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Sample records for adolescent psychiatry trials

  1. The child and adolescent psychiatry trials network (CAPTN: infrastructure development and lessons learned

    Directory of Open Access Journals (Sweden)

    Breland-Noble Alfiee

    2009-03-01

    Full Text Available Abstract Background In 2003, the National Institute of Mental Health funded the Child and Adolescent Psychiatry Trials Network (CAPTN under the Advanced Center for Services and Intervention Research (ACSIR mechanism. At the time, CAPTN was believed to be both a highly innovative undertaking and a highly speculative one. One reviewer even suggested that CAPTN was "unlikely to succeed, but would be a valuable learning experience for the field." Objective To describe valuable lessons learned in building a clinical research network in pediatric psychiatry, including innovations intended to decrease barriers to research participation. Methods The CAPTN Team has completed construction of the CAPTN network infrastructure, conducted a large, multi-center psychometric study of a novel adverse event reporting tool, and initiated a large antidepressant safety registry and linked pharmacogenomic study focused on severe adverse events. Specific challenges overcome included establishing structures for network organization and governance; recruiting over 150 active CAPTN participants and 15 child psychiatry training programs; developing and implementing procedures for site contracts, regulatory compliance, indemnification and malpractice coverage, human subjects protection training and IRB approval; and constructing an innovative electronic casa report form (eCRF running on a web-based electronic data capture system; and, finally, establishing procedures for audit trail oversight requirements put forward by, among others, the Food and Drug Administration (FDA. Conclusion Given stable funding for network construction and maintenance, our experience demonstrates that judicious use of web-based technologies for profiling investigators, investigator training, and capturing clinical trials data, when coupled to innovative approaches to network governance, data management and site management, can reduce the costs and burden and improve the feasibility of

  2. American Academy of Child and Adolescent Psychiatry

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    ... members of AACAP. Be CAPtivated - Child and Adolescent Psychiatry as a Career AACAP's Current Award Opportunities More... ... More... Copyright ©2016 - American Academy of Child Adolescent Psychiatry. All Rights Reserved. Contact Us | Disclaimer | Privacy Statement ...

  3. Factors Affecting Recruitment into Child and Adolescent Psychiatry Training

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    Shaw, Jon A.; Lewis, John E.; Katyal, Shalini

    2010-01-01

    Objective: The authors studied the factors affecting the recruitment into child and adolescent psychiatry training in the United States. Methods: Medical students (n = 154) and general and child and adolescent psychiatry residents (n = 111) completed a questionnaire to evaluate career choice in child psychiatry (n = 265). Results: Compared with…

  4. Models of Integrated Training in Psychiatry and Child and Adolescent Psychiatry

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    Sexson, Sandra B.; Thomas, Christopher R.; Pope, Kayla

    2008-01-01

    Objective: Previous studies indicate declining interest in child and adolescent psychiatry (CAP) as a career choice during psychiatry residency training. Programs have developed integrated training in psychiatry and CAP as a means to address the workforce shortage in CAP, but little is known about the number or nature of these training tracks.…

  5. Family Therapy Training in Child and Adolescent Psychiatry Fellowship Programs

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    Rait, Douglas Samuel

    2012-01-01

    Objective: This study describes the current state of family therapy training in a sample of child and adolescent psychiatry fellowship programs. Method: Child and adolescent psychiatry fellows (N = 66) from seven training programs completed a questionnaire assessing demographics, family therapy training experiences, common models of treatment and…

  6. Improving Child and Adolescent Psychiatry Education for Medical Students: An Inter-Organizational Collaborative Action Plan

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    Fox, Geraldine S.; Stock, Saundra; Briscoe, Gregory W.; Beck, Gary L.; Horton, Rita; Hunt, Jeffrey I.; Liu, Howard Y.; Rutter, Ashley Partner; Sexson, Sandra; Schlozman, Steven C.; Stubbe, Dorothy E.; Stuber, Margaret L.

    2012-01-01

    Objective: A new Child and Adolescent Psychiatry in Medical Education (CAPME) Task Force, sponsored by the Association for Directors of Medical Student Education in Psychiatry (ADMSEP), has created an inter-organizational partnership between child and adolescent psychiatry (CAP) educators and medical student educators in psychiatry. This paper…

  7. Musings: What child and adolescent psychiatry means to me

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    L Eugene Arnold

    2008-01-01

    I have been a grandfather for only 12 years, but for 37 years I have lived a grandparent's dream: people pay me to tell them how to raise their children. This is only one of the many rewards child and adolescent psychiatry has offered me. Table 1 lists some more of them.Probably the greatest satisfaction in child psychiatry is the wide selection of options for specialization: psychotherapy, psychopharmacology, nutrition, biochemistry, genetics, family therapy, parent guidance, custody and vis...

  8. A brief history of placebos and clinical trials in psychiatry.

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    Shorter, Edward

    2011-04-01

    The history of placebos in psychiatry can be understood only in the context of randomized controlled trials (RCTs). Placebo treatments are as old as medicine itself, and are particularly effective in dealing with psychosomatic symptoms. In psychiatry, placebos have mainly been featured in clinical drug trials. The earliest controlled trial in psychiatry (not involving drugs) occurred in 1922, followed by the first crossover studies during the 1930s. Meanwhile the concept of randomization was developed during the interwar years by British statistician Ronald A Fisher, and introduced in 3 trials of tuberculosis drugs between 1947 and 1951. These classic studies established the RCT as the gold standard in pharmaceutical trials, and its status was cemented during the mid-1950s. Nevertheless, while the placebo became established as a standard measure of drug action, placebo treatments became stigmatized as unethical. This is unfortunate, as they constitute one of the most powerful therapies in psychiatry. In recent years, moreover, the dogma of the placebo-controlled trial as the only acceptable data for drug licensing is also being increasingly discredited. This backlash has had 2 sources: one is the recognition that the US Food and Drug Administration has been too lax in permitting trials controlled with placebos alone, rather than also using an active agent as a test of comparative efficacy. In addition, there is evidence that in the hands of the pharmaceutical industry, the scientific integrity of RCTs themselves has been degraded into a marketing device. The once-powerful placebo is thus threatened with extinction.

  9. What Is Psychiatry?

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    Full Text Available ... training. They may become certified in: Child and adolescent psychiatry Geriatric psychiatry Forensic (legal) psychiatry Addiction psychiatry ... World Psychiatric Association American Association of Child and Adolescent Psychiatry American Association of Community Psychiatrists American Association ...

  10. Ethics and risk management in administrative child and adolescent psychiatry.

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    Sondheimer, Adrian

    2010-01-01

    This article examines ethics (the philosophic study of "doing the right thing") and risk management (the practice that seeks to manage the likelihood of "doing the wrong thing") and the relationship between them in the context of administrative child and adolescent psychiatry. Issues that affect child and adolescent psychiatrists who manage staff and business units and clinical practitioners who treat and manage individual patients are addressed. Malpractice, budgeting, credentialing, boundaries, assessment, documentation, treatment, research, dangerousness, and confidentiality are among the topics reviewed.

  11. Exposure to Child and Adolescent Psychiatry for Medical Students: Are There Optimal "Teaching Perspectives"?

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    Hunt, Jeffrey; Barrett, Rowland; Grapentine, W. Lex; Liguori, Gina; Trivedi, Harsh K.

    2008-01-01

    Objectives: The ability to develop quality medical student exposures in child and adolescent psychiatry is critical to the professional development of these future physicians and to the growth of recruitment efforts into the field. This study identifies teaching perspectives among child and adolescent psychiatry faculty to determine whether there…

  12. [Contribution of the 10th International Classification of Diseases to pediatric and adolescent psychiatry].

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    Vojtík, V

    1993-12-01

    The 10th revision of the classification of mental disorders and behavioural disorders is due to description of clinical symptoms and diagnostic criteria more accurate and enriches the activities of departments of child and adolescent psychiatry. Diagnostics, therapy and prevention profit not only from sections dealing with newly conceived disorders which begin in childhood and adolescence but also other sections where problems relating to children and adolescents are pointed out. The Czech translation inovates clinical pictures given in our textbook of Child psychiatry published in 1963 and thus replaces partly a hitherto not published modern Czech textbook of child and adolescent psychiatry.

  13. Is Mandatory Prospective Trial Registration Working to Prevent Publication of Unregistered Trials and Selective Outcome Reporting? An Observational Study of Five Psychiatry Journals That Mandate Prospective Clinical Trial Registration.

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    Amelia Scott

    Full Text Available To address the bias occurring in the medical literature associated with selective outcome reporting, in 2005, the International Committee of Medical Journal Editors (ICMJE introduced mandatory trial registration guidelines and member journals required prospective registration of trials prior to patient enrolment as a condition of publication. No research has examined whether these guidelines are impacting psychiatry publications. Our objectives were to determine the extent to which articles published in psychiatry journals adhering to ICMJE guidelines were correctly prospectively registered, whether there was evidence of selective outcome reporting and changes to participant numbers, and whether there was a relationship between registration status and source of funding.Any clinical trial (as defined by ICMJE published between 1 January 2009 and 31 July 2013 in the top five psychiatry journals adhering to ICMJE guidelines (The American Journal of Psychiatry, Archives of General Psychiatry/JAMA Psychiatry, Biological Psychiatry, Journal of the American Academy of Child and Adolescent Psychiatry, and The Journal of Clinical Psychiatry and conducted after July 2005 (or 2007 for two journals was included. For each identified trial, where possible we extracted trial registration information, changes to POMs between publication and registry to assess selective outcome reporting, changes to participant numbers, and funding type.Out of 3305 articles, 181 studies were identified as clinical trials requiring registration: 21 (11.6% were deemed unregistered, 61 (33.7% were retrospectively registered, 37 (20.4% had unclear POMs either in the article or the registry and 2 (1.1% were registered in an inaccessible trial registry. Only 60 (33.1% studies were prospectively registered with clearly defined POMs; 17 of these 60 (28.3% showed evidence of selective outcome reporting and 16 (26.7% demonstrated a change in participant numbers of 20% or more; only 26 (14

  14. Increasing Interest in Child and Adolescent Psychiatry in the Third-Year Clerkship: Results from a Post-Clerkship Survey

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    Malloy, Erin; Hollar, David; Lindsey, Anthony

    2008-01-01

    Objective: The authors aimed to determine whether a structured clinical experience in child and adolescent psychiatry (CAP) during the third-year psychiatry clerkship would impact interest in pursuing careers in psychiatry and CAP. Methods: The authors constructed and administered a post-rotation survey, the Child and Adolescent Psychiatry…

  15. Musings: What child and adolescent psychiatry means to me

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    L. Eugene Arnold

    2008-01-01

    Full Text Available I have been a grandfather for only 12 years, but for 37 years I have lived a grandparent's dream: people pay me to tell them how to raise their children. This is only one of the many rewards child and adolescent psychiatry has offered me. Table 1 lists some more of them.Probably the greatest satisfaction in child psychiatry is the wide selection of options for specialization: psychotherapy, psychopharmacology, nutrition, biochemistry, genetics, family therapy, parent guidance, custody and visitation advice, epidemiology, disorder specialization, research, consultation, public education and best of all, the chance to integrate it all and play at being a comprehensive physician. The myriad challenges provoke learning and continued development that keep one young at heart and mind. Sometimes I think I should pay to practice child psychiatry.It should be obvious by now to even the casual reader that I enjoy the privilege of being a child and adolescent psychiatrist and that enjoyment manifests in a playful attitude. That playful attitude includes not taking myself too seriously. In fact, I'm proud of my humility! It was earned at the expense of repeated humbling experiences in two ways:Confronting tragic situations that I could not help, where all my education, training, experience and brilliant diagnostic insight seemed useless; and Witnessing real heroism by some parents who struggle with sick children's difficult problems without complaining and with indefatigable hope. They outshine any professional pretensions of mine. By showing me my limitations and forcing me to compare myself to patients and parents (and occasional colleagues of superior moral caliber, child psychiatry has made a better, more honest person of me and for this I'm grateful.On the other hand, there is the mind-blowing exhilaration of watching a child improve after some prescription, potion or psychotherapeutic intervention and being allowed to believe that I had something to

  16. Academic Training in a Child and Adolescent Psychiatry Fellowship: A Curriculum Based on Leadership Experience

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    Ivany, Christopher G.; Russell, Robert K.; Vanessa, Venezia A.; Saito, Albert Y.

