Outcome Quality of Inpatient and Day-Clinic Treatment in Child and Adolescent Psychiatry—A Naturalistic Study

Background: Child and adolescent psychiatry has only recently been established as a separate specialty and is practiced in different settings. The epidemiology of psychological problems in childhood is high and varied, thus qualitative work is essential. Assessment of outcome as part of quality management is central to assure the service of psychiatric care to be effective. Method: Over a three-year period consecutively admitted patients from inpatient and day-clinic treatment were prospectively evaluated. A total of 200 from 442 patients (m = 80, f = 120; age 15.1 ± 2.8 y) agreed to participate. Patients, caregivers, and therapists answered a range of questionnaires to provide a multi-personnel rating. Questionnaires used for outcome assessment were Child Behavior Checklist (CBCL) and Youth-Self-Report (YSR) (at admission, discharge, and 6 weeks after discharge) and the problem score of the Inventory of Quality of Life for children (ILK), treatment satisfaction, and process quality by the Questionnaire for Treatment Satisfaction (FBB, at discharge) and as real-life outcome control assessment of quality of life (ILK) was added (admission, discharge, and 6 wks after discharge). Results: There was a significant reduction in psychopathologicalsymptoms (CBCL, YSR) and in the problem score. Furthermore, there was a significant increase in quality of life. QoL score and YSR/CBCL scores returned to normal levels. Treatment satisfaction was high and so was satisfaction with process quality. Factors significantly influencing outcome were severity of disease and the relationship to the therapist. No differences were found for gender and setting. Conclusion: The quality management analysis revealed significant improvements of symptom load, a significant increase in QoL and a high treatment satisfaction. Furthermore, process quality was scored highly by parents and therapists.

Correlate the Level of Internet Dependence and Associated Behavioral Problems among the Preschooler Children in the Selected Urban Area of Wardha District

India is seeing an increase in internet usage, particularly among young and children, as a result of the low cost and easy availability to touch screen mobile phones, tablet devices, and Wi-Fi. Since the previous decade, Internet use in India has grown at an exponential rate, resulting in a generation of gloomy anxiety about it, which has progressed to the point of becoming a hazardous addiction. Behavioral problems are arising due to internet dependence such as temper tantrum, aggression, thought problems, attention problems and rule breaking behaviors in the children and youth people too. Aim: To correlate the level of internet dependence and level of associated behavioral problems among the preschooler children. Materials and Methods: Descriptive correlation research design was used to conduct this study. A non-probability Convenience sampling was used to select the samples. This research study included 100 preschooler children from the Gajanan nagar (Arvi Naka) selected area of wardha district. Samples must select according to the inclusion and exclusion criteria. Young's Internet Addiction Test and behavioral scale was used to assess the level of internet dependence and also the level of associated behavioral problems of internet dependence. Results: The level of internet dependence: 3% of the preschooler children were disagree that they had internet dependence 4% had not sure, 80% had agree and 13% of them had strongly agree. Minimum Internet dependence score was 28 and maximum internet dependence score was 64. Mean Internet dependence score was 54.70±6.84 and mean percentage of Internet dependence score was 72.93±9.12. and associated Behavioural problems are 2% of the preschooler children were disagree that they had behavioral problem, 3% had not sure, 77% had agree and 18% of them had strongly agree. Minimum associated behavioral problem score was 37 and maximum associated behavioral problem score was 87. Mean associated behavioral problem score was 75.26±8.07 and mean percentage of associated behavioral problem score was 75.26±8.7. The hypothesis is tested statistically with association between internet dependence and behavioral problem. Conclusion: Parents and schools should educate their children on how to use the internet responsibly and how to balance time between online surfing, schoolwork, and outside physical activity. This study shows that there is a correlation-ship between the levels of internet dependency and associated behavioral issues in preschoolers. The situation is serious, and it will soon develop to an addicted state. Interventions such as setting limits and identifying early warning indications of underlying psychopathology are necessary.

Συγκριτική μελέτη των διαταραχών σίτισης και των παραγόντων κινδύνου σε παιδιά προσχολικής ηλικίας υγιή και με παθήσεις του πεπτικού συστήματος

