首页 > 最新文献

Adolescent Psychiatry最新文献

英文 中文
Addressing Crises in Teenage Pregnancy 解决少女怀孕危机
IF 0.4 Q4 PEDIATRICS Pub Date : 2020-01-10 DOI: 10.2174/2210676609666190531102808
Osarumen Nicole Doghor, Faith O Nomamiukor, Efe Okotcha, Edore Onigu-Otite
Adolescent pregnancy is a major public health concern with medical,psychiatric, and social implications. Within this population, there is an elevated rate ofco-occurring psychiatric conditions including mood disorders, anxiety disorders, suicidality,and substance use. However, little is known about the assessment and treatment of adolescentpregnancy within the context of these co-occurring psychiatric conditions, particularlyin an emergency situation.This article utilizes a case report to illustrate the challenges faced in consultativepsychiatry in the assessment and treatment of a pregnant suicidal youth with a complex psychosocialhistory. Topics addressed include: 1) The role of childhood trauma and suicidalityin adolescent pregnancy 2) A consideration of the risks and benefits of treating adolescentswith psychotropics during pregnancy.A literature search was performed with the key words of adolescent, pregnancy,child sexual abuse and psychiatric illness. In addition, expert opinions of a reproductive psychiatristand a psychiatrist who had specialized in addiction and adolescents were enlisted onkey aspects of the case formulation and treatment.Several studies were found that focused on depression, substance abuse and traumain adolescent pregnancy. There were more studies that looked at psychopharmacologicaltreatment in adult pregnant women and a few that focused on adolescents.Addressing the crisis of psychiatric illness in adolescent pregnancy requires athorough approach in understanding the severity of the illness and the contribution of childabuse and suicidality. Psychotherapeutic interventions are most certainly always necessaryand beneficial when dealing with this population. Deciding when to start and maintain medicationduring pregnancy should be individualized, with considerations of the risks of untreatedillness and of medication exposure.
青少年怀孕是一个重大的公共卫生问题,具有医学、精神病学和社会影响。在这一人群中,同时发生包括情绪障碍、焦虑症、自杀和药物使用在内的精神疾病的比率较高。然而,在这些共同发生的精神疾病的背景下,特别是在紧急情况下,对青少年怀孕的评估和治疗知之甚少。本文利用一个案例报告来说明咨询精神病学在评估和治疗具有复杂心理社会史的怀孕自杀青年时所面临的挑战。讨论的主题包括:1)童年创伤和自杀倾向在青少年怀孕中的作用2)考虑在怀孕期间使用精神药物治疗青少年的风险和益处。以青少年、怀孕、儿童性虐待、精神疾病为关键词进行文献检索。此外,在案例制定和治疗的关键方面,还征求了生殖精神病学家和专门研究成瘾和青少年的精神病学家的专家意见。有几项研究的重点是抑郁症、药物滥用和青少年怀孕的创伤。有更多的研究关注成年孕妇的精神药理学治疗,还有一些研究关注青少年。要解决少女怀孕期间的精神疾病危机,就需要彻底了解疾病的严重程度以及虐待儿童和自杀的原因。在处理这类人群时,心理治疗干预当然总是必要和有益的。在怀孕期间决定何时开始和维持药物治疗应该是个体化的,要考虑到未治疗的疾病和药物暴露的风险。
{"title":"Addressing Crises in Teenage Pregnancy","authors":"Osarumen Nicole Doghor, Faith O Nomamiukor, Efe Okotcha, Edore Onigu-Otite","doi":"10.2174/2210676609666190531102808","DOIUrl":"https://doi.org/10.2174/2210676609666190531102808","url":null,"abstract":"\u0000\u0000Adolescent pregnancy is a major public health concern with medical,\u0000psychiatric, and social implications. Within this population, there is an elevated rate of\u0000co-occurring psychiatric conditions including mood disorders, anxiety disorders, suicidality,\u0000and substance use. However, little is known about the assessment and treatment of adolescent\u0000pregnancy within the context of these co-occurring psychiatric conditions, particularly\u0000in an emergency situation.\u0000\u0000\u0000\u0000This article utilizes a case report to illustrate the challenges faced in consultative\u0000psychiatry in the assessment and treatment of a pregnant suicidal youth with a complex psychosocial\u0000history. Topics addressed include: 1) The role of childhood trauma and suicidality\u0000in adolescent pregnancy 2) A consideration of the risks and benefits of treating adolescents\u0000with psychotropics during pregnancy.\u0000\u0000\u0000\u0000A literature search was performed with the key words of adolescent, pregnancy,\u0000child sexual abuse and psychiatric illness. In addition, expert opinions of a reproductive psychiatrist\u0000and a psychiatrist who had specialized in addiction and adolescents were enlisted on\u0000key aspects of the case formulation and treatment.\u0000\u0000\u0000\u0000Several studies were found that focused on depression, substance abuse and trauma\u0000in adolescent pregnancy. There were more studies that looked at psychopharmacological\u0000treatment in adult pregnant women and a few that focused on adolescents.