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Longitudinal change in neurocognitive functioning in children and adolescents at clinical high risk for psychosis: a systematic review. 精神病临床高风险儿童和青少年神经认知功能的纵向变化:系统性综述。
IF 5.3 2区 医学 Q1 PEDIATRICS Pub Date : 2024-10-01 Epub Date: 2023-05-18 DOI: 10.1007/s00787-023-02221-9
Borja Pedruzo, Claudia Aymerich, Malein Pacho, Jon Herrero, María Laborda, Marta Bordenave, Anthony J Giuliano, Robert A McCutcheon, Luis Gutiérrez-Rojas, Philip McGuire, William S Stone, Paolo Fusar-Poli, Miguel Ángel González-Torres, Ana Catalan

Clinical high risk of psychosis (CHR-P) population has become an attractive area of interest in preventing transitions to psychosis. The consequences of developing a psychotic disorder may be worse in cases of early onset. Thus, childhood and adolescence represent a critical developmental window, where opportunities to gain social and adaptive abilities depend on the individuals' neurocognitive performance. There have been previous syntheses of the evidence regarding neurocognitive functioning in CHR-P individuals and its longitudinal changes. However, there has been less focus on children and adolescents at CHR-P. A multistep literature search was performed from database inception until July 15th, 2022. PRIMSA/MOOSE compliant systematic review and PROSPERO protocol were used to identify studies reporting on longitudinal changes in neurocognitive functioning in children and adolescents (mean age of sample ≤ 18 years) at CHR-P and matched healthy control (HC) group. A systematic review of identified studies was then undertaken. Three articles were included, resulting in a total sample size of 151 CHR-P patients [mean (SD) age, 16.48 (2.41) years; 32.45% female] and 64 HC individuals [mean (SD) age, 16.79 (2.38) years; 42.18% female]. CHR-P individuals had worse outcomes in verbal learning, sustained attention and executive functioning domains compared to HC. Individuals taking antidepressants had better outcomes in verbal learning in contrast with those taking antipsychotics. In children and adolescents, neurocognition may be already impaired before the psychosis onset, and remains stable during the transition to psychosis. Further study should be performed to obtain more robust evidence.

临床高危精神病(CHR-P)人群已成为预防精神病转变的一个有吸引力的领域。如果发病较早,患上精神病的后果可能会更严重。因此,童年和青春期是一个关键的发育窗口期,在这个时期,获得社交和适应能力的机会取决于个人的神经认知表现。以前曾有过关于 CHR-P 患者神经认知功能及其纵向变化的证据综述。然而,对于儿童和青少年的研究却较少。从数据库建立到 2022 年 7 月 15 日,我们进行了多步骤文献检索。采用符合 PRIMSA/MOOSE 标准的系统综述和 PROSPERO 协议,以确定报告 CHR-P 儿童和青少年(样本平均年龄小于 18 岁)神经认知功能纵向变化的研究,以及匹配的健康对照组(HC)。随后,对已确定的研究进行了系统回顾。共纳入三篇文章,样本总数为 151 名 CHR-P 患者[平均(标清)年龄为 16.48 (2.41) 岁;32.45% 为女性]和 64 名 HC 患者[平均(标清)年龄为 16.79 (2.38) 岁;42.18% 为女性]。与 HC 相比,CHR-P 患者在言语学习、持续注意力和执行功能方面的结果更差。与服用抗精神病药物的患者相比,服用抗抑郁药物的患者在言语学习方面的效果更好。在儿童和青少年中,神经认知可能在精神病发病前就已经受损,并在向精神病过渡的过程中保持稳定。要获得更有力的证据,还需要开展进一步的研究。
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引用次数: 0
Mediators of outcome in adolescent psychotherapy and their implications for theories and mechanisms of change: a systematic review. 青少年心理治疗结果的中介因素及其对变革理论和机制的影响:系统综述。
IF 5.3 2区 医学 Q1 PEDIATRICS Pub Date : 2024-10-01 Epub Date: 2023-03-15 DOI: 10.1007/s00787-023-02186-9
Svenja Taubner, Yianna Ioannou, Andrea Saliba, Célia M D Sales, Jana Volkert, Sonja Protić, Asta Adler, Rasa Barkauskiene, Sonia Conejo-Cerón, Dina Di Giacomo, Jose M Mestre, Patricia Moreno-Peral, Filipa Mucha Vieira, Catarina Pinheiro Mota, Margarida Isabel Rangel Santos Henriques, Jan Ivar Røssberg, Tjasa Stepisnik Perdih, Stefanie Julia Schmidt, Max Zettl, Randi Ulberg, Erkki Heinonen

