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Background: For over forty years diet interventions have been investigated as a treatment of ADHD in children and adolescents and, with the new discoveries of the microbiota-gut-brain axis, this research becomes more relevant than ever. The aim of this systematic review was therefore to investigate the current knowledge of diet interventions as a treatment of ADHD in children and adolescents Methods: A systematic literature search in PubMed was conducted, identifying randomized controlled trials investigating diet interventions to treat ADHD in children and adolescents. Results: The study populations were generally small and the studies varied in duration and nature of the exposure. Overall 10 out of 12 studies spoke in favour of an elimination diet, 2 out of 6 of eliminating artificial food colourings from the diet and none in favour of eliminating sucrose or aspartame from the diet to treat ADHD. Conclusion: The current evidence is not enough to recommend treating ADHD with diet interventions, but a subgroup of children and adolescents might warrant from elimination of certain food-items. Further investigations of the mechanism and effect of diet interventions to treat ADHD is needed.

The presence of comorbid conditions associated with paediatric obsessive–compulsive disorder (OCD) is reported to range from 50 to 80% and to have an impact on treatment outcome. Accurate identification of comorbid psychiatric disorders is necessary in order to provide personalised care. Reliable and valid diagnostic interviews are essential in the process of establishing the correct diagnoses. The objective of this study was to evaluate the convergent and divergent validity of four diagnose categories generated by the Schedule for Affective Disorders and Schizophrenia for School-Age Children–Present and Lifetime Version (K-SADS-PL). The diagnose categories were: anxiety, depression, attention deficit hyperactivity disorder (ADHD), and oppositional defiant disorder (ODD). The K-SADS-PL was applied in a clinical sample of youth aged 7–17 years (N = 269), who were participants in the Nordic long-term OCD-treatment study (NordLOTS). Youth and parents completed measures to evaluate symptoms of anxiety, depression, ADHD, and ODD. Convergent and divergent validity of K-SADS-PL anxiety diagnosis was supported based on both anxiety self- and parent-reports. Similarly, support was found for convergent and divergent validity of ADHD and ODD diagnoses. For depressive disorder, support for convergent validity was found based on the depression self-report. Support for divergent validity of depression was found based on both the depression self- and parent-reports. Results of the present study suggest that the K-SADS-PL generates valid diagnoses of comorbid anxiety disorders, depression disorders, ODD, and ADHD in children and adolescents with OCD.

AIM: The aim of the study was to examine the psychometric properties of a Danish version of the Obsessive Beliefs Questionnaire - Child Version (OBQ-CV). The OBQ-CV assesses dysfunctional beliefs concerning responsibility/threat estimation, perfectionism/uncertainty, and importance/control of thoughts, which according to cognitive theories are important in the development and maintenance of obsessive-compulsive disorder (OCD).METHODS: The study included a pediatric sample (age 7-17 years) consisting of 57 children and adolescents with OCD, 49 children and adolescents with an anxiety disorder (AD), and 58 typically developing (TD) children and adolescents without a psychiatric diagnosis. All participants completed the OBQ-CV and the Child Behavior Checklist - the School Age Scales (CBCL/6-18). The Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) was used to assess OCD symptom severity in the OCD group.RESULTS: Confirmatory factor analyses supported the three-factor structure and thereby the construct validity of the OBQ-CV. Gender was not associated with subscale scores, whereas age influenced the subscale scores differently in the three groups. Reliability analyses showed acceptable to excellent internal consistency and acceptable test-retest reliability of the instrument. There were significant differences between the OCD group and the TD group, supporting the criterion validity. Results on convergent validity were mixed.CONCLUSIONS: Overall, results supported the reliability and validity of the Danish OBQ-CV and thus the use of the questionnaire for future clinical and research purposes.

BACKGROUND: Knowledge on psychiatric emergencies in children and adolescents is limited. The Psychiatric Emergency Departments (PED) in Copenhagen enable the acute examination of children and adolescents 24 h a day, 7 days a week. However, very little is known about who presents to the PED, and the reason for their visit.AIM: To describe the prevalence and characteristics of presentations in PED and treatment provided.METHODS: A retrospective population based study comprising data of more than 4000 visitors presenting to PED from 2001-2010. In 2003 and 2006, two randomly chosen years, a more thorough analysis was performed, based on the individual emergency charts. Inter-rater reliability was high.RESULTS: Visits increased nearly threefold during the period. Symptom score for 2003 and 2006 revealed that more than one third of the visitors had suicidal ideation. Depressive and anxiety symptoms together with suicidal ideation rose significantly (P < 0.001). Psychoses and suicidal attempts remained unchanged. In one third of the visits, the discharge diagnosis was anxiety and stress-related disorders, followed by personality, behavioural and emotional disorders. Between 15% and 20% of the visits resulted in admission and more than 50% in referral for outpatient follow-up.CONCLUSIONS: The number of presenting psychiatric emergencies has increased over the last 10 years. Comparing symptoms from 2003 and 2006 showed a significant rise in their severity. This study highlights the need for 24-h access for acute evaluation by physicians skilled in child and adolescent psychiatry, and raises concern that the severity could increase.