\u0000\u0000\u0000\u0000Addressing the crisis of psychiatric illness in adolescent pregnancy requires a\u0000thorough approach in understanding the severity of the illness and the contribution of child\u0000abuse and suicidality. Psychotherapeutic interventions are most certainly always necessary\u0000and beneficial when dealing with this population. Deciding when to start and maintain medication\u0000during pregnancy should be individualized, with considerations of the risks of untreated\u0000illness and of medication exposure.\u0000","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":"9 1","pages":"69-80"},"PeriodicalIF":0.4,"publicationDate":"2020-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68173733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
“Medical Clearance” of Psychiatric Patients in the Emergency Department 急诊科精神病人的“医学证明
IF 0.4 Q4 PEDIATRICS Pub Date : 2020-01-10 DOI: 10.2174/2210676609666191015123100
G. Santillanes, Edore Onigu-Otite, V. Tucci, N. Moukaddam
DOI: 10.2174/2210676609666191015123100 Abstract: Background & Aims: The past few years have seen an increase in the number of children and adolescents presenting to emergency departments with mental health complaints, including, but not limited to, depression, suicidality, and substance use-related conditions. This places many demands on the emergency physicians ranging from evaluating medical stability (also known as medical clearance) to arranging for psychiatric are, be it inpatient or outpatient. The goals of this article are to describe the current landscape of emergency care for the pediatric patient presenting with mental health issues and to highlight gaps in the current system.
摘要:背景与目的:在过去的几年里,儿童和青少年因心理健康问题向急诊科就诊的人数有所增加,包括但不限于抑郁症、自杀和药物使用相关疾病。这对急诊医生提出了许多要求,从评估医疗稳定性(也称为医疗证明)到安排住院或门诊的精神病治疗。这篇文章的目的是描述当前的景观急诊护理儿科患者呈现的精神健康问题,并突出差距,在目前的系统。
{"title":"“Medical Clearance” of Psychiatric Patients in the Emergency Department","authors":"G. Santillanes, Edore Onigu-Otite, V. Tucci, N. Moukaddam","doi":"10.2174/2210676609666191015123100","DOIUrl":"https://doi.org/10.2174/2210676609666191015123100","url":null,"abstract":"DOI: 10.2174/2210676609666191015123100 Abstract: Background & Aims: The past few years have seen an increase in the number of children and adolescents presenting to emergency departments with mental health complaints, including, but not limited to, depression, suicidality, and substance use-related conditions. This places many demands on the emergency physicians ranging from evaluating medical stability (also known as medical clearance) to arranging for psychiatric are, be it inpatient or outpatient. The goals of this article are to describe the current landscape of emergency care for the pediatric patient presenting with mental health issues and to highlight gaps in the current system.","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":"9 1","pages":"159-165"},"PeriodicalIF":0.4,"publicationDate":"2020-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/2210676609666191015123100","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68174025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Management of Suicidal Adolescents Presenting to the Emergency Department 急诊科自杀青少年的管理
IF 0.4 Q4 PEDIATRICS Pub Date : 2020-01-10 DOI: 10.2174/2210676609666190730094236
N. Valles, Dana Billups, Topaz Sampson, T. Harris
Increasingly, adolescents are presented to hospital emergency departmentswith suicidal ideation (SI) and depression. Even among those who come in withother complaints, depression and SI are common. Emergency personnel are placed in the defaultposition of providing care for these patients, but often lack sufficient knowledge andskills to do this effectively.The aim of this paper is to offer guidance to emergency personnel and describegoals and strategies for screening and brief interventions.We review risk factors, assessment tools and evidence-based interventions that canbe utilized by mental health professionals working in EDs and by ED staff in the absence ofmental health professionals.Emergency departments can serve a critical role in risk management and treatmentof adolescent depression and suicidal ideation. All patients presenting to the ED shouldbe screened for current and past depression and suicidal ideation or attempts. Brief interventionscan be delivered in the ED that can increase the likelihood that patients will receive follow-up care.
