Brandhorst I, Lindenberg K, Paschke K
… +8 more, Paulus FW, Reiter A, Renner T, Klein M, Poustka L, Legenbauer T, Gimm C, Möhler E
Z Kinder Jugendpsychiatr Psychother
· 2026 Jul · PMID 42394609
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Digital media have become a central part of children's and adolescents' daily lives, with increasing usage time and decreasing age of first exposure in recent years. While digital technologies offer opportunities for soc...Digital media have become a central part of children's and adolescents' daily lives, with increasing usage time and decreasing age of first exposure in recent years. While digital technologies offer opportunities for social participation, access to information, education, and therapeutic support, they are also associated with several risks to mental health. These include problematic use patterns, cyberbullying, exposure to harmful content and hazardous contacts as well as commercial exploitation through manipulative design practices ("dark patterns"). This evidence review summarizes current research on the opportunities and risks of digital media use from a developmental perspective across three age groups (0 - 5, 6 - 13, and 14 - 18 years). Evidence suggests associations between intensive media use and risks for sleep, attention, language development, psychosocial well-being, and academic performance. In adolescence, problematic internet use is also associated with behavioral addictions and mental health problems. Overall, the findings highlight the need for a balanced approach to digital media use, including age-appropriate protection, media literacy, and regulatory measures to safeguard the mental health of young people. This overview forms the basis for the position statement of the German Scientific Society and Associations for Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy on digital media use and mental health of children and adolescents.
Klosinski M, Bernhardt K, Hahnefeld A
… +3 more, Mall V, Wermuth I, Schulte-Körne G
Z Kinder Jugendpsychiatr Psychother
· 2026 Jun · PMID 42307001
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This study aimed to assess how relevant mental health professionals consider intercultural competence to be for their work, to evaluate the existing self-rated knowledge in this area, to conduct a needs analysis for addi...This study aimed to assess how relevant mental health professionals consider intercultural competence to be for their work, to evaluate the existing self-rated knowledge in this area, to conduct a needs analysis for additional training opportunities, and to identify influencing variables. We sent a link to an online survey via the mailing list of the German Society for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy. We supplemented a standardized tool for assessing intercultural competence with aspects relevant to Child and Adolescent Psychiatry and Psychotherapy. Of the = 142 participants, over 95 % considered cultural aspects to be relevant in their work. Only 20 % had ever attended intercultural training, and over 90 % would like to receive further training. Variables such as age, sex, and experience abroad correlated with some of the item responses. The findings clearly show a need and desire for training in this field. We suggest including intercultural competence in curricula and training offers for all mental health professionals to improve the quality of mental healthcare in Child and Adolescent Psychiatry and Psychotherapy.
Z Kinder Jugendpsychiatr Psychother
· 2026 Jun · PMID 42284342
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Neurodiversity and Autism - A Critical Examination of a Popular Concept Neurodiversity refers to the natural diversity of human beings and thus emphasizes the natural range of differences between people. As simple, conv...Neurodiversity and Autism - A Critical Examination of a Popular Concept Neurodiversity refers to the natural diversity of human beings and thus emphasizes the natural range of differences between people. As simple, convincing, and popular as this assumption is, the interpretations, conclusions, and implications of this statement are just as varied. This article focuses on the scientific basis of the concept, on the one hand, and on autism and divergence, on the other. It outlines the implications regarding biological determinism, identity, and the effects on diagnosis and therapy, and examines and critically reflects on the demands arising from the concept. The author concludes that the claim of "neurological difference" posited in the context of neurodiversity - which asserts a fundamental, innate distinctiveness and, at the same time, a specific mode of functioning, as well as the determination of a person´s identity by these factors - has not been sufficiently substantiated by empirical research. Clinical evidence regarding the etiology, heterogeneity, course, and changeability of the diagnoses encompassed by this concept is not compatible with the assumed determinism regarding a person´s identity. Neurodiversity is an important approach to reducing stigmatization and promoting acceptance of difference, but diversity should not be limited by new stereotypes, and in-group-out-group processes are not helpful regarding acceptance, openness, and tolerance. Diagnoses instrumentalized in the sense of identity formation, stabilization, and justification for otherness do not imply an appreciative attitude toward those whose deficits, limited behavioral and developmental possibilities, suffering, and impairments are described by the diagnoses.