Εισαγωγή: οι διαταραχές σίτισης είναι συχνές στην παιδική ηλικία. Σύμφωνα με τη βιβλιογραφία το 25%-45% των παιδιών τυπικής ανάπτυξης αντιμετωπίζουν προβλήματα σίτισης. Τα παιδιά με παθήσεις του πεπτικού συστήματος θεωρούνται ομάδα υψηλού κινδύνου για εκδήλωση τέτοιων προβλημάτων. Σκοπός της παρούσας μελέτης ήταν η διερεύνηση του επιπολασμού και των χαρακτηριστικών των προβλημάτων σίτισης σε υγιή παιδιά τυπικής ανάπτυξης και σε παιδιά με προβλήματα του πεπτικού συστήματος, ηλικίας 2-7 ετών, στην Ελλάδα. Στα πλαίσια της μελέτης αυτής διερευνήθηκαν παράγοντες που πιθανά σχετίζονται με την εμφάνιση διαταραχών σίτισης στις δύο ομάδες παιδιών, όπως τα δημογραφικά χαρακτηριστικά των παιδιών και των γονέων, το ιστορικό σίτισης βρεφικής ηλικίας και τα αναπτυξιακά στάδια σίτισης του παιδιού, το περιβάλλον σίτισης και οι γονικές πρακτικές σίτισης. Μέθοδος: μελέτη παρατήρησης χρονικής στιγμής, τύπου ασθενών και μαρτύρων. Μετά την εφαρμογή των κριτηρίων επιλογής και αποκλεισμού στη μελέτη συμπεριλήφθηκαν 928 παιδιά (787 στην ομάδα ελέγχου και 141 στην κλινική ομάδα). Για τα παιδιά αυτά συλλέχθηκαν πληροφορίες που αφορούν τα δημογραφικά και ανθρωπομετρικά στοιχεία, τη συμπεριφορά κατά τη σίτιση, το ιατρικό ιστορικό, το ιστορικό σίτισης, το περιβάλλον σίτισης και τις γονικές πρακτικές σίτισης. Αποτελέσματα: Στην ομάδα ελέγχου, το 8,2% των παιδιών είχαν παθολογικό Total Frequency Score (TFS) σκορ (συχνότητα δυσλειτουργικών συμπεριφορών) και το 27,5% είχαν παθολογικό Total Problem Score (TPS) σκορ (αριθμός προβλημάτων που ανέφεραν οι γονείς). Τα παιδιά με παθήσεις του πεπτικού συστήματος εμφάνισαν σημαντικά υψηλότερη συχνότητα προβληματικών συμπεριφορών και σημαντικά υψηλότερο αριθμό συμπεριφορών που οι γονείς θεωρούν πρόβλημα. Συγκεκριμένα, το 18,6% της κλινικής ομάδας είχε παθολογικό TFS σκορ και το 39,5% είχε παθολογικό TPS σκορ. Οι δύο ομάδες διέφεραν σημαντικά ως προς τα χαρακτηριστικά σίτισης των παιδιών. Ωστόσο, οι συμπεριφορές που φαίνονται να απασχολούν συχνότερα τους γονείς είναι κοινές και για τις δύο ομάδες και αφορούν την τροφική νεοφοβία, τη μειωμένη κατανάλωση λαχανικών, τη διαπραγμάτευση και τη χρονοτριβή. Ανάμεσα στις δύο ομάδες διαπιστώθηκαν στατιστικά σημαντικές διαφορές σε όλα τα αναπτυξιακά στάδια της σίτισης, σε πολλά χαρακτηριστικά του περιβάλλοντος σίτισης και σε πολλές γονικές πρακτικές. Συγκεκριμένοι δημογραφικοί παράγοντες, ο χαμηλός ΔΜΣ, η καθυστέρηση στη μετάβαση στις στερεές τροφές, αρκετά χαρακτηριστικά του περιβάλλοντος σίτισης και σχεδόν όλες οι γονικές πρακτικές, συσχετίστηκαν θετικά με τις διαταραχές σίτισης στην ομάδα ελέγχου. Λιγότερα χαρακτηριστικά συσχετίστηκαν θετικά με τις διαταραχές σίτισης στην κλινική ομάδα. Συμπεράσματα: Η μελέτη κατέδειξε ότι περίπου ένα στα δέκα υγιή παιδιά εκδηλώνει διαταραχές σίτισης, ενώ ένας στους τέσσερις γονείς θεωρούν προβληματική τη σίτιση του παιδιού τους. Σχεδόν διπλάσιο ποσοστό παιδιών με παθήσεις του πεπτικού συστήματος βρέθηκε να αντιμετωπίζει παρόμοια προβλήματα. Τα ευρήματα της μελέτης συμβάλουν στην πρόληψη, πρώιμη ανίχνευση και αξιολόγηση των διαταραχών σίτισης τόσο στα υγιή παιδιά, όπου τα προβλήματα σίτισης συχνά παραβλέπονται ή υποτιμώνται, όσο και στα παιδιά με παθήσεις του πεπτικού συστήματος που αποτελούν ομάδα υψηλού κινδύνου για την εκδήλωση τέτοιων προβλημάτων. Από τα ευρήματα της μελέτης αναδείχτηκαν επίσης σημαντικές πληροφορίες για τους παράγοντες που επιδρούν στη διατροφική συμπεριφορά, παρέχοντας ένα πλαίσιο αναφοράς για πρώιμη παρέμβαση και για το σχεδιασμό όσο το δυνατό πιο στοχευμένων και αποτελεσματικών θεραπευτικών μεθόδων σε παιδιά με διαταραχές σίτισης.