越来越多的青少年因自杀意念和抑郁而被送往医院急诊室。即使在那些有其他抱怨的人中,抑郁症和SI也很常见。急救人员被置于为这些患者提供护理的默认位置,但往往缺乏足够的知识和技能来有效地做到这一点。本文的目的是为急救人员提供指导,并描述筛查和简短干预的描述和策略。我们回顾了在ED工作的心理健康专业人员和在没有心理健康专业人士的情况下ED工作人员可以使用的风险因素、评估工具和循证干预措施。急诊科可以在青少年抑郁症和自杀意念的风险管理和治疗中发挥关键作用。所有急诊科就诊的患者都应筛查当前和过去的抑郁症和自杀意念或企图。急诊科可以进行简短的干预,这可以增加患者接受后续护理的可能性。
{"title":"Management of Suicidal Adolescents Presenting to the Emergency Department","authors":"N. Valles, Dana Billups, Topaz Sampson, T. Harris","doi":"10.2174/2210676609666190730094236","DOIUrl":"https://doi.org/10.2174/2210676609666190730094236","url":null,"abstract":"\u0000\u0000Increasingly, adolescents are presented to hospital emergency departments\u0000with suicidal ideation (SI) and depression. Even among those who come in with\u0000other complaints, depression and SI are common. Emergency personnel are placed in the default\u0000position of providing care for these patients, but often lack sufficient knowledge and\u0000skills to do this effectively.\u0000\u0000\u0000\u0000The aim of this paper is to offer guidance to emergency personnel and describe\u0000goals and strategies for screening and brief interventions.\u0000\u0000\u0000\u0000We review risk factors, assessment tools and evidence-based interventions that can\u0000be utilized by mental health professionals working in EDs and by ED staff in the absence of\u0000mental health professionals.\u0000\u0000\u0000\u0000Emergency departments can serve a critical role in risk management and treatment\u0000of adolescent depression and suicidal ideation. All patients presenting to the ED should\u0000be screened for current and past depression and suicidal ideation or attempts. Brief interventions\u0000can be delivered in the ED that can increase the likelihood that patients will receive follow-\u0000up care.\u0000","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":"9 1","pages":"81-91"},"PeriodicalIF":0.4,"publicationDate":"2020-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49382391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Emergency Management in Eating Disorders 饮食失调的应急管理
IF 0.4 Q4 PEDIATRICS Pub Date : 2020-01-10 DOI: 10.2174/2210676609666190730093039
Heather E. Needham, E. Ferguson, Darcie M. Takemoto, Sindhu Idicula
Eating disorders commonly present during the adolescent andyoung adult years, and are complex in that they are a group of psychiatric diagnoses withmedical complications.The diagnosis of an eating disorder can often go undetected while a patient is beingevaluated for organic causes of weight loss. Anorexia nervosa, in particular, has thehighest mortality rate of any psychiatric diagnosis. In the Diagnostic and Statistical Manualof Mental Disorders 5th Edition (DSM-5), there are several diagnoses that are classified aseating or feeding disorders.This article will discuss anorexia nervosa and bulimia nervosa, with a focus onmedical and psychiatric emergencies that are important for primary care providers to keep inmind when caring for adolescents and young adults.
饮食失调通常出现在青少年和青年时期,其复杂性在于它们是一组伴有医疗并发症的精神病诊断。在评估患者体重减轻的器质性原因时,饮食失调的诊断往往无法被发现。尤其是神经性厌食症,是所有精神病诊断中死亡率最高的。在《精神疾病诊断和统计手册》第5版(DSM-5)中,有几种诊断被归类为进食或进食障碍。本文将讨论神经性厌食症和神经性贪食症,重点关注医疗和精神紧急情况,这对初级保健提供者在照顾青少年和年轻人时保持警惕很重要。
{"title":"Emergency Management in Eating Disorders","authors":"Heather E. Needham, E. Ferguson, Darcie M. Takemoto, Sindhu Idicula","doi":"10.2174/2210676609666190730093039","DOIUrl":"https://doi.org/10.2174/2210676609666190730093039","url":null,"abstract":"\u0000\u0000Eating disorders commonly present during the adolescent and\u0000young adult years, and are complex in that they are a group of psychiatric diagnoses with\u0000medical complications.\u0000\u0000\u0000\u0000The diagnosis of an eating disorder can often go undetected while a patient is being\u0000evaluated for organic causes of weight loss. Anorexia nervosa, in particular, has the\u0000highest mortality rate of any psychiatric diagnosis. In the Diagnostic and Statistical Manual\u0000of Mental Disorders 5th Edition (DSM-5), there are several diagnoses that are classified as\u0000eating or feeding disorders.\u0000\u0000\u0000\u0000This article will discuss anorexia nervosa and bulimia nervosa, with a focus on\u0000medical and psychiatric emergencies that are important for primary care providers to keep in\u0000mind when caring for adolescents and young adults.\u0000","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":"9 1","pages":"135-141"},"PeriodicalIF":0.4,"publicationDate":"2020-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/2210676609666190730093039","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43950174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Conscience Relevance and Sensitivity in Psychiatric Evaluations in the Youth-span 青少年精神病评估中的良心相关性和敏感性
