Zeitschrift Fur Kinder-Und Jugendpsychiatrie Und Psychotherapie最新文献

A Stepped Bereavement Care Model for Children and Young People Abstract: Objective: Losing a caregiver can have a profound impact on the health and quality of life of children and young people (CYP). The provision of needs-based support for this group is questionable. Germany lacks a structured framework that could organize bereavement care for CYP, incorporate the various professional groups and institutions involved, and lead to the establishment of quality standards. This article discusses an Irish stepped-care model at an international level. Adapting it to the German context and disseminating can contribute to the professionalization of bereavement care for CYP. Method: We adapted the stepped-care model through an iterative consensus process involving experts in psychology, psychotherapy, grief counselling, bereavement support, and social work. Results: The German adaptation outlines a four-stage model, beginning at the societal level. Support is tailored to the specific needs of CYP and their families, with support options including the social environment, low-threshold services, and psychotherapy. Facilitating transitions between the levels of care is particularly important to accommodate the dynamic nature of support needs. Conclusions: Establishing a stepped-care framework can contribute to a more needs-based approach to caring for bereaved CYP. Implementing this model requires a systematic identification of needs to avoid potential gaps in care.

Suicide Among Adolescents: Prior Use of Psychiatric Services and Opportunities Offered by Digital Prevention Programs Abstract: Suicide prevention in adolescence poses a challenge to society as a whole, in which child and adolescent psychiatry plays a central role in view of the high prevalence of mental disorders among suicides. But how often do adolescents actually seek psychiatric help before committing suicide? This review looks at contact rates with psychiatry and other institutions prior to suicide. It examines how nonlethal suicide attempts often precede suicide as a "warning signal," and which individual and structural barriers prevent young people from seeking psychiatric help. Furthermore, it discusses whether messenger-based prevention programs reach those adolescents who do not seek psychiatric care. This review highlights existing gaps in care and identifies possible starting points for digital prevention strategies in practice.

Background: Impairments in reward processing and inhibitory control are key neurocognitive dysfunctions implicated in various mental disorders during adolescence, including major depressive disorder (MDD) and behavioral addictions (BAs). They are associated with greater symptom severity and poorer treatment outcomes. Among adults, repetitive transcranial magnetic stimulation (rTMS) targeting the left dorsolateral prefrontal cortex (DLPFC) has shown promise as a neuromodulation approach targeting these neural circuits. However, evidence regarding the neurophysiological effects of rTMS in adolescents with these conditions remains scarce. This study investigates the acute, short-term, and medium-term effects of high-frequency rTMS on neurophysiological markers and clinical symptoms in adolescents with MDD and BAs. Methods: This protocol describes a double-blind, randomized, sham-controlled trial enrolling adolescents 12-17 years diagnosed with MDD or BAs. We randomized the participants to receive either active rTMS (15 Hz, 120 % resting motor threshold, 1,600 pulses per session in 40 trains of 4 s) or sham stimulation. We studied the immediate rTMS effects after and during a singular rTMS session in both diagnostic groups as well as the effects of 12 rTMS sessions for the MDD group. We assessed self-report via the Children's Depression Rating Scale-Revised (CDRS-R) and craving scales adapted for BA. The neurophysiological outcomes include EEG-derived event-related potentials (Reward Positivity, N45, P300, P60, N100, LPP) to examine reward processing, cortical excitability/inhibition, and cue reactivity. The statistical analyses applied mixed-effects models with a planned sample size of 32 participants per group. Discussion: This study provides novel insights into the neurophysiological mechanisms underlying rTMS effects on the DLPFC in adolescent MDD and BAs. Demonstrating modulation of reward- and inhibition-related EEG markers alongside clinical improvement could strengthen the evidence for rTMS as a safe and effective intervention, while informing future personalized treatment strategies for these vulnerable populations.

Depressive Disorders - From ICD-10 to ICD-11 Abstract: This article presents the main changes in the classification of depressive disorders associated with the transition from ICD-10 to ICD-11. We evaluate the changes regarding their relevance for diagnostic assessment during childhood and adolescence and the current state of research. Some changes were implemented in the categorization of disorders: In ICD-11, depressive disorders are listed as a disorder group separately from bipolar disorders and now include both dysthymic disorder as well as mixed depressive and anxiety disorder. With the introduction of ICD-11, the diagnostic criteria for depressive episodes were revised, however, specific considerations for diagnoses in children and adolescents remain unaddressed. The ICD-11 newly introduces the diagnosis of premenstrual dysphoric disorder as a depressive disorder, in parallel to DSM-5. In addition, it introduced seven diagnostic specifiers that describe depressive disorders beyond the diagnosis. The clinical descriptions and diagnostic guidelines were comprehensively updated with the revision of the ICD criteria and supplemented with developmental characteristics, which are particularly relevant for the assessment of children and adolescents. However, the guidelines are not yet included in the German draft version currently available online. More research with children and adolescents is needed to evaluate the reliability of the updated diagnostic criteria for this age group.

