Search

Neurofibromatosis 1 (NF1) is a single gene disorder associated with working Memory (WM) impairments. The aim of this study was to investigate P300 event-related potential (ERP) associated with WM in NF1. Sixteen adolescents with NF1 were compared with controls on measures of WM and EEG was recorded during a WM nback task. The NF1 group showed poorer performance on measures of WM as compared to the control group. No group differences were observed in P300 amplitude at Pz, but P300 latency was shorter in the NF1 group. Topographic analyses of P300 amplitude showed group differences indicating neural processing differences in the NF1 group relative to controls, which possibly contribute to the cognitive deficits seen in this population.

In order to support children and young people who are exploring their gender, we need to develop a shared understanding of gender identities and enhance the evidence base relating to long-term outcomes. All professionals working with children and young people should be trained in gender diversity. Health-care systems must be adapted to enable us to record gender identity; outcome measures should be developed that accommodate different gender identities. In doing so, we will develop clearer information about the number of children and young people who are exploring their gender and the way that gender identities develop throughout childhood. We will also start to demystify gender and work to enhance understanding and acceptance of diversity.

Health inequalities are high among offending groups. The comprehensive health assessment tool (CHAT) is a semi-structured assessment developed to provide a standardised approach to health screening...

There is increasing awareness of mental health problems among young children, and early years settings are encouraged to take a wider family support role in order to prevent mental health difficulties. Local population studies are needed to inform delivery of universal through to targeted services. In the current study, parents and teachers of 2% of early years children in one inner city local authority were contacted. A one-stage survey was undertaken using the Early Years Behaviour Checklist (EYBC) and questions ascertaining services required. Questionnaires were distributed in appropriate languages to parents and teachers of 364 children. About 362 teacher questionnaires and 177 parent questionnaires were returned. Detailed analysis of the teacher questionnaires demonstrated that 11% (40) of the children scored in the abnormal range on the EYBC for possible behaviour problems. Just under half of parents returned questionnaires, and 11.9% (21) of the children were scored in the abnormal range for possib...

Accessible summary • We wanted to find out how many children and young people with learning disabilities in our local authority also have mental health difficulties. • Parents and teachers of children and young people attending two schools for children with severe learning disabilities were asked to complete the Strengths and Difficulties Questionnaire. • We found that children and young people with learning disabilities were more likely to have mental health difficulties than most other groups of children and young people. • This information has been used to make suggestions for improving local services. Summary To plan the effective delivery of local services, it is important to find out the extent to which children with learning disabilities are perceived as experiencing difficulties such as finding it hard to behave or make friends, or being overactive. Having obtained ethical approval, the Strengths and Difficulties Questionnaire was sent to 178 parents and teachers of children attending one primary and one secondary school for children with severe learning disabilities. One hundred and forty-eight teacher’s questionnaires and 70 parent’s questionnaires were returned. Teachers thought that over one-third of pupils (39.2%) had serious difficulties; parents thought that about half of children (55.7%) had serious difficulties. These results are similar to some previous studies in the United Kingdom. To help plan effective service delivery, the report has been shared with the schools and local services for children. Teachers are also being encouraged to learn more about mental health problems and services that children can use to help their mental health.

The concept of gender identity disorder (GID) is complex, children may hide their conflict and receive intense reactions when they do disclose. Currently both the World Health Organisation and the American Diagnostic and Statistic Manual of Mental Disorders are being rewritten; this process has highlighted the dilemmas posed by choosing a gender that differs from ones birth sex. The aetiology and prevalence of GID is yet to be fully elucidated. A brief questionnaire examining age, ethnicity, comorbidity and service use was cascaded to identify colleagues in Central Manchester and surrounding trusts. Seven trusts were approached and 19 cases identified, 11 children were female at birth. This small audit demonstrates that there is a need for local and specialist services to manage both GID and the accompanying psychopathology.

A recent UK study identified that 11.5% of 11 – 16 year olds had a mental health disorder. A one-stage survey students in Manchester attending Key Stage 4 Pupil Referral Unit (PRU) sites was conducted as part of a larger study. The Strengths and Difficulties Questionnaire (SDQ) was accompanied by questions to collect demographic data and ascertain which services are wanted by parents and teachers. Mental health needs were higher in the PRU than the mainstream sample. These results pose implications for commissioning of child and adolescent mental health services and initiatives such as the Targeted Mental Health in Schools Project (TaMHS).

The paper assessed the ethnicity of referrals into SCAIT for possible ASD in the last financial year. Ethnicity information was compared to data from Manchester City Council on ethnic populations in electoral wards. There was found to be a difference between the percentage of referrals of different ethnic groups and the ethnic composition of the North Manchester population. Patients of White British, Bangladeshi, Chinese and Other ethnic groups were found to be underrepresented in the sample, whereas patients of Black African, Black Caribbean, and Pakistani ethnicities were proportionally overrepresented. There is a need for further investigation into ethnicity of referrals for assessment of possible ASD.