IF 0.4 Q4 PEDIATRICS Pub Date : 2020-01-10 DOI: 10.2174/2210676609666190415142734
M. Galvin, L. Hulvershorn, Margaret M. Gaffney
While practice parameters recommend assessment of conscienceand values, few resources are available to guide clinicians.To improve making moral inquiry in youth aged 15 to 24.After documenting available resources for behavioral health clinicians who are inquiringabout their patient’s moral life, we consider our studies of conscience developmentand functioning in youth. We align descriptions of domains of conscience with neurobiology.We compare youth reared in relative advantage, who have fairly smooth functional progressionsacross domains, with youth reared in adverse circumstances. We offer the heuristicconscience developmental quotient to help mind the gap between conscience in adversity andconscience in advantage. Next, we consider severity of psychopathological interference asdistinct from delay. A case illustration is provided to support the distinction beOur findings support the hypotheses that youth who experience adverse childhoodexperiences show evidence of fragmentation, unevenness and delay in their consciencestage-attainment. We demonstrate proof of concept for conscience sensitive psychiatric assessmentin the youth-span. Conscience sensitive inquiries improve upon merely consciencerelevant interpretations by affording better appreciation of moral wounding, in turn settingthe stage for moral-imaginative efforts that elicit and make the latent values of the youthmore explicit.A conscience sensitive approach should be part of both psychiatric and generalmedical education, supported explicitly by clinical guidelines recommending consciencesensitive interview techniques that aim to acquire information aligned with current neurobiologicalterminology.
虽然实践参数建议良心和价值观的评估,很少有资源可用于指导临床医生。提高15至24岁青少年的道德探究能力。在记录了询问病人道德生活的行为健康临床医生的可用资源后,我们考虑了我们对青少年良心发展和功能的研究。我们将良心领域的描述与神经生物学结合起来。我们比较了在相对优势环境中长大的年轻人,他们在各个领域的功能进步相当顺利,而在不利环境中长大的年轻人。我们提供了启发式良心发展商,以帮助理清处于逆境的良心和处于优势的良心之间的差距。接下来,我们将精神病理干扰的严重程度与延迟区分开来。我们的研究结果支持这样的假设,即经历不良童年经历的青少年在他们的良心阶段成就方面表现出碎片化、不均匀和延迟的证据。我们证明了在青少年时期良心敏感精神病评估的概念证明。对良心敏感的调查通过提供对道德伤害的更好理解,改进了仅仅与良心相关的解释,反过来为道德想象的努力奠定了基础,这些努力引出并使年轻人的潜在价值更加明确。良心敏感的方法应该成为精神病学和普通医学教育的一部分,并得到临床指导方针的明确支持,这些指导方针建议采用良心敏感的访谈技术,目的是获取与当前神经生物学术语一致的信息。
{"title":"Conscience Relevance and Sensitivity in Psychiatric Evaluations in the Youth-span","authors":"M. Galvin, L. Hulvershorn, Margaret M. Gaffney","doi":"10.2174/2210676609666190415142734","DOIUrl":"https://doi.org/10.2174/2210676609666190415142734","url":null,"abstract":"\u0000\u0000While practice parameters recommend assessment of conscience\u0000and values, few resources are available to guide clinicians.\u0000\u0000\u0000\u0000To improve making moral inquiry in youth aged 15 to 24.\u0000\u0000\u0000\u0000After documenting available resources for behavioral health clinicians who are inquiring\u0000about their patient’s moral life, we consider our studies of conscience development\u0000and functioning in youth. We align descriptions of domains of conscience with neurobiology.\u0000We compare youth reared in relative advantage, who have fairly smooth functional progressions\u0000across domains, with youth reared in adverse circumstances. We offer the heuristic\u0000conscience developmental quotient to help mind the gap between conscience in adversity and\u0000conscience in advantage. Next, we consider severity of psychopathological interference as\u0000distinct from delay. A case illustration is provided to support the distinction be\u0000\u0000\u0000\u0000Our findings support the hypotheses that youth who experience adverse childhood\u0000experiences show evidence of fragmentation, unevenness and delay in their conscience\u0000stage-attainment. We demonstrate proof of concept for conscience sensitive psychiatric assessment\u0000in the youth-span. Conscience sensitive inquiries improve upon merely conscience\u0000relevant interpretations by affording better appreciation of moral wounding, in turn setting\u0000the stage for moral-imaginative efforts that elicit and make the latent values of the youth\u0000more explicit.