ABSTRACT
Background: Developing theoretical courses for post-graduate medical training that are aligned to current workplace-based learning practices and adaptive to change in the field is challenging, especially in (sub) specialties where time for re-design is limited and needs to be performed while education continues. Approach: An instructional design method was applied based on flexible co-design to improve post-graduate theoretical courses in child and adolescent psychiatry (CAP) in the Netherlands. In four phases over a period of three years, courses were re-designed at a national level. Evaluation: Once common vision and learning goals were agreed upon and the prototype was developed (phases 1 and 2), the first courses could be tested in daily practice (phase 3). Phase 4 refined these courses in brief iterative cycles and allowed for designing additional courses building on and adding to previous experiences in brief iterative cycles. The resulting national theoretical courses re-allocated resources previously spent on a local level using easily accessible online tools. This allowed trainees to align content with their clinical rotations, personal preferences and training schedules. Reflection: The development of theoretical courses for post-graduate medical training in smaller medical (sub-)specialties with limited resources may profit from a flexible instructional design method. We consider the potential merit of such a method to other medical specialties and other (inter-)national efforts to develop theoretical teaching courses. A longer-term implementation evaluation is needed to show to what extent the investment made in the re-design proves to be future-proof and enables rapid adaptation to changes in the field.
Subject(s)
Education, Medical, Graduate , Humans , Education, Medical, Graduate/methods , Netherlands , Curriculum/trends , Adolescent Psychiatry/education , Adolescent Psychiatry/methods , Child Psychiatry/education , Child Psychiatry/methodsABSTRACT
Los trastornos psiquiátricos en la infancia y adolescencia pueden persistir, cambiar, remitir o aumentar en la edad adulta. Este estudio explora la estabilidad y las trayectorias diagnósticas de 311 niños y adolescentes entre 3 y 17 años hasta la edad adulta. Se encuentra que la estabilidad diagnóstica varía en función de la enfermedad. Los cambios de diagnóstico son más frecuentes en el trastorno de conducta y los trastornos afectivos, mientras que la mayor estabilidad diagnóstica se da en las dificultades del aprendizaje, trastorno de déficit de atención con hiperactividad y trastornos del espectro autista. La remisión completa es más frecuente en los trastornos de ansiedad. Los diagnósticos psiquiátricos tienen implicaciones sociales, emocionales y prácticas. Es necesario adaptar los recursos de salud mental a las necesidades de cada grupo de edad. (AU)
Psychiatric disorders in childhood and adolescence may persist, change, remit or increase in adulthood. This study explores the diagnostic stability and trajectories of 311 children and adolescents aged 3-17 years into adulthood. Diagnostic stability is found to vary according to pathology. Diagnostic changes are more frequent in conduct disorder and affective disorders, while the highest diagnostic stability was found in learning difficulties, attention deficit learning disabilities, attention deficit hyperactivity disorder and autism spectrum disorders. Complete remission is more frequent in anxiety disorders. Psychiatric diagnoses have social, emotional and practical implications. Mental health resources need to be adapted to the needs of each age group. (AU)
Subject(s)
Humans , Male , Female , Child , Adolescent , Mental Disorders/diagnosis , Child Psychiatry/methods , Adolescent Psychiatry/methods , Follow-Up Studies , Cohort StudiesABSTRACT
Psychiatry and psychology have a long history of competition that too often interferes with the collaboration that can characterize complementary contributions to our common missions. We hope this article will inspire our disciplines to expand on this collaboration, for the sake of our children and families, our communities, our colleagues, and honestly, ourselves. We are better together than apart. This text is a blueprint for the assumptions, attitudes, skills, and advocacy that can make this partnership healthy and successful.
