

    2015-10-01

    Service user involvement is essential for quality care in the Child and Adolescent Mental Health Services (CAMHS). This study was conducted to explore adolescents' and parents' experiences of CAMHS in relation to accessibility, approachability and appropriateness. This study used a descriptive qualitative design, and focus groups and single interviews were conducted with adolescents (n = 15) and parents (n = 32) from three mental health clinics. Data were analysed using thematic analysis. Accessing mental health services was a challenging experience for many parents and adolescents due to knowledge deficit, lack of information and limited availability of specialist services. Some parents and adolescents reported positive experiences while others reported negative experiences. They expressed a need for more information, involvement in decision making, flexible scheduling of appointments, school support and parent support groups. The nature and quality of the relationship with staff was critical to positive experience with the service; therefore, frequent changes of medical staff was disruptive. Mental health nurses can play a vital role in ensuring continuity, assessing adolescents' participation preferences and advocating for their information needs with other members of the interdisciplinary team.

  15. Self-harm and attempted suicide within inpatient psychiatric services: a review of the literature.

    PubMed

    James, Karen; Stewart, Duncan; Bowers, Len

    2012-08-01

    Self harm is a major public health concern, yet there are considerable challenges in providing support for those who self harm within psychiatric inpatient services. This paper presents the first review of research into self harm within inpatient settings. Searches of the main electronic databases were conducted using key words for self harm and inpatient care. There was substantial variation in the rates of self-harm and attempted suicide between studies, but rates were highest on forensic wards. There was no evidence of differences in prevalence of self-harm between men and women; women, however, were at increased risk of attempting suicide. People were more likely to self-harm in private areas of the ward and in the evening hours, and often self-harmed in response to psychological distress, or elements of nursing care that restricted their freedom. Wards used a variety of strategies to prevent self-harm; however, there is little research into their effectiveness.

  16. An audit of urgent referrals by the Procurator Fiscal to the Tayside Forensic Psychiatric Service.

    PubMed

    White, T; Rutherford, H

    2005-10-01

    This study describes the demographic, offence and diagnostic characteristics of subjects referred by the Procurators Fiscal operating from three courts in Tayside, Scotland. A comparison is made of referrals made between 1988 to 1995 and 1997 to 1998. There was an increased rate of referral on an urgent basis over time, primarily involving patients already in contact with the psychiatric services, 37% of whom were detained and admitted to hospital. This urgent assessment ensured that mentally-disordered offenders were not remanded in custody simply for the preparation of a report, and it allowed an early assessment to be made regarding the suitability for diversion from prosecution. This outcome is compatible with guidelines issued by the Home Office in 1990 (Home Office, 1990).

  17. Suicidal Ideation of Psychiatrically Hospitalized Adolescents has One-Year Predictive Validity for Suicide Attempts in Girls Only

    PubMed Central

    Jiang, Qingmei; Czyz, Ewa K.; Kerr, David C. R.

    2016-01-01

    Clinicians commonly incorporate adolescents’ self-reported suicidal ideation into formulations regarding adolescents’ risk for suicide. Data are limited, however, regarding the extent to which adolescent boys’ and girls’ reports of suicidal ideation have clinically significant predictive validity in terms of subsequent suicidal behavior. This study examined psychiatrically hospitalized adolescent boys’ and girls’ self-reported suicidal ideation as a predictor of suicide attempts during the first year following hospitalization. A total of 354 adolescents (97 boys; 257 girls; ages 13–17 years) hospitalized for acute suicide risk were evaluated at the time of hospitalization as well as 3, 6, and 12 months later. Study measures included the Suicidal Ideation Questionnaire-Junior, Multidimensional Anxiety Scale for Children, Children’s Depression Rating Scale-Revised, Beck Hopelessness Scale, Youth Self-Report, and Personal Experiences Screen Questionnaire. The main study outcome was presence and number of suicide attempt(s) in the year after hospitalization, measured by the Diagnostic Interview Schedule for Children. Results indicated a significant interaction between suicidal ideation, assessed during first week of hospitalization, and gender for the prediction of subsequent suicide attempts. Suicidal ideation was a significant predictor of subsequent suicide attempts for girls, but not boys. Baseline history of multiple suicide attempts was a significant predictor of subsequent suicide attempts across genders. Results support the importance of empirically validating suicide risk assessment strategies separately for adolescent boys and girls. Among adolescent boys who have been hospitalized due to acute suicide risk, low levels of self-reported suicidal ideation may not be indicative of low risk for suicidal behavior following hospitalization. PMID:23996157

  18. Adolescent health care: improving access by school-based service.

    PubMed

    Gonzales, C; Mulligan, D; Kaufman, A; Davis, S; Hunt, K; Kalishman, N; Wallerstein, N

    1985-10-01

    Participants in this discussion of the potential of school-based health care services for adolescents included family medicine physicians, school health coordinators, a school nurse, and a community worker. It was noted that health care for adolescents tends to be either inaccessible or underutilized, largely because of a lack of sensitivity to adolescent culture and values. An ideal service for adolescents would offer immediate services for crises, strict confidentiality, ready access to prescribed medications, a sliding-scale scheme, and a staff that is tolerant of divergent values and life-styles. School-based pilot adolescent clinics have been established by the University of New Mexico's Department of Family, Community, and Emergency Medicine to test the community-oriented health care model. On-site clinics provide urgent medical care, family planning, pregnancy testing, psychological counseling, alcohol and drug counseling, and classroom health education. Experience with these programs has demonstrated the necessity for an alliance among the health team and the school administration, parents, and students. Financial, ethical, and political factors can serve as constraints to school-based programs. In some cases, school administrators have been resistant to the provision of contraception to students on school grounds and parents have been unwilling to accept the adolescent's right to confidentiality. These problems in part stem from having 2 separate systems, each with its own values, orientation, and responsibilities, housed in 1 facility. In addition, there have been problems generating awareness of the school-based clinic among students. Health education theater groups, peer counseling, and student-run community services have been effective, however, in increasing student participation. It has been helpful to mold clinic services to meet the needs identified by teenagers themselves. There is an interest not only in curative services, but in services focused

  19. Substance Use Disorders in Elderly Admissions to an Academic Psychiatric Inpatient Service over a 10-Year Period

    PubMed Central

    Dombrowski, Dennis; Norrell, Nelly

    2016-01-01

    Objective. There is a paucity of research on substance use disorders (SUDs) in the elderly psychiatric population. This study examines SUDs in a geriatric psychiatry inpatient service over a 10-year period. Methods. Data from 1788 elderly psychiatric inpatients from a ten-year period was collected. Variables collected included psychiatric diagnoses, SUD, number of psychiatric admissions, and length of stay. Those with and without a SUD were compared using Chi-Square or Student's t-test as appropriate using SPSS. Results. 11.7% (N = 210) of patients had a SUD, and the most common substance was alcohol at 73.3% (N = 154) or 8.6% of all admissions. Other SUDs were sedative-hypnotics (11%), opiate (2.9%), cannabis (1%), tobacco (1.4%), and unspecified SUD (38.6%). SUD patients were significantly younger, divorced, male, and less frequently readmitted and had shorter lengths of stay. The most common comorbid diagnoses were major depression (26.1%), bipolar disorder (10.5%), and dementia (17.1%). Conclusions. Over 10% of psychogeriatric admissions were associated with a SUD, with alcohol being the most common. Considering the difficulties in diagnosing SUD in this population and the retrospective study design, the true prevalence in elderly psychiatric inpatients is likely higher. This study adds to sparse literature on SUD in elderly psychiatric patients. PMID:27840765

  20. Psychiatric, Family, and Ethnicity-Related Factors That Can Impact Treatment Utilization Among Hispanic Substance Abusing Adolescents

    PubMed Central

    Santisteban, Daniel A.; Dillon, Frank; Mena, Maite P.; Estrada, Yannine; Vaughan, Ellen L.

    2014-01-01

    SUMMARY There is great significance to improving our understanding of predictors of treatment utilization among Hispanic substance abusing youth. One hundred and ten Hispanic substance abusing adolescents and their parents participated in a study of treatment utilization. Analyses showed that adolescents with lower numbers of externalizing disorders (χ2 = 4.18, df = 1, p < .05) and parents with better parenting strategies (χ2 = 8.73, df = 2, p < .05), predicted overall treatment utilization (residential + outpatient). Better parenting practices and higher parental years in the U.S. predicted more utilization of outpatient services and lower parenting stress predicted more utilization of residential services. Without specialized engagement strategies, adolescents and families most in need may be the least likely to engage in recommended treatment. PMID:25400514

  1. ASD Symptom Severity in Adolescence of Individuals Diagnosed with PDD-NOS in Childhood: Stability and the Relation with Psychiatric Comorbidity and Societal Participation

    ERIC Educational Resources Information Center

    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.

    2015-01-01

    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…

  2. Reasons for Referral, Intervention Approaches and Demographic Characteristics of Clients with Intellectual Disability Attending Adult Psychiatric Outpatient Services in the Kingdom of Bahrain

    ERIC Educational Resources Information Center

    Grey, I.; Al-Saihati, B. A.; Al-Haddad, M.; McClean, B.

    2015-01-01

    Background: Relatively little information is available regarding the use of psychiatric services by individuals with intellectual disability (ID) in Arab countries. The current study aimed to identify (1) the reasons for referral; (2) demographic characteristics of individuals referred; (3) previous contact with child psychiatric services; (4)…

  3. Hospital Emergency Services for Children and Adolescents

    PubMed Central

    Robinson, Geoffrey C.; Klonoff, Harry

    1967-01-01

    The records of visits of children and adolescents to the emergency department of the Vancouver General Hospital were reviewed during the period July 1, 1965, to June 30, 1966, and the diagnostic and disposal data recorded. One-quarter of all visits were made by children and adolescents. Three-quarters of the visits were made for surgical conditions. There were more males than females in both surgical and medical groups, and the peaks in attendance were of those in the early preschool and late adolescent age groups. Three-quarters of the patients were referred to the family doctor and approximately one-sixth were admitted to the hospital. These findings suggested that while prompt medical attention was usually indicated, the majority of problems were not urgent and that the emergency department was becoming a substitute for the office of the family physician. PMID:6023997

  4. Intelligence and Birth Order among Children and Adolescents in Psychiatric Care

    ERIC Educational Resources Information Center

    Kirkcaldy, Bruce; Furnham, Adrian; Siefen, Georg

    2009-01-01

    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…

  5. Social Connectedness and One-Year Trajectories among Suicidal Adolescents Following Psychiatric Hospitalization

    ERIC Educational Resources Information Center

    Czyz, Ewa K.; Liu, Zhuqing; King, Cheryl A.

    2012-01-01

    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…

  6. Clinical profile of patients seeking services at urban community psychiatric services in Chandigarh

    PubMed Central

    Patra, Suravi; Chavan, Bir Singh; Gupta, Nitin; Sidana, Ajeet

    2016-01-01

    Context: About two-third of patients with mental, neurological, and substance use disorder in India do not get adequate treatment due to insufficient clinical facilities. In a country with diverse population such as India, no single model can be effective and each region needs to develop local system of service delivery unique to population needs. Community outreach clinics (COCs) being run by the department of psychiatry provide mental health services in the primary health-care setting. The study reports on the pattern of service utilization across different COCs in Chandigarh. Aims: The aim of this study was to describe the sociodemographic and clinical profile of patients seeking mental health-care services from COCs and to compare this with patients seeking care at tertiary care center. Settings and Design: This was a cross-sectional case record review. Subjects and Methods: Community services are provided in the areas adjoining Chandigarh, through four COCs: Civil Dispensary, Dhanas; Khuda Ali Sher; Rural Health Training Center, Palsaura; and Police Dispensary Sector 26 by Department of Psychiatry, Government Medical College and Hospital, Chandigarh. The current study reports on sociodemographic and clinical profile of 728 patients seen in these clinics from July 2010 to June 2011. Statistical Analysis Used: Descriptive statistics were performed using SPSS version 16.0. Chi-square test was used to compare two groups, ANOVA for comparing more than two groups. Results: Out of the 728 patients, majority were males in productive age group with diagnosis of substance use disorder. Majority were reaching the clinics on their own and only a few were referred by various community referral agencies. Only twelve patients needed referral to the Department of Psychiatry in the above mentioned period. Conclusions: Patients of substance use disorder prefer to be seen in the outreach clinics and it is possible to manage them in these clinics with very little need to refer

  7. [Definition of the core area of medical services in the psychiatric-psychotherapeutic field--the prerequisite for any delegation].

    PubMed

    Jordan, Wolfgang; Bleich, Stefan; Cohrs, Stefan; von Einsiedel, Regina; Falkai, Peter; Grosskopf, Volker; Hauth, Iris; Steiner, Johann; Adler, Lothar

    2011-11-01

    Based on legal jurisdiction, knowledge of the psychiatric-psychotherapeutic field and insight into the necessity of a new allocation of responsibilities in the overall therapeutic service of a clinic, the core areas of medical activities are defined for the first time, innovative organisational approaches to the reorganisation of therapeutic service are presented and discussed against the background of qualified staff deficit, introduction of an OPS coding for inpatient psychiatry and economic constraints.

  8. Exposure to Violence, Posttraumatic Stress Symptoms, and Borderline Personality Pathology Among Adolescents in Residential Psychiatric Treatment: The Influence of Emotion Dysregulation.

    PubMed

    Buckholdt, Kelly E; Weiss, Nicole H; Young, John; Gratz, Kim L

    2015-12-01

    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.

  9. Exposure to Violence, Posttraumatic Stress Symptoms, and Borderline Personality Pathology among Adolescents in Residential Psychiatric Treatment: The Influence of Emotion Dysregulation

    PubMed Central

    Buckholdt, Kelly E.; Weiss, Nicole H.; Young, John; Gratz, Kim L.

    2014-01-01

    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

  10. Screen Time on School Days and Risks for Psychiatric Symptoms and Self-Harm in Mainland Chinese Adolescents

    PubMed Central

    Liu, Mingli; Ming, Qingsen; Yi, Jinyao; Wang, Xiang; Yao, Shuqiao

    2016-01-01

    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

  11. White Matter Hyperintensities and Their Associations with Suicidality in Psychiatrically Hospitalized Children and Adolescents.

    ERIC Educational Resources Information Center

    Ehrlich, Stefan; Noam, Gil G.; Lyoo, In Kyoon; Kwon, Bae J.; Clark, Megan A.; Renshaw, Perry F.

    2004-01-01

    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…

  12. Psychiatric Morbidity, Violent Crime, and Suicide among Children and Adolescents Exposed to Parental Death

    ERIC Educational Resources Information Center

    Wilcox, Holly C.; Kuramoto, Satoko J.; Lichtenstein, Paul; Langstrom, Niklas; Brent, David A.; Runeson, Bo

    2010-01-01

    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…

  13. Continuity of care from child and adolescent to adult mental health services: evidence from a regional survey in Northern Italy.

    PubMed

    Stagi, Paolo; Galeotti, Simona; Mimmi, Stefano; Starace, Fabrizio; Castagnini, Augusto C

    2015-12-01

    To examine clinical and demographic factors associated with continuity of care from child-adolescent (CAMHS) to adult mental health services (AMHS), we undertook a record-linkage study to the Adult Mental Health Information System including all those 16 years old and over who were listed between 2010 and 2013 in the Child and Adolescent Neuropsychiatry Information System in Emilia-Romagna, an Italian region of nearly 4.5 million residents. From a cohort of 8239 adolescents attending CAMHS (population at risk about 144,000), 821 (19.4 %) moved to AMHS, excluding cases with specific developmental disorders, whose conditions were not managed by adult psychiatrists, and those with mental retardation who attended usually social services. Young people referred for treatment to AMHS were more likely to receive a discharge diagnosis of schizophrenia and related disorders (Odds Ratio [OR] 3.92; 95 % confidence interval [CI] 2.17-7.08), personality disorders (OR 2.69; 95 % CI 1.89-3.83), and pervasive developmental disorders (OR 2.13; 95 % CI 1.51-2.99). Further factors predicting transfer to AMHS were not living with parents, inpatient psychiatric admission, and being on medication in the previous 24 months. These findings suggest that a relatively small number of adolescents moved to AMHS and are likely to reflect the configuration of local mental health services and alternative care available, mainly for those with less-severe mental disorders.

  14. [About the heterogeneity in adolescents with gender identity disorder: differential importance of psychiatric comorbidity and considerations of individual psychodynamics].

    PubMed

    Korte, Alexander; Beier, Klaus M; Vukorepa, Julia; Mersmann, Maik; Albiez, Verena

    2014-01-01

    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.

  15. Detained Male Adolescent Offender's Emotional, Physical and Sexual Maltreatment Profiles and Their Associations to Psychiatric Disorders and Criminal Behaviors.

    PubMed

    Aebi, Marcel; Linhart, Susanne; Thun-Hohenstein, Leonhard; Bessler, Cornelia; Steinhausen, Hans-Christoph; Plattner, Belinda

    2015-07-01

    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.

  16. Caffeine Use: Association with Nicotine Use, Aggression, and Other Psychopathology in Psychiatric and Pediatric Outpatient Adolescents

    PubMed Central

    Martin, Catherine A.; Cook, Circe; Woodring, John H.; Burkhardt, Gretchen; Guenthner, Greg; Omar, Hatim A.; Kelly, Thomas H.

    2009-01-01

    The objective of this study was to evaluate the relationship between caffeine use, other drug use, and psychopathology in adolescents, using self-report measures. The study group consisted of 132 adolescents (average age 14.01 ± 2.06 years, 52% female, 19% African American, 5% other categories, 76% Caucasian). Most (47%) were recruited from a child psychiatry clinic with emphasis on youth with disruptive disorders, with 35% from an adolescent pediatric clinic with emphasis on prevention of risk-taking behavior and 18% from a pediatric clinic for families with limited resources. Subjects were consecutively recruited before or after regular clinic visits. Consent was obtained from parents and assent from the youth. High caffeine consumption was associated with daily cigarette use; aggressive behavior; conduct, attention deficit/hyperactivity, and social problems; and increased somatic complaints in adolescents. PMID:18516472

  17. Caffeine use: association with nicotine use, aggression, and other psychopathology in psychiatric and pediatric outpatient adolescents.

    PubMed

    Martin, Catherine A; Cook, Circe; Woodring, John H; Burkhardt, Gretchen; Guenthner, Greg; Omar, Hatim A; Kelly, Thomas H

    2008-05-22

    The objective of this study was to evaluate the relationship between caffeine use, other drug use, and psychopathology in adolescents, using self-report measures. The study group consisted of 132 adolescents (average age 14.01 +/- 2.06 years, 52% female, 19% African American, 5% other categories, 76% Caucasian). Most (47%) were recruited from a child psychiatry clinic with emphasis on youth with disruptive disorders, with 35% from an adolescent pediatric clinic with emphasis on prevention of risk-taking behavior and 18% from a pediatric clinic for families with limited resources. Subjects were consecutively recruited before or after regular clinic visits. Consent was obtained from parents and assent from the youth. High caffeine consumption was associated with daily cigarette use; aggressive behavior; conduct, attention deficit/hyperactivity, and social problems; and increased somatic complaints in adolescents.

  18. Development and organization of child and adolescent mental health services.

    PubMed

    Davies, Jane; Lowes, Lesley

    Against the backdrop of involving children and families in their own care and the clear need to protect their interest, this article will consider care within child and adolescent mental health services (CAMHS). Following a brief overview of the incidence and prevalence of mental health problems, the development and organization of CAMHS will be explored, giving consideration to some of the literature that discusses the effectiveness of services. A review of the literature revealed that, while there is some evidence of how children feel about the services they receive, there is not currently a significant amount of literature available. Nevertheless, these views are of value in relation to the development of service provision.

  19. Outsourcing mental health care services? The practice and potential of community-based farms in psychiatric rehabilitation.

    PubMed

    Iancu, Sorana C; Zweekhorst, Marjolein B M; Veltman, Dick J; van Balkom, Anton J L M; Bunders, Joske F G

    2015-02-01

    Psychiatric rehabilitation supports individuals with mental disorders to acquire the skills needed for independent lives in communities. This article assesses the potential of outsourcing psychiatric rehabilitation by analysing care farm services in the Netherlands. Service characteristics were analysed across 214 care farms retrieved from a national database. Qualitative insights were provided by five case descriptions, selected from 34 interviews. Institutional care farms were significantly larger and older than private care farms (comprising 88.8% of all care farms). Private, independent care farms provide real-life work conditions to users who are relatively less impaired. Private, contracted care farms tailor the work activities to their capacities and employ professional supervisors. Institutional care farms accommodate for the most vulnerable users. We conclude that collaborations with independent, contracted and institutional care farms would provide mental health care organizations with a diversity in services, enhanced community integration and a better match with users' rehabilitation needs.

  20. Commentary on "Psychiatric Aspects of Child and Adolescent Obesity: A Review of the Past 10 Years"

    ERIC Educational Resources Information Center

    Fitzgibbon, Marian L.

    2004-01-01

    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,…

  1. 'Time slip' phenomenon in adolescents and adults with autism spectrum disorders: case series.

    PubMed

    Tochimoto, Shinnichi; Kurata, Koichi; Munesue, Toshio

    2011-06-01

    In recent years, it has been noticed that adolescent and adult patients with autism spectrum disorder (ASD) sometimes visit psychiatric medical institutions. In some cases, these patients commit an act of violence and are dealt with by psychiatric emergency and forensic psychiatric services. In this report, we present two cases with ASD who visited a psychiatric emergency service because of the 'time slip' phenomenon, and discuss the clinical significance of this phenomenon.

  2. Association between fetal DES-exposure and psychiatric disorders in adolescence/adulthood: evidence from a French cohort of 1002 prenatally exposed children.

    PubMed

    Soyer-Gobillard, Marie-Odile; Paris, Françoise; Gaspari, Laura; Courtet, Philippe; Sultan, Charles

    2016-01-01

    In utero diethylstilbestrol (DES) exposure has been demonstrated to be associated with somatic abnormalities in adult men and women. Conversely, the data are contradictory regarding the association with psychological or psychiatric disorders during adolescence and adulthood. This work was designed to determine whether prenatal exposure to DES affects brain development and whether it is associated with psychiatric disorders in male and female adolescents and young adults. HHORAGES Association, a national patient support group, has assembled a cohort of 1280 women who took DES during pregnancy. We obtained questionnaire responses from 529 families, corresponding to 1182 children divided into three groups: Group 1 (n = 180): firstborn children without DES treatment, Group 2 (n = 740): exposed children, and Group 3 (n = 262): children born after a previous pregnancy treated by DES. No psychiatric disorders were reported in Group 1. In Group 2, the incidence of disorders was drastically elevated (83.8%), and in Group 3, the incidence was still elevated (6.1%) compared with the general population. This work demonstrates that prenatal exposure to DES is associated with a high risk of psychiatric disorders in adolescence and adulthood.

  3. [Drug addicts with severe mental disorders can be helped by programs using moderate means. Good results when psychiatric, social and drug abuse services cooperate].

    PubMed

    Palmstierna, T; Gadd, K; Norman, C; Svensson, J

    2000-05-03

    Dependency disorders are more common than expected in psychiatric populations. Untreated, dual diagnosis leads to severe social and psychiatric deterioration. Nine treatment resistant, homeless, drug addicts suffering from chronic psychotic disorders were selected to take part in a case management program, integrating social services with regular psychiatric treatment. All but one were greatly improved in general terms as well as regarding their ability to maintain an ordered life style. The need for institutional care decreased dramatically.

  4. Mental Health In-Service Training; Some Practical Guidelines for the Psychiatric Consultant.

    ERIC Educational Resources Information Center

    Parker, Beulah

    Based on the author's personal observations and opinions as a former public health psychiatric consultant, this book offers a theoretical orientation and practical guidelines for psychiatrists, analysts, clinical psychologists, psychiatric social workers, and others who hope to participate in community psychiatry as mental health consultants to…

  5. Social connectedness and one-year trajectories among suicidal adolescents following psychiatric hospitalization.

    PubMed

    Czyz, Ewa K; Liu, Zhuqing; King, Cheryl A

    2012-01-01

    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 17, who were assessed at 3, 6, and 12 months posthospitalization. General liner models were fitted for depressive symptoms and suicidal ideation outcomes, and logistic regression was used for the dichotomous suicide attempt outcome. The moderating effects of gender and multiple attempt history were examined. Adolescents who reported greater improvements in peer connectedness were half as likely to attempt suicide during the 12-month period. Improved peer connectedness was also associated with less severe depressive symptoms for all adolescents and with less severe suicidal ideation for female individuals, but only at the 3-month assessment time point. Improved family connectedness was related to less severe depressive symptoms and suicidal ideation across the entire year; for suicidal ideation, this protective effect was limited to nonmultiple suicide attempters. Change in connectedness with nonfamily adults was not a significant predictor of any outcome when changes in family and peer connectedness were taken into account. These results pointing to improved posthospitalization connectedness being linked to improved outcomes following hospitalization have important treatment and prevention implications given inpatient suicidal adolescents' vulnerability to suicidal behavior.

  6. Indian health care professionals' attitude towards spiritual healing and its role in alleviating stigma of psychiatric services.

