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Cet article rend compte des résultats d'une recherche menée conjointement par les professionnels d'une équipe de centre médico-psychologique et de sociologues. Il interroge les effets du premier confinement (printemps 2020) sur les situations des enfants suivis au CMP et leur famille, mais également sur les pratiques des soignants. L'étude a été mise en œuvre à partir de mai 2020, avec deux modalités de réflexion proposées à dix professionnels (psychologues, pédopsychiatres, orthophonistes, psychomotriciens, assistante sociale) du CMP : soit écrire un texte de quelques pages, soit participer à un entretien avec l'un des quatre sociologues. Dans les deux cas, la consigne était de partir de situations cliniques en détaillant les différents aspects sociaux et psychiques et de formuler des idées sur les effets du confinement, en s'appuyant sur des exemples cliniques tout en préservant l'anonymat des patients. Après ce premier temps d'élaboration commune, plusieurs rencontres entre soignants et sociologues ont eu lieu pour réfléchir ensemble au contenu de ces textes et élaborer une réflexion plus générale dont cet article est l'aboutissement. Cette recherche a permis de documenter l'effet de la crise sanitaire sur les enfants et les familles (renforcement des inégalités sociales) telles que perçues par les professionnels, ainsi que les adaptations des pratiques de soin (consultations à distance) et les questionnements des professionnels durant cette période. Concernant les situations des enfants et des familles, les données recueillies révèlent des inégalités sociales exacerbées par le contexte de crise sanitaire mais soulignent également l'existence de certains facteurs (type de logement, configurations familiales, rapport aux normes scolaires et sanitaires) qui ont pu créer des différences entre personnes pourtant issues de catégories socioprofessionnelles semblables. Concernant les pratiques et réflexions des professionnels, le souci de garantir la continuité du lien a été essentiel pour les professionnels, ce qui a donné lieu à des pratiques possiblement éloignées du cadre habituel, avec la limitation des rendez-vous en présence et l'usage du téléphone pour les consultations. Les professionnels se sont interrogés sur les effets et enjeux de ces suivis à distance et ont été contraints de se repositionner sur les plans clinique et thérapeutique. Cette expérience de recherche invite à renouveler ce type d'étude, pour la richesse des résultats obtenus grâce au croisement des regards des soignants et des sociologues, mais aussi pour son intérêt du point de vue de la réflexivité de l'équipe soignante. In this article, we present the results of a research project conducted jointly by professionals from a child and adolescent mental health center (CMP) and sociologists. We explore how the first confinement (in the spring of 2020) affected the situation of the child patients at the CMP and their families, as well as the care practices of the professionals. The study was implemented in May 2020. Nine mental health professionals (psychologists, child psychiatrists, speech therapists, psychomotor therapists, social worker) were invited either to write a text reflecting on their experience, or to participate in an interview with one of the four sociologists. In both cases, the suggestion was to describe clinical situations, focusing both on social and psychological aspects, and to formulate ideas on the effects of confinement based on these clinical examples, while preserving the anonymity of the patients. Following this phase, the mental health team and the sociologists met several times to collectively discuss the content of these texts and to elaborate a reflection at a more general level that resulted in this article. This research illustrates some effects of the Covid-19 crisis on children and families, notably the reinforcement of social inequalities, as witnessed by mental health care professionals. It also documents the adaptations of care practices (e.g. remote consultations) during this period, as well as the multiple questions that professionals had to address. Regarding the situations of the children and their families, the data collected reveal that social inequalities have been exacerbated by the context of the pandemic, but it also underscores how certain factors (type of housing, family configurations, individuals' relationships with academic and public health norms) may have contributed to differences between families from similar socio-professional categories. Regarding mental health care, it appears that guaranteeing the continuity of the relationship with the child and/or the family was a crucial concern for the professionals. As face-to-face appointments were limited, practices arose that were not seen as options in the usual work environment and habits, such as phone consultations. Professionals questioned the effects and stakes of these remote encounters and were forced to reposition themselves clinically and therapeutically. This research experience encourages us to renew this type of study, because of the richness of the results produced by an analysis associating professionals and sociologists, but also because of its contribution to the mental health team's capacity to reflect critically on its own practices. [ABSTRACT FROM AUTHOR]

Transgender and gender diverse (TGD) youth, individuals whose gender identity is different from the sex that was assigned at birth, report higher rates of mental health and emotional challenges and are approximately twice as likely to access psychiatric inpatient services compared with cisgender peers. 1 Existing research has suggested that the minority stress that TGD youth face from having to navigate transphobic cultural contexts and systems (eg, unsupportive parents/caregivers, school staff, peers) may play a key factor in mental health disparities, such as increased risk of depression, anxiety, suicidal ideation, suicide attempts, and nonsuicidal self-harm. 1,2 These higher rates of mental health challenges among TGD youth offer an explanation as to why these youth access inpatient services significantly more frequently than cisgender peers. Research has found that TGD youth often experience discrimination during psychiatric inpatient admissions (eg, being misgendered during admission intake, facing stigmatization for an evolving gender identity, and receiving care from staff who have not been trained to provide gender-affirming care), 3 despite professional organizations, such as the American Academy of Child and Adolescent Psychiatry, underscoring the importance of TGD youth receiving psychiatric care that is inclusive and affirming. 4 Given that the inpatient setting offers a unique opportunity to facilitate positive and affirming changes for TGD youth, it is essential for providers to have a strong understanding of what affirmative care looks like within this context to best support this vulnerable patient population and reduce experiences of discrimination. [ABSTRACT FROM AUTHOR]

This study examines the reliability of parental concern (PC) as an indicator for mental disorders in preschool-aged children in a clinical setting, aiming to establish sensitivity and specificity, evaluate PC’s predictive value for specific diagnoses, and explore the influence of child age on predictions. The sample comprises 574 children referred to child psychiatry services (mean age 47 months, 73% boys). Analyses of sensitivity and specificity for five distinct PC were conducted, while logistic regressions explored the predictive value of PC for corresponding diagnoses, accounting for child age. Language-related concerns emerged as the most frequent and accurate. Sensitivity ranged from 7% to 72%, while specificity ranged from 57% to 97%. PC demonstrated predictive validity for their corresponding diagnoses, except for motor disorders. Child age did not substantially influence these predictions. Findings suggest that systematically incorporating PC into the assessment process for preschool-aged children consulting in child psychiatry is warranted. [ABSTRACT FROM AUTHOR]

Background: Few studies have assessed the burden of mental disorders among children and adolescents considering the impact of co-morbidities and suicide on disability adjusted life years (DALYs). Methods: This was a multicenter cross-sectional study. Our survey data in Liaoning Province (LN) were used to estimate the burden of six mental disorders, supplemented with data from other investigative studies conducted in China to assess four other disorders. DALYs were derived from the sum of years lived with a disability (YLDs) adjusted for co-morbidities, and the years of life lost (YLLs) adjusted for suicide. The changes in DALYs, YLDs, and YLLs were compared with and without adjustment for co-morbidities and suicide. Results: The DALYs rate of mental disorders among children and adolescents in LN decreased from 1579.6/105 to 1391.4/105, after adjusting for both co-morbidities and suicide (-11.9%). The DALYs rate for major depression, anxiety disorder, and conduct disorder (-80.8/105, -75.0/105 and -30.2/105, respectively) were the top three contributors to the DALYs reduction (-188.2/105). The YLDs decreased from 72724.8 to 62478.5 after co-morbidity adjustment (-17.8%), mainly due to the reduction by major depression (-35.3%) and attention deficit/hyperactivity disorder [ADHD] (-34.2%). The YLLs increased from 130 to 1697.8 after adjusting for suicides (+ 56.9% of all suicide YLLs), mainly due to the contribution of major depression (+ 32.4%) and anxiety disorder (+ 10.4%). Compared to GBD 2010, the estimated DALY rate for mental disorders in LN was to be about 80%, with the proportion of DALYs and DALY rates explained by major depressive disorder accounted for only approximately one-third (14.6% vs. 41.9% and 202.6 vs. 759.9, respectively). But the proportion and absolute level of DALY rates explained by anxiety disorders were approximately 2-fold higher (39.7% vs. 19.6% and 552.2 vs. 323.3, respectively). Conclusions: The DALYs of mental disorders among Chinese children and adolescents were approximately 80% of the global level, with anxiety disorders imposing about 2 times the global level. Co-morbidity and suicide must be adjusted when calculating DALYs. [ABSTRACT FROM AUTHOR]

