Scandinavian Journal of Child and Adolescent Psychiatry and Psychology最新文献

Background: There is a lack of reliable and valid PTSD tests for young children that cannot read or are weak readers. The semi-projective cartoon test, "Darryl", which is read aloud, is a measure that appeals to this age group. The test has been applied in both clinical and epidemiological studies.

Objective: to validate a cartoon test, "Darryl", for children aged 6 or older in a population of children suspectedly sexually and/or physically abused.

Methods: In the Danish Child Centres, 327 children were screened with Darryl as part of an assessment for further intervention. The Bech Youth Inventory was filled out by 113 children, and 63 caregivers filled out the Strengths & Difficulties Questionnaire. Correlations were used to study the convergent validity between the scales and subscales and effect sizes were estimated. Reliability of the scales was investigated using Cronbach's alpha.

Results: Following the DSM-IV, 55.7% of the children (n = 182) had a possible PTSD diagnosis. More girls (n = 110, 62.9 %) than boys (n = 72, 47.4%) had PTSD. A total of 21.7 % (n = 71) had subclinical PTSD, lacking only one symptom of the full diagnosis. There was no significant difference in PTSD regarding physical or sexual abuse.

Clinical significance: The test allows clinicians in the pediatric field to screen for possible PTSD in a population where systematic self-report data have paramount importance.

Conclusions: Darryl appears to be a valid and reliable test for screening young children who have been physically or sexually abused. The test is helpful for clinician working with young children to identify those have developed trauma symptoms to secure them early treatment.

When the Norwegian government closed down schools and kindergartens in response to the increased spread of COVID-19, the use of homeschooling raised concerns about students with school refusal behavior and the school system's ability to address their special needs in these circumstances. Six students referred to the school absenteeism team were interviewed about their circumstances, using an author-developed interview. The results indicate that the students rated homeschooling as very satisfactory. Students with school refusal behavior participated in homeschooling and their attendance continued during the initial reopening of schools.

Background: Clozapine is the most effective antipsychotic for patients with treatment-resistant schizophrenia (TRS), however, it remains widely under-utilized in clinical practice. To date, relatively little attention has been given to patients' experience of clozapine. By synthesizing the existing literature, we sought to determine the experiences of patients with TRS treated with clozapine.

Methods: A systematic review was conducted on Embase, Medline, PsychInfo, and PubMed databases for studies from 1956 to 2021. English language studies and those based on adult patients prescribed clozapine for TRS were included.

Results: Thirteen studies were included with a total of 1487 patients and a narrative synthesis was performed. Overall, most patients reported positive experiences of clozapine, with generally high levels of satisfaction, alongside symptom improvement and preference over previous medications. Negative experiences of clozapine were less common, but when mentioned, focused on blood tests and common side effects, including hypersalivation and weight gain.

Conclusions: This is the first systematic review exploring patients' subjective experiences of clozapine for TRS. Findings suggest that patients generally have a favorable experience when being treated with clozapine. However, conclusions are limited by the risk of bias, particularly survivorship bias. High-quality longitudinal studies exploring patients' experiences of clozapine are indicated for the future.

Background and objectives: Studies have shown that COVID-19 school closures negatively impacted children's well-being. We assessed the impact of school closures on children in Japan. We postulated that screen time and sleep habits during school closure would be associated with children's mental health status.

Methods: A cross-sectional study was conducted with 959 children in four public elementary schools. Parents completed an original questionnaire in which we enquired about children's behavioral problems, screen time (duration of watching TV/videos and duration of playing video games), sleep habits, and bodyweight change during school closure. Logistic regression analyses were performed to investigate the relationships between behavioral problems, bodyweight gain, and screen time.

Results: It was found that 50.3% of children exhibited some behavioral problems during school closure; fewer children exhibited such problems after schools reopened. Moreover, children's behavioral problems during school closure were associated with longer total screen time (odds ratio [OR]: 1.2, 95% confidence interval [CI]: 1.14-1.28, p < .001). Sleep habits were not different between children with behavioral problems and those without. Of the children, 16.7% experienced bodyweight gain during school closure, which was associated with behavioral problems (OR: 2.0, 95% CI: 1.43-2.92, p < .001) and time spent watching TV/videos (OR: 1.2, 95% CI: 1.08-1.28, p < .001) during closure.