    PubMed

    Ramakrishnan, P; Rane, A; Dias, A; Bhat, J; Shukla, A; Lakshmi, S; Ansari, B K; Ramaswamy, R S; Reddy, R A; Tribulato, A; Agarwal, A K; SatyaPrasad, N; Mushtaq, A; Rao, P H; Murthy, P; Koenig, H G

    2014-12-01

    Persons with mental illnesses in India and rest of developing world continue to consult religious/spiritual (R/S) healers or traditional, complementary and alternative medicine (TCAM) professionals prior to seeking psychiatric services that are devoid of spiritual components of care. We aim to understand TCAM and allopathic professionals' perspectives on patients' R/S needs within mental health services, cross-sectional study was conducted at five TCAM and two allopathic tertiary care hospitals in three different Indian states; 393 participants completed RSMPP, a self-administered, semi-structured survey questionnaire. Perspectives of TCAM and allopathic health professionals on role of spirituality in mental health care were compared. Substantial percentage, 43.7 % TCAM and 41.3 % allopathic, of participants believe that their patients approach R/S or TCAM practitioners for severe mental illness; 91.2 % of TCAM and 69.7 % of allopaths were satisfied with R/S healers (p = 0.0019). Furthermore, 91.1 % TCAM and 73.1 % allopaths (p = 0.000) believe that mental health stigma can be minimized by integrating with spiritual care services. Overall, 87 % of TCAM and 73 % of allopaths agreed to primary criterion variable: 'spiritual healing is beneficial and complementary to psychiatric care.' A quarter of allopaths (24.4 %) and 38 % of TCAM physicians reportedly cross-refer their grieving patients to religious/TCAM healer and psychiatrist/psychologist, respectively; on logistic regression, significant (p < 0.05) predictors were clinical interactions/references to r/s healers. Providing spiritual care within the setup of psychiatric institution will not only complement psychiatric care but also alleviate stigma against mental health services. Implications on developing spiritual care services like clinical chaplaincy are discussed.

  7. Influence of mental illness on marriage, reproduction, and parenting in a society without psychiatric services.

    PubMed

    Westermeyer, J

    1980-10-01

    This survey was undertaken in a peasant society without modern psychiatric services in order to assess marriage, reproduction, and parenting functions among 35 mentally ill persons. Among the mentally ill, single persons had earlier onset of mental illness as compared to those who had ever been married. Those who had married and produced children had a high rate of divorce from their spouses and separation from their children following onset of mental illness. Among 12 parents whose onset of mental illness began when their children were still young, five were not living with their children and the other seven exercised little or no parental supervision. In two families, the psychotic parent had beaten her children severely. One infant died of neglect when a psychotic mother refused to surrender child care to others. Mentally ill subjects 18 years or older were less apt to be married than opium addicts in the same population. Infant mortality was greater among the children of mentally ill than in the general population.

  8. Enabling healthy living: Experiences of people with severe mental illness in psychiatric outpatient services.

    PubMed

    Blomqvist, Marjut; Sandgren, Anna; Carlsson, Ing-Marie; Jormfeldt, Henrika

    2017-02-03

    It is well known that people with severe mental illness have a reduced life expectancy and a greater risk of being affected by preventable physical illnesses such as metabolic syndrome, cardiovascular disease and type 2 diabetes. There are still, however, only a few published studies focusing on what enables healthy living for this group. This study thus aimed to describe what enables healthy living among people with severe mental illness in psychiatric outpatient services. The data were collected in qualitative interviews (n = 16) and content analysis was used to analyze the data. The interviews resulted in an overall theme "Being regarded as a whole human being by self and others", which showed the multidimensional nature of health and the issues that enable healthy living among people with severe mental illness. Three categories emerged: (i) everyday structure (ii), motivating life events and (iii) support from significant others. The results indicate that a person with severe mental illness needs to be encountered as a whole person if healthy living is to be enabled. Attaining healthy living requires collaboration between the providers of care, help and support. Health care organizations need to work together to develop and provide interventions to enable healthy living and to reduce poor physical health among people with severe mental illness.

  9. The Longitudinal Association of Adolescent Dating Violence with Psychiatric Disorders and Functioning

    ERIC Educational Resources Information Center

    Brown, Adrienne; Cosgrave, Elizabeth; Killackey, Eoin; Purcell, Rosemary; Buckby, Joe; Yung, Alison R.

    2009-01-01

    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…

  10. Social Connectedness and One-Year Trajectories among Suicidal Adolescents Following Psychiatric Hospitalization

    PubMed Central

    Czyz, Ewa K.; Liu, Zhuqing; King, Cheryl A.

    2012-01-01

    Objective This study examined the extent to which post-hospitalization change in connectedness with family, peers, and non-family adults predicted suicide attempts, severity of suicidal ideation, and depressive symptoms across a 12-month follow-up period among inpatient suicidal adolescents. Method Participants were 338 inpatient suicidal adolescents, ages 13-17, who were assessed at three, six, and 12 months post hospitalization. General liner models were fitted for depressive symptoms and suicidal ideation outcomes, and logistic regression was used for the dichotomous suicide attempt outcome. The moderating effects of gender and multiple attempt history were examined. Results Adolescents who reported greater improvements in peer connectedness were half as likely to attempt suicide during the 12-month period. Improved peer connectedness was also associated with less severe depressive symptoms for all adolescents and with less severe suicidal ideation for females, but only at the three-month assessment time point. Improved family connectedness was related to less severe depressive symptoms and suicidal ideation across the entire year; for suicidal ideation, this protective effect was limited to non-multiple suicide attempters. Change in connectedness with non-family adults was not a significant predictor of any outcome when changes in family and peer connectedness were taken into account. Conclusions These results pointing to improved post-hospitalization connectedness being linked to improved outcomes following hospitalization have important treatment and prevention implications given inpatient suicidal adolescents’ vulnerability to suicidal behavior. PMID:22417194

  11. Depressed Adolescents and Comorbid Psychiatric Disorders: Are There Differences in the Presentation of Depression?

    ERIC Educational Resources Information Center

    Small, David Marc; Simons, Anne D.; Yovanoff, Paul; Silva, Susan G.; Lewis, Cara C.; Murakami, Jessica L.; March, John

    2008-01-01

    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"…

  12. Specificity of Putative Psychosocial Risk Factors for Psychiatric Disorders in Children and Adolescents

    ERIC Educational Resources Information Center

    Shanahan, Lilly; Copeland, William; Costello, E. Jane; Angold, Adrian

    2008-01-01

    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…

  13. Mindfulness-Based Stress Reduction for the Treatment of Adolescent Psychiatric Outpatients: A Randomized Clinical Trial

    ERIC Educational Resources Information Center

    Biegel, Gina M.; Brown, Kirk Warren; Shapiro, Shauna L.; Schubert, Christine M.

    2009-01-01

    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…

  14. The Involuntary Treatment of Adolescent Psychiatric Inpatients--A Nation-Wide Survey from Finland

    ERIC Educational Resources Information Center

    Ellila, Heikki Toivo; Sourander, Andre; Valimaki, Maritta; Warne, Tony; Kaivosoja, Matti

    2008-01-01

    This national cross-sectional study investigates the prevalence rates, regional differences and factors associated with the involuntary inpatient treatment of adolescents in Finland on a chosen day in 2000. The proportion of inpatients with involuntary legal status was 29.5% (n=82) giving a prevalence rate of 2.5 per 10,000/12-17 years old…

  15. Service Use and Costs of Care for Depressed Adolescents: Who Uses and Who Pays?

    ERIC Educational Resources Information Center

    Domino, Marisa Elena; Burns, Barbara J.; Mario, Jeremy; Reinecke, Mark A.; Vitiello, Benedetto; Weller, Elizabeth B.; Kratochvil, Christopher J.; May, Diane E.; Feeny, Norah C.; Robins, Michele; Hallin, Mary J.; Silva, Susan G.; March, John S.

    2009-01-01

    Major depressive disorder is common in adolescence and is associated with significant morbidity and family burden. Little is known about service use by depressed adolescents. The purpose of this article is to report the patterns of services use and costs for participants in the Treatment for Adolescents with Depression Study sample during the 3…

  16. [Some impressions of child and adolescent psychiatric management in Berlin after the fall of the wall].

    PubMed

    Fegert, J M; Geiken, G; Lenz, K

    1992-12-01

    The fall of the Berlin wall caused a sudden increase in migration from East-Germany to West-Berlin. In our sample we compared 155 Berlin elementary school children to 17 children from East-Germany now living in Berlin and 25 immigrant children most oft them coming from Turkey and Poland. Although many authors expected short-term disorders of adaptation, we found a constancy of psychiatric diagnosis in the migration group. We noticed important differences particularly in the new psychosocial situation of the former East German mothers, with many single-mother-families, where the mothers now were often unemployed.

  17. Experiences of Domestic and School Violence Among Child and Adolescent Psychiatric Outpatients.

    PubMed

    Völkl-Kernstock, Sabine; Huemer, Julia; Jandl-Jager, Elisabeth; Abensberg-Traun, Marihan; Marecek, Sonja; Pellegrini, Elisabeth; Plattner, Belinda; Skala, Katrin

    2016-10-01

    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.

  18. A prospective examination of the interpersonal-psychological theory of suicidal behavior among psychiatric adolescent inpatients.

    PubMed

    Czyz, Ewa K; Berona, Johnny; King, Cheryl A

    2015-04-01

    The challenge of identifying suicide risk in adolescents, and particularly among high-risk subgroups such as adolescent inpatients, calls for further study of models of suicidal behavior that could meaningfully aid in the prediction of risk. This study examined how well the Interpersonal-Psychological Theory of Suicidal Behavior (IPTS)--with its constructs of thwarted belongingness (TB), perceived burdensomeness (PB), and an acquired capability (AC) for lethal self-injury--predicts suicide attempts among adolescents (N = 376) 3 and 12 months after hospitalization. The three-way interaction between PB, TB, and AC, defined as a history of multiple suicide attempts, was not significant. However, there were significant 2-way interaction effects, which varied by sex: girls with low AC and increasing TB, and boys with high AC and increasing PB, were more likely to attempt suicide at 3 months. Only high AC predicted 12-month attempts. Results suggest gender-specific associations between theory components and attempts. The time-limited effects of these associations point to TB and PB being dynamic and modifiable in high-risk populations, whereas the effects of AC are more lasting. The study also fills an important gap in existing research by examining IPTS prospectively.

  19. Psychiatrists and psychiatric rehabilitation.

    PubMed

    Torrey, William C; Green, Ronald L; Drake, Robert E

    2005-05-01

    Interventions that focus directly on functional impairments related to mental illnesses are termed psychiatric rehabilitation. Research demonstrates that rehabilitation services are increasingly able to help adults with psychiatric disabilities achieve the functional outcomes they desire, particularly in the areas of housing and employment. To support the community lives of adults with severe mental illnesses, psychiatrists must stay current with advances in this field and know how to integrate psychiatric rehabilitation with other interventions. This article reviews the concept of psychiatric rehabilitation, current approaches in the field, the psychiatrist's role in these services, and implications for psychiatric training and continuing education.

  20. Design in mind: eliciting service user and frontline staff perspectives on psychiatric ward design through participatory methods

    PubMed Central

    Csipke, Emese; Papoulias, Constantina; Vitoratou, Silia; Williams, Paul; Rose, Diana; Wykes, Til

    2016-01-01

    Abstract Background: Psychiatric ward design may make an important contribution to patient outcomes and well-being. However, research is hampered by an inability to assess its effects robustly. This paper reports on a study which deployed innovative methods to capture service user and staff perceptions of ward design. Method: User generated measures of the impact of ward design were developed and tested on four acute adult wards using participatory methodology. Additionally, inpatients took photographs to illustrate their experience of the space in two wards. Data were compared across wards. Results: Satisfactory reliability indices emerged based on both service user and staff responses. Black and minority ethnic (BME) service users and those with a psychosis spectrum diagnosis have more positive views of the ward layout and fixtures. Staff members have more positive views than service users, while priorities of staff and service users differ. Inpatient photographs prioritise hygiene, privacy and control and address symbolic aspects of the ward environment. Conclusions: Participatory and visual methodologies can provide robust tools for an evaluation of the impact of psychiatric ward design on users. PMID:26886239

  1. [Use of Mental Health Service Among Young Adults on Unemployment Benefit Before and after Receiving Counseling at a Psychiatric Liaison Department].

    PubMed

    Hagen, C; Bänfer, S; Werkstetter, L; Hebebrand, J; Reissner, V

    2016-12-14

    Objective: To determine mental health service utilization before and after consultation of a psychiatric liaison service ("Support 25") among youths aged 16-24 years suffering from mental disorders and receiving unemployment benefits. Methods: Longitudinal registration of mental health service use over a 9-month period (N=148); measurement of possible moderators with questionnaires and rating scales. Results: Mental health service utilization increased from initially 22% to 40% and 47.5% 3 and 6 months after receiving individual treatment recommendation. Low-threshold psychosocial counseling was frequented more often than specific psychiatric or psychotherapeutic treatment. Subjects who contacted mental health services showed a trend towards a lower level of psychosocial functioning than subjects who did not seek treatment. Stigma-related factors did not hinder mental health service use. Conclusions: Despite a high degree of psychiatric morbidity, the surveyed sample of unemployed youths had problems to successfully enter mental health services. Although a substantial increase in service use was observed after receiving psychoeducational information at a psychiatric liaison service, the use of low-threshold counseling predominated. This finding suggests that the mental health system should adapt better to the specific needs of young unemployed, for example, by expanding low-threshold psychiatric pre-treatment offers at vocational centers.

  2. Interventions to improve therapeutic communications between Black and minority ethnic patients and professionals in psychiatric services: systematic review

    PubMed Central

    Bhui, Kamaldeep S.; Aslam, Rabeea'h W.; Palinski, Andrea; McCabe, Rose; Johnson, Mark R. D.; Weich, Scott; Singh, Swaran P.; Knapp, Martin; Ardino, Vittoria; Szczepura, Ala

    2015-01-01

    Background Communication may be an influential determinant of inequality of access to, engagement with and benefit from psychiatric services. Aims To review the evidence on interventions designed to improve therapeutic communications between Black and minority ethnic patients and clinicians who provide care in psychiatric services. Method Systematic review and evidence synthesis (PROSPERO registration: CRD42011001661). Data sources included the published and the ‘grey’ literature. A survey of experts and a consultation with patients and carers all contributed to the evidence synthesis, interpretation and recommendations. Results Twenty-one studies were included in our analysis. The trials showed benefits mainly for depressive symptoms, experiences of care, knowledge, stigma, adherence to prescribed medication, insight and alliance. The effect sizes were smaller for better-quality trials (range of d 0.18–0.75) than for moderate- or lower-quality studies (range of d 0.18–4.3). The review found only two studies offering weak economic evidence. Conclusions Culturally adapted psychotherapies, and ethnographic and motivational assessment leading to psychotherapies were effective and favoured by patients and carers. Further trials are needed from outside of the UK and USA, as are economic evaluations and studies of routine psychiatric care practices. PMID:26243761

  3. Behaviour management problems as predictors of psychotropic medication and use of psychiatric services in adults with autism.

    PubMed

    Tsakanikos, Elias; Costello, Helen; Holt, Geraldine; Sturmey, Peter; Bouras, Nick

    2007-07-01

    We examined behaviour management problems as predictors of psychotropic medication, use of psychiatric consultation and in-patient admission in a group of 66 adults with pervasive developmental disorder (PDD) and intellectual disability (ID) and 99 controls matched in age, gender and level of ID. Overall, people with PDD had higher rates of most DAS behaviour problems and more frequent use of anti-psychotics than matched controls. Logistic regression analyses showed that physical aggression and problems such as pestering staff independently predicted use of anti-psychotics. Physical aggression and overactivity predicted further involvement of psychiatric services. PDD diagnosis predicted admission to an in-patient unit. The results suggest that externalizing problem behaviours in adults with autism can predict type of treatment intervention.

  4. Suicide in Adolescence

    PubMed Central

    Tonkin, R.S.

    1986-01-01

    The recent trend in suicide mortality has made it the second-most-common cause of death in adolescence. The recognition of depressed adolescents, especially males, is made difficult by their low utilization of health services and by the variety of modes of presentation. The family physician's ability to play an effective role in helping the depressed adolescent and preventing the occurrence of suicide depends on the establishment of rapport, obtaining a detailed history, and being prepared to offer continuity of care. In most depressed adolescents there is limited need for hospitalization, medication or psychiatric treatment. PMID:21267225

  5. "Coming ready or not" high fidelity human patient simulation in child and adolescent psychiatric nursing education: diffusion of Innovation.

    PubMed

    McGarry, Denise; Cashin, Andrew; Fowler, Cathrine

    2011-10-01

    This paper is the first to address high fidelity human patient simulation (HFHPS) as a technique to prepare pre-registration nursing students for practice in child and adolescent psychiatric nursing (CAPN). By examining the published literature in a systematic review, no evidence was located that discussed the application of this innovative mannequin-based educational technique for this population. Indeed, mental health nursing preparation generally had minimal literature addressing the adoption of HFHPS. Rogers' (2003) model of the "Diffusion of Innovation" was applied as a lens to explain this observation. His model fitted this observed pattern well and provided a range of explanatory paradigms. It was limited, however, in its predictive ability to suggest when and under what conditions HFHPS might be expected to be adopted by nursing preparation programmes for CAPN. At the conclusion to this examination, the absence of a conversation evident in the mental health or CAPN literature on the preparation of pre-registration nursing students using this educational technique is striking. The potential of this approach to be combined in new ways to better prepare nursing students for the challenges of practice in mental health or CAPN needs extensive examination.

  6. Psychiatric disorders and characteristics of abuse in sexually abused children and adolescents with and without intellectual disabilities.

    PubMed

    Soylu, Nusret; Alpaslan, Ahmet Hamdi; Ayaz, Muhammed; Esenyel, Selcen; Oruç, Mücahit

    2013-12-01

    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.

  7. Nicotine dependence measures among adolescents with psychiatric disorders: evaluating symptom expression as a function of dependence severity.

    PubMed

    Strong, David R; Brown, Richard A; Ramsey, Susan E; Myers, Mark G

    2003-10-01

    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.

  8. Psychiatric Disorders in Adolescents and Adults with Autism and Intellectual Disability: A Representative Study in One County in Norway

    ERIC Educational Resources Information Center

    Bakken, Trine L.; Helverschou, Sissel B; Eilertsen, Dag E.; Heggelund, Trond; Myrbakk, Even; Martinsen, Harald

    2010-01-01

    Few studies assess psychiatric disorders in representative samples of individuals with autism and ID. Symptoms of autism and psychiatric disorders have been confounded. PAC, a conceptually analysed and validated screening instrument, was used. Aims: Assess prevalence of psychiatric disorders in individuals with intellectual disability only…

  9. Patterns of Service Use, Individual and Contextual Risk Factors, and Resilience among Adolescents Using Multiple Psychosocial Services

    ERIC Educational Resources Information Center

    Ungar, Michael; Liebenberg, Linda; Dudding, Peter; Armstrong, Mary; van de Vijver, Fons J. R.

    2013-01-01

    Background: Very little research has examined the relationship between resilience, risk, and the service use patterns of adolescents with complex needs who use multiple formal and mandated services such as child welfare, mental health, juvenile justice, and special educational supports. This article reports on a study of 497 adolescents in…

  10. Combination pharmacotherapy for psychiatric disorders in children and adolescents: prevalence, efficacy, risks and research needs.

    PubMed

    Jureidini, Jon; Tonkin, Anne; Jureidini, Elsa

    2013-10-01

    Polypharmacy, defined as the concomitant use of two or more psychotropic drugs, has become increasingly common in the paediatric and adolescent population over the past two decades. Combining psychotropic drugs leads to possible increases in benefits, but also in risks, particularly given the potential for psychotropic drug interactions. Despite the increasing use of concomitant therapy in children and adolescents, there is very little evidence from controlled clinical trials to provide guidance for prescribers. Even while acknowledging the small evidence base, clinical practice guidelines from eminent medical organizations are either relatively silent on or tend to support the use of concomitant treatments more enthusiastically than the evidence would warrant, so that practice and guidance are running ahead of the science. Our narrative review shows that the published evidence for efficacy and safety of concomitant psychotropic drugs in children and adolescents is scanty. A comprehensive search located 37 studies published over the last decade, of which 18 were randomized controlled trials (RCTs). These focused mainly on stimulants, central sympatholytics (such as clonidine), antipsychotics and 'mood stabilizers'. While several small, often methodologically weak, RCTs demonstrated statistically significant advantages for dual pharmacotherapy over monotherapy, only adding central sympatholytics to stimulants for treating attention-deficit hyperactivity disorder (ADHD) symptoms was supported by substantial studies with an effect size large enough to suggest clinical importance. Non-randomized studies tended to have results that supported concomitant treatment, but all have design-related problems that decrease the reliability of the results. Two studies that specifically examined tolerability of combination pharmacotherapy compared with monotherapy showed significant increases in adverse effects, both subjective and objective, and other studies confirmed a

  11. Optimizing medication use with a pharmacist-provided comprehensive medication management service for patients with psychiatric disorders.

    PubMed

    Cobb, Carla D

    2014-12-01

    Our objective was to evaluate a pharmacist-delivered comprehensive medication management (CMM) service provided to patients with psychiatric disorders. We conducted a retrospective review and analysis of medication-related data, and a return on investment cost analysis. The project consisted of 154 patients with psychiatric disorders who were referred to the CMM service by physicians, therapists, case managers, friends, or family, and were seen by the service between April 2011 and July 2013. CMM evaluates a patient's medications to ensure that they are appropriate, effective, safe, and convenient. Patients were seen by pharmacists trained in CMM and the treatment of mental illnesses, including one board-certified psychiatric pharmacist. All medications were reviewed including prescriptions, over-the-counter medications, and nutritional supplements. The patients' medication-related concerns, goals of treatment, vital signs, and laboratory studies were reviewed. Drug therapy problems such as adverse reactions, unnecessary medications, excessive doses, and poor medication adherence were identified, and written recommendations were mailed to patients and physicians within 1 week. Patients were offered follow-up in 4-6 weeks and were seen as many times as needed to resolve drug therapy problems. The 154 patients completed 256 CMM visits. A mean of 10.1 medical and psychiatric conditions and 13.7 medications/person were assessed. A mean of 5.6 drug therapy problems/patient were identified. A total net cost savings was estimated to be $90,484.00, with a mean savings of $586.55/patient. The cost of providing the service was estimated at $32,185.93. The return on investment was estimated to be 2.8; thus for every dollar spent on providing the service, $2.80 was estimated to be saved. Patients with mental illnesses may benefit from pharmacist-delivered CMM to help resolve drug therapy problems. Medication management may improve clinical outcomes and reduce costs. In

  12. Association of Parental Depression with Psychiatric Course from Adolescence to Young Adulthood among Formerly Depressed Individuals

    PubMed Central

    Rohde, Paul; Lewinsohn, Peter M.; Klein, Daniel N.; Seeley, John R.

    2005-01-01

    We examined whether parental major depressive disorder (MDD) is associated with course of depression and other psychopathology among formerly depressed adolescents as they enter adulthood. The sample consisted of 244 individuals (age 24) in a longitudinal study who had experienced MDD by 19. Maternal MDD was associated with MDD recurrence, chronicity, and severity, anxiety disorders, and (among sons only) lower psychosocial functioning in offspring between 19–24. Paternal MDD was associated with lower functioning. Sons of depressed fathers had elevated suicidal ideation and attempt rates in young adulthood. Recurrent paternal MDD was associated with depression recurrence in daughters but not sons. The impact of parental MDD on offspring could not be attributed to characteristics of the offspring’s depression prior to 19. PMID:16117578

  13. [Neuro-psychiatric comorbidity among children and adolescents who suffer from epilepsy].

    PubMed

    Doron, Yariv; Epstein, Orna; Heyman, Eli; Lahat, Eli

    2013-01-01

    Epilepsy is quite a common disorder in the child and adolescent population, and it has been studied for many years. Recently, a better understanding has been achieved regarding the comorbidities in epilepsy, including: major depression, anxiety, learning disabilities, etc.. The comorbidities are extensive and affect many aspects in the life of the patient, and his family members, including: psychological development, learning abilities, independence, etc.. Several mechanisms take part in these comorbidities, starting in the cell and ending with a broadened psychological effect. A better understanding of these mechanisms may assist the physicians in diagnosing their patients and tailoring a wide-approach treatment plan, thereby improving the patient's clinical status and his quality of life (and that of his family). The objective of this article is to describe some of the common comorbidities that are present in epilepsy, and outline the multi-disciplinary approach in treating the epileptic child and his/her family.

  14. Pharmacogenetics Informed Decision Making in Adolescent Psychiatric Treatment: A Clinical Case Report

    PubMed Central

    Smith, Teri; Sharp, Susan; Manzardo, Ann M.; Butler, Merlin G.

    2015-01-01

    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

  15. Emergency Psychiatric Service Use by Individuals with Intellectual Disabilities Living with Family

    ERIC Educational Resources Information Center

    Lunsky, Yona; Tint, Ami; Robinson, Suzanne; Khodaverdian, Alin; Jaskulski, Christine

    2011-01-01

    The purpose of this study was to describe the experiences of individuals with intellectual disabilities (ID) and their families in the emergency department (ED). Hospital chart audits were conducted on a sample of 20 individuals with ID living with family who had visited the ED for a psychiatric crisis. Individuals had a combined total of 44 ED…

  16. Symptom, Family, and Service Predictors of Children's Psychiatric Rehospitalization within One Year of Discharge.

    ERIC Educational Resources Information Center

    Blader, Joseph C.

