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Objectives: Despite high demand, culturally adapted therapies for Arabic speaking refugee patients with depression are rare. Aim of the study was to culturally adapt and evaluate the group treatment Metacognitive Training for Depression (D-MCT) for them., Methods: The cultural adaptation of the D-MCT included translation and surface adaptation as well as an expert discussion. The comprehensibility, acceptance and feasibility of the outpatient culturally adapted D-MCT (CA-D-MCT) were then tested in an uncontrolled pilot study with n=11 refugee patients., Results: The experts rated 83% of the translations and 78% of the illustrations as unproblematic in terms of equivalence. The acceptability and feasibility of the eight modules were predominantly positive., Conclusions: From the patients' perspective, the adapted training shows a high acceptance and comprehensibility for culturally sensitive, interpreter-supported implementation., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Background: Postpartum depression constitutes a significant public health issue, with prevalence rates ranging between 8 and 19% in high-income nations. Nevertheless, numerous barriers, including time constraints, societal stigmatization, and feelings of shame, contribute to the limited utilization of healthcare services during the postpartum period. Digital interventions offer an opportunity to enhance care for women experiencing postpartum depressive symptoms., Methods: We will conduct a two-arm randomized controlled trial to assess the effectiveness of a smartphone-based intervention in comparison to a treatment-as-usual control group in Germany. Our aim is to randomize 556 participants in a 1:1 ratio. Participants in the intervention group will be provided access to a preventive smartphone-based intervention called "Smart-e-Moms," which incorporates therapeutic support and comprises 10 concise modules rooted in cognitive-behavioral therapy. For the intervention group, evaluations will take place at baseline (t0), prior to sessions 4 and 8 (intermediate assessments), and upon completing the intervention 6 weeks after baseline (t1). The control group's assessments will be at baseline (t0) and 6 weeks after baseline. Follow-up assessments are scheduled at 12 and 24 weeks from baseline to examine the short-term stability of any observed effects. We anticipate that participants in the intervention group will exhibit improvements in their postpartum depressive symptoms (as measured with the Edinburgh Postnatal Depression Scale). Additionally, we will analyze secondary outcomes, including maternal bonding, stress levels, self-efficacy, satisfaction with the intervention, and healthcare utilization., Discussion: If Smart-e-Moms proves to be effective, it has the potential to play a significant role in postpartum depression care within German-speaking regions. Ideally, this intervention could not only benefit maternal well-being but also improve the prospects for healthy child development., Trial Registration: German clinical trials registry DRKS00032324. Registered on January 26, 2024., (© 2024. The Author(s).)

ΒACKGROUND: Children of parents with a mental illness have up to 50% chance of developing a mental illness themselves. Numerous studies have shown that preventive family-oriented interventions can decrease the risk by 40% and that professionals are a decisive factor influencing family-oriented practice. There are also substantial differences between professions in terms of their family-oriented practices. This study examines the level of family-oriented practice for different professional groups in Germany., Methods: Data were used from the baseline assessment of the two-group randomized controlled multicenter trial ci-chimps as a subproject of CHIMPS-NET, which took place from January 2020 to May 2021 in 18 clinical centers in Germany. Child and adolescent mental health systems as well as adult mental health systems took part and every professional involved in the treatment was invited to participate. Data was used from 475 mental health professionals including physicians, psychologists, psychotherapists for adults and for children and adolescents, occupational/ music/ physio/ art therapists/ (social) education workers and nursing/ education service. Family-oriented mental health practice was examined using the translated version of the Family-Focused Mental Health Practice Questionnaire (FFMHPQ) with means and standard deviations calculated for each of the 18 FFMHPQ-GV subscales. ANOVAs were computed to compare professions and significant differences were examined via post hoc analyses (Scheffé). Additionally, effect sizes were calculated (Omega squared)., Results: Differences were seen between the professions in all aspects of family-oriented practice: Both regarding organizational policy and support aspects, issues concerning working with parent-clients, as well as professional skills and knowledge aspects. Psychotherapists for children and adolescents scored the highest family-oriented practices compared to all other professional groups on almost all subscales., Conclusion: This study examines the level of family-oriented practice for different professional groups in Germany. Apart from skills and knowledge about the impact of mental illness and parenting, psychotherapists for children and adolescents had the highest scores and engaged most in family-oriented practice. Psychotherapists for adults got the least workplace support for family-oriented practice but were competent providing resources and referral information to the concerned families and feel confidence working with them. Due to these results, a training need exists to improve skills and knowledge about the impact of mental illness and parenting. Additionally, there is still potential for institutional support in promoting family-oriented work., Trial Registration: The CHIMPS-NET-study was registered with the German Clinical Trials Register on 2019-12-19 (DRKS00020380) and with Clinical Trials on 2020-4-30 (NCT04369625), the ci-chimps-study was registered with the German Clinical Trials Register (DRKS00026217) on 2021-08-27 and with Clinical Trials on 2021-11-04 (NCT05106673)., (© 2024. The Author(s).)