Subject(s)
Child Psychiatry/methods , Delivery of Health Care, Integrated/organization & administration , Primary Health Care , Psychology, Child/methods , Adolescent , Child , Humans , Interprofessional Relations , Intersectoral Collaboration , Mental Health , Models, Organizational , Primary Health Care/ethics , Primary Health Care/organization & administrationABSTRACT
Psychosomatic medicine explores the psychological, behavioral, and social elements that influence people's health and quality of life. This discipline develops skills and knowledge used in the evalua tion and management of psychosocial elements interfering in the process of illness and healing. The Child and Adolescent Consultation-Liaison Psychiatry (CACLP) is a discipline that has been empi rically installed in order to favor adherence to treatments and recovery of children and teenagers du ring the process of illness. There is a need for developing this discipline in Chile, but so far there are limited national and international records and literature dedicated to it. The objective of this article is to update the concepts of structure and describe how a CACLP unit in a high complexity teaching hospital works in general, discussing the clinical challenges involved in these issues.
Subject(s)
Adolescent Psychiatry/organization & administration , Child Psychiatry/organization & administration , Hospitals, University/organization & administration , Mental Disorders/diagnosis , Mental Disorders/therapy , Psychosomatic Medicine/organization & administration , Referral and Consultation/organization & administration , Adolescent , Adolescent Psychiatry/methods , Child , Child Psychiatry/methods , Child, Preschool , Chile , Female , Humans , Infant , Infant, Newborn , Male , Psychosomatic Medicine/methodsABSTRACT
There is an urgent need for new clinical models to improve access to child mental health care. Pediatricians are tasked to care for youth with mild to moderate mental health problems, but require additional training. This article describes an outpatient child psychiatry consultation clinic (CPC) designed to empower pediatricians to care for youth with depression, anxiety, and attention deficit/hyperactivity disorder. Over a 2-year period, 40 primary care physicians (PCPs) referred 159 patients to the CPC. The most common primary diagnoses of patients seen for consultation were generalized anxiety disorder (35%), major depressive disorder (24%), and attention deficit/hyperactivity disorder (20%). Most patients (89%) had at least 2 psychiatric diagnoses. Nearly four fifths (79%) of these patients successfully returned to their PCP for ongoing care. PCPs reported that the CPC enhanced their skills and improved access to mental health care. Similar models are needed to facilitate early intervention for the millions of youth with mental health problems.
Subject(s)
Child Psychiatry/methods , Mental Disorders/therapy , Mental Health Services/statistics & numerical data , Pediatricians/statistics & numerical data , Practice Patterns, Physicians'/statistics & numerical data , Referral and Consultation , Adolescent , Child , Child, Preschool , Clinical Competence/statistics & numerical data , Female , Humans , Male , Outpatients/psychology , Pediatrics/methods , Primary Health Care/methodsABSTRACT
OBJECTIVES: The study aimed to investigate the association between maternal body mass index (BMI) in early pregnancy and children's intellectual disability (ID) risk in the absence of chromosomal disorders, neurofibromatosis and tuberous sclerosis, taking adverse birth outcomes, maternal hypertension/diabetes and maternal socioeconomic status into consideration. METHODS: We conducted a cohort study of singletons without common genetic defects born in Sweden during 1992-2006, and followed them from birth until 31 December 2014 (n=1 186 836). Cox proportional hazards models were used to analyse the association between maternal BMI in early pregnancy and the risk of offspring's ID. RESULTS: The risk of ID was higher in children born to mothers who were underweight (HR=1.21, 95% CI=1.07 to 1.36), overweight (HR=1.28, 95% CI=1.21 to 1.34) or had obesity class I (HR=1.63, 95% CI=1.53 to 1.74), obesity class II (HR=2.08, 95% CI=1.88 to 2.30) and obesity class III (HR=2.31, 95% CI=1.46 to 3.65) than in children born to normal weight mothers. Results remained consistent after excluding children with adverse birth outcome or born to mothers with gestational hypertension/diabetes. Analysis stratified by maternal education and annual household income showed that the association between maternal underweight and children's ID risk was attenuated among children of mothers with tertiary education or with high income. CONCLUSIONS: Our findings suggest that maternal underweight or overweight/obesity in early pregnancy was associated with the development of ID in their offspring. This association was independent of the effect of adverse birth outcomes and maternal hypertension/diabetes. High socioeconomic status may attenuate the risk of ID among children of underweight mothers. This study highlights the importance of improving health education before conception to reduce children's ID risk.