    2004-01-01

    Objective: To investigate predictors of readmission to inpatient psychiatric treatment for children aged 5 to 12 discharged from acute-care hospitalization. Method: One hundred nine children were followed for 1 year after discharge from inpatient care. Time to rehospitalization was the outcome of interest. Predictors of readmission, examined via…

  17. Rights-based services for adolescents living with HIV: adolescent self-efficacy and implications for health systems in Zambia.

    PubMed

    Mburu, Gitau; Hodgson, Ian; Teltschik, Anja; Ram, Mala; Haamujompa, Choolwe; Bajpai, Divya; Mutali, Beatrice

    2013-05-01

    A rights-based approach in HIV service delivery for adults is increasingly taking root in sub-Saharan Africa in the context of greater availability of antiretroviral therapy. Yet there has been comparatively little progress in strengthening a rights-based approach to adolescent HIV services, which we learned during a qualitative study in 2010 among 111 adolescents living with HIV, 21 parents and 38 health providers in three districts in Zambia. Adolescents in the study expressed a range of information and support needs and wanted locally relevant interventions to meet those needs. They wanted greater access to HIV, sexual and reproductive health information, information on how to protect themselves, privacy and confidentiality in service sites, skills training so as to be able to earn money, and better control over disclosure of their HIV status to others. Both health workers and parents acknowledged that information and services needed to be improved to meet those needs far better. This paper provides examples of successful programmes in Zimbabwe, Uganda, Tanzania, Botswana and South Africa and calls for adolescent services to be linked to both paediatric and adult services, peer networks to be established to increase adolescents' ability to collectively voice their concerns and support each other, interventions supporting adolescents' control over self-disclosure, and lastly that adolescent health should become a training specialty in sub-Saharan Africa.

  18. The Personal Service Gap: Factors Affecting Adolescents' Willingness to Seek Help

    ERIC Educational Resources Information Center

    Raviv, Amiram; Raviv, Alona; Vago-Gefen, Idit; Fink, Abby Schachter

    2009-01-01

    The study explores adolescents' attitudes toward seeking help for emotional problems. The personal service gap is examined by asking adolescents about their willingness to refer themselves and others to formal (psychologists) and informal (friends) help sources, using a within-subjects design. The study included 662 Israeli adolescents in the 10th…

  19. The impact of psychiatric diagnosis on treatment adherence and duration among victimized children and adolescents in São Paulo, Brazil

    PubMed Central

    Scivoletto, Sandra; Silva, Thiago F.; Cunha, Paulo Jannuzzi; Rosenheck, Robert A.

    2012-01-01

    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

  20. Mental health care in Italy: organisational structure, routine clinical activity and costs of a community psychiatric service in Lombardy region.

    PubMed

    Fattore, G; Percudani, M; Pugnoli, C; Contini, A; Beecham, J

    2000-01-01

    The Magenta Community Mental Health Centre (CMHC) is the public agency responsible for providing adult psychiatric care to about 85,000 adult residents. In 1995, it had 1,145 clients and incurred costs of Euro 1.9 millions. Average cost per patient and per adult resident were Euro 1,661 and Euro 22.2, respectively. These values mask large variation across diagnosis: while patients with schizophrenia and related disorders had an average cost of Euro 3,771, those with neurotic and related disorders had an average cost of Euro 439. Patients with schizophrenia and related disorders (28% of the patients) absorbed about 60% of total costs and made extensive use of several types of services (hospital, outpatient, domiciliary, social and rehabilitative care). Since integrating different types of services is the key element of Italian psychiatric care, the new fee-for-service system adopted by the NHS to fund providers does not appear appropriate, particularly for schizophrenic patients.

  1. Decline in the diagnosis of schizophrenia among first contacts with psychiatric services in north-east Scotland, 1969-1984.

    PubMed

    Eagles, J M; Hunter, D; McCance, C

    1988-06-01

    Annual age-standardised rates for first contacts with psychiatric services in the Aberdeen area from 1969 to 1984 were calculated for schizophrenia, paranoid states, reactive psychoses, all affective psychoses, mania, and depressive neuroses. Highly significant declines occurred in the diagnosis of schizophrenia and of depressive neuroses. No concomitant increase occurred. It is concluded that these results probably indicate that there has been a fall in the incidence of schizophrenia in North-East Scotland. This may have arisen due to changes in the mode of expression and/or the severity of all functional psychoses.

  2. Using clinical and criminal involvement factors to explain homelessness among clients of a psychiatric probation and parole service.

    PubMed

    Solomon, P; Draine, J

    1999-01-01

    This study sought to examine the rate of homelessness and the extent to which lifetime homelessness was associated with clinical factors, such as diagnosis and treatment history; or criminal factors, such as criminal behavior and arrest history, among psychiatric probationers and parolees. Nearly half of the clients screened had experienced homelessness in their lifetime. In a logistic regression model to explain lifetime homelessness, significant factors were younger age, less education, a greater number of lifetime arrests, a schizophrenia diagnosis, and reporting both an alcohol and drug problem. Implications for service delivery with this population are discussed.

  3. Limited English proficiency as a barrier to mental health service use: a study of Latino and Asian immigrants with psychiatric disorders.

    PubMed

    Kim, Giyeon; Aguado Loi, Claudia X; Chiriboga, David A; Jang, Yuri; Parmelee, Patricia; Allen, Rebecca S

    2011-01-01

    Language barriers pose problems in mental health care for foreign-born individuals in the United States. Immigrants with psychiatric disorders may be at particular risk but are currently understudied. The purpose of this study was to examine the effect of limited English proficiency (LEP) on mental health service use among immigrant adults with psychiatric disorders. Drawn from the National Latino and Asian American Study (NLAAS), Latino and Asian immigrant adults aged 18-86 with any instrument-determined mood, anxiety, and substance use disorder (n = 372) were included in the present analysis. Results from hierarchical logistic regression analyses showed that having health insurance, poor self-rated mental health, and more psychiatric disorders were independently associated with higher probability of mental health service use in the Latino group. After controlling for all background characteristics and mental health need factors, LEP significantly decreased odds of mental health service use among Latino immigrants. None of the factors including LEP predicted mental health service use among Asian immigrants, who were also the least likely to access such services. LEP was a barrier to mental health service use among Latino immigrants with psychiatric disorders. This study suggests that future approaches to interventions might be well advised to include not only enhancing the availability of bilingual service providers and interpretation services but also increasing awareness of such options for at least Latino immigrants. In addition, further investigation is needed to identify factors that can enhance access to mental health care services among Asians.

  4. Effects of serotonin reuptake inhibitors on aggressive behavior in psychiatrically hospitalized adolescents: results of an open trial.

    PubMed

    Constantino, J N; Liberman, M; Kincaid, M

    1997-01-01

    Low concentrations of the neurotransmitter serotonin and its 5-hydroxyindoleacetic acid metabolite in the central nervous system have been associated with increased aggressive behavior in animals and humans. Controlled clinical trials of serotonin agonists in depressed adults have suggested that aggressive behavior is less likely during treatment with these medications than with placebo, but there have been no previous studies of selective serotonin reuptake inhibitors (SSRIs) and aggression in children. We prospectively followed the course of aggressive behavior in 19 psychiatrically hospitalized adolescents (not selected for aggressiveness) who received open clinical trials of fluoxetine, paroxetine, or sertraline. The patients received standard doses (equivalent to fluoxetine 10-40 mg daily) for a minimum of 5 weeks. The starting dose was 15 +/- 5 mg, and dosages were raised at a mean rate of 5 mg every 4 days up to a mean dose of 25 +/- 10 mg daily. Results from trials of the three SSRIs were clustered because the sample sizes were not sufficient for separate analyses. Overall, there were no statistically meaningful improvements in the level of aggressive behavior, as measured on a modified version of the Overt Aggression Scale, over the course of these patients' SSRI trials. Symptoms of physical aggression toward others or self were manifest in 12 of the 19 patients while on SSRIs. Of the 19 patients, 13 were assessed both on and off SSRIs: verbal aggression (p = 0.04), physical aggression toward objects (p = 0.05), and physical aggression toward self (p < 0.02) occurred significantly more frequently on SSRIs than off; no increase was observed in physical aggression toward others. Patients with the highest baseline aggressivity scores did not show greater improvement during SSRI treatment. Further research is warranted, particularly to explore whether SSRIs may have therapeutic effects on aggression at higher (or lower) doses than were administered in this

  5. Age variation in use of a contraceptive service by adolescents.

    PubMed Central

    Philliber, S G; Namerow, P B; Jones, J E

    1985-01-01

    During the past decade, much has been written about adolescents' use of contraception and their experience of pregnancy. Few researchers, however, have distinguished between the experiences of older and younger adolescents. The purpose of this paper is to provide such a comparison. The data were collected during more than 7,000 visits made by 4,318 patients during almost 5 years of operation of an adolescent contraceptive service in the Washington Heights area of New York City. Characteristics of four groups--14 years and younger, 15-17 years, 18-19 years, and 20-21 years--were examined. The youngest teens initiated sexual intercourse 4 years earlier than the oldest group. Among those 14 or younger, 87 percent had never used contraception, and 9 percent had been pregnant. In the oldest group, more than two-thirds had used a contraceptive method, and three-fifths had already experienced a pregnancy. Results of multivariate analyses indicate that older teens are more likely to come to the clinic for contraception and to be consistent users of the first method of contraception that they select. On the other hand, younger teens are significantly more likely to revisit the clinic and to be pregnant at a second or later visit. PMID:3918321

  6. Health services utilization by school going Omani adolescents and youths with DSM IV mental disorders and barriers to service use

    PubMed Central

    Al Riyami, Asya A; Al Adawi, Samir H; Al Kharusi, Hilal A; Morsi, Magdi M; Jaju, Sanjay S

    2009-01-01

    Background Recent corpus of research suggests that psychiatric disorders amongst adolescents and youths are an emerging global challenge, but there is paucity of studies exploring health services utilization by this age group in Arab region. Aim This study focus on the health services utilization and the barriers among school going adolescents and youths with DSM IV disorders in the country Oman, whose population is predominantly youthful. Methods Representative sample of secondary school Omani adolescents and youths were concurrently interviewed for the (i) presence of DSM IV mental disorders using the face-to-face interview, World Mental Health-Composite International Diagnostic Interview (WMH-CIDI), (ii) tendency for health care utilization and (iii) predictors of utilization with clinical and demographic background. Results The proportions of lifetime cases having ever made treatment contact are low, being 5.2% for any anxiety disorder and 13.2% for any mood disorder category. None of these anxiety cases made treatment contact in the year of onset of the disorder, and the median delay when they eventually made treatment contact is about 14 years. In any mood disorders category only 3.6% made contact within the 1st year of onset with the median delay in initial treatment contact is two years for the Bipolar disorder (broad), four years for Any Mood disorder and nine years for the Major Depressive Disorder group. Male gender is significantly associated with less likelihood of making treatment contact when suffering from Social phobia (p = 0.000), Major Depressive Disorder (p = 0.000) and Bipolar Disorder (p = 0.000). The younger cohorts of 14-16 years and 17-18 years of Social phobic made significantly less lifetime any treatment contact (p = 0.000). The 14-16 year olds were significantly less likely to make lifetime any treatment contact for Bipolar Mood disorder (p = 0.000), while the 17-18 group were 1.5 times more likely to do so. Over past 12 months only

  7. Quality of life in mental health services with a focus on psychiatric rehabilitation practice.

    PubMed

    Gigantesco, Antonella; Giuliani, Massimo

    2011-01-01

    Only recently the interest in the quality of life (QoL) has gained prominence in mental health practice with respect to other medical disciplines, such as oncology or cardiology, perhaps because the QoL measures were considered as tautological and largely overlapping with measures of psychopathology. Moreover, most of the recognized components of QoL represent the main areas of psychiatric intervention. For example, psychological functioning impairment represents the main area of psychotherapeutic and psychopharmacological interventions, social functioning impairment the main area of rehabilitation intervention. In addition, measures of QoL in psychiatric patients may be biased by some aspects of the disease, including impaired evaluation capacity or decreased expectations. Nowadays, QoL issues in relation to mental health care are especially relevant with regard to part of evaluation of treatment outcomes. Suggestions for the choice of the most appropriate QoL instruments for research and routine evaluation in mental health care are given.

  8. Rates of DSM-IV Psychiatric Disorders Among Adolescents in a Large Metropolitan Area

    PubMed Central

    Roberts, Robert E.; Roberts, Catherine Ramsay; Xing, Yun

    2009-01-01

    We present prevalence data for adolescents in a large metropolitan area in the U.S. and the association of DSM-IV diagnoses to functional impairment and selected demographic correlates. We sampled 4,175 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

  9. Rates of DSM-IV psychiatric disorders among adolescents in a large metropolitan area.

    PubMed

    Roberts, Robert E; Roberts, Catherine Ramsay; Xing, Yun

    2007-12-01

    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.

  10. Barriers to Seeking Mental Health Services among Adolescents in Military Families

    PubMed Central

    Becker, Sara J.; Swenson, Rebecca; Esposito-Smythers, Christianne; Cataldo, Andrea; Spirito, Anthony

    2014-01-01

    Military families with adolescents experience high levels of stress associated with parental deployment, but many of these families do not seek or utilize mental health services. The current qualitative study was designed to better understand barriers to mental health treatment experienced by adolescents in military families. Focus groups and individual interviews were conducted with military adolescents (n = 13), military (non-enlisted) parents (n = 12), and mental health service providers who treat adolescents in military families (n = 20). Discussions primarily explored barriers to seeking treatment, with supplemental questions assessing the ideal elements of mental health services for this population. Seven barriers to engaging in mental health services were identified: four internal (confidentiality concerns, stigma, ethic of self-reliance, lack of perceived relevance) and three external (time and effort concerns, logistical concerns, financial concerns). Challenges engaging military adolescents in mental health services are discussed and several recommendations are offered for service providers attempting to work with this population. PMID:25574070

  11. Symptom, Family, and Service Predictors of Children’s Psychiatric Rehospitalization Within One Year of Discharge

    PubMed Central

    BLADER, JOSEPH C.

    2010-01-01

    Objective To investigate predictors of readmission to inpatient psychiatric treatment for children aged 5 to 12 discharged from acute-care hospitalization. Method One hundred nine children were followed for 1 year after discharge from inpatient care. Time to rehospitalization was the outcome of interest. Predictors of readmission, examined via the Cox proportional hazards model, were symptom and family factors assessed at admission, aspects of psychiatric treatment, and demographic variables. Results The Kaplan-Meier rehospitalization risk within 1 year of discharge, taking into account known readmissions and censored observations, was 0.37. Most readmissions (81%) occurred within 90 days of discharge. Four variables contributed simultaneously to predicting readmission risk. More severe conduct problems, harsh parental discipline, and disengaged parent–child relations conferred a higher risk for rehospitalization; these risks were attenuated when parents disclosed higher stress in their parenting roles. Conclusions Findings showed that psychiatric rehospitalization of children is common, most likely in the trimester after discharge, and highly related to both child symptoms and family factors measurable at admission. Results suggest that efforts to improve postdischarge outcomes of children should target the initial period following inpatient care, address vigorously the complex treatment needs of those with severe conduct problems, and aim to improve parent–child relations. PMID:15187804

  12. Association between neighbourhood air pollution concentrations and dispensed medication for psychiatric disorders in a large longitudinal cohort of Swedish children and adolescents

    PubMed Central

    Bråbäck, Lennart; Åström, Daniel Oudin; Strömgren, Magnus; Forsberg, Bertil

    2016-01-01

    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

  13. Perinatal and psychosocial circumstances associated with risk of attempted suicide, non-suicidal self-injury and psychiatric service use. A longitudinal study of young people

    PubMed Central

    2011-01-01

    Background Past studies using large population based datasets link certain perinatal circumstances (birth weight, parity, etc) with mental health outcomes such as suicide, self-harm and psychiatric problems. Problematically, population datasets omit a number of social confounds. The aim of this study is to replicate past research linking perinatal circumstances and mental health (suicidality and use of psychiatric services) and to determine if such associations remain after adjusting for social circumstances. Methods A longitudinal school-based survey of 2157 young people (surveyed at age 11, 13, 15) followed up in early adulthood (age 19). At age 11 parents of participants provided information about perinatal circumstances (birth weight, birth complications, etc.) and psychiatric service use. Participants provided data about their mental health at age 15 (attempted suicide, suicidal thoughts) and at ages 19 (self-harm, psychiatric service use). In addition, data were collected about their social and psychosocial circumstances (gender, deprivation, religion, sexual behaviour, etc.). Results Predictably, social factors were linked to mental health outcomes. For example, those with same sex partners were more likely (OR 4.84) to self-harm than those without a same sex partner. With a single exception, in both unadjusted and adjusted models, perinatal circumstances were not or only marginally associated with mental health outcomes. The exception was the number of birth complications; young people with two or more complications were approximately 2-3 times more likely than those without complications to use psychiatric services. Conclusions While we failed to replicate results found using large population based datasets, some of our results are compatible with prior research findings. Further, evidence from this study supports the influence of perinatal circumstances (birth complications) on later psychiatric problems, or at least higher than expected contact with

  14. Stigma, Social Structure, and the Biomedical Framework: Exploring the Stigma Experiences of Inpatient Service Users in Two Belgian Psychiatric Hospitals.

    PubMed

    Sercu, Charlotte; Bracke, Piet

    2016-05-31

    The study discusses the stigma experiences of service users in mental health care, within the debate on the role of the biomedical framework for mental health care and power relations in society. Interview data of inpatient users (n = 42) and care providers (n = 43) from two Belgian psychiatric hospitals were analyzed using a constructivist grounded theory approach: Findings offer insight into how stigma experiences are affected by social structure. Stigma seemed to be related to the relation between care providers and service users their social position. The concept "mental health literacy" is used to frame this finding. In paying attention to the specific cultural and normative context, which influences the relationship between mental health literacy and stigma, it is further possible to cast some light on the meaning of the biomedical model for the construction and maintenance of power relations in mental health care and broader society.

  15. Do Adolescents Who Regularly Attend Religious Services Stay out of Trouble? Results from a National Sample

    ERIC Educational Resources Information Center

    Salas-Wright, Christopher P.; Lombe, Margaret; Vaughn, Michael G.; Maynard, Brandy R.

    2016-01-01

    The relationship between religious service attendance and adolescent externalizing behavior is well established in the aggregate, but little is known about what behavioral and psychosocial differences may or may not exist among adolescents who regularly attend religious services. Using a nationally representative sample of frequent religious…

  16. Scaling Up Child and Adolescent Mental Health Services in South Africa: Human Resource Requirements and Costs

    ERIC Educational Resources Information Center

    Lund, Crick; Boyce, Gerard; Flisher, Alan J.; Kafaar, Zuhayr; Dawes, Andrew

    2009-01-01

    Background: Children and adolescents with mental health problems have poor service cover in low- and middle-income countries. Little is known about the resources that would be required to provide child and adolescent mental health services (CAMHS) in these countries. The purpose of this study was to calculate the human resources and associated…

  17. "Not in the Middle Ages"?: Alan Garner's "The Owl Service" and the Literature of Adolescence.

    ERIC Educational Resources Information Center

    Hardwick, Paul

    2000-01-01

    Discusses connecting with the Middle Ages in adolescent fiction. Discusses how, in "The Owl Service," Garner addresses a relationship between adolescence in the late twentieth century and an aspect of the past--specifically the Middle Ages. Considers how "The Owl Service" is a story energized by myth, concerning the…

  18. Reflective Team Supervision after a Frightening Event on a Psychiatric Crisis Service

    ERIC Educational Resources Information Center

    Chien, Joseph; Sugar, Jeffrey; Shoemaker, Erica; Pataki, Caroly

    2012-01-01

    Objective: The authors demonstrate the value of reflective team supervision as part of the informal curriculum in an emergency psychiatry setting after a potentially traumatizing adverse event. Method: The article gives a case presentation of a violent adolescent who eloped from his hospital Emergency Department and provides a description of team…

  19. Psychiatric morbidity in a Nigerian paediatric primary care service: a comparison of two screening instruments.

    PubMed

    Omigbodun, O; Gureje, O; Gater, R; Ikuesan, B; Adebayo, E

    1996-06-01

    We evaluated the screening properties of the Children's Behaviour Questionnaire (CBQ) and the Reporting Questionnaire for Children (RQC) in an urban primary care setting in Nigeria. Using various validity indices and the results of Receiver Operating Characteristic analysis, we showed that the two instruments had identical abilities at differentiating children with specific psychiatric disorders from those without. The cut-off threshold for the CBQ in this setting was different from what is commonly reported elsewhere. While the CBQ was able to differentiate between conduct and emotional disorders, the RQC had the advantage of relative brevity.

  20. Integrated Educational and Mental Health Services within a Day Treatment Setting.

    ERIC Educational Resources Information Center

    Francis, Greta; Radka, Dale F.

    This paper discusses the integration of educational and mental health services for children and adolescents within a psychiatric day treatment setting at the Bradley School housed in a private psychiatric hospital affiliated with Brown University in Rhode Island. A full range of mental health services are used, and therapies are delivered in the…

  1. Longitudinal Trajectory of Adolescent Exposure to Community Violence and Depressive Symptoms Among Adolescents and Young Adults: Understanding the Effect of Mental Health Service Usage.

    PubMed

    Chen, Wan-Yi; Corvo, Kenneth; Lee, Yookyong; Hahm, Hyeouk Chris

    2017-01-01

    Research on the impact of exposure to community violence tends to define victimization as a single construct. This study differentiates between direct and indirect violence victimization in their association with mental health problems and mental health service use. This study includes 8947 individuals from four waves of the National Longitudinal Study of Adolescent to Adult Health and examines (1) whether sub-types of adolescent victimization are linked to depressive symptoms; (2) whether adolescent victimization is linked with mental health service use; and (3) the role of mental health service use in attenuating symptoms arising from victimizations. Adolescents witnessing community violence were more likely to experience depressive symptoms during adolescence but not during their young adulthood; direct exposure to violence during adolescence does not predict depressive symptoms in adolescence but does in adulthood. Use of mental health service mediates report of depressive symptoms for adolescent witnessing community violence.

  2. Factors associated with seclusion in a statewide forensic psychiatric service in Australia over a 2-year period.

    PubMed

    Thomas, Stuart D M; Daffern, Michael; Martin, Trish; Ogloff, James R P; Thomson, Lindsay D G; Ferguson, Murray

    2009-02-01

    Despite seclusion being described as one of the most ethically- and legally-controversial management options available, it remains a widely-used clinical strategy for managing disruptive, aggressive, and violent behaviour. This study sought to determine how frequently seclusion was used, the common characteristics of those secluded and not secluded, and the degree to which the Level of Service Inventory - Revised: Screening Version (LSI-R: SV) could predict seclusion. The study was retrospective, covering the first 2 years of operation of a statewide forensic psychiatry hospital in Victoria, Australia. Data were collected from individual case files, electronic databases, and paper copies of records pertaining to violent incidents and episodes of seclusion. Eighty five (44%) of the 193 patients admitted during this period were secluded. Those secluded were significantly younger and had a more established psychiatric history. LSI-R: SV scores were significantly and positively associated with being secluded. A statistical model containing three LSI-R: SV items, along with age on admission and psychiatric history, achieved an area under the curve of 0.74. Seclusion is used on a regular basis in response to a range of different forms of aggressive behaviour of different severity. The LSI-R: SV demonstrated moderate-to-good accuracy in predicting seclusion and warrants further research using detailed prospective methodologies.

  3. A Comparison of Outpatients with Intellectual Disability Receiving Specialised and General Services in Ontario's Psychiatric Hospitals

    ERIC Educational Resources Information Center

    Lunsky, Y.; Gracey, C.; Bradley, E.; Koegl, C.; Durbin, J.

    2011-01-01

    Background: This study compares outpatients with intellectual disability (ID) receiving specialised services to outpatients with ID receiving general services in Ontario's tertiary mental healthcare system in terms of demographics, symptom profile, strengths and resources, and clinical service needs. Methods: A secondary analysis of Colorado…

  4. Psychiatric Disorders Associated with the Onset and Persistence of Bulimia Nervosa and Binge Eating Disorder during Adolescence.

    ERIC Educational Resources Information Center

    Zaider, Talia I.; Johnson, Jeffrey G.; Cockell, Sarah J.

    2002-01-01

    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…

  5. Evolving systems of care: Individuals found not criminally responsible on account of mental disorder in custody of civil and forensic psychiatric services.