Décrire les caractéristiques sociodémographiques et cliniques des enfants victimes de violences sexuelles en milieu scolaire. Nous avons mené une étude rétrospective et descriptive portant sur 30 dossiers d'expertises psychiatriques réalisées pour des enfants et des adolescents ayant été exposés à des situations de violence sexuelle en milieu scolaire, et qui se sont présentés au service de pédopsychiatrie au CHU Hédi Chaker de Sfax (Tunisie), suite à des réquisitions émanant des services de la police nationale. Ces dossiers d'expertises ont été recrutés durant une période de 6 mois allant du mois de janvier 2019 à juin 2019. L'âge moyen de nos patients était de 11,7 ± 3 ans dont 57 % étaient de sexe masculin. L'auteur de l'agression était de sexe masculin dans 86,7 % des cas, un mineur au moment des faits dans 53,3 % des cas et, un enseignant ou un personnel du cadre scolaire dans 30 % des cas. Les sévices subis par les enfants victimes étaient des attouchements dans 56,6 % des cas, exhibitionnisme dans 30 % des cas et la pénétration anale dans 26,7 % des cas. Les sévices étaient répétés dans 53 % des cas, essentiellement pour les sévices de type exposition à la pornographie. Les victimes présentaient à l'examen expertal essentiellement des symptômes anxieux (dans 76,7 % des cas) et des troubles du sommeil (dans 46,7 % des cas). Un trouble de stress post-traumatique a été retenu dans 16,7 % des cas. Les résultats de notre étude suggèrent que les agressions sexuelles en milieu scolaire peuvent concerner différentes classes sociodémographiques. Les agressions sexuelles entre des mineurs paraissent assez fréquentes et les manifestations cliniques présentées par les victimes sont non spécifiques. Ceci incite à mener des compagnes de sensibilisation auprès des travailleurs avec les enfants pour prévenir ce phénomène. Sexual violence in schools among children and adolescents is a public health problem. Its frequency and its short- and long-term consequences are often underestimated due to the non-specific socio-demographic and clinical characteristics of the victims. To describe the socio-demographic and clinical characteristics of child victims of sexual violence in schools. We conducted a retrospective, descriptive and analytic study of 30 psychiatric expert reports carried out for children and adolescents who had been exposed to sexual violence in the school environment. Patients were presented to the department of child psychiatry of the CHU Hédi Chaker of Sfax, following requisitions from the national police services. The psychiatric expert reports were collected over a period of six months from January 2019 to June 2019. The average age of our patients was 11.7 ± 3 years, 57% of whom were male. The perpetrator of the sexual violence was a male in 86.7% of cases, a minor at the time of the events in 53.3% of cases and a teacher or a member of the school staff in 30% of cases. Sexual abuses consisted of sexual touching in 56.6% of cases, exhibitionism in 30% of cases and anal penetration in 26.7% of cases. Sexual abuse was repeated in 53% of cases, mainly for exposure to pornography. The victim's expert examination concluded to mainly anxiety symptoms (in 76.7% of cases) and sleep disorders (in 46.7% of cases). A post-traumatic stress disorder was retained in 16.7% of cases. The results of our study suggest that sexual violence in the school environment can concern different socio-demographic classes. Sexual violence between minors seems quite frequent and the clinical manifestations presented by the victims are non-specific. This encourages the conduct of awareness-raising campaigns among workers with children to prevent this phenomenon. [ABSTRACT FROM AUTHOR]

This study aims to investigate the validation of the Rapid Interactive Screening Test for Autism in Toddlers (RITA-T) in Turkish toddlers between 18 and 36 months of age. Children aged 18–36 months were referred to the department of child psychiatry for concerns of autism spectrum disorder, language disorder, developmental delay, and typically developing children were enrolled. A total of 81 toddlers participating in the study received clinical interviews according to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.) and the Childhood Autism Rating Scale. They received the translated RIT-T from reliably trained and blinded providers. Parents completed the Modified Checklist for Autism in Toddlers form. A cut-off score was calculated based on the sensitivity, specificity, positive, and negative predictive values of the RITA-T total score that best differentiates autism spectrum disorder diagnosis. For all participants, the RITA-T total score correlated with the Modified Checklist for Autism in Toddlers (r = 0.715) and the Childhood Autism Rating Scale total score (r = 0.825). Using a cut-off score of ⩾17, the RITA-T had a sensitivity of.90 and a specificity of.927 for identifying autism spectrum disorder risk. The area under the curve was.977. Our findings demonstrate that the RITA-T is effective in Turkish toddlers for the early identification of autism spectrum disorder, early intervention settings, and allowing access to treatment. It is important to diagnose autism spectrum disorder at an early age and to start an early intervention program without delay. In this study, we aimed to validate the Rapid Interactive Screening Test for Autism in Toddlers (RITA-T) in a group of Turkish children and found that the RITA-T which has been shown to be a valid and reliable screening test for 18- to 36-month-old children in studies conducted in different countries, is also valid in Turkish children. Similar to previous studies, our results showed that the RITA-T has good sensitivity and specificity in distinguishing children with autism spectrum disorder. We think that our study will contribute to the timely initiation of early intervention programs for many children with autism by enabling a valid test to be used in screening programs. [ABSTRACT FROM AUTHOR]

In this commentary, I argue that including and operationalizing allostatic processes will become increasingly important in future research on parent–child biobehavioral coregulation. In particular, the conceptualization and modeling of dyadic oscillatory rhythms that align in expected ways with the child's developmental stage and that distinguish typical and atypical development will be useful in future work. Despite the inherent asymmetry characteristic of parent–child relationships, we should not forget to consider the child's effects on the parent within and across time, the additional environmental demands upon parents that shape parent–child coregulation, and variations in parent–child asymmetry by parental risk factors. Studying risk factors that are dyadic in nature, such as child maltreatment, may be particularly informative in gaining a deeper understanding of how parent–child coregulation interfaces with developmental psychopathology. To best model parent–child coregulation as a dynamic system, it will be critical to employ more nonlinear analytic models and better represent the multiple hierarchical domains of coregulation and their interactions, including affect, cognition, behavior, and biology. Finally, in future research, a deeper application of existing dyadic and dynamic theories, as well as the generation of new dyadic developmental theories, will aid us in obtaining a stronger understanding of the developmental function and intervention implications of parent–child biobehavioral coregulation. [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]

Aim: By studying children aged 0-6 with outpatient and health board admissions, we aimed to contribute valuable insights to the literature on early childhood support, focusing on admission complaints, diagnosis distribution, treatments, and patient follow-ups. Materials and Methods: Between 01.08.2022 and 01.02.2023 patients aged 0-6 from Diyarbakır Gazi Yaşargil Hospital's Pediatric and Adolescent Mental Health and Developmental Pediatrics clinic, including those seeking health board evaluations, were studied. This prospective analysis examined patient demographics, complaints, diagnoses, health board interactions, treatments, and additional medical conditions. Patient follow-up numbers were scanned from the system for analysis before concluding the retrospective study. Results: Of the 600 patients included in the study, 337 patients came to the health board outpatient clinic, 160 to the child psychiatry outpatient clinic, and 103 to the developmental pediatrics outpatient clinic. 220 (36.7%) were female and 380 (63.3%) were male. The most common presenting complaints of the patients were speech delay, hyperactivity, report renewal, and irritability. In our study, the presenting diagnoses were global developmental delay, isolated speech delay, autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), articulation disorder, behavioral problems, stuttering, and specific learning disorder (SLD) with decreasing frequency. It was observed that 77.5% of the patients had no follow-up and the highest rates of follow-up were ADHD (67.4%) and ASD (56.9%). It was observed that 87.5% of the patients with a health board application had no follow-up. Conclusion: Determining the diagnosis, follow-up, and treatments of the patients may guide the areas in which child psychiatrists and developmental pediatricians should work more intensively in the future. Early diagnosis, screening initiatives, awareness campaigns, and training for parents, teachers, and health professionals, along with telehealth, multidisciplinary strategies, and school collaborations, enhance health board applications and patient follow-up. [ABSTRACT FROM AUTHOR]

Introduction and objective: The interest in improving the quality of care has led to the implementation of the International Organization for Standardization (ISO) 9001:2015 standard in the Child and Adolescent Psychiatry Unit of the Santiago de Compostela University Clinical Hospital (A Coruña, Spain). The objective of this work is to describe the methodology developed to obtain it, as well as the perceived experience of the process. Method: The steps carried out were: creation of a multidisciplinary quality work group and a work schedule; preparation of the Quality Manual, Process Map and definition of the scope of the Quality Management System; preparation and planning of satisfaction surveys; definition of operational and care processes; context and stakeholder analysis; definition of the risks and opportunities of the quality system; establishment of quality measurement indicators; establishment of actions to promote continued training; review of the quality system by the hospital management; and planning of the improvement objectives. Results: The agreed schedule was met, completing all the established tasks in a period of approximately 15 months. Finally, an evaluation of compliance with requirements/results was carried out through an internal and external audit, after which certification of the Unit was achieved according to the ISO 9001:2015 standard. Discussion and Conclusions: The implementation of the ISO standard should be considered the beginning of a working method that ensures continuous improvement, teamwork and establishes a culture of quality in the Unit through continuous monitoring of its activity. [ABSTRACT FROM AUTHOR]