Background: Intense or problematic media use behavior of parents could serve as a role model for their children's media use behavior. So far, knowledge is scarce about increased children's media use (ICMU) and its association with parental stress (PS) and problematic parental media use (PPMU)., Methods: ICMU was examined using a modified set of the DSM-5 criteria for Internet Gaming Disorder. PS was assessed via the widely used Parenting Stress Index, and PPMU was assessed using the Short Compulsive Internet Use Scale. A multiple linear regression analysis was conducted to evaluate the links between ICMU, PS, and PPMU. A mediation analysis was performed to examine if PPMU mediated the relationship between PS and ICMU., Results: In sum, 809 parents ( M = 36.89 years; SD = 4.87; 81.4% female) of preschool children (average age: 44.75 months, SD = 13.68) participated in the study. ICMU was statistically significantly related to higher age of the parent, greater PPMU, and higher PS. Furthermore, we found that the association between PS and ICMU was partially mediated by PPMU., Conclusions: The results indicate that more pronounced PS and PPMU are associated with ICMU, highlighting the necessity of considering these parental variables when developing early prevention strategies for preschool-age children.

Children of parents with mental illness are at higher risk of developing cognitive, mental health or physical health difficulties. Previous studies have described several barriers for reaching parents with mental health problems (MHPs) and their utilization of psychosocial services. We conducted a cluster randomized controlled study in 24 pediatric and gynecologic practices to evaluate KID-PROTEKT, a psychosocial healthcare intervention that comprises a psychosocial assessment to identify families with psychosocial needs and refer them to support services. In this paper, we analyzed whether psychosocially distressed parents with additional MHPs (identified by the PHQ-9 and GAD-7) had higher support needs, could be referred to support and utilized it in comparison to parents with psychosocial burden only. In total, 178 pregnant women and mothers with psychosocial burden were included, of whom 55 had MHPs. Participants with MHPs were distressed in their relationships more often and medical staff rated their level of support needs higher compared to parents without MHPs. There were no significant differences between the groups regarding whether they were referred to support services or utilized the recommended services. All participants were most frequently referred to family or parent counseling/care or childcare assistance. The results indicate that despite existing barriers, parents with MHPs could be reached and identified by the KID-PROTEKT psychosocial assessment. A psychosocial intervention like KID-PROTEKT can help to provide support for mentally ill parents.

Background: Previous studies established a link between high screen time and mental health problems in childhood. The role of possible influencing factors is currently unclear. This study aims at testing correlations among mental health problems, high screen time, parenting stress, and inconsistent and positive parenting behavior., Methods: This study is based on data from the KiGGS and BELLA studies. For the present study, data from preschool children (age: 3-5 years, N = 417) and school children (age: 7-13 years, N = 239) were analyzed. Binary-logistic regressions were carried out to test for correlations between high screen time and children's mental health problems in cross-sectional and longitudinal analyses. Socioeconomic status, the child's gender, the parent's gender, parenting stress, and inconsistent and positive parenting behavior were used as control variables., Results: In the cross-sectional analysis, mental health problems in preschool children were associated with high screen time (OR = 3.02; p = 0.003), parenting stress (OR = 17.00; p < 0.001), and positive parenting behavior (OR = 0.24; p < 0.001). In the longitudinal analysis, mental health problems in school children were associated with parenting stress (OR = 4.04; p < 0.001). Socioeconomic status and the child's and parent's gender were at no point associated with mental health problems., Discussion: The sole existence of high screen time cannot explain mental health problems in children. Parental variables seem to be critical for children's mental health and should be considered in a holistic apporach on children's mental health in terms of strengthening parental competencies., (© 2023. The Author(s).)

