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Introduction: Although youth‐friendly service characteristics have been previously identified, consensus among a representative group of stakeholders about which of these characteristics are truly relevant to the youth‐friendliness of services is currently lacking. In our study, young adults, parents and professionals were consulted on this topic to reveal existing (dis)agreement. In addition, (dis)agreement on feasibility for implementation in clinical practice was also assessed. Methods: A mixed‐method Delphi approach was used with three online questionnaire rounds and a physical meeting. Young adults (18–26 years) and parents were part of a public panel and professionals were allocated to the professional panel. In the rounds, participants were asked to rate the importance and feasibility of each item. Subsequently, the percentage agreement (% of participants giving a score of 7 or above on a 9‐point Likert scale) within and across panels was calculated. Consensus was assumed to have been reached when at least 70% agreement was achieved. A thematic analysis of the qualitative data, obtained in the rounds and the physical meeting, was performed to identify overarching themes and characteristics of relevance to the youth‐friendliness of services. Results: For 65% of the items included in the Delphi questionnaire, consensus on importance was reached within both panels. Participants showed more insecurity about the feasibility of these items, however. Our thematic analysis revealed reasons for disagreement between and within the panels. Conclusions: Our study revealed substantial between‐ and within‐panel agreement on youth‐friendly service characteristics. We recommend that the items for which consensus was reached should be used as a checklist in terms of youth mental health service development, design and delivery. The characteristics for which there was disagreement between and within the panels should inspire an ongoing trialogue between young adults, parents and professionals both on the individual level and the service level. Patient or Public Contribution: In this study, (parents of) young adults with lived experience were included as experts, including one of the coauthors. This coauthor contributed to the manuscript by having a final say about the included quotes. [ABSTRACT FROM AUTHOR]

ADHD is the most common neurodevelopmental disorder presenting to child and adolescent mental health, paediatric, and primary care services. Timely and effective interventions to address core ADHD symptoms and co-occurring problems are a high priority for healthcare and society more widely. While much research has reported on the benefits and adverse effects of different interventions for ADHD, these individual research reports and the reviews, meta-analyses and guidelines summarizing their findings are sometimes inconsistent and difficult to interpret. We have summarized the current evidence and identified several methodological issues and gaps in the current evidence that we believe are important for clinicians to consider when evaluating the evidence and making treatment decisions. These include understanding potential impact of bias such as inadequate blinding and selection bias on study outcomes; the relative lack of high-quality data comparing different treatments and assessing long-term effectiveness, adverse effects and safety for both pharmacological and non-pharmacological treatments; and the problems associated with observational studies, including those based on large national registries and comparing treatments with each other. We highlight key similarities across current international clinical guidelines and discuss the reasons for divergence where these occur. We discuss the integration of these different perspective into a framework for person/family-centered evidence-based practice approach to care that aims to achieve optimal outcomes that prioritize individual strengths and impairments, as well as the personal treatment targets of children and their families. Finally, we consider how access to care for this common and impairing disorder can be improved in different healthcare systems. [ABSTRACT FROM AUTHOR]

Quality of life (QoL) describes an individual’s subjective perception of their position in life as evidenced by their physical, psychological, and social functioning. QoL has become an increasingly important measure of outcome in child mental health clinical work and research. Here we provide a systematic review of QoL studies in children and young people with attention deficit hyperactivity disorder (ADHD) and address three main questions. (1) What is the impact of ADHD on QoL? (2) What are the relationships between ADHD symptoms, functional impairment and the mediators and moderators of QoL in ADHD? (3) Does the treatment of ADHD impact on QoL? Databases were systematically searched to identify research studies describing QoL in ADHD. Thirty six relevant articles were identified. Robust negative effects on QoL are reported by the parents of children with ADHD across a broad range of psycho-social, achievement and self evaluation domains. Children with ADHD rate their own QoL less negatively than their parents and do not always seeing themselves as functioning less well than healthy controls. ADHD has a comparable overall impact on QoL compared to other mental health conditions and severe physical disorders. Increased symptom level and impairment predicts poorer QoL. The presence of comorbid conditions or psychosocial stressors helps explain these effects. There is emerging evidence that QoL improves with effective treatment. In conclusion, ADHD seriously compromises QoL especially when seen from a parents’ perspective. QoL outcomes should be included as a matter of course in future treatment studies. [ABSTRACT FROM AUTHOR]

Presents information on a study which examined the effects of atomoxetine on non-North American patients with attention-deficit/hyperactivity disorder (ADHD). Improvements in the psychosocial and functional outcomes of patients with ADHD; Safety and tolerability of atomoxetine on ADHD patients; Symptoms of the disease.