    2008-01-01

    Objective: The authors describe how one child and adolescent psychiatry fellowship program responded to emerging trends in clinical practice which increasingly demand that child and adolescent psychiatrists lead their colleagues through instruction and supervision. Methods: Data from surveys of recent graduates of child and adolescent training…

  17. [Adolescents with diabetes type 1 in adolescent psychiatry and psychotherapy].

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    Walter, Joachim

    2013-01-01

    Psychiatric comorbidity, family and biographical risk factors, and individual motivational aspects influence the therapeutic adherence and treatment motivation in Diabetes Type 1. The article provides basis diabetological knowledge for adolescent psychotherapists and describes practical out- and inpatient experiences and deliberations with especially problematic comorbid patients. In psychiatrically comorbid patients family conflicts and individual psychopathology is often reflected and manifested in selfharming diabetes management.

  18. The Differential Impact of Clerk Interest and Participation in a Child and Adolescent Psychiatry Clerkship Rotation upon Psychiatry and Pediatrics Residency Matches

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    Hanson, Mark D.; Szatmari, Peter; Eva, Kevin W.

    2011-01-01

    Objective: The authors evaluated the differential impact of clerk interest and participation in a Child and Adolescent Psychiatry (CAP) clerkship rotation upon psychiatry and pediatrics residency matches. Method: Authors studied clerks from the McMaster University M.D. program graduating years of 2005-2007. Participants were categorized as 1)…

  19. Teaching child and adolescent psychiatry to undergraduate medical students - A survey in German-speaking countries

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    Frank Florian

    2010-07-01

    Full Text Available Abstract Objective To conduct a survey about teaching child and adolescent psychiatry to undergraduate medical students in German-speaking countries. Methods A questionnaire was sent to the 33 academic departments of child and adolescent psychiatry in Germany, Austria, and the German-speaking part of Switzerland. Results All departments responded. For teaching knowledge, the methods most commonly reported were lectures and case presentations. The most important skills to be taught were thought to be how to assess psychopathology in children and how to assess families. For elective courses, the departments reported using a wide range of teaching methods, many with active involvement of the students. An average of 34 hours per semester is currently allocated by the departments for teaching child and adolescent psychiatry to medical students. Required courses are often taught in cooperation with adult psychiatry and pediatrics. Achievement of educational objectives is usually assessed with written exams or multiple-choice tests. Only a minority of the departments test the achievement of skills. Conclusions Two ways of improving education in child and adolescent psychiatry are the introduction of elective courses for students interested in the field and participation of child and adolescent psychiatrists in required courses and in longitudinal courses so as to reach all students. Cooperation within and across medical schools can enable departments of child and adolescent psychiatry, despite limited resources, to become more visible and this specialty to become more attractive to medical students. Compared to the findings in earlier surveys, this survey indicates a trend towards increased involvement of academic departments of child and adolescent psychiatry in training medical students.

  20. Exposing Medical Students to Child and Adolescent Psychiatry: A Case-Based Seminar

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    Kaplan, Jeremy S.; Lake, MaryBeth

    2008-01-01

    Objective: Despite a documented shortage of child and adolescent psychiatrists, few studies have examined whether including child and adolescent psychiatry didactics in a medical school curriculum can stimulate appreciation and interest among students, possibly leading more students to choose careers in this specialty. Methods: The authors…

  1. [Crisis Intervention in a Health Care Hospital for Child and Adolescent Psychiatry].

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    Burchard, Falk; Diebenbusch, Teresa

    2017-01-01

    Crisis Intervention in a Health Care Hospital for Child and Adolescent Psychiatry In the past years the pressure in society and psychological problems in Germany have risen up. This can especially be verified by the great influx of utilization of child and adolescent psychiatric clinics through the admission of crisis. In this connection social disadvantaged female adolescents with a low socio-economic status, students of the secondary school, children in care and the ones whose parents have to manage their upbringing alone are preferentially affected. These developments require a fast adaptation of the supply system to the transformed demands, in particular in terms of outpatient treatment, as well as a closely and structured cooperation between the youth welfare and child and adolescent psychiatric clinics in their function as systems of help. In the script statistical data and adaptive approaches of a supply department of child and adolescent psychiatry are presented.

  2. Choosing a Career in Psychiatry

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    ... of thinking and communication skills, learning, resilience, and self-esteem.” Psychiatrists make a difference because they can apply ... initial four years. They may study child and adolescent psychiatry, geriatric psychiatry, forensic (legal) psychiatry, administrative psychiatry, ...

  3. Training of Child and Adolescent Psychiatry Fellows in Autism and Intellectual Disability

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    Marrus, Natasha; Veenstra-VanderWeele, Jeremy; Hellings, Jessica A.; Stigler, Kimberly A.; Szymanski, Ludwik; King, Bryan H.; Carlisle, L. Lee; Cook, Edwin H., Jr.; Pruett, John R., Jr.

    2014-01-01

    Patients with autism spectrum disorders and intellectual disability can be clinically complex and often have limited access to psychiatric care. Because little is known about post-graduate clinical education in autism spectrum disorder and intellectual disability, we surveyed training directors of child and adolescent psychiatry fellowship…

  4. A Practical Approach to Implementing the Core Competencies in a Child and Adolescent Psychiatry Residency Program

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    Dingle, Arden D.; Sexson, Sandra B.

    2007-01-01

    Objective: The authors describe the development and implementation of the Accreditation Council for Graduate Medical Education's core competencies in a child and adolescent psychiatry residency program. Method: The authors identify the program's organizational approach and participants and detail various strategies and methods of defining,…

  5. Placebo effect in child and adolescent psychiatric trials.

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    Parellada, Mara; Moreno, Carmen; Moreno, Miguel; Espliego, Ana; de Portugal, Enrique; Arango, Celso

    2012-11-01

    Much literature has been written in the field of child psychiatry regarding the placebo as a tool to test drug efficacy in clinical trials, but quite little regarding the placebo effect itself or its clinical use in child psychiatry. In this article, we aim to critically review the literature regarding the placebo effect in children and adolescents with mental disorders, focusing especially on factors influencing the placebo effect and how they may influence the interpretation of clinical trials. The placebo effect seems to be more marked in children than adults, and particularly in children and adolescents with depression, although it is pervasive across ages and is present in non-psychiatric conditions as well. The use of a placebo in clinical trials as a comparator with drugs that have moderate efficacy at most makes it difficult to obtain positive results, and much effort is needed to design very high quality clinical trials that may overcome the limitations of using a placebo. In addition, the placebo effect across ages and clinical conditions must be tested directly (compared with no treatment whenever possible), in order to characterise which placebos work for what and to determine their use in clinical settings.

  6. Promoting Scholarship during Child and Adolescent Psychiatry Residency

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    Mezzacappa, Enrico; Hamoda, Hesham M.; DeMaso, David R.

    2012-01-01

    Background: In 2003, the Institute of Medicine (IOM) drew attention to the critical national shortage of psychiatrist-researchers and the need for competency-based curricula to promote research training during psychiatry residency as one way to address this shortage at the institutional level. Here, the authors report on the adaptation,…

  7. Drug monitoring in child and adolescent psychiatry for improved efficacy and safety of psychopharmacotherapy

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    Fegert Jörg M

    2009-04-01

    Full Text Available Abstract Most psychotropic drugs used in the treatment of children and adolescents are applied "off label" with a direct risk of under- or overdosing and a delayed risk of long-term side effects. The selection of doses in paediatric psychiatric patients requires a consideration of pharmacokinetic parameters and the development of central nervous system, and warrants specific studies in children and adolescents. Because these are lacking for most of the psychotropic drugs applied in the Child and Adolescent and Psychiatry, therapeutic drug monitoring (TDM is a valid tool to optimise pharmacotherapy and to enable to adjust the dosage of drugs according to the characteristics of the individual patient. Multi-centre TDM studies enable the identification of age- and development-dependent therapeutic ranges of blood concentrations and facilitate a highly qualified standardized documentation in the child and adolescent health care system. In addition, they will provide data for future research on psychopharmacological treatment in children and adolescents, as a baseline for example for clinically relevant interactions with various co-medications. Therefore, a German-Austrian-Swiss "Competence Network on Therapeutic Drug Monitoring in Child and Adolescent Psychiatry" was founded 1 introducing a comprehensive internet data base for the collection of demographic, safety and efficacy data as well as blood concentrations of psychotropic drugs in children and adolescents.

  8. [Structural quality in inpatient and daycare child and adolescent psychiatry- indicators for planning future staff ratios for the era following the Psychiatry Personnel Act].

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    Schepker, Renate; Fegert, Jörg M; Becker, Katja

    2015-11-01

    The German Psychiatry Personnel Act, which went into effect in 1990, has led to a decrease in the number of child and adolescent psychiatry inpatient beds, to a decrease in the length of stay, and to an increase in inpatient psychotherapy. Today, this act is outdated~ for a number of reasons, such as changes in the morbidity of the population, the rising number of emergencies, and new professional standards such as documentation. In addition, new legal provisions and conventions (like the UN Convention on the Rights of the Child) necessitate a complete reevaluation. Child and adolescent psychiatry needs a normative act to enable the necessary implementation. Many different rationales are available to support the debate.

  9. [The meaning of bibliotherapy and expressive writing in child and adolescent psychiatry].

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    Blechinger, Tobias; Klosinski, Gunther

    2011-01-01

    Child- and adolescent psychiatry is a good field for the application of creative and playful therapies. Bibliotherapy and expressive writing are two examples of them. The effectiveness of both, for different types of disorders, has been proved in many studies. Up until today it was unknown just how prevalent these therapies are within child and adolescent psychiatry in the german speaking countries. The following article summarizes the results of a survey conducted in 122 child and adolescence psychiatric clinics in Germany, Austria and Switzerland to gain more information about their use. The survey takes into account the frequency of application of bibliotherapy and expressive writing therapies depending on age and type of disorder, preferences amongst patient groups, as well as specific approaches. More than half of the surveyed child and adolescent psychiatries are using at least one of the two therapies. They are used on an irregular and non-systematic basis and rather symptom- than diagnosis-orientated. Bibliotherapy and expressive writing are dynamic therapies which can be used in manifold ways. Reading and writing are two of the main pillars of our educational system and can be utilized within a therapeutic setting. Provided that the patient is not suffering from severe cognitive or mental limitations, the spoken and written word can leave deep imprints within the patient's, but also the therapist's, soul.

  10. Clinical neuropsychology within adolescent and young-adult psychiatry: conceptualizing theory and practice.

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    Allott, Kelly; Proffitt, Tina-Marie; McGorry, Patrick D; Pantelis, Christos; Wood, Stephen J; Cumner, Marnie; Brewer, Warrick J

    2013-01-01

    Historically, clinical neuropsychology has made significant contributions to the understanding of brain-behavior relationships, particularly in neurological conditions. During the past several decades, neuropsychology has also become established as an important discipline in psychiatric settings. Cognition is increasingly recognized as being core to psychiatric illnesses and predictive of functional outcomes, augmenting theories regarding symptomatology and illness progression. Adult-type psychiatric disorders (including schizophrenia and other psychotic, mood, anxiety, eating, substance-related, and personality disorders) typically emerge during adolescence or young adulthood, a critical neurodevelopmental period. Clinical neuropsychological assessment in adolescent psychiatric patients is particularly valuable in informing clinical formulation and intervention and can be therapeutic across a number of levels. This article articulates the theoretical considerations and practical challenges and applications of clinical neuropsychology within adolescent and young-adult psychiatry. The importance of considering the neurodevelopmental context and its relationship to current theoretical models underpinning clinical practice are discussed.

  11.  Assessing Problem Based Learning in Child and Adolescent Psychiatry at the Trinity College Dublin, Ireland

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    Thomas Frodl

    2012-03-01

    Full Text Available  The School of Medicine, TCD (Trinity College Dublin has developed the undergraduate degree in Medicine in accordance with the Medical Council and the World Federation of Medical Education guidelines. The course is 5 years. At TCD, clinical and theoretical aspects of psychiatry for 4th-year medical students are delivered during a two-month attachment. Four days of the two months are allocated exclusively to Child and Adolescent Psychiatry (CAP, and up to ¼ of all students do a two-weekspeciality clinical rotation in Child and Adolescent Mental Health Services. A team of academic child and adolescent psychiatrists at TCD developed the structure and content of the PBL-based component of the program for CAP. The introduced PBL into the curriculum was received positively by the students; PBL was well liked, stimulating and preferred, especially by those interested in psychiatry as a career.