This article examines three films made during the 1950s by Elwyn James Anthony at the psychotic clinic for children at the Maudsley Hospital that marked an important transition in the purpose and practice of visual documentation in a clinical setting: film as a research tool was transitioning from the recording of external signs as indicators of internal subjective states, to the capture of the visual flow of communication between subjects. It is a shift that had a particular impact on the emergent classification of autism, a modality not yet properly separated from the broader term of psychosis, as a non-relational condition whose visual capture demonstrated a void of inter-human communicational exchange. Film was significant not only as a recording apparatus, but as a method of cutting and crafting sequences of movements into brief repetitive motifs. The filmed behaviour of children remained opaque to interpretation, a 'finding' that facilitated the modelling of an emergent autism as subjects who were isolated, alienated and automaton-like, inhabiting a separate temporality. The article situates this 'second', affectless autism, within a broader context of post-war research into gestures as a language of the body, developed largely through an intellectual network of German émigré psychoanalysts who had fled to the US and UK in the 1930s. [ABSTRACT FROM AUTHOR]

This article examines cinematographic observational studies of infants conducted by a loosely connected group of female psychologists and physicians in the USA from the 1930s to the 1960s. Largely forgotten today, these practitioners realized detailed and carefully planned research projects about infant behavior in a variety of settings—from the laboratory to the well-baby clinic. Although their studies were in conversation with better-known works, such as John Bowlby's research on attachment and René Spitz's films on institutionalized infants, they differed in a close examination of individual characteristics of babies and a critical attitude toward contemporary notions of 'pathological mothering'. In closely following the work of several researchers, including but not limited to pediatrician Margaret Fries (1898–1987), the clinical psychologist Sibylle Escalona (1915–96) and her team members—child psychiatrist Mary Leitch (1914–?) and avant-garde photographer Ellen Auerbach (1906–2004)—and psychologist Anneliese Korner (1918–2010), I argue that their cinematographic works shed a more nuanced light on the landscape of infant research and child psychiatry in the mid 20th century, and open a way for alternative readings of gender, psychoanalysis, and scientific observation at that time. [ABSTRACT FROM AUTHOR]

La négligence est la plus fréquente des maltraitances et la plus grave pour le développement de l'enfant. Elle est sous-repérée aujourd'hui. Le terme de négligence n'est pas un terme juridique ni médical. Il est pourtant employé par les médecins et travailleurs sociaux, avec une définition en creux, comme l'absence de soins adaptés pour le développement de l'enfant. La négligence est multifactorielle. Ses effets sont précoces, dépendant de l'âge de l'enfant. La mortalité et la morbidité ont augmenté, de même que les séquelles développementales sont décrites. La négligence a plus d'impact sur le développement que la violence physique. Le pédopsychiatre peut mener différentes actions au bénéfice de l'enfant négligé. D'abord le repérage de la négligence et l'alerte à donner. Le repérage implique de rechercher des indicateurs de négligence et une clinique particulière variant selon l'âge et nécessitant d'explorer les différentes lignes de développement. Le pédopsychiatre cherchera à éliminer une cause sensorielle ou neurodéveloppementale avec parfois recours à des avis spécialisés. Il observera le comportement de l'enfant seul et avec ses parents, les relations parents–enfants et considérera l'enfant au-delà du microsystème familial dans une approche écosystémique. Il pourra s'aider d'outils disponibles et normés en langue française. Il pourra être amené à signaler la situation de l'enfant aux autorités administrative et judiciaire. Ensuite, les soins apportés à l'enfant négligé se feront dans son écosystème. Les interventions devront être précoces, participatives et partenariales avec les services sociaux, les éducateurs, le personnel du lieu de placement. La prise en charge cherchera à compenser les effets négatifs développementaux de la négligence pour redresser la trajectoire développementale. Elle devra tenir compte de la psychopathologie des enfants. La psychothérapie, dont le cadre sera à adapter, aidera l'enfant à s'approprier son histoire. La dernière action à développer par le pédopsychiatre formé est préventive. Il est important que le pédopsychiatre soit informé et formé à la prise en charge de la négligence et de ses effets. Les enfants négligés d'aujourd'hui seront les adultes de demain qui auront le plus de troubles psychiatriques. Neglect is the most common form of child abuse. It can also have the most serious impact on a child's development, with an increased and accompanying risk of the emergence of psychiatric disorders from adolescence to adulthood. Child neglect is under-recognized today, due to a lack of training for professionals, the orientation of child psychiatry, and difficulties in understanding what this vague concept refers to. After proposing definitions of neglect, its characteristics, and its effects, we present the possible actions of the child psychiatrist in the ecosystem of the neglected child. Neglect is neither a legal nor a medical term. It is, however, used by doctors and social workers, with a loose definition as the absence of appropriate care for a child's development. Neglect is multifactorial. The French consensus approach to the basic needs of the child has highlighted a meta-need for security, emphasizing attachment and the particular qualities of the caregiver. In light of this report, we understand that affective or emotional neglect is the most problematic form of neglect. The effects of neglect are early, depending on the child's age. They can manifest as developmental delays, sleep disorders, tonus disorders in infants, intellectual disorders, and various internalized and externalized disorders in adolescence. Mortality and morbidity are increased in cases of neglect, and developmental sequelae have been described. Neglect has a greater impact on development than physical abuse. The child psychiatrist can take three types of action to treat the neglected child. Firstly, he or she must identify neglect and alert the appropriate instances so as to protect the child. Identification involves being aware of indicators of neglect and a particular clinical pattern that varies according to age, requiring the exploration of the different lines of development. Three clinical patterns seem to be linked to extreme neglect: anaclitic depression, post-traumatic stress disorder, particularly complex developmental trauma, and attachment disorders. When faced with symptoms suggestive of neglect, the child psychiatrist should try to rule out a sensory or neurodevelopmental cause, sometimes seeking the advice of a specialist. He or she will observe the child's behavior alone and with his or her parents, as well as parent-child relationships, and will consider the child outside the family microsystem in an ecosystemic approach. The child psychiatrist can use available standardized tools that explore the various dimensions of neglect. This multi-consultation assessment should not delay the child psychiatrist's initial actions, given the narrow developmental windows. In particular, the child psychiatrist may be required to report the child's situation to the administrative and judicial authorities. The care provided to the neglected child will then take place within the child's own ecosystem. Interventions must be early, participative and in partnership with social services, educators, and staff at the placement site. Care will seek to compensate for the negative developmental effects of neglect, in order to correct the child's developmental trajectory. It must take into account the child's psychopathology. Psychotherapy, the framework of which will need to be adapted, will help the child to assume ownership of his or her history. Child psychiatrists can also take part in innovative initiatives to help children at risk, such as mobile teams. The final action to be developed by the trained child psychiatrist is preventative. It is important that child psychiatrists be informed and trained to deal with neglect and its effects. Today's neglected children will be tomorrow's adults with the most psychiatric disorders. [ABSTRACT FROM AUTHOR]

Une société en désolation et de déliaison attaque d'abord les sciences humaines et sociales et fait encourir le risque de rupture du lien intersubjectif et de solidarité. Le renoncement à celui-ci est à l'origine de la perte du sens et du retour de la peur de la folie. Les soignants subissent l'impact de ce monde nouveau et saisis par l'urgence, agissent sur le présent, plus que n'élaborent des prospectives d'avenir tenant compte de l'histoire, et médicalisent puis psychiatrisent des problématiques humaines de vie et de mort. La rationalisation des démarches diagnostiques et thérapeutiques dictée plus par l'économisme d'aujourd'hui, qui n'est pas une science humaine et sociale mais une idéologie, menace de balayer les acquis de le Pédopsychiatrie institutionnelle, et de l'indispensable éthique de la rencontre interhumaine au cœur du soin. A society where desolation and delirium reigns attacks first and foremost the human and social sciences, and runs the risk of breaking the bonds of intersubjectivity and solidarity. The renunciation of the latter is at the root of the collective loss of meaning and the return of fear of madness. Mental health caregivers feel the impact of this new world and, seized by the urgency of the situation, act in the present rather than looking to the future, taking history into account, medicalizing and then subjecting human problems of life and death to psychiatric analysis and treatment. The rationalization of diagnostic and therapeutic approaches dictated more by today's economism, which is not a human and social science but an ideology, threatens to sweep away the achievements of institutional child psychiatry, and the indispensable ethic of inter-human encounter that lies at the heart of care. [ABSTRACT FROM AUTHOR]

During development we transition from coregulation (where regulatory processes are shared between child and caregiver) to self‐regulation. Most early coregulatory interactions aim to manage fluctuations in the infant's arousal and alertness; but over time, coregulatory processes become progressively elaborated to encompass other functions such as sociocommunicative development, attention and executive control. The fundamental aim of coregulation is to help maintain an optimal 'critical state' between hypo‐ and hyperactivity. Here, we present a dynamic framework for understanding child–caregiver coregulatory interactions in the context of psychopathology. Early coregulatory processes involve both passive entrainment, through which a child's state entrains to the caregiver's, and active contingent responsiveness, through which the caregiver changes their behaviour in response to behaviours from the child. Similar principles, of interactive but asymmetric contingency, drive joint attention and the maintenance of epistemic states as well as arousal/alertness, emotion regulation and sociocommunicative development. We describe three ways in which active child–caregiver regulation can develop atypically, in conditions such as Autism, ADHD, anxiety and depression. The most well‐known of these is insufficient contingent responsiveness, leading to reduced synchrony, which has been shown across a range of modalities in different disorders, and which is the target of most current interventions. We also present evidence that excessive contingent responsiveness and excessive synchrony can develop in some circumstances. And we show that positive feedback interactions can develop, which are contingent but mutually amplificatory child–caregiver interactions that drive the child further from their critical state. We discuss implications of these findings for future intervention research, and directions for future work. [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]