\u0000\u0000\u0000\u0000A conscience sensitive approach should be part of both psychiatric and general\u0000medical education, supported explicitly by clinical guidelines recommending conscience\u0000sensitive interview techniques that aim to acquire information aligned with current neurobiological\u0000terminology.\u0000","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":"9 1","pages":"167-184"},"PeriodicalIF":0.4,"publicationDate":"2020-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/2210676609666190415142734","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45545072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Gender Differences in the Suicide Attempts of Adolescents in Emergency Departments: Focusing on Individuals with Autism Spectrum Disorder 急诊科青少年自杀企图的性别差异:以自闭症谱系障碍个体为中心
IF 0.4 Q4 PEDIATRICS Pub Date : 2020-01-10 DOI: 10.2174/2210676609666190617144453
K. Mikami, Seiji Inomata, Yuichi Onishi, Yasushi Orihashi, Kenji Yamamoto, H. Matsumoto
Background: Few studies on gender-based diagnostic characteristics of adolescent suicide attempters in emergency departments (EDs) have included individuals with autism spectrum disorder (ASD). Objective: This study aimed to examine the clinical features of adolescent suicide attempts in EDs, focusing on gender differences and considering individuals with ASD. Methods: Ninety-four adolescent patients, aged less than 20 years, who had attempted suicide and had been hospitalized in an emergency department, participated in this study. Psychiatric diagnoses according to DSM-IV criteria and clinical features were compared between male and female patients. Results: The number (%) of males was 15 (16.0), and that of females was 79 (84.0). The mean age (SD) of males was 17.1 (1.5), and that of females was 16.9 (1.6). The attempt methods were more serious, length of stay in the emergency room longer, and rate of outpatient treatment lower in males. In addition, suicide attempters with ASD were significantly more frequent in male. Adjusting for age and gender, adjustment disorder was significantly associated with the presence of suicide attempters with ASD using a multivariable logistic regression. Conclusion: Males were less likely to visit psychiatric service previous to attempting suicides, and may be likely to complete suicides. In addition, suicide attempters with ASD are characteristic in male, and likely to have comorbid adjustment disorder. ED visits offer a window of opportunity to provide suicide prevention interventions for adolescents, and therefore, psychiatrists in EDs have a crucial role as gatekeepers of preventing suicide reattempts, especially in adolescent males including individuals with ASD having adjustment disorder.
背景:在急诊科(EDs)对青少年自杀未遂者基于性别的诊断特征的研究中,很少包括自闭症谱系障碍(ASD)患者。目的:本研究旨在探讨急诊科青少年自杀企图的临床特征,关注性别差异并考虑自闭症个体。方法:选取94例年龄在20岁以下、曾企图自杀并在急诊科住院的青少年患者为研究对象。根据DSM-IV标准和临床特征比较男女患者的精神病学诊断。结果:男性15例(16.0例),女性79例(84.0例);男性平均年龄为17.1岁(1.5岁),女性平均年龄为16.9岁(1.6岁)。男性的尝试方法更严重,在急诊室的停留时间更长,门诊治疗率更低。此外,患有自闭症谱系障碍的男性自杀未遂者明显更多。对年龄和性别进行调整后,使用多变量逻辑回归,适应障碍与ASD自杀未遂者的存在显著相关。结论:男性在企图自杀前较少去精神科就诊,并可能最终自杀。此外,有ASD的自杀企图者以男性为特征,并且可能有共病适应障碍。急诊科访问为青少年提供了一个提供自杀预防干预的机会窗口,因此,急诊科的精神科医生在预防自杀再企图方面发挥着至关重要的作用,尤其是在青少年男性中,包括患有适应障碍的ASD患者。
{"title":"Gender Differences in the Suicide Attempts of Adolescents in Emergency Departments: Focusing on Individuals with Autism Spectrum Disorder","authors":"K. Mikami, Seiji Inomata, Yuichi Onishi, Yasushi Orihashi, Kenji Yamamoto, H. Matsumoto","doi":"10.2174/2210676609666190617144453","DOIUrl":"https://doi.org/10.2174/2210676609666190617144453","url":null,"abstract":"Background: Few studies on gender-based diagnostic characteristics of adolescent suicide attempters in emergency departments (EDs) have included individuals with autism spectrum disorder (ASD). Objective: This study aimed to examine the clinical features of adolescent suicide attempts in EDs, focusing on gender differences and considering individuals with ASD. Methods: Ninety-four adolescent patients, aged less than 20 years, who had attempted suicide and had been hospitalized in an emergency department, participated in this study. Psychiatric diagnoses according to DSM-IV criteria and clinical features were compared between male and female patients. Results: The number (%) of males was 15 (16.0), and that of females was 79 (84.0). The mean age (SD) of males was 17.1 (1.5), and that of females was 16.9 (1.6). The attempt methods were more serious, length of stay in the emergency room longer, and rate