Z Kinder Jugendpsychiatr Psychother
· 2024 · PMID 38335974
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Is Physical Activity a Treatment Option for ADHD? Physical activity as an option for the prevention and treatment of psychiatric disorders is increasingly becoming the focus of research. In particular, because of improv...Is Physical Activity a Treatment Option for ADHD? Physical activity as an option for the prevention and treatment of psychiatric disorders is increasingly becoming the focus of research. In particular, because of improvements in cognitive functioning, attentional performance, impulsivity, and hyperactivity, physical exercise could be a promising treatment option for attention deficit hyperactivity disorder (ADHD). In this narrative review, we present and evaluate the current state of research on exercise effects in children and adolescents as well as in adults with ADHD. While studies of the short-term effects of a single bout of physical activity indicate robust effects on attention and inhibitory control, results on the impact on further symptoms of ADHD as well as in adults are mixed. Randomized controlled trials of longer-term physical activity are scarce and show high heterogeneity. Nevertheless, they are encouraging for further research in this area.
Juen F, Reiffen-Züger B, Lehmhaus D
… +6 more, Prentl S, Moisl S, Züger M, Rexroth I, Marton MA, Maurer MH
Z Kinder Jugendpsychiatr Psychother
· 2024 Jul · PMID 38323523
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The Operationalized Psychodynamic Diagnostic of Children and Adolescents (OPD-KJ-2) in Everyday Clinical Practice with the Plämobox: Applicability and Interrater Reliability The OPD-CA2 manual for assessing psychodynam...The Operationalized Psychodynamic Diagnostic of Children and Adolescents (OPD-KJ-2) in Everyday Clinical Practice with the Plämobox: Applicability and Interrater Reliability The OPD-CA2 manual for assessing psychodynamic aspects in children and adolescents is well established in clinical practice. However, publications regarding its reliability and validity are limited to (1) adolescents, (2) the structure of the first version of the manual and not to the comprehensive revision of the OPD-CA2, (3) the axes "structure" and (partly) "conflict" but not the axis "relationship," and (4) missing applicability in everyday clinical practice. The present study comprised 42 children aged 6-12 years (age level 2 of the OPD-CA2), with and without mental illness, and assessed them using two randomly assigned raters. We assessed them using a low-structured diagnostic symbol game with miniature figurines and objects based on videotapes. We also tested the interrater reliability of the OPD-CA2 axes. The overall assessment of structure and the assessment of the four subdimensions succeeded with good to very good agreement. We could also determine the presence of relevant conflict dynamics with very high agreement, while not recognizing specific conflicts in the clinical sample. Our assessment of the items of the relationship axis shows a low level of agreement. Overall, we can confirm the reliability of the OPD-CA2 for everyday clinical assessment in the younger age groups. Finally, we discuss which factors contribute to the heterogeneous picture.
Z Kinder Jugendpsychiatr Psychother
· 2024 Jul · PMID 38240707
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Recent research has increasingly emphasized the function of the microbiome in human health. The gut microbiome is essential for digesting food and seems to play a vital role in mental health as well. This review briefly...Recent research has increasingly emphasized the function of the microbiome in human health. The gut microbiome is essential for digesting food and seems to play a vital role in mental health as well. This review briefly overviews the gut microbiome and its interplay with the central nervous system. We then summarize some of the latest findings on the possible role of the microbiome in psychiatric disorders in children and adolescents. In particular, we focus on autism spectrum disorder, attention-deficit/hyperactivity disorder, anorexia nervosa, bipolar disorder, and major depressive disorder. Although the role of microbiota in mental development and health still needs to be researched intensively, it has become increasingly apparent that the impact of microbiota must be considered to better understand psychiatric disorders.
