Psychopathological evaluation of children and adolescents in 4 child and adolescent psychiatry referral groups--a multicenter study

Goal of the multicenter study with the Clinical Assessment Scale of Child and Adolescent Psychopathology (CASCAP) in a sample of N = 5027 patients from the inpatient and outpatient clinics of psychiatry and psychotherapy of childhood and adolescence of the universities of Berlin (Virchow Clinic), Frankfurt, Cologne and Zurich is the comparison of the clinical populations of these institutions with respect to single symptoms, to symptom scales and to the supreme level of aggregation, the clinical diagnoses according to ICD 10. On the level of diagnoses similar distributions can be found in the centers, but there are also significant differences between the centers. This differences can be found again also on the level of symptom scales and single symptoms, though the deviations are comparatively low.     

Multidisciplinary evaluation of preschool children in a military psychiatry clinic: a 10-year comparison and a brief outcome study

A little over a decade ago, the Child and Adolescent Psychiatry Service at Tripler Army Medical Center opened the Child Study Group (CSG), a multidisciplinary diagnostic team clinic for preschool children. The methods and results of the clinic were reported previously (Lee, 1987). The current study is a comparison of the cohort of children seen from January through December 1984 with the parallel group seen from January through June 1994. The paper also presents a brief follow-up study of the children seen in 1994.     

Comprehensive medicine from the child and adolescent psychiatry viewpoint

The development of a child or a adolescent and it's (psycho-)pathological manifestations call often for a multidisciplinary approach. The specialist for child and adolescent psychiatry has in such situations a coordinating and integrating function with direct involvement. His goal is therefore--be it during diagnostic or therapeutic procedures--to guarantee an attunement of biological, medical, psychological, psychiatric, pedagogical and social perspectives, to favor reflective conceptualisation and the cooperation of all the involved persons and institutions.     

Treatment of malocclusions in children and adolescents at a public dental service clinic in Sweden: extent and cost

This study was undertaken to investigate the extent and the cost of orthodontic consultation and treatment of malocclusions in 19-year-olds at a Public Dental Service (PDS) clinic. A further aim was to evaluate the group of patients who discontinued their treatment prematurely. A total of 223 patient records were reviewed. The results showed that every second patient (106 of 223) was seen by a specialist for orthodontic evaluation. Of these, 54% (57 of 106) were treated with removable appliance, 29% (31 of 106) benefited from interceptive treatment without appliance and 12% (13 of 106) were referred to a specialist clinic. The costs for specialist consultations comprised 19% of the overall orthodontic treatment cost. Premature interruption of treatment with removable appliance was found in 17% (10 of 57) of the patients. This group consumed 12% of the overall orthodontic treatment cost. Reasons for discontinuing treatment included problems with co-operation and motivation and a lack of parental support. Seventy per cent of those who discontinued their treatment prematurely had been treated with an activator.     

Parent–child interaction, television violence, and aggression of children.

Summarized and integrated results of 2 large-scale longitudinal studies (L. D. Eron, see PA, Vol 38:2452; Eron et al, in press). The relationship between TV violence and aggression in Ss was corroborated in 2 different geographical areas of the US and was found to hold for both boys and girls. The causal effect is circular, with TV violence affecting S's aggression and aggressive Ss watching more violent TV. Contributing increments to a S's level of overt aggression were popularity, intellectual ability, aggressive fantasy, extent of physical punishment, rejection by parents, and the tendency of parents to endorse attitudes and behaviors often seen in sociopathic individuals. It is shown that it is possible to intervene to attenuate the relationship between TV violence and aggression with simple tuitional procedures that supercede the influence of the parent variables studied. Important intervening variables in the TV violence–aggression relationship are S's identification with aggressive characters and the extent to which S believes TV portrays reality. (23 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Forensic child and adolescent psychiatry: a review of the past 10 years

BACKGROUND AND METHODS: Risk factors for recurrence of Crohn's disease and the evidence for progress in reducing recurrence following resection were reviewed. A Medline based literature review was carried out. RESULTS AND CONCLUSION: Only smoking has been confirmed as a significant adverse risk factor for recurrence. Evidence for differing recurrence rates in fibrostenosing disease and perforating disease is inconclusive, but such a classification along with the endoscopic findings of recurrence may have a place in the analysis of therapeutic trials. Minimal resectional surgery with clearing of only macroscopic disease seems to be justified, with no clear benefits from different anastomotic techniques. Recent trials offer encouraging evidence of the usefulness of 5-aminosalicylic acid, particularly higher-dose regimens started early after resection, although the long-term benefits are uncertain. The oral steroid, budesonide, offers a potent treatment with minimal side-effects, but evidence of its prevention of recurrence is presently weak.     

