Masanneck L, Repple J, Meuth SG
… +3 more, Holtmann M, Föcker M, Pawlitzki M
Z Kinder Jugendpsychiatr Psychother
· 2026 Jan · PMID 40758319
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While structured treatment programs for children and adolescents with psychiatric disorders exist, their geographic distribution remains unclear. Specialized addiction treatment facilities for young patients are particul...While structured treatment programs for children and adolescents with psychiatric disorders exist, their geographic distribution remains unclear. Specialized addiction treatment facilities for young patients are particularly scarce in Germany. This study examines access to child and adolescent psychiatric care using a driving time-based isochrone analysis to identify regional disparities. We mapped outpatient clinics, inpatient departments, day clinics as well as specialized addiction centers and calculated the isochrones for 30, 60, 90, and 120 minutes of driving time. We then aggregated the resulting geometric areas and applied them to the Global Human Settlement Population Grid 2025 to estimate the number of German inhabitants with access to these centers within the specified time frames. While 98 % of Germans can reach a psychiatric care unit within 1 hour, the coverage is lower for specialized addiction clinics (60.5%). Within 120 minutes, more than 95 % of Germans can reach a center of any network. In addition to the generally underserved rural areas, such as those in northeastern Germany, specialized addiction clinics are underrepresented across all regions. Germany's adolescent psychiatric care is relatively strong, though some regions still face limited access and pose challenges to patients, especially regarding acute crisis interventions, where long travel times delay urgent care.
Z Kinder Jugendpsychiatr Psychother
· 2025 Nov · PMID 40742393
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Patients with Extremist Attitudes During Child and Adolescent Psychiatric and Psychotherapeutic Treatment Extremist attitudes are widespread in the general population. Children and adolescents not only have a significan...Patients with Extremist Attitudes During Child and Adolescent Psychiatric and Psychotherapeutic Treatment Extremist attitudes are widespread in the general population. Children and adolescents not only have a significant risk of growing up in families with extremist attitudes and being confronted with extremist content in their social environment, but they also often display the respective attitudes themselves. Extremist attitudes are often rooted in problematic developmental paths and experiences of crisis. They can also be associated with the presence of mental disorders, be exacerbated by them, or trigger them. There is also a risk of their committing crimes and violent acts in connection with extremist attitudes. Based on a selective literature review, this article explains the role child and adolescent psychiatrists and psychotherapists can play in preventing extremism, the complex mechanisms and developmental paths that underlie extremism, and how to address extremism and related risk situations during treatment.
Z Kinder Jugendpsychiatr Psychother
· 2026 Jan · PMID 40735768
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Changes in the Psychiatric Prevalence and Stress Level Among Clients of Residential Youth Care Centers in Switzerland? An Evaluation of the Routine Diagnostics of a Swiss Youth Home The sharp rise in inpatient admission...Changes in the Psychiatric Prevalence and Stress Level Among Clients of Residential Youth Care Centers in Switzerland? An Evaluation of the Routine Diagnostics of a Swiss Youth Home The sharp rise in inpatient admissions of adolescents poses a challenge for both psychiatric care and policymakers. Residential facilities within the youth welfare system are becoming increasingly burdened at the care interfaces. However, we cannot determine the extent of the problem because of the broad lack of studies on the prevalence of mental disorders and their severity in residential youth homes - especially in light of the lack of long-term studies of their presumed increase. An analysis of data from the Burghof Pestalozzi-Jugendstätte - an institution of the youth welfare system in German-speaking Switzerland providing comprehensive psychiatric and psychological care - should result in better information. We analyzed the frequency of ICD-10 diagnosis categories, the global psychosocial functioning level according to MAS Axis VI, a so-called dissocialization index, and other variables statistically using systematically documented retrospective data on all 448 admissions between 2008 and 2022. The prevalence of mental disorders was very high at 80-90 %. It was both cumulatively comorbid, with a shift from mainly externalizing to increasingly internalizing symptoms, a deterioration in the level of psychosocial functioning and performance on socialization pathways, and a decrease in age at admission. Increasing the pressure to address the psychiatric care needs of young people is becoming more and more noticeable in residential youth care facilities, which are confronted with a growing responsibility for psychiatric care tasks. Because the demands on social and vocational integration remain unchanged, these facilities must be able to respond by increasing both their effectiveness and their capacity.
