scholarly journals The association between treated psychiatric and neurodevelopmental disorders and out-of-home care among Finnish children born in 1997

2021 ◽  
Author(s):  
Antti Kääriälä ◽  
David Gyllenberg ◽  
Reijo Sund ◽  
Elina Pekkarinen ◽  
Markus Keski-Säntti ◽  
...  
Keyword(s):  
Home Care ◽  
Children And Adolescents ◽  
Neurodevelopmental Disorders ◽  
Service Use ◽  
Neurodevelopmental Disorder ◽  
Significant Proportion ◽  
Psychiatric Services ◽  
Out Of Home Care ◽  
Oppositional Defiant ◽  
Self Harm

AbstractComprehensive overviews of the use of psychiatric services among children and adolescents placed in out-of-home care (OHC) by child welfare authorities are scarce. We examine specialized service use for psychiatric and neurodevelopmental disorders among children and adolescents in a total population involving children in OHC. We used the longitudinal administrative data of a complete Finnish birth cohort 1997 (N = 57,174). We estimated risk ratios (RRs) for a range of diagnosed psychiatric and neurodevelopmental disorders among children in OHC. We also estimated RRs for OHC among those with diagnosed disorders. We used descriptive methods to explore the timing of first entry into OHC relative to the first diagnosis. Among children in OHC, 61.9% were diagnosed with any psychiatric or neurodevelopmental disorder, compared with 18.0% among those never in OHC (RR: 3.7; 95% CI 3.6–3.8). The most common diagnosed disorders among children in OHC were depression and anxiety disorders, neurodevelopmental disorders, and oppositional defiant disorder/conduct disorder (ODD/CD). Among all children with any diagnosis, 18.1% experienced OHC, compared with 2.5% among those without a diagnosis (RR: 7.4; 95% CI 6.9–7.9). Of those diagnosed with self-harm and suicidality, ODD/CD, substance-related disorders, and psychotic and bipolar disorders, 43.5–61.2% experienced OHC. Of the children in OHC receiving psychiatric services, half were diagnosed before first placement in OHC. The majority of children with experience in OHC were diagnosed with psychiatric or neurodevelopmental disorders. They comprised a significant proportion of individuals treated for severe and complex psychiatric disorders and self-harm.

scholarly journals Neurodevelopmental Trajectories and Clinical Profiles in a Sample of Children and Adolescents With Early- and Very-Early-Onset Schizophrenia

2021 ◽  
Vol 12 ◽  
Author(s):  
Maria Pontillo ◽  
Roberto Averna ◽  
Maria Cristina Tata ◽  
Fabrizia Chieppa ◽  
Maria Laura Pucciarini ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Neurodevelopmental Disorders ◽  
Early Onset ◽  
Social Role ◽  
Treatment Plan ◽  
Neurodevelopmental Disorder ◽  
Communication Disorders ◽  
Autism Spectrum ◽  
Early Onset Schizophrenia ◽  
Assessment And Treatment

Schizophrenia before the age of 18 years is usually divided into two categories. Early-onset schizophrenia (EOS) presents between the ages of 13 and 17 years, whereas very-early-onset schizophrenia (VEOS) presents at or before the age of 12 years. Previous studies have found that neurodevelopmental difficulties in social, motor, and linguistic domains are commonly observed in VEOS/EOS patients. Recent research has also shown a high prevalence of neurodevelopmental disorders (e.g., intellectual disability, communication disorders, autism spectrum disorder, neurodevelopmental motor disorders) in VEOS/EOS patients, indicating genetic overlap between these conditions. These findings lend support to the neurodevelopmental continuum model, which holds that childhood neurodevelopmental disorders and difficulties and psychiatric disorders (e.g., schizophrenia) fall on an etiological and neurodevelopmental continuum, and should not be considered discrete entities. Based on this literature, in this study we focused on the overlap between neurodevelopmental disorders and schizophrenia investigating, in a large sample (N = 230) of VEOS/EOS children and adolescents, the clinical differences, at the onset of psychosis, between VEOS/EOS with neurodevelopmental disorder or neurodevelopmental difficulties and VEOS/EOS with no diagnosed neurodevelopmental disorder or neurodevelopmental difficulties. The findings showed that, in children and adolescents with a neurodevelopmental disorder or neurodevelopmental difficulties, psychosis onset occurred at an earlier age, was associated with more severe functional impairment (e.g., global, social, role), and was characterized by positive symptoms (e.g., grandiose ideas, perceptual abnormalities, disorganized communication) and disorganized symptoms (e.g., odd behavior or appearance, bizarre thinking). Instead, in children and adolescents without a neurodevelopmental disorder or neurodevelopmental difficulties, psychosis onset was mainly characterized by negative symptomatology (e.g., social anhedonia, avolition, expression of emotion, experience of emotions and self, ideational richness). Given these differences, the presence of a neurodevelopmental disorder or neurodevelopmental difficulties should be carefully investigated and integrated early into the assessment and treatment plan for VEOS/EOS patients.

scholarly journals Organisational models of health services for children and adolescents in out‐of‐home care: Health technology assessment

2019 ◽  
Vol 109 (2) ◽  
pp. 250-257
Author(s):  
Tita Mensah ◽  
Anders Hjern ◽  
Kickan Håkanson ◽  
Pia Johansson ◽  
Ann Kristine Jonsson ◽  
...  
Keyword(s):  
Health Services ◽  
Home Care ◽  
Health Technology Assessment ◽  
Children And Adolescents ◽  
Technology Assessment ◽  
Health Technology ◽  
Out Of Home Care ◽  
Care Health

Patterns of Service Use and Behavioral Health Profile of Children Placed in Out-of-Home Care