Conclusions: COVID-19 school closure negatively impacted school children physically and psychologically. Screen time was associated with both physical and mental health status. Therefore, children should not engage in arbitrary screen time during school closures and should be supported in their daily routines.

Background: This study aimed to examine the psychometric properties of reliability and validity of OCI-CV in a non-clinical sample of Malaysian children and adolescents.

Method: Participants of school-age and adolescent students from Klang Valley School completed the 21-item Malay OCI-CV using Google Form. OCI-CV English version was translated backward and forward to the Malay language. Face validity was conducted first before distributing the questionnaire to the participants. Exploratory Factor analysis (EFA) and Confirmatory Factor Analysis (CFA) was conducted to evaluate the psychometric properties of OCI-CV.

Results: A total of 102 school-age children and adolescents with a mean age of 15.96 years (male: 41.2%, female: 58.8%) participated in the study. The Malay OCI-CV showed high internal consistency, with Cronbach Alpha values of 0.90 for the whole scale. EFA showed multifactorial components. Five factors were labelled as "Washing / Ordering, Doubting, Obsessions, Checking, and Hoarding,". In the CFA, the five-factor model indicates adequate fit indices of (χ2/df = 1.51, RMSEA = .071, GFI = .824, AGFI = .769, NFI = .724, CFI = .880).

Conclusion: The Malay OCI-CV has good psychometric properties and is suitable for use in the Malaysian context. Further validation studies should be conducted among a clinical population to enhance the generalization of this finding.

Background: Wolfram Syndrome is a rare genetic disorder usually resulting from pathogenic variation in the WFS1 gene, which leads to an exaggerated endoplasmic reticulum (ER) stress response. The disorder is typically characterized by diabetes insipidus, diabetes mellitus, optic nerve atrophy, hearing loss, and neurodegenerative features. Existing literature suggests it may also have psychiatric manifestations.

Objective: To examine lifetime psychiatric diagnoses and medication history in Wolfram Syndrome.

Method: Child, adolescent, and young adult Wolfram Syndrome participants (n=39) were assessed by a child & adolescent psychiatrist to determine best estimate DSM-5 lifetime psychiatric diagnoses as well as psychoactive medication history. In addition, the Child & Adolescent Symptom Inventory-5 (CASI-5) Parent Checklist was used to determine likely psychiatric diagnoses based on symptom counts in Wolfram Syndrome patients (n=33), type 1 diabetes (n=15), and healthy comparison (n=18) groups.

Results: Study participants with Wolfram Syndrome had high lifetime rates of anxiety disorders (77%). Also, 31% had an obsessive-compulsive spectrum disorder, 33% had a mood disorder, 31% had a neurodevelopmental or disruptive behavior disorder, and 31% had a sleep-wake disorder. More than half of Wolfram Syndrome participants had taken at least one psychoactive medication, and one third had taken at least one selective serotonin reuptake inhibitor (SSRI). Some individuals reported poor response to sertraline but better response after switching to another SSRI (fluoxetine or citalopram). In general, people with Wolfram Syndrome often reported benefit from psychotherapy and/or commonly used psychoactive medications appropriate for their psychiatric diagnoses.

Conclusions: Wolfram Syndrome may be associated with elevated risk for anxiety and obsessive-compulsive spectrum disorders, which seem generally responsive to usual treatments for these disorders.

Background: Resilience is an important protective factor for psychological wellbeing. According to the previous literature, physical activity level and digital game playing are likely to impact anxiety level.

Objective: The present study aimed to identify the role of resilience, doing physical activity, and playing digital games on gifted children's anxiety levels during the Pandemic period in 2021 in Turkey.

Method: The sample consisted of 199 gifted students. Anxiety was measured using the Spielberger's State Anxiety Inventory. Resilience was measured using The Brief Resilience Scale. The physical activity and online/digital game-playing were measured using two open-ended questions.