Subject(s)
Child of Impaired Parents , Intellectual Disability , Obesity , Pregnancy Complications , Thinness , Adult , Body Mass Index , Child , Child Psychiatry/methods , Child of Impaired Parents/psychology , Child of Impaired Parents/statistics & numerical data , Cohort Studies , Female , Humans , Intellectual Disability/diagnosis , Intellectual Disability/epidemiology , Intellectual Disability/prevention & control , Male , Obesity/complications , Obesity/diagnosis , Obesity/epidemiology , Preconception Care/methods , Pregnancy , Pregnancy Complications/diagnosis , Pregnancy Complications/epidemiology , Pregnancy Outcome/epidemiology , Risk Factors , Social Class , Sweden/epidemiology , Thinness/complications , Thinness/diagnosis , Thinness/epidemiologyABSTRACT
RESUMEN La condición neurológica definida por la aparición de alteraciones en la percepción, usualmente interpretada como fenómenos extraños de metamorfosis y despersonalización, se reconoce como síndrome de Alicia en el país de las maravillas. Se presenta el caso de una paciente femenina de 9 años de edad, con el diagnóstico de síndrome de Alicia en el país de las maravillas secundario a medicación crónica con montelukast. El diagnóstico del síndrome psiquiátrico se realizó teniendo en consideración los antecedentes patológicos personales y el examen físico. El síndrome de Alicia en el país de las maravillas tiene un carácter benigno, sumamente infrecuente, y aunque su etiología no es del todo conocida, su aparición como reacción adversa a medicamentos es una opción que debe ser siempre considerada por el médico actuante (AU).
ABSTRACT The neurological condition defined by the appearance of alterations in perception usually interpreted as strange phenomena of metamorphosis and depersonalization is recognized as Alice in wonderland syndrome. The case of a 9-year-old female patient is presented, with the diagnosis of Alice in Wonderland syndrome secondary to chronic medication with montelukast. The diagnosis of the psychiatric syndrome was made taking into account personal pathological history and physical examination. Alice in Wonderland syndrome has a benign, extremely rare character and although its etiology is not fully known, its appearance, as an adverse reaction to medications, is an option that should always be considered by the acting physician (AU).
Subject(s)
Humans , Male , Female , Child , Drug-Related Side Effects and Adverse Reactions/complications , Alice in Wonderland Syndrome/chemically induced , Asthma/drug therapy , Case Reports , Child , Child Psychiatry/methods , Child Psychiatry/standards , Alice in Wonderland Syndrome/diagnosis , Alice in Wonderland Syndrome/etiology , Alice in Wonderland Syndrome/pathology , Alice in Wonderland Syndrome/psychologyABSTRACT
INTRODUCCIÓN: El ingreso de menores en unidades de hospitalización de psiquiatría de adultos constituye un problema debido a la ausencia de recursos adecuados y de datos epidemiológicos. OBJETIVO: Describir y analizar las características sociodemográficas y clínicas de los menores que ingresaron en la Unidad de Hospitalización Breve de Psiquiatría en Cáceres. Sujetos y métodos: Estudio observacional, descriptivo y retrospectivo. La muestra estuvo definida por pacientes de edades comprendidas entre los 12 y los 18 años, hospitalizados en la unidad de psiquiatría. El periodo de evaluación fue entre el 1 de enero del 2014 y el 31 de diciembre del 2018. RESULTADOS: Se incluyeron 79 pacientes. La edad media fue de 15,72 (± 1,65) años. El 93,6% presentaron antecedentes psiquiátricos personales. El diagnóstico al alta más frecuente en los varones fueron los trastornos destructivos del control de impulsos; en las mujeres los trastornos afectivos. El 40,6% presentaron antecedentes de consumo de sustancias, siendo más frecuente en varones, lo cual empeoraba el pronóstico. La estancia media fue de 5,4 (± 4,7) días. La prolongación de la estancia media se relacionó con los antecedentes de ingresos psiquiátricos previos, el número de diagnósticos al alta, un mayor número de fármacos al alta y aquellos que recibieron antipsicóticos inyectables de liberación prolongada (p < 0,005 en todos los casos). CONCLUSIONES: El estudio identifica el perfil sociodemográfico y clínico del menor ingresado en la unidad de psiquiatría y cómo la estancia hospitalaria se asoció con antecedentes psiquiátricos previos y una complejidad diagnóstica y clínica