  12. Integrating science and ethics in child and adolescent psychiatry research.

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    Vitiello, B; Jensen, P S; Hoagwood, K

    1999-10-15

    Research to elucidate the biological bases of psychopathology in children and adolescents is needed to understand pathogenesis and to develop effective and safe treatment and preventive interventions. Because of the effect of development, data collected in adults are not always applicable to youth, and direct participation of children in research is necessary. Many medications are currently used in the community to treat children and adolescents with neuropsychiatric disorders without adequate data about their safety and efficacy. Conducting research in children requires attention to specific ethical and regulatory factors. In deciding whether minors can participate in a study with potential direct benefit to the research subjects, the most important variable to consider is the balance between risks and potential benefit, in the context of the severity of the child's condition and the available alternatives. Research with no potential benefit to the participants is guided by the concepts of minimal risk (which may apply more to normal children) and minor increase over minimal risk (perhaps more relevant to children affected by psychopathology). Recently conducted studies relevant to this issue are reviewed. Of paramount importance is the ratio of risk/scientific value of the proposed experiment. In fact, no research is justifiable, no matter how low the risk may be, unless the potential yield of the study is important and may help advance our understanding of normal functioning and mental illness.

  13. [Research in child and adolescent psychiatry, promotion of young academics and publication practice].

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    Lehmkuhl, Gerd; Petermann, Franz; Warnke, Andreas

    2009-03-01

    Objective is the promotion of the international recognition of research in child and adolescent psychiatry which is published in German language. There is a necessity for change of the strategy of publication in these scientific journals. The goal is to increase the impact factor. The length of the review and publication process has to be shortened, citations should be relevant to the present, interdisciplinarity and the cooperation of the editorial boards of different disciplines should be reinforced. These efforts are necessary for a better international recognition of publications in German language.

  14. Epidemiologic Studies in Child and Adolescent Psychiatry: A Review of Methodology

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    Onur Burak Dursun

    2010-01-01

    Full Text Available Childhood psychiatric disorders are estimated to influence about 9 to 21% of relevant age group and interest in this disorders are increasing all over the world. The growing need to child and adolescent mental health leads the task of establishing proposals and policies in this field to become a priority for governments. The first step of such proposals should be determination of prevalence of child and adolescent mental disorders in that country. However, several major methodological problems make it hard to provide accurate prevalence estimates from epidemiological studies. Most common problems are within the fields of sampling, case definition, case ascertainment and data analyses. Such issues increases the costs of studies and hinder to reach large sample sizes. To minimize these problems, investigators have to be careful on choosing the appropriate methodology and diagnostic tools in their studies. Although there are many interviews and questionnaires for screening and diagnosing in child and adolescent psychiatry, only a few of them are suitable for epidemiological research. In parallel with the improvement in all fields of child and adolescent mental health in our country, some of the major screening and diagnosing tools used in prevalence studies in literature have already been translated and validated in Turkish. Most important of this tools for screening purposes are Child Behavior Checklist and Strengths and Difficulties Questionnaire and for diagnosing purposes are Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version and Development and Well-Being Assessment. The aims of this article are to review the methodological problems of epidemiologic studies in child and adolescent psychiatry and to briefly discuss suitable diagnostic tools for extended sampled epidemiologic studies in our country.

  15. Amantadine: a review of use in child and adolescent psychiatry.

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    Hosenbocus, Sheik; Chahal, Raj

    2013-02-01

    Résumé OBJECTIF: Passer en revue, résumer et discuter la littérature publiée sur la pharmacologie et l’utilisation de l’amantadine en pédopsychiatrie. MÉTHODE: Une recherche de la littérature dans plusieurs bases de données (PubMed, Psychinfo, CINAHL, Medline, PsycARTICLES, Biomedical Reference Collection et Academis Search Complete) a été menée avec le mot clé « amantadine » avec des limites: langue anglaise, essais sur des humains, tous les enfants (de 0 à 18 ans). Des articles additionnels pertinents ont été relevés dans les bibliographies. Étant donné la quantité limitée d’information obtenue, la recherche s’est élargie et a inclus « tous les enfants et les adultes », et l’information pertinente a été saisie. RÉSULTATS: L’utilisation de l’amantadine pour traiter les troubles neuro-développementaux chez les enfants est due à son effet antagoniste au recepteur N-methyl-D-aspartate (NMDA). L’effet de l’amantadine sur le système glutamatergique des neurotransmetteurs, jouer un rôle important dans de nombreux troubles psychiatriques. La majorité des études relevées étaient des études ouvertes et seulement deux étaient des études contrôlées d’enfants et d’adolescents. Un essai randomisé contrôlé rendait compte des effets bénéfiques du contrôle des symptômes d’irritabilité et d’hyperactivité chez les enfants souffrant d’un trouble autiste. Un autre essai randomisé contrôlé, une étude de comparaison directe avec le méthylphénidate, a constaté un effet statistiquement significatif sur le trouble de déficit de l’attention avec hyperactivité (TDAH). Deux autres études ouvertes constataient aussi des effets positifs sur le TDAH. Une étude pilote sur des enfants souffrant d’énurésie constatait une réduction significative de la fréquence de l’incontinence. Ouvertes pour la plupart, les études sur les adultes, relativement aux enfants et aux adolescents, rapportaient une

  16. What Is Psychiatry?

    Medline Plus

    Full Text Available ... mental disorders with psychotherapy and some specialize in psychological testing and evaluation. More Resources World Psychiatric Association American Association of Child and Adolescent Psychiatry American ...

  17. Adventure-Based Experiential Therapy with Inpatients in Child and Adolescent Psychiatry: An Approach to Practicability and Evaluation

    Science.gov (United States)

    Eckstein, Florian; Rüth, Ulrich

    2015-01-01

    This article examines the use of adventure-based experiential therapy (AET) with child and adolescent psychiatry inpatients. AET environments, indications, practicality, therapeutic effects and research are outlined and clinical findings are reported. Activities such as rock-climbing, exploring a creek and caving are discussed and the limitations…

  18. How to assess quality of life in child and adolescent psychiatry.

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    Ravens-Sieberer, Ulrike; Karow, Anne; Barthel, Dana; Klasen, Fionna

    2014-06-01

    This article provides an overview of the conceptual foundations of measuring health-related quality of life (HRQoL) in children and adolescents in child and adolescent psychiatry, and of the current state of research in this field. The available procedures for determining quality of life are presented according to their areas of use and their psychometric characteristics. The internationally available generic instruments for measuring HRQoL in children are identified and assessed in terms of their strengths and weaknesses with regard to selected criteria. As a result, seven generic HRQoL instruments and two utility procedures have been identified which satísfy the following criteria: (i) psychometric qualíty; (ii) age-appropriate measurement; (iii) versions for self-reporting and external rating; and (iv) cross-cultural measurement. The identified instruments satisfy the individual criteria to different degrees. They are increasingly being used in health services research, treatment studies, and epidemiological research; however, they are not yet widely used as part of the clinical routine in child and adolescent psychiatrics.

  19. Using participatory design to develop structured training in child and adolescent psychiatry

    DEFF Research Database (Denmark)

    Davis, Deborah J; Ringsted, Charlotte; Bonde, Mie

    2009-01-01

    CONTEXT: Learning during residency in child and adolescent psychiatry (CAP) is primarily work-based and has traditionally been opportunistic. There are increasing demands from both postgraduate trainees and medical organisations for structured programmes with defined learning outcomes. OBJECTIVES....... Several other types of professionals within the healthcare team perform many of the tasks a CAP postgraduate trainee has to learn. Participants had difficulties describing how learning takes place and what postgraduate trainees need to learn in CAP. The partnership between researchers and practitioners...... identified three key issues to consider in CAP residencies: (1) Preparation for tasks postgraduate trainees are expected to fulfil, (2) Ensuring acquisition of physician-specific knowledge and skills, and (3) Clarifying roles and professional identity within the team. A structured training programme...

  20. [Cognitive remediation therapy for children: literature data and clinical application in a child and adolescent psychiatry department].

    Science.gov (United States)

    Doyen, C; Contejean, Y; Risler, V; Asch, M; Amado, I; Launay, C; Redon, P De Bois; Burnouf, I; Kaye, K

    2015-04-01

    remediation, and the program was applied by a clinical nurse with the supervision of a child and adolescent psychiatrist and the department's neuropsychologists. Paper-pencil tasks were adapted from the CRT program for adults; the card and board games used were geometric figures, illusions, Rush Hour(®), Set(®), Jungle Speed(®), Color Addict(®), etc. These games are available in stores and the program can be applied at home, which helps families set aside their preoccupations with their child's academic performance. Diagnostic and neuropsychological evaluations were done before the beginning of the therapy and repeated at the end of the 6-month program. This program does not ignore the metapsychological impact of the therapy, and work on self-esteem is also done. The presence of the therapist is necessary, which seems better than a computer program, which cannot encourage the young subject in the same personalized and empathetic way. We therefore conducted the first clinical feasibility trial of cognitive remediation in young subjects and present a clinical case of a 6-year-old boy with attention deficit disorder and academic disorder. The results of neuropsychological evaluations before and after therapy suggest improvement in executive functions and better self-esteem. Satisfaction for the boy and his family was high. Even if these results need to be replicated, cognitive remediation appears to be a new therapeutic tool, complementary to classical approaches used in childhood psychiatric disorders. The Department of Child and Adolescent Psychiatry will submit this program to a research program conducted by the National Health Department to study the impact of this approach in a controlled study.

  1. What Is Psychiatry?

    Medline Plus

    Full Text Available ... mental disorders with psychotherapy and some specialize in psychological testing and evaluation. More Resources World Psychiatric Association American Association of Child and Adolescent Psychiatry American Association ...

  2. Sociodemographic Characteristics and Diagnoses of Individuals Referred to a Child and Adolescent Psychiatry Outpatient Clinic of a University Hospital

    Directory of Open Access Journals (Sweden)

    Sevcan Karakoç Demirkaya

    2015-04-01

    Full Text Available OBJECTIVE: The aim of this study is to evaluate the sociodemographic characteristics, complaints, and diagnoses of individuals who were admitted to a child and adolescent psychiatry outpatient clinic. MATERIALS AND METHODS: Medical charts of the patients who were admitted to the child and adolescent psychiatry unit of Adnan Menderes University between February 1st and July 31st, 2014 were retrospectively studied. RESULTS: The rate of girls and boys from a total of 832 cases who were referred to the child and adolescent psychiatry outpatient clinic in the six month period was 41.8% and 58.2%, respectively. The mean age of the girls and boys was 10.8±4.9 and 8.5±4.7 years, respectively. The most common age range was between 12 and 18 years. The proportion of patients who lived with both parents was 81.1%; however, the proportion of individuals brought in by institutional caregivers was 0.8%. The proportion of consanguineous marriages was 13.7%. The education level of mothers and fathers was mostly a primary school degree (47% and 45.6%, respectively. A positive psychiatric history was present in 13.7% of the mothers and 7.6% of the fathers. Reasons for child psychiatric assessments were as follows: 21.9% for disability report, 13.8% for forensic evaluation, 11.2% for consultation, and 52.9% for general psychiatric evaluation. Referral complaints were irritability/anger (15.7%, attention deficit/hyperactivity (14.8%, delay in speech (10.5%, fear/anxiety (5.9%, and poor school performance (5.7%. The diagnoses were as follows: attention deficit hyperactivity disorder (ADHD (20.6%, other disruptive behaviors (12.4%, and anxiety disorder (10.2%. CONCLUSION: We revealed that the most common referring complaint was irritability/anger and that the most common diagnosis was ADHD in our patient group, which was similar to previous studies. Our results showed that a low parental educational level and a positive history for parental psychopathology were

  3. Is Mandatory Prospective Trial Registration Working to Prevent Publication of Unregistered Trials and Selective Outcome Reporting? An Observational Study of Five Psychiatry Journals That Mandate Prospective Clinical Trial Registration

    OpenAIRE

    Amelia Scott; Julia J Rucklidge; Roger T Mulder

    2015-01-01

    Objective To address the bias occurring in the medical literature associated with selective outcome reporting, in 2005, the International Committee of Medical Journal Editors (ICMJE) introduced mandatory trial registration guidelines and member journals required prospective registration of trials prior to patient enrolment as a condition of publication. No research has examined whether these guidelines are impacting psychiatry publications. Our objectives were to determine the extent to which...