Psychotherapeutic treatment of adolescents requires age-specific approaches and thus plausibly also involves different change mechanisms than adult psychotherapy. To guide further research and improve therapeutic outcomes for adolescents, we reviewed all RCTs investigating mechanisms of change in the psychological treatment of adolescents to identify the most promising age-, disorder- or treatment-specific mediators. Following the preferred reporting items for systematic reviews (PRISMA), 106 studies were included that reported 252 statistical mediation tests assessed with 181 different measures. Most often studied and significant mediators were cognitive, followed by family-related, and behavioral variables. Several mediators were identified to be promising for future investigations: changes in negative thoughts, dysfunctional beliefs and metacognitive skills; family functioning and parenting skills; as well as successful engagement in therapy activities and increased impulse control. Symptom change during therapy was least often a mediator for other therapeutic changes. Relational and emotional mediators were largely understudied, whereas peer-influence appeared a promising mediator for intervention outcomes. Adolescence-specific mediators were most commonly investigated. Majority of studied mediators were not disorder-specific. There was a tendency to mainly test change mechanisms of specific theoretical models without considering other possible change theories. Further, virtually no studies fulfilled all criteria for rigorously investigating mediation and only nine were classified with an overall good study quality. While bearing in mind the current limitations in study designs, methodological rigor and reporting, there appears to be substantial evidence for transdiagnostic age-specific change models in the psychological treatment of adolescents. For future research, need for consensus on a core set of transdiagnostic and transtheoretical mediators and measures is highlighted. These should address likely core mechanisms of change, as well as take into account age-relevant developmental challenges and biological markers.

对青少年的心理治疗需要采用特定年龄的方法,因此也可能涉及与成人心理治疗不同的变化机制。为了指导进一步的研究并改善青少年的治疗效果,我们回顾了所有调查青少年心理治疗变化机制的研究性试验,以确定最有希望的年龄、障碍或治疗特定中介因素。根据系统性综述的首选报告项目(PRISMA),我们纳入了 106 项研究,这些研究共报告了 252 次统计学中介测试,使用了 181 种不同的测量方法进行评估。最常研究且意义重大的中介因素是认知变量,其次是家庭相关变量和行为变量。有几项中介因素被认为有望在未来的研究中得到应用:消极思想、功能失调信念和元认知技能的改变;家庭功能和养育技能;以及成功参与治疗活动和冲动控制能力的增强。治疗过程中的症状变化最不经常成为其他治疗变化的中介因素。关系和情感中介因素在很大程度上没有得到充分研究,而同伴影响似乎是干预结果的一个很有希望的中介因素。青少年特有的中介因素是最常被研究的。大多数研究的中介因素都不是针对特定疾病的。有一种趋势是主要测试特定理论模型的变化机制,而不考虑其他可能的变化理论。此外,几乎没有研究符合严格调查中介作用的所有标准,只有 9 项研究被归类为总体研究质量良好。尽管考虑到目前在研究设计、方法严谨性和报告方面存在的局限性,但在青少年心理治疗中,跨诊断的特定年龄变化模型似乎有大量的证据。对于未来的研究,我们强调需要就一套核心的跨诊断和跨理论中介因子和测量方法达成共识。这些因素应涉及可能发生变化的核心机制,并考虑到与年龄相关的发展挑战和生物标记。
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引用次数: 0
Interventions for prevention and treatment of substance use in youth with traumatic childhood experiences: a systematic review and synthesis of the literature. 预防和治疗有童年创伤经历的青少年使用药物的干预措施:系统回顾和文献综述。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-10-01 Epub Date: 2023-07-22 DOI: 10.1007/s00787-023-02265-x
Timothy D Becker, Santiago Castañeda Ramirez, Adriana Bruges Boude, Alicia Leong, Iliyan Ivanov, Timothy R Rice