Z Kinder Jugendpsychiatr Psychother
· 2024 · PMID 38224568
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Sports and Physical Exercise Therapy in the Treatment of Mental Health Issues in Children and Adolescents Mental disorders are among the most common chronic diseases in childhood and adolescence in Germany and worldwide...Sports and Physical Exercise Therapy in the Treatment of Mental Health Issues in Children and Adolescents Mental disorders are among the most common chronic diseases in childhood and adolescence in Germany and worldwide. The health benefits of a physically active lifestyle during adolescence are well documented. Furthermore, a growing body of evidence suggests a positive impact of physical activity on mental health and emotional well-being. Longitudinal studies also show an association between physical activity and reduced risk of developing a mental disorder. Therefore, therapeutic exercise plays an important role in child and adolescent psychiatry. High-quality randomized-controlled trials are needed to substantiate the described effects.
Bonnekoh LM, Fellmeth R, Dübbers A
… +4 more, Oesingmann-Weirich S, Fernholz J, Omran H, Romer G
Z Kinder Jugendpsychiatr Psychother
· 2024 Nov · PMID 38221850
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Case Report of a 14-Year-Old Girl with Addison's Disease Under Initial Presumptive Diagnosis of Anorexia Nervosa: Confusingly Similar and Yet so Different? Primary adrenal insufficiency (Addison's disease) is a rare di...Case Report of a 14-Year-Old Girl with Addison's Disease Under Initial Presumptive Diagnosis of Anorexia Nervosa: Confusingly Similar and Yet so Different? Primary adrenal insufficiency (Addison's disease) is a rare differential diagnosis of anorexia nervosa. This case report presents important differential diagnostic aspects. We prepared a case report of a 14-year-old female patient according to the CARE guidelines, taking the patient's and the child's parents' view into consideration. The diagnosis of primary adrenocortical insufficiency was reached using specific laboratory diagnostics approximately 9 months after the onset of symptoms, including sudden body weight loss. Significant differential diagnostic aspects were the absence of a body schema disorder and skin hyperpigmentation prominent in the physical examination. The patient experienced a high psychosocial burden because of the unclear diagnosis over 9 months. The diagnosis and substitution therapy with hydrocortisone led to a rapid improvement of the physical and psychological symptoms. This case report emphasizes the importance of a thorough somatic differential diagnosis in the context of a suspected anorexia nervosa.
Z Kinder Jugendpsychiatr Psychother
· 2024 · PMID 38098430
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Gut Microbiota and Autism Spectrum Disorders: An Overview of Correlations and Potential Implications for Therapeutic Interventions At the beginning of research on microbiota, researchers focused mainly on the role of mi...Gut Microbiota and Autism Spectrum Disorders: An Overview of Correlations and Potential Implications for Therapeutic Interventions At the beginning of research on microbiota, researchers focused mainly on the role of microbiota dysbiosis in the development of gastrointestinal diseases. However, over the last years, researchers have also identified correlations with other physical processes and neuropsychiatric diseases such as autism spectrum disorder. These correlations are believed to be at least partly mediated through the brain-gut-microbiome axis. An altered composition of microbiota in patients with autism spectrum disorder was detected compared to healthy controls. Today, the discussion centers around a possible systemic impact of the metabolites of some microbiota or microbiota-induced chronic inflammatory processes on the brain (mediated through the brain-gut-microbiome axis) as an underlying mechanism. Still, the specific underlying mechanisms remain largely unknown, so conclusions on therapeutic implications are difficult to determine. Here, we describe some promising approaches to improving autistic behavior through dietary changes, the use of prebiotics and probiotics, stool transplantation from healthy controls, and restricted absorbance of certain metabolites. We need further clinical studies of high quality to fully understand the pathophysiology of autism spectrum disorder and to improve diagnostic and therapeutic strategies.