Background: Interpersonal violence against children and adolescents can affect their mental health and functioning in the long term. To reduce mental health problems in children and adolescents, school-based mental health interventions have been shown to be beneficial. A review of school-based interventions designed to mitigate posttraumatic symptoms after interpersonal violence is lacking to date., Methods: We searched for original studies published in English or German until November 2019 in 6 electronic databases. Supplementary search strategies to reduce publication bias were implemented. Peer-reviewed original studies assessing school-based interventions for children and adolescents under the age of 21 after interpersonal violence were included. Relevant data was extracted, synthesised and assessed qualitatively. The methodological quality of included studies was assessed., Results: Of 5,021 unduplicated publications, 15 studies met eligibility criteria. The included studies were almost exclusively conducted in the USA; over half utilised a randomised-controlled design. Studies mainly focussed on Posttraumatic Stress Disorder (PTSD) or depression. In all studies, implemented interventions partially or fully mitigated posttraumatic symptoms. Nine school-based interventions, five of which were based on cognitive behavioural therapy (CBT), were identified. School staff were often involved in intervention implementation besides mental health professionals., Conclusions: School-based interventions can be beneficial to reduce mental health problems in children and adolescents after interpersonal violence. Trained school staff aided by mental health professionals can implement trauma-informed practices at school. While school-based interventions may be a feasible way to provide children and adolescents with accessible mental health care, further research on school-based trauma interventions outside the USA is necessary.

Background: Postpartum depression is a major public health concern, which is associated with negative consequences for both mothers and children. Unfortunately, many affected women neither understand the warning signs of postpartum depression nor do they know where to seek help. The aim of this study was to evaluate the feasibility of SmartMoms, a German mobile web application (web app) designed to inform women about postpartum depression, support them, and provide an easily accessible self-screening instrument., Methods: After its development, SmartMoms was distributed through healthcare providers and social media. Feasibility was assessed by examining (1) the experience of postpartum women with the web app, (2) user behaviour, and (3) the experience of healthcare providers with the web app and its distribution. A mixed methods approach was used, including online surveys, usage data, and interviews., Results: Most women used SmartMoms to prevent postpartum depression and rated the web app as good (on average 4.36 out of 5 stars). The majority of women (62.2%) accessing the self-screening instrument showed a risk for postpartum depression (Edinburgh Postnatal Depression scale score ≥ 12). Most providers (n = 12/13) felt supported through SmartMoms in discussing postpartum depression and considered it a useful offer. Suggestions for improvement were provided., Conclusions: SmartMoms meets the needs and expectations of mothers and healthcare providers interested in postpartum depression but should be further adapted to include more specific support options and additional information for professionals., (© 2023. The Author(s).)

Objective: School nurses are engaging worldwide to promote and protect children's health. Many researchers who examined the effectiveness of the school nurse criticized the inadequate methodology employed in many of the studies. We therefore carried out an evaluation on the effectiveness of school nurses based on a rigorous methodological approach., Methods: In this overview of reviews we performed an electronic databank search and global research results on the effectiveness of school nurses were sought. We identified 1,494 records through database search. Abstracts and full texts were screened and summarized using the dual control principle. We summarized the aspects of quality criteria as well as the significance of the effectiveness of the school nurse. In the first step, k = 16 systematic reviews were summarized and evaluated following the AMSTAR-2 guidelines. In a second step, j = 357 primary studies included in these k = 16 reviews were summarized and assessed following the GRADE guidelines., Results: Research results on the effectiveness of school nurses show that school nurses play a key role in improving the health of children with asthma (j = 6) and diabetes (j = 2), results on combating obesity are less certain (j = 6). The quality of identified reviews is mostly very low with only six studies of medium quality, of which one identified as a meta-analysis. A total of j = 289 primary studies were identified. Approximately 25% (j = 74) of identified primary studies were either randomized controlled trials (RCT) or observational studies, of which roughly 20% (j = 16) had a low risk of bias. Studies with physiological variables such as blood glucose or asthma labeling led to higher quality results., Conclusion: This paper represents an initial contribution and recommends further evaluation of the effectiveness of school nurses, particularly in the areas of mental health or children from low socioeconomic backgrounds. The general lack of quality standards in school nursing research should be integrated into the scientific discourse of school nursing researchers to provide robust evidence for policy planners and researchers., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Pawils et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