Alterations in brain-derived neurotrophic factor (BDNF) expression have been suggested to mediate the influence of environmental factors on the emergence of depression through epigenetic modifications. However, research on this subject in the developmental population is lacking and the pathophysiology of adolescent depression remains unclear. We aimed to investigate the alterations in BDNF expression and global DNA methylation in depression among adolescent girls. Thirty female inpatients with the initial diagnosis of depression were assessed before and after the period of antidepressant treatment and compared with thirty age-matched healthy controls. The assessment involved BDNF and proBDNF serum levels, the BDNF gene exon IV promoter methylation, and global DNA methylation. The methylation level in the BDNF gene exon IV promoter was significantly lower in the studied group compared with the control and correlated negatively with the severity of depression. The test distinguished the studied group from the controls with a sensitivity of 37% and specificity of 90%. The differences were no longer present after the period of antidepressant treatment. No differences in the global DNA methylation, BDNF, and proBDNF levels were found. We concluded that decreased methylation in the BDNF exon IV promoter could be considered as a biomarker of a depression state among adolescent girls. [ABSTRACT FROM AUTHOR]

Background: Confidentiality is a crucial ethical principle in therapy, particularly for children and adolescents, yet their perception of it remains understudied. We aimed to explore minors' perspectives and attributions on confidentiality in psychological and medical treatment. Methods: We interviewed 11 pediatric patients aged 7 to 15 and used reflexive thematic analysis to analyze their responses. Results: Four main themes were extracted from the data: (1) confidentiality and uncertainty regarding what information will be shared with clinicians and parents; (2) consequences of breaching confidentiality, encompassing breaches of confidentiality in the past and their negative effects on interactions with parents and health professionals; (3) exceptions to confidentiality, including understanding the limits of confidentiality; and (4) autonomy and self-determination, reflecting the desire for involvement in medical decisions. Conclusions: Explanations about confidentiality rules and limits, especially with younger children, are crucial. This is particularly important because it is fundamental to promote children's development and self-determination through increasing autonomy, as well as to provide a sense of security and respect through transparent rules. A single educational session on confidentiality at the outset of therapy is insufficient; ongoing conversations are needed to reinforce understanding and promote autonomy. [ABSTRACT FROM AUTHOR]

Objectives: Identification of clinically significant irritability in preschool age is important to implement effective interventions. However, varying informant and measurement methods display distinct patterns. These patterns are associated with concurrent and future mental health concerns. Patterns across multi‐informant methods in early‐childhood irritability may have clinical utility, identifying risk for impaired psychosocial functioning. Methods: Using data from the Multidimensional Assessment of Preschoolers Study (N = 425), latent profile analysis identified irritability patterns through the parent‐reported Multidimensional Assessment Profile Scales–Temper Loss (MAPS‐TL), parent‐reported interviewer‐rated Preschool Age Psychiatric Assessment (PAPA), and observer‐rated Disruptive Behavior Diagnostic Observation Schedule (DB‐DOS). These profiles were characterized on protective factors, global functioning, and mental health syndromes, concurrently and at early school age and preadolescent follow‐up. Results: Fit indices favored a five‐class model: Low All, High Observation with Examiner (high DB‐DOS Examiner Context), High All, High Parent Report (high MAPS‐TL/PAPA), and Very High Parent Report (very high MAPS‐TL/PAPA). Whereas Low All and High Observation with Examiner exhibited strong psychosocial functioning, remaining profiles showed impaired psychosocial functioning, with the Very High Parent Report group showing higher impairment at follow‐ups, ds = 0.37–1.25. Conclusions: Multi‐informant measurements of irritability may have utility for clinical prediction, and future studies should test utility for diagnostic precision. [ABSTRACT FROM AUTHOR]

Objectives: Anticipatory anxiety and heightened responses to uncertainty are central features of anxiety disorders (ADs) that contribute to clinical impairment. Anxiety symptoms typically emerge during childhood, and even subthreshold‐AD symptoms are associated with distress and risk for future psychopathology. This study compared facial emotional response to threat and uncertainty between preadolescent girls with ADs, girls with subthreshold‐AD symptoms, and controls. Methods: Facial emotional responding was characterized in preadolescent girls (age 8–11) with a range of anxiety symptoms: no/low anxiety (controls, n = 41), subthreshold‐AD (n = 73), and DSM‐5 diagnoses of separation, social, and/or generalized ADs (n = 45). A threat anticipation paradigm examined how image valence (negative/neutral) and image anticipation (uncertain/certain timing) impacted activity of the corrugator supercilii, a forehead muscle implicated in the "frown" response that is modulated by emotional stimuli (negative > neutral). Corrugator magnitude and corrugator timecourse were compared between groups. Results: Findings demonstrate greater corrugator activity during anticipation and viewing of negative stimuli, as well as increased corrugator reactivity in subthreshold‐AD and AD girls. Timecourse analyses of negative versus neutral stimuli revealed that AD and subthreshold‐AD girls had greater uncertainty‐related increases in corrugator activity compared to controls. Conclusion: Results extend the physiological characterization of childhood pathological anxiety, highlighting the impact of subthreshold‐AD symptoms. [ABSTRACT FROM AUTHOR]

La notion de développement est utilisée de manière courante dans la nosographie pédopsychiatrique depuis les années 1980 et le DSM-III. Or, depuis le DSM-5 en 2013, son usage s'est considérablement répandu à travers toute la psychiatrie dans son ensemble. Nous soutenons la thèse d'un prisme à travers lequel la clinique est regardée et la psychopathologie conçue. Nous proposons d'étudier cette évolution de la pensée médicale qui figure à notre sens l'influence théorique de la psychiatrie de l'enfant sur la psychiatrie de l'adulte. Initialement, les troubles du développement concernent, d'une part, les troubles sévères de la vie relationnelle dits envahissants et incluant l'autisme, et d'autre part, les troubles spécifiques qui affectent les apprentissages. L'essor d'un abord développemental de la pathologie correspond aux États-Unis avec la création en 1975 d'une loi qui défend le droit de ces patients, le Developmental Disabilities Act. Le DSM-5 associe le développement aux neurosciences et englobe l'ensemble des troubles pédopsychiatriques au sein d'un vaste ensemble neurodéveloppemental. Enfin, une approche dite vie entière inspire toute la psychiatrie de l'adulte. Philosophie et histoire de la psychiatrie permettent de tracer ce fil d'Ariane et in fine l'influence inattendue de la psychiatrie de l'enfant, alors que ses assises théoriques et institutionnelles sont régulièrement remises en cause. Vitalité étonnante que cette évolution conceptuelle que nous nommons développementalisme, terme créé avec un tout autre sens par le pédiatre américain Arnold Gesell au lendemain de la Seconde Guerre mondiale. The notion of development has been commonly used in child psychiatry for diagnosing since the 1980s and the DSM-III classification. Yet, since DSM 5 in 2013, its use has spread considerably throughout psychiatry as a whole and has increasingly become a prism through which general psychiatry looks mainly at clinical matters and psychopathology. We propose to consider this evolution in medical thinking in psychiatry since the 1980s and the specific links between child and general psychiatry in nosography through the lens of development. We aim to evaluate the influence of child psychiatry by studying the history of international nosography from DSM-III to DSM-5. Developmental disorders concern initially severe child disorders (pervasive developmental disorders including infantile autism) and also specific disorders affecting learning. In the United States, this increasing significance of the developmental perspective has been translated into political action in the Developmental Disabilities Act of 1975, which defends the rights of these patients. DSM-5 combines development with neuroscience and encompasses all child psychiatric disorders within a vast neurodevelopmental framework. Ultimately, a "whole life" approach inspires all adult psychiatry. Philosophy and the history of psychiatry allow us to address the increasing and unexpected influence of child psychiatry on psychiatry. We argue that this conceptual evolution that we call developmentalism, a term coined with an all-together different meaning by the American pediatrician Arnold Gesell in the aftermath of the Second World War, has an astonishing vitality. [ABSTRACT FROM AUTHOR]