of outpatient treatment lower in males. In addition, suicide attempters with ASD were significantly more frequent in male. Adjusting for age and gender, adjustment disorder was significantly associated with the presence of suicide attempters with ASD using a multivariable logistic regression. Conclusion: Males were less likely to visit psychiatric service previous to attempting suicides, and may be likely to complete suicides. In addition, suicide attempters with ASD are characteristic in male, and likely to have comorbid adjustment disorder. ED visits offer a window of opportunity to provide suicide prevention interventions for adolescents, and therefore, psychiatrists in EDs have a crucial role as gatekeepers of preventing suicide reattempts, especially in adolescent males including individuals with ASD having adjustment disorder.","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":"9 1","pages":"232-240"},"PeriodicalIF":0.4,"publicationDate":"2020-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/2210676609666190617144453","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42343626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Addressing Sexual Acting Out Behaviors with Adolescents on the Autism Spectrum 自闭症青少年的性表演行为
IF 0.4 Q4 PEDIATRICS Pub Date : 2020-01-10 DOI: 10.2174/2210676609666190730091304
Leah N. Clionsky, Amanda M. N’zi
DOI: 10.2174/2210676609666190730091304 Abstract: Adolescents with autism spectrum disorders (ASDs) have similar sexual desires and relationship needs to their neuro-typical peers. However, they may be more likely to demonstrate problematic sexual behaviors as they mature, due to lack of education about sexuality, vulnerability to sexual abuse, deficits in social communication and understanding, restricted and repetitive interests and behaviors, and sensory interests. Treatment for sexual acting out behaviors in adolescents with ASD has not been explored and current recommendations focus on prevention through sexual education, which provides little guidance to clinicians working with adolescents who are already displaying sexual acting out behaviors. Adapting treatments for problematic sexual behaviors in neuro-typical children and adolescents may be the first step, although adaptation is complicated by developmental abilities that may not match an adolescent’s chronological age. A thorough developmental and sexual assessment is the first step to designing an appropriate treatment plan. Further research should focus on adapting and applying current treatments for sexual acting out by the ASD population.
摘要:患有自闭症谱系障碍(asd)的青少年与神经正常的同龄人有着相似的性欲和关系需求。然而,由于缺乏性教育,易受性虐待,缺乏社会沟通和理解,限制和重复的兴趣和行为,以及感官兴趣,他们更有可能在成熟后表现出有问题的性行为。对患有自闭症的青少年的性行为的治疗还没有被探索过,目前的建议主要是通过性教育来预防,这对治疗已经表现出性行为的青少年的临床医生提供的指导很少。对神经正常的儿童和青少年的问题性行为进行适应性治疗可能是第一步,尽管由于发育能力可能与青少年的实际年龄不匹配,适应性治疗变得复杂。全面的发育和性评估是设计适当治疗计划的第一步。进一步的研究应该集中在适应和应用目前的治疗方法来治疗ASD人群的性行为。
{"title":"Addressing Sexual Acting Out Behaviors with Adolescents on the Autism Spectrum","authors":"Leah N. Clionsky, Amanda M. N’zi","doi":"10.2174/2210676609666190730091304","DOIUrl":"https://doi.org/10.2174/2210676609666190730091304","url":null,"abstract":"DOI: 10.2174/2210676609666190730091304 Abstract: Adolescents with autism spectrum disorders (ASDs) have similar sexual desires and relationship needs to their neuro-typical peers. However, they may be more likely to demonstrate problematic sexual behaviors as they mature, due to lack of education about sexuality, vulnerability to sexual abuse, deficits in social communication and understanding, restricted and repetitive interests and behaviors, and sensory interests. Treatment for sexual acting out behaviors in adolescents with ASD has not been explored and current recommendations focus on prevention through sexual education, which provides little guidance to clinicians working with adolescents who are already displaying sexual acting out behaviors. Adapting treatments for problematic sexual behaviors in neuro-typical children and adolescents may be the first step, although adaptation is complicated by developmental abilities that may not match an adolescent’s chronological age. A thorough developmental and sexual assessment is the first step to designing an appropriate treatment plan. Further research should focus on adapting and applying current treatments for sexual acting out by the ASD population.","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":"9 1","pages":"129-134"},"PeriodicalIF":0.4,"publicationDate":"2020-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/2210676609666190730091304","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41480992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Is Knowledge Enough? The Relationship Between Mental Health Knowledge and Stigmatising Attitudes Among Australian Adolescents 知识足够吗?澳大利亚青少年心理健康知识与羞辱态度的关系
