Z Kinder Jugendpsychiatr Psychother
· 2023 Jul · PMID 36330728
·
Publisher ↗
Experiences of Violence During Inpatient Child and Adolescent Psychiatric Treatment: An Explorative Study with Implications for Child Protection Educational and medical institutions care for children and adolescents by...Experiences of Violence During Inpatient Child and Adolescent Psychiatric Treatment: An Explorative Study with Implications for Child Protection Educational and medical institutions care for children and adolescents by providing supervision, schooling, education, therapy, and protection. Nevertheless, children in institutional care are exposed to potential danger through maltreatment and abuse. As part of the establishment of the protection concept at the University Hospital for Child and Adolescent Psychiatry in Würzburg, a retrospective patient survey was conducted. The study population consisted of former inpatient clients from 2006 and 2007, who at the time of the catamnesis were of legal age. The survey was conducted by mail. In addition to items on their experiences of violence, the questionnaire included established scales to assess treatment satisfaction and quality of life (FBB-K, WHO-BREF). Of 568 former patients, 87 (15.3 %) provided valid responses (59 female, mean age at the time of the survey: 24.5 years): 35 former patients (40.2 % of the participants) reported experiences of violence during their inpatient treatment (26 victims only, 7 experiences as victims and perpetrators, and 2 perpetrators only). Experiences as victims mainly included emotional violence (34.5 %), but also physical (5.7 %) and sexual violence (10.3 %). We found a significant correlation between experiences of violence, on the one hand, and retrospective treatment satisfaction and current quality of life, on the other hand. The results of the survey underline the importance of establishing protection concepts in clinics and other institutions.
Adam J, Goletz H, Viefhaus P
… +2 more, Woitecki K, Döpfner M
Z Kinder Jugendpsychiatr Psychother
· 2023 May · PMID 36259642
·
Publisher ↗
Although there is clear evidence-based knowledge regarding state-of-the-art treatment for pediatric obsessive-compulsive disorder (OCD), two main issues remain in clinical practice: (1) Exposure-based cognitive behaviora...Although there is clear evidence-based knowledge regarding state-of-the-art treatment for pediatric obsessive-compulsive disorder (OCD), two main issues remain in clinical practice: (1) Exposure-based cognitive behavioral therapy (CBT) is limited in terms of availability and accessibility or is not adequately provided, and (2) despite large effect sizes of exposure-based CBT, the achieved recovery rates of 50-60 % still show room for improvement. These issues have prompted an increasing focus on delivering exposure-based CBT in new and innovative ways. This study aims to evaluate an intensive therapist-administered online coaching program consisting of exposure with response prevention via video teleconferencing (VTC) as an add-on to weekly outpatient CBT (blended therapy). The blended therapy is examined in = 5 children and adolescents with OCD using an AB design and multi-informant ratings. This single-case study shows promising results, indicating that a decrease in OCD severity and related functional impairment can be attributed to blended therapy. Moreover, satisfaction with online coaching was high. Despite some principal limitations, the results support the effectiveness and feasibility of blended therapy.
Z Kinder Jugendpsychiatr Psychother
· 2023 May · PMID 36205025
·
Publisher ↗
Social Networks of Children with Mental Disorders The study compares the social networks of children with mental disorders with a matched control group ( = 75/75, male 69 %/69 %, age: 9.4/9.0 years). In addition, we exa...Social Networks of Children with Mental Disorders The study compares the social networks of children with mental disorders with a matched control group ( = 75/75, male 69 %/69 %, age: 9.4/9.0 years). In addition, we examined the quantity and structure of social networks as well as the stresses and resources in the respective patient group in general and regarding specific disorders (hyperkinetic disorder, HKS, and childhood emotional disorder). We assessed their use of social networks with a revision of the Social Relationship Test for Children (SoBeKi-R) and their mental disorders via clinical diagnoses, CBCL, and SDQ. The patients reported significantly smaller networks overall and fewer social resources, particularly in the nonfamily domains. While children with emotional disorders were found to have fewer social strains than the comparison group, children with ADHD tended to have higher strain scores per network person, and externalizing symptoms were significantly associated with higher network strains. The results, which vary by disorder, suggest complex disorder-specific associations between the syndromes and the reported social network resources and strains.
