Adolescent Psychiatry

青少年精神病学
  • 文章类型: Editorial
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  • 文章类型: Journal Article
    The S3 Guideline on the Treatment of Language Development Disorders: Summary of Recommendations Abstract: The German S3 Guidelines on the Treatment of Developmental Speech and Language Disorders (AWMF: No. 049-015) were published on the AWMF homepage at the end of 2022. The German Society for Phoniatrics and Paedaudiologie coordinated the work and developed the guideline text together with linguists and speech and language therapists. Many scientific medical societies consented to the respective recommendations. For the first time in the German-speaking area, the guideline group reviewed international research results on the treatment of various speech and language disorders and formulated evidence- or consensus-based recommendations for clinical care. The present article summarizes these recommendations and evaluates the guidelines from the perspective of child and adolescent psychiatry and psychotherapy.
    Zusammenfassung: Die S3-Leitlinie zur Therapie von Sprachentwicklungsstörungen (AWMF: Nr. 049-015), die Ende 2022 auf der Homepage der AWMF veröffentlich wurde, ist unter Federführung der Deutschen Gesellschaft für Phoniatrie und Pädaudiologie in Kooperation mit zahlreichen Sprachwissenschaftler_innen und Sprachtherapeut_innen entwickelt und von zahlreichen wissenschaftlichen medizinischen Fachgesellschaften konsentiert worden. Die Leitliniengruppe hat erstmalig für den deutschen Sprachraum versucht, die internationale Studienlage zur Therapie unterschiedlicher Sprach- und Sprechstörungen aufzuarbeiten und darauf basierend Evidenz- oder auch Konsensus-basierte Empfehlungen für die klinische Versorgung zu formulieren. In dem vorliegenden Artikel werden diese Empfehlungen zusammenfassend dargestellt, und es wird eine Wertung der Leitlinie aus Kinder- und Jugendpsychiatrischer Sicht vorgenommen.
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  • 文章类型: Journal Article
    超过一半的患有注意力缺陷/多动障碍(ADHD)的年轻人患有并存的精神病或医学疾病,这给治疗带来了挑战。兴奋剂是学龄前儿童对成人最有效的ADHD药物治疗,但经常会出现有关同时发生的疾病的安全性问题。此外,围绕诊断和治疗的污名会对护理产生负面影响。该手稿提供了基于证据的实践珍珠,以指导患有ADHD和常见并存的精神病和医疗状况的青少年的治疗决策。建议解决特定的兴奋剂不良反应(即,焦虑,心脏,增长,躁狂症,精神病)以及管理策略。珍珠是为最常见的临床问题而开发的,有争议的话题,或可能不广为人知的治疗问题。本手稿的目标是:1)为跨专业团队提供有关ADHD青少年使用兴奋剂的详细资源,2)通过基于证据的建议,改善患有ADHD和同时发生的精神病和/或医疗状况的青年的治疗结果,3)通过教育减少与兴奋剂使用相关的污名。
    Over half of youth with attention-deficit/hyperactivity disorder (ADHD) have co-occurring psychiatric or medical conditions that present treatment challenges. Stimulants are the most effective pharmacologic treatment of ADHD for preschoolers to adults but questions about safety with co-occurring conditions frequently arise. In addition, stigma surrounding diagnosis and treatment can negatively impact care. This manuscript presents evidence-based practice pearls to guide treatment decisions for youth with ADHD and common coexisting psychiatric and medical conditions. Recommendations address specific stimulant adverse effects (i.e., anxiety, cardiac, growth, mania, psychosis) along with management strategies. Pearls were developed for the most common clinical questions, controversial topics, or therapeutic issues that may not be widely known. The goals of this manuscript are to: 1) provide a detailed resource for interprofessional teams regarding stimulant use in youth with ADHD, 2) improve therapeutic outcomes for youth with ADHD and co-occurring psychiatric and/or medical conditions through evidence-based recommendations, and 3) decrease stigma associated with stimulant use through education.