Most substance use begins in adolescence. Both childhood trauma and associated post-traumatic stress disorder (PTSD) increase risk for early substance use, which is associated with greater eventual severity of substance use disorders (SUDs). When co-occurring, PTSD and SUD can reinforce and exacerbate each other, necessitating integrated treatment approaches. To systematically review existing literature on interventions for prevention or treatment of SUDs among adolescents (aged 10-24) with a history of trauma, with or without PTSD, we searched databases (PubMed, PsycInfo, CINAHL, Cochrane CENTRAL) using search terms related to substance use, trauma, adolescents, and interventions. Searches identified 8134 unique articles, 68 of which prompted full-text screening. Authors extracted data, applied the Effective Public Health Practice Project Quality Assessment Tool to evaluate the evidence, and synthesized findings. Thirty three articles met eligibility criteria, including 13 RCTs. Twenty studies (10 RCTs) evaluated interventions for substance use and co-occurring problems among youth with a history of trauma, predominantly via individual therapy based on cognitive-behavioral principles, although group therapy, case management, and other approaches have also been studied. Interventions with exposure-based components were infrequent but had robust results and minimal adverse outcomes. Thirteen studies examined differential response of youth with a history of trauma to standard SUD treatments, compared to youth without a history of trauma, with mixed findings. Youth with a history of trauma face elevated risk of SUDs and may respond differently to SUD treatments. Several promising interventions have been recently developed.

大多数药物使用始于青春期。童年创伤和相关的创伤后应激障碍(PTSD)都会增加早期使用药物的风险,而这与药物使用障碍(SUD)的最终严重程度有关。当创伤后应激障碍和药物使用障碍同时存在时,它们会相互强化和加剧,因此需要采取综合治疗方法。为了系统回顾现有文献,了解在有创伤史、伴有或不伴有创伤后应激障碍的青少年(10-24 岁)中预防或治疗 SUD 的干预措施,我们使用与药物使用、创伤、青少年和干预措施相关的检索词对数据库(PubMed、PsycInfo、CINAHL、Cochrane CENTRAL)进行了检索。通过检索发现了 8134 篇文章,其中 68 篇进行了全文筛选。作者提取了数据,应用 "有效公共卫生实践项目质量评估工具 "对证据进行了评估,并对结果进行了综合。有 33 篇文章符合资格标准,其中包括 13 项研究性试验。20 项研究(10 项 RCT)评估了针对有创伤史青少年的药物使用和共存问题的干预措施,主要是通过基于认知行为原则的个体治疗,尽管也研究了团体治疗、个案管理和其他方法。以暴露为基础的干预措施并不常见,但效果显著,不良后果极小。有 13 项研究调查了有心理创伤史的青少年与无心理创伤史的青少年对标准 SUD 治疗的不同反应,结果不一。有心理创伤史的青少年面临着更高的罹患精神疾病的风险,可能会对精神疾病治疗做出不同的反应。最近开发了几种很有前景的干预措施。
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引用次数: 0
How social is social media for transgender and gender-diverse youth? Association of online social experiences with internalizing mental health problems. 变性和性别多元化青少年的社交媒体有多社交?网络社交体验与内化心理健康问题的关联。
IF 5.3 2区 医学 Q1 PEDIATRICS Pub Date : 2024-10-01 Epub Date: 2024-03-17 DOI: 10.1007/s00787-024-02396-9
Lena Herrmann, Claus Barkmann, Carola Bindt, Sarah Hohmann, Saskia Fahrenkrug, Inga Becker-Hebly