INTRODUCTION: The admission of minors into adult psychiatric units is a problem and is due to the lack of adequate resources and epidemiology data. OBJECTIVE: The aim of this study is to describe and analyse the sociodemographic and clinical characteristics of minors that were admitted into the Short-Stay Psychiatric Hospitalisation Unit of Caceres, Spain. MATERIALS AND METHODS: A retrospective, observational, and descriptive study was conducted on a sample of patients between 12 and 18 years-old admitted to the Psychiatric Unit. The study period was between January 1, 2014 and December 31, 2018. RESULTS: A total of 79 patients, with a mean age of 15.72 (± 1.65) years, were included. Almost all of them (93.6%) had a personal psychiatric history. The most common diagnoses at discharge in males were disruptive, impulse-control and conduct disorders, and mood disorders in females. A history of substance consumption was present in 40.6%, and was more common in males, which led to a worse prognosis. The mean stay was 5.4 (± 4.7) days. Prolongation of the mean stay was associated with a history of previous psychiatric admissions, the number of diagnoses at discharge, a greater number of drugs at discharge, and those that received long-acting injectable antipsychotic drugs (p < 0.005 in all cases). CONCLUSIONS: The study identified the sociodemographic and clinical profile of the minor admitted to the Psychiatric Unit, and how the hospital stay was associated with previous psychiatric history, as well as diagnostic and clinical complexity
Subject(s)
Humans , Male , Female , Child , Adolescent , Hospitalization , Psychiatric Department, Hospital/statistics & numerical data , Adolescent Psychiatry/methods , Child Psychiatry/methods , Epidemiology, Descriptive , Retrospective Studies , Length of StayABSTRACT
The clinical and diagnostic debate circulating pediatric bipolar disorder (PBD) has been highlighted as one of the most controversial themes in child psychiatry. With atypical symptomatic expression, constituting its predominant diagnostic discrepancy, PBD is manifested through prolonged manic episodes and affective storms, lacking the symptomatic cycling and episodic nature presented in adult BD. Apart from its unique clinical presentation, the substantial symptomatic overlap with attention deficit hyperactivity disorder (ADHD) indicate an important diagnostic challenge in PBD. Specifically, both disorders share core characteristics such as irritability, hyperactivity, excessive talking and distractibility. Against this background of findings on the overlapping symptomatology between PBD and ADHD, current research guidelines highlight the need of exploring non-symptomatic markers as potential clinical phenotypes. Especially in disorders with distinctive biologic underpinnings, both clinicians and researchers have shown increased interest in establishing neuropsychological profiles. Recent neuropsychological studies indicated the distinct nature of neurocognitive deficits in PBD, describing impairments in various cognitive skills during acute episodes phases, while this severe deterioration of cognitive deficits appears to persist even during euthymic states. Regarding neuropsychological assessment in AHD, recent findings suggested dysfunctions in the domains of working memory, verbal memory and response inhibition. Furthermore, neuroimaging studies are fast becoming a key instrument to establish distinct neuropsychological profiles for PBD and ADHD. A large number of neuroimaging studies have indicated abnormalities in limbic, cortical and subcortical brain systems, while meta-analytic findings of voxel based morphometric studies highlight abnormalities in dorsolateral and lateral orbitofrontal-temporal areas in PBD. In recent neuroimaging findings with focus on neurocognitive performance during an emotional Stroop task, patients diagnosed with ADHD indicated activation on higher cortical centres associated with processing speed and significantly decreased role of sustained attention. Furthermore, these findings suggest emotional regulation and inhibitory control are moderately intercorrelated, adding more complexity to the theme of neurocognitive deficits in ADHD. These observations on the neurobiological mechanisms of cognitive impairments in PBD appear to provide robust evidence on a potential specific neuropsychological profile of PBD, the relationship between mood states and neuropsychological functioning, and the link between emotion generation and regulation in children with PBD.
