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Zum Stand der Ärztlichen Weiterbildung in der Kinder- und Jugendpsychiatrie und -psychotherapie. 儿童和青少年精神病学和心理治疗方面的继续医学教育状况。
IF 0.8 4区 医学 Q4 PSYCHIATRY Pub Date : 2024-07-01 DOI: 10.1024/1422-4917/a000987
Marianne Klein
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引用次数: 0
The Microbiome in Child and Adolescent Psychiatry. 儿童和青少年精神病学中的微生物组。
IF 0.8 4区 医学 Q4 PSYCHIATRY Pub Date : 2024-07-01 Epub Date: 2024-01-19 DOI: 10.1024/1422-4917/a000965
Alexandra Zimmermann-Rösner, Alexander Prehn-Kristensen

Recent research has increasingly emphasized the function of the microbiome in human health. The gut microbiome is essential for digesting food and seems to play a vital role in mental health as well. This review briefly overviews the gut microbiome and its interplay with the central nervous system. We then summarize some of the latest findings on the possible role of the microbiome in psychiatric disorders in children and adolescents. In particular, we focus on autism spectrum disorder, attention-deficit/hyperactivity disorder, anorexia nervosa, bipolar disorder, and major depressive disorder. Although the role of microbiota in mental development and health still needs to be researched intensively, it has become increasingly apparent that the impact of microbiota must be considered to better understand psychiatric disorders.

