Z Kinder Jugendpsychiatr Psychother
· 2023 Sep · PMID 37681648
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Practical Guideline on Dealing with Transgender Patients in Child and Adolescent Psychiatric Inpatient Settings The guideline provided by the Federal Association of Leading Medical Directors for Child and Adolescent Psy...Practical Guideline on Dealing with Transgender Patients in Child and Adolescent Psychiatric Inpatient Settings The guideline provided by the Federal Association of Leading Medical Directors for Child and Adolescent Psychiatry offers a framework for dealing with transgender patients in child and adolescent psychiatric clinics. It addresses the clinical challenges arising from the significant increase in transgender patients and the paradigm shift in the medical field. The guideline includes recommendations for dealing with transgender patients in various settings. Key treatment principles comprise adopting a destigmatizing approach, using preferred names and pronouns, accommodating individual room assignments, and considering relevant comorbidities. Only experienced medical doctors and psychotherapists should carry out diagnosis and treatment. The goals for supporting adolescents with gender dysphoria include promoting self-acceptance, addressing negative emotions, facilitating social integration, and fostering identity development.
Degenhardt F, Wohlleber E, Jamra RA
… +1 more, Hebebrand J
Z Kinder Jugendpsychiatr Psychother
· 2024 Jan · PMID 37641943
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Genetic Diagnostics in Everyday Clinical Practice in Child and Adolescent Psychiatry: Indications, Framework Conditions, Hurdles, and Proposed Solutions Health insurance covers medically necessary genetic testing in Ger...Genetic Diagnostics in Everyday Clinical Practice in Child and Adolescent Psychiatry: Indications, Framework Conditions, Hurdles, and Proposed Solutions Health insurance covers medically necessary genetic testing in Germany. Diagnostic genetic testing has become increasingly important for child and adolescent psychiatry (CAP), reflected by the rising number of national guidelines relevant to CAP, including genetic testing in the recommended diagnostic work-up. However, implementation of theses guidelines in routine clinical care is lacking. This article provides a concise overview of the relevance of genetic testing in CAP-related national guidelines. It outlines the legal and financial framework for genetic testing in Germany. Furthermore, it points out barriers to implementation and offers potential solutions. It then provides examples from clinical practice highlighting the potential benefits patients and their family members might have from receiving a genetic diagnosis. The article closes by outlining future CAP-relevant areas in which genetic testing may become clinically relevant.
Z Kinder Jugendpsychiatr Psychother
· 2023 Jul · PMID 37417965
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Knowledge about the prevalence of mental disorders in childhood and adolescence is important for clinicians and policymakers. This study examines the prevalence and trends in self-reported mental health problems among 11...Knowledge about the prevalence of mental disorders in childhood and adolescence is important for clinicians and policymakers. This study examines the prevalence and trends in self-reported mental health problems among 11- to 17-year-olds in Germany. We evaluated data from the self-report version of the Strength and Difficulties Questionnaire (SDQ) of 6,725 children and adolescents from the baseline of the German Health Interview and Examination Survey (KiGGS, 2003-2006) and 6,145 from its second wave (KiGGS wave 2, 2014-2017). According to the SDQ total difficulties score, the prevalence estimates did not vary significantly between the study waves, neither regarding the category "abnormal" (9.3 % vs. 9.4 %) nor the pooled categories "borderline/abnormal" (16.9 % vs. 15.4 %). We confirmed the results by linear regression analyses using mean values instead of the SDQ categories. Analyses of the SDQ subscales revealed gender and age-specific time trends. These findings differ from those based on the SDQ parent report, which suggests significant declines in symptom load between the study waves. The results indicate the importance of integrating youth self-reports when measuring mental health problems, at least as part of a multi-informant approach.
