Nasal congestion is a known but likely underreported side effect of antipsychotic treatment and is not captured by most side-effect interviews or rating scales. Although usually benign, it can in some cases lead to substantial discomfort. We report a case of a young patient with quetiapine-induced nasal congestion in whom surgical intervention was avoided by switching medication.
Background: Recently there has been a rapid adoption of initiatives driven by a desire to be inclusive of diversity. Though this is certainly positive, many strategies are implemented based on the untested hypothesis that their adoption is genuinely wanted and beneficial to those whom these approaches are designed to benefit. One area where this phenomenon is occurring is in the context of neurodivergence, where events are increasingly employing silent clapping, otherwise known as "jazz hands" or "flapplause," in place of traditional applause, with the aim of creating more inclusive environments.
Methods: We conducted an international survey to examine whether "silent clapping" is indeed of substance to the neurodivergent community by surveying neurodivergent (n=389) and neurotypical (n=237) individuals. We compared the perspectives of neurodivergent and neurotypical respondents on silent clapping and also examined whether endorsement of silent clapping varied among specific subgroups of the neurodivergent population.
Results: Generally, both neurotypical and neurodivergent individuals perceived silent clapping similarly. However, there were mixed responses regarding the endorsement of silent clapping, and no clear consensus emerged. Autistic individuals tended to endorse silent clapping more than other neurodivergent individuals, although variability in endorsement remained. Qualitative responses reflected both support for silent clapping but also concerns about its use.
Conclusions: While silent clapping is largely endorsed, we find no overwhelming support or clear consensus. Findings suggest that silent clapping may be beneficial and wanted by particular subsets of the neurodivergent community, particularly for autistic individuals, but that it can also introduce other concerns. We caution against the indiscriminate implementation of such initiatives in favor of more considered and targeted strategies. Implementation of any initiative aimed at increasing inclusion should be guided by consultation with the relevant community.
Background: Serotonin selective reuptake inhibitor (SSRI) - induced activation and manic/hypomanic switch in children should be defined and delimited from each other. If not, this could contribute to inappropriate treatment decisions. This systematic review aimed, therefore, to explore how SSRI - induced activation and manic/hypomanic switch in children are defined, delimited from each other, assessed, and diagnosed.
Methods: The PRISMA guidelines were followed. A systematic literature search was conducted in Pubmed, Cochrane, Scopus, and PsychINFO (from 8th to 15th March 2023). Eligible studies were in English, covering a population aged six to 18 years, where the outcome was activation or manic/hypomanic switch in relation to SSRI treatment. Two blinded assessors independently screened all abstracts, and thirty articles were included. Definitions, described symptoms, assessments, and inter-rater reliability were recorded.
Results: Twelve articles were categorized as activation and 18 as mania/hypomania. Eight articles presented a clear definition of activation and four of mania/hypomania. Two articles presented inter-rater/test-retest reliability. One specific instrument was used for assessment of activation. No instrument was used for assessment of mania/hypomania. Symptom overlap was found, but more symptoms of 'aggression and hostility', 'anxiety and panic', and 'suicide and self-harm' were reported in activation while more 'cognitive and thought process alterations' and 'changes in mood and emotions' were reported in mania/hypomania.
Discussion/conclusion: Vague definitions, and inadequate assessments and diagnostic procedures were found. There were some differences in symptoms between activation and manic/hypomanic switch.
Other: The study protocol was published on Prospero 2023, CRD42023422133.
Introduction: Although both nonsuicidal self-injury (NSSI) and cyberbullying (CB) are very common among adolescents, there are only a few studies examining the relationship between the two phenomena. The aim of our study was to explore the relationship between CB and NSSI, and to examine the potential mediating effects of anxiety and depression.
Methods: 119 Hungarian adolescents (70% female, 13-18-year-olds) were involved in the study. A self-report questionnaire about CB, the Inventory of Statements About Self-injury, and the Mini International Neuropsychiatric Interview - Kid were administered. Regression and network analysis were conducted to analyze the interrelationships among CB, NSSI, and anxiety/depression.