最近的研究越来越强调微生物组在人类健康中的功能。肠道微生物组对消化食物至关重要,似乎对心理健康也起着至关重要的作用。本综述简要概述了肠道微生物组及其与中枢神经系统的相互作用。然后,我们总结了微生物组在儿童和青少年精神疾病中可能扮演的角色的一些最新发现。我们尤其关注自闭症谱系障碍、注意力缺陷/多动症、神经性厌食症、双相情感障碍和重度抑郁症。尽管微生物群在精神发育和健康中的作用仍有待深入研究,但要更好地理解精神疾病,就必须考虑微生物群的影响,这一点已变得越来越明显。
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引用次数: 0
Handreichung Time-out. 讲义超时。
IF 0.8 4区 医学 Q4 PSYCHIATRY Pub Date : 2024-07-01 DOI: 10.1024/1422-4917/a000986
Claus-Rüdiger Haas
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引用次数: 0
[Beyond NICE: Updated Systematic Review on the Current Evidence of Using Puberty Blocking Pharmacological Agents and Cross-Sex-Hormones in Minors with Gender Dysphoria]. [超越 NICE:关于对患有性别焦虑症的未成年人使用青春期阻断药剂和跨性别激素的现有证据的最新系统性综述]。
IF 0.8 4区 医学 Q4 PSYCHIATRY Pub Date : 2024-01-01 Epub Date: 2024-02-27 DOI: 10.1024/1422-4917/a000972
Florian D Zepf, Laura König, Anna Kaiser, Carolin Ligges, Marc Ligges, Veit Roessner, Tobias Banaschewski, Martin Holtmann
<p><p>Beyond NICE: Updated Systematic Review on the Current Evidence of Using Puberty Blocking Pharmacological Agents and Cross-Sex-Hormones in Minors with Gender Dysphoria <b>Abstract:</b> <i>Objective:</i> The suppression of physiological puberty using puberty-blocking pharmacological agents (PB) and prescribing cross-sex hormones (CSH) to minors with gender dysphoria (GD) is a current matter of discussion, and in some cases, PB and CSH are used in clinical practice for this particular population. Two systematic reviews (one on PB, one on CSH treatment) by the British National Institute for Clinical Excellence (NICE) from 2020 indicated no clear clinical benefit of such treatments regarding critical outcome variables. In particular, these two systematic NICE reviews on the use of PB and CSH in minors with GD detected no clear improvements of GD symptoms. Moreover, the overall scientific quality of the available evidence, as discussed within the above-mentioned two NICE reviews, was classified as "very low certainty" regarding modified GRADE criteria. <i>Method:</i> The present systematic review presents an updated literature search on this particular topic (use of PB and CSH in minors with GD) following NICE principles and PICO criteria for all relevant new original research studies published since the release of the two above-mentioned NICE reviews (updated literature search period was July 2020-August 2023). <i>Results:</i> The newly conducted literature search revealed no newly published original studies targeting NICE-defined critical and important outcomes and the related use of PB in minors with GD following PICO criteria. For CSH treatment, we found two new studies that met PICO criteria, but these particular two studies had low participant numbers, yielded no significant additional clear evidence for specific and clearly beneficial effects of CSH in minors with GD, and could be classified as "low certainty" tfollowing modified GRADE criteria. <i>Conclusions:</i> The currently available studies on the use of PB and CSH in minors with GD have significant conceptual and methodological flaws. The available evidence on the use of PB and CSH in minors with GD is very limited and based on only a few studies with small numbers, and these studies have problematic methodology and quality. There also is a lack of adequate and meaningful long-term studies. Current evidence doesn't suggest that GD symptoms and mental health significantly improve when PB or CSH are used in minors with GD. Psychotherapeutic interventions to address and reduce the experienced burden can become relevant in children and adolescents with GD. If the decision to use PB and/or CSH is made on an individual case-by-case basis and after a complete and thorough mental health assessment, potential treatment of possibly co-occurring mental health problems as well as after a thoroughly conducted and carefully executed individual risk-benefit evaluation, doing so as part of clinical
超越 NICE:关于对患有性别障碍的未成年人使用青春期阻断药理制剂和跨性别激素的现有证据的最新系统综述 摘要:目的:对患有性别焦虑症(GD)的未成年人使用青春期阻断药理制剂(PB)抑制其生理青春期发育和使用异性激素(CSH)是目前讨论的一个问题,在某些情况下,PB和CSH被用于这一特殊人群的临床实践中。英国国家临床优化研究所(NICE)于 2020 年发布的两篇系统性综述(一篇关于 PB 治疗,一篇关于 CSH 治疗)显示,在关键结果变量方面,此类治疗没有明显的临床益处。特别是,这两份 NICE 系统性综述对患有 GD 的未成年人使用 PB 和 CSH 没有发现明显的 GD 症状改善。此外,根据修改后的 GRADE 标准,上述两篇 NICE 综述所讨论的现有证据的总体科学质量被归类为 "确定性极低"。方法:本系统性综述按照 NICE 原则和 PICO 标准,对自上述两篇 NICE 综述发布以来(更新的文献检索期为 2020 年 7 月至 2023 年 8 月)发表的所有相关新原创研究进行了文献检索。结果:在新近进行的文献检索中,我们没有发现针对 NICE 定义的关键和重要结果以及按照 PICO 标准在患有 GD 的未成年人中使用 PB 的相关新发表的原创研究。在 CSH 治疗方面,我们发现了两项符合 PICO 标准的新研究,但这两项研究的参与人数较少,没有提供重要的额外明确证据来证明 CSH 对患有 GD 的未成年人具有特定且明显的有益效果,根据修改后的 GRADE 标准,可将其归类为 "低确定性"。结论:目前现有的关于在患有 GD 的未成年人中使用 PB 和 CSH 的研究在概念和方法上存在重大缺陷。关于在患有 GD 的未成年人中使用 PB 和 CSH 的现有证据非常有限,而且仅基于少数几项数量较少的研究,这些研究的方法和质量都存在问题。此外,还缺乏充分而有意义的长期研究。目前的证据并不表明,对患有 GD 的未成年人使用 PB 或 CSH 能明显改善 GD 症状和心理健康。对于患有 GD 的儿童和青少年,可以采取心理治疗干预措施来解决和减轻经历的负担。如果在进行全面彻底的心理健康评估、对可能并发的心理健康问题进行可能的治疗以及全面开展和仔细执行个人风险效益评估后,根据具体情况决定使用 PB 和/或 CSH,那么作为临床研究或研究项目的一部分来使用 PB 和/或 CSH,就像目前在英国所做的那样,在生成新的研究数据方面具有价值。电子增补件(ESM)1 是该著作的改编和缩写英文版。
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引用次数: 0
Nach der Cannabislegalisierung: Was steht an aus Sicht der Kinder- und Jugendpsychiatrie? 大麻合法化之后:从儿童和青少年精神病学的角度看下一步该怎么办?
IF 0.8 4区 医学 Q4 PSYCHIATRY Pub Date : 2024-01-01 DOI: 10.1024/1422-4917/a000979
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引用次数: 0
[Sexualized Violence Toward Children and Adolescents: The Visibility and Implementation of Safeguarding Concepts in Sports, Music, and Church]. [针对儿童和青少年的性暴力:体育、音乐和教会中保护概念的可见性和实施]。
IF 1.2 4区 医学 Q4 PSYCHIATRY Pub Date : 2024-01-01 Epub Date: 2023-12-01 DOI: 10.1024/1422-4917/a000959
Teresa Walter, Marius Stickel, Jörg M Fegert, Andreas Jud

Sexualized Violence Toward Children and Adolescents: The Visibility and Implementation of Safeguarding Concepts in Sports, Music, and Church Abstract: Objective: In 2010, the disclosure of sexualized violence in educational organizations led to a public debate and calls for safeguarding concepts against sexualized violence toward children and adolescents. However, there have been few efforts to systematically record the visibility, availability, and implementation of such concepts. We used a broad Google search and a telephone survey as an initial approach to close this research gap. Method: In a systematic Google search and a telephone survey (N = 50), we identified and examined safeguarding concepts against sexualized violence toward children and adolescents in the context of religious organizations, sports, and musical education regarding its visibility, availability, and implementation level. Results: The results of our systematic internet research show a low hit rate of identified safeguarding concepts in all contexts. The low number of search hits indicates that the issue of sexualized violence toward children and adolescents has been inadequately addressed in many institutions, and that protective measures have been neglected. The supplementary results of the telephone survey suggest a low implementation level within organizations and a low availability of existing safeguarding concepts.