IF 0.4 Q4 PEDIATRICS Pub Date : 2020-01-10 DOI: 10.2174/2210676609666181204145835
Emmelin. Teng, Venning Anthony, Winefield Helen, Crabb Shona
Young people carry mental health problems disproportionate to thesize of their population, and rates of help-seeking are low. School mental health programshave been developed to address these issues, founded on an educational approach to targetmental health literacy, and indirectly improve help-seeking. However, it has been suggestedthat knowledge does not necessarily predict health behaviour in young people.A cross-sectional study was conducted to explore whether knowledgeabout mental illness was related to attitudes towards mental illness and intentions to seekhelp in a sample of adolescent girls (N=327).Results indicated a weak negative relationship between knowledge about mentalhealth and stigmatising attitudes about mental illness, but no relationship betweenknowledge about mental health and intentions to seek help for mental health problems.When mental health was categorised (e.g., optimal vs. poorer mental health), a negativerelationship between knowledge about and stigmatising attitudes toward mental health wasshown in those with poor mental health, but not for adolescents categorised as havingmoderate or optimal mental health.Findings suggest that while the traditional adage - more information on mentalhealth equals better attitude to mental health - may be true for those with ‘poorer’ levels ofmental health (e.g., high levels of psychological distress), it may not reduce stigmaassociated with mental illness or motivate positive health behaviour in adolescent girls with‘optimal’ mental health (e.g., low or no levels of psychological distress).
年轻人的心理健康问题与他们的人口比例不成比例,寻求帮助的比率也很低。学校心理健康计划是为了解决这些问题而制定的,它建立在一种教育方法的基础上,以提高心理健康素养,并间接改善求助。然而,有人认为,知识并不一定能预测年轻人的健康行为。一项横断面研究探讨了有关精神疾病的知识是否与青春期女孩对精神疾病的态度和寻求帮助的意愿有关(N=327)。结果表明,有关精神健康的知识与对精神疾病污名化的态度之间存在微弱的负向关系,但有关心理健康的知识和寻求心理健康问题帮助的意图之间没有关系。当对心理健康进行分类时(例如,最佳心理健康与较差心理健康),对心理健康的认识和污名化态度之间的负相关关系在心理健康较差的人身上表现出来,但在被归类为中等或最佳心理健康的青少年身上则没有。研究结果表明,尽管传统的格言——更多的心理健康信息意味着对心理健康的态度更好——对于那些心理健康水平“较差”的人(例如,心理困扰程度高)来说可能是正确的,它可能不会减少与精神疾病相关的污名,也不会激发心理健康状况“最佳”(例如,心理痛苦程度低或没有)的青春期女孩的积极健康行为。
{"title":"Is Knowledge Enough? The Relationship Between Mental Health Knowledge and Stigmatising Attitudes Among Australian Adolescents","authors":"Emmelin. Teng, Venning Anthony, Winefield Helen, Crabb Shona","doi":"10.2174/2210676609666181204145835","DOIUrl":"https://doi.org/10.2174/2210676609666181204145835","url":null,"abstract":"\u0000\u0000Young people carry mental health problems disproportionate to the\u0000size of their population, and rates of help-seeking are low. School mental health programs\u0000have been developed to address these issues, founded on an educational approach to target\u0000mental health literacy, and indirectly improve help-seeking. However, it has been suggested\u0000that knowledge does not necessarily predict health behaviour in young people.\u0000\u0000\u0000\u0000A cross-sectional study was conducted to explore whether knowledge\u0000about mental illness was related to attitudes towards mental illness and intentions to seek\u0000help in a sample of adolescent girls (N=327).\u0000\u0000\u0000\u0000Results indicated a weak negative relationship between knowledge about mental\u0000health and stigmatising attitudes about mental illness, but no relationship between\u0000knowledge about mental health and intentions to seek help for mental health problems.\u0000When mental health was categorised (e.g., optimal vs. poorer mental health), a negative\u0000relationship between knowledge about and stigmatising attitudes toward mental health was\u0000shown in those with poor mental health, but not for adolescents categorised as having\u0000moderate or optimal mental health.\u0000\u0000\u0000\u0000Findings suggest that while the traditional adage - more information on mental\u0000health equals better attitude to mental health - may be true for those with ‘poorer’ levels of\u0000mental health (e.g., high levels of psychological distress), it may not reduce stigma\u0000associated with mental illness or motivate positive health behaviour in adolescent girls with\u0000‘optimal’ mental health (e.g., low or no levels of psychological distress).\u0000","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":"9 1","pages":"206-219"},"PeriodicalIF":0.4,"publicationDate":"2020-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/2210676609666181204145835","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46822375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hashimoto’s Encephalopathy Presenting as Recurrent Brief Psychotic Episodes in a 13-Year-Old Girl: A Case Report 13岁女孩桥本脑病为复发性短暂精神病发作:一例报告