The aim was to test this in a nationwide register study of diagnoses used in child and adolescents psychiatry in Denmark. A larger number of different diagnoses were expected to be applied after the introduction of the 10th version of the International Classification of Diseases (ICD-10). Reflecting the time trend, we particularly expected an increase in the number of neuropsychiatric diagnoses. From the Danish Psychiatric Central Register data were drawn on clinical discharge diagnoses. All patients aged 0-15 years examined at psychiatric hospitals from 1995-2002 were included; 22,469 children and adolescents with a first contact were registered. The most frequent discharge diagnoses were pervasive development disorders (PDD; 11.9%), adjustment disorders (10.6%), conduct disorder (9.5%), emotional and anxiety disorders (7.6%), hyperkinetic disorders (7.3%), and specific developmental disorders (7.3%). We found a significant increase in the number of neuropsychiatric and affective diagnoses and a significant decrease in the number of adjustment, conduct and anxiety diagnoses during the study period. Of the 22,469 diagnoses, 45% were only partly specified according to ICD-10. Thirty-four per cent had diagnoses unspecified on the four-character level (Fxx.9) and 11% had Z-diagnoses. A larger number of different diagnoses and an increase in the use of neuropsychiatric diagnoses were seen after the introduction of ICD-10. Many diagnoses were only partly specified; consequently, a more detailed specification of the ICD-10 is still required.

The objective of this study was to examine whether social risk factors adjusted for gender and some well-known perinatal risk factors were related to parental descriptions of deviant behaviour in 3(1/2)-year-old children. The study was a prospective cohort study of 1345 mothers enrolled during early pregnancy. Parents answered a questionnaire and children's behavioural difficulties were categorized into the following groups; "hyperactive-distractible", "hostile-aggressive" and "anxious-fearful" following a modified Behar scale. The male gender was found to be related to a description of all kinds of deviant behaviour. Having a family member experiencing employment difficulties was the factor most closely related to "hyperactive-distractible" behaviour. Familial stress due to lack of time, experience of divorce and mothers in excess of 35 years at childbirth were found to be related to "hostile-aggressive" behaviour, but male gender was the most closely related. Social disadvantage was not found to be related to "anxious-fearful" behaviour.

Obsessive-compulsive disorder is a far from rare neuropsychiatric disorder in children and adolescents which affects approximately 1-1.5% of the pediatric population. Obsessive-compulsive disorder is defined by the presence of obsessions and/or compulsions. It often takes a chronic course with either persistent, constantly distressing obsessive-compulsive symptoms or a waxing and waning course. The best documented and most efficient treatment is cognitive behavioural therapy and antidepressant medication with serotonin specific agents. In most cases, an improvement rate of 20-50% is reported following medication alone.

Genetic aspects of obsessive-compulsive disorder (OCD) are reviewed. The prevalence of OCD is higher than believed previously, probably affecting about 1-3% of the adult population, and the search for etiologic factors has increased. All family studies indicate that OCD in relatives of patients is much more common than the general risk for OCD in the population, and during the past decade some well-conducted family studies, using uniform diagnostic criteria, have been performed. There have been no good twin studies, specifically focusing on OCD. There is still a need for genetic research in the field of OCD and related disorders.

This study is retrospective and based on the charts of 146 patients (72 boys and 74 girls) admitted to a Danish adolescent psychiatric department in the period 1976 to 1986. Reasons for admission, previous treatment, and arrangements at discharge are presented. The commonest reason for admission was conduct disorder resulting in truancy (30% About 28% were referred with conditions of anxiety, phobias, and obsessions as major problems. No significant differences between boys and girls emerged, except for eating disorders, in which girls predominated. Almost half of the adolescents had consulted a school psychologist before referral to psychiatric hospital. More boys than girls had been in a day and night institution before referral. About 50% of the patients returned to their home at discharge. About 35% were referred to an institution, a youth pension, or professional family care. The reasons for admission to a psychiatric hospital and the need for further psychiatric treatment after discharge are discussed.

This case-report presents a 17-year-old girl who had had elective mutism since the age of 6 years and was treated successfully with citalopram. In addition to the elective mutism she also showed signs of comorbid symptoms such as obsessive-compulsive rituals, abnormal eating habits, and social phobia. The patient showed a limitation in social skills but appeared not to have a cognitive-based social dysfunction or any pervasive developmental disorder. Before medical treatment at the age of 17 years she had been treated with family therapy, individual psychotherapy, and behavioural therapy/milieu therapy during periods of in- and outpatient status. None of these treatment strategies had shown any significant improvement with regard to socializing or speaking in public. The girl was treated with citalopram, a highly specific selective serotonin reuptake inhibitor, with a maximum dosage of 40 mg/day, without reported side effects. After several weeks of medication her speech gradually increased, and she was able to engage more in social settings. The dosage was later reduced to 20 mg/day, with a subjective feeling of deterioration in her speech difficulties. She did not, however, experience any relapse of her elective mutism during the following year, on continued dosage of 20 mg. This case report suggests that citalopram may be safe and efficacious in the treatment of some cases of severe elective mutism, but controlled studies are still required.

In order to improve clinical diagnostic assessment and research in child and adolescent psychiatry disorders we need an ongoing refinement and development of diagnostic interviews and questionnaire...