    PubMed

    Crocker, A G; Côté, G

    2009-09-01

    Following psychiatric deinstitutionalization and changes in involuntary civil commitment laws, many individuals with severe mental disorders have been receiving mental health services through the back door, that is, the criminal justice system. Significant changes to the section of Criminal Code of Canada dealing with individuals with mental disorders have led to significant annual increases in the number of individuals declared Not criminally responsible on account of mental disorder (NCRMD), many of whom are directed to civil psychiatric settings. The goal of the present study was to describe the psychosociocriminological and risk characteristics of individuals found NCRMD remanded to civil psychiatric hospitals (CPH) compared to a forensic psychiatric hospital (FPH). This study was conducted between October 2004 and August 2006 in the sole FPH of the province of Québec and two large CPH in the Montréal metropolitan area. The final sample for the current study consisted of 96 men: 60 from the FPH and 36 from the two CPH. Results indicate that individuals in both settings have similar psychosociocriminal profiles, including PCL-R scores, but that individuals in CPH have higher scores in the Risk subscale of the HCR-20 than do their counterparts in the FPH. This difference is due to a higher score on two items: exposure to destabilizing factors and noncompliance with remediation attempts. Results are discussed in terms of the need for civil psychiatric settings to implement risk assessment and management programs into their services, and the need for further research into forensic mental health services.

  6. The right location? Experiences of refugee adolescents seen by school-based mental health services.

    PubMed

    Fazel, Mina; Garcia, Jo; Stein, Alan

    2016-07-01

    Access to needed mental health services can be particularly difficult for newly arrived refugee and asylum-seeking adolescents, although many attend school. This study examined young refugees' impressions and experience of mental health services integrated within the school system. Semi-structured interviews were conducted with 40 adolescent refugees discharged by three school-based mental health services across the United Kingdom. Two-thirds preferred to be seen at school. Rumination and worry about insecurity in the asylum process had a negative impact particularly on the adolescents' social functioning and ability to focus at school. The important role played by teachers in supporting and mediating contact with mental health services was valued by those interviewed. The study confirms that schools offer an important location for mental health services for adolescent refugees and provide an important portal for integration of services.

  7. Juvenile Mental Health Courts for Adjudicated Youth: Role Implications for Child and Adolescent Psychiatric Mental Health Nurses

    PubMed Central

    Burriss, F. Antoinette; Breland-Noble, Alfiee M.; Webster, Joe L.; Soto, Jose A.

    2013-01-01

    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

  8. Child and adolescent service experience (ChASE): measuring service quality and therapeutic process.

    PubMed

    Day, Crispin; Michelson, Daniel; Hassan, Imren

    2011-11-01

    OBJECTIVES. Dissatisfaction with services has been associated with poorer child mental health outcomes, early treatment termination as well as disagreements over the nature of mental health difficulties, reasons for referral and therapy goals. The development of straightforward, reliable, and accurate methods of eliciting service users' views is essential within child and adolescent mental health care. This paper describes the development of the child and adolescent service experience (ChASE), a tool to measure children and young people's service experience DESIGN. The study comprises a non-experimental, cross-sectional design. METHODS. Participants were 132 mental health service users aged 8-18 years. Participants and their main carer completed the ChASE, Parent Satisfaction Questionnaire (PSQ) (Stallard, 1996) and Strengths and Difficulties (SDQ) Impact Supplement. Clinicians completed the SDQ Impact Supplement and provided clinical activity data. A sub-sample of participants completed the ChASE on a second occasion, 6 weeks after the completion of the first questionnaire. RESULTS. Scrutiny of ChASE data indicated high levels of completion. Principal axis factoring identified three factors within the ChASE: Relationship, Privacy, and Session Activity. The ChASE has good internal consistency and test-retest reliability. Significant correlations were found between the ChASE and carer satisfaction, service use, and youth clinical outcomes. CONCLUSIONS. The ChASE is a short, psychometrically robust tool for routine measurement of children, and young people's experience of mental health services, which users can complete easily. The results underline the importance of alliance factors to children and young people and their association with clinical improvement as well as the potential for the ChASE to be used a measure of children's therapeutic progress and alliance.

  9. Association of socioeconomic status with psychiatric problems and violent behaviours in a nationally representative sample of Iranian children and adolescents: the CASPIAN-IV study

    PubMed Central

    Heshmat, Ramin; Qorbani, Mostafa; Ghoreshi, Behnaz; Djalalinia, Shirin; Tabatabaie, Omid Reza; Safiri, Saeid; Noroozi, Mehdi; Motlagh, Mohammad-Esmaeil; Ahadi, Zeinab; Asayesh, Hamid; Kelishadi, Roya

    2016-01-01

    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

  10. Tailoring family planning services to the special needs of adolescents.

    PubMed

    Winter, L; Breckenmaker, L C

    1991-01-01

    Experimental service protocols tailored to the needs of teenage family planning patients were developed that emphasized indepth counseling, education geared to an adolescent's level of development, and the provision of reassurance and social support. These protocols were tested against usual service delivery practices in a study involving 1,261 patients under 18 years of age at six nonmetropolitan family planning clinics. A comparison with teenagers obtaining services at control sites found that six months after their first clinic visit, patients at the experimental sites were more likely to be using a method, were less likely to experience difficulty in dealing with problems, were more likely to continue using their method despite problems and had learned more during the educational session. Teenage patients at the experimental clinics were also less likely to have become pregnant within one year than those who went to control clinics. Attrition during the year following the first study visit was similar among both groups; patient satisfaction was very high, and equivalent at experimental and control sites. The data show that the extra time and effort required to meet the special needs of teenagers is justified by their improved contraceptive use, greater knowledge and lower pregnancy rates.

  11. Use of specialty mental health services by Asian Americans with psychiatric disorders.

    PubMed

    Le Meyer, Oanh; Zane, Nolan; Cho, Young Il; Takeuchi, David T

    2009-10-01

    Research suggests that Asian Americans underutilize mental health services but an understanding of the multiple factors involved in utilization has not been examined in a nationally representative sample. The current study analyzed data from the National Latino and Asian American Study (NLAAS) and examined 368 individuals with disorders to understand utilization and what factors were related to the utilization of specialty mental health services. Significant underutilization was found for Asian Americans; moreover, underutilization was especially acute among Asian American immigrants. For U.S.-born Asian Americans, use of primary care services was significantly associated with use of mental health services, but for foreign-born Asian Americans, use of primary care services was unrelated to mental health services use. For both U.S.-born and foreign-born Asian Americans, use of alternative services appeared to significantly affect whether Asian Americans with disorders utilize mental health services, but the nature of the influence varied depending on the individual's level of English-language proficiency. These findings revealed that a major mental health disparity, the underutilization of mental health services by Asian Americans, was nuanced by use of other health-related services and immigration-related factors.

  12. Validation of the Spanish-language version of the Rapid Assessment for Adolescent Preventive Services among Colombian adolescents.

    PubMed

    Suárez-Pinto, Tatiana A; Blanco-Gómez, Argénida; Díaz-Martínez, Luis A

    2016-10-01

    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).

  13. Eradicating Barriers to Mental Health Care Through Integrated Service Models: Contemporary Perspectives for Psychiatric-Mental Health Nurses.

    PubMed

    Ellis, Horace; Alexander, Vinette

    2016-06-01

    There has been renewed, global interest in developing new and transformative models of facilitating access to high-quality, cost-effective, and individually-centered health care for severe mentally-ill (SMI) persons of diverse racial/ethnic, cultural and socioeconomic backgrounds. However, in our present-day health-service delivery systems, scholars have identified layers of barriers to widespread dispersal of well-needed mental health care both nationally and internationally. It is crucial that contemporary models directed at eradicating barriers to mental health services are interdisciplinary in context, design, scope, sequence, and best-practice standards. Contextually, nurses are well-positioned to influence the incorporation and integration of new concepts into operationally interdisciplinary, evidence-based care models with measurable outcomes. The aim of this concept paper is to use the available evidence to contextually explicate how the blended roles of psychiatric mental health (PMH) nursing can be influential in eradicating barriers to care and services for SMI persons through the integrated principles of collaboration, integration and service expansion across health, socioeconomic, and community systems. A large body of literature proposes that any best-practice standards aimed at eliminating barriers to the health care needs of SMI persons require systematic, well-coordinated interdisciplinary partnerships through evidence-based, high-quality, person-centered, and outcome-driven processes. Transforming the conceptual models of collaboration, integration and service expansion could be revolutionary in how care and services are coordinated and dispersed to populations across disadvantaged communities. Building on their longstanding commitment to individual and community care approaches, and their pivotal roles in research, education, leadership, practice, and legislative processes; PMH nurses are well-positioned to be both influential and instrumental in

  14. Service referral for juvenile justice youths: associations with psychiatric disorder and recidivism.

    PubMed

    Hoeve, Machteld; McReynolds, Larkin S; Wasserman, Gail A

    2014-05-01

    Secondary multiple regression analyses related disorder profile, probation officers' mental health/substance use service referrals, and recidivism in 361 juvenile justice youths. Those with externalizing (disruptive behavior or substance use) disorder or substance offenses were most likely to receive service referrals. Substance disordered youths with service referrals had lower recidivism risk compared to counterparts without referrals; referral lowered the recidivism odds to approximately that for youths without a substance use disorder. Providing juvenile justice youths with systematic mental health assessment and linking those with substance use disorder to mental health and substance use services likely reduces recidivism risk.

  15. Bibliometric assessment of publication output of child and adolescent psychiatric/psychological affiliations between 2005 and 2010 based on the databases PubMed and Scopus.

    PubMed

    Albayrak, Ozgür; Föcker, Manuel; Wibker, Katrin; Hebebrand, Johannes

    2012-06-01

    We aimed to determine the quantitative scientific publication output of child and adolescent psychiatric/psychological affiliations during 2005-2010 by country based on both, "PubMed" and "Scopus" and performed a bibliometric qualitative evaluation for 2009 using "PubMed". We performed our search by affiliation related to child and adolescent psychiatric/psychological institutions using "PubMed". For the quantitative analysis for 2005-2010, we counted the number of abstracts. For the qualitative analysis for 2009 we derived the impact factor of each abstract's journal from "Journal Citation Reports". We related total impact factor scores to the gross domestic product (GDP) and population size of each country. Additionally, we used "Scopus" to determine the number of abstracts for each country that was identified via "PubMed" for 2009 and compared the ranking of countries between the two databases. 61 % of the publications between 2005 and 2010 originated from European countries and 26 % from the USA. After adjustment for GDP and population size, the ranking positions changed in favor of smaller European countries with a population size of less than 20 million inhabitants. The ranking of countries for the count of articles in 2009 as derived from "Scopus" was similar to that identified via the "PubMed" search. The performed search revealed only minor differences between "Scopus" and "PubMed" related to the ranking of countries. Our data indicate a sharp difference between countries with a high versus low GDP with regard to scientific publication output in child and adolescent psychiatry/psychology.

  16. Challenges to Improve Inter-Professional Care and Service Collaboration for People Living With Psychiatric Disabilities in Ordinary Housing

    PubMed Central

    Ainalem, Ingrid; Berg, Agneta; Janlöv, Ann-Christin

    2016-01-01

    The aim of this study was to describe health care- and social service professionals' experiences of a quality-improvement program implemented in the south of Sweden. The focus of the program was to develop inter-professional collaboration to improve care and service to people with psychiatric disabilities in ordinary housing. Focus group interviews and a thematic analysis were used. The result was captured as themes along steps in process. (I) Entering the quality-improvement program: Lack of information about the program, The challenge of getting started, and Approaching the resources reluctantly. (II) Doing the practice-based improvement work: Facing unprepared workplaces, and Doing twice the work. (III) Looking back—evaluation over 1 year: Balancing theoretical knowledge with practical training, and Considering profound knowledge as an integral part of work. The improvement process in clinical practice was found to be both time and energy consuming, yet worth the effort. The findings also indicate that collaboration across organizational boundaries was broadened, and the care and service delivery were improved. PMID:26783867

  17. A PROJECT DEMONSTRATING THE EFFECTIVENESS OF VOCATIONAL REHABILITATION SERVICES IN A TOTAL PSYCHIATRIC CARE PROGRAM.

    ERIC Educational Resources Information Center

    Georgia State Board of Health, Atlanta.

    A COOPERATIVE PROGRAM OFFERED A COMPLETE RANGE OF INTEGRATED MEDICAL, PSYCHOLOGICAL, SOCIAL, AND VOCATIONAL SERVICES TO REINTEGRATE MENTAL PATIENTS INTO THE LIFE OF THE COMMUNITY. THE PROGRAM PROPOSED TO DEMONSTRATE THE EFFECTIVENESS OF CERTAIN REHABILITATION PROCEDURES TO EXTEND AND IMPROVE REHABILITATION SERVICES, AND TO ESTABLISH EFFECTIVE…

  18. A Comparison of Patients with Intellectual Disability Receiving Specialised and General Services in Ontario's Psychiatric Hospitals

    ERIC Educational Resources Information Center

    Lunsky, Y.; Bradley, E.; Durbin, J.; Koegl, C.

    2008-01-01

    Background: Over the years, the closure of institutions has meant that individuals with intellectual disabilities (IDs) must access mainstream (i.e. general) mental health services. However, concern that general services may not adequately meet the needs of patients with ID and mental illness has led to the development and implementation of more…

  19. Integration of a Psychiatric Service in a Long-Term Charitable Facility for People with Intellectual Disabilities: A 5-Year Medication Survey

    ERIC Educational Resources Information Center

    Ruggerini, Ciro; Guaraldi, Gian Paolo; Russo, Angela; Neviani, Vittoria; Castagnini, Augusto

    2004-01-01

    Since the implementation of a psychiatric service in a long-term facility for people with intellectual disability, the usage of psychotropic and anti-convulsant drugs has been surveyed over the 5-year period 1994-1999. At that time, although the overall prevalence rate of residents on medication was not declining significantly, a decrease in…

  20. Cannabis and psychiatric disorders.

    PubMed

    Loga, Slobodan; Loga-Zec, Svjetlana; Spremo, Mira

    2010-06-01

    There are connection between use of cannabis and many psychiatric disturbances in adolescents, especially "cannabis psychosis", depression, panic attacks and suicide. Negative effects could occur either as a result of a specific pharmacological effect of cannabis, or as the result of stressful experiences during the intoxication of cannabis in young people. Potentially is very dangerous high frequency suicidal ideation among cannabis users.

  1. Serving the Cyberteen: Library Service for the 21st Century Adolescent.

    ERIC Educational Resources Information Center

    Amey, Larry; Elliott, Stephen

    1997-01-01

    Arguing that today's youth yearns for initiation into adult society, this article examines visions of the future of adolescence in Western Society by contrasting the films "Star Trek" and "Blade Runner," and questions the role of information technology. Discusses library services for adolescents and the role of librarians as…

  2. Children's Views Matter Too! A Pilot Project Assessing Children's and Adolescents' Experiences of Clinical Psychology Services

    ERIC Educational Resources Information Center

    Gordon, Michael; Russo, Kate

    2009-01-01

    This pilot study explored the experiences and understanding of clinical psychology practices and services of children and adolescents attending clinical psychology outpatient appointments. Fifteen young participants took part in the study. A content analysis indicated that young children and adolescents have an appropriate understanding of the…

  3. Mental Health Needs in Adolescents with Intellectual Disabilities: Cross-Sectional Survey of a Service Sample

    ERIC Educational Resources Information Center

    Hassiotis, A.; Turk, J.

    2012-01-01

    Background: Little research has been conducted on the mental health needs of adolescents with intellectual disability, despite the severity and rates of such needs being high throughout childhood and in adulthood. We have investigated the prevalence and predictors of mental health needs and service use in adolescents with intellectual…

  4. Rural Adolescent Health: The Importance of Prevention Services in the Rural Community

    ERIC Educational Resources Information Center

    Curtis, Alexa C.; Waters, Catherine M.; Brindis, Claire

    2011-01-01

    Context: Adolescence is a pivotal developmental period for the establishment of positive health and health practices. However, developmentally propelled risk behaviors coinciding with barriers to health services may increase the propensity for untoward health outcomes in adolescence. In addition, the sociocultural context of the rural environment…

  5. Availability of Reproductive Health Care Services at Schools and Subsequent Birth Outcomes among Adolescent Mothers

    ERIC Educational Resources Information Center

    Madkour, Aubrey S.; Xie, Yiqiong; Harville, Emily W.

    2016-01-01

    Background: Adverse birth outcomes are more common among adolescent versus adult mothers, but little is known about school-based services that may improve birth outcomes in this group. Methods: Data from Waves I and IV of the National Longitudinal Study of Adolescent Health were analyzed. Girls and women who gave birth to singleton live infants…

  6. Ethnicity and Adolescent Depression: Prevalence, Access to Services, and Promising Interventions

    ERIC Educational Resources Information Center

    Wagstaff, Amanda E.; Polo, Antonio J.

    2012-01-01

    Depression is more common among adolescents of ethnic minority backgrounds, who also are less likely to receive professional help. This article presents information about prevalence of depression and service use across ethnic groups, and then outlines several promising intervention programs that are designed for adolescents suffering from…

  7. Predictors of Service Disengagement in First-Admitted Adolescents with Psychosis

    ERIC Educational Resources Information Center

    Schimmelmann, Benno Graf; Conus, Philippe; Schacht, Melanie; McGorry, Patrick; Lambert, Martin

    2006-01-01

    Objective: To assess the risk and predictors of service disengagement in adolescents with first-episode psychosis (FEP) receiving their first treatment in a long-standing early intervention and prevention centre. Method: The Early Psychosis Prevention and Intervention Centre (EPPIC) in Australia admitted 157 adolescents, ages 15 to 18, with FEP…

  8. Racial/Ethnic Differences in Mental Health Service Use among Adolescents with Major Depression

    ERIC Educational Resources Information Center

    Cummings, Janet R.; Druss, Benjamin G.

    2011-01-01

    Objective: Little is known about racial/ethnic differences in the receipt of treatment for major depression in adolescents. This study examined differences in mental health service use in non-Hispanic white, black, Hispanic, and Asian adolescents who experienced an episode of major depression. Method: Five years of data (2004-2008) were pooled…

  9. American Psychiatric Association: Position Statement on Firearm Access, Acts of Violence and the Relationship to Mental Illness and Mental Health Services.

    PubMed

    Pinals, Debra A; Appelbaum, Paul S; Bonnie, Richard; Fisher, Carl E; Gold, Liza H; Lee, Li-Wen

    2015-06-01

    The American Psychiatric Association, ("APA"), with more than 36,000 members at present, is the Nation's leading organization of physicians who specialize in psychiatry. APA provides for education and advocacy and develops policy through Position Statements. It promotes enhanced knowledge of particular topics relevant to psychiatric practice and patient care through Resource Documents. Since 1993, the APA has developed various positions and resource materials related to firearms and mental illness, incorporating evolving themes as new issues emerge. This paper reflects the APA's 2014 Position Statement on Firearm Access, Acts of Violence and the Relationship to Mental Illness and Mental Health Services.

  10. Medication Adherence, Work Performance and Self-Esteem among Psychiatric Patients Attending Psychosocial Rehabilitation Services at Bangalore, India

    PubMed Central

    Gandhi, Sailaxmi; Pavalur, Rajitha; Thanapal, Sivakumar; Parathasarathy, Nirmala B.; Desai, Geetha; Bhola, Poornima; Philip, Mariamma; Chaturvedi, Santosh K.

    2014-01-01

    Context: Work benefits mental health in innumerable ways. Vocational rehabilitation can enhance self-esteem. Medication adherence can improve work performance and thereby the individuals’ self-esteem. Aim: To test the hypothesis that there would be a significant correlation between medication adherence, work performance and self-esteem. Setting and Design: A quantitative, descriptive correlational research design was adopted to invite patients attending psychiatric rehabilitation services to participate in the research. Material and Methods: Data was collected from a convenience sample of 60 subjects using the ‘Medication Adherence Rating scale’, ‘Griffiths work behaviour scale’ and the ‘Rosenberg's Self-esteem scale’. Statistical analysis used: Analysis was done using spss18 with descriptive statistics, Pearsons correlation coefficient and multiple regression analysis. Results: There were 36 males and 24 females who participated in this study. The subjects had good mean medication adherence of 8.4 ± 1.5 with median of 9.00, high mean self-esteem of 17.65 ± 2.97 with median of 18.0 and good mean work performance of 88.62 ± 22.56 with median of 93.0. Although weak and not significant, there was a positive correlation (r = 0.22, P = 0.103) between medication adherence and work performance; positive correlation between (r = 0.25, P = 0.067) medication adherence and self–esteem; positive correlation between (r = 0.136, P = 0.299) work performance and self-esteem. Multiple regression analysis showed no significant predictors for medication adherence, work performance and self-esteem among patients with psychiatric illness. Conclusions: Medication monitoring and strengthening of work habit can improve self-esteem thereby, strengthening hope of recovery from illness. PMID:25336771

  11. Body Dysmorphic Disorder and Other Clinically Significant Body Image Concerns in Adolescent Psychiatric Inpatients: Prevalence and Clinical Characteristics

    ERIC Educational Resources Information Center

    Dyl, Jennifer; Kittler, Jennifer; Phillips, Katharine A.; Hunt, Jeffrey I.

    2006-01-01

    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.…

  12. Psychometric Properties of the Resiliency Scales for Children and Adolescents and Use for Youth with Psychiatric Disorders

    ERIC Educational Resources Information Center

    Prince-Embury, Sandra

    2010-01-01

    This study examines psychometric properties of the Resiliency Scales for Children and Adolescents (RSCA) in two clinical samples: one child sample (n = 110) and one adolescent sample (n = 178). The purpose of the study was to examine the distribution characteristics and internal consistency of RSCA scale, subscale, and index scores for youth who…

  13. The Child-Adolescent Perfectionism Scale: Development, Psychometric Properties, and Associations With Stress, Distress, and Psychiatric Symptoms

    ERIC Educational Resources Information Center

    Flett, Gordon L.; Hewitt, Paul L.; Besser, Avi; Su, Chang; Vaillancourt, Tracy; Boucher, Daniel; Munro, Yvette; Davidson, Lisa A.; Gale, Olga

    2016-01-01

    There is growing interest in perfectionism among children and adolescents as well as growing interest in the measures designed to assess perfectionism in young people. The current article describes the development and psychometric characteristics of the Child-Adolescent Perfectionism Scale (CAPS), a measure that assesses self-oriented…

  14. Pathways into and through Mental Health Services for Children and Adolescents.

    ERIC Educational Resources Information Center

    Farmer, Elizabeth M. Z.; Burns, Barbara J.; Phillips, Susan D.; Angold, Adrian; Costello, E. Jane

    2003-01-01

    Examined points of entry into mental health service system for children and adolescents and patterns of movement through five service sectors (specialty mental health services, education, general medicine, juvenile justice, child welfare). Education sector plays central role as point of entry. Interagency collaboration among education, specialty…

  15. 42 CFR 424.13 - Requirements for inpatient services of hospitals other than inpatient psychiatric facilities.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...) The reasons for either— (i) Hospitalization of the patient for inpatient medical treatment or medically required inpatient diagnostic study; or (ii) Special or unusual services for cost outlier cases... treatment in a SNF but no bed is available in a participating SNF. (2) If this is the basis for...

  16. 42 CFR 424.13 - Requirements for inpatient services of hospitals other than psychiatric hospitals.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... patient for medical treatment or medically required inpatient diagnostic study; or (ii) Special or unusual services for cost outlier cases (under the prospective payment system set forth in subpart F of part 412 of... physician finds that the patient could receive proper treatment in a SNF but no bed is available in...

  17. 42 CFR 424.13 - Requirements for inpatient services of hospitals other than psychiatric hospitals.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... of the patient for medical treatment or medically required inpatient diagnostic study; or (ii) Special or unusual services for cost outlier cases (under the prospective payment system set forth in... hospitalization if the physician finds that the patient could receive proper treatment in a SNF but no bed...

  18. 42 CFR 424.13 - Requirements for inpatient services of hospitals other than psychiatric hospitals.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... patient for medical treatment or medically required inpatient diagnostic study; or (ii) Special or unusual services for cost outlier cases (under the prospective payment system set forth in subpart F of part 412 of... physician finds that the patient could receive proper treatment in a SNF but no bed is available in...

  19. 42 CFR 424.13 - Requirements for inpatient services of hospitals other than inpatient psychiatric facilities.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...) The reasons for either— (i) Hospitalization of the patient for inpatient medical treatment or medically required inpatient diagnostic study; or (ii) Special or unusual services for cost outlier cases... treatment in a SNF but no bed is available in a participating SNF. (2) If this is the basis for...

  20. Priority mental health disorders of children and adolescents in primary-care pediatric setting in India 1: developing a child and adolescent mental health policy, program, and service model.

    PubMed

    Russell, P S; Mammen, P; Nair, M K C; Russell, Sushila; Shankar, S R

    2012-01-01

    India has a huge child and adolescent population. Psychiatric disorders are widely prevalent and the mental health needs of these children are well recognized. Nonetheless, there are no country-centric and child specific mental health policies, plans or programs. There is also a significant lack of human resources for child and adolescent mental health in India. This combination of factors makes the primary care a critical setting for the early identification, treatment, consultation and referral of children and adolescents with mental health and developmental needs. Even though the importance of primary care as a system for addressing the mental health care has been recognized for decades, its potential requires further development in India as the Child and Adolescent Mental Health Services (CAMHS) emerge and evolve. A country and child specific mental health policy, plan and program needs to be formulated as well an integrated, multi-tier CAMHS with a focus on the primary-care physicians as care providers for this population has to be developed.

