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Adolescents seeking gender-affirming medical care (GAMC) face numerous barriers that may delay or inhibit their access to these services. Such obstacles include mental health professional (MHP) assessment requirements prior to initiating GAMC.MHP letters ultimately carry little benefit for patients. Their formulaic nature discourages nuance, reduces likelihood of capturing gender embodiment goals (beyond a narrow definition of gender dysphoria), and may cause clinicians to overlook presenting mental health concerns. MHP assessment requirements also reinforce the conception of gender dysphoria as a mental health disorder. Moreover, studies have not shown that requiring MHP assessment letters effectively reduces regret among patients. Fortunately, primary clinicians who provide GAMC are most often capable of assessing patients without additional input from an MHP. In this article, we provide an ethical framework for clinicians that prioritizes patient autonomy through an informed assent approach. We discuss Appelbaum's criteria and its application, and contexts in which MHP consultation is appropriate. We also address common questions about informed assent among clinicians, patients, and families. Finally, we advocate for bolstering multidisciplinary support teams involved in GAMC to facilitate the informed assent process. This approach upholds patient autonomy, expands access to GAMC, and utilizes the mental health workforce more effectively. [ABSTRACT FROM AUTHOR]

This study investigates the impact of the Neurosequential Model of Therapeutics (NMT) in child and adolescent psychiatric care, addressing a gap in current clinical methodologies that tend to focus on single problems rather than the interconnected nature of many real-life mental health issues. The study was conducted in a residential setting over an extended period, including children aged 7–13, to observe the effects of implementing NMT. The children presented with complex symptoms and multiple diagnoses. The methods incorporated the NMT approach, emphasizing individualized treatment plans based on each child's unique brain development, and aimed at addressing multiple, interconnected problems simultaneously. Results from multilevel model analyses of behavioral difficulties, measured using the Child Behavior Checklist (CBCL), revealed substantial improvements in treatment effectiveness post-NMT implementation. Despite the limitations, such as a non-randomized participant selection and limited sample size, the findings strongly suggest that NMT enhances care effectiveness in real-world clinical settings, particularly for children with complex mental health issues. The study concludes that relationally oriented milieu therapy, and specifically the NMT approach, holds great promise for advancing pediatric psychiatric care, advocating for its broader application and further research to refine and substantiate its efficacy. [ABSTRACT FROM AUTHOR]

Objective: Qualitative research methods are based on the analysis of words rather than numbers; they encourage self-reflection on the investigator's part; they are attuned to social interaction and nuance; and they incorporate their subjects' thoughts and feelings as primary sources. Despite appearing well suited for research in child and adolescent psychiatry (CAP), qualitative methods have had relatively minor uptake in the discipline. We conducted a qualitative study of CAPs involved in qualitative research to learn about these investigators' lived experiences, and to identify modifiable factors to promote qualitative methods within the field of youth mental health. Methods: We conducted individual, semi-structured 1-h long interviews through Zoom. Using purposive sample, we selected 23 participants drawn from the US (n = 12) and from France (n = 11), and equally divided in each country across seniority level. All participants were current or aspiring CAPs and had published at least one peer-reviewed qualitative article. Ten participants were women (44%). We recorded all interviews digitally and transcribed them for analysis. We coded the transcripts according to the principles of thematic analysis and approached data analysis, interpretation, and conceptualization informed by an interpersonal phenomenological analysis (IPA) framework. Results: Through iterative thematic analysis we developed a conceptual model consisting of three domains: (1) Becoming a qualitativist: embracing a different way of knowing (in turn divided into the three themes of priming factors/personal fit; discovering qualitative research; and transitioning in); (2) Being a qualitativist: immersing oneself in a different kind of research (in turn divided into quality: doing qualitative research well; and community: mentors, mentees, and teams); and (3) Nurturing: toward a higher quality future in CAP (in turn divided into current state of qualitative methods in CAP; and advocating for qualitative methods in CAP). For each domain, we go on to propose specific strategies to enhance entry into qualitative careers and research in CAP: (1) Becoming: personalizing the investigator's research focus; balancing inward and outward views; and leveraging practical advantages; (2) Being: seeking epistemological flexibility; moving beyond bibliometrics; and the potential and risks of mixing methods; and (3) Nurturing: invigorating a quality pipeline; and building communities. Conclusions: We have identified factors that can support or impede entry into qualitative research among CAPs. Based on these modifiable findings, we propose possible solutions to enhance entry into qualitative methods in CAP (pathways), and to foster longer-term commitment to this type of research (identity). [ABSTRACT FROM AUTHOR]

Background: Research shows that only around half of all survivors of child sexual abuse (CSA) disclose the abuse during childhood and adolescence. This is worrying, as CSA is related to substantial suffering later in life. The proportion of children and adolescents who have been exposed to CSA is significantly higher in Child and Adolescent Psychiatry (CAP) than in the general population. Healthcare professionals report that uncovering CSA is a complex and challenging task. However, we know little about how they proceed when uncovering CSA. More knowledge of healthcare personnel's experience is therefore necessary to facilitate and increase CSA disclosure. The study aims to explore how CAP healthcare professionals in Norway proceed when assessing and detecting CSA, how they experience this work, and what hinders or facilitates their efforts. Methods: The study employed a mixed method approach. Data was collected through an anonymous online survey, generating both quantitative and qualitative data. The sample consisted of 111 healthcare professionals in CAP, of whom 84% were women, with a mean age of 40.7 years (range 24–72; sd = 10.8). Mean years of CAP clinical experience were 8.3 years (range 0–41; sd = 7.5). The quantitative data was analysed using descriptive statistics, correlations, and independent sample t-tests, while the qualitative data was analysed using a team-based qualitative content analysis. Results: The results showed that detection of CSA was viewed as an important, but complex task in CAP, and the existing procedures were deemed to be insufficient. The therapists mostly felt confident about how to proceed when they suspected or detected CSA, yet they seldom detected CSA. In their initial assessment they applied standardised procedures, but if their suspicion of possible CSA persisted, they seemed to rely more on clinical judgement. Specific challenges and facilitators for CSA detection were identified, both in the individual and in the organisation. Conclusions: The study highlights the challenges and complexities healthcare professionals and the CAP system face when assessing CSA, which may account for the low detection rate. The results show that healthcare professionals believe room for clinical autonomy and targeted competence development may improve CSA detection. Additionally, the findings suggest a need for CAP to define roles and responsibilities within and between agencies. [ABSTRACT FROM AUTHOR]

Background: Deliberate self-harm (DSH) and emotion dysregulation (ED) peaks in adolescence, and is associated with an increased risk of psychopathology, suicide and lower functioning in adulthood. DBT-A has been established as an effective treatment for reducing DSH, however less is known about changes in emotion dysregulation. This study aimed to identify baseline predictors of treatment response in outcome trajectories of DSH and emotion dysregulation. Methods: Response trajectories of DSH and ED were investigated using Latent Class Analysis on RCT data comparing DBT-A and EUC for 77 adolescents treated for deliberate self-harm and borderline traits. Logistic regression analysis was used to examine baseline predictors. Results: Two-class solutions were selected for both indicators, distinguishing between early and late responders in DSH, and responders and non-responders in ED. Higher levels of depression, shorter DSH histories and not receiving DBT-A predicted less favourable response in DSH, while DBT-A was the only predictor of treatment response in ED. Conclusions: DBT-A was associated with a significantly faster reduction of deliberate self-harm in the short-term and improved emotion regulation in the long-term. [ABSTRACT FROM AUTHOR]