Adolescents spend a critical amount of their free time on the Internet and social media. Transgender and gender-diverse (TGD) adolescents, who report elevated rates of mental health issues, especially internalizing problems, have both positive and negative online social experiences (e.g., support and cyberbullying). This can have both beneficial and/or harmful effects on their mental health. Given the lack of research, the present study examined TGD adolescents' online (social) experiences and the association of positive and negative online social experiences with internalizing problems. The sample consisted of n = 165 TGD adolescents (11-18 years) diagnosed with gender dysphoria who attended a Gender Identity Service for children and adolescents (Hamburg GIS) in Germany between January 2020 and December 2022 during the COVID-19 pandemic. Positive (use of online support networks) and negative online social experiences (cyberbullying or other adverse online interactions) were assessed using study-specific items and internalizing problems using the Youth Self-Report. Frequencies of various online (social) experiences were analyzed, and a multiple linear regression analysis was performed to test their association with internalizing problems. In total, 42% of participants reported positive online social experiences (use of online support networks) and 51% of participants reported negative online social experiences (cyberbullying or other adverse online interactions). There was no significant association between negative online social experiences and internalizing problems but between positive online social experiences and more internalizing problems (adjusted R2 = .01). TGD adolescents may seek online support, especially when struggling with mental health problems. Therefore, it is crucial to support youth navigating these online spaces more safely and positively and to empower them to buffer against potentially harmful experiences. Furthermore, strengthening offline relations with peers and family members is pivotal, given their importance for TGD adolescents' mental health.

青少年在互联网和社交媒体上花费了大量的空闲时间。变性和性别多元化(TGD)青少年的心理健康问题,尤其是内化问题的发生率较高,他们在网上既有积极的社交经历,也有消极的社交经历(如支持和网络欺凌)。这可能会对他们的心理健康产生有利和/或有害的影响。鉴于缺乏相关研究,本研究调查了 TGD 青少年的网络(社交)经历,以及积极和消极网络社交经历与内化问题之间的关联。样本包括 n = 165 名被诊断患有性别焦虑症的 TGD 青少年(11-18 岁),他们在 COVID-19 大流行期间的 2020 年 1 月至 2022 年 12 月期间参加了德国的儿童和青少年性别认同服务机构(汉堡 GIS)。积极的(使用在线支持网络)和消极的在线社交经历(网络欺凌或其他不良在线互动)使用研究特定项目进行评估,内化问题使用青少年自我报告进行评估。对各种网络(社交)经历的频率进行了分析,并进行了多元线性回归分析,以检验这些经历与内化问题之间的关联。共有 42% 的参与者报告了积极的网上社交经历(使用网上支持网络),51% 的参与者报告了消极的网上社交经历(网络欺凌或其他不良的网上互动)。消极的网络社交经历与内化问题之间没有明显联系,但积极的网络社交经历与更多的内化问题之间有明显联系(调整后 R2 = 0.01)。TGD 青少年可能会寻求网络支持,尤其是在遇到心理健康问题时。因此,至关重要的是要支持青少年更安全、更积极地浏览这些网络空间,并赋予他们缓冲潜在有害经历的能力。此外,鉴于朋辈和家庭成员对 TGD 青少年心理健康的重要性,加强与他们的线下关系也至关重要。
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引用次数: 0
Generation time-out grows up: young adults' reports about childhood time-out use and their mental health, attachment, and emotion regulation. 超时一代的成长:年轻人对童年超时使用情况的报告及其心理健康、依恋和情绪调节。
IF 5.3 2区 医学 Q1 PEDIATRICS Pub Date : 2024-10-01 Epub Date: 2024-03-05 DOI: 10.1007/s00787-024-02408-8
Jingyi Xu, Lucy A Tully, Mark R Dadds