2021 ◽  
Vol 17 ◽  
Author(s):  
Svetlana Yampolskaya ◽  
Roxann McNeish ◽  
Quynh Tran
Keyword(s):  
Mental Health ◽  
Home Care ◽  
Behavioral Health ◽  
Service Use ◽  
Latent Class ◽  
Service Providers ◽  
Inpatient Psychiatric Care ◽  
Complex Needs ◽  
Out Of Home Care ◽  
Health Profiles

Aims: This study focused on describing profiles of children placed in out-of-home care. Background: Research has shown that children placed in out-of-home care have numerous problems related to trauma associated with child maltreatment and behavioral health. However, they often do not receive adequate care. Prior research suggested that to improve outcomes for these children it is essential to address co-occurring problems and tailor services to their individual needs. This, however, can be a serious challenge to service providers due to the lack of information about behavioral health profiles and maltreatment histories as well as patterns of service use. Objective: The aim of this study was to identify subgroups of children with similar mental health profiles and examine service use patterns amongst these groups. Methods: Latent class analysis (LCA) was used to describe the profile of children with similar behavioral health characteristics and service patterns. Results: Two distinct groups were identified: Children with Multiple Needs and Children in Families with Complex Needs. Children with Multiple Needs had a much higher rate of mental health diagnoses, caregiver loss, a higher number of emergency room visits for behavioral health reasons, and spending substantially more days in inpatient psychiatric care. Children in Families with Complex Needs had a much higher probability of experiencing neglect, having parents with substance abuse problems, and having a history of domestic violence. Conclusion: These findings suggest that Children with Multiple Needs represent the most vulnerable population and specific strategies should be developed to address co-occurring needs of these children by utilizing community-based services and the least restrictive settings. Implications of the findings are discussed.

scholarly journals Supporting Transition from Out of Home Care to Adulthood: Linked Data Is Central to The Compass Social Impact Bond

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Sharon Williams ◽  
Mark Sipthorp ◽  
Nicholas Ivkovic ◽  
Alexander Inglis
Keyword(s):  
Young People ◽  
Home Care ◽  
Linked Data ◽  
Social Impact ◽  
Service Use ◽  
Outcome Measurement ◽  
Service Design ◽  
Control Group ◽  
Out Of Home Care ◽  
Care Leavers

The COMPASS program supports young people to successfully transition from Out of Home Care to adulthood. COMPASS is a social impact bond partnership between Victorian government, not-for-profit organisations and investors. COMPASS uses linked data in every phase from design, to implementation, to outcome measurement. IntroductionStudies demonstrates that young care leavers experience significantly poorer outcomes than their peers. COMPASS is a preventative program progressivelyproviding 200 care leavers with access to housing and individualised support. The Centre for Victorian Data Linkage (CVDL) developed the Victorian Linkage Map (VLM) in 2016, linking 20 plus health and human services datasets with births and deaths data. Linked data provides a critical evidence base for COMPASS. Objectives and ApproachThe presentation describes application of linked data for COMPASS design, implementation and measurement. Linked data cohort analysis of post-care service use of 6000 young people informed the program design. Linked data also provides the basis for a stratification tool to measure the complexity profile of referrals. Health, housing and justice payable outcomes are measured by comparing relative performance of participants with a matched control group using linked data. ResultsImplementation of COMPASS has highlighted the value of linked data in service design and measurement of payable outcomes. It has also highlighted the challenges of using linked data in a real-world environment, including the need for thorough documentation and testing of specifications, calculations and processes. Conclusion / ImplicationsThe use of linked data for COMPASS provides a model for evidence-based service design and tests the use of linked data for robust and sustainable outcome measurement. The lessons from COMPASS are applicable to other social impact bonds and service implementation and outcome measurement more broadly.

Child and Adolescent Psychiatry

2014 ◽  
Author(s):  
Daniel T. Chrzanowski ◽  
Elisabeth B. Guthrie ◽  
Matthew B. Perkins ◽  
Moira A. Rynn
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Children And Adolescents ◽  
Attention Deficit ◽  
Neurodevelopmental Disorders ◽  
Externalizing Disorders ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Multiple Informants ◽  
Hyperactivity Disorder ◽  
Oppositional Defiant

Common disorders of children and adolescents include neurodevelopmental disorders (e.g., intellectual disability, autistic spectrum disorder, and learning disorders), internalizing disorders (e.g., mood and anxiety disorders), and externalizing disorders (e.g., oppositional defiant disorder and conduct disorder). The assessment of a child or adolescent patient always includes multiple informants, the context in which the child’s difficulties occur, and a functional behavioral assessment. Patients with autism spectrum disorder tend to have persistent deficits in social communication and social interaction, a restricted repertoire of behaviors and interests, and abnormal cognitive functioning. Children with disruptive mood dysregulation disorder experience chronic and severe irritability and frequent temper outbursts. Attention deficit hyperactivity disorder is characterized by hyperactivity, impulsivity, and inattention before 12 years of age. Behavior therapy has been effectively used to treat children and adolescents with neurodevelopmental disorders, attention deficit hyperactivity disorder, tic disorders, feeding and elimination disorders, and externalizing disorders. Fluoxetine is approved for treatment of depression in children and escitalopram, for adolescents. Methylphenidate and amphetamine preparations are first-line treatment for children with attention deficit hyperactivity disorder.

scholarly journals Out‐of‐home care placements of children and adolescents born preterm: A register‐based cohort study

2019 ◽  
Vol 34 (1) ◽  
pp. 38-47
Author(s):  
Suvi Alenius ◽  
Eero Kajantie ◽  
Reijo Sund ◽  
Markku Nurhonen ◽  
Pieta Näsänen‐Gilmore ◽  
...  
Keyword(s):  
Cohort Study ◽  
Home Care ◽  
Children And Adolescents ◽  
Out Of Home Care
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