Subject(s)
Attention Deficit Disorder with Hyperactivity , Bipolar Disorder , Child Psychiatry , Neuropsychological Tests , Adolescent , Attention Deficit Disorder with Hyperactivity/diagnosis , Attention Deficit Disorder with Hyperactivity/physiopathology , Attention Deficit Disorder with Hyperactivity/psychology , Bipolar Disorder/diagnosis , Bipolar Disorder/physiopathology , Bipolar Disorder/psychology , Child , Child Psychiatry/methods , Child Psychiatry/trends , Humans , Neuroimaging/methods , Psychiatric Status Rating ScalesSubject(s)
Adolescent Psychiatry , COVID-19 , Child Psychiatry , Mental Disorders , Mental Health Services/standards , Physical Distancing , Telemedicine , Adolescent , Adolescent Psychiatry/methods , Adolescent Psychiatry/trends , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/psychology , Child , Child Psychiatry/methods , Child Psychiatry/trends , Family Health , Humans , Internet-Based Intervention , Mental Disorders/epidemiology , Mental Disorders/therapy , SARS-CoV-2 , Singapore/epidemiology , Telemedicine/ethics , Telemedicine/methods , Telemedicine/standardsABSTRACT
Oxidative stress is now believed to play a crucial role for neurodevelopment disorders such as autism spectrum disorders (ASD) and attention deficit hyperactivity disorder (ADHD). To review the most recent literature regarding the role of oxidative stress for the pathophysiology of ASD and ADHD, we conducted a systematic search of the relevant literature and further discuss the clinical and research implications of this knowledge. A systematic search in PubMed database retrieved 132 articles, of which 33 were included in the review. This review found relevant evidence concerning the role of oxidative status in ASD and ADHD, albeit with some contradictory findings. In order to overcome the incongruities found, more studies are needed in the study of neurodevelopmental disorders, with more thorough study designs and particular attention to the accuracy of the diagnostic tools used for the cases included.
Subject(s)
Attention Deficit Disorder with Hyperactivity/complications , Attention/physiology , Autism Spectrum Disorder/complications , Oxidative Stress/physiology , Behavior/physiology , Child Psychiatry/methods , HumansABSTRACT
As in other European countries, the current COVID-19 pandemic has not only massively restricted normal life in Germany but it is also having a significant effect on medical treatment, particularly in the areas of child and adolescent psychiatric care, as well as on university teaching. The federal structure of Germany and epidemiological differences between individual federal states have had a crucial impact on the regulations issued and their success. During the last number of weeks, tele-child-psychiatry and psychotherapy have increased, and outpatient services have been used cautiously and sparingly. Medical staff numbers will be augmented by doctors and nurses returning from retirement and also by medical students on a voluntary basis. The federal government has warned that discrepancies in education will increase due to the closure of schools. Questions of child protection are currently of particular importance in the context of such closures and the non-availability of day-care centers.
Subject(s)
Adolescent Psychiatry/education , Betacoronavirus , Child Psychiatry/education , Coronavirus Infections/psychology , Mental Disorders/therapy , Pneumonia, Viral/psychology , Adolescent , Adolescent Psychiatry/methods , COVID-19 , Child , Child Psychiatry/methods , Germany , Humans , Mental Disorders/psychology , Pandemics , SARS-CoV-2ABSTRACT
OBJECTIVE: to identify the knowledge of professionals of mental health services and social work on Behavior Disorders (BD) in childhood and adolescence, and to analyze their actions in care for children and adolescents with such disorders. METHOD: a qualitative, descriptive-exploratory study with 13 professionals from two mental health services and two tutorial councils. The data were collected in interviews and submitted to thematic content analysis. RESULTS: three categories emerged from the interviews: "Knowledge about behavior disorders", which defines BD as deviations from normality and lack of limits. "Integrated and group care", which explains the integrated, multidisciplinary and group actions. "Specialized and legal care", which explains the actions through specialized, medical and judicial care. FINAL CONSIDERATIONS: the results point out weaknesses and knowledge gaps of professionals, causing potential harm in the programming of effective actions, such as identification, referral and therapeutic planning.
