Clinical Child Psychology and Psychiatry最新文献

Intensive outpatient (IOP) psychiatric treatment is increasingly deployed to meet the needs of psychiatrically high-risk youth; however, documentation of treatment disposition for in-person and/or telehealth modalities following treatment referral is largely unknown. The current study examined psychiatrically high-risk youth baseline treatment disposition patterns and explored variations according to treatment modality (telehealth vs. in-person). Using archival records of 744 adolescents (M_age = 14.91, SD = 1.60) admitted to a psychiatric IOP, multinomial logistic regressions revealed that commercially insured youth fared better than non-commercially insured youth with respect to treatment completion. When treatment modality was accounted for, youth treated on telehealth were no more likely to be psychiatrically hospitalized compared to youth treated with in-person services. However, youth treated on telehealth dropped out due to excessive absences or withdrawal/refusal to a greater extent than those treated in person. Future studies should examine clinical outcomes in addition to treatment disposition patterns to further understand youth's course of treatment at intermediate level of care settings (e.g., IOP).

Sluggish cognitive tempo (SCT) (cognitive disengagement syndrome) (CDS) describes a cluster of symptoms including slowness, lethargy, and daydreaming. This study aims to evaluate the psychometric properties of the Turkish version of the Child and Adolescent Behavior Inventory (CABI-SCT) scale and its relationship to other psychological difficulties. A total of 328 children and adolescents aged between 6-18 years were included in the study. CABI-SCT, Revised Child Anxiety and Depression Scale (RCADS), Barkley Child Attention Scale (BCAS), ADHD Rating Scale-IV, and Strengths and Challenges Questionnaire (SDQ) were administered to parents of participants. Reliability analysis demonstrated good internal consistency and reliability. Confirmatory factor analysis indicated that the one-factor model of the Turkish version of CABI-SCT is an acceptable construct. This study supports the validity and reliability of the Turkish version of CABI-SCT for use in children and adolescents providing initial data concerning the psychometric properties and difficulties associated with the Turkish version of the CABI-SCT.

The COVID-19 viral outbreak is a one in 100 year public health crisis. In addition to the stunning morbidity and mortality rates related to infection, multiple psychiatric sequelae erupted. Unfortunately, children and adolescents are neither immune to infection nor to the emotional consequences associated with the pandemic. Not surprisingly, the field's understanding of the psychological consequences of the viral outbreak are nascent. Consequently, this study examines the relationship between parents' and children's intolerance of uncertainty (IU) and their reactions to COVID-19. Seventy-three parents and 62 children participated in the on-line survey utilizing innovative measures of IU and COVID-19- related thoughts/behaviors. The results revealed remarkable similarities in parents' and children's responses. Parents' and children's reports of the impact of COVID on their lives were highly correlated (r = .53, df = 60, p < .001). Parents' perceptions of children's COVID-19 thoughts and behaviors were strongly aligned with the youths' self-report of their COVID reactions (r = .69, df = 60, p < .001) as well as the appraisal of the virus' impact on their lives (r = .-.42, df = 60, p < .001). Finally, children's reports of their COVID-19 related thoughts and behaviors were significantly linked to their IU (r = .60, df = 60, p < .001). Methodological limitations notwithstanding, the study's findings provide compelling implications for the conceptualization, assessment, and treatment of emotional distress in the peri- and post-pandemic periods.

Objective: Nonsuicidal Self-Injury (NSSI) in China has increasingly interested clinicians, although few studies have investigated its risk and protective factors. This study examined the risk factors of NSSI among Chinese adolescents.

Methods: The researchers recruited adolescent participants with NSSI from a hospital outpatient clinic to form a case group and recruited adolescents without NSSI who provided informed consent from the school to form a control group. Participants completed a questionnaire, and data were analyzed using logistic regression.

Results: A total of 138 cases and 276 controls participated in this study. Binary multivariate logistic regression analysis with adjusting for age and sex showed that domestic violence (OR = 8.615, 95%CI: 3.081-24.091), parental overconcern (OR = 6.995, 95%CI: 3.447-14.192), guilt (OR = 4.949, 95%CI: 2.227-10.996), and school bullying (OR = 21.676, 95%CI: 6.799-69.109) increased the risk of NSSI, while peer support (OR = 0.068, 95%CI: 0.030-0.150) and living in an urban environment (OR = 0.157, 95%CI: 0.056-0.437) decreased the risk of NSSI.

Conclusion: Some psychosocial factors were confirmed to be independent risk and protective factors for NSSI in this study. However, the clinical significance of the results needs to be interpreted with caution due to sample size limitations.