Historically providing specialized advocacy training to Child and Adolescent Psychiatrists (CAP) beyond traditional medical education has been ambiguous at best. This is alarming particularly in light of the National Emergency in Child and Adolescent Mental Health and the increasing concern about health inequities resulting from social determinants of health (SDH). While Graduate Medical Education (GME) programs are adopting advocacy curricula, the authors argue that the shortage of trained CAPs and the growing need for advocacy makes it essential to focus on advocacy training that targets patients, organizations, or entire populations. The authors performed a systematic literature review across all medical specialties, highlighting the inadequacy of current advocacy training for CAPs, particularly in comparison to pediatrics, and the Accreditation Council of Graduate Medical Education (ACGME) requirements. The article suggests that advocacy training should be more emphasized in CAP training to address health inequities and promote better outcomes for children and adolescents. The training focused on medical-legal partnerships (MLP) is particularly crucial in addressing the social causes of health disparities and addressing unmet needs such as food, housing, and income that drive disparities, especially amongst vulnerable populations. The article concludes that providing an informed and evidence-based representation of current practices and methodologies used to train residents around advocacy is essential to ensure that CAPs are prepared to advocate for their patients and address health disparities resulting from SDH. Given the growing demand for mental health services and the unprecedented need for advocacy, specialized training for CAPs can no longer be ignored. [ABSTRACT FROM AUTHOR]

Objective: Body dysmorphic disorder (BDD) is defined as a highly disturbing condition characterized by the patient developing an excessive anxiety and repetitive behaviors. The prevalence of BDD in the orthodontic patients is still not well known. The aim of this study was to evaluate reliability and validity study of the Turkish version of the Yale-Brown Obsessive-Compulsive Scale modified for Body Dysmorphic Disorder (TR-YBOCS-BDD) for adolescents. Methods: This study consisted of two groups, the study group and the control group. The study group consisted of 126 patients who were admitted with aesthetic complaints (n=126). The control group consisted of 126 participants who were admitted with non-aesthetic complaints such as dental calculus, caries and pain. Turkish versions of YBOCS-BDD and Body Image Disturbance Questionnaire (T-BIDQ) were administered to 252 patients in total for reliability and validity studies. Results: The internal consistency coefficient of the TR-YBOCSBDD scale was 0.903. The scores of the subareas of the TRYBOCS- BDD scale were analyzed with Principal Components Factor Analysis and it was concluded that 8 factors corresponded to 62.104% of the total variance. The test re-test analysis was carried out by applying the TR-YBOCS-BDD scale to 126 participants and same test re-test was made at one-week interval. High positive correlation was found between the first total scale results and the total score calculated one week later (rho =0.986, p

Researchers are increasingly acknowledging that psychopathological conditions usually grouped together under the generic label "depression" are highly diverse. However, no differential therapeutic approach currently exists that is sensitive to the varieties of depression afflicting young people. In fact, the discussion is missing something much more fundamental: a specification of the types of adolescent depression. Recent research that has aimed to classify different kinds of depression has mainly studied adult populations and predominantly used technically complicated measurements of biological markers. The neglect of the potential particularities of dysphoric disorders affecting youths is unfortunate, and the exclusive focus on biological parameters unnecessarily restrictive. Moreover, this one-sidedness obfuscates more directly available sources of clinically relevant data that could orient conceptualization efforts in child and adolescent psychiatry. Particularly, clues for discriminating different types of adolescent depression may be obtained by analyzing personally articulated accounts of how affected young people experience changes in their relation to the world and to themselves. Thus, here we present and discuss the findings of a study that explored the possibility of specifying types of adolescent depression in a phenomenological way. The study investigated the association between these types and the vicissitudes of personality development. In accounts given by youths diagnosed with depression during semi-structured interviews, we identified themes and examined their phenomenological centrality. Specifically, our qualitative analyses aimed to determine the relative importance of certain themes with respect to the overall intelligibility of the described changes to the relational space. Based on the findings of these analyses, we differentiate three specifiers of adolescent depression and suggest an association between particular types of experiences and the trajectory of affected adolescents' personality development. To our knowledge, this is the first phenomenologically grounded specification of types of adolescent depression with potential therapeutic significance. Thus, based on this contribution, we propose that modes of scientific exploration that are close to phenomenological philosophy--which have been ignored in the context of developmental psychopathology--could offer a foundation to theories developed in the field of child and adolescent psychiatry. [ABSTRACT FROM AUTHOR]

Objective: To draw implications for training of therapist responsiveness from a sequential mixed-methods study on challenging clinical situations. Method: Study 1: online survey mapping frequency and perceived difficulty of 15 clinical situations in a representative sample of psychologists. Study 2: online survey mapping frequency and perceived difficulty of 19 clinical situations among therapists in child and adolescent psychiatry. Study 3: focus group study exploring the situations identified through study 1 and 2. Results: Study 1 and 2 showed that ratings of each situation varied between individuals and context. Study 3 showed that the degree to which a situation was challenging was described as depending on the characteristics of the therapist and the context. Experientially, challenging situations were characterized by lacking access to necessary information, falling short, and disturbing arousal. Perceiving therapeutic opportunities despite the challenging nature of the situation, collegial support, self-knowledge, and engagement were important resources. Conclusion: Six implications of the results from the three studies for training of responsiveness are discussed: (1) building self-awareness and conceptualization skills; (2) personalizing training; (3) transforming disturbing arousal into engagement; (4) being exposed to a broad range of clinical situations; (5) training on commonly encountered situations; and (6) building tolerance for uncertainty and capacity to seek support. [ABSTRACT FROM AUTHOR]

Comment le pédopsychiatre, qui accompagne des enfants ou adolescents sujets à des psychotraumatismes complexes, est-il amené à penser la dimension clinique mais aussi socio-politique de sa pratique ? Nous discutons ici certains des questionnements qui peuvent être ceux du clinicien dans le domaine de la psychotraumatologie, jusqu'à se réinterroger sur les principes actifs fondamentaux de l'intervention soignante, et en particulier en matière de santé mentale. What do child psychiatrists who work with children or adolescents suffering from complex psychotraumatic disorders think about the clinical and socio-political dimensions of their practice? In this article, we discuss some of the questions that clinicians in the field of psychotraumatology may ask themselves, to the point of re-examining the fundamental active principles of healthcare intervention, particularly in the field of mental health. [ABSTRACT FROM AUTHOR]