  1. ICD-10 mental and behavioural disorders due to use of crack and powder cocaine as treated at a public psychiatric emergency service: an analysis of visit predictors.

    PubMed

    da Cruz, Thalita Alves; da Cunha, Gustavo Nunes; de Moraes, Vinicius Papa Milani; Massarini, Renata; Yoshida, Camila Mie Kawata; Tenguam, Patrícia Tomiatto; Garcia, Marcelo Valeiro; Varoto, Daniela Arruda; de Oliveira, Murilo Barutti; de Andrade, Arthur Guerra; de Azevedo-Marques Périco, Cíntia; do Nascimento, Vania Barbosa; Castaldelli-Maia, João Mauricio

    2014-08-01

    The present study investigated the predictors of an increased number of visits from individuals with some of the diagnoses noted in chapter F14 of ICD-10, from calls to the emergency psychiatric unit of a general hospital in São Paulo state, Brazil, in the period 2011-2012. Poisson regression models were carried out for the outcome variable, accounting for number of subsequent visits to the psychiatric emergency unit. For the analysis of this outcome we took into account the exposure time of each individual in the study. Our findings point to a population at risk for frequent psychiatric emergency service visits: individuals over 25 years. This population should be targeted for interventions on entry into public healthcare due to increased psychiatric morbidity and greater clinical morbidity already confirmed by previous studies. We discussed the need of these individuals for special attention during the clinical or psychiatric emergency consultation which, unfortunately, may be the access point for the public health system. None of the other variables were related to the outcome of interest, such as those related to the level of individual entry into the care network before and after treatment, and other variables related to medical acts during the visit.

  2. [The psychiatric hospital circuit: the trajectories of young people prior to psychiatric hospitalization].

    PubMed

    Scisleski, Andrea Cristina Coelho; Maraschin, Cleci; Silva, Rosane Neves da

    2008-02-01

    This article analyzes psychiatric hospitalization of young patients from a contemporary social-subjective (rather than a psychopathological) perspective, following the trajectory of these youth prior to their admission. The study was conducted at the Center for Comprehensive Psychosocial Care for Children and Adolescents, São Pedro Psychiatric Hospital, in the city of Porto Alegre, Rio Grande do Sul State, Brazil. Recurrent traits in the trajectory of these youth expressed how the health care network functioned with them prior to their hospitalization, with a consistent pattern of socioeconomic deprivation, low schooling, and drug use. Another key aspect was the role of the court system in referring them for hospitalization, adhering to a kind of logic that punished both the youth and the services and paradoxically formed a strategy for access to health services.

  3. Attenuated psychotic and basic symptom characteristics in adolescents with ultra-high risk criteria for psychosis, other non-psychotic psychiatric disorders and early-onset psychosis.

    PubMed

    Lo Cascio, Nella; Saba, Riccardo; Hauser, Marta; Vernal, Ditte Lammers; Al-Jadiri, Aseel; Borenstein, Yehonatan; Sheridan, Eva M; Kishimoto, Taishiro; Armando, Marco; Vicari, Stefano; Fiori Nastro, Paolo; Girardi, Paolo; Gebhardt, Eva; Kane, John M; Auther, Andrea; Carrión, Ricardo E; Cornblatt, Barbara A; Schimmelmann, Benno G; Schultze-Lutter, Frauke; Correll, Christoph U

    2016-10-01

    While attenuated psychotic symptoms (APS) and basic symptoms (BS) are the main current predictors of psychosis in adults, studies in adolescents are scarce. Thus, we (1) described the prevalence and severity of positive, negative, disorganization, general, and basic symptoms in adolescent patients at ultra-high risk for psychosis (UHR), with other non-psychotic psychiatric disorders (PC) and with early-onset psychosis (EOP); and (2) investigated BS criteria in relation to UHR criteria. Sixty-nine 12-18-year-old adolescents (15.3 ± 1.7 years, female = 58.0 %, UHR = 22, PC = 27, EOP = 20) were assessed with the structured interview for prodromal syndromes (SIPS) and the schizophrenia proneness instrument-child and youth version (SPI-CY). Despite similar current and past 12-month global functioning, both UHR and EOP had significantly higher SIPS total and subscale scores compared to PC, with moderate-large effect sizes. Expectedly, UHR had significantly lower SIPS positive symptom scores than EOP, but similar SIPS negative, disorganized, and general symptom scores. Compared to PC, both EOP and UHR had more severe basic thought and perception disturbances, and significantly more often met cognitive disturbances criteria (EOP = 50.0 %, UHR = 40.9 %, PC = 14.8 %). Compared to UHR, both EOP and PC significantly less often met cognitive-perceptive BS criteria (EOP = 35.0 %, UHR = 68.2 %, PC = 25.9 %). BS were significantly more prevalent in both EOP and UHR than PC, and UHR were similar to EOP in symptom domains. Given the uncertain outcome of adolescents at clinical high-risk of psychosis, future research is needed to determine whether the combined assessment of early subjective disturbances with observable APS can improve the accuracy of psychosis prediction.

  4. Child and adolescent psychiatric nursing and the 'plastic man': reflections on the implementation of change drawing insights from Lewin's theory of planned change.

    PubMed

    McGarry, Denise; Cashin, Andrew; Fowler, Cathrine

    2012-06-01

    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.

  5. Practice parameter for the prevention and management of aggressive behavior in child and adolescent psychiatric institutions, with special reference to seclusion and restraint.

    PubMed

    Masters, Kim J; Bellonci, Christopher; Bernet, William; Arnold, Valerie; Beitchman, Joseph; Benson, R Scott; Bukstein, Oscar; Kinlan, Joan; McClellan, Jon; Rue, David; Shaw, Jon A; Stock, Saundra

    2002-02-01

    This parameter reviews the current state of the prevention and management of child and adolescent aggressive behavior in psychiatric institutions, with particular reference to the indications and use of seclusion and restraint. It also presents guidelines that have been developed in response to professional, regulatory, and public concern about the use of restrictive interventions with aggressive patients with regard to personal safety and patient rights. The literature on the use of seclusion, physical restraint, mechanical restraint, and chemical restraint is reviewed, and procedures for carrying out each of these interventions are described. Clinical and regulatory agency perspectives on these interventions are presented. Effectiveness, indications, contraindications, complications, and adverse effects of seclusion and restraint procedures are addressed. Interventions are presented to provide more opportunities to promote patient independence and satisfaction with treatment while diminishing the necessity of using restrictive procedures.

  6. Summary of the practice parameter for the prevention and management of aggressive behavior in child and adolescent psychiatric institutions with special reference to seclusion and restraint.

    PubMed

    Masters, K J; Bellonci, C; Bernet, W; Arnold, V; Beitchman, J; Benson, S; Bukstein, O; Kinlan, J; McClellan, J; Rue, D; Shaw, J A; Stock, S; Kroeger, K

    2001-11-01

    This parameter reviews the current state of the prevention and management of child and adolescent aggressive behavior in psychiatric institutions, with particular reference to the indications and use of seclusion and restraint. It also presents guidelines that have been developed in response to professional, regulatory, and public concern about the use of restrictive interventions with aggressive patients with regard to personal safety and patient rights. The literature on the use of seclusion, physical restraint, mechanical restraint, and chemical restraint is reviewed, and procedures for carrying out each of these interventions are described. Clinical and regulatory agency perspectives on these interventions are presented. Effectiveness, indications, contraindications, complications, and adverse effects of seclusion and restraint procedures are addressed. Interventions are presented to provide more opportunities to promote patient independence and satisfaction with treatment while diminishing the necessity of using restrictive procedures.

  7. Does Familiarity Breed Complacency? HIV Knowledge, Personal Contact, and Sexual Risk Behavior of Psychiatrically Referred Latino Adolescent Girls.

    ERIC Educational Resources Information Center

    Dudley, Cheryl; O'Sullivan, Lucia F.; Moreau, Donna

    2002-01-01

    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…

  8. Problems in Differentiating Sexually from Nonsexually Abused Adolescent Psychiatric Inpatients by Self-Reported Anxiety, Depression, Internalization, and Externalization.

    ERIC Educational Resources Information Center

    Kumar, Geetha; And Others

    1996-01-01

    Several measures of psychopathology were administered to 111 psychiatric inpatients (ages 13 to 17) including 46 patients who reported sexually abusive experiences. None of the scales was correlated with sexual abuse in either sex, and a history of physical abuse was the only characteristic that significantly correlated with sexual abuse for both…

  9. The psychiatric hospital and its place in a mental health service

    PubMed Central

    Tooth, Geoffrey

    1958-01-01

    Modern methods of treatment of mental disease enable the average length of stay in hospital to be drastically reduced. The former overcrowding is therefore disappearing; in fact, it should be possible to contemplate a reduction in the size of the hospitals, particularly if new admissions are kept to a minimum by the provision of efficient out-patient clinics and of adequate geriatric and domiciliary nursing services. Taking recent trends in England and Wales as his starting point, the author outlines ways in which a modern mental health service might be built up around existing facilities under a variety of conditions. He advocates that, as far as possible, the treatment of mental disease should be integrated into general medicine, and emphasises the need for close co-operation between psychiatrists, family doctors, and the staff of general hospitals. PMID:13585081

  10. Improving access to competitive employment for service users in forensic psychiatric units.

    PubMed

    Beck, Charlotte; Wernham, Connie

    2014-01-01

    Employment has been proven to be an effective recovery tool and therapeutic intervention for those with severe and enduring mental health conditions. Aside from monetary reward, employment is a means of structuring time and provides a sense of worth and achievement, which enhances self-esteem and confidence. A social identity is developed through employment, encouraging social support and increasing social networks. Securing employment can bring about improved quality of life and positive change in one's social circumstances; therefore it can reduce symptoms associated with mental illness and potentially prevent re-offending, as the individual develops a sense of independence, self-efficacy, and value. Barriers to employment exist for forensic mental health service users and therefore it is imperative that employment needs are addressed at the earliest possible stage in recovery. An evaluation of employment activities across two forensic mental health units revealed a lack of appropriate employment opportunities for service users, and those roles available were not implemented in line with recommended best practice. In response to this issue several enterprises were established to offer opportunities for service users to engage in meaningful employment and develop skills that a future employer would value. Each enterprise responds to a business need within the units to ensure sustainability of services. The enterprises are essentially micro-businesses with social objectives whose surpluses are reinvested for the purpose of increasing opportunities for service users. The enterprises are underpinned by the philosophy of the Individual Placement and Support (IPS) model; empirical evidence suggests that the IPS model is the most effective intervention, based on the 'place then train' philosophy. The model recommends a focus upon rapid job search to achieve competitive employment for those who want to work; opportunities sourced should be consistent with individual

  11. Improving access to competitive employment for service users in forensic psychiatric units

    PubMed Central

    Beck, Charlotte; Wernham, Connie

    2014-01-01

    Employment has been proven to be an effective recovery tool and therapeutic intervention for those with severe and enduring mental health conditions. Aside from monetary reward, employment is a means of structuring time and provides a sense of worth and achievement, which enhances self-esteem and confidence. A social identity is developed through employment, encouraging social support and increasing social networks. Securing employment can bring about improved quality of life and positive change in one's social circumstances; therefore it can reduce symptoms associated with mental illness and potentially prevent re-offending, as the individual develops a sense of independence, self-efficacy, and value. Barriers to employment exist for forensic mental health service users and therefore it is imperative that employment needs are addressed at the earliest possible stage in recovery. An evaluation of employment activities across two forensic mental health units revealed a lack of appropriate employment opportunities for service users, and those roles available were not implemented in line with recommended best practice. In response to this issue several enterprises were established to offer opportunities for service users to engage in meaningful employment and develop skills that a future employer would value. Each enterprise responds to a business need within the units to ensure sustainability of services. The enterprises are essentially micro-businesses with social objectives whose surpluses are reinvested for the purpose of increasing opportunities for service users. The enterprises are underpinned by the philosophy of the Individual Placement and Support (IPS) model; empirical evidence suggests that the IPS model is the most effective intervention, based on the ‘place then train’ philosophy. The model recommends a focus upon rapid job search to achieve competitive employment for those who want to work; opportunities sourced should be consistent with individual

  12. Adolescents' Use of School-Based Health Clinics for Reproductive Health Services: Data from the National Longitudinal Study of Adolescent Health.

    ERIC Educational Resources Information Center

    Crosby, Richard A.; St. Lawrence, Janet

    2000-01-01

    Describes adolescents' use of school-based health clinics (SBCs) for family planning and sexually transmitted disease (STD)-related services, using data from the National Longitudinal Study of Adolescent Health. Results indicated that 13 percent received family planning and 8.9 percent received STD-related services from SBCs. Factors affecting the…

  13. Crisis Reliability Indicators Supporting Emergency Services (CRISES): A Framework for Developing Performance Measures for Behavioral Health Crisis and Psychiatric Emergency Programs.

    PubMed

    Balfour, Margaret E; Tanner, Kathleen; Jurica, Paul J; Rhoads, Richard; Carson, Chris A

    2016-01-01

    Crisis and emergency psychiatric services are an integral part of the healthcare system, yet there are no standardized measures for programs providing these services. We developed the Crisis Reliability Indicators Supporting Emergency Services (CRISES) framework to create measures that inform internal performance improvement initiatives and allow comparison across programs. The framework consists of two components-the CRISES domains (timely, safe, accessible, least-restrictive, effective, consumer/family centered, and partnership) and the measures supporting each domain. The CRISES framework provides a foundation for development of standardized measures for the crisis field. This will become increasingly important as pay-for-performance initiatives expand with healthcare reform.

  14. Quality of life of caregivers with relatives suffering from mental illness in Hong Kong: roles of caregiver characteristics, caregiving burdens, and satisfaction with psychiatric services

    PubMed Central

    2012-01-01

    Background The study attempted to explore the quality of life (QoL) of Chinese caregivers with mentally ill relatives. It also aimed to examine the differential roles of caregiving burdens, caregiver characteristics, and satisfaction with psychiatric services in caregivers' QoL. Methods 276 caregivers with relatives attending community psychiatric facilities in Hong Kong were invited to fill out a questionnaire. One sample t-tests were conducted to compare the results of this study with that of other Chinese populations in Hong Kong, Taiwan, and mainland China. A hierarchical regression analysis was performed to examine the relative influence of different factors on caregivers' QoL. Results Our sample of caregivers had significantly lower QoL scores than other Chinese populations. Results also suggest that Chinese caregivers who had chronic illness, younger in age, a lower education level, experienced more difficulties in handling negative symptoms, and were more dissatisfied with mental health services had poorer quality of life. Indeed, caregiver characteristics displayed a much stronger association with caregivers' QoL than did caregiving burdens and satisfaction with psychiatric services. Conclusions This study supports the strong association of caregiver characteristics and the QoL of caregivers and establishes the nature of the relationship between satisfaction with mental health services and caregiver QoL. Implications for future research and practice are discussed. PMID:22289443

  15. Predictors of valued everyday occupations, empowerment and satisfaction in day centres: implications for services for persons with psychiatric disabilities.

    PubMed

    Eklund, Mona; Sandlund, Mikael

    2014-09-01

    This study addresses predictors of occupational value, empowerment and satisfaction with the rehabilitation received in day centres for people with psychiatric disabilities. These outcomes represent varying aspects of relevance for the day centre context and together create a manifold outcome picture. This was a longitudinal study with approval from the regional research vetting board. Self-report instruments were used, and the investigated predictors motivation for going to the day centre, occupational engagement, socio-demographic factors and self-reported diagnosis. Attendees (N = 108) at 8 day centres participated and filled in self-report questionnaires regarding the predictor and outcome variables. A baseline measurement and a 14-month follow-up composed the data. Occupational engagement at baseline could predict all three outcomes at the follow-up. Motivation for the day centre activities and not preferring work before attending the day centre were positive for satisfaction with the day centre. A low participation rate, although comparable with previous studies on the target group, was a limitation of this study. To conclude, both occupational engagement and motivation are factors that can be stimulated by the staff in day centres. Actions for how to accomplish that, and thereby also more positive outcomes of the day centre services, are proposed, such as a system of freedom of choice among day centres, and between day centres and supported employment.

  16. Perceptions of Early Intervention Services: Adolescent and Adult Mothers in Two States

    ERIC Educational Resources Information Center

    Thompson, Stacy D.; Bruns, Deborah A.

    2013-01-01

    Early intervention (EI) provides critical services to families with young children who have diagnosed disabilities, developmental delays, or who are at-risk for developmental delays. Very little is known about the experiences of adolescent mothers who have children who qualify for EI services. The authors investigated the perceptions of adolescent…

  17. Reliability of the Services for Children and Adolescents-Parent Interview.

    ERIC Educational Resources Information Center

    Hoagwood, Kimberly Eaton; Jensen, Peter S.; Arnold, L. Eugene; Roper, Margaret; Severe, Joanne; Odbert, Carol; Molina, Brooke S.G.

    2004-01-01

    Objective: To describe the psychometric properties and test the reliability of a new instrument designed to measure mental health services use within pediatric clinical samples, the Services for Children and Adolescents-Parent Interview (SCAPI), which was developed by the National Institute of Mental Health Multimodal Treatment Study of Children…

  18. [Factors influencing the course and duration of inpatient child and adolescent psychiatric treatment: between empiricism and clinical reality].

    PubMed

    Branik, Emil

    2003-09-01

    In the last two decades considerable changes influenced the scope of inpatient treatment in child and adolescent psychiatry. Proceeding from a literature review dilemmas between available research data and clinical practice will be pointed out. Proposals will be made to take into account the complex developmental processes, the individuality and the social context by psychic impaired children and adolescents requiring hospitalisation. This could improve the transfer of research findings into the clinical practice. It will be argued against a confusion of economical interests with research findings.

  19. The National Center on Indigenous Hawaiian Behavioral Health Study of Prevalence of Psychiatric Disorders in Native Hawaiian Adolescents

    ERIC Educational Resources Information Center

    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.

    2006-01-01

    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…

  20. A One-Session Human Immunodeficiency Virus Risk-Reduction Intervention in Adolescents with Psychiatric and Substance Use Disorders

    ERIC Educational Resources Information Center

    Thurstone, Christian; Riggs, Paula D.; Klein, Constance; Mikulich-Gilbertson, Susan K.

    2007-01-01

    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…

  1. 42 CFR 441.152 - Certification of need for services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... SERVICES Inpatient Psychiatric Services for Individuals Under Age 21 in Psychiatric Facilities or Programs...) Proper treatment of the beneficiary's psychiatric condition requires services on an inpatient basis...

  2. 42 CFR 441.152 - Certification of need for services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... SERVICES Inpatient Psychiatric Services for Individuals Under Age 21 in Psychiatric Facilities or Programs...) Proper treatment of the beneficiary's psychiatric condition requires services on an inpatient basis...

  3. 42 CFR 441.152 - Certification of need for services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... SERVICES Inpatient Psychiatric Services for Individuals Under Age 21 in Psychiatric Facilities or Programs...) Proper treatment of the beneficiary's psychiatric condition requires services on an inpatient basis...

  4. 42 CFR 441.152 - Certification of need for services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... SERVICES Inpatient Psychiatric Services for Individuals Under Age 21 in Psychiatric Facilities or Programs...) Proper treatment of the recipient's psychiatric condition requires services on an inpatient basis...

  5. Legislation and reality in public dental services in Norway: dental health services for children and adolescents in 1975 and 1985.

    PubMed

    Rossow, I; Holst, D

    1991-01-01

    The act relating to dental health service implied a reorganization of the public dental health services in Norway in 1984. The act intended to extend the target group of public dental health services and to achieve social and geographic equality in the distribution of dental health services among children and adolescents. The purpose of this study was to assess the degree to which these intentions had been fulfilled. The material comprised two nationwide, stratified, and randomly selected samples of 3,356 and 2,970 children and adolescents in the age group zero to 18 years. Data were collected in 1975 and 1985. Both the theoretical and the empirical models applied structural and individual resources to explain individual variation in use of dental health services. The results showed that the proportion of zero- to 18-year-olds who had seen a dentist within the past 12 months was higher in 1985 than in 1975 (81.7% and 75.8%, respectively). Bivariate and trivariate table analyses showed that statistically significant associations between structural resources and use of dental health services disappeared when controlling for a third variable. Use of dental health services among children and adolescents in Norway was not systemically influenced by the same factors, as was the use of dental health services in the adult population. Thus, the Public Dental Health Service in Norway seems to have had the capability of compensating for most of the discriminating effects that individual and structural factors may have on the use of dental health services both before and after the reorganization of the public dental health service.

  6. Commentary: Leveraging discovery science to advance child and adolescent psychiatric research--a commentary on Zhao and Castellanos 2016.

    PubMed

    Mennes, Maarten

    2016-03-01

    'Big Data' and 'Population Imaging' are becoming integral parts of inspiring research aimed at delineating the biological underpinnings of psychiatric disorders. The scientific strategies currently associated with big data and population imaging are typically embedded in so-called discovery science, thereby pointing to the hypothesis-generating rather than hypothesis-testing nature of discovery science. In this issue, Yihong Zhao and F. Xavier Castellanos provide a compelling overview of strategies for discovery science aimed at progressing our understanding of neuropsychiatric disorders. In particular, they focus on efforts in genetic and neuroimaging research, which, together with extended behavioural testing, form the main pillars of psychopathology research.

  7. Determinants of Maternity Care Services Utilization among Married Adolescents in Rural India

    PubMed Central

    Singh, Prashant Kumar; Rai, Rajesh Kumar; Alagarajan, Manoj; Singh, Lucky

    2012-01-01

    Background Coupled with the largest number of maternal deaths, adolescent pregnancy in India has received paramount importance due to early age at marriage and low contraceptive use. The factors associated with the utilization of maternal healthcare services among married adolescents in rural India are poorly discussed. Methodology/Principal Findings Using the data from third wave of National Family Health Survey (2005–06), available in public domain for the use by researchers, this paper examines the factors associated with the utilization of maternal healthcare services among married adolescent women (aged 15–19 years) in rural India. Three components of maternal healthcare service utilization were measured: full antenatal care, safe delivery, and postnatal care within 42 days of delivery for the women who gave births in the last five years preceding the survey. Considering the framework on causes of maternal mortality proposed by Thaddeus and Maine (1994), selected socioeconomic, demographic, and cultural factors influencing outcome events were included as the predictor variables. Bi-variate analyses including chi-square test to determine the difference in proportion, and logistic regression to understand the net effect of predictor variables on selected outcomes were applied. Findings indicate the significant differences in the use of selected maternal healthcare utilization by educational attainment, economic status and region of residence. Muslim women, and women belonged to Scheduled Castes, Scheduled Tribes, and Other Backward Classes are less likely to avail safe delivery services. Additionally, adolescent women from the southern region utilizing the highest maternal healthcare services than the other regions. Conclusions The present study documents several socioeconomic and cultural factors affecting the utilization of maternal healthcare services among rural adolescent women in India. The ongoing healthcare programs should start targeting household

  8. The Next Big Thing in Child and Adolescent Psychiatry: Interventions to Prevent and Intervene Early in Psychiatric Illnesses.

    PubMed

    Shoemaker, Erica Z; Tully, Laura M; Niendam, Tara A; Peterson, Bradley S

    2015-09-01

    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.

  9. Integration of a psychiatric service in a long-term charitable facility for people with intellectual disabilities: a 5-year medication survey.

    PubMed

    Ruggerini, Ciro; Guaraldi, Gian Paolo; Russo, Angela; Neviani, Vittoria; Castagnini, Augusto

    2004-01-01

    Since the implementation of a psychiatric service in a long-term facility for people with intellectual disability, the usage of psychotropic and anti-convulsant drugs has been surveyed over the 5-year period 1994-1999. At that time, although the overall prevalence rate of residents on medication was not declining significantly, a decrease in number, dosage and polypharmacy of those receiving neuroleptic drugs occurred than 1994. A reduction also resulted among the in-patients prescribed anxiolytic preparations, despite a relative increase in their mean daily intake. Anti-convulsant drugs climbed slightly during the same interval with a parallel increase in the mean daily dosage. A retrospective comparison of current findings to prevalence, dosage and type of psychoactive medications dispensed 10 years previously in 1989 revealed no trend towards drug rationalisation. Until interdisciplinary training programmes as well as effective community services combining disability and mental health needs are forthcoming, a therapeutic approach involving early psychiatric inputs may contribute to ensure a more rational prescribing practice for long-stay adults with intellectual disability who are referred for neuro-psychiatric consultation.