摘要:目的:2010年,教育机构中性暴力行为的曝光引发了一场公众辩论,呼吁对儿童和青少年的性暴力行为进行保护。然而,很少有人系统地记录这些概念的可见性、可用性和实现。我们使用了广泛的谷歌搜索和电话调查作为缩小这一研究差距的初步方法。方法:通过系统的谷歌搜索和电话调查(N = 50),我们确定并检查了在宗教组织、体育和音乐教育背景下防止针对儿童和青少年的性暴力的保护概念,包括其可见性、可用性和实施水平。结果:我们系统的互联网研究结果表明,在所有情况下,已确定的保护概念的命中率都很低。搜索命中数低表明,许多机构没有充分处理针对儿童和青少年的性暴力问题,而且忽视了保护措施。电话调查的补充结果表明,各组织内部的执行水平较低,现有保护概念的可得性较低。
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引用次数: 0
The Course of Anxiety-Specific Cognitive Bias Following Daycare/Inpatient Treatment in Youths with Social Phobia and School Absenteeism. 社交恐惧症和旷课青年日托/住院治疗后焦虑特异性认知偏差的过程。
IF 1.2 4区 医学 Q4 PSYCHIATRY Pub Date : 2024-01-01 Epub Date: 2023-09-28 DOI: 10.1024/1422-4917/a000951
Lisa Veit, Stefanie Maria Jungmann, Christine Margarete Freitag

Social phobia (SP) is a common mental disorder in youth often accompanied by absence from school, which may require daycare or inpatient intervention (DC/IN). Objective: The present explorative study investigates changes in anxiety-specific implicit assumptions and interpretation bias following DC/IN. Methods: The study included 16 youths with SP (M age = 15.8 [SD = 1.24], females: 62.5 %) participating in DC/IN. We assessed the main outcomes using the Implicit Association Test and Affective Misattribution Procedure. Results: A large effect was shown for reducing implicit assumptions of feeling anxious (p = .142; η2p = .171) and for reducing the implicit interpretation bias (p = .137; η2p = .162). No change was indicated by effect size in implicit assumptions of feeling socially rejected (p = .649; η2p = .016). Social phobia symptoms initially correlated with changes in implicit assumptions of feeling anxious (r = .45). Conclusion: Effect sizes indicate that implicit anxiety-specific assumptions and interpretation bias descriptively improved following DC/IN. Thus, DC/IN may lead to meaningful improvements of anxiety-specific cognition in some individuals with high SP symptoms, emphasizing the relevance of cognitive behavioral approaches in the treatment of SP. Several limitations are discussed.

社交恐惧症(SP)是一种常见的青少年精神障碍,通常伴有缺课,可能需要日托或住院干预(DC/in)。目的:本探索性研究调查了DC/in后焦虑特异性内隐假设和解释偏倚的变化。方法:本研究包括16名SP青年(男性年龄=15.8[SD=1.24],女性:62.5%)参与DC/in。我们使用内隐联想测试和情感错误归因程序评估了主要结果。结果:在减少焦虑感的内隐假设(p=.142;η2p=.171)和减少内隐解释偏差(p=.137;η2p=.162)方面显示出很大的效果。感觉被社会排斥的内隐假定的效果大小没有变化(p=.649;η2p=0.16)。社交恐惧症症状最初与感觉的内隐设想的变化相关焦虑(r=.45)。结论:效应大小表明,内隐焦虑特异性假设和解释偏差在DC/IN后有描述性改善。因此,DC/IN可能会有意义地改善一些高SP症状患者的焦虑特异性认知,强调认知行为方法在SP治疗中的相关性。
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引用次数: 0
[Gut Microbiota and Autism Spectrum Disorders: An Overview of Correlations and Potential Implications for Therapeutic Interventions]. [肠道微生物群与自闭症谱系障碍:肠道微生物群与自闭症谱系障碍:相关性概述及对治疗干预的潜在影响]。
IF 1.2 4区 医学 Q4 PSYCHIATRY Pub Date : 2024-01-01 Epub Date: 2023-12-15 DOI: 10.1024/1422-4917/a000962
Johanna Neubauer, Anna Kaiser, Sarah Hohmann