Substance use disorders in a geriatric psychiatry outpatient clinic: prevalence and epidemiologic characteristics

The effects of linoleic acid, linoleic acid anilide, and arachidonic acid on the expression of CD11b/ CD18, CD11c/CD18 integrins and L-selectin on human neutrophils were studied by flow cytometry in a whole blood assay. None of these compounds had any effect on the basal expression of CD11b, CD11c, or L-selectin in the concentration range of 20-100 microM. However, linoleic acid at a concentration of 1000 microM slightly up-regulated CD11b and CD11c by a factor of 2.1 and 1.7, respectively. Linoleic acid, linoleic acid anilide, and arachidonic acid did not affect the formyl-methionyl-leucyl-phenylalanine induced up-regulation of CD11b or CD11c. However, linoleic acid and linoleic acid anilide slightly inhibited the phorbol myristate acetate (PMA)-induced expression of CD11b, which was decreased by 27 and 21% at concentrations of 100 and 1000 microM, respectively. Likewise, arachidonic acid at 40 microM inhibited the PMA-induced expression of CD11b by 19%. Our results suggest that linoleic acid, linoleic acid anilide, and arachidonic acid do not dramatically affect the expression of leukocyte adhesion molecules in a whole blood assay.     

Posttraumatic stress in children and adolescents exposed to family violence: I. Overview and issues.

Exposure to child physical abuse and parents' domestic violence can subject youth to pervasive traumatic stress and can lead to posttraumatic stress disorder (PTSD). This article presents evolving conceptualizations in the burgeoning field of trauma related to family violence exposure and describes how the often repeating and ongoing nature of family violence exposure can complicate a PTSD diagnosis. In addition, recent literature indicates that children exposed to family violence may experience problems in multiple domains of functioning and may meet criteria for multiple disorders in addition to PTSD. Considerations salient to the recognition of traumatic stress in this population and that inform assessment and treatment planning are presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Experiences of psychiatry board exam casualties: a survey report

A quantitative study of the regional distribution of serotonin (5-HT) in the forebrain, was performed in adult cats, following brainstem lesions. Seven to 10 days survival times were used to avoid nonspecific variations of the amine levels, as were observed in chronic preparations. Significant decreases of 5-HT levels were found after lesions of the nucleus centralis superior (CS), in hypothalamus, preoptic area, amygdala and hippocampus. After lesions of the nucleus dorsalis raphe (Dr), significant 5-HT decreases were also found in the hypothalamus and hippocampus. There was no change of 5-HT levels after lesions placed in the lateral midbrain, pontine tegmentum, or caudal pontine raphe, contrary to that was reported for chronic lesioned cats. These results suggest that CS and Dr may integrate different serotonergic subsystems and, probably, each one of these subsystems is related to specific functional phenomena.     

Assessing community violence: the children''s report of exposure to violence

Optical imaging methods are being explored as a potential means of screening for breast cancer. Previous investigations of time-resolved imaging techniques have suggested that due to the lack of photons with sufficiently small pathlengths, the spatial resolution achievable through a human breast would be unlikely to be better than a centimeter. Experimental results presented here indicate, however, that higher resolution may be achieved by extrapolating the measured temporal distribution of transmitted photons. This is performed using a least-squares fit between data and an analytic model of photon transport. The spatial resolution of a time-resolved imaging system was evaluated by measuring the edge response produced by an opaque mask embedded in the center of a 51-mm-thick, very highly scattering medium. The limiting spatial resolution was improved from about 13 mm to about 5 mm.     

Impact of clinical pathways for total hip replacement: a community-based analysis

Technological advances have greatly improved the management of the patient undergoing microlaryngeal surgery. The use of a laser, high frequency jet ventilation (HFJV), total intravenous anesthetic techniques (TIVA), and specially designed endotracheal tubes (Xomed Hunsaker Mon-Jet ventilation tube [Xomed Surgical Products, Jacksonville, FL]) are recognized as cutting edge approaches to the management of these cases. The use of high technology adjuncts requires considerable skill and knowledge from the perspective of the anesthesia provider. This case report describes an approach to anesthetic management for a patient with a history of achondroplastic dwarfism having laser excision of bilateral vocal cord granulomas. Further increasing the complexity of the case was the surgical use of an autogenous tissue glue, which required a period of 'airway silence' during the application process.     