Dans cet article, l'auteure retrace les premiers moments de l'introduction de la psychanalyse en pédopsychiatrie et le contexte de leur émergence dans les années 1920 et 1930 en France. Ils sont contemporains de la difficile introduction de la psychanalyse dans l'univers médical. La psychanalyse de l'enfant apparaît alors comme une prophylaxie des troubles névrotiques et suscite l'intérêt des psychopédagogues et des éducateurs. L'auteure retrace les travaux pionniers de la psychanalyste Sophie Morgenstern au sein de la consultation de psychiatrie infantile de Georges Heuyer, et ceux de Pierre Mâle dans sa consultation de psychiatrie infantile à Henri Rousselle. Celui-ci deviendra, à la Libération, le spécialiste de la psychothérapie de l'adolescent. Cependant, l'héritage de Morgenstern va être oublié ou renié par ceux qui vont lui succéder, et elle s'interroge sur les raisons de ce phénomène. Ces travaux pionniers, qui dessinent un nouveau visage de l'enfance normale et anormale, vont connaître une forte expansion après la Seconde Guerre mondiale. In this paper, the author describes the first moments of the introduction of psychoanalysis in child psychiatry and the context of their emergence in the 1920s and 1930s in France. They are contemporaneous with the difficult introduction of psychoanalysis into the medical world. Child psychoanalysis then appeared as a prophylaxis of neurotic disorders, and aroused the interest of educational psychologists and educators. It traces the pioneering work of psychoanalyst Sophie Morgenstern in Georges Heuyer's child psychiatry consultation, and that of Pierre Mâle in Henri Rousselle's child psychiatry consultation. After the Liberation, he became the recognized specialist in adolescent psychotherapy. On the other hand, Morgenstern's legacy will be forgotten or disowned by those who will succeed her, and the author wonders about the reasons for this phenomenon. This pioneering work, which drew a new face of normal and abnormal childhood, was to be greatly expanded after the Second World War. [ABSTRACT FROM AUTHOR]

Perinatal mental health conditions are the most common complications of childbirth and have well-established enduring negative effects. Obstetric (Ob) clinicians care for patients with perinatal mental health conditions across a spectrum of acuity, severity, and complexity. Ob and psychiatric clinicians can collaborate to create a cohesive continuum of psychopharmacologic care for perinatal patients. This chapter provides an overall framework for Ob-psychiatric clinician collaboration with examples of innovation in care delivery. [ABSTRACT FROM AUTHOR]

• Anxiety and depression account for up to 50% of annual mental health costs. • The transferability of evidence-based interventions into practice is required. • Super Skills for Life is effective in children with diagnosed emotional disorders. Super Skills for Life (SSL) is a CBT-transdiagnostic group intervention currently being translated and validated in multiple countries. In Spanish children, it has shown a positive impact on anxious and depressive symptoms, as well as other variables such as self-concept, prosocial behaviors, or behavioral problems. However, the effectiveness of the program to treat internalizing symptoms in children with a mental disorder in a clinical setting has not been examined so far. The aim of this study was to evaluate the effectiveness of SSL in a Spanish sample of children with a major internalizing disorder. Participants aged 8–12 years (71.6% boys) were randomly allocated to the SSL group (n = 43) or the waiting list control (WLC) group (n = 43). All children and their parents completed a series of measures before the first session and after the last session or at about the same time in the WLC group. The effectiveness of the intervention was assessed using generalized estimating equations. Significant reductions from pretest to posttest across multiple outcomes were found in children who participated in SSL group compared to those in the WLC group, including anxiety symptoms (SCAS, p =.02), anxiety interference (CALIS, p =.002), depressive symptoms (CDI, p =.033) and remission from diagnosis (K-SADS, p <.001). This study provides initial support for SSL as an effective treatment for children with emotional disorders in clinical settings. Future studies are needed to analyze long-term effects and broader benefits of the program in clinical contexts. [ABSTRACT FROM AUTHOR]

In 1957, the British-Indian child psychiatrist Dr Elwyn James Anthony travelled to the Zurich International Congress of Psychiatry to show a film featuring 70 children with such complex symptomatology and behaviour that they betrayed the certainty of contemporary theories of developmental psychology and psychoanalysis. This article examines the significance of Anthony's film to the creation of new scientific models in international developmental psychology and psychiatric epidemiology. It marked a significant change in the use of filmed evidence that sought to create a truly global and universalist approach to atypical child development based purely on scientific observations. This new observational work was important in shaping new internationally ratified models to study the epidemiology of children's psychiatric conditions. [ABSTRACT FROM AUTHOR]

Background: Knowledge of the association between parental personality disorders and mental disorders in children is limited. To examine the association between parental personality disorders and the risk of mental disorders in offspring. Methods: We linked Danish health registers to create a cohort of children born from January 1, 1995, to December 31, 2016. Children were followed until their 18th birthday, diagnosis set, emigration, death, or December 31, 2016. Parental personality disorders according to the International Classification of Diseases (ICD) Eighth or 10th Revision. Poisson regression analyses were used to estimate the incidence risk ratio (IRR) and cumulative incidence of ICD 10th mental disorders in offspring (age 0–17). Results: The study cohort included 1,406,965 children. For girls, maternal or paternal personality disorder (MPD/PPD) was associated with mental disorders: MPD girls (IRR, 2.74; 95% CI, 2.59–2.89) and PPD girls (IRR, 2.10; 95% CI, 1.94–2.27). Likewise, the risk was increased for both MPD boys (IRR, 2.44; 95% CI, 2.33–2.56) and PPD boys (IRR, 2.04; 95% CI, 1.91–2.18). For girls and boys combined, exposure to two parents with a personality disorder was associated with the highest risk (IRR, 3.69; 95% CI, 3.15–4.33). At age 18, the cumulative incidence of any mental disorder in children of one or two parents with a personality disorder was 34.1% (95% CI, 33.0–35.1), which was twice the cumulative incidence of mental disorders in nonexposed children (15.2% [95% CI, 15.1–15.3]). Conclusion: Children of parents with a personality disorder were at a 2 to 3.5 times higher risk of mental disorders compared with nonexposed offspring. Possible mechanisms of transmission of mental disorders from parent to child involve genetic, environmental, and gene–environment pathways. More research into these mechanisms and research into preventive interventions is warranted. [ABSTRACT FROM AUTHOR]

Background: Systemic therapy (ST) is a psychotherapeutic intervention in complex human systems (both psychological and interpersonal). Cognitive behavioural therapy (CBT) is an established treatment for children and adolescents with mental disorders. As methodologically rigorous systematic reviews on ST in this population are lacking, we conducted a systematic review and meta-analysis to compare the benefit and harm of ST (and ST as an add-on to CBT) with CBT in children and adolescents with mental disorders. Methods: We searched MEDLINE, Embase, PsycINFO and other sources for randomised controlled trials in 14 mental disorder classes for the above comparisons in respect of effects on patient-relevant outcomes (search date: 7/2022). Where possible, meta-analyses were performed and results were graded into 3 different evidence categories: "proof", "indication", or "hint" (or none of these categories). PRISMA standards were followed. Results: Fifteen studies in 5 mental disorder classes with usable data were identified. 2079 patients (mean age: 10 to 19 years) were analysed. 12/15 studies and 29/30 outcomes showed a high risk of bias. In 2 classes, statistically significant and clinically relevant effects in favour of ST were found, supporting the conclusion of a hint of greater benefit of ST for mental and behavioural disorders due to psychoactive substance use and of ST as an add-on to CBT for obsessive-compulsive disorders. In 2 other classes (eating disorders; hyperkinetic disorders), there was no evidence of greater benefit or harm of ST. For affective disorders, a statistically significant effect to the disadvantage of ST was found for 1 outcome, supporting the conclusion of a hint of lesser benefit of ST. Conclusions: Our results show a hint of greater benefit of ST (or ST as an add-on to CBT) compared with CBT for 2 mental disorder classes in children and adolescents (mental and behavioural disorders due to psychoactive substance use, obsessive compulsive disorders). Given the importance of CBT as a control intervention, ST can therefore be considered a beneficial treatment option for children and adolescents with certain mental disorders. Limitations include an overall high risk of bias of studies and outcomes and a lack of data for several disorders. [ABSTRACT FROM AUTHOR]

Background: During the COVID 19 pandemic, there were social restrictions with severe mental stress for a long time. Most studies on mental health consequences of the pandemic focused primarily on the beginning of the pandemic. The present study on families of patients or study participants of a child and adolescent psychiatry aimed to examine long-term profiles of emotions and worries in adults with and without mental health condition (mhc) during the first 1.5 years of the COVID-19 pandemic. Methods: We surveyed emotions and worries of 128 adults with (n = 32) and without (n = 96) pre-pandemic mhc over a 1.5-year study period from spring 2020 until summer/autumn 2021. Emotions and worries were captured at four time points: [i] pre-pandemic, [ii] spring 2020 (first lockdown was implemented), [iii] December 2020 (hard lockdown at Christmas time) and [iv] summer/autumn 2021 (considerable ease of regulations); [i] pre-pandemic and [iii] December 2020 were measured retrospectively). First, we run non-parametric tests to compare emotions and worries between adults with and without pre-pandemic mhc at the four time points. Next, we conducted latent profile analysis to identify subgroups from the total sample who share similar trajectories of emotions and worries. Finally, a logistic regression analysis was run to examine whether socio-demographic and psycho-social factors were related to identified trajectories of emotions and worries. Results: Adults without pre-pandemic mhc reported a strong worsening of emotions and worries at the beginning of the pandemic and a lower worsening during the course, while adults with pre-pandemic mhc reported a constant worsening of emotions and worries. The latent profile analysis revealed three profiles of adults who show either i) an adaption, ii) no adaption or iii) a continuous high condition. With increasing age, higher perceived stress and pre-pandemic mhc, the likelihood of an adaption was increased. Conclusion: The results of the present study suggested that adults (both with and without pre-pandemic mhc) coped the crisis with different strategies and that most of them returned to their initial, pre-pandemic levels of emotions and worries when social restrictions were considerably eased or stopped. [ABSTRACT FROM AUTHOR]

