NEUROPSYCHIATRIE最新文献

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.

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.

The status of care in child and adoelscent psychiatry in Austria is still incomplete but increasing since the foundation of this medical specialty. Corona pandemia increases the pressure on the caring structures.In this paper the current state of publically paid outpatient care is reviewed and summarized. Differences between current state and the desired/planned state of care will document existing deficits and needed developments.The 9 federal states of Austria have made variable progress in developing the general child psychiatric care. We conclude with recommendations for further implementations.

Background and research question: This article presents and analyses the landscape for inpatient child and adolescent psychiatric care in Austria and examines current data from June 2022.

Method: In June 2022, the authors surveyed the current status of child and adolescent psychiatric primary care in Austria. Both systemised beds and day hospital beds as well as the number of specialists and assistant doctors were taken into account.

Results: A bed index of 0.05 beds/1000 inhabitants (as of 6/2022) was calculated, which is below the guideline for beds needed and does not correspond with the need depicted for sufficient provision of care ("Österreichischer Strukturplan Gesundheit"). Moreover, in June 2022, 40 beds had to be closed due to staff shortages and 26.5 training positions were vacant across Austria.

Discussion and conclusions: Even though the training ratio was raised to 1:2 as of 07.02.2022 within the framework of the "Mangelfachverordnung" for a limited period of time until 31.05.2027, it is hardly possible to guarantee sufficient mental health care according to the increased demand for child and adolescent psychiatry, especially in times of the pandemic. Measures need to be urgently taken to improve child and adolescent psychiatric treatment options. In order to ensure adequate care for the increasing number of mentally ill children and adolescents (a) the number of beds must be increased, (b) structural deficits have to improve, and (c) innovative treatment options in the sense of inpatient-equivalent treatment (home treatment) has to be considered.