Lipoprotein profile determinants in children and adolescents from a lipid consultation clinic. The impact of diet, body composition and physical activity]

The production of extracellular beta-amylase by some Bacillus cereus, Bacillus megaterium and Bacillus polymyxa [corrected] strains was investigated, and the maximal yields of the enzyme were 3.6; 9.3 and 20.4 U/mL of the culture fluid, respectively (U, 1 mumol of maltose equivalent per min at 30 degrees C). Several cultivation media were used for beta-amylase production. Bacillus cereus and some strains of Bacillus megaterium gave good yields of beta-amylase only in medium with the addition of nutrient broth. However, beta-amylase produced during growth in protein rich medium (nutrient broth) was highly unstable, probably due to inactivation by proteolytic enzymes co-existing in the culture fluid. Bacillus polymyxa [corrected] strains can produce good yields of beta-amylase on a semi-synthetic medium consisting of inorganic salts, potato starch and inexpensive soybean extract instead of costly peptone and meat extract. The most potential beta-amylase producer was the strain Bacillus polymyxa [corrected] NCIB 8524. The tested Bacillus megaterium and Bacillus polymyxa [corrected] strains were apparently differentiated by temperature cultivation (30 and 37 degrees C) suitable for beta-amylase amylase yield.     

Clinical child psychology: A practice specialty serving children, adolescents, and their families.

[Correction Notice: An erratum for this article was reported in Vol 41(3) of Professional Psychology: Research and Practice (see record 2010-11935-006). The following sentence on page 79 is incorrect: “As evidence of the growing recognition of board certification, many institutions providing services to children, adolescents, and families are requiring their psychologists to become certified by ABPP (e.g., Mayo Clinic) and some insurance companies now mandate this for their panels (e.g., Group Health in Seattle).” In fact Group Health in Seattle does not mandate ABPP certification for psychologists. The sentence should not contain the example in the second set of parentheses.] Clinical child psychology is a growing and vibrant field of practice and research within professional psychology. The purpose of this article is to contribute to the recent series of articles on specialties in Professional Psychology Research and Practice and delineate the development, design, and purpose of clinical child psychology. The article describes the current trends in the specialty and the challenges clinical child psychologists face in tending to the mental health needs of youth and their families. The need for the specialty and the definition of the scope of the work of clinical child psychologists is described. The parameters of training are also discussed, with a focus on the distinctiveness of the role of the clinical child psychologist. Outlined are applications of the work with children, adolescents, and their families including types of professional practice and collaborations with other professionals. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Use of atypical neuroleptics in child and adolescent psychiatry

BACKGROUND: This article reviews the published clinical experience with atypical neuroleptics in children and adolescents. METHOD: A computerized literature search was conducted (MEDLINE, 1974-1998) to retrieve all reports on the use of atypical neuroleptics in children and adolescents. A hand search was performed as well. All relevant clinical data were collated by type of drug. RESULTS: We found 5 blind placebo-controlled clinical trials (105 patients), 24 open-label clinical trials (387 patients), and 33 case series (115 patients) describing the use of the atypical neuroleptics clozapine, risperidone, olanzapine, sulpiride, tiapride, amisulpride, remoxipride, and clothiapine in children and adolescents. Some of these agents, especially clozapine, risperidone, and olanzapine, were found to be efficacious in the treatment of schizophrenia, bipolar disorders, and pervasive developmental disorders. The role of atypical neuroleptics as augmenters of serotonin reuptake inhibitors in obsessive-compulsive disorder is unclear. Risperidone appears to possess anti-tic properties in patients with Tourette's disorder. CONCLUSION: The most convincing evidence of the efficacy of atypical neuroleptics in children and adolescents concerns clozapine in the treatment of schizophrenia. Data on other atypical neuroleptics in other disorders are still sparse, and further research is needed. Some of the atypical neuroleptics may become the first-line treatment for childhood schizophrenia and pervasive developmental disorders.     

Changing self-esteem in children and adolescents: a meta-analytic review

Conducted a meta-analytic review of 116 studies, which indicated significant improvement in children's and adolescents' self-esteem and self-concept, and significant concomitant changes in behavioral, personality, and academic functioning. Interventions specifically focused on changing self-esteem and self-concept were significantly more effective (mean effect size = 0.57) than programs focused on another target, such as behavior or social skills (0.10). Treatment programs were also more effective (0.47) than primary prevention programs (0.09) in changing self-esteem. Four variables emerged as significant predictors of self-esteem outcomes: 2 methodological features (type of design and control group), the use of a theoretical or empirical rationale, and the type of program (treatment or prevention). Future research needs to examine the causal connection between changes occurring in self-esteem and other areas of adjustment, assess intervention success for different ethnic groups and for children of different ages and sex, and determine the long-term impact of interventions.