Background: Maternal psychological stress during pregnancy and postnatally has been shown to be associated with offspring atopic diseases (asthma, atopic dermatitis and allergic rhinitis). The aim of this study was to assess whether this association may be attributable to the child's own mental health disorders. Method: The study population included 15,092 twin children born 2002–2010 in Sweden. Questionnaire data at age 9 years was linked to national patient‐ and prescription registers. Maternal mental health during pregnancy and 3 years postnatally were identified from diagnosis and medication data (depression, anxiety and stress disorders). Atopic diseases in children were identified from questionnaires, diagnosis and medication data. Child mental health status (depression and anxiety) was identified from questionnaires. Three‐way decomposition methods tested for mediation or interaction by child mental health disorders. Results: Maternal mental health disorders were associated with most child atopic diseases including asthma aRR1.36 (95% CI 1.12, 1.60), and child mental health disorders, aRR1.73 (95% CI 1.56, 1.92). Children with mental health disorders were comorbid for atopic diseases with only asthma reaching statistical significance, aRR1.29 (95% CI 1.14, 1.47). Three‐way decomposition found that mediation or interaction by child mental health disorders did not account for the mother mental health and child atopy associations except in parent‐report asthma, where child mental health disorders mediated 13.4% (95% CI 2.1, 24.7) of the effect, but not for objectively defined (diagnosis and medication) asthma. Conclusion: The associations between maternal mental health and child asthma and allergic diseases do not appear to be attributable to child mental health 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]

Introduction: Mental disorders in children can present with non specific behavioural issues, like irritability and procrastination. These issues are often neglected, which can negatively affect academic performance and overall development. Teachers hold a unique position to promote mental health and facilitate early identification of mental disorders, leading to timely referrals for early intervention. Aim: To examine the knowledge and attitude of school teachers towards mental disorders in school-going children. Materials and Methods: A cross-sectional study was conducted in Karwar city over a period of two months (July and August 2019) at the Karwar Institute of Medical Sciences, Karnataka, India. A total of 121 primary and high school teachers from 11 schools participated in the study. Purposive sampling was used, as all schools in Karwar city were approached for the study. A self-designed questionnaire consisting of 20 questions (10 questions on knowledge and 10 questions on attitude towards children with mental disorders) was used. Descriptive statistics, such as percentages, were used for data analysis. Results: The study revealed that teachers had moderate knowledge about child mental disorders. However, there was a lack of awareness about the treatment and care of such children. Sixty-three (52.07%) teachers believed that mental disorders result from incorrect thinking. Seventy-nine (65.29%) teachers were of the opinion that sleeping pills are not the only available treatment. Attitude towards children with mental disorders were both positive and negative. 82 (67.77%) teachers believed such children to be less intelligent, while 76 (62.81%) teachers did not believe mentally ill children indulge in violence. Many teachers were aware that these children can be vulnerable to bullying and discrimination by their peers. Conclusion: The study concluded that there is moderate knowledge and mixed attitude among school teachers regarding mental disorders in school-going children. This highlights the need for proper training programs that can aid in early identification, timely referrals for mental health evaluation, and the promotion of child mental health. [ABSTRACT FROM AUTHOR]

Attention-deficit/hyperactivity disorder (ADHD) is among the most common mental disorders in children and adolescents. While most studies in this field have focused on the genetic and neurobiological underpinnings of the disorder, research focusing on the family environment as a critical context contributing toward the manifestation and maintenance of child ADHD symptoms is still less extensive. Therefore, the aim of this study was to examine longitudinal and bidirectional associations between child hyperactivity, mother–child negativity, and sibling dyad negativity. Data were analyzed of up to 4,429 children from the Avon Longitudinal Study of Parents and Children, a nationally representative prospective birth cohort study in the United Kingdom, at three time points (T1–T3, children aged 4, 7, and 8 years). At baseline (T1, n = 4,063), the child sample (98.8% White ethnic background) composed of 51.6% males. Child hyperactivity symptoms, mother–child negativity, and sibling dyad negativity were examined based on maternal reports. The random intercepts cross-lagged panel model was adopted to parcel out between-family differences from within-family fluctuations and test bidirectional associations. On the between-family level, families with higher child hyperactivity reported higher mother–child and sibling dyad negativity. On the within-family level, unidirectional spillover processes between sibling dyad negativity and mother–child negativity as well as between mother–child negativity and child hyperactivity emerged. Future work in the area of child hyperactivity should implement a transactional family systems approach incorporating both parent–child and sibling subsystems. Interventions to reduce negative interactions between parents and hyperactive children may offer promising improvements in child symptoms and thus alleviate family burden. [ABSTRACT FROM AUTHOR]

Objectives: Eating disorders are serious psychiatric conditions that affect people of all ages. Many psychiatry trainees' first and only experience with eating disorders during training is their Child and Adolescent Psychiatry (CAP) rotation. This study aimed to explore the learning experience of psychiatry trainees working within an Eating Disorder Program (EDP) during their CAP rotation. Methods: Fifteen trainees who participated in the EDP were recruited to complete an online survey and focus groups; a thematic analysis design was used to identify themes emerging from their responses. Results: Themes emerged from the trainee learning experience of working in the EDP around what they found they learnt, what aided that process, what was difficult, and recommendations for future improvement. Conclusions: This study provided insight into the trainee experience in an EDP as one example of how trainees can learn about eating disorders and one way that could inform future workforce and training initiatives. [ABSTRACT FROM AUTHOR]

Psychiatric and neurodevelopmental conditions in children are common, often co-occur, and can be highly impairing. Moreover, psychiatric disorders that typically do not fully manifest until adulthood, such as schizophrenia, have their roots in early development, with atypical brain and behavioral patterns arising well before a clinical diagnosis is made. The relevance of brain development to improving outcomes of psychiatric and neurodevelopmental conditions underscores the need to cultivate a pipeline of investigators with the necessary training to conduct rigorous, developmentally focused research. [ABSTRACT FROM AUTHOR]

Les violences sexuelles sur les mineurs ont des répercussions psychologiques importantes tout au long de la vie. Chez les adolescents, elles peuvent notamment se traduire par des mises en danger comme des tentatives de suicide. Leur repérage par les professionnels de santé est donc un enjeu important afin de proposer à ces jeunes une prise en charge médicale et sociale adaptée. Des recommandations professionnelles émergent quant au repérage des violences sexuelles chez les mineurs, mais malgré cela elles restent souvent sous-diagnostiquées. Au sein du centre hospitalier Robert-Ballanger (Aulnay-sous-Bois, Seine-St-Denis), un protocole spécifique permet l'hospitalisation en pédiatrie de tous les adolescents suicidants. Nous avons réalisé une étude afin de mettre à profit ce temps d'hospitalisation pour un meilleur repérage des antécédents d'agressions sexuelles chez les adolescents. Nous avons réalisé une étude rétrospective basée sur l'analyse des dossiers médicaux de 138 adolescents hospitalisés dans le service de pédiatrie et suivis par l'équipe de liaison de pédopsychiatrie au centre hospitalier Robert-Ballanger en 2021. Nous retrouvions significativement plus d'adolescents agressés sexuellement parmi les adolescents hospitalisés pour des gestes ou des idées suicidaires (12 sur 54; 22 %) que parmi les adolescents hospitalisés pour d'autres motifs pédopsychiatriques (5 sur 84; 6 %). Les situations d'agressions sexuelles décrites par les adolescents concernés étaient concordantes avec les données des études épidémiologiques françaises : elles concernaient majoritairement les filles (14 sur 17), étaient des agressions répétées dans les trois quarts des cas, et il s'agissait d'agressions intrafamiliales dans un tiers des cas. La révélation des faits était souvent faite à un soignant (pour 5 adolescents sur 17). Les adolescents avec un antécédent d'agression sexuelle étaient davantage concernés par des faits de violences intrafamiliales, mais aussi de harcèlement scolaire. Nous retrouvions un nombre significativement plus élevé de tentatives de suicide chez les adolescents agressés sexuellement, ainsi qu'un nombre plus élevé de tentatives de suicide ayant nécessité une hospitalisation en réanimation. L'hospitalisation en pédiatrie des adolescents suite à une tentative de suicide apparaît comme un outil intéressant pour le repérage des antécédents d'agression sexuelle chez ces jeunes. Notre étude met en évidence une sur-représentation des adolescents agressés sexuellement parmi ceux pris en charge pour des idées suicidaires ou des tentatives de suicide, ainsi que des points de vigilance spécifiques. Un cadre rassurant, la sensibilisation des professionnels et une attention particulière pourraient permettre un meilleur repérage et, de fait, une meilleure protection et un suivi thérapeutique adapté. Sexual violence against minors has important psychological repercussions throughout life. In adolescents, it can result in endangerment or self-aggressive behaviour such as suicide attempts. Its detection by health professionals is therefore an important issue in order to provide these young people with appropriate medical and social care. Professional recommendations call for systematic hospitalization of adolescents who have attempted suicide, but these recommendations have not yet been widely applied. At the Robert-Ballanger hospital (Aulnay-sous-Bois, Seine-St-Denis, France), a specific protocol has been established between paediatrics and child psychiatry departments, allowing all suicidal adolescents to be hospitalized in paediatrics. We conducted a study to take advantage of this hospitalization time to better identify sexual violence in adolescents. We conducted a retrospective study based on the analysis of the medical records of 138 adolescents hospitalized in the paediatric ward and followed by the child psychiatry liaison team at the centre hospitalier Robert-Ballanger (Aulnay-sous-Bois) in 2021. We found significantly more sexually assaulted adolescents among those hospitalized for suicidal gestures or ideas (12 out of 54; 22%) than among those hospitalized for other reasons (5 out of 84; 6%). The sexual assaults described by the adolescents concerned were consistent with data from epidemiological studies and French victimization surveys : they mainly concerned girls (14 out of 17), were repeated assaults in three quarters of cases, and were intrafamilial assaults in one third of cases. The disclosure was often made to a caregiver (for 5 of 17 adolescents). Adolescents with a history of sexual assault were more concerned with intrafamilial violence but also with school harassment. We found a significantly higher number of suicide attempts among sexually assaulted adolescents, as well as a higher number of suicide attempts requiring hospitalization in intensive care. Paediatric hospitalization of adolescents attempting suicide appears to be an interesting tool for identifying a history of sexual assault in these young people. Our study highlights an over-representation of sexually assaulted adolescents among those treated for suicidal thoughts or suicide attempts, as well as specific factors that should be vigilantly monitored. A reassuring environment, awareness-raising among professionals, and special attention to detail could all help to improve detection and hence protection and appropriate therapeutic follow-up. [ABSTRACT FROM AUTHOR]

