Holtmann M, Klein M, Krömer T
… +5 more, Melchers P, Reis O, Schimansky G, Wenzel A, Thomasius R
Z Kinder Jugendpsychiatr Psychother
· 2025 Jan · PMID 39388529
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Recommendations for the Medical Treatment of ADHD in Comorbid, Substance-Related Disorders: Statement of the Joint Addiction Commission of the German Child and Adolescent Psychiatric Society and Associations Attention-...Recommendations for the Medical Treatment of ADHD in Comorbid, Substance-Related Disorders: Statement of the Joint Addiction Commission of the German Child and Adolescent Psychiatric Society and Associations Attention-deficit/hyperactivity disorder (ADHD) and substance use disorder (SUD) often occur together in adolescents. The available guidelines give the group of children and adolescents with ADHD and comorbid SUD little consideration. The Joint Addiction Commission of the German Child and Adolescent Psychiatric Society and Associations has drawn up a statement with treatment recommendations intended to provide orientation as a best-practice approach. Early treatment with stimulants in adolescents with ADHD and SUD may.
Emons B, Eigendorf L, Haussleiter IS
… +8 more, Bender S, Burchard JF, Haas CR, Holtmann M, Norra C, Hoffmann K, Kronmüller KT, Juckel G
Z Kinder Jugendpsychiatr Psychother
· 2024 Nov · PMID 39388521
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The situation of patient's relatives is still not broadly studied in psychiatry. Their needs are often overlooked. We developed a digital questionnaire concerning the patient's sociodemographic, disease-related, and fam...The situation of patient's relatives is still not broadly studied in psychiatry. Their needs are often overlooked. We developed a digital questionnaire concerning the patient's sociodemographic, disease-related, and family-related data and had the patient's therapist fill it out. The patients included ( = 1766) were persons hospitalized on a selected date. One-third of patients had at least one relative with mental illness, prior treatment, or need for treatment. The main diagnoses in relatives were affective, substance use, and somatoform disorders, often in concordance with their index patient. Teenage patients had the most affected relatives. The therapists of the minors included were better informed about their familial situation, whereas the therapists of the 30-59-year-olds knew the least. The comparably lower rate of affected relatives in adults stems most likely from underassessment and needs further investigation.
Z Kinder Jugendpsychiatr Psychother
· 2024 Nov · PMID 39239978
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Adolescents with Gender Incongruence - Special Case Constellations Adolescents with gender incongruence and gender identity variants have a high rate of accompanying mental disorders, such as depression, autism spectrum...Adolescents with Gender Incongruence - Special Case Constellations Adolescents with gender incongruence and gender identity variants have a high rate of accompanying mental disorders, such as depression, autism spectrum disorders, or eating disorders. Yet, the interaction between gender incongruence, gender dysphoric distress, and accompanying mental disorders is complex and varies considerably from case to case. We need an individualized approach and careful professional assessment to help those affected and their guardians make informed decisions regarding possible treatment steps in complex case constellations. Maintaining careful process support and planning of the treatment steps can help to resolve blocked development processes in adolescents with gender incongruence and accompanying psychological disorders or in young people with unstable gender identity development.
Kohl SH, Henn AT, Fendel JC
… +3 more, Luttermann A, van Noort BM, Konrad K
Z Kinder Jugendpsychiatr Psychother
· 2024 Sep · PMID 39175332
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Digital Beacons of Hope? The Challenges and Potentials of Digital Health Applications for Children and Adolescents with Mental Disorders in Germany With the Digital Healthcare Act, Germany has taken a decisive step towa...Digital Beacons of Hope? The Challenges and Potentials of Digital Health Applications for Children and Adolescents with Mental Disorders in Germany With the Digital Healthcare Act, Germany has taken a decisive step toward promoting high-quality, evidence-based digital health applications (DiHAs). Presently, there is a significant gap in the provision of mental health services throughout Germany, particularly regarding children and adolescents and especially in the aftermath of the COVID-19 pandemic. DiHAs as low-threshold, location- and time-independent additional mental health services - may offer a way to address this situation. Particularly in the emerging generation of digital natives, there is a high demand for digital mental health services. However, despite the rapidly growing supply of DiHAs for adults, there is a lack of approved DiHAs for children and adolescents with mental disorders. Rather, the demand for care is left to the unregulated market of diverse internet- and mobile-based interventions; early studies have questioned the evidence base, safety, and quality. This discrepancy arises from various specific challenges and risks that reduce incentives to develop DiHAs for this particularly vulnerable target group, including (1) limited evidence, (2) high complexity in study execution, (3) high complexity in the development of applications, (4) poorly researched specific risks, and (5) high regulatory requirements. This article discusses these challenges and risks and outlines the perspectives for a high-quality, safe, and evidence-based digital mental healthcare for children and adolescents.