  4. [Selection and destruction--treatment of "unworthy-to-live" children in the Third Reich and the role of child and adolescent psychiatry].

    Science.gov (United States)

    Dahl, M

    2001-03-01

    During the period of National Socialism in Germany, many "asocial", mentally retarded or disabled minors were persecuted. Several measures had been discussed theoretically before, but the National Socialists put the theoretical proposals into practice. As a result children and adolescents were separated, sterilized or killed. In concentration camps so-called "depraved" minors were selected to get special education. The object of this effort was to adapt minors to the ideology of national socialism. After passing the law to sterilize patients with "hereditary diseases" in 1933 about 375.000 people were sterilized unvoluntarily. In 193/span>9 sterilizations came to an end except for adolescents at "high risk of reproduction". During the second world war more than 160.000 adult psychiatric patients were murdered. In addition to that, also a large number of disabled and mentally retarded minors were killed. This campaign was called child "euthanasia". Physicians tried to determine children's "value of life" by economic criteria. Children with negative ratings (i.e. inability to work or insufficient mental maturing) were killed by fasting "cures" or by barbiturates. Beyond that children were also used as research subjects. Their death was an accepted consequence. Physicians were also very interested in brain research. Finally, the relation to German child and adolescent psychiatry will be analysed. In the special political and social context of the Third Reich the German child and adolescent psychiatry became more significant. As a result of this the German association of child and adolescent psychiatry and allied professions was founded 1940 in Vienna. On this conference, some speakers suggested to persecute "asocial" minors. This suggestion was realized consequently. Up to now, the role of the German child and adolescent psychiatry has not been thoroughly discussed.

  5. Intentional self-harm in children and adolescents: A study from psychiatry consultation liaison services of a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Sandeep Grover

    2015-01-01

    Full Text Available Objective: The objective of this study was to evaluate the socio-demographic and the clinical profile of children and adolescents presenting with Intentional self-harm. Materials and Methods: Records of all children and adolescents (≤19 years seen by the consultation liaison (CL services during the period of 2000-2012 were screened. Patients with a diagnosis of intentional self-harm (at the time of assessment were taken up for this study. Data was extracted from the records, to study the socio-demographic and clinical profile. Results: During the study period, 101 patients aged ≤19 years and diagnosed with intentional self-harm at the time of admission were evaluated by the psychiatry CL services in various emergency and medical surgical wards. In the study population, females (N = 61; 60.4% outnumbered males. The age of the patients ranged from 12 to 19 with a median and mean of 17.0 years (standard deviation-1.6 years; interquartile range 16-18 years. Children and adolescent with self harm were more commonly females, from nuclear families, middle socio-economic status and Hindu by religion. The common method of self-harm in adolescents is by ingestion of insecticides (65% and the self-harm behavior was often precipitated by interpersonal problems in the family context. About one-fifth of the patients have psychiatric morbidity. Conclusion: Findings suggest that the most common method of intentional self-harm in children and adolescents is consumption of insecticides and precipitated by interpersonal problems in the family context.

  6. Smartphone application for multi-phasic interventional trials in psychiatry: Technical design of an automated smart server.

    Science.gov (United States)

    Zhang, Melvyn W B; Ho, Roger C M

    2016-12-13

    Smartphones and their accompanying applications are currently widely utilized in various healthcare interventions. Prior to the deployment of these tools for healthcare intervention, typically, proof of concept feasibility studies, as well as randomized trials are conducted to determine that these tools are efficacious prior to their actual implementation. In the field of psychiatry, most of the current interventions seek to compare smartphone based intervention against conventional care. There remains a paucity of research evaluating different forms of interventions using a single smartphone application. In the field of nutrition, there has been recent pioneering research demonstrating how a multi-phasic randomized controlled trial could be conducted using a single smartphone application. Despite the innovativeness of the previous smartphone conceptualization, there remains a paucity of technical information underlying the conceptualization that would support a multi-phasic interventional trial. It is thus the aim of the current technical note to share insights into an innovative server design that would enable the delivery of multi-phasic trials.

  7. Report of the Psychotherapy Task Force of the American Academy of Child and Adolescent Psychiatry

    OpenAIRE

    Ritvo, Rachel; Al-mateen, Cheryl; Ascherman, Lee; Beardslee, William; Hartmann, Lawrence; Lewis, Owen; Papilsky, Shirley; Sargent, John; Sperling, Eva; Stiener, Gregory; Szigethy, Eva

    1999-01-01

    In this task force report, the authors define the field of child and adolescent psychotherapy; review the state of the field with respect to advocacy, training, research, and clinical practice; and recommend steps to ensure that psychotherapy remains a core competence of child and adolescent psychiatrists. (The Journal of Psychotherapy Practice and Research 1999; 8:93–102)

  8. [Qualitative research approaches in practical use in child and adolescent psychiatry].

    Science.gov (United States)

    Fegert, J; Gerwert, U

    1993-10-01

    Experimental study designs and quantitative analysis are dominating the methodology of child psychiatric research. Sometimes the "box of tools" consisting of standardized software packages for statistical analysis seems to lead to a regrettable uniformity in research strategies. Elaborated sociological research concepts in the tradition of Max Weber and the "Chicago school" could close the scientific gap between quantitative studies on large samples and simple case-reports. They are excellent instruments for generating hypothesis on relatively rare clinical problems or in new fields of child psychiatric research. Based on a review of the literature potential applications of qualitative methodology in child psychiatry will be discussed.

  9. Off-Label Prescription of Psychopharmacological Drugs in Child and Adolescent Psychiatry

    DEFF Research Database (Denmark)

    Braüner, Julie Vestergaard; Johansen, Lily Manzello; Roesbjerg, Troels;

    2016-01-01

    This study aimed to describe the frequency of off-label prescriptions of psychopharmacological drugs in a child and adolescent psychiatric setting. A cross-sectional study was conducted on November 1, 2014, including all inpatients and outpatients at the Mental Health Centre for Child and Adolesc......This study aimed to describe the frequency of off-label prescriptions of psychopharmacological drugs in a child and adolescent psychiatric setting. A cross-sectional study was conducted on November 1, 2014, including all inpatients and outpatients at the Mental Health Centre for Child...

  10. [Gender identity disorder and related sexual behavior problems in children and adolescents: from the perspective of development and child psychiatry].

    Science.gov (United States)

    Yamashita, Hiroshi

    2013-01-01

    The present paper reviews the theoretical and empirical literature on children and adolescents with gender identity disorder. The organizational framework underlying this review is one that presents gender behavior in children and adolescents as a continuum rather than as a dichotomy of normal versus abnormal categories. Theories of normative gender development, prevalence, assessment, developmental trajectories, and comorbidity were investigated. There is a greater fluidity and likelihood of change in the pre-pubertal period. It was reported that the majority of affected children had been eventually developing a homosexual orientation. As an approach to determine the prevalence of GID in clinical samples in our child psychiatry clinic, screening instruments that include items on cross-gender or cross-sex identification were used. We applied the Child Behavior Checklist (CBCL). Of the 113 items in the Japanese version of the CBCL, there are two measures of cross-gender identification: "behaves like opposite sex" and "wishes to be opposite sex." Like the other items, they are scored on a 3-point scale of: 0-not true, 1- somewhat true, and 2-very true. Our study of 323 clinically-referred children aged 4-15 years reported that, among the boys, 9.6% assigned a score of 1 (somewhat true) or a score of 2 (very true) to the two items. The corresponding rates for the clinically-referred girls were 24.5%. The item of diagnosis of GID in our clinical sample was significantly higher than in non-referred children, reported as 2-5% using the same method. Two clinical case histories of screened children are also presented. Both of them were diagnosed with PDDNOS. Together with the literature review, most of the gender-related symptoms in autistic spectrum disorders (ASD) could be related to the behavioral and psychological characteristics of autism as shown in case histories. ASD subjects in adolescence can sometimes develop a unique confusion of identity that occasionally

  11. Feasibility and acceptability of the DSM-5 Field Trial procedures in the Johns Hopkins Community Psychiatry Programs.

    Science.gov (United States)

    Clarke, Diana E; Wilcox, Holly C; Miller, Leslie; Cullen, Bernadette; Gerring, Joan; Greiner, Lisa H; Newcomer, Alison; McKitty, Mellisha V; Regier, Darrel A; Narrow, William E

    2014-06-01

    The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) contains criteria for psychiatric diagnoses that reflect advances in the science and conceptualization of mental disorders and address the needs of clinicians. DSM-5 also recommends research on dimensional measures of cross-cutting symptoms and diagnostic severity, which are expected to better capture patients' experiences with mental disorders. Prior to its May 2013 release, the American Psychiatric Association (APA) conducted field trials to examine the feasibility, clinical utility, reliability, and where possible, the validity of proposed DSM-5 diagnostic criteria and dimensional measures. The methods and measures proposed for the DSM-5 field trials were pilot tested in adult and child/adolescent clinical samples, with the goal to identify and correct design and procedural problems with the proposed methods before resources were expended for the larger DSM-5 Field Trials. Results allowed for the refinement of the protocols, procedures, and measures, which facilitated recruitment, implementation, and completion of the DSM-5 Field Trials. These results highlight the benefits of pilot studies in planning large multisite studies.

  12. [Teaching child and adolescent psychiatry and psychotherapy in Germany-inventory and implications].

    Science.gov (United States)

    Becker, Katja; Resch, Franz; Fegert, Jörg M; Häßler, Frank

    2013-07-01

    Einleitung: Wissen über kinder- und jugendpsychiatrische Störungen, deren Diagnostik und Therapie, Kenntnisse über Risiken devianter Entwicklungen, sowie das Erlernen von Fertigkeiten im adäquaten Umgang mit Kindern und Jugendlichen gehören in jede Medizinerausbildung. Die vorliegende Arbeit ist eine Bestandsaufnahme der Lehre im Fach Kinder- und Jugendpsychiatrie (KJP) an den medizinischen Fakultäten in Deutschland. Methodik: Es wurden alle Lehrstuhlinhaber für KJP befragt zur Einbindung in die Pflichtlehre, zu den Lehrangeboten für KJP vor Ort und zu Lehrangeboten für andere Fachbereiche. Ergebnisse: An 25 von 26 medizinischen Fakultäten mit Lehrstuhl für KJP ist das Fach KJP bereits in die Pflichtlehre für Mediziner integriert. Die Vorlesung wird entweder als eigenständige KJP-Vorlesung gehalten oder ist in die Vorlesung Psychiatrie, Pädiatrie und/oder Psychosomatik integriert. Die durchschnittlich 1.2 Semesterwochenstunden umfassende Hauptvorlesung (Range von 0.1 bis 2 SWS; entsprechend 2 bis 28 Unterrichtseinheiten KJP pro Semester) wird durch zahlreiche weitere Lehrangebote ergänzt, wie Praktika, vertiefende Veranstaltungen und Wahlpflichtfachangebote. Das KJP-Wahltertial des Praktischen Jahrs kann an allen Orten mit KJP-Lehrstuhl absolviert werden. Oft wird KJP-Lehre auch für andere Fachbereiche angeboten, am häufigsten für Studierende der Psychologie und der Pädagogik. Schlussfolgerung: Ein übergeordnetes Ziel sollte es sein, KJP aufgrund ihrer Bedeutung als Approbationsfach in der ärztlichen Ausbildungsordnung zu verankern und zukünftig an allen 35 Universitäten mit Fachbereich Medizin in Deutschland zu lehren.

  13. [Concept of budget-based remuneration system for the fields of psychiatry and psychotherapy, psychosomatic medicine and psychotherapy, child and adolescent psychiatry and psychotherapy].