Gut Microbiota and Autism Spectrum Disorders: An Overview of Correlations and Potential Implications for Therapeutic Interventions Abstract: At the beginning of research on microbiota, researchers focused mainly on the role of microbiota dysbiosis in the development of gastrointestinal diseases. However, over the last years, researchers have also identified correlations with other physical processes and neuropsychiatric diseases such as autism spectrum disorder. These correlations are believed to be at least partly mediated through the brain-gut-microbiome axis. An altered composition of microbiota in patients with autism spectrum disorder was detected compared to healthy controls. Today, the discussion centers around a possible systemic impact of the metabolites of some microbiota or microbiota-induced chronic inflammatory processes on the brain (mediated through the brain-gut-microbiome axis) as an underlying mechanism. Still, the specific underlying mechanisms remain largely unknown, so conclusions on therapeutic implications are difficult to determine. Here, we describe some promising approaches to improving autistic behavior through dietary changes, the use of prebiotics and probiotics, stool transplantation from healthy controls, and restricted absorbance of certain metabolites. We need further clinical studies of high quality to fully understand the pathophysiology of autism spectrum disorder and to improve diagnostic and therapeutic strategies.

肠道微生物群与自闭症谱系障碍:肠道微生物群与自闭症谱系障碍:相关性概述及对治疗干预的潜在影响 摘要:在微生物群研究的初期,研究人员主要关注微生物群失调在胃肠道疾病发展中的作用。然而,在过去几年中,研究人员也发现了微生物群与其他生理过程和神经精神疾病(如自闭症谱系障碍)之间的相关性。据信,这些相关性至少部分是通过大脑-肠道-微生物群轴介导的。与健康对照组相比,自闭症谱系障碍患者的微生物群组成发生了改变。如今,讨论的焦点集中在某些微生物群的代谢物或微生物群诱导的慢性炎症过程对大脑可能产生的系统性影响(通过大脑-肠道-微生物群轴介导)这一潜在机制上。然而,具体的潜在机制在很大程度上仍不为人所知,因此难以确定治疗意义的结论。在此,我们介绍了通过改变饮食习惯、使用益生菌和益生菌、从健康对照组移植粪便以及限制吸收某些代谢物来改善自闭症行为的一些可行方法。我们需要进一步开展高质量的临床研究,以充分了解自闭症谱系障碍的病理生理学,并改进诊断和治疗策略。
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引用次数: 0
[Genetic Diagnostics in Everyday Clinical Practice in Child and Adolescent Psychiatry: Indications, Framework Conditions, Hurdles, and Proposed Solutions]. [儿童和青少年精神病学日常临床实践中的基因诊断:适应症、框架条件、障碍和拟议解决方案]。
IF 1.2 4区 医学 Q4 PSYCHIATRY Pub Date : 2024-01-01 Epub Date: 2023-08-29 DOI: 10.1024/1422-4917/a000941
Franziska Degenhardt, Eva Wohlleber, Rami Abou Jamra, Johannes Hebebrand

Genetic Diagnostics in Everyday Clinical Practice in Child and Adolescent Psychiatry: Indications, Framework Conditions, Hurdles, and Proposed Solutions Abstract: Health insurance covers medically necessary genetic testing in Germany. Diagnostic genetic testing has become increasingly important for child and adolescent psychiatry (CAP), reflected by the rising number of national guidelines relevant to CAP, including genetic testing in the recommended diagnostic work-up. However, implementation of theses guidelines in routine clinical care is lacking. This article provides a concise overview of the relevance of genetic testing in CAP-related national guidelines. It outlines the legal and financial framework for genetic testing in Germany. Furthermore, it points out barriers to implementation and offers potential solutions. It then provides examples from clinical practice highlighting the potential benefits patients and their family members might have from receiving a genetic diagnosis. The article closes by outlining future CAP-relevant areas in which genetic testing may become clinically relevant.

儿童和青少年精神病学日常临床实践中的基因诊断:适应症、框架条件、障碍和建议的解决方案 摘要:在德国,医疗保险涵盖医疗必需的基因检测。基因诊断检测在儿童和青少年精神病学(CAP)中的重要性与日俱增,这体现在与 CAP 相关的国家指南数量不断增加,其中包括将基因检测纳入建议的诊断工作中。然而,这些指南在常规临床护理中的实施还很欠缺。本文简要概述了基因检测在 CAP 相关国家指南中的相关性。文章概述了德国基因检测的法律和财政框架。此外,文章还指出了实施过程中的障碍,并提供了潜在的解决方案。然后,文章提供了临床实践中的一些实例,强调了患者及其家庭成员从接受基因诊断中可能获得的潜在益处。文章最后概述了基因检测未来可能与临床相关的 CAP 相关领域。
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引用次数: 0
Mitteilungen. 留言
IF 0.8 4区 医学 Q4 PSYCHIATRY Pub Date : 2024-01-01 DOI: 10.1024/1422-4917/a000980
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引用次数: 0
期刊
Zeitschrift Fur Kinder-Und Jugendpsychiatrie Und Psychotherapie
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