How impaired are children and adolescents by mental health problems? Results of the BELLA study. (17/49)

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Adolescent self harm patients: audit of assessment in an accident and emergency department. (18/49)

OBJECTIVE: To examine the assessment of adolescent self harm patients attending an accident and emergency department. DESIGN: Retrospective assessment of case notes. SETTING: Accident and emergency department, Leicester Royal Infirmary. PATIENTS: 210 adolescent patients (aged 9-19 years) attending the department during 1 January 1989-31 December 1989 after deliberate self poisoning; records were available for 200. MAIN OUTCOME MEASURES: Numbers of admissions, discharges from department without either a psychiatric consultation or some form of follow up, and discharges with either of these; scoring of adequacy of psychiatric and social assessment by accident and emergency doctor. RESULTS: 89 patients were admitted (mean score 5.1, excluding 22 patients too drowsy or unforthcoming for proper assessment), 80 were discharged without specific psychiatric consultation or other follow up (mean score 5.4), and 31 were discharged with psychiatric consultation or other follow up (mean score 9.1). The percentage of patients in each group whose assessment by the accident and emergency doctor was considered to be adequate or better than adequate over 10 headings ranged from 0%-40% for admitted patients, 0%-50% for those discharged without psychiatric assessment, and 0%-61% in the remaining group. Overall, in almost half (49%, 54/111) of all of those discharged documentation of the suicidal state was inadequate. CONCLUSION: The assessment of many adolescent self harm patients in this clinic was unsatisfactory. IMPLICATIONS: Doctors working in accident and emergency departments should be encouraged to liaise with child psychiatrists before discharging such patients.  (+info)

The birth of child and adolescent neuropsychiatry: from rehabilitation and social inclusion of the mentally handicapped, to the care of mental health during development. (19/49)

Child and adolescent neuropsychiatry services' development is described from early deinstitutionalization, through to rehabilitation, intervention and social inclusion of children with disability. The issues that have changed the services in order to meet the growing mental health problem, and the protection of mental well-being trough developmental years, are then dealt with in detail. Finally we draw a picture of the organization of child and adolescent neuropsychiatry services in Italy and in the different regional contexts.  (+info)

Teaching pediatric residents to assess adolescent suicide risk with a standardized patient module. (20/49)

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Cognitive and psychiatric predictors to psychosis in velocardiofacial syndrome: a 3-year follow-up study. (21/49)

OBJECTIVE: To predict prodromal psychosis in adolescents with velocardiofacial syndrome (VCFS). METHOD: A total of 70 youth with VCFS, 27 siblings of youth with VCFS, and 25 community controls were followed from childhood (mean age = 11.8 years) into mid-adolescence (mean age = 15.0 years). Psychological tests measuring intelligence, academic achievement, learning/memory, attention, and executive functioning as well as measures of parent and clinician ratings of child psychiatric functioning were completed at both time points. RESULTS: Major depressive disorder, oppositional defiant disorder, and generalized anxiety disorder diagnoses increased in the VCFS sample. With very low false positive rates, the best predictor of adolescent prodromal psychotic symptoms was parent ratings of childhood odd/eccentric symptoms and child performance on a measure of executive functioning, the Wisconsin Card Sorting Test. CONCLUSIONS: Similar to the non-VCFS prodromal psychosis literature, a combination of cognitive and psychiatric variables appears to predict psychosis in adolescence. A child with VCFS who screens positive is noteworthy and demands clinical attention.  (+info)

Clinical, demographic, and familial correlates of bipolar spectrum disorders among offspring of parents with bipolar disorder. (22/49)

OBJECTIVE: Despite increased risk, most offspring of parents with bipolar disorder (BP) do not manifest BP. The identification of risk factors for BP among offspring could improve preventive and treatment strategies. We examined this topic in the Pittsburgh Bipolar Offspring Study (BIOS). METHOD: Subjects included 388 offspring, ages 7-17 years, of 233 parents with BP-I or BP-II (via the Structured Clinical Interview for DSM-IV). Offspring diagnoses were determined using the Schedule for Affective Disorders and Schizophrenia for School-Aged Children, Present and Lifetime version (KSADS-PL). Analyses focused on the 41 offspring who were diagnosed with BP-I (N = 9), BP-II (N = 5), or BP-NOS (N = 27). RESULTS: Offspring with BP had proband parents who were significantly younger at the time of their birth, were more likely to be female, and had lower socio-economic status, versus proband parents of offspring without BP. Parental clinical variables and obstetric variables were not significantly associated with BP among offspring. History of physical and/or sexual abuse, exposure to antidepressants, and exposure to stimulants was significantly greater among offspring with versus without BP. There was significantly greater prevalence of attention-deficit/hyperactivity disorder (ADHD), anxiety disorders, oppositional defiant disorder/conduct disorder (ODD/CD), and exposure to stimulants and antidepressants among offspring with versus without BP. Variables significantly associated with BP among offspring in regression analyses were as follows: older offspring age, younger parent age at birth, offspring anxiety disorders and ODD/CD, and biological coparent with BP. CONCLUSION: History of anxiety and/or disruptive behavior disorders, as well as presence of bi-lineal parental BP, is associated with elevated risk of bipolar spectrum disorders among offspring. If replicated prospectively, these findings could have implications for the diagnosis and treatment of psychopathology among BP offspring.  (+info)

The emerging role for repetitive transcranial magnetic stimulation in optimizing the treatment of adolescent depression. (23/49)

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A brief intervention is sufficient for many adolescents seeking help from low threshold adolescent psychiatric services. (24/49)

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