Objective: To provide an overview of Joe Biederman's contributions to child and adolescent psychiatry. Method: Nine colleagues described his contributions to: psychopharmacology, comorbidity and genetics, pediatric bipolar disorder, autism spectrum disorders, Tourette's and tic disorders, clinical and neuro biomarkers for pediatric mood disorders, executive functioning, and adult ADHD. Results: Joe Biederman left us with many concrete indicators of his contributions to child and adolescent psychiatry. He set up the world's first pediatric psychopharmacology clinic and clinical research program in child adolescent psychiatry. As a young faculty member he began a research program that led to many awards and eventual promotion to full professor at Harvard Medical School. He was for many years the most highly cited researcher in ADHD. He achieved this while maintaining a full clinical load and was widely respected for his clinical acumen. Conclusion: The world is a better place because Joe Biederman was here. [ABSTRACT FROM AUTHOR]

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Background: The current literature lacks scientific research on child and adolescent psychiatrists' (CAPPS) perspectives on dental and oral health. This study aims to investigate the opinions and approaches of child and adolescent psychiatrists and their patients regarding oral and dental health. Methods: A questionnaire-based cross-sectional study was conducted among members of the Professional Association for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy in Germany. Results: Out of the association members, 10.9% (n = 109) participated, with 5.2% (n = 52; 38f/14m) completing the questionnaire. Dental and oral health topics were discussed with one-fifth of the patients (19.2%), while 11.5% reported that they were "never" a part of their therapy. Patient-related concerns about dental and oral health were primarily brought into the context of child and adolescent psychiatric work. Dental treatment anxieties were prominent. Only 3.8% of the participants regularly assigned diagnoses related to dental status. The CAPPS employ a bio-psycho-social model for the genesis of oral health-related conditions in Children and Adolescents with Special Needs. Conclusions: CAPPS have a foundation in relationship-based work for assessing oral and dental healthcare and providing recommendations for further dental care. Regional networking and science must be further developed. [ABSTRACT FROM AUTHOR]

Objective: Evidence for pharmacogenomic (PGx) guided treatment in child and adolescent psychiatry is growing. This study evaluated the impact of PGx testing on psychotropic medication prescribing in an ambulatory child and adolescent psychiatry and a developmental pediatrics clinic. Methods: This was a single-center, retrospective, descriptive analysis of patients who underwent PGx testing between January 2015 and October 2022 at a child and adolescent psychiatry clinic or developmental pediatrics clinic. The primary outcome was the proportion of patients with at least one psychotropic medication modification made 6-month posttesting that could be attributed to CYP2C19, CYP2D6, HLA-B*15:02, or HLA-A*31:01. Secondary outcomes included reason for testing, types of therapeutic modifications made, and whether the therapeutic modifications concorded with PGx guidelines. Results: A total of 193 patients were analyzed. The average age was 10 ± 4 years old, 60% were male, 78% were Caucasian. Sixty-eight percent had a primary diagnosis of a neurodevelopmental disorder, namely autism spectrum disorder (51%), and attention-deficit/hyperactivity disorder (14%). The reasons for PGx testing included medication inefficacy (34%), medication intolerance (20%), and family request (19%). At the time of PGx testing, 37% of patients were taking ≥1 psychotropic medication with PGx annotation. Overall, 35 PGx-related therapeutic modifications were made in 32 (17%) patients. These included continuing current PGx medication (6.2%) and starting PGx medication (5.2%). These modifications mainly involved antidepressants. Out of these 35 PGx-related therapeutic modifications, 94% were concordant with PGx guidelines. Among 29 patients who were prescribed at least one CYP2D6 inhibitor, 25 (86%) underwent CYP2D6 phenoconversion. Conclusions: It is critical to apply pediatric age-specific considerations when utilizing PGx testing in child and adolescent psychiatry. PGx testing stewardship could provide a framework to guide the clinical utility of PGx in a pediatric population with mental health conditions, including neurodevelopmental disorders. [ABSTRACT FROM AUTHOR]

The efficacy and tolerability of psychotropic medications can vary significantly among children and adolescents, and some of this variability relates to pharmacogenetic factors. Pharmacogenetics (PGx) in child and adolescent psychiatry can potentially improve treatment outcomes and minimize adverse drug reactions. This article reviews key pharmacokinetic and pharmacodynamic genes and principles of pharmacogenetic testing and discusses the evidence base for clinical decision-making concerning PGx testing. This article reviews current guidelines from the United States Food and Drug Administration (FDA), the Clinical Pharmacogenetics Implementation Consortium (CPIC), and the Dutch Pharmacogenetics Working Group (DPWG) and explores potential future directions. This review discusses key clinical considerations for clinicians prescribing psychotropic medications in children and adolescents, focusing on antidepressants, antipsychotics, stimulants, norepinephrine reuptake inhibitors, and alpha-2 agonists. Finally, this review synthesizes the practical use of pharmacogenetic testing and clinical decision support systems. [ABSTRACT FROM AUTHOR]

Background: Adjustment disorder (AD) in individuals suffering from end‐stage organ failure can negatively impact treatment adherence and overall quality of life. Previous research focusing on adults has suggested that AD might serve as a precursor to major mental disorders. However, although it is frequently used as a diagnosis in consultation‐liaison psychiatry, our understanding of AD in pediatric transplant candidates remains limited. Therefore, the objective of this study is to assess AD and identify its associated risk factors among children who are candidates for heart, kidney, and liver transplantation. Methods: Data were collected retrospectively from a cohort of 155 children, aged between 6 months and 18 years (mean age 9.4), who had undergone consultations for child and adolescent psychiatry at a hospital with a transplant center within the past 10 years. Results: The predominant diagnosis among children assessed during the pre‐transplant period was AD (20%), with the subtype "with depressed mood" being the most commonly observed (35.5%). Organ type and length of hospital stay were identified as significant independent predictors of AD. Being a heart transplant candidate was determined as the strongest predictor of AD among children who underwent consultations with child and adolescent psychiatry within the population of transplant candidates. Conclusions: The study found that AD was the most common diagnosis among transplant candidates who underwent psychiatric consultations. Additionally, the study identified the length of hospital stay and the type of organ needed as independent predictors of AD. Screening for AD by considering risk factors may provide an opportunity for early intervention before the occurrence of major mental disorders in transplant candidates. [ABSTRACT FROM AUTHOR]

In the context of ongoing workforce shortages, rising symptom severity, and increased rates of psychotropic prescribing, the 2021 declaration of a national emergency in child and adolescent psychiatry (CAP) has highlighted the need for innovative strategies to address access to quality care. As valued members of the interdisciplinary team, Board‐Certified Psychiatric Pharmacists (BCPPs) in CAP are well‐positioned to address these needs as they are integrated across various settings (e.g., ambulatory clinics, and psychiatric hospitals) and have expertise in psychiatric and neurodevelopmental disorders. As educators and advocates for evidence‐based psychotropic medication management, BCPPs in CAP decrease polypharmacy, increase medication adherence and knowledge, and enhance patient outcomes. Given the need for interdisciplinary collaboration among BCPPs, CAP, and primary care providers, it is crucial for pharmacy administrators to respond and recognize the necessity of integrating pharmacy services into CAP and integrating BCPPs into pharmacy departments. [ABSTRACT FROM AUTHOR]

