NEUROPSYCHIATRIE最新文献

Transition in psychiatry describes the transition from child psychiatric to adult psychiatric care. This transition is not purely medical, it takes place on many levels of care. Transition in the narrow sense describes the targeted and planned process of making this change ideal for patients and medical treaters.Due to the legally fixed border to be an adult at the age of 18 years and different financing systems for children and adults, there is often a break in care of psychiatric ill adolescents. The few available studies show that only about a quarter of patients are satisfied with the process of transition and 90% of employees in the healthcare system also experience this phase as deficient.So far there are no general concepts for an orderly transition in Austria, different individual solutions are available regionally.It is necessary to include all professional groups involved, but due to the regionally very heterogeneous supply, adapted concepts are necessary. It is aimed to include a meeting of all involved professionals, the establishment of good communication and flexibility regarding to the age of transition. Concerning the need for specialized transition facilities, there is currently a lack of solid data in Austria, these data should be collected. Likewise, legal framework conditions would have to be specified and then outpatient, day clinic and inpatient settings would have to be created under child psychiatric and adult psychiatric co-management in order to support the process of transition as best as possible.

An increasing need for child and adolescent psychiatric care is clearly observed in recent years. The present study deals with 20 child and youth care facilities taking care of 439 children and adolescents, in the industrial district, in Lower Austria. The aim of the study is to evaluate treatment needs of this special group of patients. The care facilities reported that 270 children and adolescents (62%) show psychiatric problems. Of these, 220 (50.1%) are diagnosed with one or more psychiatric diagnoses, and 200 children and adolescents are receiving child and adolescent psychiatric treatment. Eleven care facilities reported the necessity for treatment in 80-100% of their accommodated children and adolescents. This results in highly stressful working conditions for professional psychosocial helpers and high treatment needs within their fosterlings. It is evident that more intensive networking and cooperation between institutions and helpers involved is necessary. Further, the development of new, low-threshold child and adolescent psychiatric services would be desirable to adequately meet the increasing need for psychiatric treatment in children and adolescents.

The COVID-19 pandemic and the accompanying containment measures have had a fundamental impact on the mental health of children and adolescents. In the present study, the emergency admissions of the first two Corona years (2020/21) at the Department for Child and Adolescent Psychiatry Hall i. T./Innsbruck were retrospectively analysed and compared with the two years before the COVID-19 pandemic (2018/19). There was no change in the total number of emergency admissions in 2020 compared to 2019 before Corona, but in 2021 emergency admissions increased by 40.1%. The pre-Corona (2018/19) gender ratio of 65.4% girls to 34.6% boys did not change in 2020. In 2021, the proportion of girls increased to 74.4%. In the COVID-19 pandemic, acute suicidality increased (+48.3%) while aggression decreased (-51.0%). Acute intoxications increased in the first Corona year and decreased again in 2021. The present study results show that the mental health needs of children and adolescents increased significantly in the course of the COVID-19 pandemic and that this was also reflected in child and adolescent psychiatry. The increased demands must now be met with appropriate care and prevention measures as well as sufficient child and adolescent psychiatric bed capacities in order to mitigate the longer-term psychosocial effects of the COVID-19 pandemic as best as possible.

Although intensive, assertive treatment options in child and adoledcent psychiatry have been successfully evaluated and established in several countries, this development is just beginning in Austria. As part of the so called home-treatment, care is provided by a multiprofessional team to patients with severe mental disorders, who would otherwise be treated in an inpatiet setting at their own home. This opens up the opportunity for a better generalizability of therapeutic progress and an intensive work with the family system. Alternative models for inpatient care like home-treatment, show the potential for intensive therapeutic options independent of building structures. Further development of this therapeutic option based on evaluated model projects is desirable within the Austrian health care system.

Background: Day-care clinics as specialized care units of child and adolescent psychiatric care in Austria represent an important component for person-orientated treatment offers. In addition to numerous advantages, they also put higher demands on the young patients and their relatives.

Methods: The Austrian structure for day-care settings is recorded in the Austrian structure plan for health. Therefore, particular attention is paid to structural quality criteria, which are based on the Austrian concept of performance-oriented hospital financing.

Results: A high demand and need for readiness for transdisciplinary, multimodal treatment concepts and forms is discussed. It becomes ovious that there is a need for large spatial resource requirements. The establishment of several day clinic groups at one location and spatial requirements cannot be found in the concept of performance-oriented hospital financing.

Conclusion: To ensure and evaluate the quality of treatment, recommendations are made on a patient-related and team- or organization-related level. The workgroup "day-care-clinic" of the Austrian Society for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy recommends a treatment structure characterized by transdisciplinarity and participation. Further, it regionalized and local access and the integration of the day clinic into the community is necessary. Networking with other care structures and using social-psychiatric networks is essential. Regional characteristics should be taken into account and specialized, topic-specific day clinic groups should be increasingly included in further planning and concepts.

This article is intended to provide an overview of the supply situation with independent outpatient clinics and dislocated Hospital ambulances for Child and Adolescent Psychiatry, taking into account minimum professional standards. The level of care, the mandate to provide care, requirements, structural quality criteria and implementation recommendations are described. 13 outpatient clinics and dislocated Hospital ambulances are described in a data matrix.A comprehensive Austria-wide survey of the staffing and care offerings identified 13 outpatient clinics and outpatient clinics that meet minimum standards. This proves a difference between the current situation and the number of outpatient clinics required nationwide of 26 to 36 (depending on the assessment 1/350k or 1/250k)Thus, the findings provided here, lead us to the conclusion that the patient care in Austria's child and adolescent psychiatric outpatient clinics is not sufficiently guaranteed due to the largely tolerated but technically incorrect interpretation of the legally valid minimum standards.If the current deficiencies are retained, a central child and adolescent psychiatric care level remains with an effectiveness of less than 50% of the Austrian health structure plan (OSG).

Background and research question: The Austrian Society for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy (ÖGKJP) is publishing a series of articles in a special issue of Neuropsychiatrie dealing with the current provision of care in child and adolescent psychiatry. Aim of this article is to give an overview of provision of care for children and adolescents with mental health problems in Austria, Germany, and Switzerland and then draw conclusions for the Austrian child and adolescent psychiatric care landscape.

Method: First, epidemiologic data as well as different traditions and treatment philosophies and their effect for provision of care in child and adolescent psychiatry in Austria, Germany and Switzerland are presented. Subsequently, data of provided child and adolescent psychiatric care in Austria and Germany are presented and related to each other.

Results and conclusions: On the basis of the data presented, the current deterioration of mental health in children and adolescents due to the pandemic as well as the deficit of available inpatient beds (0.03-0.09) there is an urgent need for action in Austrian provision of child and adolescent psychiatric care. An improvement of the structural deficits in the child and adolescent psychiatric research and care landscape, a significant increase of capacities for inpatient treatment, day-care as well as outpatient treatment with establishment of modern treatment options such as home treatment is necessary.