Results: The prevalence of NSSI was significantly higher among those who were involved in CB, compared to those who were not, χ2(1) = 5.62, p = 0.02. CB and NSSI were mediated by anxiety, and anxiety disorder was directly related to NSSI. Conversely, depression was not directly related to CB, only to anxiety. Victimization was positively related to anxiety, which, in turn, was positively associated with NSSI.
Conclusion: Our results draw attention to the importance of focusing on comorbid anxiety disorders and to both those who are involved in CB and those who witness CB in NSSI prevention strategies.
Background: Level of social functioning is an important outcome in psychiatric research and in clinical practice. The Personal and Social Performance Scale is a comprehensive and well-validated measure of social functioning in adults with psychiatric illness.
Objective: Evaluations of the psychometric qualities of the scale are scarce when applied to adolescents. This small-scale study examines the inter-rater reliability of the Personal and Social Performance Scale in adolescents.
Methods: A semi-structured interview was conducted with eight Danish participants between age 13 and 17 years, with or without a diagnosed psychiatric illness. Agreement on ratings of the Personal and Social Performance Scale between six independent assessors was evaluated with Intraclass Correlation Coefficient (ICC).
Results: We found that agreement on the Personal and Social Performance Scale total scores was good (ICC=0.85). Agreement on subareas of the Personal and Social Performance Scale ranged from moderate to excellent (ICC=0.59 to ICC=0.92).
Conclusions: These findings contribute with preliminary evidence of the reliability of the Personal and Social Performance Scale when applied in adolescents. We suggest that future studies should explore the psychometric quality in larger samples with more variation in level of social functioning.
Background: Children of parents with mental illness are known to be at risk of developing mental illnesses due to hereditary and socio-economic factors. The family-focused practice in the treatment of adult patients with severe mental illness benefits patients and their children, and can help prevent mental health problems in children of parents with mental illness. Therefore, professionals caring for adult patients must contribute to the early identification of families at risk and initiate the necessary care.
Objective: This study aimed to determine the current practices of psychologists and psychiatrists in the Czech Republic-the extent to which they include parental issues and their patients' children in their treatment, how informed they are about the available support, their attitudes toward a family-focused practice, potential barriers to family-focused practice, and recommendations for improvements in care for children of parents with mental illness.
Methods: A structured online questionnaire completed by 193 professionals (51.8% psychiatrists, 48.2% psychologists) working with adults with severe mental illness in various healthcare settings.
Results: A large majority (95.9%) of respondents regularly asked about the parenting status of their patients and 75.1% had a positive attitude toward involving children more in treatment. Although most respondents were comfortable discussing parenting (91.2%), they only discussed parenting topics if the patients themselves brought them up. Minors were rarely invited to treatment (26.4%), usually on a one-off basis. Major barriers cited include a lack of set procedures for working with families, lack of coherence of services, lack of time, shortage of professionals to refer to, and perceived lack of training and experience.
Conclusion: Although most professionals know that their patients have children and believe that children of parents with mental illness are at risk of developing problems, they are hindered by a variety of organizational and systemic barriers in implementing the family-focused approach more frequently in practice. Subject to wider expert discourse, the findings may contribute to informed policy formulation.
This systematic review summarizes studies of the association between traditional leisure activity engagement in adolescence and subsequent psychiatric morbidity up to early adulthood. The literature search for the review was conducted in May 2022 and in November 2023 utilizing three electronic databases. In total, eleven studies published between 2010 and 2023 fulfilled the inclusion criteria. The results showed that active participation to leisure time activities in adolescence associated with a lower likelihood of being diagnosed with a psychiatric disorder by young adulthood. The most well-established link and strongest supporting data were found for depression, anxiety, and psychotic disorders but for other psychiatric disorders, the evidence was indicative. The findings of reviewed studies highlight the importance of socially engaging recreational activities for adolescents' long-term mental health. Additional research is required to explore the associations between different leisure activities, including solo hobbies, and different specified mental disorders.