Z Kinder Jugendpsychiatr Psychother
· 2024 Jul · PMID 38967057
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When Old People Suffer Because of the Sex of the Young: A Commentary on Korte, A. & Tschuschke, V. (2023). The Media's Stranglehold on Sturm und Drang - The Sorrows of Generation Z Regarding Sex and Gender In their arti...When Old People Suffer Because of the Sex of the Young: A Commentary on Korte, A. & Tschuschke, V. (2023). The Media's Stranglehold on Sturm und Drang - The Sorrows of Generation Z Regarding Sex and Gender In their article "Sturm und Drang im Medien - Die Leiden der jungen Generation am eigenen Geschlecht" in the für Kinder- und (volume 51, issue 5), our colleagues Korte and Tschuschke address the question of the extent to which the increase in gender identity deviations among adolescents "also results from upheavals the cultural landscape and, above all, in media technology." The authors look critically at the planned German "Self-Determination Law," the social transition of children and adolescents, the so-called puberty blockade, and hormone therapy in adolescents and justify their preference for a gender-critical over a transaffirmative therapy approach. Although the article introduces some interesting hypotheses from the perspective of cultural studies and philosophy (among others), it may contribute to uncertainty among colleagues in treating trans*people because of its trans-critical tone. This stems from linguistic devices, misleading and erroneous quotations, and incomplete or incorrect descriptions of facts. This contribution therefore takes a critical look at the article by Korte and Tschuschke, using critical linguistic analysis and examining the facts, data, and sources cited by the authors. It encourages our colleagues to engage in a joint treatment process with gender-dysphoric children and adolescents while exploring the sizeable intermediate area between "gender-critical" and "transaffirmative" attitudes, which the authors Korte and Tschuschke barely touch on in their article.
Z Kinder Jugendpsychiatr Psychother
· 2024 Jul · PMID 38967056
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The S3 Guideline on the Treatment of Language Development Disorders: Summary of Recommendations The German S3 Guidelines on the Treatment of Developmental Speech and Language Disorders (AWMF: No. 049-015) were published...The S3 Guideline on the Treatment of Language Development Disorders: Summary of Recommendations The German S3 Guidelines on the Treatment of Developmental Speech and Language Disorders (AWMF: No. 049-015) were published on the AWMF homepage at the end of 2022. The German Society for Phoniatrics and Paedaudiologie coordinated the work and developed the guideline text together with linguists and speech and language therapists. Many scientific medical societies consented to the respective recommendations. For the first time in the German-speaking area, the guideline group reviewed international research results on the treatment of various speech and language disorders and formulated evidence- or consensus-based recommendations for clinical care. The present article summarizes these recommendations and evaluates the guidelines from the perspective of child and adolescent psychiatry and psychotherapy.