IF 0.4 Q4 PEDIATRICS Pub Date : 2020-01-10 DOI: 10.2174/2210676609666190415125923
N. Uvais
Hashimoto’s encephalopathy (HE) is a debilitating manifestation ofan autoimmune reaction against the thyroid that rarely can present with prominent psychiatricsymptoms. It is often under-diagnosed primarily due to its variety of symptoms as well asa lack of definitive diagnostic criteria.We report the case of a 13-year-old girl who has been diagnosed with HE after presenting with recurrent and severe psychosis with fever and a thyroidopathy. The patient had prominent visual hallucinations and paranoid delusions. Between episodes, the patient did not show evidence of psychiatric symptoms. This patient struggled with several incorrect diagnoses and treatments for two years before the correct diagnosis of HE was made and displayed extreme improvement upon corticosteroid administration. This case illustrates the importance of increasing awareness of HE as well as includingHE in a differential diagnosis when paediatric patients present with psychosis andconcurrent thyroidopathy.
桥本脑病(HE)是一种针对甲状腺的自身免疫反应的衰弱表现,很少出现突出的精神症状。它经常被低估,主要是因为它的各种症状以及缺乏明确的诊断标准。我们报告了一例13岁女孩的病例,她在出现反复发作的严重精神病伴发烧和甲状腺疾病后被诊断为HE。患者有明显的视觉幻觉和妄想症。在两次发作之间,患者没有表现出精神症状的证据。该患者在几次错误的诊断和治疗中挣扎了两年,才做出正确的HE诊断,并在皮质类固醇给药后表现出极大的改善。该病例说明了当儿科患者出现精神病和并发甲状腺疾病时,提高对HE的认识以及将HE纳入鉴别诊断的重要性。
{"title":"Hashimoto’s Encephalopathy Presenting as Recurrent Brief Psychotic Episodes in a 13-Year-Old Girl: A Case Report","authors":"N. Uvais","doi":"10.2174/2210676609666190415125923","DOIUrl":"https://doi.org/10.2174/2210676609666190415125923","url":null,"abstract":"\u0000\u0000Hashimoto’s encephalopathy (HE) is a debilitating manifestation of\u0000an autoimmune reaction against the thyroid that rarely can present with prominent psychiatric\u0000symptoms. It is often under-diagnosed primarily due to its variety of symptoms as well as\u0000a lack of definitive diagnostic criteria.\u0000\u0000\u0000\u0000We report the case of a 13-year-old girl who has been diagnosed with HE after presenting with recurrent and severe psychosis with fever and a thyroidopathy. The patient had prominent visual hallucinations and paranoid delusions. Between episodes, the patient did not show evidence of psychiatric symptoms. This patient struggled with several incorrect diagnoses and treatments for two years before the correct diagnosis of HE was made and displayed extreme improvement upon corticosteroid administration. \u0000\u0000\u0000\u0000This case illustrates the importance of increasing awareness of HE as well as including\u0000HE in a differential diagnosis when paediatric patients present with psychosis and\u0000concurrent thyroidopathy.\u0000","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2020-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44302503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Critical Issues in Adolescent Mental Health in the Emergency Department: Looking Beyond Triage and Risk Assessment 急诊科青少年心理健康的关键问题:超越分类和风险评估
IF 0.4 Q4 PEDIATRICS Pub Date : 2020-01-10 DOI: 10.2174/221067660902200110090955
N. Moukaddam, Edore Onigu-Otite, V. Tucci
{"title":"Critical Issues in Adolescent Mental Health in the Emergency Department: Looking Beyond Triage and Risk Assessment","authors":"N. Moukaddam, Edore Onigu-Otite, V. Tucci","doi":"10.2174/221067660902200110090955","DOIUrl":"https://doi.org/10.2174/221067660902200110090955","url":null,"abstract":"<jats:sec>\u0000<jats:title />\u0000<jats:p />\u0000</jats:sec>","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":"9 1","pages":"67-68"},"PeriodicalIF":0.4,"publicationDate":"2020-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47250828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
期刊
Adolescent Psychiatry
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1