Subject(s)
Clinical Competence/standards , Health Personnel/standards , Mental Disorders/therapy , Social Work/standards , Adolescent , Child , Child Psychiatry/methods , Clinical Competence/statistics & numerical data , Female , Health Personnel/statistics & numerical data , Humans , Male , Mental Disorders/psychology , Mental Health Services , Qualitative Research , Social Work/methods , Social Work/statistics & numerical dataABSTRACT
BACKGROUND: Enhancements in mobile phone technology allow the study of children and adolescents' everyday lives like never before. Ecological momentary assessment (EMA) uses these advancements to allow in-depth measurements of links between context, behavior, and physiology in youths' everyday lives. FINDINGS: A large and diverse literature now exists on using EMA to study mental and behavioral health among youth. Modern EMA methods are built on a rich tradition of idiographic inquiry focused on the intensive study of individuals. Studies of child and adolescent mental and behavioral health have used EMA to characterize lived experience, document naturalistic within-person processes and individual differences in these processes, measure familiar constructs in novel ways, and examine temporal order and dynamics in youths' everyday lives. CONCLUSIONS: Ecological momentary assessment is feasible and reliable for studying the daily lives of youth. EMA can inform the development and augmentation of traditional and momentary intervention. Continued research and technological development in mobile intervention design and implementation, EMA-sensor integration, and complex real-time data analysis are needed to realize the potential of just-in-time adaptive intervention, which may allow researchers to reach high-risk youth with intervention content when and where it is needed most.
Subject(s)
Adolescent Psychiatry/methods , Behavioral Symptoms/diagnosis , Child Psychiatry/methods , Ecological Momentary Assessment/standards , Mental Disorders/diagnosis , Psychology, Child/methods , Adolescent , Child , HumansABSTRACT
Nepal is a low and medium-income country (LMIC), situated in South-east Asia, with a population of 29 million, of which, 40-50% are children and adolescents. The Coronavirus Disease 2019 (COVID-19) pandemic has affected the lives of people around the world, including Nepal. The child and adolescent mental health (CAMH) needs and services in Nepal have a significant gap. CAMH in Nepal suffers from lack of specialized training in this field as well as scarcity of human resources and services. There is only one full-time child and adolescent psychiatry (CAP) out-patient clinic in the country. Some recent activities have focused on CAMH in Nepal but the COVID-19 pandemic has produced new challenges. Access to mental health services for children and adolescents (C&A) across Nepal has been adversely affected. Factors such as closure of schools, confinement at home, lockdown, transportation problems, uncertainty, loss of usual routine and fear of infection have affected the mental health of C&A. This has highlighted a need to build capacity of available local human resources, enhance community support, teach measures of coping with stress and improve CAMH service delivery by strengthening the referral system, but these have to be addressed overcoming problems of travel restrictions and limited resources. To address these needs, online platform can be a suitable approach. With this view, a multi-tier CAMH intervention model was developed, which utilizes online platform for training mental health professionals across Nepal, who would then facilitate sessions for C&A, teachers, parents and caregivers; and link them to CAMH services locally, and remotely through teleconsultation. This started as a pilot from June 2020 and will continue till end of February 2021, with the aim to reach 40,000 C&A, parents, teachers and caregivers. As of Nov 2020, this model has been used to successfully conduct 1,415 sessions, with 28,597 population reached. Among them, 16,571 are C&A and 12,026 are parents, teachers and caregivers, across all 7 provinces of Nepal. In this paper, the multi-tier intervention to address the COVID-19 related CAMH problems has been discussed as a feasible framework for resource limited settings and LMICs like Nepal.