Background Electronic-learning describes the use of information technology or the internet for learning activities. Integrating e-learning into medical education is supported by adult learning theory; learners control content, sequence, pace, time and media, fitting different learning styles. Courses are standardized in terms of content and delivery and can include assessment and feedback. Implications Technology is a tool for deeper learning, and learning experiences beyond lecture-based learning. With the emergence of students who have grown up with technology, e-learning may increase. In an era of value for money, e-learning offers an opportunity to disseminate the experience of clinicians to a wide audience.

Compulsory education in the United Kingdom ends at 16. This paper explores the challenges of attempting to find a representative sample of 16 – 17 year olds. The authors worked with Connexions, the careers advisory service and sent out a one stage postal questionnaire survey. Sixty young people returned questionnaires, information was also provided by parents and connexions workers. About 17% of young people identified that they needed professional help, as did a similar proportion of Connexions workers, while parents felt about 14% of adolescents needed professional help. Data from the Strengths and Difficulties Questionnaire identified that this sample had high levels of mental health needs.

Within the UK, around 10% of children have mental health problems, but this is likely to be higher among certain specific populations. Children and young people attending provisions for social, emotional and behavioural difficulties (SEBD) are a particularly vulnerable group whose mental health needs are under-researched. The authors, Latha Hackett, Louise Theodosiou, Freya Spicer and Rachel Lever of the Winnicott Centre, Manchester, Claire Blackburn who is a clinical psychologist and Caroline Bond of Manchester University conducted a study which involved all pupils in two schools for children with SEBD. The views of parents and teachers were sought for a sample of 71 children. The Strength and Difficulties Questionnaire and a supplementary questionnaire were used to gain a broad picture of the mental health needs of this group and the services required. The findings from these questionnaires indicate a much higher than national level of perceived mental health difficulties within this population. This piece of research highlights that both teachers and parents identified a need for professional support, from education, social care, health and other services. These findings have implications for future commissioning of services.

There is growing awareness of mental health problems among children, and schools are increasingly being encouraged to take a wider role in preventing mental health difficulties. Local population studies are needed to inform delivery of universal through to targeted services. In the current study, parents and teachers of 2% of primary school children in one inner city local authority were contacted. A one‐stage survey was undertaken using the Strengths and Difficulties Questionnaire (SDQ). The SDQ is a brief behavioural screening questionnaire for 3–16 year olds designed to identify some possible mental health problems and their level of chronicity. In addition to the SDQ, a supplementary questionnaire was also used in order to ascertain services that respondents felt were needed. Questionnaires were distributed to the teachers and parents of 507 children in appropriate languages. Four hundred and three teacher questionnaires and 159 parent questionnaires were returned. Detailed analysis of the teacher que...

Background: Little is known about the satisfaction of the parents of children receiving child and adolescent mental health services in general, and autistic spectrum services in particular. Method: This audit examined parent and carer perceptions of the Autistic Spectrum Disorder assessments undertaken by the multi-agency team in a Tier Three CAMHS in Manchester. Forty families completed a brief questionnaire. Results: The majority of parents and carers reported satisfaction with the service (95%), although responses highlighted areas in both the assessment process and the service facilities that needed improvement. Conclusions: Useful information with both local and national applications can be gathered quickly in an easily replicated manner.

BackgroundResearch has revealed high levels of mental health needs in young offenders but many studies have been small, focusing on specific populations.AimsTo evaluate the mental health and psychosocial needs of a nationally representative sample of juvenile offenders in England and Wales, including female offenders and those from Black and minority ethnic groups.MethodA cross-sectional survey of 301 young offenders, 151 in custody and 150 in the community, was conducted in six geographically representative areas across England and Wales. Each young person was interviewed to obtain demographic information, mental health and social needs, and psychometric data.ResultsYoung offenders were found to have high levels of needs in a number of different areas including mental health (31%), education/work (36%) and social relationships (48%). Young offenders in the community had significantly more needs than those in secure care and needs were often unmet. One in five young offenders was also identified as having a learning disability (IQ < 70).ConclusionsNeeds for young offenders were high but often unmet. This emphasises the importance of structured needs assessment within custody and community settings in conjunction with a care programme approach that improves continuity of care.

In 2000, about 350 million adults used the internet and people increasingly take articles from websites to medical appointments. The quality and safety of websites vary widely and some users are reluctant to access mainstream sites. People are vulnerable to misinformation and exploitation: there is evidence that online purchases have caused morbidity and mortality. This paper reviews the current evidence on the dissemination of health information on the internet and the various strategies that are developing to assess and screen site quality. Such strategies include ‘quality assurance’ marking, specially designed search engines, and operational criteria for individuals to apply to sites. It also discusses the medical community's roles and responsibilities in relation to this burgeoning area.