In 2019, the University of California at San Francisco (UCSF) launched the Child and Adolescent Psychiatry Portal (CAPP), a pediatric mental health care access (PMHCA) program providing remote mental health consultation services to pediatric primary care providers (PCPs) throughout Northern and Central California. The development and implementation of CAPP was guided by Human-Centered Design (HCD), an iterative, rapid-paced innovation process focusing on stakeholders' needs and experiences, which shaped the development of CAPP's programs. The resulting key programmatic elements are designed for pediatric workforce development: (1) PCP consultation with a child and adolescent psychiatrist via a telephone warmline; and (2) training and education for providers. CAPP has grown rapidly since its launch, having enrolled 1,714 providers from 257 practices spread across 36 counties and provided 3,288 consults on 2,703 unique lives as of August 2023. Preliminary evaluation findings indicate high PCP satisfaction with CAPP's services, despite continued challenges of integrating behavioral health into primary care. Throughout the HCD and implementation process, multidisciplinary partnerships have proven critical in providing end-user input to inform and improve program design. This growing network of partnerships, developed through the cultivation of personal relationships and trust over time, has also proven essential for CAPP's rapid growth and sustainability. Overall, this Community Case Study highlights the critical role of partnerships and the importance of taking a people-centered approach, as captured in CAPP's motto, "Connecting for Care. [ABSTRACT FROM AUTHOR]

Background: Death by suicide is one of the leading causes of death among adolescents. Genome-wide association studies (GWAS) have identified loci that associate with suicidal ideation and related behaviours. One such group of loci are the six contactin genes (CNTN1-6) that are critical to neurodevelopment through regulating neurite structure. Because single nucleotide polymorphisms (SNPs) detected by GWAS often map to non-coding intergenic regions, we investigated whether repetitive variants in CNTNs associated with suicidality in a young cohort aged 8 to 21. Understanding the genetic liability of suicidal thought and behavior in this age group will promote early intervention and treatment. Methods: Genotypic and phenotypic data were obtained from the Philadelphia Neurodevelopment Cohort (PNC). Across six CNTNs, 232 short tandem repeats (STRs) were analyzed in up to 4,595 individuals of European ancestry who expressed current, previous, or no suicidal ideation. STRs were imputed into SNP arrays using a phased SNP-STR haplotype reference panel from the 1000 Genomes Project. We tested several additive and interactive models of locuslevel burden (i.e., sum of STR alleles) with respect to suicidal ideation. Additive models included sex, birth year, developmental stage ("DevStage"), and the first 10 principal components of ancestry as covariates; interactive models assessed the effect of STR-by-DevStage considering all other covariates. Results: CNTN1-[T]N interacted with DevStage to increase risk for current suicidal ideation (CNTN1-[T]N-by-DevStage; p = 0.00035). Compared to the youngest age group, the middle (OR = 1.80, p = 0.0514) and oldest (OR = 3.82, p = 0.0002) participant groups had significantly higher odds of suicidal ideation as their STR length expanded; this result was independent of polygenic scores for suicidal ideation. Discussion: These findings highlight diversity in the genetic effects (i.e., SNP and STR) acting on suicidal thoughts and behavior and advance our understanding of suicidal ideation across childhood and adolescence. [ABSTRACT FROM AUTHOR]

Objective: Body dysmorphic disorder (BDD) is defined as a highly disturbing condition characterized by the patient developing an excessive anxiety and repetitive behaviors. The prevalence of BDD in the orthodontic patients is still not well known. The aim of this study was to evaluate reliability and validity study of the Turkish version of the Yale-Brown Obsessive-Compulsive Scale modified for Body Dysmorphic Disorder (TR-YBOCS-BDD) for adolescents. Methods: This study consisted of two groups, the study group and the control group. The study group consisted of 126 patients who were admitted with aesthetic complaints (n=126). The control group consisted of 126 participants who were admitted with non-aesthetic complaints such as dental calculus, caries and pain. Turkish versions of YBOCS-BDD and Body Image Disturbance Questionnaire (T-BIDQ) were administered to 252 patients in total for reliability and validity studies. Results: The internal consistency coefficient of the TR-YBOCSBDD scale was 0.903. The scores of the subareas of the TRYBOCS-BDD scale were analyzed with Principal Components Factor Analysis and it was concluded that 8 factors corresponded to 62.104% of the total variance. The test re-test analysis was carried out by applying the TR-YBOCS-BDD scale to 126 participants and same test re-test was made at one-week interval. High positive correlation was found between the first total scale results and the total score calculated one week later (rho =0.986, p<0.001). Conclusion: The Turkish translation of the BDD-YBOCS has content and construct validity and is also reliable method. The clinicians can apply this test to adolescents in the Turkish-speaking countries. [ABSTRACT FROM AUTHOR]

This study examines parents' experiences of support, investigation and treatment from child healthcare/psychiatry and habilitation in children with ESSENCE symptoms (neurodevelopmental symptoms). Data were collected through focus interviews, with 13 parents. A conventional qualitative analysis revealed four main categories: confidence, information, competence and collaboration, affecting parents. While waiting for an investigation parents experience anxiety, frustration, lack of information and confidence and doubts about their parenting ability, which also affects the child. The categories were interpreted using Bronfenbrenner's bioecological model to illustrate the effects on the family's interaction with the context. Parents demand a greater insight and participation in the ongoing process and improved collaboration between the various professionals Trial registration: Retrospectively registered clinical Trials 2021, PLUSS identifier, NCT04815889. [ABSTRACT FROM AUTHOR]

Changes in parental roles have renewed the focus on a father's involvement in an offspring's psychological development. However, fathers are still under-represented in family research. There are only a few structured father-centered intervention programs in child and adolescent psychiatry. In a German population sample, a pilot father-centered family intervention program with n = 16 participants, conducted in person (n = 8) and online (n = 8), in a child and adolescent psychiatry inpatient/day clinic setting was evaluated by comparing paternal stress, PSE, and child-rated paternal competence in a pre–post design. Participating fathers showed significant decreases in child-related parenting stress (presence: p = 0.042, online: p = 0.047) and significant increases in PSE (p = 0.006/0.012). Parent-related stress and child-rated paternal competence were unaffected (p = 0.108/0.171; p = 0.167/0.101), while small-to-medium effect size measures pointed in the direction of our hypothesis (d = 0.48/0.36; d = 0.37/0.50). Participant satisfaction was higher in person than online (p = 0.008). As social and biological fathers have important influences on child and adolescent well-being and development, they should be included more frequently in prevention and intervention programs. Fathers seem to benefit from gender-specific intervention programs with regard to stress reduction, as well as experiencing competence- and PSE-increasing effects. [ABSTRACT FROM AUTHOR]