Subject(s)
Adolescent Psychiatry/education , COVID-19/psychology , Child Psychiatry/education , Mental Health Services , Adolescent , Adolescent Psychiatry/methods , Child , Child Psychiatry/methods , Health Services Accessibility , Humans , NepalABSTRACT
OBJECTIVES: Evaluate the effectiveness of the Eyes Movement Desensitization and Reprocessing psychotherapy for children with Post-Traumatic Stress Disorder. METHODS: A retrospective study was conducted in the Child Psychiatry Department of CHU Mongi Slim, Marsa (Tunis, Tunisia). All Outpatients with a Post-Traumatic Stress Disorder diagnosis and who had Eyes Movement Desensitization and Reprocessing psychotherapy during the period from July 2016 to May 2018 were included. They were evaluated according to DSM 5 criteria in pre and post therapy. RESULTS: The sample consisted of sixteen children with a sex-ratio of 1.6. Their age ranged from 3 to 17 years old with a mean age of 9.5±4.6 years. Five patients were less than six years old. Our patients were exposed to a sexual assault (4 cases), a death of a family member (3 cases), a road accident (3 cases), a physical assault (4 cases), an arrest of the father (1 case) and burglary of the house (1 case). In 15 cases, the traumatic event was unique while it was repeated in one sexual assault case. The total number of follow-up sessions ranged from one to seven sessions with an average of 3±2.4 sessions. The average number of sessions for preschool children was 2.6±0.5 sessions. Bilateral tactile stimulations were used with thirteen children in our population, including the five children younger than six years old. At the end of the therapy all patients no longer met the criteria for Post-Traumatic Stress Disorder diagnosis. All the preschool patients and eight children older than 6 years did not respond to any of the four Post-Traumatic Stress Disorder criteria. The difference between the scores of the DSM 5 criteria in pre and post EMDR was statistically significant. We found P=10-3 for children over six years and P<0.05 for children under six years old. CONCLUSION: Eyes Movement Desensitization and Reprocessing is a therapy that has several advantages. First, it is effective in Post Traumatic Stress Disorder in children. Second, its protocol is flexible and adaptable to all ages and developmental level of the child. Third, the number of sessions is usually reduced, which is a great advantage over other trauma-focused psychotherapies.
Subject(s)
Eye Movement Desensitization Reprocessing , Stress Disorders, Post-Traumatic/therapy , Adolescent , Child , Child Psychiatry/methods , Child, Preschool , Cognitive Behavioral Therapy/methods , Eye Movement Desensitization Reprocessing/methods , Female , Humans , Male , Retrospective Studies , Stress Disorders, Post-Traumatic/epidemiology , Treatment Outcome , Tunisia/epidemiologySubject(s)
Acetamides/therapeutic use , Antidepressive Agents, Second-Generation/therapeutic use , Attention Deficit Disorder with Hyperactivity/drug therapy , Autism Spectrum Disorder/drug therapy , Adolescent , Adolescent Psychiatry/methods , Child , Child Psychiatry/methods , Humans , Off-Label Use , Randomized Controlled Trials as Topic , Treatment OutcomeABSTRACT
Background: Recently, the number of epidemiological studies of child psychiatry has increased, but most of these studies focus on children living in city centres. Unfortunately, one-third of the global population lives in rural areas, and various habitations exist in cities, including city centres and slums. Moreover, despite having a high risk for psychopathology development, individuals who have symptoms but fall outside the limits specified for diagnoses due to having fewer symptoms than those mentioned in diagnostic systems and individuals who do not fulfil the impairment criteria listed in diagnostic systems are not addressed in these studies.Aim: The purpose of this study was to understand the prevalence of DSM-IV childhood psychiatric disorders and subthreshold psychiatric problems from middle-class city centres, city centres in slums, towns and village areas of Turkey with a nationally representative sample using a state-of-the-art methodology.Methods: In total, 1080 children were randomly selected from second and third grades for the study's sample. A structured diagnostic interview was applied.Results: The overall prevalence of psychiatric disorders was 8.4% (n = 91); 7.2% (n = 78) of the children were subthreshold cases. The general prevalence of psychiatric disorders was higher among children living in villages with respect to all the other human settlement areas included in the study.Conclusions: Although global urbanisation foregrounds the mental health of children living in cities, children in rural areas may have a greater risk of developing a mental disorder. This study confirmed that an equal amount of children fell outside of the diagnosing limits.