Mechler K, Banaschewski T, Hellenschmidt T
… +14 more, Correll CU, Theisen FM, Kaess M, Kölch M, Libal G, Renner TJ, Fegert JM, Karwautz A, Plener PL, Heuschmann P, Fekete S, Romanos M, Egberts K, Häge A
Z Kinder Jugendpsychiatr Psychother
· 2025 Sep · PMID 40548886
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Attention-deficit/hyperactivity disorder (ADHD) affects 6-10 % of children and adolescents worldwide. While psychopharmacological treatments effectively reduce symptoms, incomplete adherence is common, diminishing their...Attention-deficit/hyperactivity disorder (ADHD) affects 6-10 % of children and adolescents worldwide. While psychopharmacological treatments effectively reduce symptoms, incomplete adherence is common, diminishing their effectiveness. This study investigated medication nonadherence and its predictors in children and adolescents with ADHD. The TDM-VIGIL study, a multicenter prospective observational study in Germany, examined drug-related risks of ADHD medication in hyperkinetic disorders and nonadherence. Participants aged 6-18 years with ADHD (ICD-10/DSM-IV) starting stimulants or nonstimulants were assessed for nonadherence using the Medication Assessment Questionnaire (MAQ) at multiple time points. Patients were classified as fully or not fully adherent, and logistic regression analysis was used to identify predictors. Among 198 participants (mean age = 10.4 years), 66.1 %-75.4 % were fully adherent across time points. Higher age and lower intelligence were significantly associated with nonadherence, while sex, disease severity, adverse events, treatment setting (outpatient, day clinic, inpatient), medication class (stimulant, nonstimulant), and treatment strategy (mono- versus polypharmacy) were not. Medication nonadherence is common in youth with ADHD, with higher age and lower intelligence representing relevant risk factors. Clinicians should consistently monitor adherence and address individual barriers.
Z Kinder Jugendpsychiatr Psychother
· 2025 Nov · PMID 40462767
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The Role of Parental Emotional Communication in the Socioemotional Development of Deaf and Hard-of-Hearing Preschoolers Parents' communication with their children about emotions plays an important role in children's so...The Role of Parental Emotional Communication in the Socioemotional Development of Deaf and Hard-of-Hearing Preschoolers Parents' communication with their children about emotions plays an important role in children's socioemotional development. In deaf and hard-of-hearing (DHH) children, emotional communication may be complicated by the effects of hearing loss. This study investigated the importance of emotional communication for the socioemotional development of DHH children and their parents' experience of stress. We interviewed the parents of 102 DHH preschool children aged 3;0 to 6;11 years in writing about parental emotional communication, parental responsiveness, children's communicative competence, parental stress, and their children's socioemotional development. We analyzed the data using path analysis. The results show that emotional communication has no direct effects on parental stress and children's socioemotional development, although there are some indirect effects. Emotional communication contributes to a lower parental stress level ( = -.06, = .04) via parental responsiveness and to fewer behavioral problems in the children ( = -.07, = .04). Emotional communication also contributes to better socioemotional skills of the children via the children's communicative competence ( = .08, = .04). Children with additional needs and their families are particularly at risk. Higher parental stress ( = .25, < .001) and lower socioemotional skills in the children ( = -.18, = .02) are evident. The results support previous findings in the literature regarding the role of parental responsiveness and communicative competence in the development of DHH children. In the context of family-centered early intervention, in addition to these important skills, parental support in communicating about feelings with their child should also be considered as a development-strengthening factor.
Stelling U, Sundsgaard L, von Strachwitz A
… +2 more, Romer G, Rölver A
Z Kinder Jugendpsychiatr Psychother
· 2025 Apr · PMID 40183699
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Analyzing the Care Situation for Children and Adolescents with Gender Dysphoria from the Perspective of Clinical Experts Abstract. Objective: The use of healthcare services by minors with gender dysphoria has steadi...Analyzing the Care Situation for Children and Adolescents with Gender Dysphoria from the Perspective of Clinical Experts Abstract. Objective: The use of healthcare services by minors with gender dysphoria has steadily increased in recent years. Long waiting times indicate the difficulties in providing professional care for this vulnerable patient group. The study analyzed the medical care situation in the German-speaking countries according to medical and/or therapeutic experts primarily treating minors with gender dysphoria. Method: We conducted 41 guideline-based interviews with experts and prepared a subsequent content analysis. Results: We could confirm an increasing demand over the last 10 years. Patients nowadays have more specific ideas and seem to be better informed. The experts attribute changes in demand to increased public presence of gender diversity, increasing tolerance and acceptance, and easier access to information. They assessed the care situation as inadequate; particularly care capacity is insufficient, and previous experiences in healthcare are often negative. The young age of the patients, comorbidities, and research gaps pose challenges regarding the indication. Patient satisfaction with somatomedical measures is rated as rather high, and experiences with detransitions are rare. Conclusions: From the experts' view, the need for health care is high and requires more research in addition to further education for social/educational and medical/psychological/therapeutic professionals.
