(1/49) Report of the Psychotherapy Task Force of the American Academy of Child and Adolescent Psychiatry.
In this task force report, the authors define the field of child and adolescent psychotherapy; review the state of the field with respect to advocacy, training, research, and clinical practice; and recommend steps to ensure that psychotherapy remains a core competence of child and adolescent psychiatrists. (+info)
(2/49) Feelings of inferiority and suicide ideation and suicide attempt among youth.
AIM: To determine the association between feelings of inferiority and suicidal ideation and suicide attempt among youth in the United States. METHODS: Data were drawn from the National Comorbidity Survey carried out among a representative sample of the 15-54 year old population (n=8,098) in the United States. The subsample analyzed in this study included 1,456 respondents aged 15-19. Multivariate logistic regression analyses were used to determine the relationship between feelings of inferiority and the likelihood of suicidal ideation and suicide attempt among youth them. RESULTS: Among the youth, 4.2% described themselves as having feelings of inferiority. Feelings of inferiority were associated with a significantly increased odds of suicidal ideation (odds ratio (OR)=3.2; 95% confidence interval (95%CI)=1.8-5.7) and suicide attempt (OR=2.2; 95%CI=1.0-4.8), which persisted after adjusting for differences in socio-demographic characteristics and comorbid mental disorders among youth in the community. There was evidence of interaction between feelings of inferiority and major depression in the likelihood of suicide attempt. CONCLUSIONS: This preliminary evidence suggests that feelings of inferiority are associated with a significantly increased likelihood of suicidal thoughts and suicidal behavior among youth in the community. Intervention and prevention strategies aimed at identifying and intervening with youth at risk may benefit from the assessment of feelings of inferiority. (+info)
(3/49) What British psychiatrists read: questionnaire survey of journal usage among clinicians.
BACKGROUND: The role of journals in disseminating research to clinicians is increasingly debated. Current measures of esteem for journals (e.g. impact factors) may not indicate clinical penetration. AIMS: To assess the perceived importance of different mental health journals to psychiatrists' clinical practice and compare this with impact factors. METHOD: Random samples of psychiatrists providing child and adolescent, adults of working age and old age services chose up to ten journals read or consulted with regard to their clinical work, ranking the top three. For these journals, comparisons were made with impact factors and importance as outlets for UK psychiatry research. RESULTS: A total of 560 questionnaires were completed (47%). Two membership journals (the British Journal of Psychiatry and the BMJ) were most read and highest ranked. Associations between impact factors, clinicians' ratings and importance as outlets for psychiatry papers varied. CONCLUSIONS: The results could lead to reconsideration of the importance of some journals. Academic assessments of the status of journals should not be assumed to reflect their influence on clinicians. (+info)
(4/49) Measuring provider attitudes toward evidence-based practice: consideration of organizational context and individual differences.
Mental health provider attitudes toward adoption of innovation in general and toward evidence-based practice (EBP) in particular are important in considering how best to disseminate and implement EBPs. This article explores the role of attitudes in acceptance of innovation and proposes a model of organizational and individual factors that may affect or be affected by attitudes toward adoption of EBP. A recently developed measure of mental health provider attitudes toward adoption of EBP is described along with a summary of preliminary reliability and validity findings. Attitudes toward adoption of EBP are discussed in regard to provider individual differences and the context of mental health services. Finally, potential applications of attitude research to adoption of EBP are discussed. (+info)
(5/49) Applying a cognitive-behavioral model of HIV risk to youths in psychiatric care.