Emergency inpatient admissions of children and adolescents are more difficult if the patient is admitted involuntarily and/or the caregivers or custodians of institutional care are absent. The present study aimed to clinically characterize involuntary versus voluntary admissions by examining the reasons for presentation and associated factors. We retrospectively analyzed patients who presented to the emergency department of a hospital for child and adolescent psychiatry in Bavaria, Germany, and were admitted as inpatients for crisis intervention in the 4th quarter of 2014–2018. Reasons for presentation, clinical and sociodemographic characteristics, and type of admission (voluntary versus involuntary) were analyzed for 431 emergency inpatient admissions. A total of 106 (24.6%) patients were involuntarily admitted. In a binominal logistic regression, presentation due to alcohol consumption, deviant social behavior, and psychosocial burden was positively associated, whereas difficulties at school and depression were negatively associated, with the likelihood of involuntary admission. 58.5% of the 123 unaccompanied patients were admitted involuntarily. Reasons for the presentation of unaccompanied and voluntary inpatient admissions were suicidal thoughts, psychosocial burden, and externalized aggression. A substantial number of child and adolescent psychiatric admissions represent emergency admissions. Involuntarily admitted patients and unaccompanied children/adolescents represent a non-negligible proportion of clinical routine and the clinical and legal background factors need to be further clarified in future studies. This study is registered in the German Clinical Trials Register (24 September 2019, DRKS00017689). [ABSTRACT FROM AUTHOR]

Introduction: Resilience and quality of life (QOL) can involve a positive approach in group interventions for parents of children with autism spectrum disorders (ASD). This study aims to evaluate resilience and family QOL at the start of a psychoeducational group. Methods: Cross-sectional assessment of resilience and family QOL used the Family Quality of Life Scale (ECVF) and 14-item Resilience Scale (RS-14). Results: The study group showed high levels of resilience. Parents considered the resources/support domain crucial, although satisfaction in this area was comparatively lower. Concerns about low satisfaction with available resources and support were notable. Gender differences were observed but not statistically significant. Discussion: The study's findings support prior research on parental resilience in families of children with ASD. The literature on the QOL for these families presents mixed findings. The importance of parental involvement in service planning is highlighted. Conclusions: This study emphasizes the importance of resilience in parents of children with ASD, suggesting it as a potential therapeutic target. The findings underscore the need to address the perceived low quality of available resources and support. Further investigation is needed. [ABSTRACT FROM AUTHOR]

Epigenetics refers to the modification of gene expression rather than alteration of the genetic code itself. The DNA doesn't [ABSTRACT FROM AUTHOR]

Mastering family therapy is a core competence in the Brown child and adolescent psychiatry fellowship program. To acuminate our skills, in addition to working doing a half day per week of family therapy for the duration of our training, we have weekly family therapy seminars led by Dr. Michelle Rickerby. Most of the time, we spend the hour discussing one or two challenging cases among our class, and if there is time, allot the last 5 to 10 minutes of class to play out a particularly arduous interaction. However, once or twice a year, Dr. Rickerby invites improvisational "improv" actors from a local theater for an extended workshop on family therapy. I was fortunate that my case was chosen as a prompt for this year's workshop. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Suicide is of primary public concern for adolescents and young adults (AYAs) who commonly use social media platforms to express their suicidal thoughts and behaviors. Understanding how AYAs communicate their suicide-related thoughts and behaviors in texts can support early detection of suicide risk from their social media posts. Therefore, this study sought to identify themes relevant to suicide risk in AYAs and explore words or terms used by AYAs when they described suicidal thoughts and behaviors. METHOD: This secondary data analysis utilized an existing data set collected from 255 AYAs between 12 and 25 years of age, who provided brief descriptions of how they and their peers expressed their experiences of self-harm, suicidal thinking, and attempts. Text analysis was conducted using KH Coder software. Three-step theory of suicide was used to guide a content analysis to explore the key themes from the narratives. RESULTS: A word co-occurrence network with 24 clusters of words was generated from the text analysis. These word clusters were further grouped into pain or hopelessness, connectedness, and capacity to attempt suicide in the content analysis. Six subthemes corresponding to these three themes were identified to provide detailed information: psychological or physical pain, hopelessness, relationship, help seeking, methods, and outcomes. Moreover, several slang terms and acronyms (e.g., Kermit Sewage Slide, KMS) were also identified. CONCLUSIONS: The findings of this study, including themes and slang terms and acronyms, are valuable to facilitate the use of terms or phrases within social media texts to identify suicide risk in AYAs. [ABSTRACT FROM AUTHOR]

Racial inequity in mental health care quality is influenced by many systems-level factors, as elucidated by critical race theory, structural competency, and other keystone frameworks.1 A growing body of literature also suggests provider-level bias to be a key driver.1-3 There is specific evidence that racism is an important driver of health inequities among youth4 and that it is mediated, in part, by provider-level processes related to diagnosis and treatment.2 For example, in child and adolescent psychiatry, youth who are Black, Indigenous, and People of Color (BIPOC) experience disproportionate rates of delayed diagnosis and treatment of autism spectrum disorder, overdiagnosis of conduct disorder, and underdiagnosis of attention-deficit/hyperactivity disorder.4 Black and multiracial adolescents are at highest risk of suicide,5 yet are least likely to receive preventive psychotherapy.4.

Background: This study aims to evaluate the relationship between headaches and psychiatric symptoms in a psychiatric clinic. Methods: We compared 102 children aged 8-16 years (31 girls, 30.4%) who presented to the child and adolescent psychiatry clinic (study group) with 100 children aged 8-16 years, (52 girls, 52%) who did not (control group). Headache was evaluated with the Headache-Attributed Restriction, Disability, Social Handicap, and Impaired Participation (HARDSHIP) Questionnaire. Psychiatric symptoms (depression, anxiety, sleep, attention, hyperactivity) were evaluated via standardized scales. Results: The study group had more headaches in the preceding year as well as the day before. Depression, anxiety and sleep problems were positively correlated with headache frequency in the preceding week in the study group, and in the study group, children with migraine had more depression, anxiety, and emotional problems. While the total quality of life (QoL) scores were not significantly different between groups, migraine decreased the QoL in both the study and control groups. Conclusion: This study indicates that headache type and burden should be evaluated in psychiatric clinics as depression and anxiety are associated with headache, especially migraine. [ABSTRACT FROM AUTHOR]

