Psychotherapy, psychological education, medical education in the work of a particular child / adolescent psychiatrist

2020 ◽  
Vol LII (2) ◽  
pp. 97-101
Author(s):  
Olga P. Shmakova
Keyword(s):  
Medical Education ◽  
Psychiatric Care ◽  
Social Adaptation ◽  
Childhood And Adolescence ◽  
Adolescent Psychiatrist ◽  
The Social ◽  
Education Medical ◽  
Outpatient Psychiatric Care

In order to develop a comprehensive methodology for outpatient psychiatric care for children and adolescents that can improve the social adaptation of patients, we analyzed the data of long-term clinical catamnestic follow-up of a cohort of patients with various mental disorders in childhood and adolescence. The methods of psychotherapy, psycho-education and medical education suitable for outpatient care are discussed.

scholarly journals NIMG-66. LONG-TERM FOLLOW-UP OF NEUROFIBROMATOSIS TYPE 1 PATIENTS USING WHOLE-BODY MRI DEMONSTRATES DYNAMIC CHANGES IN INTERNAL NEUROFIBROMA SIZE

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi176-vi176
Author(s):  
Ina Ly ◽  
Raquel Thalheimer ◽  
Wenli Cai ◽  
Miriam Bredella ◽  
Vanessa Merker ◽  
...  
Keyword(s):  
Tumor Growth ◽  
Neurofibromatosis Type 1 ◽  
Neurofibromatosis Type ◽  
Whole Body ◽  
Childhood And Adolescence ◽  
Entire Study ◽  
Whole Body Mri

Abstract BACKGROUND Neurofibromas affect 40–50% of neurofibromatosis type 1 (NF1) patients and can cause significant morbidity and mortality. They grow more rapidly during childhood and adolescence but studies in adults are limited by their retrospective nature and follow-up time < 3 years. The long-term natural history of neurofibromas remains unknown. No guidelines exist on the need and frequency of surveillance imaging for patients. Whole-body MRI (WBMRI) can detect whole-body tumor burden, including internal neurofibromas. METHODS 17 adult NF1 patients who underwent WBMRI between 2007–2010 (Scan 1) underwent repeat WBMRI between 2018–2019 (Scan 2). Internal neurofibromas were segmented on short tau inversion recovery (STIR) sequences and tumor volume was calculated using a computerized volumetry and three-dimensional segmentation software. Circumscribed tumors were defined as discrete; invasive tumors or those involving multiple nerves were defined as plexiform. Tumor growth and shrinkage were defined as volume change ≥ 20% over the entire study period. RESULTS Median patient age was 43 years during Scan 1 and 53 years during Scan 2. Median time between Scan 1 and 2 was 9 years. A total of 140 neurofibromas were assessed. 24% of tumors grew by a median 63% (6.8% per year). 54% of tumors spontaneously decreased in volume by a median 60% (7% per year) without treatment. On a per-patient basis, 18% of patients had overall tumor growth and 41% overall tumor shrinkage. 8 new tumors developed in 7 patients. 16 tumors resolved entirely without medical or surgical intervention. Growth behavior did not correlate with discrete or plexiform morphology. CONCLUSION A subset of internal neurofibromas in adult NF1 patients grow significantly over a long-term period, suggesting that continued monitoring of these patients may be warranted. Surprisingly, more than half of neurofibromas shrink spontaneously without intervention. Continued patient enrollment and correlation of imaging findings with functional outcomes are underway.

Quality of life in long-term survivors of CNS tumors of childhood and adolescence.

1991 ◽  
Vol 9 (4) ◽  
pp. 592-599 ◽  
Author(s):  
E N Mostow ◽  
J Byrne ◽  
R R Connelly ◽  
J J Mulvihill
Keyword(s):  
Quality Of Life ◽  
Late Effects ◽  
Pediatric Brain Tumor ◽  
Adverse Outcomes ◽  
Cns Tumors ◽  
Childhood And Adolescence ◽  
Long Term Survivors