Donath C, Atzmüller L, Florack J
… +2 more, Engel C, Luttenberger K
Z Kinder Jugendpsychiatr Psychother
· 2024 · PMID 38063057
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The Effect of Exercise Therapy on Adolescent Mental Health: A Systematic Review with Practical Example The mental health of children and adolescents in Germany is currently highly burdened. Because of the psychotherapeu...The Effect of Exercise Therapy on Adolescent Mental Health: A Systematic Review with Practical Example The mental health of children and adolescents in Germany is currently highly burdened. Because of the psychotherapeutic care situation, easily accessible, less stigmatizing, and efficient offers are urgently needed. Exercise therapy would be one possibility. However, the effectiveness of such offers must first be proven. We conducted a systematic review concerning the effectiveness of exercise therapy on the mental health of children and adolescents which included studies since 2020 (subsequent to Hale et al., 2021). We analyzed a total of 17 intervention studies based on the PRISMA statement. The results show that exercise therapy interventions significantly affect certain populations: Attention and cognitive skills significantly improved in children and adolescents with ADHD; for depression, we found positive effects for affection. Some studies revealed significant effects across populations on the quality of life and sleep. In children and adolescents with autism or learning disabilities, we found positive effects on social behavior. Thus, according to the literature, exercise therapy is a recommendable therapy option for children and adolescents with mental health problems. As an illustration, we present a boulder intervention as a combined exercise intervention and psychotherapy along with its feasibility as a possible practical example.
Z Kinder Jugendpsychiatr Psychother
· 2024 Jan · PMID 38037336
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Sexualized Violence Toward Children and Adolescents: The Visibility and Implementation of Safeguarding Concepts in Sports, Music, and Church In 2010, the disclosure of sexualized violence in educational organizations l...Sexualized Violence Toward Children and Adolescents: The Visibility and Implementation of Safeguarding Concepts in Sports, Music, and Church In 2010, the disclosure of sexualized violence in educational organizations led to a public debate and calls for safeguarding concepts against sexualized violence toward children and adolescents. However, there have been few efforts to systematically record the visibility, availability, and implementation of such concepts. We used a broad Google search and a telephone survey as an initial approach to close this research gap. In a systematic Google search and a telephone survey ( = 50), we identified and examined safeguarding concepts against sexualized violence toward children and adolescents in the context of religious organizations, sports, and musical education regarding its visibility, availability, and implementation level. The results of our systematic internet research show a low hit rate of identified safeguarding concepts in all contexts. The low number of search hits indicates that the issue of sexualized violence toward children and adolescents has been inadequately addressed in many institutions, and that protective measures have been neglected. The supplementary results of the telephone survey suggest a low implementation level within organizations and a low availability of existing safeguarding concepts.
Herrmann L, Fahrenkrug S, Bindt C
… +1 more, Becker-Hebly I
Z Kinder Jugendpsychiatr Psychother
· 2024 Jan · PMID 37947191
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Gender Experiences of Transgender Youth: How Changeable is the Gender Experience of Binary vs. Nonbinary Identifying Transgender Youth and What Factors Are Involved? Nonbinary gender identities are becoming increasingl...Gender Experiences of Transgender Youth: How Changeable is the Gender Experience of Binary vs. Nonbinary Identifying Transgender Youth and What Factors Are Involved? Nonbinary gender identities are becoming increasingly visible in transgender healthcare and research. However, little is known about the various gender identities of transgender adolescents - whether they are stable or fluid and which factors influence their gender experience. The present study investigates these different aspects of gender in transgender adolescents with various gender identities. The sample comprised a recent cohort of 114 adolescents diagnosed with gender dysphoria (GD) attending the Hamburg Gender Identity Service for Children and Adolescents (Hamburg GIS). We used the to assess the different aspects of gender. In total, 83 % of the sample reported a binary (BI) and 17 % a nonbinary gender identity or were still questioning their gender identity (NBGQ). 15-18 % of the transgender adolescents reported gender fluidity. The NBGQ group reported significantly higher levels of gender fluidity or more often that their gender identity was still open to change, respectively, than the BI group. Puberty (79 %), physical distress (70 %), and social media (36 %) were the most frequently mentioned factors influencing their gender experience. The present study underscores that gender experience is not binary and fixed for all transgender adolescents, but that, in some cases, it may be nonbinary or fluid. This heterogeneity, the possible fluidity, and the puberty-related physical distress may challenge treatment decisions in transgender adolescents diagnosed with GD. This situation highlights the importance of developing individualized treatment plans.