Time-out (TO) is a widely utilised parental discipline technique with a strong evidence-base that nonetheless has attracted controversy regarding potential adverse effects on mental health in developing children. Associations between TO implementation and mental health outcomes have rarely been investigated, especially through the eyes of children who grew up experiencing TO. This study recruited 407 university students (Study 1) and a community sample of 535 young adults (Study 2); both samples aged 18-30 years. Young adults were surveyed on their retrospective reports of childhood TO experience, childhood experiences of adversity, perceived parenting style and parental attachment, and their current mental health outcomes (attachment style, emotion regulation and mental health). In Study 1, 334 (82.1%) young adults reported experiencing TO in childhood, but with widely varied implementation that differed considerably from its evidence-based ideal. Reports of more TO appropriate implementation were associated with less avoidant attachment, better mental health, and emotion regulation, over and above the effects associated with authoritative parenting and secure attachment in childhood. While exposure to childhood adversity was associated with poorer adulthood outcomes, TO implementation did not moderate the association. Study 2 replicated most findings from Study 1, except that appropriate TO implementation displayed a positive association with mental health and no associations with anxious and avoidant attachment and emotion regulation. These findings suggest the safety of TO use with young children, including those who experienced childhood adversity, and highlight the importance of disseminating sufficient parenting information on TO in the community.

超时(TO)是一种广泛使用的家长管教方法,具有很强的证据基础,但却因其对发育期儿童心理健康的潜在不利影响而引起争议。有关 "暂停 "的实施与心理健康结果之间的关系,尤其是通过经历过 "暂停 "的儿童的视角进行调查的情况还很少见。本研究招募了 407 名大学生(研究 1)和一个由 535 名年轻人组成的社区样本(研究 2);两个样本的年龄均为 18-30 岁。研究调查了年轻人对童年涂改经历的回顾性报告、童年逆境经历、感知到的父母教养方式和父母依恋,以及他们目前的心理健康结果(依恋方式、情绪调节和心理健康)。在研究 1 中,有 334 名(82.1%)青少年报告说他们在童年时有过 "托 "的经历,但实施情况大相径庭,与以证据为基础的理想 "托 "大相径庭。据报告,在童年时期,如果实施了更多适当的 "托",就会减少回避型依恋,改善心理健康和情绪调节,其效果远远超过权威型养育和安全型依恋。虽然童年时期的逆境与成年后较差的结果有关,但《教育指南》的实施并没有缓和这种关联。研究 2 复制了研究 1 中的大部分发现,但适当实施《教养条例》与心理健康呈正相关,而与焦虑型和回避型依恋以及情绪调节没有关联。这些研究结果表明,对幼儿(包括经历过童年逆境的幼儿)使用《教养手册》是安全的,并强调了在社区中传播足够的《教养手册》育儿信息的重要性。
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引用次数: 0
Understanding priorities and needs for child and adolescent mental health in Greece from multiple informants: an open resource dataset. 从多方信息来源了解希腊儿童和青少年心理健康的优先事项和需求:开放资源数据集。
IF 5.3 2区 医学 Q1 PEDIATRICS Pub Date : 2024-10-01 Epub Date: 2024-04-01 DOI: 10.1007/s00787-024-02400-2
Anastasia Koumoula, Lauro Estivalete Marchionatti, Vasiliki Eirini Karagiorga, Julia Luiza Schafer, André Simioni, Arthur Caye, Aspasia Serdari, Konstantinos Kotsis, Maria Basta, Lilian Athanasopoulou, Vaios Dafoulis, Paraskevi Tatsiopoulou, Nikos Zilikis, Evangelia Vergouli, Panagiota Balikou, Efstathia Kapsimalli, Andromachi Mitropoulou, Alexandra Tzotzi, Nikanthi Klavdianou, Domna Zeleni, Sotiria Mitroulaki, Anna Botzaki, Giorgos Gerostergios, Giorgos Samiotakis, Giorgos Moschos, Ioanna Giannopoulou, Katerina Papanikolaou, Katerina Angeli, Nikolaos Scarmeas, Jill Emanuele, Kenneth Schuster, Eirini Karyotaki, Lily Kalikow, Katerina Pronoiti, Kathleen R Merikangas, Peter Szatmari, Pim Cuijpers, Katholiki Georgiades, Michael P Milham, Mimi Corcoran, Sarah Burke, Harold Koplewicz, Giovanni Abrahão Salum