KID-PROTEKT is a child-centred psychosocial healthcare intervention which aims at improving the identification of psychosocial needs and navigation in the outpatient gynaecologic and paediatric setting. In this cluster randomized-controlled trail we examined the effect of KID-PROTEKT on the referrals (to support services) in comparison to the regular gynaecologic and paediatric outpatient healthcare . A variant based on the qualification of the healthcare providers (qualified treatment, QT) and a variant with social worker (supported treatment, ST) were compared to the regular healthcare (treatment as usual, TAU). Twenty-four gynaecologic and paediatric practices were randomized to one of three study arms. Therefore 8,458 pregnant women and families recruited in one of these practices were enrolled in the study. Participating patients reported on average 1.73 ( SD = 1.34) psychosocial risks. In total 522 patients were linked to a support service. Compared to TAU, the probability of a referral was significantly higher in QT ( OR = 10.70) and ST ( OR = 11.28). Also, a higher number of psychosocial risks were linked to a referral ( OR = 2.72). These findings support the importance of a psychosocial assessment in the gynaecologic and paediatric setting., Competing Interests: Conflict of Interest: The authors of this article declare no conflict of interest., (Copyright © 2023, Colegio Oficial de la Psicología de Madrid.)

Background: The perinatal period is a time of increased vulnerability to mental health problems, however, only a small proportion of women seek help. Poor mental health literacy (MHL) is a major barrier to seeking help for mental health problems. This study aimed to collect the existing evidence of MHL associated with perinatal mental health problems (PMHP) among perinatal women and the public. This review analysed which tools were used to assess perinatal MHL as well as the findings concerning individual components of perinatal MHL., Methods: Four electronic databases (PubMed, PsycINFO, Web of Science, and CINAHL) were analysed from their inception until September 1, 2020. Not only quantitative studies reporting on components of MHL (knowledge, attitudes, and help-seeking), but also studies reporting overall levels of MHL relating to PMHP were taken into account. Two independent reviewers were involved in the screening and extraction process and data were analysed descriptively., Results: Thirty-eight of the 13,676 retrieved articles satisfied the inclusion criteria. The majority of selected studies examined MHL related to PMHP in perinatal women (N = 28). The most frequently examined component of MHL in the selected data set was help-seeking. A lack of uniformity in assessing MHL components was found. The most common focus of these studies was postpartum depression. It was found that the ability to recognize PMHP and to identify relevant symptoms was lacking among both perinatal women and the public. Perinatal women had low intentions of seeking help for PMHP and preferred seeking help from informal sources while reporting a variety of structural and personal barriers to seeking help. Stigmatizing attitudes associated with PMHP were found among the public., Conclusions: There is a need for educational campaigns and interventions to improve perinatal MHL in perinatal women and the public as a whole., (© 2022. The Author(s).)

Background: Psychosocial stress can have detrimental effects on the mother's health and the development of the child. The aim of the family intervention "Babylotse ambulant" in gynecologic practices is the systematic and early identification of psychosocially distressed families as well as consulting and connecting them to the regional health and social care system., Objectives: The effectiveness of the family intervention in six gynecologic practices was investigated through a pre-post control group design using perceived self-efficacy as outcome. It was assumed that participation in the intervention would result in increased maternal self-efficacy as a measurement of faith in one's own abilities to solve problems., Methods: Self-efficacy of n=202 psychosocially distressed and n=262 non-distressed patients, who were screened in one of the six gynaecologic practices, was assessed using the Self-Efficacy Scale during the first trimester (T0) and one year after birth (T1)., Results: Psychosocially distressed mothers, who all received counselling from social workers, showed a significantly higher self-efficacy at T1 compared to T0. After the intervention, no significant differences were found between distressed patients and the control group of non-distressed patients who received no intervention., Discussion: Increased self-efficacy in distressed mothers after giving birth and thus, more faith in their own problem-solving capabilities points to the positive effects of the intervention during pregnancy in an outpatient gynecologic setting., Conclusion: Addressing psychosocial distress and strengthening self-efficacy is relevant in clinical interventions. As interface management, a pilot-based intervention like "Babylotse ambulant" can provide relief in the care of distressed patients during pregnancy and birth., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Background: Postpartum depression (PPD) is one of the most common mental illnesses in the postpartum period. If left untreated, it can have serious consequences for the mother-child relationship and the development of the child. In order to prevent possible negative effects, early diagnosis of affected mothers and professional care are essential., Aim of the Study: This article explores the sense of responsibility of the four primary care providers in the postpartum period-midwives, gynaecologists, general practitioners and paediatricians-and examines how they deal with the disease as well as the barriers and possibilities for optimisation in care., Materials and Methods: The primary care providers of postpartum women in Germany were interviewed in four independent studies. Quantitative questionnaires were used to interview midwives, gynaecologists and general practitioners, and a qualitative telephone survey was conducted with representatives of the German Association of Paediatricians and Adolescents (BVKJ). A systematic comparative analysis was carried out., Results and Discussion: Midwives and gynaecologists showed a significantly higher sense of responsibility for the recognition and treatment of PPD than general practitioners and paediatricians. Closer interdisciplinary cooperation and thus a wider range of referral and therapy options were named by all four professional groups as a central prerequisite for improving the care situation in Germany. A uniform regulation of financial remuneration is also an important aspect for all providers., (© 2022. The Author(s).)