Herwerth L, Prinz K, Brauner H
… +2 more, Müller K, Fleischhaker C
Z Kinder Jugendpsychiatr Psychother
· 2023 May · PMID 36205021
·
Publisher ↗
Psychoses on the Schizophrenia Spectrum in Adolescence: A Cross-sectional Study of Factors Influencing Neuropsychology, Treatment Outcome, and Negative Symptoms The present study evaluated the factors influencing the c...Psychoses on the Schizophrenia Spectrum in Adolescence: A Cross-sectional Study of Factors Influencing Neuropsychology, Treatment Outcome, and Negative Symptoms The present study evaluated the factors influencing the course of disease of children and adolescents in an inpatient rehabilitation suffering from psychosis within the schizophrenia spectrum. 33 patients (mean age 19.4 years, = 2.3), 12 of (36 %) were female, participated. They were assessed with clinical interviews (IRAOS, SANS/SAPS), neuropsychological tests (WAIS-IV, TMT), and questionnaires (FBB, BSCL). The neuropsychological functioning level and the premorbid cognitive performance were correlated, as were treatment success from the patient's perspective with a good relationship with the therapist, and greater negative symptomatology with a longer duration of untreated psychosis (DUP) and a longer initial hospital stay. Possible approaches to improving the treatment of adolescents with psychosis of the schizophrenic spectrum include a shortening of the DUP and a good therapeutic relationship.
Z Kinder Jugendpsychiatr Psychother
· 2023 Jan · PMID 36111580
·
Publisher ↗
Factors associated with adolescent development influence the occurrence and presentation of school refusal (SR). Cognitive-behavioral therapy (CBT) manuals for the treatment of SR account for these developmental issues t...Factors associated with adolescent development influence the occurrence and presentation of school refusal (SR). Cognitive-behavioral therapy (CBT) manuals for the treatment of SR account for these developmental issues to varying degrees. Some multimodal treatments aim to address the complexity of adolescent SR by incorporating interventions alongside CBT, such as medication, inpatient treatment, and educational support in a special setting. However, CBT manuals and multimodal treatments appear to fail to help approximately one-third to two-thirds of adolescents, with respect to achieving regular school attendance. This paper provides an overview of suggestions in the literature for improving treatment for SR, with a focus on adolescent SR. Seven signposts emerge from the literature, namely, increased number or frequency of sessions, greater attention to social anxiety disorder and social functioning, greater attention to depression, greater attention to emotion regulation, careful consideration of the role of parents, greater attention to parent-adolescent communication and problem-solving, and the use of alternative educational settings. Professionals may find these signposts helpful when planning and delivering treatment for SR in adolescents. Research is needed to determine the benefit of including one or more of these adaptations alongside an existing SR treatment.
Kloidt B, Blatz L, Flemming M
… +2 more, von Spee L, Giersdorf M
Z Kinder Jugendpsychiatr Psychother
· 2023 Jan · PMID 35942650
·
Publisher ↗
Challenges and Influencial Factors in Autism-Specific Diagnostics in Toddlers What are the particular challenges that make early diagnosis of young children difficult in the clinical routine? What recommendations can b...Challenges and Influencial Factors in Autism-Specific Diagnostics in Toddlers What are the particular challenges that make early diagnosis of young children difficult in the clinical routine? What recommendations can be derived from this in practice? Our interdisciplinary social pediatric team examined 31 toddlers aged 2 to 3 years twice in intervals of 6-9 months in the for outpatient diagnostics regarding suspected autism spectrum disorder (ASD). In addition, we conducted an online survey with further experts. After the first anamnestic interview, 8 of the 31 (26 %) children were diagnosed with a differential diagnosis of ASD. Comorbid disorders, familial peculiarities, and challenges posed by the examination setting and anamnesis made a reliable clinical classification difficult. In our experience, many toddlers can only receive a valid diagnosis after a follow-up examination after starting one or more therapies and regularly carrying out these therapies over a period of 6-9 months and possibly also after structural changes have taken place (care in nursery, implementation of youth welfare measures, or similar).