Beer CS, Jörke CM, Kölch M
… +3 more, Legenbauer T, Holtmann M, Bienioschek S
Z Kinder Jugendpsychiatr Psychother
· 2026 Jun · PMID 42281462
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Depression is among the most common disorders in adolescence and is closely linked to sleep behavior and quality of life. Long-term studies examining the course of depressive symptoms after inpatient treatment are scarce...Depression is among the most common disorders in adolescence and is closely linked to sleep behavior and quality of life. Long-term studies examining the course of depressive symptoms after inpatient treatment are scarce. The present study investigated changes in depressive symptoms among adolescents following inpatient treatment, focusing on associations with sleep-wake rhythm and subjective quality of life. The sample comprised = 38 adolescents (age = 18.63, age = 1.71; 85.4 % female) who had previously been hospitalized for a depressive disorder. The follow-up study spanned 5 years, during which sociodemographic data as well as the values from the Beck Depression Inventory-II (BDI-II), the Morningness-Eveningness Questionnaire (MEQ), and the KIDSCREEN were collected annually online. Significant reductions in depressive symptoms and increases in life satisfaction were observed between follow-up II and the catamnesis assessment. BDI-II and MEQ scores were significantly correlated, whereas changes in depressive symptoms were not associated with alterations in sleep behavior. The MEQ indicated a significant shift in chronotype from eveningness to morningness over time. Symptom improvement was evident at the catamnesis timepoint. Due to the small sample size, no generalizable conclusions can be drawn. Further follow-up studies are needed to examine symptom trajectories after inpatient treatment.
Waltereit J, Borghoff C, Schulte-Rüther M
… +2 more, Roessner V, Waltereit R
Z Kinder Jugendpsychiatr Psychother
· 2026 Jun · PMID 42262184
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Algorithm for the Retrospective Diagnostic Assessment of ICD-10, ICD-11, and DSM-5 ADHD Symptoms in Primary School Reports According to the German S3 guideline, diagnosing attention deficit/hyperactivity disorder (ADHD)...Algorithm for the Retrospective Diagnostic Assessment of ICD-10, ICD-11, and DSM-5 ADHD Symptoms in Primary School Reports According to the German S3 guideline, diagnosing attention deficit/hyperactivity disorder (ADHD) requires evidence of symptom onset during childhood. This poses a particular challenge when assessing adolescents and young adults. Primary school reports can provide valuable information about earlier patterns of work and social behavior, thereby allowing a retrospective assessment of ADHD-related symptoms - specifically inattention, impulsivity, and hyperactivity. In our 2025 study (Waltereit et al., 2025), we systematically and quantitatively analyzed primary school reports from a sample in the German federal state of Saxony using the diagnostic criteria for ADHD according to ICD-10, ICD-11, and DSM-5. The results demonstrated high diagnostic discrimination between reports of children with ADHD and those of healthy controls. Based on these findings, we developed the ADHD-ZEBRA (Analysis of Primary School Reports for Symptoms of ADHD) through an iterative design process. This article presents and discusses the procedure that operationalizes the empirical findings for the practical application in clinical settings. The aim is to make this frequently used, but to date nonstandardized source of information more usable and to strengthen the diagnostic validity of ADHD in adolescence and young adulthood.
Roessner V, Weise V, Voigt A
… +4 more, Rothe J, Nagler T, Balzer A, Holtmann M
Z Kinder Jugendpsychiatr Psychother
· 2026 Jun · PMID 42240205
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School Support Assistance as an Instrument for Inclusive Schooling in Germany: A Pedagogical and Child and Adolescent Psychiatric Perspective This article examines the role of school support assistance in Germany from b...School Support Assistance as an Instrument for Inclusive Schooling in Germany: A Pedagogical and Child and Adolescent Psychiatric Perspective This article examines the role of school support assistance in Germany from both a pedagogical and a child and adolescent psychiatric and psychotherapeutic perspective. It analyzes its conditions, potentials, and limitations based on legal and structural-systemic considerations. The findings indicate that school support services too often serve as a central prerequisite for attendance in mainstream schools, as they are frequently deployed when schools are unable to provide the structural conditions for inclusive education. As a result, the responsibility for ensuring educational participation is shifted from the institutional level of the school system to individually approved services within the child and youth welfare system. Coordination and delineation problems emerge at the interface of these two systems. These problems are further intensified by heterogeneous qualification levels and role conflicts and increase the risk of unintended exclusionary effects. Particularly for students experiencing psychological distress, school support assistance often assumes tasks that would require a continuous and professionally grounded integration of child and adolescent psychiatric and psychotherapeutic expertise in school-based support processes. This situation points to the need for a quantitatively and qualitatively stronger presence of relevant professional expertise in everyday school practice as well as for systematically coordinated cooperation with the therapeutic systems involved in treatment. From the perspective of child and adolescent psychiatry and psychotherapy, binding cooperation structures between schools, child and youth welfare services, and child and adolescent psychiatry and psychotherapy as well as clearly defined qualification standards and an increased emphasis on structurally oriented support models must therefore be developed and consistently implemented to secure inclusive education in a sustainable and participation-oriented manner.