    Science.gov (United States)

    2015-11-01

    A new remuneration system is currently being developed for the hospital care of people with mental disorders. Last year, because of sharp criticism the option phase of the planned Flat-rate Charges in Psychiatry and Psychosomatics (Pauschalierende Entgelte Psychiatrie und Psychosomatik, PEPP) was extended by 2 years. During this time the Federal Ministry of Health wants to look for alternatives and possible starting points for the further development of care. Now, 16 scientific professional associations and organisations have presented a joint concept for a sustainable solution: the budget-based remuneration system. The system is suitable for ensuring that people with mental disorders are treated according to their particular needs and for promoting the appropriate further development of regional care in all treatment settings. It corresponds with the objectives as formulated in Section 17d of the Hospital Finance Act (Krankenhausfinanzierungsgesetz, KHG) and translates the PEPP system, which is currently being developed and focusses on average prices, into a performance-oriented, transparent budgetary system. The fundamental principle is the separation of the individual hospitals' budgeting on the basis of evidence-based, feature- and performance-related modules and billing in the form of advance payments from the agreed budget.

  14. Transformational Impact of Health Information Technology on the Clinical Practice of Child and Adolescent Psychiatry.

    Science.gov (United States)

    Peters, Todd E

    2017-01-01

    Compared with other medical specialties, psychiatrists have been slower adopters of health information technology (IT) practices, such as electronic health records (EHRs). This delay in implementation could compromise patient safety and impede integration into accountable care organizations and multidisciplinary treatment settings. This article focuses on optimizing use of EHRs for clinical practice, leveraging health IT to improve quality of care, and focusing on the potential for future growth in health IT in child and adolescent psychiatric practice. Aligning with other medical fields and focusing on transparency of mental health treatment will help psychiatrists reach parity with other medical specialties.

  15. Child Maltreatment Prevention and the Scope of Child and Adolescent Psychiatry.

    Science.gov (United States)

    Constantino, John N

    2016-04-01

    Child maltreatment is one of the most deleterious known influences on the mental health and development of children. This article briefly reviews a complement of methods that are ready to incorporate into child and adolescent psychiatric practice, by having been validated either with respect to the prevention of child maltreatment or with respect to adverse outcomes associated with maltreatment (and primarily focused on enhancing the caregiving environment); they are feasible for integration into clinical decision making, and most importantly, can be included in the training of the next generation of clinicians.

  16. Emergency in pediatric and adolescent psychiatry. Note taking for the primary health assistance.

    Directory of Open Access Journals (Sweden)

    Zenaida María Sáez

    2003-04-01

    Full Text Available The psyquiatric emergences in children and adolescents are usually manifested as alterations of the feelings, behavior or in the school efficiency and its origin is found in the physical tensions, contradictions in the breeding, marital conflicts, bad interpersonal relationships, negligence, loss of the significant model at home, etc. It is important to address that there is no direct relationship between the causal factor and the onset of the symptoms. This largely depends on variables such as temperament, levels of development, nature and duration of the stress, past experience and family capacity/ability of the family to get adapted to new situations.Parents frequently come to visit General Comprehensive doctor because they are worried about their children´s behaviors, i.e.; if they are normal or require certain intervention.In the current review we make reference to the psychosocial issues that may bring about psychopathological manifestations which need a timely intervention. Otherwise, there is a risk for the physical integrity of the kid, adolescent or another people which may result into a remarkable complications and suffering for the patients or their relatives. We are going to make reference to the abuse of some substances, adoption, nervous anorexia, suicide attempt, infant abuse, fire provocation and mourning reaction.We are making emphasis on the clinical assessment of the risk factors which contribute to the appearance of these issues and the management in the primary level of assistance to prevent further complications.

  17. Clinical trials of N-acetylcysteine in psychiatry and neurology: A systematic review.

    Science.gov (United States)

    Deepmala; Slattery, John; Kumar, Nihit; Delhey, Leanna; Berk, Michael; Dean, Olivia; Spielholz, Charles; Frye, Richard

    2015-08-01

    N-acetylcysteine (NAC) is recognized for its role in acetaminophen overdose and as a mucolytic. Over the past decade, there has been growing evidence for the use of NAC in treating psychiatric and neurological disorders, considering its role in attenuating pathophysiological processes associated with these disorders, including oxidative stress, apoptosis, mitochondrial dysfunction, neuroinflammation and glutamate and dopamine dysregulation. In this systematic review we find favorable evidence for the use of NAC in several psychiatric and neurological disorders, particularly autism, Alzheimer's disease, cocaine and cannabis addiction, bipolar disorder, depression, trichotillomania, nail biting, skin picking, obsessive-compulsive disorder, schizophrenia, drug-induced neuropathy and progressive myoclonic epilepsy. Disorders such as anxiety, attention deficit hyperactivity disorder and mild traumatic brain injury have preliminary evidence and require larger confirmatory studies while current evidence does not support the use of NAC in gambling, methamphetamine and nicotine addictions and amyotrophic lateral sclerosis. Overall, NAC treatment appears to be safe and tolerable. Further well designed, larger controlled trials are needed for specific psychiatric and neurological disorders where the evidence is favorable.

  18. The Impact of Health Information Technology on the Doctor-Patient Relationship in Child and Adolescent Psychiatry.

    Science.gov (United States)

    Krishna, Rajeev

    2017-01-01

    As health information technology continues to expand and permeate medicine, there is increasing concern for the effect on the therapeutic relationship between patient and psychiatrist. This article explores this impact, seeking wisdom from adult psychiatry and more broadly from general medical disciplines to draw conclusions regarding how the child psychiatry encounter may be affected. Several proposed strategies to mitigate potential negative impacts of health information technology on the therapeutic relationship across practice settings are offered.

  19. Psychiatry and political-institutional abuse from the historical perspective: the ethical lessons of the Nuremberg Trial on their 60th anniversary.

    Science.gov (United States)

    López-Muñoz, Francisco; Alamo, Cecilio; Dudley, Michael; Rubio, Gabriel; García-García, Pilar; Molina, Juan D; Okasha, Ahmed

    2007-05-09

    Sixty years ago at the Nuremberg Trials, 23 Nazi leaders were tried as war criminals, in what was known as "The Doctors' Trial". This trial exposed a perverse system of the criminal use of medicine in the fields of public health and human research. These practices, in which racial hygiene constituted one of the fundamental principles and euthanasia programmes were the most obvious consequence, violated the majority of known bioethical principles. Psychiatry played a central role in these programmes, and the mentally ill were the principal victims. The aim of the present work is to review, from the historical perspective, the antecedents of the shameful euthanasia programmes for the mentally ill, the procedures involved in their implementation and the use of mentally ill people as research material. The Nuremberg Code, a direct consequence of the Doctors' Trial, is considered to be the first international code of ethics for research with human beings, and represented an attempt to prevent any repeat of the tragedy that occurred under Nazism. Nevertheless, the last 60 years have seen continued government-endorsed psychiatric abuse and illegitimate use of psychoactive drugs in countries such as the Soviet Union or China, and even in some with a long democratic tradition, such as the United States. Even today, the improper use of psychiatry on behalf of governments is seen to be occurring in numerous parts of the globe: religious repression in China, enforced hospitalization in Russia, administration of psychoactive drugs in immigrant detention centres in Australia, and the application of the death penalty by lethal injection and psychiatric participation in coercive interrogation at military prisons, in relation to the USA. The Declaration of Madrid in 1996 constituted the most recent attempt to eradicate, from the ethical point of view, these horrendous practices. Various strategies can be used to combat such abuses, though it is uncertain how effective they are in

  20. Altruistic reasoning in adolescent-parent dyads considering participation in a hypothetical sexual health clinical trial for adolescents.

    Science.gov (United States)

    Chávez, Noé Rubén; Williams, Camille Y; Ipp, Lisa S; Catallozzi, Marina; Rosenthal, Susan L; Breitkopf, Carmen Radecki

    2016-04-01

    Altruism is a well-established reason underlying research participation. Less is known about altruism in adolescent-parent decision-making about clinical trials enrolling healthy adolescents. This qualitative investigation focused on identifying spontaneous statements of altruism within adolescent-parent (dyadic) discussions of participation in a hypothetical phase I clinical trial related to adolescent sexual health. Content analysis revealed several response patterns to each other's altruistic reasoning. Across 70 adolescent-parent dyads in which adolescents were 14-17 years of age and 91% of their parents were mothers, a majority (61%) of dyadic discussions included a statement reflecting altruism. Parents responded to adolescents' statements of altruism more frequently than adolescents responded to parents' statements. Responses included: expresses concern, reiterates altruistic reasoning, agrees with altruistic reasoning, and adds to/expands altruistic reasoning. Since an altruistic perspective was often balanced with concerns about risk or study procedures, researchers cannot assume that altruism will directly lead to study participation. Optimizing the informed consent process for early phase clinical trials involving healthy adolescents may include supporting parents to have conversations with their adolescents which will enhance their capacity to consider all aspects of trial participation.

  1. [Placement of children and adolescents following seclusion and restraint actions–a study on family-court approvals of minors in youth welfare, child and adolescent psychiatry and jail according to Para. 1631 German Civil Code].

    Science.gov (United States)

    Kölch, Michael; Vogel, Harald

    2016-01-01

    According to German law (Para. 1631b German Civil Code), the placement of children and adolescents following seclusion and restraint actions must be approved by a family court. We analyzed the family court data of a court district in Berlin (Tempelhof-Kreuzberg) concerning cases of “placement of minors” between 2008 and 2011. A total of 474 such procedures were discovered. After data clearing and correction of cases (e. g., because of emergency interventions of the youth welfare system taking children into custody according to Para. 42, German Civil Code VIII), 376 cases remained. Of these 376 procedures in the years 2008 to 2011, 127 cases concerned children and adolescents according to Para. 1631b German Civil Code, and 249 procedures were settled either by dismissal, withdrawal or by repealing the initial decision to place the child with restrain or seclusion by means of an interim order or by filing an appeal against the final decision. Of the 127 procedures, 68 concerned girls, who were on average slightly younger than boys (14.5 years vs. 15.1 years). In two thirds of the procedures, the children and adolescents were German citizens. The majority of youths involved were living at home at the time of the procedure, but in 15 % of the case the youths were homeless. Most of the adolescents were treated with restraint in child and adolescent psychiatry. The most frequently quoted reasons for seclusion were substance abuse, suicide risk and running away from home/being homeless.

  2. Child and adolescent psychiatry: which knowledge and skills do primary care physicians need to have? A survey in general practitioners and paediatricians.

    Science.gov (United States)

    Lempp, Thomas; Heinzel-Gutenbrunner, Monika; Bachmann, Christian

    2016-04-01

    Primary care physicians (PCPs) play a key role in the initial assessment and management of children and adolescents with mental health problems. However, it is unclear whether current medical education curricula sufficiently equip PCPs for this task. The aim of this study was to investigate, which child and adolescent psychiatry (CAP)-related skills and knowledge PCPs say they require in their daily practice. A questionnaire was generated, employing a modified two-step Delphi approach. Besides socio-demographic items, the questionnaire contained 17 CAP-related knowledge items and 13 CAP-related skills items, which had to be rated by importance in daily practice. The questionnaire was distributed to 348 office-based paediatricians and 500 general practitioners (GPs) in Germany. The overall return rate was 51.3% (435/848). Regarding CAP-related knowledge, both paediatricians and GPs rated somatoform disorders and obesity as highly important for daily practice. Moreover, paediatricians also deemed regulatory disorders during infancy (e.g. crying, sleep disorders) as important, while GPs assessed knowledge on paediatric depression as relevant. For paediatricians and GPs, the most relevant CAP-related skills were communicating with children and adolescents and their parents. Additionally, paediatricians rated differentiating between non-pathologic and clinically relevant behaviour problems very relevant, while GPs considered basic psychotherapeutic skills essential. The CAP-related knowledge and skills perceived relevant for doctors in primary care differ from the majority of current medical school CAP curricula, which cover mainly typical, epitomic CAP disorders and are predominantly knowledge-oriented. Therefore, medical education in CAP should be amended to reflect the needs of PCPs to improve healthcare for children and adolescents with mental health problems.

  3. Prevalence and predictors of e-cigarette trial among adolescents in Argentina

    Directory of Open Access Journals (Sweden)

    Paola Morello

    2016-12-01

    In Argentina, illicit trial of e-cigarettes among early adolescents is low but appears to be rapidly increasing. Identifying students at risk could help identify policies and programs to prevent increasing use in this population.