Background: Growing emphasis is placed on supporting children and adolescents with attention deficit hyperactivity disorder (ADHD) in participating in their own healthcare; however, more knowledge is needed to guide practice.
Objective: To review the scientific literature on user participation and opportunities for shared decision-making involving younger people referred for ADHD in mental healthcare services, to provide recommendations for clinical practice and future research.
Method: A systematic scoping review was performed. Eligibility was determined in two steps by two and three independent researchers, respectively. Data were extracted and analyzed using qualitative content analysis. The findings were synthesized across the various contexts and participation groups represented in the included studies. In all, the analysis involved three phases: preparation, organization, and reporting.
Results: Of the thirty full-text papers identified, five met the inclusion criteria. Four categories and seven subcategories related to user participation and opportunities for shared decision-making involving children and adolescents with ADHD were identified. The four categories were: (1) sidelined from the start, (2) lack of information, (3) trapped in medication, and (4) growing into active decision-makers; these indicate that children with ADHD feel excluded from the diagnostic process, may have limited treatment choices, and may not be heard. This review also discovers a bias in the existing literature on user participation, with a tendency to emphasize caregivers' or clinicians' perspectives over those of the young people.
Conclusions: Young people with ADHD experience they have limited opportunities to participate in their mental healthcare services. User participation and shared decision-making by young people with ADHD should be promoted in clinical practice. Accordingly, future research should explore ways to implement user participation among young people themselves when assessing and treating ADHD, not only among clinicians and caregivers.
Background: Screen use, including gaming and social media, has increased over the past decade, potentially having adverse effects on child development and mental health. To prevent the potential problems arising from excessive screen use (ESU) and problem gaming (PG) scholars have developed a Family centered program for PG and ESU (FAME) involving both children and at least one parent in the program. The aim of this study was to explore the experiences of children's and parents' participation in the pilot-FAME program.
Method: Out of ten families who participated in the pilot-FAME, eight children (age 12-15; two girls), along with ten parents, out of which three fathers, participated in individual semi-structured interviews involving questions about a) families' perceptions of the program and b) suggestions for improvement of the program. The data were analyzed with Reflexive Thematic Analysis.
Results: Four distinct themes were constructed: Theme 1, "Positivity regarding program", Theme 2, "Criticism regarding the program", Theme 3, "Program delivery", and Theme 4, "Content development". Specifically, while the program was well-received for its group format and the peer support it facilitated, making adaptions such as incorporating more discussion and learning opportunities, along with extending the duration, would have potential to improve its delivery and feasibility.
Conclusion: The pilot-FAME program shows promise in addressing the challenges associated with PG and ESU among children and their parents. With further refinements, the program could become an effective tool for supporting healthy family dynamics and screen use.
Background: Socialization and communication are complex processes. It is important to identify the factors related to their development.
Objectives: This study aimed to determine how attention to social information affects the development of socialization and communication in children with typical development.
Methods: We recruited 24 typically developing preschool children. Using the all-in-one eye-tracking system, Gazefinder, we measured the percentage fixation time allocated to social information depicted in movies with human faces, people, and geometry in preference paradigm movies showing these stimuli simultaneously, as well as others at Waves 1 (4.01±0.84 years), 2 (5.22±0.66 years), and 3 (6.57±0.63 years). We also used the Second Edition of the Vineland Adaptive Behavior Scales to measure socialization and communication in Waves 1-3. We then used a 3-wave cross-lagged effects model in a structural equation modeling framework to determine the impact of attention to social information on the development of socialization and communication.
Results: Only the preference paradigm, movies simultaneously presenting people and geometric shapes, fulfilled the model fit criteria. The percentage of fixation times on the people region in Wave 1 affected the socialization score in Wave 2.
Conclusions: Although the limitation of "the sample size is small" should be considered, the degree of interest in people has a strong positive influence on the development of socialization during early childhood. Attention to social information other than the preference paradigm may have been influenced by a relatively large number of factors and/or by the lesser degree of effects of the factors that strongly influenced the preference paradigm and did not fit the model criteria proposed in this study.
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