A genome-wide association study of total child psychiatric problems scores

ABSTRACTSubstantial genetic correlations have been reported across psychiatric disorders and numerous cross-disorder genetic variants have been detected. To identify the genetic variants underlying general psychopathology in childhood, we performed a genome-wide association study using a total psychiatric problem score. We analyzed 6,844,199 common SNPs in 38,418 school-aged children from 20 population-based cohorts participating in the EArly Genetics and Lifecourse Epidemiology (EAGLE) consortium. The SNP heritability of total psychiatric problems was 5.4% (SE=0.01) and two loci reached genome-wide significance: rs10767094 and rs202005905. We also observed an association of SBF2, a gene associated with neuroticism in previous GWAS, with total psychiatric problems. The genetic effects underlying the total psychiatric problem score were shared with known genetic variants for common psychiatric disorders only (attention-deficit/hyperactivity disorder, anxiety, depression, insomnia) (rG > 0.49), but not with autism or the less common adult disorders (schizophrenia, bipolar disorder, or eating disorders) (rG < 0.01). Importantly, the total psychiatric problem score also showed at least a moderate genetic correlation of with intelligence, educational attainment, wellbeing, smoking, and body fat (rG > 0.29).The results suggest that many common genetic variants are associated with childhood psychiatric symptoms and related phenotypes in general instead of with specific symptoms. Further research is needed to establish causality and pleiotropic mechanisms between psychiatric disorders and related traits.

Study Of Relationship Between Attitude And Problems Experienced By Mothers Of Children With Cerebral Palsy

The present research work was carried out to study the attitudes and problems experienced by mothers of children with cerebral palsy. To achieve this broad objective, scales for the attitudes of mothers and problems experienced by them were developed. It was found that a mother's attitudes to cerebral palsy were determined by the severity of the child's disability. The severe the disability, the less favourable were the mother's attitudes. Mothers having better attitudes experienced less problems compared to those who had poor and unfavourable attitudes. The degree of cerebral palsy in the child and its I.Q. were seen to influence their problem score. The age, sex, birth order of the child, age of mother and the type of family did not affect the mother's problem score. However, parental education, occupation, habitat and family income were found to be directly related to their problems.

Life stress and depression in a tribal area of Pakistan

BackgroundDepression is common in Pakistan but no research on this subject has been reported from the North West Frontier Province (NWFP), host to numerous Afghan refugees.AimsTo measure depressive symptoms and associated features in a population-based sample.MethodA Pushto translation of the Self Reporting Questionnaire (SRQ) was administered to 471 adults living in a village in one of the federally administered tribal areas. Respondents were also assessed with a life events checklist for social problems, a social support questionnaire and the Brief Disability Questionnaire.ResultsSixty per cent (95/158) of women and 45% (140/313) of men scored 9 or more on the SRQ. High SRQ score was associated with few years of education, higher social problem score, less social support and greater disability. High social problem score was the strongest correlate.ConclusionsThis population reports more depressive symptoms than other communities in Pakistan and this probably reflects the very high degree of social stress experienced in the NWFP, which has been affected by years of turmoil in neighbouring Afghanistan.

Prevalence of psychological problems in Irish school going adolescents

Objectives: To establish the prevalence of psychological problems in older adolescents.Method: The Youth Self Report was completed by teenagers in a class group. Percentages scoring above clinical threshold were calculated. Gender differences and variances between school type were examined.Results: Seven hundred and seventy-nine students participated in the study, 373 males and 406 females. Of the girls 23% reported problems in the clinical range on total problem score compared with 19% of boys. Significant gender differences were noted on total problem and internalising scores but not on externalising scores. The levels of psychological problems did not appear to be influenced by school type. Of the total group 6.4% reported thinking of suicide frequently (almost twice as many girls as boys) and this rose to 25% of girls who scored in the clinical range of total problem score and 15% of boys.Conclusions: Twenty-one per cent of adolescents had problems in the clinical range. Girls reported more problems than boys. It was surprising to find that there was no gender difference in reported levels of externalising problems. The high expression of suicidal and thoughts of self-harm in those with externalising and internalising problems is of concern. This highlights the vulnerability of older adolescents as they tend to fall between the current child and adolescent services. Service provision for this population should be a priority in rural areas and on a national basis.