Peu d'études ont recherché de manière systématique des antécédents de violences sexuelles chez des adolescents présentant des troubles psychiatriques sévères et hospitalisés en pédopsychiatrie. Nous présentons ici les résultats d'une étude rétrospective menée sur les dossiers de l'ensemble des adolescents hospitalisés dans un service de pédopsychiatrie du département de la Seine Saint-Denis entre 2017 et 2021. L'objectif de l'étude était de rechercher la fréquence des Antécédents d'Agression Sexuelle (AAS) chez les adolescents hospitalisés en service de pédopsychiatrie et de tenter de décrire des liens chronologiques et symptomatologiques entre ces antécédents et l'hospitalisation en pédopsychiatrie, dans le but de proposer d'éventuelles recommandations de dépistage et de prise en charge. Nous avons réalisé une étude rétrospective basée sur l'analyse des dossiers médicaux des 141 adolescents hospitalisés dans un service de pédopsychiatrie entre 2017 et 2021. En rappelant l'épidémiologie des agressions sexuelles dans l'enfance et l'adolescence (fréquente, concernant garçons et filles, dans un tiers des cas intrafamiliale, et dans environ la moitié des situations non crue et non-accompagnée) notre étude souligne l'importance de leur dépistage par les médecins et les soignants. La prévalence significativement plus importante des tentatives de suicide et des automutilations doit particulièrement attirer l'attention sur le risque d'antécédents d'agression sexuelle, car ces symptômes sont fortement associés dans notre étude. La prévalence significativement plus importante des dépressions et des troubles de personnalité limite peut permettre d'aller vers une meilleure compréhension des répercussions des agressions sexuelles à l'adolescence. Le délai court entre l'agression sexuelle et sa révélation dans notre observation et les révélations d'agressions sexuelles intra familiales majoritairement faites durant l'hospitalisation soulignent l'intérêt d'une hospitalisation systématique des adolescents, notamment après une tentative de suicide. Le cadre rassurant d'une hospitalisation peut favoriser une révélation d'agression sexuelle plus rapide et ainsi en diminuer les effets psychiques dévastateurs à l'adolescence. Une faiblesse potentielle de notre étude est que, même dans un service spécialisé, de tels antécédents sont encore probablement sous-évalués et insuffisamment notés dans les dossiers médicaux. Une attention accrue est certainement nécessaire lors des entretiens pédopsychiatriques sur d'éventuels antécédent d'agressions sexuelles. Néanmoins, la rareté des études systématiques sur le sujet fait que cette étude ouvre la voie à la réalisation d'études prospectives. Des recommandations peuvent être proposées, également pour des situations moins graves, sans troubles psychiatriques avérés, mais suite à une tentative de suicide. L'hospitalisation peut alors se dérouler en service de pédiatrie avec un accompagnement psychologique adapté et non en service de pédopsychiatrie. Quel que soit le lieu de prise en charge psychologique des adolescents ayant fait une tentative de suicide, l'attention sur les antécédents d'agression sexuelle doit être améliorée afin de les repérer au plus tôt, d'effectuer une prévention secondaire et d'éviter une dégradation psychique du processus adolescent qui s'en trouve fragilisé. Few studies have systematically searched for a history of sexual violence in adolescents with severe psychiatric disorders hospitalized in departments of child psychiatry. Here, we present the results of a retrospective study conducted on the records of all adolescents hospitalized in a child psychiatry department in the Seine Saint-Denis department between 2017 and 2021. The aim of the study was to investigate the frequency of Antecedents of Sexual Aggression (AAS) in adolescents hospitalized in child psychiatry departments and to attempt to describe chronological and symptomatological links between these antecedents and hospitalization in child psychiatry, with the aim of proposing possible screening and management recommendations. We conducted a retrospective study based on analysis of the medical records of 141 adolescents hospitalized in a child psychiatry department between 2017 and 2021. By recalling the epidemiology of sexual aggression in childhood and adolescence (frequent, involving both boys and girls, in a third of cases intrafamilial, and in about half of the situations uncrushed and unaccompanied) our study underlines the importance of their detection by physicians and caregivers. The significantly higher prevalence of suicide attempts and self-harm should draw particular attention to the risk of a history of sexual assault, as these symptoms are strongly associated in our study. The significantly higher prevalence of depression and borderline personality disorder may provide a better understanding of the repercussions of sexual assault in adolescence. The short delay between the sexual assault and its disclosure in our observation, and the fact that most disclosures of intra-family sexual assaults were made during hospitalization, underline the value of systematic hospitalization of adolescents, particularly after a suicide attempt. The reassuring environment of hospitalization may encourage a more rapid disclosure of sexual assault, and thus lessen its devastating psychic effects during adolescence. A potential weakness of our study is that, even in a specialized service, such antecedents are probably still undervalued and insufficiently noted in medical records. More attention should certainly be paid during child psychiatric interviews to any history of sexual assault. Nevertheless, given the scarcity of systematic studies on the subject, this study paves the way for prospective studies. Recommendations can also be made for less serious situations, with no proven psychiatric disorders, but following a suicide attempt. In such cases, the patient could be hospitalized in a pediatric ward, with appropriate psychological support, rather than in a child psychiatry ward. Regardless of where adolescents who have attempted suicide are psychologically cared for, greater attention needs to be paid to any history of sexual aggression, so as to identify it as early as possible, provide secondary prevention and avoid the psychic deterioration of the adolescent process which would be weakened as a result. [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]

Recently, there has been an increase in telemedicine applied to child neuropsychiatry, such as the use of online platforms to collect remotely case histories and demographic and behavioral information. In the present proof-of-concept study, we aimed to understand to what extent information parents and teachers provide through online questionnaires overlaps with clinicians' diagnostic conclusions on attention-deficit/hyperactivity disorder (ADHD). Moreover, we intended to explore a possible role that autism spectrum disorders (ASD) symptoms played in this process. We examined parent- and teacher-rated questionnaires collected remotely and an on-site evaluation of intelligence quotients from 342 subjects (18% females), aged 3–16 years, and referred for suspected ADHD. An easily interpretable machine learning model—decision tree (DT)—was built to simulate the clinical process of classifying ADHD/non-ADHD based on collected data. Then, we tested the DT model's predictive accuracy through a cross-validation approach. The DT classifier's performance was compared with those that other machine learning models achieved, such as random forest and support vector machines. Differences in ASD symptoms in the DT-identified classes were tested to address their role in performing a diagnostic error using the DT model. The DT identified the decision rules clinicians adopt to classify an ADHD diagnosis with an 82% accuracy rate. Regarding the cross-validation experiment, our DT model reached a predictive accuracy of 74% that was similar to those of other classification algorithms. The caregiver-reported ADHD core symptom severity proved the most discriminative information for clinicians during the diagnostic decision process. However, ASD symptoms were a confounding factor when ADHD severity had to be established. Telehealth procedures proved effective in obtaining an automated output regarding a diagnostic risk, reducing the time delay between symptom detection and diagnosis. However, this should not be considered an alternative to on-site procedures but rather as automated support for clinical practice, enabling clinicians to allocate further resources to the most complex cases. [ABSTRACT FROM AUTHOR]