Circadian rhythm disruptions are a hallmark feature of mood disorders. Patients experiencing acute depressive episodes report noticeable changes in their sleep–wake cycles. This research explains the association between depression and various circadian rhythm metrics, explicitly focusing on adolescents diagnosed with depressive disorders. Adolescence is a critical period marked by significant physiological and psychological changes, making it imperative to understand how mood disorders manifest during this phase. However, there have been minimal specific studies in pediatric populations to determine whether circadian rhythm changes differ between adolescents with first and multiple-recurrent depressive episodes. Our study involved a group of 61 adolescents aged between 13 and 18. We performed a cross-sectional study of a clinical population of patients presenting to a child and adolescent psychiatry clinic diagnosed with depression. Participants were asked to complete self-report evaluations using several tools: the Korean version of the Biological Rhythms Interview of Assessment in Neuropsychiatry (K-BRIAN), the Korean Translation of Composite Scale to Measure Morningness-Eveningness (KtCS), and the Seasonal Pattern Assessment Questionnaire (SPAQ). Tools such as the Children's Depression Inventory (CDI), State-Trait Anxiety Inventory (STAI), and K-Mood Disorder Questionnaire (K-MDQ) were employed for the assessment of clinical characteristics of depression. Based on the frequency of their depressive episodes, participants were bifurcated into two distinct groups: those experiencing their first episode (n = 22, mean age: 15.09 ± 1.44 years) and those with recurrent episodes (n = 39, mean age: 15.95 ± 1.26 years). At first, the two groups' data revealed no significant differences regarding mood or circadian rhythm metrics (CDI: first episode 26.18 ± 10.54 and recurrent episode 25.90 ± 10.59, STAI-S: first episode 56.91 ± 12.12 and recurrent episode 57.49 ± 11.93, STAI-T: first episode 60.36 ± 11.63 and recurrent episode 59.09 ± 12.10, SPAQ-total: first episode 6.59 ± 4.86 and recurrent episode 6.77 ± 5.23, KtCS: first episode 30.32 ± 5.83 and recurrent episode 28.13 ± 7.36). However, we observed significant correlations between circadian rhythm disruptions and depression scales (CDI with SPAQ-weight (r = 0.26), KtCS (r = −0.48), K-BRIAN-sleep (r = 0.58), K-BRIAN-activity (r = 0.64), K-BRIAN-social (r = 0.71), and K-BRIAN-eating (r = 0.40)). These correlations were especially pronounced in the recurrent episode group, suggesting that with the progression and chronicity of depression, the relationship between circadian rhythms and depression becomes more intertwined and evident. In conclusion, especially in adolescents, as the severity and chronicity of depression increase, the interplay between circadian rhythms and mood disorders becomes more pronounced, warranting further research and clinical attention. [ABSTRACT FROM AUTHOR]

Objective: The Schedule for Affective Disorders and Schizophrenia for School‐Age Children‐Present and Lifetime version (K‐SADS‐PL) is a widely used semi‐structured diagnostic interview in child and adolescent psychiatry. However, the psychometric properties of its updated version, the K‐SADS‐PL for DSM‐5, have scarcely been examined, especially for criterion validity. This study was designed to examine the inter‐rater reliability, criterion validity and construct validity of the K‐SADS‐PL for DSM‐5 in 137 Japanese outpatients. Methods: Two of 12 experienced clinicians independently performed the K‐SADS interview for each patient in a conjoint session, and the resulting consensus diagnosis was compared with a "best‐estimate" diagnosis made by two of eight experienced clinicians using all available information for the patient. Results: The inter‐rater reliability was excellent, as shown by κ > 0.75 for all disorders, with the exception of current separation anxiety disorder. The criterion validity was fair to good, as shown by κ > 0.40 for all disorders, with the exception of current and lifetime agoraphobia. The construct validity was also good, as shown by theoretically expected associations between the K‐SADS‐PL diagnoses and subscales of the child behavior checklist. Conclusion: The K‐SADS‐PL for DSM‐5, now available in Japanese, generates valid diagnoses in child and adolescent psychiatry. [ABSTRACT FROM AUTHOR]

Youth depression is an impairing pediatric condition for which psychotherapy effects are modest. Can outcomes be improved by treatments that address the family context, as proposed in practice parameters of the American Academy of Child and Adolescent Psychiatry? To find out, we searched five decades of research for randomized controlled trials testing family-based interventions; 11 trials were found for ages 4–18 years. Using robust variance estimation, we obtained estimates of effect size (ES) and tested candidate moderators that might explain variation in ES. Overall pooled ES of the studies was 0.33 at posttreatment, similar to that reported for all youth depression treatments in three prior meta-analyses (i.e., 0.36, 0.30, and 0.29), but higher for adolescents (ages ≥ 13, 0.50) than children (0.04). Taken together, our findings do not show superior outcomes for family-based interventions, and raise questions about how much confidence can be placed in the evidence base to date. The small number of relevant studies in more than five decades, together with the publication bias and risk of bias concerns, highlights the need for more trials testing family-based treatment, and for pre-registered reports, publicly-available preprints, and other mechanisms for improving the dissemination of completed research. [ABSTRACT FROM AUTHOR]

This study aimed to identify organized sports participation patterns and their prevalence from adolescence to emerging adulthood, and the educational and family-related determinants of the patterns. Adolescents in the Finnish Health Promoting Sports Club (FHPSC) study answered a health behaviour questionnaire and reported on sports club participation at ages 15 and 19 (N = 609). In emerging adulthood, dropouts (total 41.05%; females 43.72%; males 36.56%), maintainers (30.87; 26.44; 38.33), nonparticipants (27.59; 29.32; 24.67), and joiners (0.49; 0.52; 0.44) (p =.024) were identified. A mixed multinomial logistic regression analysis showed, that male gender, as compared to female gender, increased the odds of being a maintainer rather than a nonparticipant or dropout. Among females, high achievement at school and aspiration towards upper secondary school at age 15 increased the odds of being a maintainer at age 19 rather than a nonparticipant. High achievement at school and experiencing a (strong) decrease in parental support for physical activity/sport increased the odds of being a dropout rather than a nonparticipant. Having no experience of a strong decrease in parental support increased the odds of being a maintainer rather than a dropout. Among males, aspiration towards upper secondary school increased the odds of being a maintainer or dropout rather than a nonparticipant. The most common reason for dropping out was study, which was also the most prevalent life status at age 19. The findings highlight a need for more flexible possibilities to combine organized sports participation and school studies, and the importance of parental support for physical activity/sport. [ABSTRACT FROM AUTHOR]

With a limited number of child and adolescent psychiatrists available to see youth patients, many common psychiatric problems in youth are managed by other providers. Clinical pearls from experts in child and adolescent psychiatry can help general practitioners with this management. Some common issues are discussed here for which practical guidance is offered, ranging from approaches to assessment and how to start and titrate medications for the treatment of attention deficit hyperactivity disorder, depression, and sleep problems. [ABSTRACT FROM AUTHOR]

