Overcoming traps and challenges in child and adolescent psychiatry

Appropriate healthcare and psychological support for children and adolescents is essential for the successful development and good mental health. Unfortunately, this is often a neglected element in the healthcare systems around the world. It is known that approximately half of all adult psychiatric disorders start under the age of 14 and that the prevalence of child and adolescent-onset psychiatric conditions is increasing. The real reason for this increase remains unclear but it demands our attention as does the care of affected children, adolescents and their families. Transitions between different age groups need to be made easily navigable for the patients and their families. Many challenges in child and adolescent psychiatry are present, especially in developing countries such as in Serbia. A possible solution for overcoming these challenges is uniting of child and adolescent professional societies from all over the world. These societies should work together to develop unified strategies for diagnosis, treatment and support of children affected by psychiatric conditions. By working closely with pediatricians, family physicians, psychologists, nurses and other professionals, child and adolescent psychiatry can use knowledge and skills to support practice while teaching other professionals how to optimize the utilization of child and adolescent psychiatry services

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Child and adolescent psychiatry: general aspects of care

Psychiatry ◽

10.1093/oso/9780198754008.003.0024 ◽

2019 ◽

Author(s):

Rebecca McKnight ◽

Jonathan Price ◽

John Geddes

Keyword(s):

Young People ◽

Adolescent Psychiatry ◽

Child And Adolescent ◽

Child And Adolescent Psychiatry ◽

Learning Disorders ◽

Emotional Symptoms ◽

Normal Behaviour ◽

Oppositional Defiance Disorder ◽

Adult Psychiatry ◽

Psychiatric Conditions

Child and adolescent psychiatry is a broad discipline relevant to any health professional who has regular contact with young people. Childhood emotional, behavioural, and developmental problems are common, especially in children with other medical or social difficulties. This chapter aims to provide an approach to child mental health difficulties, while Chapter 32 deals with common and/ or important psychiatric disorders that are specific to childhood. You may find it helpful to revise some basic child development— this can be found in any general paediatrics text (see ‘Further reading’). An overview of the differences between child and adult psychiatry is shown in Box 17.1. As in adult psychiatry, diagnosis of psychiatric disorders often relies on the clinician being able to recognize variants of and the limits of normal behaviour and emotions. In children, problems should be classified as either a delay in, or a deviation from, the usual pattern of development. Sometimes problems are due to an excess of what is an inherently normal characteristic in young people (e.g. anger in oppositional defiance disorder), rather than a new phenomenon (e.g. hallucinations or self- harm) as is frequently seen in adults. There are four types of symptoms that typically present to child and adolescent psychiatry services: … 1 Emotional symptoms: anxiety, fears, obsessions, mood, sleep, appetite, somatization. 2 Behavioural disorders: defiant behaviour, aggression, antisocial behaviour, eating disorders. 3 Developmental delays: motor, speech, play, attention, bladder/ bowels, reading, writing and maths. 4 Relationship difficulties with other children or adults…. There will also be other presenting complaints which fit the usual presentation of an adult disorder (e.g. mania, psychosis), and these are classified as they would be in an adult. Occasionally, there will also be a situation where the child is healthy, but the problem is either a parental illness, or abuse of the child by an adult. Learning disorders are covered in Chapter 19. Table 17.1 outlines specific psychiatric conditions diagnosed at less than 18 years, and Box 17.2 lists general psychiatric conditions that are also commonly found in children.

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Helping each other help children — worldwide research networks in child and adolescent mental health

International Psychiatry ◽

10.1192/s1749367600002241 ◽

2008 ◽

Vol 5 (4) ◽

pp. 84-86 ◽

Cited By ~ 1

Author(s):

Stefan Ehrlich ◽

Paul L. Plener

Keyword(s):

Mental Health ◽

Professional Development ◽

Adolescent Psychiatry ◽

International Association ◽

Adolescent Mental Health ◽

Child And Adolescent ◽

Child And Adolescent Psychiatry ◽

Emerging Leaders ◽

The World ◽

Travel Fellowship

The International Congress of the International Association of Child and Adolescent Psychiatry and Allied Professions (IACAPAP) takes place every other year. It is an opportunity for specialists from around the world to meet, exchange ideas and plan new projects. Since 2006, the Donald J. Cohen (DJC) Travel Fellowship has been an integral part of the Congress. It aims to foster the professional development of ‘emerging leaders’ in child and adolescent mental health (Adler et al, 2007).

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Infant Psychiatry: Developments

Bulletin of the Royal College of Psychiatrists ◽

10.1192/pb.8.5.85 ◽

1984 ◽

Vol 8 (5) ◽

pp. 85-85

Author(s):

D. Vorster

Keyword(s):

Adolescent Psychiatry ◽

Child And Adolescent ◽

Child And Adolescent Psychiatry ◽

International Conference ◽

New Knowledge ◽

The World ◽

Preventive Psychiatry

Developments in preventive psychiatry should occur as a result of new knowledge of the psychiatry of infancy as presented at recent conferences: the International Conference of Child and Adolescent Psychiatry, Dublin 1982; the World Infant Psychiatry Congress at Cannes, March 1983; and the Child and Adolescent Psychiatry Congress in July 1983 at Lausanne.

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Pediatric Psychopharmacological Research in the Post EU Regulation 1901/2006 Era

Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie ◽

10.1024/1422-4917/a000322 ◽

2014 ◽

Vol 42 (6) ◽

pp. 441-449 ◽

Cited By ~ 6

Author(s):

Christine Schmäl ◽

Katja Becker ◽

Ruth Berg ◽

Michael Brünger ◽

Gerd Lehmkuhl ◽

...