Z Kinder Jugendpsychiatr Psychother
· 2023 Mar · PMID 35904434
·
Publisher ↗
Loneliness in Adolescents Against the Background of the COVID-19 Pandemic: A Risk Factor On the one hand, loneliness is the subjective experience of inadequate social integration and support. It is a normal phenomenon t...Loneliness in Adolescents Against the Background of the COVID-19 Pandemic: A Risk Factor On the one hand, loneliness is the subjective experience of inadequate social integration and support. It is a normal phenomenon that can be dealt with in an emotional and action-oriented way within the framework of individual development. On the other hand, chronic loneliness goes hand in hand with considerable suffering, reduced quality of life, and an increased risk of psychological and somatic diseases. In the context of current social developments associated with the fragmentation of social networks and programmatic individualism, we discuss an increase in the problem of loneliness, especially among young people. Interventions to reduce the experience of loneliness are effective if, in addition to making social offers, they focus on the dynamics common in chronic loneliness (low self-esteem, evaluation of neutral communication as devaluing, etc.). There is no evidence that the use of virtual social networks persistently reduces feelings of loneliness in young people. In addition, the question arises on what basis of shared values and goals social integration of young people who experience loneliness will be possible in the future. According to the results of the first systematic surveys on the psychosocial consequences of the COVID-19 pandemic, we must assume that the loneliness problem of young people will continue to gain relevance because of the associated massive restrictions on real social life.
Z Kinder Jugendpsychiatr Psychother
· 2023 Jan · PMID 35892211
·
Publisher ↗
The Specific Treatment of Children and Adolescents with Substance Use Disorders in a Special Setting - A Qualitative Study of the Minimum Characteristics of OPS Code 9-694 The minimum characteristics for the treatment...The Specific Treatment of Children and Adolescents with Substance Use Disorders in a Special Setting - A Qualitative Study of the Minimum Characteristics of OPS Code 9-694 The minimum characteristics for the treatment of children and adolescents with substance use disorders are shown in the additional code 9-694 of the Operation and Procedure Code (OPS). The OPS acts as an instrument of the PEPP remuneration system as well as for external quality assurance. In the presented study, we present the assessments of practitioners with regard to the practical relevance and feasibility of the OPS code as well as possible further development potentials. We used a qualitative research design to evaluate the topicality and practical feasibility of applicable minimum characteristics. A draft of a treatment concept prepared by the author according to the minimum characteristics of OPS code 9-694 served as the starting material for the study. The results of the expert interviews were evaluated using qualitative content analysis. The minimum characteristics are assessed as being practical, with additional work becoming a burden, while resources remain the same. There is a need for adapting and defining disorder- and age-specific peculiarities as well as for designing the treatment setting and therapeutic methods. A clear setting, transparency, and the possibility of individual procedures enable practical implementation. Con This study reveals the need for specialized treatment concepts that map needs and specifications equally. Accordingly, the results of the study represent an important reference for the design of future treatment concepts. The implementation of further development potentials as well as professional transfer of theory to practice require further evaluation involving all those involved in the treatment process.
Z Kinder Jugendpsychiatr Psychother
· 2023 May · PMID 35856746
·
Publisher ↗
Misophonia in Childhood and Adolescence: A Narrative Review Misophonia describes a phenomenon in which the affected children and adolescents show a strong negative physiological and emotional reaction when confronted wi...Misophonia in Childhood and Adolescence: A Narrative Review Misophonia describes a phenomenon in which the affected children and adolescents show a strong negative physiological and emotional reaction when confronted with specific (misophonic) auditory stimuli (most commonly eating or breathing sounds). Several studies with adults yielded prevalence rates between 6 % and 20 % in various (clinical) samples, but the representativeness of samples was largely limited. More than 80 % of the first manifestation of symptoms occurs during childhood and adolescence. Regarding comorbid disorders, studies show great heterogeneity, with estimates ranging from 28-76 % of comorbid mental disorders and approximately 25 % with comorbid physical disorders. The exact etiology is currently not well studied. Initial neurophysiological explanations and imaging studies point to a specific physiological response in misophonia patients. Although many case reports are now available, and diagnostic criteria and measurement tools have been developed, misophonia currently does not represent a distinct neurological, audiological, or psychiatric disorder in the DSM-5 or ICD-11.