  4. Webcam Delivery of the Camperdown Program for Adolescents Who Stutter: A Phase I Trial

    Science.gov (United States)

    Carey, Brenda; O'Brian, Sue; Onslow, Mark; Packman, Ann; Menzies, Ross

    2012-01-01

    Purpose: This Phase I clinical trial explored the viability of webcam Internet delivery of the Camperdown Program for adolescents who stutter. Method and Procedure: Participants were 3 adolescents ages 13, 15, and 16 years, with moderate-severe stuttering. Each was treated with the Camperdown Program delivered by webcam with no clinic attendance.…

  5. Webcam Delivery of the Camperdown Program for Adolescents Who Stutter: A Phase II Trial

    Science.gov (United States)

    Carey, Brenda; O'Brian, Sue; Lowe, Robyn; Onslow, Mark

    2014-01-01

    Purpose: This Phase II clinical trial examined stuttering adolescents' responsiveness to the Webcam-delivered Camperdown Program. Method: Sixteen adolescents were treated by Webcam with no clinic attendance. Primary outcome was percentage of syllables stuttered (%SS). Secondary outcomes were number of sessions, weeks and hours to maintenance,…

  6. Lessons learned from a lipid lowering trial in adolescents with type 1 diabetes

    Directory of Open Access Journals (Sweden)

    Bishop Franziska K

    2012-07-01

    Full Text Available Abstract Herein, we describe recruitment efforts for a trial of lipid-lowering medications in adolescents with type 1 diabetes, age 12–21 years. Based on our experience, future studies will require multiple centers to enroll a sufficient number of participants for adequate data to direct dyslipidemia medication treatment guidelines for adolescents with type 1 diabetes.

  7. Parents' and Adolescents' Preferences for Intensified or Reduced Treatment in Randomized Lymphoblastic Leukemia Trials

    DEFF Research Database (Denmark)

    Tulstrup, Morten; Larsen, Hanne Baekgaard; Castor, Anders;

    2016-01-01

    .01). Younger children participated more frequently in only 6MP than in only ASP (14% vs. 5%), and adolescents vice versa (2% vs. 17%; P = 0.001). CONCLUSIONS: Parents' and adolescents' divergent inclinations toward intensified or reduced therapy emphasize the necessity of actively involving adolescents......BACKGROUND: When offered participation in clinical trials, families of children with cancer face a delicate balance between cure and toxicity. Since parents and children may perceive this balance differently, this paper explores whether adolescent patients have different enrollment patterns...... prospectively registered by the treating physicians. RESULTS: Parents of young children favored treatment intensifications (Dx/VCR: 12% refusal; 6MP: 14%; ASP: 21%), whereas parents of adolescents favored treatment reductions (Dx/VCR: 52% refusal; 6MP: 30%; ASP: 8%). Adolescents were more likely to refuse...

  8. Child Psychiatry: What Are We Teaching Medical Students?

    Science.gov (United States)

    Dingle, Arden D.

    2010-01-01

    Objective: The author describes child and adolescent psychiatry (CAP) undergraduate teaching in American and Canadian medical schools. Methods: A survey asking for information on CAP teaching, student interest in CAP, and opinions about the CAP importance was sent to the medical student psychiatry director at 142 accredited medical schools in the…

  9. An open trial of Acceptance-based Separated Family Treatment (ASFT) for adolescents with anorexia nervosa.

    Science.gov (United States)

    Timko, C Alix; Zucker, Nancy L; Herbert, James D; Rodriguez, Daniel; Merwin, Rhonda M

    2015-06-01

    Family based-treatments have the most empirical support in the treatment of adolescent anorexia nervosa; yet, a significant percentage of adolescents and their families do not respond to manualized family based treatment (FBT). The aim of this open trial was to conduct a preliminary evaluation of an innovative family-based approach to the treatment of anorexia: Acceptance-based Separated Family Treatment (ASFT). Treatment was grounded in Acceptance and Commitment Therapy (ACT), delivered in a separated format, and included an ACT-informed skills program. Adolescents (ages 12-18) with anorexia or sub-threshold anorexia and their families received 20 treatment sessions over 24 weeks. Outcome indices included eating disorder symptomatology reported by the parent and adolescent, percentage of expected body weight achieved, and changes in psychological acceptance/avoidance. Half of the adolescents (48.0%) met criteria for full remission at the end of treatment, 29.8% met criteria for partial remission, and 21.3% did not improve. Overall, adolescents had a significant reduction in eating disorder symptoms and reached expected body weight. Treatment resulted in changes in psychological acceptance in the expected direction for both parents and adolescents. This open trial provides preliminary evidence for the feasibility, acceptability, and efficacy of ASFT for adolescents with anorexia. Directions for future research are discussed.

  10. Epigenetics and Child Psychiatry: Ethical and Legal Issues.

    Science.gov (United States)

    Thomas, Christopher R

    2015-10-01

    Epigenetics has the potential to revolutionize diagnosis and treatment in psychiatry, especially child psychiatry, as it may offer the opportunity for early detection and prevention, as well as development of new treatments. As with the previous introduction of genetic research in psychiatry, there is also the problem of unrealistic expectations and new legal and ethical problems. This article reviews the potential contributions and problems of epigenetic research in child psychiatry. Previous legal and ethical issues in genetic research serve as a guide to those in epigenetic research. Recommendations for safeguards and guidelines on the use of epigenetics with children and adolescents are outlined based on the identified issues.

  11. Understanding Adolescent Nonresponsiveness to Text Messages: Lessons from the DepoText Trial

    OpenAIRE

    Irons, Mallory; Tomaszewski, Kathy; Muñoz Buchanan, Cara R.; Trent, Maria

    2015-01-01

    Urban adolescents face economic, social, and behavioral challenges in adhering to long-term contraceptive use. Use of text messaging reminders has the potential to increase adherence to family planning appointments and to educate patients about safe sexual health practices; however, nonresponsiveness to messages is difficult to interpret and may jeopardize programmatic success. We aimed to understand why adolescent girls enrolled in a randomized, controlled pilot trial (DepoText) designed to ...

  12. [An integrative research model for child and adolescent psychiatry bringing together biological, psychological and social research approaches].

    Science.gov (United States)

    Remschmidt, Helmut

    2006-11-01

    After some general remarks on the current situation of child and adolescent psychiatric research in Germany, a research concept is presented which in the course of 30 years of testing and further development has proven to be successful both in the inauguration of scientific projects, as well as in the qualification of trainees and co-workers. The nucleus of this concept is a research unit that is to a large extent independent of the daily health care routine. Some of the unit staff members are natural scientists holding permanent positions, complemented by a secondary labour force of young doctors and psychologists aspiring to a scientific career. This research unit provides supply for scientific projects and basic research, as well as for the development of new methods. The unit was endorsed by a Clinical Research Group funded by the German Research Foundation (DFG) that proved of value as power supply for research (e.g. by raising substantial third-party funds) and as an instrument for the qualification of young scientists. The article describes some results of four research projects derived from this approach (schizophrenia research, dyslexia research, research on Asperger syndrome, quality assurance, and therapy evaluation research).

  13. Undergraduate Child Psychiatry Teaching in Melbourne, Australia

    Science.gov (United States)

    Gough, Jenny K.; McCallum, Zoe; Bevan, Catherine; Vance, Alasdair

    2010-01-01

    Objective: The teaching of child psychiatry in Australian medical schools is under review: the content, the placement of the field within medical curricula, and the appropriate teaching and learning methods are all contested. The authors developed a 1-day program in the 9-week child and adolescent health course conducted in the final two semesters…

  14. TOWARDS AN ANTHROPOLOGICAL PSYCHIATRY

    NARCIS (Netherlands)

    Mooij, A.W.M.

    1995-01-01

    The situation of present day psychiatry is described as being dominated by an empiricist perspective. The limitations of this perspective are analyzed and a rough sketch of the hermeneutical approach in psychiatry is offered. It is argued that a fully developed hermeneutical psychiatry implies a ref

  15. Randomized Controlled Trial: Multimodal Anxiety and Social Skill Intervention for Adolescents with Autism Spectrum Disorder

    Science.gov (United States)

    White, Susan W.; Ollendick, Thomas; Albano, Anne Marie; Oswald, Donald; Johnson, Cynthia; Southam-Gerow, Michael A.; Kim, Inyoung; Scahill, Lawrence

    2013-01-01

    Anxiety is common among adolescents with autism spectrum disorders (ASD) and may amplify the core social disability, thus necessitating combined treatment approaches. This pilot, randomized controlled trial evaluated the feasibility and preliminary outcomes of the Multimodal Anxiety and Social Skills Intervention (MASSI) program in a sample of 30…

  16. Randomized Trial of Anger Control Training for Adolescents with Tourette's Syndrome and Disruptive Behavior

    Science.gov (United States)

    Sukhdolsky, Denis G.; Vitulano, Lawrence A.; Carroll, Deirdre H.; McGuire, Joseph; Leckman, James F.; Scahill, Lawrence

    2009-01-01

    A randomized trial to examine the efficacy of anger control training for treating adolescents with Tourette's syndrome and disruptive behavior reveals that those administered with the anger control training showed a decrease in their Disruptive Behavior Rating Scale score by 52 percent as compared with a decrease of 11 percent in the treatment as…

  17. A Multisite Psychotherapy and Medication Trial for Depressed Adolescents: Background and Benefits

    Science.gov (United States)

    Kratochvil, Christopher J.; Simons, Anne; Vitiello, Benedetto; Walkup, John; Emslie, Graham; Rosenberg, David; March, John S.

    2005-01-01

    The Treatment for Adolescents With Depression Study (TADS) is an NIMH-supported multisite clinical trial that compares the effectiveness of a depression-specific cognitive behavioral therapy (CBT), medication management with fluoxetine (FLX), the combination of CBT and FLX (COMB), and medical management with pill placebo (PBO). TADS was…

  18. Escitalopram in the Treatment of Adolescent Depression: A Randomized Placebo-Controlled Multisite Trial

    Science.gov (United States)

    Emslie, Graham J.; Ventura, Daniel; Korotzer, Andrew; Tourkodimitris, Stavros

    2009-01-01

    A randomized, double-blind, placebo-controlled trial that involves 312 male and female patients aged 12-17 reveal the effectiveness of escitalopram in the treatment of depressed adolescents. Eighty-three percent of the participants or 259 participants completed the 8 weeks therapy period.

  19. Casein improves brachial and central aortic diastolic blood pressure in overweight adolescents: a randomised, controlled trial

    DEFF Research Database (Denmark)

    Arnberg, Karina; Larnkjær, Anni; Michaelsen, Kim F.

    2013-01-01

    of water, skimmed milk, whey or casein for 12 weeks. The milk-based test drinks contained 35 g protein/l. The effects were compared with the water group and a pretest control group consisting of thirty-two of the adolescents followed 12 weeks before the start of the intervention. Outcomes were brachial......Arterial stiffness, blood pressure (BP) and blood lipids may be improved by milk in adults and the effects may be mediated via proteins. However, limited is known about the effects of milk proteins on central aortic BP and no studies have examined the effects in children. Therefore, the present...... trial examined the effect of milk and milk proteins on brachial and central aortic BP, blood lipids, inflammation and arterial stiffness in overweight adolescents. A randomised controlled trial was conducted in 193 overweight adolescents aged 12–15 years. They were randomly assigned to drink 1 litre...

  20. Conceptualising molecular psychiatry and translational psychiatry.

    Science.gov (United States)

    Thome, Johannes

    2011-09-01

    The terms "molecular psychiatry" and "translational psychiatry" are frequently used key words of today's scientific community. However, the exact meaning of these terms remains surprisingly unclear. They also seem to be interpreted in different ways by different authors. Here, we first analyse how the terms have emerged historically and then try to indicate how meaningful and widely acceptable definitions could be achieved. Clearly, with the further development of these emerging psychiatric research areas, it will be necessary to regularly adjust these definitions accordingly.