  10. Psychiatric diagnosis, psychiatric power and psychiatric abuse.

    PubMed Central

    Szasz, T

    1994-01-01

    Psychiatric abuse, such as we usually associate with practices in the former Soviet Union, is related not to the misuse of psychiatric diagnoses, but to the political power intrinsic to the social role of the psychiatrist in totalitarian and democratic societies alike. Some reflections are offered on the modern, therapeutic state's proclivity to treat adults as patients rather than citizens, disjoin rights from responsibilities, and thus corrupt the language of political-philosophical discourse. PMID:7996558

  11. Childhood ADHD Symptoms: Association with Parental Social Networks and Mental Health Service Use during Adolescence

    PubMed Central

    Bussing, Regina; Meyer, Johanna; Zima, Bonnie T.; Mason, Dana M.; Gary, Faye A.; Garvan, Cynthia Wilson

    2015-01-01

    Objective: This study examines the associations of childhood attention-deficit/hyperactivity disorder (ADHD) risk status with subsequent parental social network characteristics and caregiver strain in adolescence; and examines predictors of adolescent mental health service use. Methods: Baseline ADHD screening identified children at high risk (n = 207) and low risk (n = 167) for ADHD. At eight-year follow-up, parents reported their social network characteristics, caregiver strain, adolescents’ psychopathology and mental health service utilization, whereas adolescents self-reported their emotional status and ADHD stigma perceptions. Analyses were conducted using ANOVAs and nested logistic regression modeling. Results: Parents of youth with childhood ADHD reported support networks consisting of fewer spouses but more healthcare professionals, and lower levels of support than control parents. Caregiver strain increased with adolescent age and psychopathology. Increased parental network support, youth ADHD symptoms, and caregiver strain, but lower youth stigma perceptions were independently associated with increased service use. Conclusions: Raising children with ADHD appears to significantly impact parental social network experiences. Reduced spousal support and overall lower network support levels may contribute to high caregiver strain commonly reported among parents of ADHD youth. Parental social network experiences influence adolescent ADHD service use. With advances in social networking technology, further research is needed to elucidate ways to enhance caregiver support during ADHD care. PMID:26402692

  12. Evaluation of the Relation between Deliberate Self-Harm Behavior and Childhood Trauma Experiences in Patients Admitted to a Secondary-Care Psychiatric Outpatient Clinic for Adolescents and Young Adults

    PubMed Central

    SAÇARÇELİK, Gülhazar; TÜRKCAN, Ahmet; GÜVELİ, Hülya; YEŞİLBAŞ, Dilek

    2013-01-01

    Introduction The aim of this study was to determine the prevalence and the features of deliberate self-harm (DSH) behavior in patients admitted to the psychiatric outpatient clinic for adolescents and young adults and also to detect the association between the act of DSH and childhood traumas. Method In this study, we included all patients who were admitted to the secondary-care psychiatric outpatient clinic for adolescents and young adults in Bakırkoy Research and Training Hospital Psychiatry, Neurology and Neurosurgery throughout a month. A sociodemographic data form, the Childhood Trauma Questionnaire (CTQ-28), Childhood Abuse and Neglect Question List and the Deliberate Self-Harm and Intent Screening Form were applied to three hundred participants. Result The prevalence of DSH was 50.0% among the participants (56.8% for females and 28.8% for males). Childhood abuse was detected in 57.0% of all participants (60.4% of females and 46.6% of males). Among patients with act of DSH, the rate of childhood abuse was 71.3%, while it was 42.7% in the subjects without act of DSH. Conclusion DSH is a common behavior among adolescent psychiatric patients. It is more common in females than in males. The prevalence of experience of childhood abuse and neglect is remarkably high and is associated with self-harm behavior.

  13. 28 CFR 549.42 - Use of psychiatric medications.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Use of psychiatric medications. 549.42... MEDICAL SERVICES Psychiatric Evaluation and Treatment § 549.42 Use of psychiatric medications. Psychiatric..., for which such medication is accepted treatment. Psychiatric medication will be administered...

  14. 28 CFR 549.42 - Use of psychiatric medications.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Use of psychiatric medications. 549.42... MEDICAL SERVICES Psychiatric Evaluation and Treatment § 549.42 Use of psychiatric medications. Psychiatric..., for which such medication is accepted treatment. Psychiatric medication will be administered...

  15. 28 CFR 549.42 - Use of psychiatric medications.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Use of psychiatric medications. 549.42... MEDICAL SERVICES Psychiatric Evaluation and Treatment § 549.42 Use of psychiatric medications. Psychiatric..., for which such medication is accepted treatment. Psychiatric medication will be administered...

  16. Stability of childhood anxiety disorder diagnoses: a follow-up naturalistic study in psychiatric care.

    PubMed

    Carballo, Juan J; Baca-Garcia, Enrique; Blanco, Carlos; Perez-Rodriguez, M Mercedes; Arriero, Miguel A Jimenez; Artes-Rodriguez, Antonio; Rynn, Moira; Shaffer, David; Oquendo, Maria A

    2010-04-01

    Few studies have examined the stability of major psychiatric disorders in pediatric psychiatric clinical populations. The objective of this study was to examine the long-term stability of anxiety diagnoses starting with pre-school age children through adolescence evaluated at multiple time points. Prospective cohort study was conducted of all children and adolescents receiving psychiatric care at all pediatric psychiatric clinics belonging to two catchment areas in Madrid, Spain, between 1 January, 1992 and 30 April, 2006. Patients were selected from among 24,163 children and adolescents who received psychiatric care. Patients had to have a diagnosis of an ICD-10 anxiety disorder during at least one of the consultations and had to have received psychiatric care for the anxiety disorder. We grouped anxiety disorder diagnoses according to the following categories: phobic disorders, social anxiety disorders, obsessive-compulsive disorder (OCD), stress-related disorders, and "other" anxiety disorders which, among others, included generalized anxiety disorder, and panic disorder. Complementary indices of diagnostic stability were calculated. As much as 1,869 subjects were included and had 27,945 psychiatric/psychological consultations. The stability of all ICD-10 anxiety disorder categories studied was high regardless of the measure of diagnostic stability used. Phobic and social anxiety disorders showed the highest diagnostic stability, whereas OCD and "other" anxiety disorders showed the lowest diagnostic stability. No significant sex differences were observed on the diagnostic stability of the anxiety disorder categories studied. Diagnostic stability measures for phobic, social anxiety, and "other" anxiety disorder diagnoses varied depending on the age at first evaluation. In this clinical pediatric outpatient sample it appears that phobic, social anxiety, and stress-related disorder diagnoses in children and adolescents treated in community outpatient services may

  17. Treated Prevalence of and Mental Health Services Received by Children and Adolescents in 42 Low-and-Middle-Income Countries

    ERIC Educational Resources Information Center

    Morris, Jodi; Belfer, Myron; Daniels, Amy; Flisher, Alan; Ville, Liesbet; Lora, Antonio; Saxena, Shekhar

    2011-01-01

    Background: Little is known about the treated prevalence and services received by children and adolescents in low- and middle-income countries (LAMICs). The purpose of this study is to describe the characteristics and capacity of mental health services for children and adolescents in 42 LAMICs. Methods: The "World Health Organization Assessment…

  18. Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis mimicking a primary psychiatric disorder in an adolescent.

    PubMed

    Lebon, Sébastien; Mayor-Dubois, Claire; Popea, Irina; Poloni, Claudia; Selvadoray, Nalini; Gumy, Alain; Roulet-Perez, Eliane

    2012-12-01

    Anti-N-methyl-D-aspartate (anti-NMDA) receptor encephalitis likely has a wider clinical spectrum than previously recognized. This article reports a previously healthy 16-year-old girl who was diagnosed with anti-NMDA receptor encephalitis 3 months after onset of severe depression with psychotic features. She had no neurological manifestations, and cerebral magnetic resonance imaging (MRI) was normal. Slow background on electroencephalogram and an oligoclonal band in the cerebrospinal fluid prompted the search for anti-NMDA receptor antibodies. She markedly improved over time but remained with mild neuropsychological sequelae after a trial of late immunotherapy. Only a high index of suspicion enables recognition of the milder forms of the disease masquerading as primary psychiatric disorders.

  19. Brief Report: The Self Harm Questionnaire--A New Tool Designed to Improve Identification of Self Harm in Adolescents

    ERIC Educational Resources Information Center

    Ougrin, Dennis; Boege, Isabel

    2013-01-01

    The Self Harm Questionnaire (SHQ) aiming at identification of self-harm in adolescents has been developed and piloted in a sample of 12-17 year olds (n = 100). The adolescents were recruited from both in- and outpatient psychiatric services. Concurrent validity of the SHQ was evaluated by comparing the SHQ results with recorded self harm in the…

  20. Youth Mental Health in a Populous City of the Developing World: Results from the Mexican Adolescent Mental Health Survey

    ERIC Educational Resources Information Center

    Benjet, Corina; Borges, Guilherme; Medina-Mora, Maria Elena; Zambrano, Joaquin; Aguilar-Gaxiola, Sergio

    2009-01-01

    Background: Because the epidemiologic data available for adolescents from the developing world is scarce, the objective is to estimate the prevalence and severity of psychiatric disorders among Mexico City adolescents, the socio-demographic correlates associated with these disorders and service utilization patterns. Methods: This is a multistage…

  1. The Efficacy of Interpersonal Psychotherapy-Adolescent Skill Training (IPT-AST) in Preventing Depression: A Mixed Methods Approach

    ERIC Educational Resources Information Center

    Kerner, Sarah Shankman

    2015-01-01

    Adolescent depression is a prevalent and debilitating disorder that is associated with social and academic impairment, suicidality, comorbid psychiatric disorders, and high-risk behaviors (Horowitz, Garber, Ciesla, Young, & Mufson, 2007). Yet many adolescents experiencing depressive symptoms do not receive adequate services, and those that do…

  2. Annual Research Review: Discovery science strategies in studies of the pathophysiology of child and adolescent psychiatric disorders: promises and limitations

    PubMed Central

    Zhao, Yihong; Castellanos, F. Xavier

    2015-01-01

    Background and Scope Psychiatric science remains descriptive, with a categorical nosology intended to enhance inter-observer reliability. Increased awareness of the mismatch between categorical classifications and the complexity of biological systems drives the search for novel frameworks including discovery science in Big Data. In this review, we provide an overview of incipient approaches, primarily focused on classically categorical diagnoses such as schizophrenia (SZ), autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), but also reference convincing, if focal, advances in cancer biology, to describe the challenges of Big Data and discovery science, and outline approaches being formulated to overcome existing obstacles. Findings A paradigm shift from categorical diagnoses to a domain/structure-based nosology and from linear causal chains to complex causal network models of brain-behavior relationship is ongoing. This (r)evolution involves appreciating the complexity, dimensionality and heterogeneity of neuropsychiatric data collected from multiple sources (“broad” data) along with data obtained at multiple levels of analysis, ranging from genes to molecules, cells, circuits and behaviors (“deep” data). Both of these types of Big Data landscapes require the use and development of robust and powerful informatics and statistical approaches. Thus, we describe Big Data analysis pipelines and the promise and potential limitations in using Big Data approaches to study psychiatric disorders. Conclusion We highlight key resources available for psychopathological studies and call for the application and development of Big Data approaches to dissect the causes and mechanisms of neuropsychiatric disorders and identify corresponding biomarkers for early diagnosis. PMID:26732133

  3. Tailoring clinical services to address the unique needs of adolescents from the pregnancy test to parenthood.

    PubMed

    Moriarty Daley, Alison; Sadler, Lois S; Dawn Reynolds, Heather

    2013-04-01

    Clinicians across disciplines and practice settings are likely to encounter adolescents who are at risk for a pregnancy. In 2010, 34.2/1000 15-19-year-old teens had a live birth in the United States, many more will seek care for a pregnancy scare or options counseling. Teen mothers are also at risk for a second or higher-order pregnancy during adolescence. This paper provides clinicians with adolescent-friendly clinical and counseling strategies for pregnancy prevention, pre- and post-pregnancy test counseling, pregnancy-related care, and a review of the developmental challenges encountered by teens in the transition to parenthood. Clinicians are in a better position to approach the developmental, health and mental health needs of adolescents related to pregnancy if they understand and appreciate the obstacles adolescents may face negotiating the healthcare system. In addition, when clinical services are specially tailored to the needs of the adolescent, fewer opportunities will be lost to prevent unintended pregnancies, assist teens into timely prenatal services, and improve outcomes for their pregnancies and the transition to parenthood.

  4. Tailoring Clinical Services to Address the Unique Needs of Adolescents from the Pregnancy Test to Parenthood

    PubMed Central

    Daley, Alison Moriarty; Sadler, Lois S.; Reynolds, Heather Dawn

    2013-01-01

    Clinicians across disciplines and practice settings are likely to encounter adolescents who are at risk for a pregnancy. In 2010, 34.2/1000 15–19 year old teens had a live birth in the United States, many more will seek care for a pregnancy scare or options counseling. Teen mothers are also at risk for a second or higher order pregnancy during adolescence. This paper provides clinicians with adolescent-friendly clinical and counseling strategies for pregnancy prevention, pre- and post-pregnancy test counseling, pregnancy-related care, and a review of the developmental challenges encountered by teens in the transition to parenthood. Clinicians are in a better position to approach the developmental, health and mental health needs of adolescents related to pregnancy if they understand and appreciate the obstacles adolescents may face negotiating the health care system. In addition, when clinical services are specially tailored to the needs of the adolescent, fewer opportunities will be lost to prevent unintended pregnancies, assist teens into timely prenatal services, and improve outcomes for their pregnancies and the transition to parenthood. PMID:23522339

  5. A stepped-care model of post-disaster child and adolescent mental health service provision

    PubMed Central

    McDermott, Brett M.; Cobham, Vanessa E.

    2014-01-01

    Background From a global perspective, natural disasters are common events. Published research highlights that a significant minority of exposed children and adolescents develop disaster-related mental health syndromes and associated functional impairment. Consistent with the considerable unmet need of children and adolescents with regard to psychopathology, there is strong evidence that many children and adolescents with post-disaster mental health presentations are not receiving adequate interventions. Objective To critique existing child and adolescent mental health services (CAMHS) models of care and the capacity of such models to deal with any post-disaster surge in clinical demand. Further, to detail an innovative service response; a child and adolescent stepped-care service provision model. Method A narrative review of traditional CAMHS is presented. Important elements of a disaster response – individual versus community recovery, public health approaches, capacity for promotion and prevention and service reach are discussed and compared with the CAMHS approach. Results Difficulties with traditional models of care are highlighted across all levels of intervention; from the ability to provide preventative initiatives to the capacity to provide intense specialised posttraumatic stress disorder interventions. In response, our over-arching stepped-care model is advocated. The general response is discussed and details of the three tiers of the model are provided: Tier 1 communication strategy, Tier 2 parent effectiveness and teacher training, and Tier 3 screening linked to trauma-focused cognitive behavioural therapy. Conclusion In this paper, we argue that traditional CAMHS are not an appropriate model of care to meet the clinical needs of this group in the post-disaster setting. We conclude with suggestions how improved post-disaster child and adolescent mental health outcomes can be achieved by applying an innovative service approach. PMID:25045422

  6. In-Service Teachers' Perspectives on Adolescent ELL Writing Instruction

    ERIC Educational Resources Information Center

    Kibler, Amanda K.; Heny, Natasha A.; Andrei, Elena

    2016-01-01

    As writing has assumed increasing importance in discussions of pedagogy for diverse classrooms, attention to the contexts in which secondary teachers develop and implement writing instruction for adolescent English language learners (ELLs) is of great importance. Drawing on ecological language learning theories and situated teacher learning theory…

  7. Resilience in Parentally Bereaved Children and Adolescents Seeking Preventive Services

    ERIC Educational Resources Information Center

    Lin, Kirk K.; Sandler, Irwin N.; Ayers, Tim S.; Wolchik, Sharlene A.; Luecken, Linda J.

    2004-01-01

    This study examined environmental stress, family, and child variables that differentiate resilient children and adolescents from those with mental health problems following the death of a primary caregiver. The community-based sample included 179 bereaved children ages 8 to 16 years and their surviving caregivers who completed a test battery of…

  8. Access to diagnosis, treatment, and supportive services among pharmacotherapy-treated children/adolescents with ADHD in Europe: data from the Caregiver Perspective on Pediatric ADHD survey

    PubMed Central

    Fridman, Moshe; Banaschewski, Tobias; Sikirica, Vanja; Quintero, Javier; Chen, Kristina S

    2017-01-01

    Background Attention-deficit/hyperactivity disorder (ADHD) is one of the most common childhood psychiatric disorders and negatively impacts caregivers’ lives. Factors including barriers to accessing care, dissatisfaction with support services, and lack of caregiver resources may contribute to this. Objectives To report caregivers’ experiences of ADHD diagnosis, behavioral therapy (BT), and supportive care for children/adolescents with ADHD. Methods The Caregiver Perspective on Pediatric ADHD (CAPPA) survey included caregivers of children/adolescents (6–17 years) from ten European countries who were currently receiving/had received ADHD pharmacotherapy in the previous 6 months. Caregivers reported experiences of obtaining an ADHD diagnosis, access to BT, availability of caregiver resources, and level of health care/school support. Pan-EU and country-specific descriptive statistics are reported; responses were compared across countries. Results Of 3,616 caregivers, 66% were female. Mean age of children/adolescents was 11.5 years; 80% were male. Mean time from the first doctor visit to diagnosis was 10.8 (95% confidence interval 10.2, 11.3) months; 31% of caregivers reported the greatest degrees of difficulty in obtaining an ADHD diagnosis; 44% of children/adolescents did not receive BT. Forty-seven percent of caregivers reported that sufficient resources were available, 44% were “very satisfied”/“satisfied” with medical care, and 50% found health care providers “very supportive”/“somewhat supportive”. Mainstream schools were attended by 82% of children/adolescents. Of those, 67% of caregivers thought schools could help more with the child/adolescent’s ADHD and 48% received extra help/special arrangement. Results varied significantly between countries (P<0.001, all parameters). Conclusion Almost a third of caregivers reported a high degree of difficulty in obtaining an ADHD diagnosis for their child/adolescent, less than half felt that

  9. Implications of Comprehensive Mental Health Services Embedded in an Adolescent Obstetric Medical Home.

    PubMed

    Ashby, Bethany; Ranadive, Nikhil; Alaniz, Veronica; St John-Larkin, Celeste; Scott, Stephen

    2016-06-01

    Purpose Mental health issues in perinatal adolescents are well documented and studies have shown high rates of depressive disorders among this population. Treatment is challenging because pregnant adolescents are poorly adherent with mental health services. We describe a novel integrated mental health care program for pregnant and parenting adolescent mothers and their children. Methods The Colorado Adolescent Maternity Program (CAMP) is a comprehensive, multidisciplinary teen pregnancy and parenting medical home program serving an ethnically diverse and low socioeconomic status population in the Denver metro area. We describe the Healthy Expectations Adolescent Response Team (HEART), an embedded mental health care program focused on improving identification of mental health symptoms and increasing rates mental health treatment in adolescent mothers. Results From January 1, 2011-January 16 2014, 894 pregnant adolescents were enrolled in CAMP and 885 patients were screened for mental health issues. Prior to HEART's inception, 20 % of patients were identified as having mood symptoms in the postpartum period. Successful referrals to community mental health facilities occurred in only 5 % of identified patients. Following the creation of HEART, 41 % of patients were identified as needing mental health services. Nearly half of the identified patients (47 %) engaged in mental health treatment with the psychologist. Demographic factors including age, parity, ethnicity, and parent and partner involvement did not have a significant impact on treatment engagement. Trauma history was associated with lower treatment engagement. Conclusion Our findings suggest that an embedded mental health program in an adolescent obstetric and pediatric medical home is successful in improving identification and engagement in mental health treatment. Key components of the program include universal screening, intensive social work and case management involvement, and ready access to onsite

  10. [Tacit metarepresentation and affective sense of personal identity. An approach to understanding severe psychiatric disorders of adolescence and young adulthood].

    PubMed

    Balbi, Juan

    2011-01-01

    The results of present-day research in the field of "Dissociation Paradigm", regarding the capacity of the human mind to perceive, learn, and store information that in appearance passes as unnoticed, support the constructivist hypothesis of the active, selective and constructive condition of consciousness, in addition to the existence of a tacit dimension of knowledge that operates in functional relationship with the former. Unconscious mental states are intrinsically intentional. This is to say that they imply a semantic or cognitive connotation that is capable of affecting phenomenical experience and therefore behavior. In addition, the precocious existence of a tacit metarepresentational system in normally developed children has been proven, which is essential for guaranteeing the deployment of the process of functional coevolution between affectivity and consciousness, by which the experience of personal identity is acquired. These discoveries allow the inference of a "tacit affective metarepresentational recurrence", the organizational foundation on which a unified, sustainable, and continuous sense of the experience of personal identity is structured, and also allow us to hypothesize a "tacit metarepresentational mourning", a specific type of grief which is the chief foundation of the majority of psychopathological disorders. This concept may represent a potential explanation of the severe mental disorders of adolescence and young adulthood. The hypothesis of the present work is that, in the ambiguous context of Postmodern Culture, the prolongation of the adolescent period, facilitated by the welfare state, hinders the dealing with the aforementioned mourning, leading to an increment of depressive states and suicidal behavior among young people.

  11. A Process Analysis of Supported Employment Services for Persons with Serious Psychiatric Disability: Implications for Program Design.

    ERIC Educational Resources Information Center

    Rogers, E. Sally; MacDonald-Wilson, Kim; Danley, Karen; Martin, Rose; Anthony, William A.

    1997-01-01

    This paper reports on a process analysis of a three-year research and demonstration project evaluating a supported-employment program serving 20 adults with psychiatric disabilities. Staff were found to have frequent, brief contact with participants at varied times of day and through varied means of contact, with much of this contact spent…

  12. Behaviour Management Problems as Predictors of Psychotropic Medication and Use of Psychiatric Services in Adults with Autism

    ERIC Educational Resources Information Center

    Tsakanikos, Elias; Costello, Helen; Holt, Geraldine; Sturmey, Peter; Bouras, Nick

    2007-01-01

    We examined behaviour management problems as predictors of psychotropic medication, use of psychiatric consultation and in-patient admission in a group of 66 adults with pervasive developmental disorder (PDD) and intellectual disability (ID) and 99 controls matched in age, gender and level of ID. Overall, people with PDD had higher rates of most…

  13. Health Care Resources and Mental Health Service Use Among Suicidal Adolescents.

    PubMed

    LeCloux, Mary; Maramaldi, Peter; Thomas, Kristie; Wharff, Elizabeth

    2017-04-01

    Developing policies and interventions that increase rates of mental health service use for suicidal adolescents is crucial for suicide prevention. Data from a sample of suicidal youth (n = 1356) from the National Longitudinal Study of Adolescent Health (Add Health) were analyzed to examine whether type of insurance, receipt of routine medical care, and access to school-based mental health treatment predicted mental health service use cross-sectionally and longitudinally. Rates of mental health service use were low in cross-sectional analyses at all three waves (∼11%-30%), despite the fact that respondents were at high risk for suicide attempts and depression. With demographic factors and symptom severity controlled, only receipt of a routine physical predicted an increased likelihood of mental health service use at wave I and in longitudinal analyses. Implications discussed include the utility of universal suicide screenings and integrated behavioral health care as potential intervention strategies for this population.

  14. New Frontiers in Psychiatric Technology.

    ERIC Educational Resources Information Center

    Fuzessery, Zoltan, Ed.

    The second annual educational workshop concerned utilization of psychiatric technicians for technical service to allied professions. Manuscripts are included for the following presentations: (1) "Brief History of Colorado Psychiatric Technicians Association" by Francis L. Hedges, (2) "Hominology--The Approach to the Whole Man"…

  15. 42 CFR 456.482 - Medical, psychiatric, and social evaluations.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Medical, psychiatric, and social evaluations. 456... HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Inpatient Psychiatric..., psychiatric, and social evaluations. If a facility provides inpatient psychiatric services to a...

  16. 42 CFR 456.482 - Medical, psychiatric, and social evaluations.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Medical, psychiatric, and social evaluations. 456... HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Inpatient Psychiatric..., psychiatric, and social evaluations. If a facility provides inpatient psychiatric services to a...

  17. 42 CFR 456.482 - Medical, psychiatric, and social evaluations.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Medical, psychiatric, and social evaluations. 456... HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Inpatient Psychiatric..., psychiatric, and social evaluations. If a facility provides inpatient psychiatric services to a...

  18. 42 CFR 456.482 - Medical, psychiatric, and social evaluations.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Medical, psychiatric, and social evaluations. 456... HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Inpatient Psychiatric..., psychiatric, and social evaluations. If a facility provides inpatient psychiatric services to a...

  19. 42 CFR 456.482 - Medical, psychiatric, and social evaluations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Medical, psychiatric, and social evaluations. 456... HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Inpatient Psychiatric..., psychiatric, and social evaluations. If a facility provides inpatient psychiatric services to a...

  20. Enhancing Health Literacy through Accessing Health Information, Products, and Services: An Exercise for Children and Adolescents

    ERIC Educational Resources Information Center

    Brey, Rebecca A.; Clark, Susan E.; Wantz, Molly S.

