Search

Quality of life (QoL) is significantly lower in children with mental health issues compared to those who are typically developing or have physical health problems. However, little research has examined factors associated with QoL in this particularly vulnerable population. To address this limitation, 347 clinically referred children and adolescents were assessed using the interRAI Child and Youth Mental Health (ChYMH) Assessment and Self-reported Quality of Life- Child and Youth Mental Health (QoL-ChYMH). Hierarchical multiple linear regression analyses were conducted to examine QoL at the domain-specific level. Children and adolescents who experienced heightened anhedonia and depressive symptoms reported lower social QoL (e.g., family, friends and activities; p = 0.024, 0.046, respectively). Additionally, children and youth who experienced heightened depressive symptoms reported lower QoL at the individual level (e.g., autonomy, health; p = 0.000), and level of basic needs (e.g., food, safety; p = 0.013). In contrast, no mental state indicators were associated with QoL related to services (e.g., school, treatment). Due to the paucity of research examining predictors of QoL in children and youth with mental health challenges, this study contributes to the field in assisting service providers with care planning and further providing implications for practice., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The Handling Editor JF declared a past co-authorship/collaboration with one of the authors SS., (Copyright © 2021 Celebre, Stewart, Theall and Lapshina.)

Suicide is the second leading cause of death in adolescents within Canada. While several risk factors have been found to be associated with increased risk, appropriate decision-support tools are needed to identify children who are at highest risk for suicide and self-harm. The aim of the present study was to develop and validate a methodology for identifying children at heightened risk for self-harm and suicide. Ontario data based on the interRAI Child and Youth Mental Health Screener (ChYMH-S) were analyzed to develop a decision-support algorithm to identify young persons at risk for suicide or self-harm. The algorithm was validated with additional data from 59 agencies and found to be a strong predictor of suicidal ideation and self-harm. The RiSsK algorithm provides a psychometrically sound decision-support tool that may be used to identify children and youth who exhibit signs and symptoms noted to increase the likelihood of suicide and self-harm.

Mental health concerns among children are pervasive, with one in five in North America experiencing a mental health issue. Unfortunately, only about a quarter will receive the support they need. interRAI is an organization of expert researchers and clinicians who develop integrated assessment systems to improve evaluation for vulnerable populations. The interRAI Child and Youth Mental Health Screener (ChYMH-S) is a brief screener that provides an initial assessment for early identification, triaging, and prioritization of services. This study assesses the psychometric properties of the ChYMH-S. Data from children aged 4-18 years across Ontario mental health agencies were obtained. The screener demonstrated strong inter-item reliability on all measured scales and good convergent validity with the Behaviour Assessment System for Children, with all hypothesized comparisons demonstrating positive, significant correlations. Overall, results provide initial support for the reliability and convergent validity of the ChYMH-S in detecting mental health concerns in child populations.

Background: Approximately 40-70% of justice-involved youth have untreated mental health problems. There is no current research that directly compares the mental health profiles of youth involved in the justice system to that of inpatients and outpatients. The research reported is significant because it directly compares the needs of these population by use of the same suite of standardized assessment tools., Methods: The sample consisted of 755 youth aged 16-19 years recruited from youth justice and mental health facilities in Ontario, Canada. Participants completed semi-structured assessment interviews using the interRAI child and youth suite of instruments to assess for internalizing and externalizing concerns as well as exposure to traumatic life events., Results: Findings indicated that justice-involved youth experienced higher levels of certain types of trauma. Analyses examining sex differences indicated that, controlling for age, males in the youth justice group reported higher cumulative trauma compared to male outpatients but not inpatients. Females in the youth justice group reported experiencing higher cumulative trauma compared to female outpatients and inpatients. In addition, controlling for sex and age, the youth justice group reported lower internalizing symptoms scores than inpatients and outpatients. Finally, males in the youth justice group scored lower than inpatients in externalizing symptoms, whereas females within the youth justice group scored higher in externalizing symptoms compared to inpatients and outpatients., Conclusions: Results indicated that youth who are involved with the justice system exhibit significant psychosocial issues that represent complex service needs which require unique interventions in order to be addressed appropriately.

Background: Some children with mental health (MH) problems have been found to receive ongoing care, either continuously or episodically. We sought to replicate patterns of MH service use over extended time periods, and test predictors of these patterns., Methods: Latent class analyses were applied to 4 years of visit data from five MH agencies and nearly 6000 children, 4- to 13-years-old at their first visit., Results: Five patterns of service use were identified, replicating previous findings. Overall, 14% of cases had two or more episodes of care and 23% were involved for more than 2 years. Most children (53%) were seen for just a few visits within a few months. Two patterns represented cases with two or more episodes of care spanning multiple years. In the two remaining patterns, children tended to have just one episode of care, but the number of sessions and length of involvement varied. Using discriminant function analyses, we were able to predict with just over 50% accuracy children's pattern of service use. Severe externalizing behaviors, high impairment, and high family burden predicted service use patterns with long durations of involvement and frequent visits., Conclusions: Optimal treatment approaches for children seen for repeated episodes of care or for care lasting multiple years need to be developed. Children with the highest level of need (severe pathology, impairment, and burden) are probably best served by providing high intensity services at the start of care.