Le 3 août 2021 marque une étape importante dans l'histoire de la psychiatrie en Espagne avec la création du titre de médecin spécialiste en psychiatrie de l'enfant et de l'adolescent. Jusque-là, l'Espagne était l'un des rares pays d'Europe où cette mesure n'avait pas été mise en place. Cet article propose une description du développement de la pédopsychiatrie en Espagne, en mettant en évidence les différentes contributions qui ont permis sa réalisation. Une revue bibliographique a été réalisée pour retracer l'évolution de la pédopsychiatrie. Les avancées de la pédopsychiatrie à travers le monde sont d'abord exposées, puis le cas spécifique de l'Espagne est examiné. Il ressort que le développement de la pédopsychiatrie en Espagne a été plus lent que dans les pays voisins. De plus, il existe une inquiétante disparité dans sa mise en œuvre à l'échelle nationale. Les résultats suggèrent que de nouveaux défis se présentent, notamment la nécessité d'élaborer des plans de formation et des directives cliniques basés sur des preuves scientifiques. Il est également primordial de garantir des services de soins efficaces, de qualité et équitables pour les enfants au sein du système national de santé, en accordant une attention particulière aux patients souffrant de troubles mentaux graves. La création du titre de médecin spécialiste en psychiatrie de l'enfant et de l'adolescent en Espagne constitue une avancée majeure. Cependant, il est crucial de relever les nouveaux défis qui se posent et de mettre en place des mesures visant à assurer des soins appropriés et équitables pour les enfants et les adolescents présentant des troubles mentaux. Cela inclut l'élaboration de plans de formation et de directives cliniques basées sur des preuves scientifiques solides. August 3, 2021 marks an important milestone in the history of psychiatry in Spain with the establishment of the title of specialist in child and adolescent psychiatry. Until then, Spain remained one of the few European countries where this measure had not been implemented. This article aims to examine the development of child and adolescent psychiatry, highlighting the various contributions that have made it possible. A literature review was conducted to trace the historical evolution of child and adolescent psychiatry. The advancements in child and adolescent psychiatry worldwide are first presented, followed by an examination of the specific case of Spain. It is evident that the development of child and adolescent psychiatry in Spain has been slower compared to neighboring countries. Additionally, there is concerning heterogeneity in its implementation within the Spanish state. The findings suggest the emergence of new challenges, including the need to develop training programs and clinical guidelines based on scientific evidence. Ensuring effective, quality, and equitable mental healthcare services for children within the national health system is essential, with particular attention to patients with severe mental disorders. The introduction of the specialist title in child and adolescent psychiatry in Spain represents a significant advancement. However, new challenges need to be addressed, such as the formulation of evidence-based training plans and clinical guidelines. It is crucial to establish measures that ensure appropriate and equitable care for children and adolescents with mental disorders. [ABSTRACT FROM AUTHOR]

Investigating the risk factors associated with bullying and victimisation in Ireland is important for understanding the individual and environmental conditions in which these actions emerge, and for informing the design of preventative programmes in childhood and adolescence. The aim of this systematic review is to identify studies which, over the past 10 years, have examined the risk factors associated with bullying and victimisation in Irish school settings, and to examine which preventative programmes have been made to date to counter these phenomena. Using systematic literature search techniques, we identified 19 relevant studies. Data were extracted, the quality of papers was appraised, and a descriptive synthesis was applied. The results of the systematic review suggest a varied picture of risk factors that included individual and social-relational factors connected with bullying (e.g. minority group belonging, behavioural adaptation problems, lack of prosociality, psychoticism) and victimisation (e.g. poor school support, minority group belonging, neurotic, socio-behavioural problems with peers, ease in communication with peer and parent). Theoretical and psycho-educational implications are discussed. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the effectiveness of relapse prevention (RP) as a treatment for internet gaming disorder (IGD). Design: Randomized controlled trial. Setting: Three child and adolescent psychiatry (CAP) units in Region Skåne, Sweden. Participants: Children aged 13-18 years, coming for their first visit to CAP during 2022, were screened for gaming behavior. Those who met the proposed DSM-5 criteria for IGD were offered participation in the trial, if they had the capacity to provide written informed consent and if they spoke Swedish. A total of 111 CAP patients agreed to participate. Out of those, 11 patients were excluded due to incorrect inclusion such as young age (n = 1), or due to the absence of responses to follow-up measures (n = 9). After exclusion, 102 participants remained (intervention = 47, control = 55). Interventions: The intervention, RP, is based on cognitive behavioral treatment (CBT) and was provided individually, comprising of five to seven 45-min sessions over a period of 5 to 7 weeks versus treatment as usual. Outcome measures: Participants were assessed with Game Addiction Scale for Adolescents pre-treatment (GASA) (baseline), post-treatment (treatment group only), and 3 months after baseline (follow-up). Results: The repeated measures ANOVA showed a significant interaction effect between treatment and time. Both the control group and treatment group lowered their mean GASA score from baseline to follow-up significantly, but the improvement was greater in the treatment group (mean difference in control group -5.1, p < 0.001, 95% CI = - 3.390 to -6.755, mean difference in treatment group -9.9, p < 0.001, 95% CI = -11.746 to -8.105). Conclusion: RP was found to be superior to treatment as usual in terms of reduction of IGD symptoms. Future research should address which aspects within a given treatment are effective, who benefits from treatment, in what aspects, and why. [ABSTRACT FROM AUTHOR]

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The article discusses the threats to the health and well-being of children and young people in Australia due to climate change, ecological degradation, migrating populations, conflict, inequalities, and predatory commercial practices. It highlights Australia's poor performance in climate and sustainability issues, ranking low in carbon emissions and electronic waste production. The article also addresses the impact of unhealthy living conditions on children's mental and physical well-being and emphasizes the need for sustainable environments for children. It suggests viewing government policies through a child's lens and holding politicians accountable for improving children's future. [Extracted from the article]

Background: Patient simulation has been used in medical education to provide a safe and supportive learning environment for learners to practice clinical and interpersonal skills. However, simulation involving pediatric populations, particularly in child and adolescent psychiatry, is rare and generally does not reflect the child-caregiver dyad or the longitudinal aspects of this care, nor does it provide learners with an opportunity to engage with and reflect on these dynamics. Methods: We organized as an educational opportunity a series of seven observed patient simulation sessions with a cohort of a dozen child and adolescent psychiatrists (eight fellows approaching graduation and four senior educators). In these sessions, we utilized the co-constructive patient simulation model to create the simulation cases. We included the use of at least two patient actors in most sessions, and two of the case narratives were longitudinally followed across multiple simulation sessions. We approached the data collected during the simulations and their respective debriefings by using thematic analysis informed by a symbolic interactionist approach. Results: Based on data from the debriefing sessions and longitudinal narratives, we identified four overarching themes: (1) Reflecting on dyadic challenges: role reversal and individuation; (2) Centering the child, allying with the parent, and treating the family system; (3) Ambivalence in and about the parent-child dyad; and (4) Longitudinal narratives and ambivalence over time. Conclusion: The emotional experience of the simulations, for interviewers and observers alike, provided an opportunity to reflect on personal and professional experiences and triggered meaningful insights and connections between participants. These simulated cases called for emotional labor, particularly in the form of creating holding environments; in this way, the simulated encounters and the debriefing sessions became dialogic experiences, in which the patient and provider, parent and child, and learner and instructor could co-construct meaning and foster professional development as reflective practitioners. [ABSTRACT FROM AUTHOR]

The number of visits to psychiatric hospital emergency departments fell sharply during the first wave of Covid-19 in France and worldwide, particularly in the paediatric population. From November 2020 onwards, an increase in the number of visits to paediatric emergency departments, with numerous suicide attempts, was observed in the Île-de-France region and throughout the country. The clinical reflection we shall present here stems from the observation that the number of requests for psychiatric advice in the emergency department and in the general pediatric department of the Montreuil General Hospital, doubled between November 2020 and April 2021. We shall examine the origins of this suffering among adolescents, which manifests itself in a louder form and more frequently than before the pandemic. We shall suggest that the normal identification processes in adolescence are impaired by social distancing and the various health measures taken in response to the current pandemic, affecting both the general population and those with psychiatric disorders. We also assume that the various institutions, those of family, school and outpatient care, have also been disrupted by the health crisis, and are thus less able to deal with adolescent anxiety, leading to an increase in hospitalisation for the adolescents affected. [ABSTRACT FROM AUTHOR]