    2007-01-01

    The second National Health Education Standard states the importance of student demonstration of the ability to access valid health information and services. The teaching technique presented in this article provides an opportunity for children and adolescents to develop their health literacy and advocacy skills by contributing to a class resource…

  1. Ensuring Quality Service-Learning Experiences for At-Risk Adolescents

    ERIC Educational Resources Information Center

    Nelson, Judith A.; Sneller, Susan

    2011-01-01

    Service-learning is one way of reconstructing educators' thinking about adolescents who demonstrate at-risk behaviors. It allows educators and others to involve youth considered to be "at risk" in talking about their concerns and interests, solving problems, and making decisions as they construct their own identities with the help and…

  2. Guidelines for Adolescent Preventive Services: A Role for the School Nurse.

    ERIC Educational Resources Information Center

    Allensworth, Diane DeMuth; Bradley, Beverly

    1996-01-01

    Investigates the use of school nurses to deliver the American Medical Association's Guidelines for Adolescent Preventive Services (GAPS) in collaboration with school and community professionals. Examines GAPS' components and related critical issues (identifying students for screening, screening students, triage, interdisciplinary and interagency…

  3. Clinical Profile of Childhood Onset Depression Presenting to Child Adolescent and Family Services in Northampton

    ERIC Educational Resources Information Center

    Majumder, Pallab; Hammad, Hala

    2006-01-01

    Background: The clinical profile of depressive disorder in children and young people in Child Adolescent and Family Services (CAFS), Northampton was studied. Methods: Twenty-five patients who had attended the CAFS over a period of 2 years were analysed retrospectively. Results: The age range of subjects was 8 to 19 years. Majority of patients were…

  4. Text and Turbulence: Representing Adolescence as Pathology in the Human Services.

    ERIC Educational Resources Information Center

    Finn, Janet L.

    2001-01-01

    Examines constructions of adolescence and pathology and their relation to human service intervention. Locates history of related discourses along a trajectory of 20th-century capitalism, attending especially to racialized, gendered, and class-based aspects. Argues that the youth treatment industry may not be preparing youth for healthy adulthood,…

  5. Psychiatric rehabilitation in Europe.

    PubMed

    Rössler, W; Drake, R E

    2017-01-19

    To describe the core elements of modern psychiatric rehabilitation. Based on selected examples we describe the discussion about values in mental health care with focus on Europe. We present outcome data from studies, which have tried to implement care structures based on this value discussion. In the second half of the 20th century, mental health care in all European and other high-income countries changed conceptually and structurally. Deinstitutionalisation reduced the number of psychiatric beds and transferred priority to outpatient care and community-based services, but community mental health programs developed differently across and within these countries. High-income countries in Europe continued to invest in costly traditional services that were neither evidence-based nor person-centered by emphasising inpatient services, sheltered group homes and sheltered workshops. We argue that evidence-based, person-centred, recovery-oriented psychiatric rehabilitation offers a parsimonious solution to developing a consensus plan for community-based care in Europe. The challenges to scaling up effective psychiatric rehabilitation services in high-income countries are not primarily a lack of resources, but rather a lack of political will and inefficient use and dysfunctional allocation of resources.

  6. The Role of Psychiatric Emergency Services in Aiding Community Alternatives to Hospitalization in an Inner-City Population

    PubMed Central

    Bell, Carl C.

    1978-01-01

    In the proper political/economic environment, Crisis Intervention Programs can reduce the recidivism rate of patients who suffer from recurrent intermittent acute psychotic episodes. The author seeks to outline such a program and demonstrate its effectiveness in providing an alternative to brief hospitalization. It is believed that this form of management of the psychiatric emergency aids the practice of community psychiatry and supports the use of day treatment facilities, outpatient clinics, emergency housing, family therapy, and other community support systems. PMID:731721

  7. Ethnic Group, Acculturation, and Psychiatric Problems in Young Immigrants

    ERIC Educational Resources Information Center

    Oppedal, Brit; Roysamb, Espen; Heyerdahl, Sonja

    2005-01-01

    Background: The goal of this study was to investigate the effects of ethnic origin and acculturation factors on psychiatric problems among immigrant adolescents. One aim was to examine variations in psychiatric problems according to gender and immigrant generation level. Another aim was to explore ethnic group differences in psychiatric problems…

  8. Elements of Successful School Reentry after Psychiatric Hospitalization

    ERIC Educational Resources Information Center

    Clemens, Elysia V.; Welfare, Laura E.; Williams, Amy M.

    2011-01-01

    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…

  9. Predictors of aggression on the psychiatric inpatient service: self-esteem, narcissism, and theory of mind deficits.

    PubMed

    Goldberg, Brett R; Serper, Mark R; Sheets, Michelle; Beech, Danielle; Dill, Charles; Duffy, Kristine G

    2007-05-01

    Aggressive behavior committed by inpatients has significant negative effects on patients, clinical staff, the therapeutic milieu, and inpatient community as whole. Past research examining nonpsychiatric patient groups has suggested that elevated self-esteem and narcissism levels as well as self-serving theory of mind (ToM) biases may be robust predictors of aggressive behavior. In the present study, we examined whether these constructs were useful in predicting aggressive acts committed by psychiatric inpatients. Severity of psychiatric symptoms, demographic variables and patients' anger, and hostility severity were also examined. We found patients who committed acts of aggression were differentiated from their nonaggressive counterparts by exhibiting significantly higher levels of self-esteem and narcissistic superiority. In addition, aggressors demonstrated self-serving ToM biases, attributing more positive attributes to themselves, relative to their perceptions of how others viewed them. Aggressors also showed increased psychosis, fewer depressive symptoms, and had significantly fewer years of formal education than their nonaggressive peers. These results support and extend the view that in addition to clinical variables, specific personality traits and self-serving attributions are linked to aggressive behavior in acutely ill psychiatric patients.

  10. Pediatric and adolescent mental health emergencies in the emergency medical services system.

    PubMed

    Dolan, Margaret A; Fein, Joel A

    2011-05-01

    Emergency department (ED) health care professionals often care for patients with previously diagnosed psychiatric illnesses who are ill, injured, or having a behavioral crisis. In addition, ED personnel encounter children with psychiatric illnesses who may not present to the ED with overt mental health symptoms. Staff education and training regarding identification and management of pediatric mental health illness can help EDs overcome the perceived limitations of the setting that influence timely and comprehensive evaluation. In addition, ED physicians can inform and advocate for policy changes at local, state, and national levels that are needed to ensure comprehensive care of children with mental health illnesses. This report addresses the roles that the ED and ED health care professionals play in emergency mental health care of children and adolescents in the United States, which includes the stabilization and management of patients in mental health crisis, the discovery of mental illnesses and suicidal ideation in ED patients, and approaches to advocating for improved recognition and treatment of mental illnesses in children. The report also addresses special issues related to mental illness in the ED, such as minority populations, children with special health care needs, and children's mental health during and after disasters and trauma.

  11. Aggregation of Lifetime Axis I Psychiatric Disorders through Age 30: Incidence, Predictors, and Associated Psychosocial Outcomes

    PubMed Central

    Farmer, Richard F.; Kosty, Derek B.; Seeley, John R.; Olino, Thomas M.; Lewinsohn, Peter M.

    2013-01-01

    Longitudinal data from representative birth cohorts on the aggregation of psychiatric disorders, or the cumulative number of unique diagnosed disorders experienced by persons within a circumscribed period, are limited. Consequently, risk factors for and psychosocial implications of lifetime disorder aggregation in the general population remain largely unknown. This research evaluates the incidence, predictors, and psychosocial sequela of lifetime disorder aggregation from childhood through age 30. Over a 14-year period, participants in the Oregon Adolescent Depression Project (probands; N = 816) were repeatedly evaluated for psychiatric disorders and assessed with multiple measures of psychosocial functioning. First-degree relatives of probands (N = 2,414) were also interviewed to establish their lifetime psychiatric history. The cumulative prevalence of common lifetime psychiatric disorders for the proband sample was 71%. Three-quarters of all proband psychiatric disorders occurred among 37% of the sample, and 82% of all disorder diagnoses were made among persons who met criteria for at least one other lifetime disorder. Lifetime disorder aggregation in probands was predicted by lifetime psychiatric disorder densities among first-degree relatives and was related to heterotypic comorbidity patterns that included disorders from both internalizing and externalizing domains, most notably major depressive and alcohol use disorders. By age 30, disorder aggregation was significantly associated with mental health care service utilization and predictive of personality disorder pathology and numerous indicators of poor psychosocial functioning. Possible implications of disorder aggregation on the conceptualization of lifetime psychiatric disorder comorbidity are discussed. PMID:23421525

  12. [Satisfaction with child and adolescent mental health services by user and clinician sex].

    PubMed

    Bunge, Eduardo L; Barilá, Carina V; Sánchez, Natalia A; Maglio, Ana L

    2014-01-01

    Client Satisfaction with mental health services is an important aspect in the evaluation of quality of those services. In youth mental health field, a few studies had being made about this characteristic. The aim of this study is to evaluate the relationship between satisfaction of parents, children and adolescents according to sex of patients and therapists. The sample included 382 subjects who attended to Buenos Aires private services who completed the questionnaire of experiences with the service. The results in teenagers' group showed differences in the satisfaction with the service matching the sex of teenagers with the sex of therapist, however in children and parent groups we haven't found significant differences. We discuss the implications of the results in order to improve the services given in youth area.

  13. [Relationship between the 1st experience with the use of an information bank to optimize management of a territorial psychiatric service and the task of rehabilitating mental patients].

    PubMed

    Mazur, M A

    1981-01-01

    The paper concerns results of the use of an information bank for purposes of optimizing, from the standpoint of a total systems approach, the structure and activity of psychiatric services in the region and enhancing the effectivity of the rehabilitative programmes. The main principles of forming the bank of information, including computer analogues of case histories, the system of managing the bases and models of optimizing the activities of facilities and their subunits, are described. A systemic coordination of such models provided a complete continuity in the activities of hospitals, dispensaries and intermediate subunits. This circumstance allowed an implementation of successful outpatient treatment in a large group of patients with a protracted development of diseases and consequently to enhance the efficacy of the activities of mental health services in the region.

  14. Clinical significance of psychiatric comorbidity in children and adolescents with obsessive-compulsive disorder: subtyping a complex disorder.

    PubMed

    Ortiz, A E; Morer, A; Moreno, E; Plana, M T; Cordovilla, C; Lázaro, L

    2016-04-01

    A promising approach in relation to reducing phenotypic heterogeneity involves the identification of homogeneous subtypes of OCD based on age of onset, gender, clinical course and comorbidity. This study aims to assess the sociodemographic characteristics and clinical features of OCD patients in relation to gender and the presence or absence of another comorbid disorder. The sample comprised 112 children and adolescents of both sexes and aged 8-18 years, all of whom had a diagnosis of OCD. Overall, 67 % of OCD patients had one comorbid diagnosis, 20.5 % had two such diagnoses and 2.6 % had three comorbid diagnoses. The group of OCD patients with a comorbid neurodevelopmental disorder had significantly more family history of OCD in parents (p = .049), as compared with the no comorbidity group and the group with a comorbid internalizing disorder, and they also showed a greater predominance of males (p = .013) than did the group with a comorbid internalizing disorder. The group of OCD patients with internalizing comorbidity had a later age of onset of OCD (p = .001) compared with both the other groups. Although the initial severity was similar in all three groups, the need for pharmacological treatment and for hospitalization due to OCD symptomatology was greater in the groups with a comorbid neurodevelopmental disorder (p = .038 and p = .009, respectively) and a comorbid internalizing disorder (p = .008 and p = .004, respectively) than in the group without comorbidity. Our findings suggest that two subtypes of OCD can be defined on the basis of the comorbid pathology presented. The identification of different subtypes according to comorbidity is potentially useful in terms of understanding clinical variations, as well as in relation to treatment management and the use of therapeutic resources.

  15. The role of reflection in the effects of community service on adolescent development: a meta-analysis.

    PubMed

    van Goethem, Anne; van Hoof, Anne; Orobio de Castro, Bram; Van Aken, Marcel; Hart, Daniel

    2014-01-01

    This meta-analysis assessed the effect of community service on adolescent development and the moderation of this effect by reflection, community service, and adolescent characteristics to explicate the mechanisms underlying community service effects. Random effects analyses, based on 49 studies (24,477 participants, 12-20 years old), revealed that community service had positive effects on academic, personal, social, and civic outcomes. Moderation analyses indicated that reflection was essential; the effect for studies that include reflection was substantial (mean ES = .41) while community service in the absence of reflection yielded negligible benefits (mean ES = .05). Effects increased when studies include more frequent reflection and community service, reflection on academic content, and older adolescents. These findings have implications for understanding and improving community service.

  16. Provision of Reproductive Health Services for Adolescents--Report of a Study in Two Local Government Areas (LGAs) of Nigeria.

    ERIC Educational Resources Information Center

    Olukoya, Adepeju A.

    1996-01-01

    Studied adolescent reproductive health services in two Nigerian states. Found that adolescents use health facilities mostly for general health problems. Only 6.1% (south) and 31.8% (north) of cases involved reproductive health, the gap attributable to maternity cases of northern married women. Reproductive health problems such as abortion and…

  17. Mental Health Service and Drug Treatment Utilization: Adolescents with Substance Use/Mental Disorders and Dual Diagnosis

    ERIC Educational Resources Information Center

    Cheng, Tyrone C.; Lo, Celia C.

    2010-01-01

    This research is a secondary data analysis of the impact of adolescents' mental/substance-use disorders and dual diagnosis on their utilization of drug treatment and mental health services. By analyzing the same teenagers who participated in the NIMH Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) study, logistic…

  18. Determinants of utilization of antenatal care services among adolescent girls and young women in Indonesia.

    PubMed

    Efendi, Ferry; Chen, Ching-Min; Kurniati, Anna; Berliana, Sarni Maniar

    2016-05-26

    Due to the high number of maternal deaths, provision of antenatal care services (ANC) in Indonesia is one of the key aims of the post-Millennium Development Goals agenda. This study aimed to assess the key factors determining use of ANC by adolescent girls and young women in Indonesia. Data from the Indonesia Demographic and Health Survey 2012 were used, with a focus on married adolescent girls (aged 15-19 years, n = 543) and young women (20-24 years, n = 2,916) who were mothers. Bivariate and multiple logistic regression analyses were performed to determine the factors associated with ANC use. The findings indicated that adolescents were less likely to make ANC visits than young women. Richer women were more likely to make four ANC visits in both groups compared to the poorer women. Living in urban areas, higher educational attainment, and lower birth order were also all associated with higher levels of receiving ANC among young women. The results showed that socio-economic factors were related to the use of ANC among adolescent girls and young women. Ongoing health-care interventions should thus put a priority on adolescent mothers coming from poor socio-economic backgrounds.

  19. Improving the Quality of Health Care Services for Adolescents, Globally: A Standards-Driven Approach

    PubMed Central

    Nair, Manisha; Baltag, Valentina; Bose, Krishna; Boschi-Pinto, Cynthia; Lambrechts, Thierry; Mathai, Matthews

    2015-01-01

    Purpose The World Health Organization (WHO) undertook an extensive and elaborate process to develop eight Global Standards to improve quality of health care services for adolescents. The objectives of this article are to present the Global Standards and their method of development. Methods The Global Standards were developed through a four-stage process: (1) conducting needs assessment; (2) developing the Global Standards and their criteria; (3) expert consultations; and (4) assessing their usability. Needs assessment involved conducting a meta-review of systematic reviews and two online global surveys in 2013, one with primary health care providers and another with adolescents. The Global Standards were developed based on the needs assessment in conjunction with analysis of 26 national standards from 25 countries. The final document was reviewed by experts from the World Health Organization regional and country offices, governments, academia, nongovernmental organizations, and development partners. The standards were subsequently tested in Benin and in a regional expert consultation of Latin America and Caribbean countries for their usability. Results The process resulted in the development of eight Global Standards and 79 criteria for measuring them: (1) adolescents' health literacy; (2) community support; (3) appropriate package of services; (4) providers' competencies; (5) facility characteristics; (6) equity and nondiscrimination; (7) data and quality improvement; and (8) adolescents' participation. Conclusions The eight standards are intended to act as benchmarks against which quality of health care provided to adolescents could be compared. Health care services can use the standards as part of their internal quality assurance mechanisms or as part of an external accreditation process. PMID:26299556

  20. Community Psychiatric Rehabilitation in Israel.

    ERIC Educational Resources Information Center

    Levy, Amihay; Neumann, Micha

    1988-01-01

    This paper describes the development of community-based rehabilitation services for persons with mental illness in Israel. It focuses on occupational, social, and residential community psychiatric rehabilitation services. The paper argues that service development has been slow and out of step with the philosophy and objectives of community…

  1. A Study of the Influence of Service on Early Adolescents' Critical and Caring Thoughts and Actions

    ERIC Educational Resources Information Center

    Lashley, Judith A.

    2013-01-01

    The purpose of this study was to investigate the question of what impact opportunities for service had on early adolescents. I also hoped to discover what types of service might inspire critical, caring thought and action. Four principal implications emerged from this inquiry. For service to inspire caring, it should be practiced and personally…

  2. Addressing Adolescent Depression in Schools: Evaluation of an In-Service Training for School Staff in the United States

    ERIC Educational Resources Information Center

    Valdez, Carmen R.; Budge, Stephanie L.

    2012-01-01

    This study evaluated an adolescent depression in-service training for school staff in the United States. A total of 252 school staff (e.g., teachers, principals, counselors) completed assessments prior to and following the in-service and a subsample of these staff participated in focus groups following the in-service and three months later.…

  3. Adolescent Turmoil.

    ERIC Educational Resources Information Center

    Offer, Daniel

    1982-01-01

    Examines recent empirical evidence to test theories postulated in separate works by G. Stanley Hall and Anna Freud that adolescents must experience psychological turbulence in the transition to adulthood. Concludes that turmoil is no longer a necessary condition of adolescence and that those who do experience it need psychiatric attention.…

  4. Consumer satisfaction and child behaviour problems in child and adolescent mental health services.

    PubMed

    Barber, Andrew J; Tischler, Victoria A; Healy, Elaine

    2006-03-01

    Consumer satisfaction with health care is one of the goals of health care delivery. Information on what affects satisfaction helps health care providers to deliver patient-centred care. The aim of this study was to explore the relationship between young persons' symptoms and satisfaction with Child and Adolescent Mental Health Services (CAMHS). It also examined differences in satisfaction of the parent/carer and their child. Self-report questionnaires were used to gather information from respondents. High levels of satisfaction were reported, although children and adolescents were less satisfied than parents/carers. Young people with self-reported conduct problems were least satisfied with CAMHS, as were those who rated their problems as having a significant impact on their lives. There was no relationship between carer-reported 'caseness' and carer satisfaction with services. Further exploration of the needs and expectations of young people who have behavioural difficulties is necessary so that their needs are better understood and expectations met.

  5. Prevalence of adolescent violence in the home and service system capacity in rural Victoria.

    PubMed

    Reid, Carol; Ervin, Kaye

    2015-01-01

    Adolescent violence in the home (AVITH) is increasing. In Victoria alone, police call-out data indicates a consistent 9% rise per annum from 2006. Community services are struggling to provide a cohesive response to this issue. This study examined the prevalence, risk factors and service system capacity regarding AVITH in Mitchell Shire, a geographical location in central Victoria. The results of the study revealed that specific funding was perceived by organisations to be the single highest need in regards to this phenomenon. Recommendations for the service system in Mitchell Shire included a collaborative approach to establish assessment guidelines, referral pathways and protocols for responding to the disclosure of AVITH. To effectively support workers in Mitchell Shire, a quality service system response would involve the development of common standards of practices across these processes. The methodology used with the AVITH Service System Capacity Assessment Survey, specifically developed for this study, may provide a useful tool for other locations investigating service gaps and needs in relation to adolescent family violence.

  6. Preventing Adolescent Pregnancy: A Role for Social Work Services.

    ERIC Educational Resources Information Center

    Edelman, Marion Wright

    1988-01-01

    For poor and minority teenagers the lack of adequate life options may increase their desire for early pregnancy. Since teen mothers face probable poverty and single parenthood, it is imperative that schools and school social workers provide counseling, health services, and work preparation as well as academic skills training. (VM)

  7. School Mental Health Resources and Adolescent Mental Health Service Use

    ERIC Educational Resources Information Center

    Green, Jennifer Greif; McLaughlin, Katie A.; Alegria, Margarita; Costello, E. Jane; Gruber, Michael J.; Hoagwood, Kimberly; Leaf, Philip J.; Olin, Serene; Sampson, Nancy A.; Kessler, Ronald C.

    2013-01-01

    Objective: Although schools are identified as critical for detecting youth mental disorders, little is known about whether the number of mental health providers and types of resources that they offer influence student mental health service use. Such information could inform the development and allocation of appropriate school-based resources to…

  8. Adolescent sexual offenders: a total survey of referrals to Social Services in Sweden and subgroup characteristics.

    PubMed

    Kjellgren, Cecilia; Wassberg, Annika; Carlberg, Margareta; Långström, Niklas; Svedin, Carl Göran

    2006-10-01

    Sampling methodology (e.g. population-based vs. clinical samples, anonymous self-reports vs. data collected as part of mandated treatment) affects the validity of conclusions drawn from research addressing the etiology of adolescent sexual offending. Studies of unselected samples allow testing of the generalizability of etiological models suggested from investigation of selected clinical or forensic populations. Further, representative epidemiological data on adolescent sexual offending is needed for policy-making and the planning of services. We conducted a national survey of all adolescent sexual offenders (ASOs, 12-17 years) referred to Social Services during 2000. Social workers at all child and adolescent units in Social Service authorities throughout Sweden (N=285, 99% response rate) completed a questionnaire about new ASO referrals in 2000. The National Board of Health and Welfare commissioned the survey and questionnaire items tapped offender, offence, and victim characteristics. A total of 197 boys and 2 girls aged 12-17 years were referred to Social Services because of sexually abusive behavior in 2000. Focusing specifically on males, this yielded a one-year incidence of .060% (95% confidence interval = .052-.068). Forty-six percent of male ASOs abused at least one child younger than age 12 years (child offenders) whereas the rest had abused peer or adult victims (peer offenders). Forty-two percent of male ASOs had ever committed sexual offences together with at least one other offender (group offenders). Child- vs. peer offenders and group vs. single offenders, suggested typologies in the literature, were compared to explore potential subtype-specific risk factors and correlates. The results suggested a higher proportion of group ASOs than previously reported and stronger support for subdividing ASOs into child vs. peer offenders than into group vs. single ASOs.

  9. Mental health care reforms in Latin America: child and adolescent mental health services in Mexico.

    PubMed

    Espinola-Nadurille, Mariana; Vargas Huicochea, Ingrid; Raviola, Giuseppe; Ramirez-Bermudez, Jesus; Kutcher, Stan

    2010-05-01

    This column provides an overview of child and adolescent mental health services in Mexico, where prevalence rates of mental disorders among young people are up to twice as high as U.S. and Canadian rates. The mental health care system in Mexico is underdeveloped and underfunded, and for the approximately 40% of the population with no insurance, access to and quality of care are particularly poor. This column offers policy recommendations aimed at better meeting the needs of this vulnerable population.

  10. Childhood Trauma and Psychiatric Disorders as Correlates of School Dropout in a National Sample of Young Adults

    PubMed Central

    Porche, Michelle V.; Fortuna, Lisa R.; Lin, Julia; Alegria, Margarita

    2010-01-01

    The effect of childhood trauma, psychiatric diagnoses, and mental health services on school dropout among U.S. born and immigrant youth is examined using data from the Collaborative Psychiatric Epidemiology Surveys (CPES), a nationally representative probability sample of African Americans, Afro-Caribbeans, Asians, Latinos, and non-Latino Whites, including 2532 young adults, ages 21 to 29. The dropout prevalence rate was 16% overall, with variation by childhood trauma, childhood psychiatric diagnosis, race/ethnicity, and nativity. Childhood substance and conduct disorders mediated the relationship between trauma and school dropout. Likelihood of dropout was decreased for Asians, and increased for African Americans and Latinos, compared to non-Latino Whites as a function of psychiatric disorders and trauma. Timing of U.S. immigration during adolescence increased risk of dropout. PMID:21410919

  11. Young voices in mental health care: Exploring children's and adolescents' service experiences and preferences.

    PubMed

    Persson, Stefan; Hagquist, Curt; Michelson, Daniel

    2017-01-01

    The development of 'youth-friendly' services has become a priority across a wide range of health-care contexts. However, relatively few studies have specifically examined users' experiences of, and preferences for, child and adolescent mental health care. The current study investigated young service users' views of outpatient and community mental health clinics in Sweden, based on two data sources. First, focus group interviews were conducted with seven children and adolescents (aged 10-18 years) to explore both positive and negative experiences of mental health care. Second, written suggestions about specific service improvements were obtained from 106 children and adolescents. Qualitative content analysis revealed three overarching themes: 'Accessibility', 'Being heard and seen' and 'Usefulness of sessions'. Young people's recommendations for improving practice included more convenient appointment times, offered in welcoming settings; opportunities to communicate more openly with clinical staff, enabling sensitive discussion of mental health and wider personal issues; and more structured treatments that offer greater credibility and relevance to young people's mental health and developmental needs. Young people also discussed being compelled by parents and school professionals to engage in treatment. Attending to young people's preferences must be a priority in order to overcome ambivalence about session attendance, and enhance treatment participation and outcomes.

  12. The Impact of Single Mothers' Health Insurance Coverage on Behavioral Health Services Utilization by Their Adolescent Children.

    PubMed

    Ali, Mir M; Teich, Judith L; Mutter, Ryan

    2017-03-02

    Adolescents living in single-mother households are more likely to have behavioral health conditions, but are less likely to utilize any behavioral health services. Using nationally representative mother-child pair data pooled over 6 years from the National Survey on Drug Use and Health, the study finds that when single mothers were uninsured, their adolescent children were less likely to utilize any behavioral health services, even when the children themselves were covered by insurance. The extension of health coverage under the Affordable Care Act (ACA) to uninsured single mothers could improve the behavioral health of the adolescent population.