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  • 文章类型: Journal Article
    据报道,青年中儿童和青少年精神科的再入院率正在增加。
    该研究旨在确定在儿童和青少年精神科的青少年精神病患者的再入院率和与再入院相关的因素。
    豪登省一家专科医院,南非。
    这项回顾性队列研究利用了青少年住院病房五年内住院患者的记录数据。使用生存分析方法计算从指标入院起出院一年内的累积发生率和再入院发生率。通过应用多变量Cox比例风险回归模型确定与再入院显着相关的特征。
    在纳入分析的189名患者中,出院后1年内再入院的累积发生率为17.5%.发病率为每10000人天5.31次再入院。最终的多变量模型显示,精神分裂症的诊断(p=0.015),诊断为注意缺陷多动障碍(p=0.039),来自儿童和青年护理中心或临时安全护理(p=0.018)增加了再次入院的风险,而患有疾病(p=0.008)则降低了风险。
    精神病诊断和住院护理可能是再次入院的潜在风险标志。改善保健和社会服务在住宿护理方面的合作将是有益的。
    确定使青少年精神病患者容易再次入院的因素可以告知并改善管理和风险评估。
    UNASSIGNED: Readmission rates to child and adolescent psychiatric units among the youth have been reported to be increasing.
    UNASSIGNED: The study aimed to determine the readmission rate and factors associated with readmission of adolescent psychiatric patients at a child and adolescent psychiatric unit.
    UNASSIGNED: A specialised psychiatric hospital in Gauteng province, South Africa.
    UNASSIGNED: This retrospective cohort study utilised data from the records of patients admitted to the adolescent inpatient unit over a period of five years. The cumulative incidence and incidence rate of readmission within one year of discharge from the index admission was calculated using survival analysis methods. Characteristics significantly associated with readmission were determined by applying the multivariable Cox proportional hazards regression model.
    UNASSIGNED: Among the 189 patients included in the analysis, the cumulative incidence of readmission within one year of discharge was 17.5%. The incidence rate was 5.31 readmissions per 10 000 person-days. The final multivariable model showed that a diagnosis of schizophrenia (p = 0.015), a diagnosis of attention deficit hyperactivity disorder (p = 0.039), and coming from a child and youth care centre or temporary safe care (p = 0.018) increased the risk of readmission while having a medical condition (p = 0.008) reduced the risk.
    UNASSIGNED: Psychiatric diagnosis and residential care could be potential risk markers for readmission. Improving the collaboration between health and social services in residential care would be beneficial.
    UNASSIGNED: Identifying factors that predispose adolescent psychiatric patients to readmission can inform and improve management and risk assessments.
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  • 文章类型: Journal Article
    注意缺陷多动障碍(ADHD)是一种非常普遍的神经发育障碍,发生在爱尔兰大约二十个年轻人中,在参加爱尔兰儿童和青少年心理健康服务(CAMHS)的人中,有三分之一。治疗多动症很重要,因为未治疗/治疗不良的ADHD与一系列负面的健康和社会经济结果有关。多动症的有效干预措施是可用的,以及标准化的使用,基于证据的ADHD评估和管理途径可优化结局。尽管如此,在爱尔兰,没有国家标准化的ADHD评估和治疗临床路径.ADMiRE,爱尔兰首个针对儿童和青少年的公共医疗专家服务,开发了一种强有力的证据,高效,ADHD评估和管理的有效和安全的临床路径。本文介绍了ADMiRE临床路径,并引用了可用于其他服务的ADMiRE资源。
    Attention deficit hyperactivity disorder (ADHD) is a highly prevalent neurodevelopmental disorder occurring in approximately one in twenty young people in Ireland, and in one-third of those attending Irish Child and Adolescent Mental Health Services (CAMHS). It is important to treat ADHD, as un/poorly treated ADHD is associated with a raft of negative health and socio-economic outcomes. Effective interventions for ADHD are available, and the use of standardised, evidence-based pathways for assessment and management of ADHD optimises outcomes. Despite this, there is no national standardised clinical pathway for assessment and treatment of ADHD in Ireland. ADMiRE, the first public healthcare specialist service for children and adolescents in Ireland, has developed a strongly evidence-based, efficient, effective and safe clinical pathway for assessment and management of ADHD. This paper describes the ADMiRE Clinical Pathway and references ADMiRE resources that are available to other services.