This article studies the use of digital technology by adolescents in times of social distancing during the Covid 19 pandemic and characterises the new forms of interpersonal interaction, group identification, and support for the adolescent quest for identity that it offers. The use of technology, and more especially digital technology, among teenagers seems to have the ability to be an effective tool in the fight against anxiety-inducing situations, such as loneliness, abandonment, loss of connection to others and questioning of identity, particularly during a pandemic. Digital technology has helped to enable these distressed teenagers continue to build their identity by integrating it into their psyche. This integration is based on the teenager's own relationship with digital technology, whose main characteristics are highlighted. The specific situation of intensive use of video games has enabled teenagers to try to soothe or mentally escape from anxiety-inducing claustrophobic family situations presenting too intense interpersonal proximity. Solitary game-playing allows them to distance themselves from a real-life environmental situation, evoking a cleavage mechanism, while shared online activity used wisely can provide access to a shared group experience, supporting identity-construction possibilities. [ABSTRACT FROM AUTHOR]

Objective: Internalizing and externalizing disorders are developmentally complex entities with multifactorial pathogenesis. The findings from recent research on the transdiagnostic responsibility of self-regulation and rumination suggest that their deficits underlie all psychiatric disorders in adults, and yet only a small number of studies have been conducted on the population of adolescents. Method: The clinical study included 162 adolescents, divided into two clinical groups, treated in the Department of Child and Adolescent Psychiatry in Hospital. The first clinical group consisted of 91 adolescents with internalizing mental disorders, with the second clinical group consisting of 71 adolescents with externalizing mental disorders. They had been referred for psychodiagnostic assessment after their first psychiatric examination, and were diagnosed according to the International Classification of Diseases (ICD-)10 criteria, the diagnoses confirmed through structured clinical interviews. They additionally met the inclusion and exclusion criteria for participating in this study. Results: The results suggest that self-regulation significantly and negatively predicted symptoms of mental disorder in both clinical groups, and rumination significantly predicted symptoms of anxiety and depression in the group of adolescents suffering from internalizing disorders. Conclusions: The findings emphasize the importance of maladaptive selfregulation as a transdiagnostic factor underlying various forms of psychopathology in adolescents, and the importance of rumination as a unique transdiagnostic process related to different disorders in the internalizing dimension. [ABSTRACT FROM AUTHOR]

BackgroundDeath by suicide is one of the leading causes of death among adolescents. Genome-wide association studies (GWAS) have identified loci that associate with suicidal ideation and related behaviours. One such group of loci are the six contactin genes (CNTN1-6) that are critical to neurodevelopment through regulating neurite structure. Because single nucleotide polymorphisms (SNPs) detected by GWAS often map to non-coding intergenic regions, we investigated whether repetitive variants in CNTNs associated with suicidality in a young cohort aged 8 to 21. Understanding the genetic liability of suicidal thought and behavior in this age group will promote early intervention and treatment.MethodsGenotypic and phenotypic data were obtained from the Philadelphia Neurodevelopment Cohort (PNC). Across six CNTNs, 232 short tandem repeats (STRs) were analyzed in up to 4,595 individuals of European ancestry who expressed current, previous, or no suicidal ideation. STRs were imputed into SNP arrays using a phased SNP-STR haplotype reference panel from the 1000 Genomes Project. We tested several additive and interactive models of locus-level burden (i.e., sum of STR alleles) with respect to suicidal ideation. Additive models included sex, birth year, developmental stage (“DevStage”), and the first 10 principal components of ancestry as covariates; interactive models assessed the effect of STR-by-DevStage considering all other covariates.ResultsCNTN1-[T]N interacted with DevStage to increase risk for current suicidal ideation (CNTN1-[T]N-by-DevStage; p = 0.00035). Compared to the youngest age group, the middle (OR = 1.80, p = 0.0514) and oldest (OR = 3.82, p = 0.0002) participant groups had significantly higher odds of suicidal ideation as their STR length expanded; this result was independent of polygenic scores for suicidal ideation.DiscussionThese findings highlight diversity in the genetic effects (i.e., SNP and STR) acting on suicidal thoughts and behavior and advance our understanding of suicidal ideation across childhood and adolescence.

This article discusses the importance of psychometric properties in psychiatric measurement tools for adolescents and young adults. Adolescence is a critical period characterized by biological changes and evolving psychosocial competencies. Mental health problems and disorders affect a significant percentage of this population, leading to increased disability. Validity and reliability are key aspects of psychometric properties, ensuring that measurement tools accurately measure the intended concepts and produce consistent results. The article emphasizes the need for evidence-based culture, reporting trial results, refining and selecting items, and continual re-evaluation to enhance the psychometric properties of measurement tools. [Extracted from the article]

A year ago, 17-year-old "Alex" was brought into the emergency department after a self-inflicted gunshot wound. Neither his primary care doctor nor his psychologist were aware of his first attempt 6 months previously. Unfortunately, this attempt was successful. It occurred in front of his home, and in front of his mother who was just seconds too late to stop him. In the aftermath, we wondered why the medical system that he had access to could not intervene in time. [ABSTRACT FROM AUTHOR]

Introduction. The coronavirus pandemic caused a restructuring of mental health services, marked by a decrease of hospital work capacity and increased reliance on telemedicine. Children and adolescents are a particularly vulnerable group that has been affected by the newly arisen corona virus-19 pandemic. The objective was to evaluate the correlation between the coronavirus pandemic and alternations in hospitalization rates, seasonal distribution, and sociodemographic characteristics of patients admitted to the Department of Child and Adolescent Psychiatry. Material and Methods. The study was conducted at the Psychiatry Clinic of the Department of Child and Adolescent Psychiatry at the University Clinical Center of Vojvodina in the period from March 6, 2017 to March 5, 2021. The sample comprised 1114 inpatients and individuals undergoing partial hospitalizations, diagnosed with mental disorders classified according to the International Classification of Diseases. Participants were categorized into two groups: one treated before the onset of the pandemic (March 2017-March 2020) and another treated during the pandemic (March 2020-March 2021). Statistical analysis was performed on the collected data, with the results presented in tables and graphs. Results. During the pandemic, an overall reduction in admissions (-32.34%) was observed, accompanied by a noticeable decrease in admissions during the spring compared to the pre-coronavirus period (p=0.011). The most prevalent diagnoses were F9 and F4, respectively (p<0.01). A higher number of hospitalizations were noted in middle adolescence (p<0.001), among females (p=0.006) and those residing in urban areas (p=0.009). Conclusion. The coronavirus pandemic led to alternations in the functioning and dynamics on Department of Child and Adolescent Psychiatry. The sociodemographic characteristics of the youth changed during the pandemic. [ABSTRACT FROM AUTHOR]