Internalizing difficulties in children and adolescents refer to inner-directed disordered mood and emotions. The purpose of this study was to develop and assess the reliability and validity of the internalizing subscale on the interRAI Child and Youth Mental Health (ChYMH) in assessing broadband internalizing mental health symptoms. Data were collected from clinically-referred children/youths 4 to 18 years of age between 2015 and 2016 (N = 2536). After initial items relevant to internalizing disturbances underwent expert content validation, exploratory first-order and bifactor factor analyses and multidimensional item response theory (MIRT) parameterizations were conducted to test the validity of the measurement model. The internalizing subscale demonstrated strong measurement properties for a three-factor structure (i.e., depression, anxiety, anhedonia) and MIRT analyses showed individual items had acceptable discrimination parameters across the latent continuum. A series of four competing models using confirmatory factor analyses were conducted in a separate sample of 1397 children/youth assessed in 2017 and the bifactor model showed superior fit compared to other models. Finally, concurrent validity of this measure was confirmed based on relationships with other established subscales from criterion measures. The interRAI ChYMH internalizing subscale could be used to provide useful information for triaging and prioritizing referrals for children/youths., (Copyright © 2019 Elsevier B.V. All rights reserved.)

The present study aims to validate the interRAI Child and Youth Mental Health (interRAI ChYMH), Disruptive/Aggression Behaviour Scale (DABS) and Hyperactive/Distraction Scale (HDS). Data were collected from children/youth aged 4-18 (N = 3464) across 39 mental health agencies in Ontario, Canada. Unrestricted factor analysis using polychoric correlation matrices and Samejima's graded item response theory (IRT) parameterizations were conducted for both measures. Scores on the HDS and DABS were also compared amongst children/youth diagnosed with attention-deficit hyperactivity disorder (ADHD) and disruptive behaviour disorder (DBD) respectively using DSM-IV criteria. Results from the factor analysis and IRT analysis demonstrated good measurement properties. Using a receiver operating characteristics curve, the area under the curve (AUC) for the HDS and DABS is 0.79 and 0.75 for a diagnosis of ADHD and DBD respectively. Overall, converging results suggest that the interRAI HDS and DABS may serve as effective measures that detect externalizing mental health indicators.

Although bullying victimization has been linked to a number of behavioral and emotional problems among adolescents, few studies have investigate the mechanism through which bullying victimization affect non-suicidal self-injury. The objectives of this study were to examine the effect of bullying victimization on non-suicidal self-injury and the mediating effect of depressive symptoms on the relationship between bullying victimization and non-suicidal self-injury among adolescents. Data for this study came from the interRAI Child and Youth Mental Health dataset. A total of 1650 adolescents aged 12-18 years (M =14.56; SD =1.79; 54.2% males) were analyzed. Binary logistic and Poisson regression models were conducted to identify the mediating effect of depressive symptoms on the relationship between bullying victimization and non-suicidal self-injury. Of the 1650 adolescents studied, 611 representing 37% engaged in non-suicidal self-injury and 26.7% were victims of bullying. The effect of bullying victimization on non-suicidal self-injury was partially mediated by depressive symptoms after adjusting for the effect of demographic characteristics, history of childhood abuse, social support, and mental health diagnoses. The contribution of bullying victimization and depression to non-suicidal self-injury adds to the case for the development of trauma-focused interventions in reducing the risk of non-suicidal self-injury among adolescents., (Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.)

The objectives of this study were to examine the prevalence of, and determine the effect of adverse childhood experiences on non-suicidal self-injury among children and adolescents referred to community and inpatient mental health settings. Data for this study were obtained from the interRAI Child and Youth Mental Health dataset. A total of 2038 children and adolescents aged 8-18 years (M=12.49; SD=2.88, 61.1% males) were analyzed. Binary logistic regression was fitted to identify predictors of non-suicidal self-injury as a function of adverse childhood experiences, depression, and social support while simultaneously controlling for age, gender, type of patient, legal guardianship, marital status of parents/caregivers, history of foster family placement, and mental health diagnoses. Of the 2038 children and adolescents examined, 592 (29%) of this clinical sample engaged in non-suicidal self-injury. In the multivariate logistic regression model, children and adolescents who were physically abused had 49% higher odds of engaging in non-suicidal self-injury and children and adolescents who were sexually abused had 60% higher odds of engaging in non-suicidal self-injury, when compared to their non-abused counterparts. Other predictors of non-suicidal self-injury include: older age, female gender, inpatient status, depression, attention deficit-hyperactivity disorder, disruptive behavior disorder, and mood disorders. Children and adolescents who had some form of social support had a 26% decrease in the odds of engaging in non-suicidal self-injury. Assessment procedures for indicators of mental health, particularly among children and adolescents with a history of adverse childhood experiences, should also take into account non-suicidal self-injury. In addition to bolstering social support networks, addressing depression and related emotion regulation skills in childhood may help prevent future non-suicidal self-injury behaviors., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