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  • 文章类型: Editorial
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  • 文章类型: Journal Article
    本文回顾了与公共宣传中的医学培训有关的现有文献,并为读者提供了一些培训示例,以在儿童和青少年精神病学研究金或联合培训计划中考虑。社区内的倡导培训,法医,综合护理,学校,以及整个培训过程中的许多其他经验提供了受训者将来在任何环境中练习时将使用的技能和工具。这种全面的培训方法与儿童和青少年心理健康的不断发展的景观相一致,在这种情况下,对公共卫生和宣传的深入承诺越来越重要。
    This article reviews the existing literature related to medical training in public advocacy and provides the reader with several training examples to consider in a child and adolescent psychiatry fellowship or in combined training programs. Advocacy training embedded within community, forensic, integrated care, school, and many other experiences throughout training provides the skills and tools that the trainee will use in the future when they practice in any setting. This comprehensive training approach aligns with the evolving landscape of child and adolescent mental health where a deep commitment to public health and advocacy is increasingly essential.
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  • 文章类型: Journal Article
    健康不平等的持续存在以及儿童和青少年精神病学中劳动力多样化的需要需要系统的解决方案。有建议和策略,特别是针对培训计划的“所有上述”方法来解决这些复杂的系统性问题。方法之一是通过减少现有和创新的培训管道泄漏来思考,提高质量,扩展类型和大小,并将它们连接到有需要的儿童和青少年。
    The persistence of health inequity and the need for workforce diverse representation within child and adolescent psychiatry require systemic solutions. There are recommendations and strategies particularly for the training programs with \"all of the above\" approach to tackle these complex systemic issues. One of the ways is to think through existing and innovative training pipelines by making them less leaky, enhancing quality, expanding the type and size, and connecting them to reach children and adolescents in need.
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  • 文章类型: Journal Article
    儿童和青少年精神科医生(CAPs)在提供临床护理方面起着至关重要的作用。CAPs具有独特的位置,可以理解和帮助患者在精神病护理中的细线,健康和幸福,以及支持或损害这些过程的法律和政策。关注弱势群体,如法律制度影响青年和家庭,CAPs可以为今天和明天的儿童不断发展一个更加公正和公平的世界做出贡献。
    Child and adolescent psychiatrists (CAPs) play a crucial role beyond the provision of clinical care. CAPs are uniquely placed to understand and help patients navigate the fine line among psychiatric care, health and well-being, and the laws and policies supporting or impairing these processes. Focusing on vulnerable populations, such as legal system impacted youth and families, CAPs can contribute to the ongoing development of a more just and equitable world for the children of today and of tomorrow.
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  • 文章类型: Journal Article
    本文强调了学校在解决青少年心理健康障碍方面的关键作用。它倡导卫生和教育部门之间的合作,强调儿童和青少年精神科医生对学校心理健康素养和干预措施的重大贡献。本文鼓励儿童和青少年精神科医生参与政策宣传,促进可获得和包容性的精神卫生保健,通过倡导资金支持可持续的精神卫生服务,培训,和政策支持。
    This article highlights the key role of schools in addressing rising mental health disorders among youth. It champions collaboration between health and educational sectors, emphasizing child and adolescent psychiatrists\' significant contribution to school-based mental health literacy and interventions. This article encourages for child and adolescent psychiatrists\' involvement in policy advocacy for accessible and inclusive mental health care, championing sustainable mental health services through advocating for funding, training, and policy support.
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