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Objective: U.S. and Canadian data demonstrate decreasing inpatient days, increasing nonurgent emergency department (ED) visits, and short supply of child psychiatrists. Our study aims to determine whether aftercare reduces ED visits and/or readmission in adolescents with first psychiatric hospitalization. Method: We conducted a population-based cohort analysis using linked health administrative databases with accrual from April 1, 2002, to March 1, 2004. The study cohort included all 15- to 19-year-old adolescents with first psychiatric admission. Adolescents with and without aftercare in the month post-discharge were matched on their propensity to receive aftercare. Our primary outcome was time to first psychiatric ED visit or readmission. Secondary outcomes were time to first psychiatric ED visit and readmission, separately. Results: We identified 4,472 adolescents with first-time psychiatric admission. Of these, 57% had aftercare in the month post-discharge. Propensity-score-based matching, which accounted for each individual's propensity for aftercare, produced a cohort of 3,004 adolescents. In matched analyses, relative to those with no aftercare in the month post-discharge, those with aftercare had increased likelihood of combined outcome (hazard ratio [HR] = 1.22, 95% confidence interval [CI] = 1.05-1.42), and readmission (HR = 1.38, 95% CI = 1.14-1.66), but not ED visits (HR = 1.14, 95% CI = 0.95-1.37). Conclusions: Our results are provocative: we found that aftercare in the month post-discharge increased the likelihood of readmission but not ED visit. Over and above confounding by severity and Canadian/U.S. systems differences, our results may indicate a relative lack of psychiatric services for youth. Our results point to the need for improved data capture of pediatric mental health service use. (Contains 6 tables and 1 figure.)

Objective: Long-term effects of psychostimulants on growth in height and in weight are investigated in children with attention-deficit/hyperactivity disorder. Method: Participants were 79 children, 6 to 12 years of age, with attention-deficit/hyperactivity disorder, who were followed annually for up to 5 years, between the years 1993 and 1994 and 1998 and 1999. Annual height and weight measurements were standardized by age and gender using the 2000 Centers for Disease Control and Prevention Growth Charts for the United States and reported as z scores. For children taking stimulants throughout the previous school year, dose potency was standardized to methylphenidate in milligrams per kilogram per day. We used hierarchical linear modeling to investigate the influence of dose and duration of stimulant treatment on the rate of growth in height and weight. Results: Controlling for time since initiation of treatment, daily dose of stimulant medication was negatively associated with z scores for height ([beta] = -0.11, SE = 0.03, p less than 0.01) and for weight ([beta] = -0.29, SE = 0.04, p less than 0.01). Estimates based on the statistical model suggest that children receiving greater than or equal to 1.5 mg/kg/day methylphenidate will show diminished weight gain after 1 year; those receiving greater than or equal to 2.5 mg/kg/day methylphenidate will show diminished gains in height after 4 years. Conclusion: Long-term use of high doses of stimulants during a period of 1 to 5 years is likely to have measurable effects on the rate of growth in school-age children with attention-deficit/hyperactivity disorder. (Contains 5 tables.)

The article presents a case study which researches how aftercare for children in the U.S. and Canada impacts emergency department (ED) visits and psychiatric hospitalization readmission by examining health administrative databases. Children in need of mental health services were assessed, and the results found that aftercare increases the possibility of readmission and continuity of care, but it did not increase the need for ED visits or emergency psychiatry.

Objective: Long-term effects of psychostimulants on growth in height and in weight are investigated in children with attention-deficit/hyperactivity disorder. Method: Participants were 79 children, 6 to 12 years of age, with attention-deficit/hyperactivity disorder, who were followed annually for up to 5 years, between the years 1993 and 1994 and 1998 and 1999. Annual height and weight measurements were standardized by age and gender using the 2000 Centers for Disease Control and Prevention Growth Charts for the United States and reported as z scores. For children taking stimulants throughout the previous school year, dose potency was standardized to methylphenidate in milligrams per kilogram per day. We used hierarchical linear modeling to investigate the influence of dose and duration of stimulant treatment on the rate of growth in height and weight. Results: Controlling for time since initiation of treatment, daily dose of stimulant medication was negatively associated with z scores for height (13 = -.11, SE = 0.03, p < .01 ) and for weight (β = -.29, SE = 0.04, p < .01). Estimates based on the statistical model suggest that children receiving ≥1.5 mg/kg/day methylphenidate will show diminished weight gain after 1 year; those receiving ≥2.5 mg/kg/day methylphenidate will show diminished gains in height after 4 years. Conclusion: Long-term use of high doses of stimulants during a period of 1 to 5 years is likely to have measurable effects on the rate of growth in school-age children with attention-deficit/hyperactivity disorder. [ABSTRACT FROM AUTHOR]

The objective was to assess the nature, rate, predictive factors, and neuroimaging correlates of novel (new-onset) depressive disorders, both definite and subclinical, after traumatic brain injury (TBI). Children with TBI from consecutive admissions were enrolled and studied with psychiatric interviews soon after injury (baseline), and again 6 months post-injury. Novel definite/subclinical depressive disorders at 6-month follow up occurred in 11% (n=15) of the children and subsets of children with non-anxious depression (n=9) and anxious depression (n=6) were identified. Novel definite/subclinical depressive disorder was significantly associated with older age at the time of injury, family history of anxiety disorder, left inferior frontal gyrus (IFG) lesions, and right frontal white matter lesions. Non-anxious depressions were associated with older age at injury, left IFG and left temporal pole lesions. Anxious depressions were associated with family history of anxiety disorder, Personality Change due to TBI, right frontal white matter lesions, and left parietal lesions. These findings, which are similar to those reported after adult TBI, identify both similarities and differences in non-anxious and anxious depression following childhood TBI with respect to lesion laterality, genetic factors (in the form of family psychiatric history of anxiety disorder), age at injury, and more generalized affective dysregulation., (Copyright © 2012 ISDN. Published by Elsevier Ltd. All rights reserved.)