The Child and Adolescent Mental Health Initiative (CAMHI) aims to enhance mental health care capacity for children and adolescents across Greece. Considering the need for evidence-based policy, the program developed an open-resource dataset for researching the field within the country. A comprehensive, mixed-method, community-based research was conducted in 2022/2023 assessing the current state, needs, barriers, and opportunities according to multiple viewpoints. We surveyed geographically distributed samples of 1,756 caregivers, 1,201 children/adolescents, 404 schoolteachers, and 475 health professionals using validated instruments to assess mental health symptoms, mental health needs, literacy and stigma, service use and access, professional practices, training background, and training needs and preferences. Fourteen focus groups were conducted with informants from diverse populations (including underrepresented minorities) to reach an in-depth understanding of those topics. A dataset with quantitative and qualitative findings is now available for researchers, policymakers, and society [ https://osf.io/crz6h/ and https://rpubs.com/camhi/sdashboard ]. This resource offers valuable data for assessing the needs and priorities for child and adolescent mental health care in Greece. It is now freely available to consult, and is expected to inform upcoming research and evidence-based professional training. This initiative may inspire similar ones in other countries, informing methodological strategies for researching mental health needs.

儿童和青少年心理健康倡议(CAMHI)旨在提高希腊全国儿童和青少年的心理健康保健能力。考虑到对循证政策的需求,该计划在国内开发了一个用于研究该领域的开放资源数据集。2022/2023 年,我们开展了一项以社区为基础的混合方法综合研究,根据多种观点对现状、需求、障碍和机遇进行了评估。我们使用经过验证的工具,对地理分布广泛的 1 756 名照顾者、1 201 名儿童/青少年、404 名学校教师和 475 名卫生专业人员进行了抽样调查,以评估心理健康症状、心理健康需求、扫盲和污名化、服务使用和获取、专业实践、培训背景以及培训需求和偏好。为了深入了解这些主题,还与来自不同人群(包括代表性不足的少数群体)的信息提供者进行了 14 次焦点小组讨论。目前,研究人员、政策制定者和社会各界均可查阅包含定量和定性研究结果的数据集 [ https://osf.io/crz6h/ 和 https://rpubs.com/camhi/sdashboard ]。该资源为评估希腊儿童和青少年心理保健的需求和优先事项提供了宝贵的数据。现在可以免费查阅,并有望为即将开展的研究和以证据为基础的专业培训提供信息。这一举措可能会对其他国家的类似举措有所启发,为研究心理健康需求的方法战略提供参考。
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引用次数: 0
Symptoms of selective mutism beyond failure to speak in children and adolescents. 选择性缄默症的症状超出了儿童和青少年不会说话的范围。
IF 5.3 2区 医学 Q1 PEDIATRICS Pub Date : 2024-10-01 Epub Date: 2024-03-27 DOI: 10.1007/s00787-024-02415-9
Felix Vogel, Carolin Röse, Christina Schwenck

Understanding the symptoms of a mental disorder is essential for accurate diagnosis or selecting appropriate treatment targets. Despite this, there is a surprising lack of systematic research on the symptoms of selective mutism (SM). While the DSM-5 defines failure to speak as the only core symptom of SM, sparse research suggests that children with SM may experience additional symptoms. Previous studies have been limited in their identification of symptoms of SM, either by using a predefined set of symptoms or by only asking for anxiety-specific symptoms. This may have resulted in important symptoms being overlooked. In this study, we provided n = 86 parents of children and adolescents with SM (3-18 years) with a symptom definition appropriate for the target group. Additionally, parents were asked an open-ended question about any other symptoms they had observed in their children, beyond the failure to speak. The symptoms reported were categorized using qualitative content analysis (QCA) and examined for frequency and association with symptom severity. Ten different symptom categories were identified, with fear, freezing, and avoidance/security behaviors being the most prevalent. On average, parents reported M = 4.74 (SD = 2.37) symptoms from different symptom categories. Only fear was found to be related to symptom severity of SM. As the findings suggest that SM encompasses various symptoms beyond failure to speak, a more sophisticated understanding of SM as a mental disorder with multiple symptoms seems essential. The clinical implications of this are discussed in further detail.