Wandinger E, Reis O, Lincke L
… +4 more, Brähler E, Weirich S, Dück A, Kölch M
Z Kinder Jugendpsychiatr Psychother
· 2025 Mar · PMID 40127170
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Attitudes Toward Coercive Measures in Psychiatry: Indicators of Polarized Attitudes from a Representative German Sample This study examined the attitudes of the German general population toward physical restraint (PR)...Attitudes Toward Coercive Measures in Psychiatry: Indicators of Polarized Attitudes from a Representative German Sample This study examined the attitudes of the German general population toward physical restraint (PR) and chemical restraint (CR) used in psychiatric settings to protect against self-endangerment and endangerment of others. We analyzed attitudes toward coercive measures (CM) in a representative German sample ( = 2.485), exploring their distribution and association with sociodemographic factors using chi tests and multinomial logistic regressions. Two-thirds of subjects indicated acceptance of CR, whereas only 6 % approved PR. Rejection of CM was more common in people from West Germany ((3) = 33.396, < .001, = .116), rural areas ((3) = 14.065, = .018, = .057), and among individuals associated with right-wing political parties ((3) = 17.602, = .008, = .105). 67 % of the sample accept coercive medication, while a quarter reject it, which illustrates the heterogeneity of attitudes and the need for more information and education. Despite the political tendency toward more coercive elements in psychiatric treatment, this contradicts the professional discourse, which is why a public survey could be useful in sharpening professional policy positions.
Eilts J, Rademacher A, Wilke J
… +2 more, Essau C, Bäker N
Z Kinder Jugendpsychiatr Psychother
· 2025 Mar · PMID 40094494
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Prevalence of Callous-Unemotional Traits in a German Adolescent Sample Both the DSM-5 and ICD-11 introduced the specifier "with impaired prosocial emotions (IPE)" to more accurately diagnose Conduct Disorder (CD) in ad...Prevalence of Callous-Unemotional Traits in a German Adolescent Sample Both the DSM-5 and ICD-11 introduced the specifier "with impaired prosocial emotions (IPE)" to more accurately diagnose Conduct Disorder (CD) in adolescents with conduct problems and elevated callous-unemotional (CU) traits. Thus, this also emphasizes the importance of these traits in predicting future maladaptive development. In the general adult population, the prevalence of CU traits is 4.5 % and varies between 2-6 % in adolescents. This study examines the applicability of the -values developed by the LSU Developmental Psychology Lab (2023) to assess clinically relevant or critical callous-unemotional (CU) traits in adolescents in the German general population. We investigate whether these internationally calculated -values can be used validly for the German-speaking countries without calculating own -values or cut-off values based on the sample. The sample consists of = 1622 adolescents (50 % female), with an average age of = 13.63 years, whom we recruited at schools. To categorize the present data, the study utilized age- and gender-based norms (-scores) from the 2023 Developmental Psychopathology Lab's community sample. We employed -tests and ANOVAs to determine significant age differences (11-14 years, 15-17 years), gender, and gender-by-age interaction effect groups. Our findings indicate that 91.5 % of the sample falls within the normative group, 4.3 % are at risk, and 4.2 % display clinical characteristics. We observed significant age differences, while gender differences were not prominent. The interaction effects of age and gender were significant. Posthoc analyses revealed significant differences between male adolescents and between male and female adolescents across both age groups. The study provides valuable insights into the prevalence of CU traits in a German school sample. Understanding the distribution of CU traits is crucial for early detection and the development of tailored interventions. In addition to educational staff, professionals in the clinical context also benefit from early identification to initiate targeted diagnostic and therapeutic measures.
Z Kinder Jugendpsychiatr Psychother
· 2025 · PMID 40094407
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"Where am I, and where do I want to go?" A Group Therapy Program for Disorientated, Psychosomatically Ill Young People What influence does the concretization of the postinpatient life and career perspective have on the..."Where am I, and where do I want to go?" A Group Therapy Program for Disorientated, Psychosomatically Ill Young People What influence does the concretization of the postinpatient life and career perspective have on the outcome of the inpatient treatment of psychosomatically ill young people? A randomized case-control study. The participants receive the perspective or orientation group well and see it as an important part of the treatment. Participating patients experience significantly less stress when discharge of (residual) symptoms than patients in the control group. The group program succeeds in drawing the focus of many affected persons away from patient identity toward a healthy future orientation and thus improving the course of therapy. Accordingly, the program should be integrated into standard inpatient therapy. In addition, the question arises as to the possible role of the program in primary prevention.