Patients with Extremist Attitudes During Child and Adolescent Psychiatric and Psychotherapeutic Treatment Abstract: Extremist attitudes are widespread in the general population. Children and adolescents not only have a significant risk of growing up in families with extremist attitudes and being confronted with extremist content in their social environment, but they also often display the respective attitudes themselves. Extremist attitudes are often rooted in problematic developmental paths and experiences of crisis. They can also be associated with the presence of mental disorders, be exacerbated by them, or trigger them. There is also a risk of their committing crimes and violent acts in connection with extremist attitudes. Based on a selective literature review, this article explains the role child and adolescent psychiatrists and psychotherapists can play in preventing extremism, the complex mechanisms and developmental paths that underlie extremism, and how to address extremism and related risk situations during treatment.

Mental Health and Physical Activity among Adolescents from Different Social Backgrounds: Results of the German COMO-Study Summary: Objective: Investigating the effects of the COVID-19 pandemic is central to future health strategies. This article provides population-based data on the mental health and physical activity of children and adolescents in Germany, considering sociodemographic characteristics. Method: The data refer to the population-based representative COMO-study with 5240 participants aged 4 to 17 years, surveyed between October 2023 and February 2024. It assessed mental health problems (SDQ), health-related quality of life (HRQoL, KIDSCREEN-10); and physical activity (WHO physical activity recommendation, sport) and calculated prevalence stratified by age, gender, and socioeconomic status (SES) as well as regression analyses. Results: 21 % of youth reported mental health problems, 14.5 % had low HRQoL, and 19.8 % fulfilled the WHO activity recommendation. Adolescents with low SES showed more mental health problems (29.9 % low vs. 10.7 % high), lower HRQoL, and were less active both in sports clubs (46.8 % low vs. 77.1 % high) and outside sports clubs. Physical activity was associated with fewer mental health problems (OR = 0.66-0.74) and higher HRQoL (OR = 1.19-1.73). Differences in age and gender showed heterogeneous results. Conclusions: Five years into the pandemic, socioeconomic inequalities in mental health, well-being, and physical activity persist. Physical activity can be a promising complementary approach to promoting mental health in youth.

"ich bin alles": A Web-Based Information Portal on Depression and Mental Health in Children and Adolescents Abstract: "ich bin alles" is a digital information portal that provides evidence-based information on depression and mental health in children and adolescents through a website and associated social media channels. The service is aimed at children and adolescents aged 12-18 with and without depression as well as their parents. The aims are 1) to educate about depression and prevention and treatment options, 2) to strengthen mental health and increase help-seeking behaviour, and 3) to destigmatise the disorder. Evidence-based information on the symptoms, diagnosis, causes, and course of depression as well as guideline-based treatment are provided to the target groups, thus fostering specific knowledge and concrete help for early diagnosis and treatment. In addition, children, adolescents, and their parents receive information about prevention options. The website is scientifically evaluated on an ongoing basis. A central aspect in all phases of the project is the active participation of all target groups, who continuously contribute to the development of content, website design, and social-media channels as well as to the evaluation. Information regarding "ich bin alles" is distributed in a variety of ways, including workshops, media, and scientific congresses. This article provides the first comprehensive introduction of the project in a scientific journal and informs about the development of evidence-based digital information tools as well as how to disseminate "ich bin alles" among colleagues and target groups.

The Role of Parental Emotional Communication in the Socioemotional Development of Deaf and Hard-of-Hearing Preschoolers Abstract: Objectives: Parents' communication with their children about emotions plays an important role in children's socioemotional development. In deaf and hard-of-hearing (DHH) children, emotional communication may be complicated by the effects of hearing loss. This study investigated the importance of emotional communication for the socioemotional development of DHH children and their parents' experience of stress. Methods: We interviewed the parents of 102 DHH preschool children aged 3;0 to 6;11 years in writing about parental emotional communication, parental responsiveness, children's communicative competence, parental stress, and their children's socioemotional development. We analyzed the data using path analysis. Results: The results show that emotional communication has no direct effects on parental stress and children's socioemotional development, although there are some indirect effects. Emotional communication contributes to a lower parental stress level (β = -.06, p = .04) via parental responsiveness and to fewer behavioral problems in the children (β = -.07, p = .04). Emotional communication also contributes to better socioemotional skills of the children via the children's communicative competence (β = .08, p = .04). Children with additional needs and their families are particularly at risk. Higher parental stress (β = .25, p < .001) and lower socioemotional skills in the children (β = -.18, p = .02) are evident. Conclusions: The results support previous findings in the literature regarding the role of parental responsiveness and communicative competence in the development of DHH children. In the context of family-centered early intervention, in addition to these important skills, parental support in communicating about feelings with their child should also be considered as a development-strengthening factor.