The aim of this retrospective review was to determine the clinical value of simultaneous binaural bithermal caloric testing (SBT) versus alternate binaural bithermal caloric testing (ABB) in the setting of a tertiary care neurotology clinic. Charts of 131 adults who had presented with otologic complaints and had undergone both SBT and ABB examinations were included in the study. The main outcome measure was the identification of peripheral hypofunction. One hundred two patients had a normal ABB caloric examination; 86 of those 102 patients (84.3%) had normal ABB examinations but abnormal SBT results. We conclude that SBT is a more sensitive measure of peripheral pathology than the traditional ABB examination. If peripheral pathology is suspected but not confirmed by ABB, SBT appears useful for detecting mildly reduced vestibular response.

Criteria to define an episode of care in children's mental health services are needed. Various criteria were applied to 5 years of visit data from children 4-11 years (N = 5,206) at their first visit to 1 of 3 children's mental health agencies. A minimum of 3 visits with 180 days between episodes optimized agreement with other dates (e.g., telephone intake assessment) marking the start and end of an episode, and clinician-rated number of episodes. Grouping visits into episodes provides a clearer representation of how services are distributed over extended periods of time, facilitating research and enhancing accuracy in service planning.

We examine in Drosophila a group of ∼35 ionotropic receptors (IRs), the IR20a clade, about which remarkably little is known. Of 28 genes analyzed, GAL4 drivers representing 11 showed expression in the larva. Eight drivers labeled neurons of the pharynx, a taste organ, and three labeled neurons of the body wall that may be chemosensory. Expression was not observed in neurons of one taste organ, the terminal organ, although these neurons express many drivers of the Gr (Gustatory receptor) family. For most drivers of the IR20a clade, we observed expression in a single pair of cells in the animal, with limited coexpression, and only a fraction of pharyngeal neurons are labeled. The organization of IR20a clade expression thus appears different from the organization of the Gr family or the Odor receptor (Or) family in the larva. A remarkable feature of the larval pharynx is that some of its organs are incorporated into the adult pharynx, and several drivers of this clade are expressed in the pharynx of both larvae and adults. Different IR drivers show different developmental dynamics across the larval stages, either increasing or decreasing. Among neurons expressing drivers in the pharynx, two projection patterns can be distinguished in the CNS. Neurons exhibiting these two kinds of projection patterns may activate different circuits, possibly signaling the presence of cues with different valence. Taken together, the simplest interpretation of our results is that the IR20a clade encodes a class of larval taste receptors.

Background: The purpose of this study was to examine demographic, background, and psychopathology variables that predict length of stay and readmission among youth with mental health needs., Method: We analyzed data on 2445 youth who were admitted into adult psychiatric beds in Ontario, Canada. Multiple regression was used to examine length of stay, whereas logistic regression was used to examine the predictors of readmission., Results: Youth were likely to stay longer in hospital if they were older, were boys, had a diagnosis of schizophrenia, mood disorders, eating disorders, personality disorders, and intellectual disability. Education, discharged against medical advice, and a diagnosis of adjustment disorders were all associated with shorter length of stay. Age, living in a group home or assisted care, a diagnosis of schizophrenia, mood disorders, and intellectual disability predicted readmission., Conclusion: Strategies to improve current psychiatric services (e.g. how to reduce psychiatric hospital readmissions) are discussed., (© 2013 The Authors. Child and Adolescent Mental Health. © 2013 Association for Child and Adolescent Mental Health.)

Objective: To develop side effect (SE) monitoring checklists for four categories of psychotropic medications (antipsychotics, mood stabilizers, stimulants, and selective serotonin-reuptake inhibitors), to improve residential direct care staff's confidence and competence in SE monitoring, and to facilitate communication of potential observed SE to medical personnel (e.g., nurse, physician)., Methods: Seventy-two staff members (three nurses, 69 child/youth workers) from five residential units at a tertiary mental health centre utilized the Psychotropic Medication Monitoring Checklists (PMMC) for eight weeks and completed pre- and post-test measures of staff characteristics and PMMC satisfaction., Results: The use of PMMC led to significant changes in direct care staff's awareness and beliefs associated with medication monitoring. An increase in staff-physician communication with direct care staff was marginally significant. Further investigation into the educational qualities of the PMMC revealed that staff with very little prior formal medication education showed greater change compared to those staff reporting greater formal medication instruction. Staff ratings of the PMMC exceeded mild levels of satisfaction, indicating that the checklists were a well-received and useful tool for monitoring SE in a residential care setting., Conclusions: The PMMC are useful as an educational SE monitoring tool for direct care staff in child residential care settings, with potential utility for multiple types of healthcare settings.