Background: There is limited data on gastric emptying in dyspeptic children. We aimed to determine solid and liquid emptying rates in dyspeptic children and correlate with clinical characteristics. Methods: Charts of dyspeptic children undergoing 4‐hour dual‐phase gastric scintigraphy were reviewed for demographics, symptoms, and comorbidities. Key Results: In 1078 dyspeptic patients (65% females, median age 13 years) vomiting (55%), nausea (53%), and abdominal pain (52%) were the most common symptoms. The most common comorbidities were mental health (32%), neurologic (27%), and hypermobility spectrum disorders (20%). Solid and liquid emptying rates were aligned in 61.23%. Delayed solid with normal liquid emptying were noted in 2.5%, compared to delayed liquid with normal solid emptying in 26.16%. Abdominal pain had a trend for association with delayed or normal solid emptying (p = 0.06). Nausea was mostly reported with normal solid emptying (p < 0.0001) and underreported in patients <12 years with vomiting (29%). Abnormal solid emptying (rapid and delayed) was noted more frequently in children with mental health disorders (p = 0.027). Rapid liquid emptying was more common in children with genetic disorders (p = 0.032). Conclusion and Inferences: Over half of children with dyspepsia had delayed liquid gastric emptying, and one quarter had delayed liquid with normal solid emptying. Dual‐phase gastric emptying studies may help target therapy in dyspeptic children. Nausea is not a reliable symptom for dyspepsia in younger children. Given the significant association of abnormal gastric emptying in children with mental health disorders, we recommend screening and treating children with dyspepsia. [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]

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]

Children's screen time may affect their growth and development. However, differences in the impact of various psychiatric and psychological factors on children's screen time is a research gap. This study aimed to explore the differences in the influence of related factors affecting children's screen time based on their sleep, difficulties, and parental control among Japanese elementary and junior high school students. A cross-sectional survey was conducted among parents in Japan. Data on screen time duration, parent–child background, strengths and difficulties, sleep variables, and parental control types were collected from 225 households. A regression analysis revealed that high Strengths and Difficulties Questionnaire (SDQ) scores (β = 0.166, p = 0.008), sleep duration (β = −0.281, p < 0.001), and parental control (β = −0.204, p = 0.001) were significantly related to children's screen time. Additionally, it was found that parents' late bedtimes affect children's screen time by mediating children's sleep duration. This study, together with previous research, provides comprehensive insights into design interventions to decrease the screen time of children in the Japanese context. [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]

En France, les soins en pédopsychiatrie peuvent comporter des défis éthiques importants. Suite aux dernières recommandations du Contôleur général des lieux de privation de liberté (CGLPL) et aux modifications de la loi encadrant les mesures d'isolement et de contention en psychiatrie adulte, il est nécessaire de réfléchir à leur opérationnalisation dans la pratique des soins afin de trouver l'équilibre entre les impératifs de protection et le respect des jeunes hospitalisés en pédopsychiatrie. Élaborer des recommandations concernant l'usage de l'isolement et de la contention en pédopsychiatrie à la lumière des modifications législatives récentes et des enjeux éthiques spécifiques à la discipline. Dans le cadre de la Commission nationale de la psychiatrie, un groupe de travail, réunissant de nombreux pédopsychiatres, a été mis en place, en 2021, pour réfléchir aux enjeux contemporains de notre discipline. L'un des axes étudié – en lien avec le groupe de psychiatrie légale – a porté spécifiquement sur l'isolement et le contention en pédopsychiatrie. Une analyse des enjeux éthiques, à partir des principes de Beauchamp and Childress, est définie et adaptée au contexte pédopsychiatrique. Le groupe de travail a permis d'identifier les enjeux juridiques et éthiques spécifiques à leur discipline. À partir de l'analyse éthique de deux situations d'accompagnement difficile en pédopsychiatrie : (1) la pratique de l'électroconvulsivothérapie auprès des adolescents ; et (2) la gestion de la violence chez les jeunes avec autisme et déficience intellectuelle, les principaux conflits de valeurs sont identifiés en se référant, notamment, aux principes de non-nuisance, de bienfaisance, d'autonomie et de justice. À partir des travaux de recherches en éthique de l'enfance, la dimension relationnelle de l'autonomie est discutée en se référant aux concepts de « vulnérabilité partagée » et de « participation aux soins ». Des préconisations spécifiques à la pédopsychiatrie sont proposées pour promouvoir la reconnaissance des enfants et des adolescents hospitalisés en pédopsychiatrie, en tant qu'agent moral. In France, child psychiatry care can involve significant ethical challenges. Following the last recommendations of the Controller General of places of deprivation of liberty (CGLPL) and the modifications of the law framing the control measures (seclusion room and restraints) in adult psychiatry, it is necessary to reflect on their operationalization in providing care in order to find the balance between the imperatives of protection and the respect of the young people hospitalized in child psychiatry. To develop recommendations concerning the use of seclusion and restraint in child psychiatry in the light of recent legislative changes and associated ethical issues. Within the framework of the national commission of psychiatry, a working group bringing together many child psychiatrists was set up in 2021 to reflect on contemporary issues in our discipline. One of the axes studied – in connection with the forensic psychiatry group – was specifically concerned with isolation and restraint in child psychiatry. An analysis of the ethical issues based on the four principles of Beauchamp and Childress is defined and adapted for the child psychiatric context. The working group identified the legal and ethical issues specific to their discipline. Based on the ethical analysis of two difficult support situations in child psychiatry: (1) the practice of electroconvulsive therapy with adolescents; and (2) the management of violence in young people with autism and intellectual disabilities, the main conflicts of values were identified referring to the principles of non-maleficience, beneficence, autonomy and justice. Based on research in childhood ethics, the relational dimension of autonomy is discussed with reference to the concepts of "shared vulnerability" and "shared care planning". Specific recommendations for child psychiatry are proposed in order to promote the recognition as moral agents of children and adolescents hospitalized in child psychiatry. [ABSTRACT FROM AUTHOR]

Les notions de crise et d'urgence sont fréquemment confondues autant par les familles que par bon nombre de professionnels bien qu'elles ne soient pas synonymes. L'urgence en pédopsychiatrie correspond à une situation pathologique aiguë à laquelle s'associe la notion de risque vital pour le jeune. Alors que l'urgence exige une prise en charge immédiate du jeune, la crise nécessite, quant à elle, le développement de nouvelles manières de voir et de faire ainsi que de nouveaux mécanismes adaptatifs pour faire face aux changements. Suite à la nouvelle politique en santé mentale enfants-adolescents développée par le ministère de la Santé publique belge en 2015, l'unité thérapeutique adolescents destinée aux 10–18 ans de l'hôpital Vincent Van Gogh, a dédié 2 de ses 15 lits pour la prise en charge spécifique de la crise pédopsychiatrique. L'objectif de cet article est de présenter le fonctionnement du dispositif « lits de crise » au sein de l'unité. Seront définis tout d'abord la notion de crise ainsi que les modèles théoriques d'intervention proposés en clinique. Ensuite, le contexte historique de l'implémentation des lits de crises de l'hôpital VVG ainsi que leur fonctionnement seront évoqués. Enfin, 3 cas cliniques illustreront non seulement toute la prise en charge réalisée en unité de crise mais aussi les différentes issues possibles au terme du séjour. À travers ceux-ci, sera mis en évidence également l'impact qu'ont les facteurs individuels intrapsychiques et systémiques sur la crise et son devenir. The notions of crisis and emergency are frequently mixed up by family members, as well as by many professionals, although they are not synonymous. In child psychiatry, an emergency is an acute pathological situation which is associated with the idea that the child's life is in danger. While an emergency requires immediate care, a crisis requires the development of new ways of seeing and navigating the world, as well as new adaptive mechanisms to deal with these changes. Following the new child-adolescent mental health policy developed by the Belgian Ministry of Public Health in 2015, the therapeutic unit for adolescents (10 to 18-year-old) at the Vincent Van Gogh Hospital dedicated two of its fifteen beds to the treatment of child psychiatric crises. The objective of this paper is to present the functioning of the "crisis beds" device within the hospital unit. We will begin with a definition of the notion of crisis and of the theoretical models of intervention offered in clinics. This will be followed by an explanation of the historical context behind the implementation of the crisis beds in the Vincent Van Gogh hospital and a description of how this device works. We will conclude with an overview of three clinical cases which illustrate the extent of the treatment provided in the crisis unit and the different possible outcomes at the end of the stay. The influence of individual intrapsychic and systemic factors on the crisis and its aftermath will be highlighted through these cases. [ABSTRACT FROM AUTHOR]