Clinical reports of small numbers of pediatric brain tumor patients observed for brief periods suggest that long-term survivors continue to have major handicaps into adulthood. To quantify these late effects we interviewed 342 adults (or their proxies) who had CNS tumors diagnosed before the age of 20 between 1945 and 1974, survived at least 5 years, and reached 21 years of age. Survivors were 32 years old on average at follow-up. When compared with 479 matched siblings as controls. CNS tumor survivors were more likely to have died or to have become mentally incompetent sometime during the follow-up period. They were more likely to be at risk for such adverse outcomes as unemployment (odds ratio [OR], 10.8; 95% confidence interval [CI], 4.6 to 25.7], to have a health condition that affected their ability to work (OR, 5.9; CI, 3.7 to 9.4), to be unable to drive (OR, 28.8; CI, 6.9 to 119.9), or to describe their current health as poor (OR, 7.8; CI, 1.7 to 35.7). Unfavorable outcomes were more frequent in male survivors than in females, in those with supratentorial tumors compared with infratentorial ones, and in those who received radiation therapy. As clinicians consider improving therapies, they should anticipate late effects, such as those we observed, and attempt to target subgroups for interventions that may improve subsequent quality of life.

Disability pensions in severely disturbed in-patient adolescents

1998 ◽  
Vol 172 (2) ◽  
pp. 159-163 ◽  
Author(s):  
M. Pelkonen ◽  
M. Marttunen ◽  
E. Pulkkinen ◽  
P. Laippala ◽  
J. Lönnqvist ◽  
...  
Keyword(s):  
Psychosocial Functioning ◽  
Disability Pension ◽  
Psychiatric Care ◽  
Critical Time ◽  
Working Capacity ◽  
Short Term ◽  
Related Factors ◽  
Long Term Prognosis

BackgroundKnowledge of working capacity from adolescence until adulthood among severely disturbed in-patients is scarce.MethodIn a follow-up study of 61 adolescent in-patients, we studied associations between being on a disability pension 20 years after hospitalisation, and the patients' psychopathology and treatment-related factors during the hospitalisation and seven-year follow-up.ResultsOf the former in-patients. 27% had not been on a disability pension, 20% had short-term pension periods, and 53% were pensioned. Subjects whose overall psychosocial functioning had improved and who had not utilised in-patient services until the seven-year follow-up, had a better prognosis in terms of working capacity Half of the subjects who had not been on pension during the follow-up had received a diagnosis of conduct disorder at discharge, and half of those pensioned had a psychotic disorder.ConclusionsThe patients' level of psychosocial functioning and capability to work in young adulthood were associated with long-term prognosis in terms of working capacity Adolescence seems to be the critical time for intensive psychiatric care combined with vocational rehabilitation programmes.

scholarly journals Long-Term Follow-Up of Thyroid Function in Patients Who Received Bone Marrow Transplantation during Childhood and Adolescence

2004 ◽  
Vol 89 (12) ◽  
pp. 5981-5986 ◽  
Author(s):  
Hiroyuki Ishiguro ◽  
Yukiharu Yasuda ◽  
Yuuichiro Tomita ◽  
Tsuyoshi Shinagawa ◽  
Takashi Shimizu ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Thyroid Function ◽  
Marrow Transplantation ◽  
Childhood And Adolescence ◽  
Long Term Follow Up

scholarly journals Depressive disorders in childhood

2022 ◽  
Vol 10 (19) ◽  
pp. 52-58
Author(s):  
Elva J. Corona-Olivera
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Social Development ◽  
Depressive Disorders ◽  
Behavioral Therapy ◽  
Childhood And Adolescence ◽  
Timely Manner ◽  
Development Environment ◽  
The Social ◽  
First Contact

Depression is one of the main psychiatric disorders that prevails during childhood and adolescence. The causes are multifactorial, of which the following stand out: traumatic events, the social development environment, genetics and brain chemistry accompanied by some anatomical and functional alterations. The consequences can be serious in the long term and can even contribute to the problem if it is not identified and referred promptly or lead to suicide, once the diagnosis has not been effective. The treatment for depression is complex and includes drugs and cognitive-behavioral therapy. This article aims to help first contact physicians to diagnose in a timely manner to act in situations that may endanger the patient with this condition, and therefore refer to specialists.