了解精神障碍的症状对于准确诊断或选择适当的治疗目标至关重要。尽管如此,关于选择性缄默症(SM)症状的系统研究却出奇地缺乏。虽然 DSM-5 将不说话定义为选择性缄默症的唯一核心症状,但稀少的研究表明,患有选择性缄默症的儿童可能还会出现其他症状。以往的研究在识别选择性缄默症的症状方面存在局限性,要么使用了一组预先定义的症状,要么只询问了焦虑症的特定症状。这可能会导致重要症状被忽视。在本研究中,我们为 n = 86 名患有 SM 的儿童和青少年(3-18 岁)的家长提供了适合目标群体的症状定义。此外,我们还向家长们提出了一个开放式问题,询问他们在孩子身上观察到的除无法说话之外的其他症状。使用定性内容分析法(QCA)对所报告的症状进行分类,并检查频率和与症状严重程度的关联。共确定了 10 种不同的症状类别,其中以恐惧、冻结和回避/安全行为最为普遍。平均而言,家长们报告了不同症状类别中的 M = 4.74(SD = 2.37)个症状。研究发现,只有恐惧与 SM 的症状严重程度有关。研究结果表明,除了不能说话之外,SM 还包括其他各种症状,因此,将 SM 视为一种具有多种症状的精神障碍似乎至关重要。本文将进一步详细讨论其临床意义。
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引用次数: 0
Co-constructive patient simulation at international conferences: strengthening interactions and deepening reflection. 国际会议上的共同建构病人模拟:加强互动和深化思考。
IF 6 2区 医学 Q1 PEDIATRICS Pub Date : 2024-10-01 Epub Date: 2024-02-22 DOI: 10.1007/s00787-024-02384-z
Marie-José van Hoof, Marie-Aude Piot, Giulia Iozzia, Khatun Mirsujan, Mark D Hanson, Andrés Martin
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引用次数: 0
Drop-out and ineffective treatment in youth with severe and enduring mental health problems: a systematic review. 有严重和持久精神健康问题的青少年的辍学和无效治疗:系统综述。
IF 5.3 2区 医学 Q1 PEDIATRICS Pub Date : 2024-10-01 Epub Date: 2023-03-07 DOI: 10.1007/s00787-023-02182-z
R de Soet, R R J M Vermeiren, C H Bansema, H van Ewijk, L Nijland, L A Nooteboom

Youth with severe and enduring mental health problems (SEMHP) tend to drop out of treatment or insufficiently profit from treatment in child and adolescent psychiatry (CAP). Knowledge about factors related to treatment failure in this group is scarce. Therefore, the aim of this systematic review was to thematically explore factors associated with dropout and ineffective treatment among youth with SEMHP. After including 36 studies, a descriptive thematic analysis was conducted. Themes were divided into three main categories: client, treatment, and organizational factors. The strongest evidence was found for the association between treatment failure and the following subthemes: type of treatment, engagement, transparency and communication, goodness of fit and, perspective of practitioner. However, most other themes showed limited evidence and little research has been done on organizational factors. To prevent treatment failure, attention should be paid to a good match between youth and both the treatment and the practitioner. Practitioners need to be aware of their own perceptions of youth's perspectives, and transparent communication with youth contributes to regaining their trust.

