The Canadian child and adolescent psychiatry review = La revue canadienne de psychiatrie de l'enfant et de l'adolescent最新文献

Introduction: To look at the specificities of the work of a Transcultural Child Psychiatry Team developed to meet the need for specialized services for Montreal and Quebec's culturally diverse immigrant and refugee pediatric population.

Method: A Transcultural Child Psychiatry Team was started at McGill University in 1995. The clinic's development and method of service provision for its patient population will be described.

Results: Modalities of assessment and treatment are modified to meet the needs of the team's clientele and also reflect the philosophical underpinnings of the team's practitioners.

Conclusion: In this model of service delivery, current mental health care practice is modified in order to address the social specificities and cultural diversity of transcultural child psychiatric populations.

Introduction: Immigrant and refugee families underutilize mental health services and schools are in a good position to develop prevention programs to help children adapt to their new environment.

Method: The transcultural psychiatry team at the Montreal Children's Hospital, in partnership with schools, has implemented creative expression workshops for kindergarten, elementary schools, and high school to help the children bridge the gap between past and present, culture of origin and host society.

Results: The workshops provide a safe space for expression, acknowledge and value diversity, allow the establishment of continuity, and facilitate the transformation of adversity.

Conclusion: Refugee and immigrant children's needs should be addressed through intersectoral programs that target exclusion and support a sense of agency.

Introduction: This article examines the potential modifications of care indicated to engage migrant and refugee families in making use of needed mental health services for their children in Canada and the role psychiatrists can play in this process.

Method: The clinical and consultative role of the members of the Transcultural Child Psychiatry Service at the Montreal Children's Hospital is used as a model. This model has been useful in engaging both migrant families and local front line service providers to work with each other in a collaborative manner.

Results: Important aspects to be considered in these cases are: Modifications in obtaining access to care; Issues of communication (i.e., the use of interpreters); Addressing cultural differences in understanding and responding to a child's difficulties; recognizing the plasticity of culture; Collaboration with colleagues in hospitals and with professionals in the community.

Conclusions: New models of care, involving increased collaboration between professionals, need to be devised to facilitate the mental health care of immigrant and refugee children and their families.

Introduction: There is currently no depression prevention intervention available to adolescents in primary care.

Method: Fourteen late adolescents evaluated the acceptability (performance and ratings), potential adverse effects (negative emotions), and benefits (pre/post measures of three risk factors for depression) of a combined primary care Internet-based depression prevention intervention. Nearly all participants engaged the website (13/14) and 8/14 completed the entire intervention.

Results: Completers reported high levels of readability and ease of understanding and low levels of negative emotions. Completers showed favorable trends for the targeted risk factors: depressive symptoms, dysfunctional thinking, and low social support.

Conclusion: A primary care/prevention intervention may be acceptable and favorably impact risk factors for depression.

Introduction: Children and youth with affect dysregulation (such as problems with explosive rage and anger) commonly present to health care professionals.

Method: Standard DSM-IV differential diagnoses for affect instability include bipolar disorder, ADHD and oppositional defiant disorder. However, clinicians may wish to consider the possibility of sensory processing difficulties, which are difficulties with the processing of sensory input, which can lead to problems with under- or over-arousal, thus contributing to affect dysregulation.

Results: In such cases, referral to occupational therapy may be helpful. Even in cases where occupational therapy is not available, being able to direct families to readings and internet resources about sensory processing may be helpful.

Conclusion: This article presents the diagnosis and management of a case of sensory processing disorder, followed by a narrative review of the literature.

Introduction: This study aimed to identify the trajectories of physical aggression during early childhood and antecedents of high levels of physical aggression early in life.

Methods: 572 families with a 5-month-old newborn were recruited. Assessments of physical aggression frequency were obtained from mothers at 17, 30, and 42 months after birth. Using a semiparametric mixture model and multivariate logit regression analyses, distinct clusters of physical aggression trajectories were identified, as well as family and child characteristics that predict high level aggression trajectories.

Results: THREE TRAJECTORIES OF PHYSICAL AGGRESSION WERE IDENTIFIED: 1. children (28% of sample) who displayed little or no physical aggression, 2. approximately 58% followed a rising trajectory of modest aggression, and 3. a rising trajectory of high physical aggression (14%).

Conclusions: Children who are at highest risk of not learning to regulate physical aggression in early childhood have mothers with a history of antisocial behaviour during their school years, mothers who start childbearing early and who smoke during pregnancy, and parents who have low income and have serious problems living together. Preventive interventions should target families with high-risk profiles on these variables.