Long-Term Surveillance and Life-Time Care for Pediatric Patients Suffering from Hydrocephalus

2020 ◽  
Vol 18 (06) ◽  
pp. 297-300
Author(s):  
Matthias Krause ◽  
Andreas Merkenschlager ◽  
Cynthia Vanessa Mahr ◽  
Matthias K. Bernhard ◽  
Ekkehard M. Kasper ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Life Time ◽  
Outcome Data ◽  
Continuous Treatment ◽  
Childhood And Adolescence ◽  
Long Term Follow Up ◽  
Optimal Setting ◽  
Screening Intervals

AbstractEven though shunt surgery has been an established and widely accepted treatment for congenital hydrocephalus for five decades, long-term follow-up and functional outcome data are scarce. Based on our experience, we advocate a very rigid follow-up regimen throughout life for every hydrocephalus patient encountered with individual screening intervals not longer than 1 year in childhood and adolescence and surveillance intervals of 2 years in adulthood. A continuous treatment of the patients at the primary institution that performed hydrocephalus surgery provides an optimal setting to be prepared for the detection of adverse events of shunt malfunctioning. However, some patients may still encounter catastrophic events resulting in persistent deficits or death.

scholarly journals The Stockholm Follow-up Study of Users Diagnosed with Psychosis (SUPP): A 10-year Follow-up 2004–2013

2020 ◽  
Author(s):  
Per Bülow ◽  
Alain Topor ◽  
Gunnel Andersson ◽  
Anne Denhov ◽  
Claes-Göran Stefansson
Keyword(s):  
Mental Illness ◽  
Social Services ◽  
Psychiatric Care ◽  
Institutional Care ◽  
Living Conditions ◽  
Supported Housing ◽  
Western World ◽  
Follow Up Study ◽  
The Social

AbstractSince the 1970s, psychiatric care in the western world has undergone fundamental changes known as de-institutionalisation. This has changed the living conditions for people with severe mental illness. The purpose of this study was to investigate the living conditions and utilisation of care and social services for a group of people in Sweden with diagnosis of psychosis over a 10-year period, 2004–2013. During this period, psychiatric care decreased at the same time as interventions from the social services increased. Half of the persons in the studied group did not have any institutional care, that is, neither been hospitalised nor dwelling in supported housing, during the last 5 years, and just over 20% had no contact with either psychiatry or the municipality's social services during the last 2 years of the investigated period.

Home point-of-care international normalised ratio monitoring sustained by a non-selective educational program in children

2012 ◽  
Vol 108 (10) ◽  
pp. 710-718 ◽  
Author(s):  
Caroline Elie ◽  
Radhia Cheurfi ◽  
Aurélie Grazioli ◽  
Maladon Traore ◽  
Patrick Souillard ◽  
...  
Keyword(s):  
Adverse Events ◽  
Point Of Care ◽  
Underlying Disease ◽  
Median Number ◽  
Self Testing ◽  
The Social ◽  
International Normalised Ratio ◽  
Compliance To Treatment

SummaryAdverse events related to vitamin K antagonist (VKA) therapy might be reduced by point-of-care international normalised ratio (POC INR) monitoring supported by an education program (EP). Our aim was to evaluate the efficacy of a non-selective VKA paediatric EP (regardless of the social, economic, educational or linguistic levels) by analysing the time spent in the therapeutic range (TTR), VKA adverse events and compliance to treatment, and INR control prescriptions. The EP was modified from the pediatric EP previously described but improved by a specifically devised child-focused game. One hundred four consecutive children (median age 8 years) receiving VKA were included in a standardised E P. Patients were in self-testing, and dose adjustments were made by a single physician for three tolerance ranges according to the underlying disease: [2.5–4], [1.8–3.2], and [1.5–2.5]. The median follow-up was 481 days [70–1,001]. The overall TTR was 81.4% [36–100]. The TTR were 74%, 85.6% and 89% for the ranges [2.5–4], [1.8–3.2], and [1.5–2.5], respectively. These results were sustainable during the study period. Only one serious VKA adverse event was recorded. The median number of POC INR tests was 2.5 [1.6–5.7] INR per patient and month. Patients/families performed POC INR when requested in 86.9% of the cases. More than 90% of the families found the EP supportive and wished to follow a long-term reinforcement program. In conclusion, this non-selective child-focused EP for VKA therapy, strongly supported by our dedicated game, is useful in maintaining efficacy, safety and compliance to anticoagulation and its monitoring.