有严重和持久心理健康问题(SEMHP)的青少年往往会放弃治疗,或者无法从儿童和青少年精神病学(CAP)的治疗中充分获益。有关这一群体治疗失败相关因素的知识还很少。因此,本系统性综述旨在专题探讨与 SEMHP 青少年辍学和治疗无效相关的因素。在纳入 36 项研究后,我们进行了描述性主题分析。主题分为三大类:客户、治疗和组织因素。研究发现,治疗失败与以下次主题之间的关联证据最为充分:治疗类型、参与、透明度和沟通、契合度以及从业人员的观点。然而,大多数其他主题的证据有限,对组织因素的研究也很少。为防止治疗失败,应注意青少年与治疗方法和从业人员之间的良好匹配。从业人员需要了解自己对青少年观点的看法,与青少年进行透明的沟通有助于重新获得他们的信任。
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引用次数: 0
Mental and physical health in children of women with a history of anorexia nervosa. 有神经性厌食症病史妇女的子女的身心健康。
IF 5.3 2区 医学 Q1 PEDIATRICS Pub Date : 2024-10-01 Epub Date: 2024-03-13 DOI: 10.1007/s00787-024-02393-y
Sandra Rydberg Dobrescu, Lisa Dinkler, Carina Gillberg, Christopher Gillberg, Maria Råstam, Elisabet Wentz

Few studies have investigated the offspring of women with anorexia nervosa (AN). The aim of this study was to examine perinatal status, mental and physical health in the offspring of mothers with a history of AN. Fifty-one individuals with adolescent-onset AN and 51 matched controls (COMP) have been followed prospectively. Presently, 30 years after AN onset, at a mean age of 44 years, female participants who had given birth (nAN = 40, nCOMP = 40) were interviewed regarding psychiatric health in their offspring using the Developmental and Well-Being Assessment and the MINI International Neuropsychiatric Interview. In addition, information on the offspring's perinatal status, psychiatric- and physical health was obtained from the Swedish Medical Birth Register and The Swedish National Patient Register. Data regarding mental and physical health were available for 83 and 86 offspring in the AN and COMP groups, respectively. At birth, all of weight, length, head circumference and ponderal index were significantly reduced in the offspring of mothers with a history of AN. In adolescence, parental interviews indicated an overrepresentation of current psychiatric diagnoses in the offspring of mothers with AN. Compared with the offspring in the COMP group, endocrinological, immune and metabolic disorders were much more common in the offspring of the AN group. In conclusion, a history of AN increases the risk of worse perinatal outcome of the offspring. Later on, in childhood and adolescence, psychiatric and physical morbidity may be overrepresented in the offspring of women with AN.

很少有研究对神经性厌食症(AN)女性的后代进行调查。本研究的目的是调查有神经性厌食症病史的母亲的后代的围产期状况、身心健康情况。研究人员对51名青少年期厌食症患者和51名匹配对照组(COMP)进行了前瞻性跟踪调查。目前,在AN发病30年后、平均年龄44岁时,我们使用发育与幸福评估(Developmental and Well-Being Assessment)和MINI国际神经精神访谈(MINI International Neuropsychiatric Interview)对生育过的女性参与者(nAN = 40,nCOMP = 40)进行了关于其后代精神健康状况的访谈。此外,他们还从瑞典出生医学登记册和瑞典全国患者登记册中获得了有关后代围产期状况、精神和身体健康的信息。AN组和COMP组分别有83名和86名后代获得了精神和身体健康方面的数据。有 AN 病史的母亲的后代在出生时体重、身长、头围和腹围指数都明显下降。在青春期,对父母的访谈显示,有自闭症母亲的后代中目前患有精神病诊断的比例过高。与COMP组的后代相比,AN组的后代更常见内分泌、免疫和代谢紊乱。总之,有自闭症史会增加后代围产期结局恶化的风险。之后,在儿童和青少年时期,患有自闭症妇女的后代中精神和身体疾病的比例可能会更高。
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引用次数: 0
期刊
European Child & Adolescent Psychiatry
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