  1. Ask: a health advocacy program for adolescents with an intellectual disability: a cluster randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Lennox Nicholas

    2012-09-01

    Full Text Available Abstract Background Adolescents with intellectual disability often have poor health and healthcare. This is partly as a consequence of poor communication and recall difficulties, and the possible loss of specialised paediatric services. Methods/Design A cluster randomised trial was conducted with adolescents with intellectual disability to investigate a health intervention package to enhance interactions among adolescents with intellectual disability, their parents/carers, and general practitioners (GPs. The trial took place in Queensland, Australia, between February 2007 and September 2010. The intervention package was designed to improve communication with health professionals and families’ organisation of health information, and to increase clinical activities beneficial to improved health outcomes. It consisted of the Comprehensive Health Assessment Program (CHAP, a one-off health check, and the Ask Health Diary, designed for on-going use. Participants were drawn from Special Education Schools and Special Education Units. The education component of the intervention was delivered as part of the school curriculum. Educators were surveyed at baseline and followed-up four months later. Carers were surveyed at baseline and after 26 months. Evidence of health promotion, disease prevention and case-finding activities were extracted from GPs clinical records. Qualitative interviews of educators occurred after completion of the educational component of the intervention and with adolescents and carers after the CHAP. Discussion Adolescents with intellectual disability have difficulty obtaining many health services and often find it difficult to become empowered to improve and protect their health. The health intervention package proposed may aid them by augmenting communication, improving documentation of health encounters, and improving access to, and quality of, GP care. Recruitment strategies to consider for future studies in this population

  2. Evaluation of an Intervention among Adolescents to Reduce Preventive Misconception in HIV Vaccine Clinical Trials

    Science.gov (United States)

    Lally, Michelle; Goldsworthy, Richard; Sarr, Moussa; Kahn, Jessica; Brown, Larry; Peralta, Ligia; Zimet, Greg

    2014-01-01

    Purpose Placebo and randomization are important concepts that must be understood before youth can safely participate in HIV vaccine studies or other biomedical trials for HIV prevention. These concepts are central to the phenomenon of preventive misconception which may be associated with an increase in risk behavior among study participants related to mistaken beliefs. Persuasive messaging, traditionally used in the field of marketing, could enhance educational efforts associated with randomized clinical trials. Methods Two educational brochures were designed to increase knowledge about HIV vaccine clinical trials via 1 and 2-sided persuasive messaging. Through the Adolescent Medicine Trials Network, 120 youth were enrolled, administered a mock HIV vaccine trial consent, and then randomized to receive either no supplemental information or one of the two brochures. Results The 2-sided brochure group in which common clinical trial misconceptions were acknowledgedand then refuted had significantly higher scores on knowledge of randomization and interpretation of side effects than the consent-only control group, and willingness to participate in an HIV vaccine trial was not decreased with the use of this brochure. Conclusion Two sided persuasive messaging improves understanding of the concepts of randomization and placebo among youth who would consider participating in an HIV vaccine trial. Further evaluation of this approach should be considered for at-risk youth participating in an actual trial of a biomedical intervention for HIV prevention. PMID:24613097

  3. A randomised controlled trial of the efficacy of the ABCD Parenting Young Adolescents Program: rationale and methodology

    Directory of Open Access Journals (Sweden)

    Burke Kylie

    2010-08-01

    Full Text Available Abstract Background The transition to adolescence is a time of increased vulnerability for risk taking and poor health, social and academic outcomes. Parents have an important role in protecting their children from these potential harms. While the effectiveness of parenting programs in reducing problem behavior has been demonstrated, it is not known if parenting programs that target families prior to the onset of significant behavioral difficulties in early adolescence (9-14 years improve the wellbeing of adolescents and their parents. This paper describes the rationale and methodology of a randomised controlled trial testing the efficacy of a parenting program for the promotion of factors known to be associated with positive adolescent outcomes, such as positive parenting practices, parent-adolescent relationships and adolescent behavior. Methods/Design One hundred and eighty parents were randomly allocated to an intervention or wait list control group. Parents in the intervention group participated in the ABCD Parenting Young Adolescents Program, a 6-session behavioral family intervention program which also incorporates acceptance-based strategies. Participants in the Wait List control group did not receive the intervention during a six month waiting period. The study was designed to comply with recommendations of the CONSORT statement. The primary outcome measures were reduction in parent-adolescent conflict and improvements in parent-adolescent relationships. Secondary outcomes included improvements in parent psychosocial wellbeing, parenting self-efficacy and perceived effectiveness, parent-adolescent communication and adolescent behavior. Conclusions Despite the effectiveness of parenting programs in reducing child behavioral difficulties, very few parenting programs for preventing problems in adolescents have been described in the peer reviewed literature. This study will provide data which can be used to examine the efficacy of a

  4. [(Community) psychiatry, a parenthesis?].

    Science.gov (United States)

    Bucheron, Bastien

    2015-01-01

    Beyond an a priori antagonism between these two notions, alienism and mental health cultivate analogies as to the place to which they assign mental health. Is community psychiatry not therefore simply a parenthesis in the history of psychiatry? The question is raised therefore regarding the place given to subjectivity and complexity. What must be done to ensure that this parenthesis of community psychiatry does not close? It is perhaps a case of making use of the tools which institutional psychotherapy has developed to keep the community psychiatry spirit alive.

  5. Treating adolescents with cannabis use disorder with Multidimensional Family Therapy (MDFT): Main results of a Randomized Controlled Trial (RCT)

    NARCIS (Netherlands)

    P. Tossmann (Peter); B. Jonas (Benjamin); H. Rigter (Henk); A. Gantner (Andreas)

    2012-01-01

    textabstractAims: To determine the effectiveness of Multidimensional Family Therapy (MDFT) among adolescents with cannabis use disorder in Germany. Methods: In a randomized controlled trial (RCT), MDFT was compared with Youth Psychotherapy (JUP), an individual intervention including Cognitive Behavi

  6. Olanzapine versus Placebo in Adolescents with Schizophrenia; a 6-Week, Randomized Double-Blind, Placebo-Controlled Trial

    Science.gov (United States)

    Kryzhanovskaya, Ludmila; Schulz, Charles; McDougle, Christopher; Frazier, Jean; Dittman, Ralf; Robertson-Plouch, Carol; Bauer, Theresa; Xu, Wen; Wang, Wei; Carlson, Janice; Tohen, Mauricio

    2009-01-01

    The efficacy of olanzapine in treating schizophrenia was tested through a placebo-controlled trial involving one hundred seven inpatient and outpatients adolescents. Patients who took olanzapine experienced significant symptom improvement.

  7. Management of adolescents with very poorly controlled type 1 diabetes by nurses: a parallel group randomized controlled trial

    OpenAIRE

    Kassai, Behrouz; Rabilloud, Muriel; Bernoux, Delphine; Michal, Catherine; Riche, Benjamin; Ginhoux, Tiphanie; Laudy, Valérie; Terral, Daniel; Didier-Wright, Catherine; Maire, Veronique; Dumont, Catherine; Cottancin, Gilles; Plasse, Muriel; Jeannoel, Guy-Patrick; Khoury, Jamil

    2015-01-01

    Backgrounds Fluctuation in glycemia due to hormonal changes, growth periods, physical activity, and emotions make diabetes management difficult during adolescence. Our objective was to show that a close control of patients’ self-management of diabetes by nurse-counseling could probably improve metabolic control in adolescents with type 1 diabetes. Methods We designed a multicenter, randomized controlled, parallel group, clinical trial. Seventy seven adolescents aged 12–17 years with A1C >8 % ...

  8. Effectiveness of the 'Healthy School and Drugs' prevention programme on adolescents' substance use: a randomized clustered trial

    NARCIS (Netherlands)

    Malmberg, M.; Kleinjan, M.; Overbeek, G.J.; Vermulst, A.A.; Monshouwer, K.; Lammers, J.; Vollebergh, W.A.M.; Engels, R.C.M.E.

    2014-01-01

    Aim To evaluate the effectiveness of the Healthy School and Drugs programme on alcohol, tobacco and marijuana use among Dutch early adolescents. Design Randomized clustered trial with two intervention conditions (i.e. e-learning and integral). Setting General population of 11-15-year-old adolescents

  9. The Treatment of Adolescent Suicide Attempters Study (TASA): Predictors of Suicidal Events in an Open Treatment Trial

    Science.gov (United States)

    Brent, David A.; Greenhill, Laurence L.; Compton, Scott; Emslie, Graham; Wells, Karen; Walkup, John T.; Vitiello, Benedetto; Bukstein, Oscar; Stanley, Barbara; Posner, Kelly; Kennard, Betsy D.; Cwik, Mary F.; Wagner, Ann; Coffey, Barbara; March, John S.; Riddle, Mark; Goldstein, Tina; Curry, John; Barnett, Shannon; Capasso, Lisa; Zelazny, Jamie; Hughes, Jennifer; Shen, Sa; Gugga, S. Sonia; Turner, J. Blake

    2009-01-01

    Objective: To identify the predictors of suicidal events and attempts in adolescent suicide attempters with depression treated in an open treatment trial. Method: Adolescents who had made a recent suicide attempt and had unipolar depression (n =124) were either randomized (n = 22) or given a choice (n = 102) among three conditions. Two…

  10. Risk moderation of a parent and student preventive alcohol intervention by adolescent and family factors : A cluster randomized trial

    NARCIS (Netherlands)

    Verdurmen, Jacqueline E E; Koning, Ina M.; Vollebergh, Wilma A M; van den Eijnden, Regina J J M; Engels, Rutger C M E

    2014-01-01

    Objective: To examine risk moderation of an alcohol intervention targeting parents and adolescents. Design: A cluster randomized trial including 2937 Dutch early adolescents (m=12.68. years, SD=0.51) and their parents randomized over four conditions: parent intervention, student intervention, combin

  11. Effectiveness of the 'Healthy School and Drugs' prevention programme on adolescents' substance use: a randomized clustered trial

    NARCIS (Netherlands)

    Malmberg, M.; Kleinjan, M.; Overbeek, G.; Vermulst, A.; Monshouwer, K.; Lammers, J.; Vollebergh, W.A.M.; Engels, R.C.M.E.

    2014-01-01

    Aim: To evaluate the effectiveness of the Healthy School and Drugs programme on alcohol, tobacco and marijuana use among Dutch early adolescents. Design: Randomized clustered trial with two intervention conditions (i.e. e-learning and integral). Setting: General population of 11-15-year-old adolesce

  12. Effectiveness of the 'Healthy School and Drugs' prevention programme on adolescents' substance use : A randomized clustered trial

    NARCIS (Netherlands)

    Malmberg, Monique; Kleinjan, Marloes; Overbeek, Geertjan; Vermulst, Ad; Monshouwer, Karin; Lammers, Jeroen; Vollebergh, Wilma A M; Engels, Rutger C M E

    2014-01-01

    Aim: To evaluate the effectiveness of the Healthy School and Drugs programme on alcohol, tobacco and marijuana use among Dutch early adolescents. Design: Randomized clustered trial with two intervention conditions (i.e. e-learning and integral). Setting: General population of 11-15-year-old adolesce

  13. Adolescent type 1 Diabetes cardio-renal Intervention Trial (AdDIT

    Directory of Open Access Journals (Sweden)

    2009-12-01

    Full Text Available Abstract Background The prognosis for young people diagnosed with diabetes during childhood remains poor and this is mainly related to the long-term risk of developing vascular complications. Microalbuminuria identifies subjects at risk for diabetic nephropathy (DN and cardiovascular disease (CVD. It is often detected in adolescence but is rarely treated before the age of 18 years, as at the end of puberty albumin excretion may decline and in some subjects will return into the normal range. However, evidence indicates that subjects with both transient and persistent microalbuminuria have experienced renal damage during puberty and thus reno-protection to prevent long-term complications is warranted. In adults with diabetes and microalbuminuria, the use of angiotensin converting enzyme inhibitors (ACEI and Statins is increasing, and in order to determine whether these agents are of value in the adolescent population a large randomized controlled clinical trial is needed. Methods/Design The Adolescent type 1 Diabetes cardio-renal Intervention Trial (AdDIT is a multi-center, randomized, double-blind, placebo-controlled trial of ACEI and Statin therapy in adolescents with type 1 diabetes. 500 high-risk adolescents, defined on the basis of their albumin excretion, are randomized to receive either ACEI (Quinapril or Statins (Atorvastatin or combination therapy or placebo for 3-4 years. There will also be a parallel open observational study, based on the follow-up of 400 low-risk non-randomized adolescents. The major endpoint of the study is the change in albumin excretion; secondary endpoints include markers of CVD, renal function, retinopathy, quality of life combined with assessment of compliance and potential health economic benefits. Discussion AdDIT will provide important data on the potential renal and cardiovascular protective effects of ACEI and Statins in high-risk adolescents. Long-term follow-up of the randomized subjects will provide

  14. Building psychosocial assets and wellbeing among adolescent girls: A randomized controlled trial.

    Science.gov (United States)

    Leventhal, Katherine Sachs; Gillham, Jane; DeMaria, Lisa; Andrew, Gracy; Peabody, John; Leventhal, Steve

    2015-12-01

    We conducted a randomized controlled trial of a 5-month resilience-based program (Girls First Resilience Curriculum or RC) among 2308 rural adolescent girls at 57 government schools in Bihar, India. Local women with at least a 10th grade education served as group facilitators. Girls receiving RC improved more (vs. controls) on emotional resilience, self-efficacy, social-emotional assets, psychological wellbeing, and social wellbeing. Effects were not detected on depression. There was a small, statistically significant negative effect on anxiety (though not likely clinically significant). Results suggest psychosocial assets and wellbeing can be improved for girls in high-poverty, rural schools through a brief school-day program. To our knowledge, this is one of the largest developing country trials of a resilience-based school-day curriculum for adolescents.