Hearn B, von Lucadou A, Rauh R
… +1 more, Fleischhaker C
Z Kinder Jugendpsychiatr Psychother
· 2026 Apr · PMID 42037361
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Pilot Study on the Feasibility and Effectiveness of IPT-A for the Outpatient Treatment of Depression at a German Healthcare Clinic Depression in adolescence is highly prevalent and requires effective treatment approach...Pilot Study on the Feasibility and Effectiveness of IPT-A for the Outpatient Treatment of Depression at a German Healthcare Clinic Depression in adolescence is highly prevalent and requires effective treatment approaches. Interpersonal Psychotherapy for Adolescents (IPT-A) has proved effective internationally, but data from German clinical settings are lacking. This pilot study aimed to examine the feasibility and effectiveness of the German version of IPT-A for adolescents with depression. Twenty-four outpatients (17 female, 7 male) aged 12 - 18 years ( = 15.96, = 1.66) with a primary diagnosis of depression received 12 - 16 sessions of IPT-A. We assessed feasibility via dropout rate. The primary outcome measure was the Children's Depression Rating Scale-Revised (CDRS-R), assessed at pretreatment, posttreatment, and 6-month follow-up. Additionally, questionnaires were included (Beck Depression Inventory II [BDI-II], Global Assessment of Functioning Scale [GAF], Conflict Behavior Questionnaire [CBQ-20]). The dropout rate was 25 %. Depressive symptoms, as measured by the CDRS-R, decreased significantly over time with a large effect size, and reductions were maintained at the 6-month follow-up. The findings indicate that IPT-A is feasible in the German clinical care context and can reduce depressive symptoms in adolescents. Further research with larger samples and randomized controlled designs is needed to confirm these results and to investigate treatment mechanisms in more detail.
Z Kinder Jugendpsychiatr Psychother
· 2026 Jul · PMID 41995162
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The Mental Health Crisis The mental health of adolescents has deteriorated in many countries around the world over the past two decades. This article presents the possible causes, such as the consequences of the current...The Mental Health Crisis The mental health of adolescents has deteriorated in many countries around the world over the past two decades. This article presents the possible causes, such as the consequences of the current global crises and the influence of social media, against the backdrop of current literature. It examines alternative hypotheses for the increase in various diagnoses (gender dysphoria, autism spectrum disorder, attention deficit/hyperactivity disorder) and discusses topics ranging from changes in diagnostic criteria, the neurodiversity movement, and the expansion of diagnostic concepts ("concept creep") to looping effects. It also examines possible consequences (care-prevalence paradox) regarding specific risk groups and derives implications for good and equitable child and adolescent psychiatric and psychotherapeutic care in the future.
Z Kinder Jugendpsychiatr Psychother
· 2026 Apr · PMID 41954413
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In this observational study, we investigated which therapeutic characteristics affect the attitudes of psychotherapists working with children and adolescents toward Outcome (OM) and Routine Outcome Monitoring (ROM), and...In this observational study, we investigated which therapeutic characteristics affect the attitudes of psychotherapists working with children and adolescents toward Outcome (OM) and Routine Outcome Monitoring (ROM), and how implementation is affected by previous experience and attitudes toward administering OM/ROM. We assessed the attitudes of licensed German psychotherapists and psychotherapists in training working with children and adolescents toward the OM/ROM in an online survey conducted between June 2023 and March 2024 ( = 126). Compared with psychoanalytic-oriented therapists, therapists with an orientation in cognitive behavioral therapy (CBT) presented more positive attitudes, but we found no significant difference between orientations in CBT and psychodynamic psychotherapy. Therapists working in institutionalized outpatient settings reported more positive attitudes than those working in private practices. We found no effect of previous experience in administering OM/ROM for either implementation barriers or facilitators. However, more positive attitudes toward OM/ROM are associated with higher expectations regarding both support in therapeutic processes and support in clarification. OM/ROM systems should consider assessing concepts from different psychotherapeutic orientations. The implementation of OM/ROM could benefit from close monitoring.
Z Kinder Jugendpsychiatr Psychother
· 2026 Mar · PMID 41665918
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The Development of Suicide Rates Among Children and Adolescents in Germany from 2005 to 2023: Gender- and Age-Specific Trends An analysis of suicide progression figures can provide indications of the influencing (suicid...The Development of Suicide Rates Among Children and Adolescents in Germany from 2005 to 2023: Gender- and Age-Specific Trends An analysis of suicide progression figures can provide indications of the influencing (suicide-prevention) factors and therefore represents a relevant health policy task. Suicide-prevention factors can be effective depending on age and gender. For this reason, suicide rates should be analyzed separately by gender and age range. Before the impact of the corona pandemic, suicide figures in Germany were at an all-time low. From a child and adolescent psychiatric and psychotherapeutic perspective, the question arises as to whether the decline in numbers - and thus the effectiveness of suicide-prevention efforts - also relates to childhood and adolescence. We calculated joinpoint regressions to analyze possible trends and significant trend changes in the development of suicide rates over time. There was a decline in suicide rates of older male adolescents from 2005 to 2023. For older female adolescents, on the other hand, there is an overall increase in suicide rates, significant trend changes, and a significant increase in suicide rates even before the corona pandemic. The rise in suicide rates among females is also evident in younger female adolescents. In contrast, there is no significant trend among younger male adolescents. The suicide progression figures illustrate the need for gender- and age-specific analyses. We present the implications of these findings for suicide prevention in childhood and adolescence.