Z Kinder Jugendpsychiatr Psychother
· 2023 Sep · PMID 37272401
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Functional (Nonorganic) Enuresis and Daytime Urinary Incontinence in Children and Adolescents: Clinical Guideline for Assessment and Treatment Enuresis and daytime urinary incontinence are common disorders in children...Functional (Nonorganic) Enuresis and Daytime Urinary Incontinence in Children and Adolescents: Clinical Guideline for Assessment and Treatment Enuresis and daytime urinary incontinence are common disorders in children and adolescents and are associated with incapacitation and a high rate of comorbid psychological disorders. This interdisciplinary guideline summarizes the current state of knowledge regarding somatic and psychiatric assessment and treatment. We formulate consensus-based, practical recommendations. The members of this guideline commission consisted of 18 professional associations. The guideline results from current literature searches, several online surveys, and consensus conferences based on standard procedures. According to the International Children's Continence Society (ICCS), there are four different subtypes of nocturnal enuresis and nine subtypes of daytime urinary incontinence. Organic factors first have to be excluded. Clinical and noninvasive assessment is sufficient in most cases. Standard urotherapy is the mainstay of treatment. If indicated, one can add specific urotherapy and pharmacotherapy. Medication can be useful, especially in enuresis and urge incontinence. Psychological and somatic comorbid disorders must also be addressed. The recommendations of this guideline were passed with a high consensus. Interdisciplinary cooperation is especially important, as somatic factors and comorbid psychological disorders and symptoms need to be considered. More research is required especially regarding functional (nonorganic) daytime urinary incontinence.
Z Kinder Jugendpsychiatr Psychother
· 2023 Jul · PMID 37166813
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COVID-19 and Psychiatric Disorders in Minors: Changes in Inpatient Treatment According to Hospital Statistics Increased rates of psychiatric disorders and psychiatric emergencies in children and adolescents stemming fro...COVID-19 and Psychiatric Disorders in Minors: Changes in Inpatient Treatment According to Hospital Statistics Increased rates of psychiatric disorders and psychiatric emergencies in children and adolescents stemming from the COVID-19 pandemic have been reported, with more children and adolescents suffering from internalizing disorders. This study analyzes whether the increased rates led to increased rates of inpatient treatment in child and adolescent psychiatric and pediatric hospitals in Germany as well as a change in diagnoses of the treated patients. We analyzed routine hospital data ("InEK" data, § 21 KHG data files) from a prepandemic (2019) and a pandemic (2021) half-year regarding changes in the number of cases, diagnoses, and length of stay (LoS) in child and adolescent psychiatry and pediatrics. We also investigated the development of psychiatric emergencies in minors. We found an increase in internalizing problems (depression, anorexia nervosa, trauma-related disorders) and a decrease in externalizing problems among the admitted psychiatric inpatients. Further, we observed a halving of cases treated for alcohol intoxication. However, we discovered no change for the frequency of psychiatric emergency treatments nationwide. A more detailed analysis revealed that, in areas with a low number of child and adolescent psychiatry inpatient beds, emergency care was prioritized and LoS decreased, whereas in areas with a fair bed-to-inhabitant ratio among minors, there was a trend toward increased LoS, also in pediatric departments. We recommend continued monitoring of inpatient care after the pandemic, with special attention paid to underprivileged children and adolescents such as those with externalizing problems.
Schneider A, Zeiler M, Kopp K
… +2 more, Wagner G, Karwautz A
Z Kinder Jugendpsychiatr Psychother
· 2023 Nov · PMID 37070434
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The Therapeutic Potential of Prebiotics and Probiotics in Child and Adolescent Psychiatric Disorders This short review summarizes the literature available on therapeutic interventions with prebiotics and probiotics and...The Therapeutic Potential of Prebiotics and Probiotics in Child and Adolescent Psychiatric Disorders This short review summarizes the literature available on therapeutic interventions with prebiotics and probiotics and their potential use in psychiatric disorders in childhood, adolescence, and adulthood. Most studies of children and adolescents are done on ADHD and autism spectrum disorders, whereas single reports exist largely on positive effects on cognitive symptoms and quality of life. Initial studies regarding anorexia nervosa point to a potential effect of weight gain and reduction of gastrointestinal symptoms. To date, the effects of prebiotics and probiotics in depression, bipolar disorder, anxiety disorders, and schizophrenia have been mainly investigated in adults. The best reported evidence exists for depression, whereas the effects on depressive symptomatology are small. Positive effects are seen on gastrointestinal symptoms in these disorders. Given these positive effects, the mixed literature reports may result from very heterogeneous study designs. Nevertheless, the high potential of prebiotics and probiotics may be seen for minors with mental health problems. Further studies that include child and adolescent psychiatric populations and reflect the complexity of the gut-brain axis are urgently needed.