Zeitschrift Fur Kinder-Und Jugendpsychiatrie Und Psychotherapie最新文献

Functional (Nonorganic) Enuresis and Daytime Urinary Incontinence in Children and Adolescents: Clinical Guideline for Assessment and Treatment Abstract: Objective: Enuresis and daytime urinary incontinence are common disorders in children and adolescents and are associated with incapacitation and a high rate of comorbid psychological disorders. This interdisciplinary guideline summarizes the current state of knowledge regarding somatic and psychiatric assessment and treatment. We formulate consensus-based, practical recommendations. Methods: The members of this guideline commission consisted of 18 professional associations. The guideline results from current literature searches, several online surveys, and consensus conferences based on standard procedures. Results: According to the International Children's Continence Society (ICCS), there are four different subtypes of nocturnal enuresis and nine subtypes of daytime urinary incontinence. Organic factors first have to be excluded. Clinical and noninvasive assessment is sufficient in most cases. Standard urotherapy is the mainstay of treatment. If indicated, one can add specific urotherapy and pharmacotherapy. Medication can be useful, especially in enuresis and urge incontinence. Psychological and somatic comorbid disorders must also be addressed. Conclusions: The recommendations of this guideline were passed with a high consensus. Interdisciplinary cooperation is especially important, as somatic factors and comorbid psychological disorders and symptoms need to be considered. More research is required especially regarding functional (nonorganic) daytime urinary incontinence.

Practical Guideline on Dealing with Transgender Patients in Child and Adolescent Psychiatric Inpatient Settings Abstract: The guideline provided by the Federal Association of Leading Medical Directors for Child and Adolescent Psychiatry offers a framework for dealing with transgender patients in child and adolescent psychiatric clinics. It addresses the clinical challenges arising from the significant increase in transgender patients and the paradigm shift in the medical field. The guideline includes recommendations for dealing with transgender patients in various settings. Key treatment principles comprise adopting a destigmatizing approach, using preferred names and pronouns, accommodating individual room assignments, and considering relevant comorbidities. Only experienced medical doctors and psychotherapists should carry out diagnosis and treatment. The goals for supporting adolescents with gender dysphoria include promoting self-acceptance, addressing negative emotions, facilitating social integration, and fostering identity development.

Objective: Knowledge about the prevalence of mental disorders in childhood and adolescence is important for clinicians and policymakers. This study examines the prevalence and trends in self-reported mental health problems among 11- to 17-year-olds in Germany. Method: We evaluated data from the self-report version of the Strength and Difficulties Questionnaire (SDQ) of 6,725 children and adolescents from the baseline of the German Health Interview and Examination Survey (KiGGS, 2003-2006) and 6,145 from its second wave (KiGGS wave 2, 2014-2017). Results: According to the SDQ total difficulties score, the prevalence estimates did not vary significantly between the study waves, neither regarding the category "abnormal" (9.3 % vs. 9.4 %) nor the pooled categories "borderline/abnormal" (16.9 % vs. 15.4 %). We confirmed the results by linear regression analyses using mean values instead of the SDQ categories. Analyses of the SDQ subscales revealed gender and age-specific time trends. Conclusions: These findings differ from those based on the SDQ parent report, which suggests significant declines in symptom load between the study waves. The results indicate the importance of integrating youth self-reports when measuring mental health problems, at least as part of a multi-informant approach.

Pathological Demand Avoidance: Current State of Research and Critical Discussion Abstract: Pathological demand avoidance (PDA) describes children who obsessively avoid any demand to a clinically relevant extent and is presently the subject of controversial discussion. Their behavior may be interpreted as an attempt to reduce anxiety by establishing security and predictability through rigid control of the environment as well as the demands and expectations of others. The symptoms are described in the context of autism spectrum disorder. This article reviews the current state of research and discusses the questionable validity of pathological demand avoidance as an independent diagnostic entity. It also addresses the impact of the behavior profile on development and treatment. This paper concludes that PDA is not a diagnostic entity nor a subtype of autism; rather, it is a behavior profile that can be associated with adverse illness progression and unfavorable outcomes. PDA is one feature in a complex model. We must consider not only the patient's characteristics but also those of the caregiver and their psychopathology. The reactions of the interaction partners as well as the treatment decisions play a key role play for the affected individuals. Substantial research is needed concerning the occurrence of the behavior profile PDA in diverse disorders, treatment options, and treatment responses.