Cognitive disengagement syndrome (CDS) has been found to be associated with internalizing symptoms. Yet, no study thus far has focused on whether there is an association between obsessive-compulsive disorder (OCD) and CDS. The purpose of this study is to examine the symptom frequency and clinical implications of CDS in children with OCD. The study included sixty-one children with OCD and sixty-six typically developing children. Children were evaluated by a semi-constructed diagnosis interview, Obsessive-Compulsive Inventory, Barkley Child Attention Scale, and Stroop test. The frequency of elevated symptoms of CDS, and total time, total error, and total correction scores of the Stroop test were significantly higher in the OCD group compared to the controls. Elevated CDS symptoms were significantly associated with higher OCD symptom prevalence and poorer performance on the Stroop Test. Moreover, poor insight, hoarding symptoms, mental compulsions, and ADHD comorbidity were significantly higher in those with elevated CDS symptoms than in those without CDS in the OCD group. The findings of this study provide clinical implications that CDS symptoms may contribute to deficits in attentional orientation, conceptual flexibility, and cognitive processing speed in OCD.

Background: Knowledge of the continuity of sleep problems and the associations between sleep and psychiatric symptoms in child psychiatric patients is scarce.

Objectives: To investigate the persistency of sleep problems and how sleep at preschool age predicts sleep problems and psychiatric symptoms at school age in child psychiatric patients.

Methods: Participants (n = 68) were child psychiatry outpatients at Helsinki University Hospital in 2015-2017. Caregivers evaluated sleep with the Sleep Disturbance Scale for Children (SDSC) and psychiatric symptoms with the Child Behavior Checklist (CBCL) at baseline (age 4-7 years) and again at follow-up (age 8-13 years). Family background information was collected at both time points.

Results: Sleep problems at preschool age predicted sleep problems at school age (R2Adjusted = .48, p < .001). Persistent sleep problems associated strongly with the intensity of psychiatric symptoms (p = .001). Internalizing symptoms were predicted by sleep problems (p = .038) even after controlling for age, sex, and psychiatric symptoms at preschool age.

Conclusion: Sleep problems are prevalent and persistent and relate to psychiatric symptoms in children treated at child psychiatry clinics. These results emphasize the need for identification and treatment of sleep problems in these children.

Objective: Procrastination behavior (PB) negatively impacts individuals' daily lives. Based on existing evidence that states executive function (EF) problems and internalizing symptoms (IS) are related to PB, this study examined IS, EF problems, and sluggish cognitive tempo (SCT) symptoms in adolescents, and their relationships with PB and gender.

Methods: The sample consisted of 78 adolescents (56.4% female) aged 12-18 years. Participants and their families completed the Children's Depression Inventory (CDI), Screen for Child Anxiety Related Disorders (SCARED), Barkley Sluggish Cognitive Tempo Scale-Children and Adolescent (BSCTS-CA), General and Academic Procrastination Scales, Behavior Rating Inventory of Executive Function (BRIEF), and Strengths and Difficulties Questionnaire (SDQ).

Results: The scores for academic PB were significantly positively associated with the CDI, SCARED, subscales comprising the metacognitive index of the BRIEF, and all four subscales of the SDQ but not with SCT. General and academic PB yielded similar results except for the conduct problems. Academic PB and EF problems were more prevalent in males. Lack of organizational skills, a part of EF; IS; and attention problems were associated with academic and general PB in girls and boys.

Conclusion: Adolescents who have difficulty organizing their work and attention problems may have higher PB.

Objective: Pediatric catatonia case report and literature review.

Methods: Retrospective chart review and provider consultation.

Results: A case of pediatric catatonia is described in the setting of mood and psychotic disorders. Treatment course and outcomes are considered in the context of supporting literature review and discussion.

Conclusions: Pediatric catatonia is a debilitating and at times life threatening condition. Pediatric catatonia is historically underdiagnosed and its clinical presentation may differ from more common adult cases of catatonia. Correct identification, acute treatment, and long-term management is key to optimizing prognosis and patient outcomes.

Children living with parental mental illness are referred to as an invisible population because mental health services rarely target them, as the focus is often on the parent who is ill mentally. The same situation occurs even in school where they are unnoticed. This study conducted in Ghana creates awareness about what these children think about their interactions at school in the context of parental mental illness. Data was collected through interviews and diaries with 13 children living with parental mental illness and analysed to attain the essential features through Husserl's transcendental phenomenology. The children find the school as a happy space where they do not have to be worried about the parent's mental illness. Ultimately, though, even at school, most of the children become concerned about the mental wellbeing of the parent due to their loyalty towards them. This results in the school paradox where the children are torn between having their own time at school and being worried about the parent's condition back home, wanting to be there for the parent. The school paradox is an unhealthy cycle that could be addressed with coordinated efforts from mental health professionals, social workers, psychologists and teachers.