Aim Methods Results Conclusions Although the incidence of mental health problems is highest in young people, the majority do not seek help. Reducing the discrepancy between need for care and access to services requires an understanding of the user perspective, which is largely lacking. This study aimed to examine preferences for mental health service attributes and their relative importance among young people, as well as the potential impact on actual help‐seeking intentions.Youth aged 16–24 years (N = 258) participated in a discrete choice experiment. In addition to choosing which service would suit their needs most out of two service options in nine choice sets, participants were asked whether they would consult the chosen service in the case of mental health problems. Demographic information was also collected, as well as their current mental health status, experience with and perceived barriers to care. Panel mixed logit models were estimated.Young people's preferences were mostly driven by the attribute ‘format’, with a preference for individual rather than group therapy. Other attributes, in order of importance, were ‘wait times’ (short), ‘cost’ (low), ‘healthcare professionals' expertise’ (particular experience with working with youth aged 12 to 25 years), and ‘location’ (house in a city). However, a majority of young people would not consult the service they had indicated, mainly due to attitudinal barriers such as wanting to deal with problems on their own (self‐reliance).Addressing psychological barriers to access care should be a priority in mental health policies. Furthermore, entry point services, in particular, should be able to provide the option of individual treatment. [ABSTRACT FROM AUTHOR]

Objectives: Task characteristics can alter motivation. Understanding how individuals respond to these characteristics is important in understanding how to adapt tasks to increase engagement of individuals with mental health problems. We describe the development of a self‐report questionnaire quantifying individual differences in task‐related motivation—The Child and Adolescent Motivational Profile (CHAMP). We explore the association with externalizing/internalizing problems. Methods: A 64‐item prototype scale was designed to measure how children and adolescents perceive the motivational significance of a range of task characteristics (n = 688; age range: 8–16 years). Parents completed the "Strengths and Difficulties Questionnaire" measuring externalizing and internalizing problems (Van Widenfelt, Goedhart, Treffers & Goodman, 2003). Results: Exploratory factor analysis identified eight distinct task characteristics that affected motivation: (a) requiring focus, (b) predictable, (c) marked/graded, (d) rewarded, (e) socially evaluated, (f) cognitively challenging, (g) competitive, and (h) collaborative. A 32‐item scale based on these factors was constructed. Internal consistency of each factor was high (Cronbach's alpha:.79–.91), and test–retest reliability was acceptable (SBC = .43–.65). Externalizing and internalizing problems were associated with a distinct motivational profile. Conclusion: These results highlight the multidimensional nature of children and adolescents' task‐related motivation for tasks and the differential links to internalizing and externalizing problems. [ABSTRACT FROM AUTHOR]

Background. The validity of clinical guidelines changes over time, because new evidencebased knowledge and experience develop. Objective. Hence, the European clinical guidelines on hyperkinetic disorder from 1998 had to be evaluated and modified. Method. Discussions at the European Network for Hyperkinetic Disorders (EUNETHYDIS) and iterative critique of each clinical analysis. Guided by evidence-based information and based on evaluation (rather than metaanalysis) of the scientific evidence a group of child psychiatrists and psychologists from several European countries updated the guidelines of 1998. When reliable information is lacking the group gives a clinical consensus when it could be found among themselves. Results. The group presents here a set of recommendations for the conceptualisation and management of hyperkinetic disorder and attention deficit/hyperactivity disorder (ADHD). Conclusion. A general scheme for practice in Europe could be provided, on behalf of the European Society for Child and Adolescent Psychiatry (ESCAP). [ABSTRACT FROM AUTHOR]