Schultze-Lutter F, Banaschewski T, Barth GM
… +26 more, Bechdolf A, Bender S, Flechtner HH, Hackler S, Heuer F, Hohmann S, Holzner L, Huss M, Koutsouleris N, Lipp M, Mandl S, Meisenzahl E, Munz M, Osman N, Peschl J, Reissner V, Renner T, Riedel A, Romanos M, Romer G, Schomerus G, Thiemann U, Uhlhaas PJ, Woopen C, Correll CU, Care-Konsortium D
Z Kinder Jugendpsychiatr Psychother
· 2024 Sep · PMID 38809160
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As a vulnerable group, minors require special protection in studies. For this reason, researchers are often reluctant to initiate studies, and ethics committees are reluctant to authorize such studies. This often exclude...As a vulnerable group, minors require special protection in studies. For this reason, researchers are often reluctant to initiate studies, and ethics committees are reluctant to authorize such studies. This often excludes minors from participating in clinical studies. This exclusion can lead to researchers and clinicians receiving only incomplete data or having to rely on adult-based findings in the treatment of minors. Using the example of the study "Computer-Assisted Risk Evaluation in the Early Detection of Psychotic Disorders" (CARE), which was conducted as an 'other clinical investigation' according to the Medical Device Regulation, we present a line of argumentation for the inclusion of minors which weighs the ethical principles of nonmaleficence (especially regarding possible stigmatization), beneficence, autonomy, and fairness. We show the necessity of including minors based on the development-specific differences in diagnostics and early intervention. Further, we present specific protective measures. This argumentation can also be transferred to other disorders with the onset in childhood and adolescence and thus help to avoid excluding minors from appropriate evidence-based care because of insufficient studies.
Zepf FD, König L, Kaiser A
… +5 more, Ligges C, Ligges M, Roessner V, Banaschewski T, Holtmann M
Z Kinder Jugendpsychiatr Psychother
· 2024 · PMID 38410090
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Beyond NICE: Updated Systematic Review on the Current Evidence of Using Puberty Blocking Pharmacological Agents and Cross-Sex-Hormones in Minors with Gender Dysphoria The suppression of physiological puberty using pube...Beyond NICE: Updated Systematic Review on the Current Evidence of Using Puberty Blocking Pharmacological Agents and Cross-Sex-Hormones in Minors with Gender Dysphoria The suppression of physiological puberty using puberty-blocking pharmacological agents (PB) and prescribing cross-sex hormones (CSH) to minors with gender dysphoria (GD) is a current matter of discussion, and in some cases, PB and CSH are used in clinical practice for this particular population. Two systematic reviews (one on PB, one on CSH treatment) by the British National Institute for Clinical Excellence (NICE) from 2020 indicated no clear clinical benefit of such treatments regarding critical outcome variables. In particular, these two systematic NICE reviews on the use of PB and CSH in minors with GD detected no clear improvements of GD symptoms. Moreover, the overall scientific quality of the available evidence, as discussed within the above-mentioned two NICE reviews, was classified as "very low certainty" regarding modified GRADE criteria. The present systematic review presents an updated literature search on this particular topic (use of PB and CSH in minors with GD) following NICE principles and PICO criteria for all relevant new original research studies published since the release of the two above-mentioned NICE reviews (updated literature search period was July 2020-August 2023). The newly conducted literature search revealed no newly published original studies targeting NICE-defined critical and important outcomes and the related use of PB in minors with GD following PICO criteria. For CSH treatment, we found two new studies that met PICO criteria, but these particular two studies had low participant numbers, yielded no significant additional clear evidence for specific and clearly beneficial effects of CSH in minors with GD, and could be classified as "low certainty" tfollowing modified GRADE criteria. The currently available studies on the use of PB and CSH in minors with GD have significant conceptual and methodological flaws. The available evidence on the use of PB and CSH in minors with GD is very limited and based on only a few studies with small numbers, and these studies have problematic methodology and quality. There also is a lack of adequate and meaningful long-term studies. Current evidence doesn't suggest that GD symptoms and mental health significantly improve when PB or CSH are used in minors with GD. Psychotherapeutic interventions to address and reduce the experienced burden can become relevant in children and adolescents with GD. If the decision to use PB and/or CSH is made on an individual case-by-case basis and after a complete and thorough mental health assessment, potential treatment of possibly co-occurring mental health problems as well as after a thoroughly conducted and carefully executed individual risk-benefit evaluation, doing so as part of clinical studies or research projects, as currently done in England, can be of value in terms of generation of new research data. The electronic supplement (ESM) 1 is an adapted and abreviated English version of this work.