Wunram HL, Kasparbauer AM, Oberste M
… +1 more, Bender S
Z Kinder Jugendpsychiatr Psychother
· 2024 · PMID 37851436
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Movement as a Neuromodulator: How Physical Activity Influences the Physiology of Adolescent Depression In the context of adolescent depression, physical activity is becoming increasingly recognized for its positive effe...Movement as a Neuromodulator: How Physical Activity Influences the Physiology of Adolescent Depression In the context of adolescent depression, physical activity is becoming increasingly recognized for its positive effects on neuropathology. Current scientific findings indicate that physical training affects the biological effects of depression during adolescence. Yet the pathophysiology of adolescent depression is not yet fully understood. Besides psychosocial and genetic influences, various neurobiological factors are being discussed. One explanation model describes a dysfunction of the hypothalamus-pituitary-adrenal axis (HPA axis) with a sustained elevation in cortisol concentration. Recent studies highlight neuroimmunological processes and a reduced concentration of growth factors as causative factors. These changes appear to lead to a dysregulation of the excitation and inhibition balance of the cerebral cortex as well as to cerebral morphological alterations. Regular physical training can potentially counteract the dysregulation of the HPA axis and normalize cortisol levels. The release of proinflammatory cytokines is inhibited, and the expression of growth factors involved in adult neurogenesis is stimulated. One should ensure the synergistic interaction of biological and psychosocial factors when designing the exercise schedule (endurance or strength training, group or individual sports, frequency, duration, and intensity). Addressing these open questions is essential when integrating physical activity into the guidelines for treating depressive disorders in children and adolescents.
Z Kinder Jugendpsychiatr Psychother
· 2024 Jan · PMID 37768010
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Social phobia (SP) is a common mental disorder in youth often accompanied by absence from school, which may require daycare or inpatient intervention (DC/IN). The present explorative study investigates changes in anxiet...Social phobia (SP) is a common mental disorder in youth often accompanied by absence from school, which may require daycare or inpatient intervention (DC/IN). The present explorative study investigates changes in anxiety-specific implicit assumptions and interpretation bias DC/IN. The study included 16 youths with SP ( age = 15.8 [ = 1.24], females: 62.5 %) participating in DC/IN. We assessed the main outcomes using the Implicit Association Test and Affective Misattribution Procedure. A large effect was shown for reducing implicit assumptions of feeling anxious ( = .142; = .171) and for reducing the implicit interpretation bias ( = .137; = .162). No change was indicated by effect size in implicit assumptions of feeling socially rejected ( = .649; = .016). Social phobia symptoms initially correlated with changes in implicit assumptions of feeling anxious ( = .45). Effect sizes indicate that implicit anxiety-specific assumptions and interpretation bias descriptively improved following DC/IN. Thus, DC/IN may lead to meaningful improvements of anxiety-specific cognition in some individuals with high SP symptoms, emphasizing the relevance of cognitive behavioral approaches in the treatment of SP. Several limitations are discussed.
Z Kinder Jugendpsychiatr Psychother
· 2023 Sep · PMID 37681655
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Media's Stranglehold on Storm and Stress - The Sorrows of Generation Z about Sex and Gender The feeling of not belonging to one's birth sex is not new; one can trace this phenomenon back even to ancient mythology. Altho...Media's Stranglehold on Storm and Stress - The Sorrows of Generation Z about Sex and Gender The feeling of not belonging to one's birth sex is not new; one can trace this phenomenon back even to ancient mythology. Although it has always been rare, there has recently been a sharp increase in gender identity deviations among adolescents. This text addresses this problem by asking to what extent this development also results from upheavals in the cultural landscape and, above all, in media technology. Do they cause young people to believe they are in the "wrong gender" and, in extreme cases, to strive for transition? We present the most salient cornerstones of the planned German self-determination law (Self-ID), most of which, however, are unlikely to do justice to the underlying problem. The text concludes by describing several unanswered questions concerning this matter and by attempting to propose first answers. The advantages of a gender-exploratory over the trans affirmative therapy approach are summarized.