Background: ADHD is estimated to affect 3 – 5% of British children with evidence of persistence into adulthood. Evidence for a genetic component underscores the importance of understanding the impact on families. Aim: To examine ADHD symptoms in parents attending clinic with an affected child. Method: The Adult Self Report Scale (v1.1) was given to a sample of parents. General mental health questionnaires (GHQ-12) and demographic factors were also collected. Results: 45.83% of parents showed ADHD symptoms. Family size greater than four correlated to high symptom scores. Conclusion: ADHD rates in parents were higher in this sample than general population rates of adult ADHD.

Over recent years there has been concern regarding health service accessibility for minority ethnic groups and this was reflected in the introduction of mandatory recordings of patient ethnicity upon hospital admission ([Giu & Johnson, 1995][1]). British community-based epidemiological studies

There is a growing body of work elucidating the demographics surrounding autistic spectrum disorders. This study sought to develop the local evidence base, enhance the awareness of educationalists in north Manchester and test the hypothesis that young people from all cultural groups are able to access the mental health service. The Social Communication Assessment and Intervention Team in the North Manchester Child and Adolescent Mental Health Service received 89 referrals of children with suspected autism between April 2010 and June 2011. Information was available about 69 cases. Some cases are still in the process of assessment while 20 children and young adults have received a diagnoses of autistic spectrum disorders; 4 African Caribbean, 11 White British, 3 Pakistani, 1 dual heritage and 1 did not complete the form. Further demographics and implications for training are discussed.

Background. Studies have indicated possible links between substance use disorder and other psychiatric disorders and suggested a high prevalence of unmet mental health needs amongst those with substance use disorders compared to the general population. Method. The study investigated the mental health needs of adolescents attending a substance misuse service. Mental health needs were assessed using the Strengths and Difficulties Questionnaire, the Conners screen for Attention Deficit Hyperactivity Disorder and a brief measure ascertaining demographics, drug use, and the service required by young people. Results. Young people were found to have higher than normal rates of mental health problems; this was not reflected in referral rates from the service. Conclusion. The findings are relevant to both commissioners and service providers. There is a need for integration between mental health services and those working with young substance users to provide a model of care that caters for dual diagnosis. Furthermore, offering mental health training to teams working with drug-using young people is recommended.

Emerge is an innovative Child and Adolescent Mental Health Service that provides support for 16-17 year olds. The team provide a community based multi-disciplinary, open access model, texting young people and travelling to locations convenient to them. There is an enhanced duty system providing a rapid flexible response within working hours.To examine the referral data as part of the ongoing annual audit cycle and to establish prevalence of alcohol, cigarettes and substance use among young people referred to the service.Data from the case notes was analysed using Statistical Package for Social Science. Demographic details, referrer profession, reason for referral, other services involved and substance use were examined.There were 437 patients referred to Emerge between 1/4/2010 and 31/3/2011, and 387 patients were accepted while 50 were signposted on. Cases were not accepted if they fell outside the age and geographical area, or were not in need of a mental health service. Overall, 24% of young people were reported to consume alcohol, 19% used cannabis and 9% reported using cigarettes. In all categories there were areas where documentation was not complete, and we suggest that these figures are an underestimate.This data has been fed back to the team, a full morning of teaching regarding drugs and alcohol has been delivered. Emerge often works with young people who are marginalised and may be harder to reach, consequently early sessions require neutral and supportive questions, thus if young people do not return after the first appointment, histories may be incomplete. The team will be reflecting on the lessons learned and considering ways to optimise their work.

Background. User feedback is now an integral part of both clinical governance and service development, and it also provides a key route to engaging parents and children. Autistic spectrum disorders (ASDs) can impact on all members of a family, and close working between parents and professionals is essential. Aim. To explore parental satisfaction rates and identify areas in need of improvement. Method. A postal survey was completed by parents whose children had been diagnosed with an ASD in the past 18 months in a Manchester Child and Adolescent Mental Health Service. The National Autism Plan for Children was used as a gold standard. Results. Parents were particularly satisfied with the way team members dealt with them and their children during appointments. However, the standard of written information provided about the condition, diagnosis, and support available could be improved. The findings show the benefits of receiving a diagnosis in the recommended timeframe. Discussion. We discuss ways of effectively using scarce resources.

[][1] This book is a challenging read. Timimi writes with a forceful style that at times can feel didactic; his sentences are long, and his punctuation sparse. I found myself needing a clear head and firm concentration to understand his concepts. My experience of child psychiatry

Adolescence can be associated with increased difficulties for young people, and those experiencing mental health problems can be more susceptible to substance misuse. This increased vulnerability is something health professionals must be aware of and recognise promptly; this increased risk is escalating and can have detrimental effects on both psychological and physical health. This is a re-audit including 369 case notes of substance misuse prevalence in a 16-17 year old community based Manchester CAMHS service “Emerge”. 28% of referrals disclosed problems with substance misuse – confirming the suspected high levels of misuse present amongst young people with mental health problems. This audit offers an opportunity to evaluate service provisions and analyse data collected.