This study examined the utility of cognitive and behavioral constructs (AIDS information, motivation, and behavioral skills) in explaining sexual risk taking among 172 12-20-year-old ethnically diverse urban youths in outpatient psychiatric care. Structural equation modeling revealed only moderate support for the model, explaining low to moderate levels of variance in global sexual risk taking. The amount of explained variance improved when age was included as a predictor in the model. Findings shed light on the contribution of AIDS information, motivation, and behavioral skills to risky sexual behavior among teens receiving outpatient psychiatric care. Results suggest that cognitive and behavioral factors alone may not explain sexual risk taking among teens whose cognitive and emotional deficits (e.g., impaired judgment, poor reality testing, affect dysregulation) interfere with HIV preventive behavior. The most powerful explanatory model will likely include a combination of cognitive, behavioral, developmental, social (e.g., family), and personal (e.g., psychopathology) risk mechanisms. (+info)
(6/49) Antecedents, psychiatric characteristics and follow-up of adolescents hospitalized for suicide attempt of overwhelming suicidal ideation.
OBJECTIVES: To evaluate the socio-demographic as well as the health and psychiatric profiles of adolescents hospitalised for suicide attempt or overwhelming suicide ideation and to assess repetition of suicide attempt over a period of 18 months. PATIENTS AND METHODS: Between April 2000 and September 2001, all patients aged 16 to 21 years admitted to the University Hospitals of Geneva and Lausanne for suicide attempt or ideation were included in the study. At this time (T0) semi-structured face to face interviews were conducted to identify socio-demographic data, mental health and antecedents regarding suicidal conducts. Current psychiatric status was assessed with the MINI (Mini International Neuropsychiatric Instrument). At T1 and T2, reassessments included psychiatric status (MINI) as well as lifestyles, socio-professional situation and suicidal behaviours. RESULTS: At T0, 269 subjects met the study criteria, among whom 83 subjects (56 girls and 27 boys) left the hospital too quickly to be involved or refused to participate in the study (final sample at T0: 149 girls; 37 boys). The participation rate at T1 and T2 was respectively 66% and 62% of the original sample. The percentage of adolescents meeting the criteria for psychiatric diagnoses (91%) was high: affective disorder (78%); anxiety disorder (64%); substance use disorder (39%); eating disorder (9%); psychotic disorder (11%); antisocial personality (7%) with most subjects (85%) having more than one disorder. Around 90% of the subjects interviewed at T1, and/or T2, had received follow-up care after their hospitalisation, either by a primary care physician or a psychotherapist or both. Two subjects died of violent death and 18% made a further suicide attempt. CONCLUSION: Most adolescents hospitalised for suicidal episodes suffer from psychiatric problems which should be addressed by a careful psychiatric assessment, followed up if needed by a structured after care plan. (+info)
(7/49) Mental health provision for young offenders: service use and cost.
BACKGROUND: The full costs of accommodating and supporting young people in the criminal justice system are unknown. There is also concern about the level of mental health needs among young offenders and the provision of appropriate mental health services. AIMS: To estimate the full cost of supporting young people in the criminal justice system in England and Wales and to examine the relationship between needs, service use and cost. METHOD: Cross-sectional survey of 301 young offenders, 151 in custody and 150 in the community, conducted in six geographically representative areas of England and Wales. RESULTS: Mental health service use was low despite high levels of need, particularly in the community. Monthly costs were significantly higher among young people interviewed in secure facilities than in the community (pound 4645 v. pound 1863; P<0.001). Younger age and a depressed mood were associated with greater costs. CONCLUSIONS: Young people in the criminal justice system are a significant financial burden not only on that system but also on social services, health and education. The relationship between cost and depressed mood indicates a role for mental health services in supporting young offenders, particularly those in the community. (+info)
(8/49) Use of a routine mental health measure in an adolescent secure unit.
We examined the use of a staff-completed measure, the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA), to record mental health problems in adolescents in local authority secure accommodation. It proved possible to train staff and implement completion of the HoNOSCA on 64 consecutive admissions. Interrater reliability was high. The HoNOSCA identified high levels of psychological problems on admission (mean 18.5, s.d.=5.5). Follow-up HoNOSCA ratings proved sensitive to change; however, correlation between HoNOSCA and adolescent-completed questionnaires was poor. We concluded that HoNOSCA can be helpful in documenting mental health problems among young people admitted to secure local authority units. (+info)