Results: Results provided evidence that resilience had a strong negative association with anxiety among gifted students during the Pandemic period (β = -.59, p<.001). Doing physical activity was associated with anxiety among gifted boys (β = -.16, p<.001) but not girls. Finally, digital game playing was associated with anxiety among neither girls nor boys.

Conclusions: These results reflected the importance of resilience for anxiety.

Offspring of parents with anxiety disorders have an increased risk of developing anxiety themselves. Very few studies have evaluated interventions aiming to prevent anxiety in offspring of anxious parents. This study was a small (N=40) randomized pilot study with three arms evaluating the feasibility of a novel parent support group for anxious parents, the Supporting Anxious Parents Program (SAPP). The primary objective was to evaluate the acceptability of the SAPP. In addition, we also evaluated preliminary effects on child anxiety, parent risk factors, and quality of life, and feasibility of the study design. Excessive parental worry and anxiety and having a child not meeting criteria for an anxiety disorder (6-12 years old), served as inclusion criteria. Thirteen parents were randomly allocated to a group-based intervention, 14 to an individual Internet-based version of the intervention, and 13 to a waitlist control condition. The intervention was developed to target three risk factors involved in the parent-child transmission of anxiety; criticism/low warmth, overprotective behaviors, and modeling of anxiety. The results showed that parents were generally very satisfied with the intervention. We did not find any significant decreases in child anxiety in the intervention conditions. However, for the parents, we found preliminary support for reduced overprotective behaviors, reduced worry, and increased quality of life. The study design was found to be feasible. According to the results, a revision of the intervention is recommended before a full randomized controlled trial could be conducted.

Background: The lockdown due to COVID-19, has affected the mental health of the population. Recent literature suggests a greater psychological impact on adolescents regardless of their cultural background.

Objective: The aim is to analyze the emotional state, life satisfaction and worries about COVID-19 in Chilean and Spanish adolescents.

Method: A total of 1078 adolescents (M=15.18; SD=1.25) completed the Depression, Anxiety and Stress Scale, the COVID-19 Worry Scale and the Life Satisfaction Scale. The design was cross-sectional and descriptive. Descriptive analyses, t-tests, and linear regressions were performed.

Results: More emotional symptoms, worries and lower life satisfaction were observed in Chile. Girls had more worries and emotional symptoms. An affected psychological state is also observed in Spanish adolescents, especially in Chilean adolescents. Worries about COVID-19 affect depression, anxiety, stress and life satisfaction in both samples.

Conclusions: Further research is needed to prevent psychological distress in future pandemics. Developing tailored interventions are encouraged.

Background: Children are particularly vulnerable to the psychological effects of the COVID-19 pandemic. The disruption in daily life has impacted children significantly. Moreover, the increased worrying associated with the probability of getting infected or becoming seriously unwell due to infection can potentially precipitate anxiety disorders among children.

Objective: This study aimed to determine rates of elevated anxiety symptoms in children with COVID-19 infection. It also explored whether there were any differences in terms of age, gender, and residency status.

Method: A cross-sectional, questionnaire-based study with 88 participants (children aged 7-13 years, 54.5% males, 45.5% females) from two institutional quarantine centers. The Spence Children's Anxiety Scale and its validated Arabic version (self-reported questionnaires) were used to measure anxiety symptoms.

Results: 36.3% children reported elevated anxiety symptoms. A lower rate of 32.8% was reported in younger children (7-11 years) compared to 45.8% in older children (12 and 13 years). 70.4% and 57.9% children reported physical injury fears and separation anxiety respectively. A higher prevalence of overall anxiety was reported in children from expatriate families (40.6%) compared to native children (25%). The difference in the mean scores between the expatriate and native group of children was found statistically significant for obsessive-compulsive symptoms.

Conclusions: The prevalence of elevated anxiety symptoms among children in quarantine with COVID-19 infection can be much higher than that reported in the general population. Older children can have elevated anxiety symptoms more commonly than their younger counterparts can. Expatriate children are likely to be more vulnerable to the psychological impact of the pandemic compared to children from local families. Our results suggest the crucial need of focusing on the psychological impact of COVID-19 pandemic on children. The prioritization and effective management of the mental health needs of children should be a vital component of the overall, global response to the pandemic.