In 2020, the number of reported cases of child maltreatment in Germany has never been higher and most of them showed signs of neglect. Most of the time, dental neglect (DN) appears together with a general form of neglect, and includes, apart from caries, many other negative short- and long-term effects for the affected child. In this study, the prevalence of DN in Germany and the way dental practices are currently addressing the topic are examined. Moreover, this study explored whether the experiences of German dentists with DN are related to their work experience, their gender or further education about DN. The data was collected using an anonymous questionnaire. The hypotheses were tested using unpaired t -tests based on differences in mean values. The three most common reasons for a suspected case of child maltreatment were the interaction of children with parents, or a legal guardian, insufficient oral or general hygiene, and grave caries. Even though most of the participating dentists agree that it is the task of the dentist to report suspected cases of child maltreatment, only few of them have done so in the past themselves. Not only insecurity about recognition and whom to contact in the suspected case, but also concern about unfounded suspicion were the most common reasons not to report a suspected case of DN. The detection and communication of suspected cases should be encouraged in order to protect affected children.

Background: Dental neglect (DN) is characterized within the wider framework of child neglect, though it is under-recognized by professionals., Aim: To get an overview of the prevalence of DN worldwide and highlight the possible risk factors associated with it., Methods: A systematic review was conducted according to PRISMA guidelines. Studies on children and adolescents aged 0-19 years were included. Studies were identified by searching in the various scientific databases up to 14 January 2020., Results: Ten primary studies were included in which DN or indicators of DN were examined. The prevalence estimate range of DN reported by seven of the included studies after removing the outliers is from 34% to 56%. The prevalence of untreated caries reported by three of the included studies ranged from 38.9% to 99%. The education level and SES of parents and parental attitudes towards dental health affect children's oral health. Moreover, looked-after children and children of refugees are at higher risk of DN., Conclusion: The study showed a high prevalence of DN and untreated caries. Due to the under-reporting of DN and a limited number of included studies, the results cannot be generalized worldwide. There is a need to make policies that include reporting of DN to higher authorities by dental professionals., (© 2021 The Authors. International Journal of Paediatric Dentistry published by BSPD, IAPD and John Wiley & Sons Ltd.)

Background: In Germany, approximately three million children under the age of eighteen have a mentally ill parent. These children are at an increased risk of developing a mental illness themselves (1) as well as a physical illness (2). While research has identified numerous evidence-based family-oriented interventions, little is known about how to implement such interventions effectively and efficiently in clinical practice in Germany. This implementation study (ci-chimps) evaluates three clinical implementation projects with three different implementation interventions for the optimal implementation of the tailored family-oriented preventive and therapeutic interventions in the CHIMPS-NET (children of mentally ill parents-research network) with an implementation model for children of mentally ill parents., Methods: A two-group randomized controlled multicenter trial will examine changes in family-oriented practice and aspects of implementation at baseline as well as at 12- and 24-months follow-up. The CHIMPS-Network consists of 20 clinical centers. The centers in the intervention group receive the support of all of the three implementation interventions: (1) optimal pathways to care, (2) education and a training program for professionals, and (3) systematic screening for children. The centers in the control group do not receive this specific implementation support., Discussion: While we know that children of mentally ill parents are an important target group to be addressed by preventive and therapeutic interventions, there is often a lack of structured implementation of family-oriented interventions in clinical practice in Germany. Using a randomized controlled multicenter trial design with a large and wide-ranging sample (clinics for adult psychiatry and clinics for child and adolescent psychiatry, university clinics and clinics at the real health care) will provide a robust understanding of implementing family-oriented changes in German clinical practice., Trial Registration: The CHIMPS-NET-study was registered with the German Clinical Trials Register on 2019-12-19 (DRKS00020380) and with Clinical Trials on 2020-4-30 (NCT04369625), the ci-chimps-study was registered with the German Clinical Trials Register (DRKS00026217) on 2021-08-27, the Clinical Trials registration is in review process., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Laser, Modarressi, Skogøy, Reupert, Daubmann, Höller, Zapf, Pawils, Taubner, Winter, Maybery and Wiegand-Grefe.)