  13. The MAPI as a Treatment Outcome Measure for Adolescent Inpatients.

    ERIC Educational Resources Information Center

    Piersma, Harry L.; And Others

    1993-01-01

    Administered Millon Adolescent Personality Inventory at admission and discharge to 215 hospitalized adolescent psychiatric patients. Found significant mean score differences for both internalizing (affective disorder) and externalizing (disruptive behavior disorder) adolescents. Internalizing adolescents reported significantly greater distress at…

  14. Psychiatric pharmacogenomics in pediatric psychopharmacology.

    PubMed

    Wall, Christopher A; Croarkin, Paul E; Swintak, Cosima; Koplin, Brett A

    2012-10-01

    This article provides an overview of where psychiatric pharmacogenomic testing stands as an emerging clinical tool in modern psychotropic prescribing practice, specifically in the pediatric population. This practical discussion is organized around the state of psychiatric pharmacogenomics research when choosing psychopharmacologic interventions in the most commonly encountered mental illnesses in youth. As with the rest of the topics on psychopharmacology for children and adolescents in this publication, a clinical vignette is presented, this one highlighting a clinical case of a 16 year old genotyped during hospitalization for recalcitrant depression.

  15. Maltreatment clusters among youth in outpatient substance abuse treatment: co-occurring patterns of psychiatric symptoms and sexual risk behaviors.

    PubMed

    Tubman, Jonathan G; Oshri, Assaf; Taylor, Heather L; Morris, Staci L

    2011-04-01

    The purpose of the current study was to describe the use of a brief maltreatment assessment instrument to classify adolescents receiving alcohol or other drug (AOD) treatment services based on the extensiveness and severity of prior maltreatment. This goal is significant because maltreatment reduces the effectiveness of AOD treatment and is associated significantly with co-occurring patterns of psychiatric symptoms and sexual risk behaviors. Structured interviews were administered to 300 adolescent treatment clients (202 males, 98 females; M = 16.22 years; SD = 1.13 years) to assess childhood maltreatment experiences, past year psychiatric symptoms, and sexual risk behaviors during the past 180 days. Cluster analysis classified adolescents into unique groups via self-reported sexual abuse, physical punishment, and parental neglect/negative home environment. Significant between-cluster differences in psychiatric symptoms and sexual risk behaviors were documented using MANOVA and chi-square analyses. More severe maltreatment profiles were associated with higher scores for psychiatric symptoms and unprotected intercourse. Significant heterogeneity and distinct types within this treatment sample of adolescents supports the adaptation of selected prevention efforts to promote HIV/STI risk reduction.

  16. Mechanisms for achieving adolescent-friendly services in Ecuador: a realist evaluation approach

    PubMed Central

    Goicolea, Isabel; Coe, Anna-Britt; Hurtig, Anna-Karin; San Sebastian, Miguel

    2012-01-01

    Background Despite evidence showing that adolescent-friendly health services (AFSs) increase young people's access to these services, health systems across the world are failing to integrate this approach. In Latin America, policies aimed at strengthening AFS abound. However, such services are offered only in a limited number of sites, and providers’ attitudes and respect for confidentiality have not been addressed to a sufficient extent. Methods The aim of this study was to explore the mechanisms that triggered the transformation of an ‘ordinary’ health care facility into an AFS in Ecuador. For this purpose, a realist evaluation approach was used in order to analyse three well-functioning AFSs. Information was gathered at the national level and from each of the settings including: (i) statistical information and unpublished reports; (ii) in-depth interviews and focus group discussions with policy makers, health care providers, users and adolescents participating in youth organisations and (iii) observations at the health care facilities. Thematic analysis was carried out, driven by the realist evaluation approach, namely exploring the connections between mechanisms, contexts and outcomes. Results The results highlighted that the development of the AFSs was mediated by four mechanisms: grounded self-confidence in trying new things, legitimacy, a transformative process and an integral approach to adolescents. Along this process, contextual factors at the national and institutional levels were further explored. Conclusion The Ministry of Health of Ecuador, based on the New Guidelines for Comprehensive Care of Adolescent Health, has started the scaling up of AFSs. Our research points towards the need to recognise and incorporate these mechanisms as part of the implementation strategy from the very beginning of the process. Although contextually limited to Ecuador, many mechanisms and good practices in these AFS may be relevant to the Latin American setting and

  17. Using administrative data to assess the process of treatment services for adolescents with substance use disorders.

    PubMed

    Cavanaugh, Doreen A; Doucette, Ann

    2004-12-01

    In 1998, the Center for Substance Abuse Treatment (CSAT), Substance Abuse and Mental Health Services Administration (SAMHSA) convened an expert panel comprised of a multidisciplinary group of providers, researchers, managed care representatives and public policymakers known as the Washington Circle (WC) to improve the quality and effectiveness of treatment for substance use disorders through the use of performance measures. The initial goals of the panel included developing, testing and implementing performance measures in health plans and encouraging collaboration with key stakeholders to ensure widespread adoption of the measures. The WC focused its initial efforts on the prevention, recognition and treatment of adults with alcohol and other drug (AOD) disorders who receive health care through private and/or public sector health plans (McCorry et al. 2000). In 2002, CSAT, aware of the need to improve access and quality of treatment for adolescents, supported the Washington Circle in the establishment of a special subcommittee focused specifically on adolescent treatment issues. This article introduces the work of the Washington Circle and describes the Adolescent Subcommittee's progress in developing performance measures for the treatment of adolescents with substance use disorders.

  18. Comparing service use and costs among adolescents with autism spectrum disorders, special needs and typical development.

    PubMed

    Barrett, Barbara; Mosweu, Iris; Jones, Catherine Rg; Charman, Tony; Baird, Gillian; Simonoff, Emily; Pickles, Andrew; Happé, Francesca; Byford, Sarah

    2015-07-01

    Autism spectrum disorder is a complex condition that requires specialised care. Knowledge of the costs of autism spectrum disorder, especially in comparison with other conditions, may be useful to galvanise policymakers and leverage investment in education and intervention to mitigate aspects of autism spectrum disorder that negatively impact individuals with the disorder and their families. This article describes the services and associated costs for four groups of individuals: adolescents with autistic disorder, adolescents with other autism spectrum disorders, adolescents with other special educational needs and typically developing adolescents using data from a large, well-characterised cohort assessed as part of the UK Special Needs and Autism Project at the age of 12 years. Average total costs per participant over 6 months were highest in the autistic disorder group (£11,029), followed by the special educational needs group (£9268), the broader autism spectrum disorder group (£8968) and the typically developing group (£2954). Specialised day or residential schooling accounted for the vast majority of costs. In regression analysis, lower age and lower adaptive functioning were associated with higher costs in the groups with an autism spectrum disorder. Sex, ethnicity, number of International Classification of Diseases (10th revision) symptoms, autism spectrum disorder symptom scores and levels of mental health difficulties were not associated with cost.

  19. Caregiver Factors Predicting Service Utilization among Youth Participating in a School-Based Mental Health Intervention

    ERIC Educational Resources Information Center

    Burnett-Zeigler, Inger; Lyons, John S.

    2010-01-01

    Large numbers of children and adolescents experience diagnosable psychiatric disturbances; however, the majority of those with need do not utilize mental health services. Characteristics of caregivers are important predictors of which youth will access and continue to use services over time. In recent years school-based mental health intervention…

  20. Mental Health Services for Children; Focus: The Community Mental Health Center.

    ERIC Educational Resources Information Center

    National Inst. of Mental Health (DHEW), Rockville, MD. Center for Studies of Child and Family Mental Health.

    The need to help the emotionally disturbed is discussed with a focus on community mental health centers. Psychiatric services described are diagnosis, inpatient care, day care, outpatient care, emergency care, continuity of care and services, and care adjusted to age groupings ranging from infancy to adolescence. Aspects of the community goal of…

  1. Childhood Sexual Abuse, Adult Psychiatric Morbidity, and Criminal Outcomes in Women Assessed by Medium Secure Forensic Service

    ERIC Educational Resources Information Center

    Dolan, Mairead; Whitworth, Helen

    2013-01-01

    There is little literature on childhood sexual abuse in women seen by forensic services. A cohort of 225 cases of women seen by forensic services in a medium secure unit in the UK were examined, and childhood sexual abuse and non-childhood sexual abuse cases were compared. Over half the sample had a history of childhood sexual abuse, and 5.6% of…

  2. Psychiatric emergencies.

    PubMed

    Cavanaugh, S V

    1986-09-01

    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

  3. Comprehensive Adolescent Health Programs That Include Sexual and Reproductive Health Services: A Systematic Review

    PubMed Central

    Parekh, Jenita; Tunçalp, Özge; Turke, Shani; Blum, Robert William

    2014-01-01

    We systematically reviewed peer-reviewed and gray literature on comprehensive adolescent health (CAH) programs (1998–2013), including sexual and reproductive health services. We screened 36 119 records and extracted articles using predefined criteria. We synthesized data into descriptive characteristics and assessed quality by evidence level. We extracted data on 46 programs, of which 19 were defined as comprehensive. Ten met all inclusion criteria. Most were US based; others were implemented in Egypt, Ethiopia, and Mexico. Three programs displayed rigorous evidence; 5 had strong and 2 had modest evidence. Those with rigorous or strong evidence directly or indirectly influenced adolescent sexual and reproductive health. The long-term impact of many CAH programs cannot be proven because of insufficient evaluations. Evaluation approaches that take into account the complex operating conditions of many programs are needed to better understand mechanisms behind program effects. PMID:25320876

  4. Perceived humiliation during admission to a psychiatric emergency service and its relation to socio-demography and psychopathology

    PubMed Central

    2013-01-01

    Background There is a lack of empirical studies of patients’ level of humiliation during the hospital admission process and its implications for the clinical setting. We wanted to explore associations between self-rated humiliation and socio-demography and psychopathology in relation to admission to a psychiatric emergency unit. Methods Consecutively admitted patients (N = 186) were interviewed with several validated instruments. The patients self-rated humiliation by The Cantril Ladder, and 35% of the sample was defined as the high humiliation group. Results Final multivariate analysis found significant associations between compulsory admission, not being in paid work, high scores on hostility, and on entitlement, and high levels of humiliation. No significant interactions were observed between these variables, and the narcissism score was not a confounder concerning humiliation. Conclusions High level of humiliation during the admission process was mainly related to patient factors, but also to compulsory admission which should be avoided as much as possible protecting the self-esteem of the patients. PMID:23988222

  5. Mental Health Service Use among 18-Year-Old Adolescent Boys: A Prospective 10-Year Follow-Up Study.

    ERIC Educational Resources Information Center

    Sourander, Andre; Multimaki, Petteri; Santalahti, Paivi; Parkkola, Kai; Haavisto, Antti; Helenius, Hans; Nikolakaros, Georgios; Piha, Jorma; Tamminen, Tuula; Moilanen, Irma; Kumpulainen, Kirsti; Aronen, Eeva T.; Linna, Sirkka-Liisa; Puura, Kaija; Almqvist, Fredrik

    2004-01-01

    Objective: To study prevalence and factors associated with mental health service use among 18-year-old adolescent boys. Method: Predictors at age 8 and factors at age 18 associated with mental health service use during the preceding 12 months were studied in a general population sample of 2,316 Finnish boys born in 1981 attending military call-up…

  6. The effect of marijuana scenes in anti-marijuana public service announcements on adolescents' evaluation of ad effectiveness.

    PubMed

    Kang, Yahui; Cappella, Joseph N; Fishbein, Martin

    2009-09-01

    This study explored the possible negative impact of a specific ad feature-marijuana scenes-on adolescents' perceptions of ad effectiveness. A secondary data analysis was conducted on adolescents' evaluations of 60 anti-marijuana public service announcements that were a part of national and state anti-drug campaigns directed at adolescents. The major finding of the study was that marijuana scenes in anti-marijuana public service announcements negatively affected ad liking and thought valence toward the ads among adolescents who were at higher levels of risk for marijuana use. This negative impact was not reversed in the presence of strong anti-marijuana arguments. The results may be used to partially explain the lack of effectiveness of the anti-drug media campaign. It may also help researchers design more effective anti-marijuana ads by isolating adverse elements in the ads that may elicit boomerang effects in the target population.

  7. Implementing CBT for Traumatized Children and Adolescents after September 11: Lessons Learned from the Child and Adolescent Trauma Treatments and Services (CATS) Project

    ERIC Educational Resources Information Center

    Journal of Clinical Child and Adolescent Psychology, 2007

    2007-01-01

    The Child and Adolescent Trauma Treatments and Services Consortium (CATS) was the largest youth trauma project associated with the September 11 World Trade Center disaster. CATS was created as a collaborative project involving New York State policymakers; academic scientists; clinical treatment developers; and routine practicing clinicians,…

  8. Motivational Interviewing and Adolescent Psychopharmacology

    ERIC Educational Resources Information Center

    Dilallo, John J.; Weiss, Gony

    2009-01-01

    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.

  9. Child and Adolescent Mental Health in Haiti: Developing Long-Term Mental Health Services After the 2010 Earthquake.

    PubMed

    Legha, Rupinder K; Solages, Martine

    2015-10-01

    This article presents an overview of child and adolescent mental health in Haiti, emphasizing the role of structural violence and the factors shaping child protection. The 2010 Haiti earthquake is discussed as an acute on chronic event that highlighted the lack of pre-existing formal biomedical mental health services and worsened the impact of structural violence. Considerations for long-term, sustainable, culturally relevant child and adolescent mental health care in Haiti are also provided.

  10. QUANTITATIVE ASSESSMENT OF SOME PREVENTIVE HEALTH SERVICES PROVIDED FOR ADOLESCENT INDIVIDUALS IN DUBAI.

    PubMed

    Khansaheb, Hamda; Hussein, Ayman; Hamidi, Samer; Brown, David; Younis, Mustafa Z

    2016-01-01

    The United Arab Emirate (UAE) of Dubai, faces significant adolescent health problems. In 2009, evidence based clinical guidelines were developed for primary health care professionals in Dubai to help reduce adolescent health problems. This research study explores adolescents' self-reports about health education services received between 2008 and 2010. The sample consisted of 730 public high school students in grades 10 through 12 between the ages of 15 and 19. 357 (48.9%) of the sample were males and 373 (51.1%) were female. The major language spoken in the home was Arabic (77.4%). All students completed a 27-item survey in Arabic that was adapted from the Young Adult Health Care Survey (YAHCS). The YAHCS is a 56-item research instrument traditionally administered in English and Spanish. The sample reported they had received little or no health education from their health care providers. 94.2% reported receiving no information about using a helmet for bicycle and motorbike safety; 88.2% reported receiving no information about drug use; and 81.9% reported that they received no information about smoking. The instrument also explored the health education material students received within the last 12 months. 65.5% of the sample reported seeing and/or hearing safety tips; 84.9% reported hearing and/or seeing health information about healthy diet, physical activity and exercise; and 79.2% reported seeing and/or hearing information about the risks of smoking and substance abuse.

  11. The characteristics and activities of child and adolescent mental health services in Italy: a regional survey

    PubMed Central

    2012-01-01

    Background To date, no studies have assessed in detail the characteristics, organisation, and functioning of Child and Adolescent Mental Health Services (CAMHS). This information gap represents a major limitation for researchers and clinicians because most mental disorders have their onset in childhood or adolescence, and effective interventions can therefore represent a major factor in avoiding chronicity. Interventions and mental health care are delivered by and through services, and not by individual, private clinicians, and drawbacks or limitations of services generally translate in inappropriateness and ineffectiveness of treatments and interventions: therefore information about services is essential to improve the quality of care and ultimately the course and outcome of mental disorders in childhood and adolescence. The present paper reports the results of the first study aimed at providing detailed, updated and comprehensive data on CAMHS of a densely populated Italian region (over 4 million inhabitants) with a target population of 633,725 subjects aged 0-17 years. Methods Unit Chiefs of all the CAMHS filled in a structured 'Facility Form', with activity data referring to 2008 (data for inpatient facilities referred to 2009), which were then analysed in detail. Results Eleven CAMHS were operative, including 110 outpatient units, with a ratio of approximately 20 child psychiatrists and 23 psychologists per 100,000 inhabitants aged 0-17 years. All outpatient units were well equipped and organized and all granted free service access. In 2008, approximately 6% of the target population was in contact with outpatient CAMHS, showing substantial homogeneity across the eleven areas thereby. Most patients in contact in 2008 received a language disorder- or learning disability diagnosis (41%). First-ever contacts accounted for 30% of annual visits across all units. Hospital bed availability was 5 per 100,000 inhabitants aged 0-17 years. Conclusion The percentage of

  12. Preparedness of County Referral Health Facilities in Implementing Adolescent Friendly Health Services: A Case Study of Mama Lucy Kibaki Hosptal

    PubMed Central

    Owuondo, Pacific Akinyi; Mwaura-Tenembergen, Wanja; Adoyo, Maureen; Kiilu, Elizabeth M.

    2015-01-01

    Health service delivery is a key pillar of the health system management .The World Health Organization recently emphasized the need to develop adolescent -friendly health services to improve the care provided to young people throughout the world. However, there is limited peer reviewed literature on this subject therefore necessitating assessment of whether the existing health facilities are prepared to implement the adolescent friendly health services. Adolescent friendly health services remains a relatively new and sensitive area mainly due to restrictive norms and policies guiding the services. After International Conference on Population and Development in 1994, countries started implementing adolescent friendly health services. The Government of Kenya together with partners in an attempt to address the health challenges came up with the Adolescent package of care (APOC) in 2013 whose guidelines were finalized in November 2014 and released for use by service providers . Despite this package of care, there is still ineffective staff capacity in relation to skills and knowledge gap of health professionals, training needs, health resources as well as health system factors that can affect implementation of AFHS. The study explored ways of mitigating or addressing the barriers to implementation of these services. The study used both quantitative and qualitative approaches to collect data. The study utilized survey research adapting descriptive cross sectional design and semi-structured questionnaire to interview 348 health care providers and 472 adolescents in Mam Lucy Kibaki Hospital from 3rd May 2014 to 16 June 2014 .The key informants were mainly nurses, clinical officers and Medical doctors who were working at the health service delivery area at the time of study and were interviewed using an interview guide. The managers at the hospital were interviewed using an in-depth interview guide while the adolescents were interviewed through interview guide and focused

  13. The National Trajectory Project of Individuals Found Not Criminally Responsible on Account of Mental Disorder. Part 5: How Essential Are Gender-Specific Forensic Psychiatric Services?

    PubMed Central

    Nicholls, Tonia L; Crocker, Anne G; Seto, Michael C; Wilson, Catherine M; Charette, Yanick; Côté, Gilles

    2015-01-01

    Objective: To state the sociodemographic characteristics, mental health histories, index offence characteristics, and criminal histories of male and female forensic psychiatric patients. Clinicians and researchers advocate that mental health and criminal justice organizations implement gender-specific services; however, few studies have sampled forensic patients to evaluate the extent to which men’s and women’s treatment and management needs are different. Method: Data were collected from Review Board files from May 2000 to April 2005 in the 3 largest Canadian provinces. Using official criminal records, participants were followed for 3 to 8 years, until December 2008. The final sample comprised 1800 individuals: 15.6% were women and 84.4% were men. Results: There were few demographic differences, but women had higher psychosocial functioning than men. Both men and women had extensive mental health histories; women were more likely diagnosed with mood disorders and PDs and men were more likely diagnosed with schizophrenia spectrum disorders and SUDs. The nature of the index offence did not differ by gender, except women were more likely to have perpetrated murders and attempted murders. For offences against a person, women were more likely to offend against offspring and partners and less likely to offend against strangers, compared with men. Women had significantly less extensive criminal histories than men. Conclusions: Not criminally responsible on account of mental disorder–accused women have a distinct psychosocial, clinical, and criminological profile from their male counterparts, which may suggest gender-specific assessment, risk management, and treatment in forensic services could benefit patients. The findings are also consistent with traditional models (Risk-Need-Responsivity) and ultimately demonstrate the importance of individual assessment and client-centred services. PMID:25886689

  14. Improving the Implementation of Evidence-Based Clinical Practices in Adolescent Reproductive Health Care Services

    PubMed Central

    Romero, Lisa M.; Middleton, Dawn; Mueller, Trisha; Avellino, Lia; Hallum-Montes, Rachel

    2015-01-01

    Purpose The purposes of the study were to describe baseline data in the implementation of evidence-based clinical practices among health center partners as part of a community-wide teen pregnancy prevention initiative and to identify opportunities for health center improvement. Methods Health center partner baseline data were collected in the first year (2011) and before program implementation of a 5-year community-wide teen pregnancy prevention initiative. A needs assessment on health center capacity and implementation of evidence-based clinical practices was administered with 51 health centers partners in 10 communities in the United States with high rates of teen pregnancy. Results Health centers reported inconsistent implementation of evidence-based clinical practices in providing reproductive health services to adolescents. Approximately 94.1% offered same-day appointments, 91.1% had infrastructure to reduce cost barriers, 90.2% offered after-school appointments, and 80.4% prescribed hormonal contraception without prerequisite examinations or testing. Approximately three quarters provided visual and audio privacy in examination rooms (76.5%) and counseling areas (74.5%). Fewer offered a wide range of contraceptive methods (67.8%) and took a sexual health history at every visit (54.9%). Only 45.1% reported Quick Start initiation of hormonal contraception, emergency contraception (43.1%), or intrauterine devices (12.5%) were “always” available to adolescents. Conclusions The assessment highlighted opportunities for health center improvement. Strategies to build capacity of health center partners to implement evidence-based clinical practices may lead to accessibility and quality of reproductive health services for adolescents in the funded communities. PMID:26381918

  15. Trends in Psychopathology across the Adolescent Years: What Changes When Children become Adolescents, and When Adolescents become Adults?

    ERIC Educational Resources Information Center

    Costello, E. Jane; Copeland, William; Angold, Adrian

    2011-01-01

    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…

  16. Childhood ADHD Is Strongly Associated with a Broad Range of Psychiatric Disorders during Adolescence: A Population-Based Birth Cohort Study

    ERIC Educational Resources Information Center

    Yoshimasu, Kouichi; Barbaresi, William J.; Colligan, Robert C.; Voigt, Robert G.; Killian, Jill M.; Weaver, Amy L.; Katusic, Slavica K.

    2012-01-01

    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…

  17. Preliminary Evidence Suggesting Caution in the Use of Psychiatric Self-Report Measures with Adolescents with High-Functioning Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Mazefsky, C. A.; Kao, J.; Oswald, D. P.

    2011-01-01

    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…

  18. The TAPS Project 41: homes for life? Residential stability five years after hospital discharge. Team for the Assessment of Psychiatric Services.

    PubMed

    Trieman, N; Smith, H E; Kendal, R; Leff, J

    1998-08-01

    This paper describes pathways followed by 567 long-stay patients who were resettled into the community, as part of a program to close two psychiatric hospitals in London and replace them with community-based services. Sixty-one percent of the former patients remained in their original placement--mostly group homes--over the five-year follow-up. Transition from one house to another mostly took a direct course, with only 27 patients changing houses by way of long intermediate hospitalisation. Change of residence was at the same level of support, with only a slight trend towards less supervised facilities. Ten patients could not be traced and have possibly become homeless. Only 3 patients were in prison during the five-year follow-up. More than a third of the sample were readmitted at least once during that period. It is concluded that community residences established under the resettlement program served as relatively stable homes for the majority of patients.

  19. Improving smoking cessation policy by assessing user demand for an inpatient smoking cessation service in adult psychiatric wards.

    PubMed

    Liu, Kathy; Creamer, Andrew

    2015-01-01

    Smoking rates are higher among people with mental health conditions compared to the general population. Smoking reduces physical, mental and financial well-being, and interacts with psychotropic drugs. An inpatient admission provides an opportunity to engage and support smokers in smoking cessation. Compliance with Trust/NICE smoking cessation guidelines was assessed in two inpatient wards, and a questionnaire evaluated user demand for an inpatient smoking cessation service. A need for improved documentation of smoking status to identify and treat smokers routinely was revealed. A new electronic health form was designed and introduced, and a clear pathway for onward referrals was developed. This intervention preceded the introduction of the Trust-wide smoke free policy from October 2014. The intervention doubled rates of documentation of smoking status, cessation advice and offer of NRT/referral. There were large differences between the two wards, highlighting the need for a tailored approach.

  20. Psychiatric symptoms, social disablement and illness behaviour.

    PubMed

    Hurry, J; Bebbington, P E; Tennant, C

    1987-03-01

    In this paper we investigate the relationship between social performance and the use of medical services, and to what extent this is independent of clinical disorder. In a sample of adults living in Camberwell, South London, social disability and clinical disorder were both predictive of service use. Those subjects who were admitted to psychiatric day-patient or inpatient facilities were found to show the highest levels of both types of impairment, followed by psychiatric outpatients. People who had seen their general practitioner because of their 'nerves' were less impaired than those in touch with the specialist psychiatric services but had significantly poorer social performance and a higher level of clinical disorder than people not in contact with medical services at all. When the severity of clinical disorder was controlled, however, levels of social performance no longer discriminated between the different groups of service users, except that psychiatric outpatients remained significantly more socially disabled than the general practice group.