scholarly journals Risk of ESKD in Older Live Kidney Donors with Hypertension

2019 ◽  
Vol 14 (7) ◽  
pp. 1048-1055 ◽  
Author(s):  
Fawaz Al Ammary ◽  
Xun Luo ◽  
Abimereki D. Muzaale ◽  
Allan B. Massie ◽  
Deidra C. Crews ◽  
...  
Keyword(s):  
Antihypertensive Therapy ◽  
Absolute Risk ◽  
Hazard Ratio ◽  
Long Term Outcomes ◽  
Hypertension Guidelines ◽  
Mortality Hazard ◽  
The Social ◽  
Mortality Hazard Ratio

Background and objectivesHypertension in older kidney donor candidates is viewed as safe. However, hypertension guidelines have evolved and long-term outcomes have not been explored. We sought to quantify the 15-year risk of ESKD and mortality in older donors (≥50 years old) with versus those without hypertension.Design, setting, participants, & measurementsA United States cohort of 24,533 older donors from 1999 to 2016, including 2265 with predonation hypertension, were linked to Centers for Medicare and Medicaid Services data and the Social Security Death Master File to ascertain ESKD development and mortality. The exposure of interest was predonation hypertension. From 2004 to 2016, hypertension was defined as documented predonation use of antihypertensive therapy, regardless of systolic BP or diastolic BP; from 1999 to 2003, when there was no documentation of antihypertensive therapy, hypertension was defined as predonation systolic BP ≥140 or diastolic BP ≥90 mm Hg.ResultsOlder donors were 82% white, 6% black, 7% Hispanic, and 3% Asian. The median follow-up was 7.1 years (interquartile range, 3.4–11.1; maximum, 18). There were 24 ESKD and 252 death events during the study period. The 15-year risk of ESKD was 0.8% (95% confidence interval [95% CI], 0.4 to 1.6) for donors with hypertension (mean systolic BP, 138 mm Hg) versus 0.2% (95% CI, 0.1 to 0.4) for donors without hypertension (mean systolic BP, 123 mm Hg; adjusted hazard ratio, 3.04; 95% CI, 1.28 to 7.22; P=0.01). When predonation antihypertensive therapy was available, the risk of ESKD was 6.21-fold higher (95% CI, 1.20 to 32.17; P=0.03) for donors using antihypertensive therapy (mean systolic BP, 132 mm Hg) versus those not using antihypertensive therapy (mean systolic BP, 124 mm Hg). There was no significant association between donor hypertension and 15-year mortality (hazard ratio, 1.18; 95% CI, 0.84 to 1.66; P=0.34).ConclusionsCompared with older donors without hypertension, older donors with hypertension had higher risk of ESKD, but not mortality, for 15 years postdonation. However, the absolute risk of ESKD was small.

The History of Clinical Neuropsychology in Israel

2016 ◽  
Author(s):  
Eli Vakil ◽  
Dan Hoofien
Keyword(s):  
Social Implication ◽  
Clinical Neuropsychology ◽  
Theoretical Frameworks ◽  
Neuropsychological Rehabilitation ◽  
The Social ◽  
Long Term Follow Up ◽  
History Of ◽  
State Of Israel

The history of clinical neuropsychology in Israel has been affected by both the worldwide development of the field of neuropsychology, which began in the 1970s and provided the conceptual and theoretical frameworks of clinical neuropsychology, and by the social implication of the unique geopolitical situation of the state of Israel. These circumstances led to a great need for neuropsychological rehabilitation services initially for veterans and later for civilians. While European and American influences are evident in the scientific knowledge of neuropsychology and neuropsychological assessment, Israel has been pioneering, creative, and original in neuropsychological rehabilitation. Israel’s contributions are reflected in the research conducted on various aspects of rehabilitation that has exploited an advantage that exists in Israel—the long-term follow-up of individuals after traumatic brain injury (TBI). This research has, in turn, encouraged the formation of graduate programs and training facilities for clinical neuropsychology at most of the universities in Israel.

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