Keyword(s):

Children And Adolescents ◽

Adolescent Psychiatry ◽

Age Groups ◽

Child And Adolescent ◽

German Society ◽

Child And Adolescent Psychiatry ◽

The European Union ◽

Medicinal Products ◽

Pediatric Populations ◽

Areas Of Concern

Although the use of psychotropic medications in child and adolescent psychiatry in Germany is on the increase, most compounds are in fact prescribed “off-label” because of a lack of regulatory approval in these age groups. In 2007, the European Parliament introduced Regulation 1901/2006 concerning medicinal products in pediatric populations, with a subsequent amendment in the form of Regulation 1902/2006. The main aim of this legislation was to encourage research and clinical trials in children and adolescents, and thus promote the availability of medications with marketing authorization for these age groups. Furthermore, initiatives such as the European 7th Framework Program of the European Union now offer substantial funding for pediatric pharmacological research. At a recent Congress of the German Society for Child and Adolescent Psychiatry and Psychotherapy (DGKJP), experts from the field and the pharmaceutical industry held a symposium with lay representatives in order to discuss attitudes toward, and experience with, pediatric psychopharmacology research in Germany since 2007. Several areas of concern were identified. The present paper derives from that symposium and provides an overview of these opinions, which remain crucial to the field. A wider discussion of how to facilitate psychopharmacological research in Germany in order to optimize the treatment and welfare of children and adolescents with psychiatric disorders is now warranted.

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Child and Adolescent Psychiatry

Oxford Assess and Progress: Psychiatry ◽

10.1093/oso/9780199665662.003.0018 ◽

2014 ◽

Author(s):

Louise Morganstein ◽

Jonathan Hill

Keyword(s):

Young People ◽

Adolescent Psychiatry ◽

Separation Anxiety ◽

Age Groups ◽

Child And Adolescent ◽

Child And Adolescent Psychiatry ◽

Emotional Wellbeing ◽

Children And Young People ◽

Therapeutic Modalities ◽

Adult Psychiatry

Child and adolescent psychiatry is the medical specialty that works with children, young people, and families with emotional and behavioural problems. As children and young people are still developing and growing, their emotional wellbeing and functioning needs to be thought about in this context, making it different from adult psychiatry. Communication with people of all ages is vital within the specialty and information from a wide variety of sources, including parents or carers, school, and peers, is used to inform the clinical picture, in addition to history-taking and direct observations of the child’s behaviour. Play is often used to understand younger children’s thoughts and feelings. In theory, the specialty covers children and young people from birth up to the teenage years, although different services cover slightly different age ranges. The spectrum of difficulties covered within the specialty include psychiatric disorders also seen in adults (such as psychosis); problems specific to the age group (such as separation anxiety); lifelong conditions which start in childhood (such as ADHD); and conditions that may present in different ways in childhood or adolescence (such as phobias). Approaches to treatment include psychopharmacological interventions, and numerous therapeutic modalities including family therapy and CBT, which can be modified for different age groups. Most work is community based, although there are specialist inpatient units which offer on-going educational opportunities to young people who need the intensive support and risk reduction of a hospital admission. Work tends to be done within MDTs using a range of knowledge and expertise to offer the most appropriate care.

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Clinical practice during the COVID-19 pandemic: a qualitative study among child and adolescent psychiatrists across the world

Child and Adolescent Psychiatry and Mental Health ◽

10.1186/s13034-021-00417-y ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Jordan Sibeoni ◽

Emilie Manolios ◽

Emmanuel Costa-Drolon ◽

Jean-Pierre Meunier ◽

Laurence Verneuil ◽

...

Keyword(s):

Clinical Practice ◽

Qualitative Study ◽

Lived Experience ◽

Adolescent Psychiatry ◽

Child And Adolescent ◽

Child And Adolescent Psychiatry ◽

The Body ◽

Therapeutic Function ◽

The World ◽

Key Aspects

Abstract Background The COVID-19 pandemic has directly impacted the field of child and adolescent psychiatry, affecting all aspects of the lives of children and their families and increasing their risk of distress and mental health issues, especially among children with preexisting psychiatric disorders. Child and adolescent psychiatrists (CAPs) across the world have had to adapt their practice, due to lockdown and social distancing measures. This study aimed to explore how CAPs experienced their clinical practice in these singular conditions. Methods This exploratory international qualitative study used the Inductive Process to analyse the Structure of lived Experience (IPSE) approach, which is a five-stage inductive process used to explore the lived experience of participants in depth and to analyze their structure of lived experience. This study took place from March through July 2020 through individual in-depth video interviews. The sample size was determined according to the principles of theoretical sufficiency. Results 39 CAPs from 26 countries participated (age range 32–70 years; 23 women). Data analysis produced a structure of lived experience comprising three central axes of experience: (1) lost in space, lost in time, describing CAPs’ experience of disorganization of their clinical practice in the dimensions of lived time and lived space, (2) the body—of CAPs and patients—underlining their disconcerting experience of both sensory aspects and the non-embodied encounter during clinical practice, and (3) unpleasant emotions, with angst and loneliness the two main feelings coloring their clinical practice experience. Conclusions This analysis of the structure of lived experience of CAPs went beyond the sole context of the pandemic and revealed key aspects of what usually organizes CAP clinical practice. It identified two blind spots or conceptual voids within the child and adolescent psychiatry field: first, the intrinsic therapeutic function of a CAP clinical practice and, second, the important diagnostic and therapeutic function of the embodied encounter during CAP consultations. Beyond the context of COVID-19, further research should investigate these aspects to better define what a CAP does in practice and to increase both attractiveness and recruitment in this specialty.

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