  15. Sequential Multiple Assignment Randomized Trial (SMART) to Construct Weight Loss Interventions for African American Adolescents.

    Science.gov (United States)

    Naar-King, Sylvie; Ellis, Deborah A; Idalski Carcone, April; Templin, Thomas; Jacques-Tiura, Angela J; Brogan Hartlieb, Kathryn; Cunningham, Phillippe; Jen, Kai-Lin Catherine

    2016-01-01

    The purpose of this study was to develop an adaptive behavioral treatment for African American adolescents with obesity. In a sequential multiple assignment randomized trial, 181 youth ages 12-16 years with primary obesity and their caregiver were first randomized to 3 months of home-based versus office-based delivery of motivational interviewing plus skills building. After 3 months, nonresponders to first phase treatment were rerandomized to continued home-based skills or contingency management. Primary outcome was percent overweight and hypothesized moderators were adolescent executive functioning and depression. There were no significant differences in primary outcome between home-based or office-based delivery or between continued home-based skills or contingency management for nonresponders to first-phase treatment. However, families receiving home-based treatment initially attended significantly more sessions in both phases of the trial, and families receiving contingency management attended more sessions in the second phase. Overall, participants demonstrated decreases in percent overweight over the course of the trial (3%), and adolescent executive functioning moderated this effect such that those with higher functioning lost more weight. More potent behavioral treatments to address the obesity epidemic are necessary, targeting new areas such as executive functioning. Delivering treatment in the home with contingency management may increase session attendance for this population.

  16. What Is Psychiatry?

    Medline Plus

    Full Text Available ... APA Foundation APA Annual Meeting Psychiatric News PsychiatryOnline Workplace Mental Health Sign In Join General Residents and ... Learning Center APA Annual Meeting Psychiatric News PsychiatryOnline Workplace Mental Health Terms of Use Copyright Contact © 2017 ...

  17. Foundations of Child Psychiatry.

    Science.gov (United States)

    Miller, Emanuel, Ed.; And Others

    Twenty-eight papers examine basic theories and clinical methods in child psychiatry. Theories and methods discussed concern child psychiatry and the World Health Organization, pediatrics, child disturbances, observation, the psychodiagnostic approach, longitudinal research in child development, the comparative approach to early child development,…

  18. Effects of media campaign messages targeting parents on adolescent sexual beliefs: a randomized controlled trial with a national sample.

    Science.gov (United States)

    Palen, Lori-Ann; Ashley, Olivia Silber; Gard, Jennifer C; Kan, Marni L; Davis, Kevin C; Evans, W Douglas

    2011-01-01

    Using a randomized controlled trial, this study evaluated the effects of media messages targeting parents on the sexual beliefs of 404 adolescents. The messages aimed to increase parent-child communication about waiting to initiate sexual activity. Compared with children of unexposed parents, children of parents exposed to media messages were more likely to believe that teen sexual activity is psychologically harmful. However, effects varied by parent and adolescent gender; treatment effects were only significant among adolescents whose opposite-sex parent was exposed. Parent exposure strengthened beliefs that teen sexual activity is physically harmful only among adolescents with at least 1 sexually active friend.

  19. Brief Strategic Family Therapy versus Treatment as Usual: Results of a Multisite Randomized Trial for Substance Using Adolescents

    Science.gov (United States)

    Robbins, Michael S.; Feaster, Daniel J.; Horigian, Viviana E.; Rohrbaugh, Michael; Shoham, Varda; Bachrach, Ken; Miller, Michael; Burlew, Kathleen A.; Hodgkins, Candy; Carrion, Ibis; Vandermark, Nancy; Schindler, Eric; Werstlein, Robert; Szapocznik, Jose

    2011-01-01

    Objective: To determine the effectiveness of brief strategic family therapy (BSFT; an evidence-based family therapy) compared to treatment as usual (TAU) as provided in community-based adolescent outpatient drug abuse programs. Method: A randomized effectiveness trial in the National Drug Abuse Treatment Clinical Trials Network compared BSFT to…

  20. Multidimensional family therapy decreases the rate of externalising behavioural disorder symptoms in cannabis abusing adolescents: Outcomes of the INCANT trial

    NARCIS (Netherlands)

    M. Schaub (Michael); C.E. Henderson (Craig); I. Pelc (Isidore); P. Tossmann (Peter); O. Phan (Olivier); V. Hendriks (Vincent); C. Rowe (Cindy); H. Rigter (Henk)

    2014-01-01

    textabstractBackground: US-based trials have shown that Multidimensional Family Therapy (MDFT) not only reduces substance abuse among adolescents, but also decreases mental and behavioural disorder symptoms, most notably externalising symptoms. In the INCANT trial, MDFT decreased the rate of cannabi

  1. The future of community psychiatry.

    Science.gov (United States)

    Cohen, Carl I; Feiner, Joel S; Huffine, Charles; Moffic, H Steven; Thompson, Kenneth S

    2003-10-01

    Leaders of national groups that have focused on issues of community and social psychiatry present their ideas about the future of psychiatry. They identify five areas: theory development; the relevance of community psychiatry in the 21st century; education and training; the relationship between community psychiatry and health maintenance organizations; and role of community psychiatry in bridging medical science with humanism. The unifying theme for these topics is that community psychiatry can be a vehicle for modifying general psychiatry's propensity towards individualism and reductionism by offering a more holistic and integrative approach to illness and well-being.

  2. Historicizing Indian psychiatry.

    Science.gov (United States)

    Basu, Amit Ranjan

    2005-04-01

    Our historical endeavour to map Indian psychiatry has largely remained linear, positivistic and evolutionary. Whether it starts from the ancient times or modern, it shows our past as a tale of victory for the western science, without questioning the borrowed paradigm. The use of historical methods for serious enquiry of psychiatry has been ignored. Emergence of a new genre of historicism that is critical of both colonialism and psychiatry as a universal science, has raised hopes to critically review the emergence of psychiatric knowledge.

  3. A Nutrition Education Intervention Trial for Adolescent Girls in Isfahan: Study Design and Protocol

    Directory of Open Access Journals (Sweden)

    Morvarid Ghasab Shirazi

    2016-11-01

    Full Text Available BackgroundNutrition behaviors of adolescent girls is of serious health concerns. Although nutrition education interventions in Iran have met with some success, most of them could not promote nutrition behavioral changes. The aim of our study is to determine a school-based nutrition education intervention to improve adolescents’ nutrition behaviors and behavioral mediators based on the social cognitive theory (SCT.Materials and MethodsThis study is a single-blind randomized controlled trial. Eligible participants will be all student girls in grade 6 and 7, their parents and teachers in Isfahan governmental schools. This multi com­ponent school-based intervention include adolescents’ nutrition education package, parents’ nutrition massages, participatory homework, parents and teachers nutrition education package, supportive group, and collaboration with decision makers. Changing in nutrition behaviors including breakfast, fruit and vegetable, snack and fast food consumption will be examined, as primary outcome. Secondary outcome will be behavioral mediators such as knowledge, self-efficacy, intention, situation, self-regulation, social support, outcome expectations and expectancies, in adolescent girls. The outcomes will be assessed at baseline, and after 3 and 6-month follow-up.DiscussionThis study evaluates a school-based, guided SCT intervention, designed to improve healthy dietary behaviors, nutrition knowledge of adolescent girls. Few behavioral interventions have targeted this high-risk population in Iran. The intervention seems to be promising and has the potential to bridge the gap of the limited program outcomes of nutrition education in Iranian adolescents.

  4. What Is Psychiatry?

    Medline Plus

    Full Text Available ... Releases Message from the President Reporting on Mental Health Conditions APA Blogs Annual Meeting Advocacy & APAPAC APA ... APA Annual Meeting Psychiatric News PsychiatryOnline Workplace Mental Health Sign In Join General Residents and Fellows Medical ...

  5. What Is Psychiatry?

    Medline Plus

    Full Text Available ... and insomnia. Hypnotics – used to induce and maintain sleep. Mood stabilizers – used to treat bipolar disorder. Stimulants – ... psychiatry Pain medicine Psychosomatic (mind and body) medicine Sleep medicine Some psychiatrists choose additional training in psychoanalysis ...

  6. Psychiatry and music

    OpenAIRE

    Nizamie, Shamsul Haque; Tikka, Sai Krishna

    2014-01-01

    Vocal and/or instrumental sounds combined in such a way as to produce beauty of form, harmony and expression of emotion is music. Brain, mind and music are remarkably related to each other and music has got a strong impact on psychiatry. With the advent of music therapy, as an efficient form of alternative therapy in treating major psychiatric conditions, this impact has been further strengthened. In this review, we deliberate upon the historical aspects of the relationship between psychiatry...

  7. Indicated school-based intervention to improve depressive symptoms among at risk Chilean adolescents: a randomized controlled trial

    OpenAIRE

    Gaete, Jorge; Martinez, Vania; Fritsch, Rosemarie; Rojas, Graciela; Montgomery, Alan A.; Araya, Ricardo

    2016-01-01

    Background Depression is a disabling condition affecting people of all ages, but generally starting during adolescence. Schools seem to be an excellent setting where preventive interventions may be delivered. This study aimed to test the effectiveness of an indicated school-based intervention to reduce depressive symptoms among at-risk adolescents from low-income families. Methods A two-arm, parallel, randomized controlled trial was conducted in 11 secondary schools in vulnerable socioeconomi...

  8. Challenges in conducting psychiatry studies in India

    Directory of Open Access Journals (Sweden)

    Saifuddin Kharawala

    2011-01-01

    Full Text Available A large number of psychiatry studies are conducted in India. Psychiatry studies are complex and present unique challenges in the Indian setting. Ethical issues pertaining to the risk of worsening of illness, use of placebo and validity of informed consents are commonly faced. Site selection can be difficult due to the relative paucity of ICH-GCP (International Conference on Harmonisation - Good Clinical Practice trained psychiatry investigators in India. Recruitment can be challenging due to issues such as strict eligibility criteria, (lack of availability of caregiver, illness-related considerations, etc. Assessment of the consent capacity of patients is not simple, while structured assessments are not commonly employed. As the illness fluctuates, the consent capacity may change, thus requiring continued assessment of consent capacity. Study patients run the risk of worsening of illness and suicide due to exposure to inactive treatments; this risk is counterbalanced by use of appropriate study designs, as well as the indirect psychotherapeutic support received. Psychiatry studies are associated with a high placebo response. This necessitates conduct of placebo-controlled studies despite the attendant difficulties. Also, the high placebo response is often the cause of failed trials. Rating scales are essential for assessment of drug response. Some rating instruments as well as some rater training procedures may not be suitable for the Indian setting. Technological advancements may increase the procedural complexity but improve the quality of ratings. Psychiatry studies present monitors and auditors with unique scenarios too. Utilization of psychiatry specific training and expertise is recommended to ensure successful conduct of these studies in India.

  9. Behavioral activation for late adolescents with subthreshold depression: a randomized controlled trial.

    Science.gov (United States)

    Takagaki, Koki; Okamoto, Yasumasa; Jinnin, Ran; Mori, Asako; Nishiyama, Yoshiko; Yamamura, Takanao; Yokoyama, Satoshi; Shiota, Syouichi; Okamoto, Yuri; Miyake, Yoshie; Ogata, Akiko; Kunisato, Yoshihiko; Shimoda, Haruki; Kawakami, Norito; Furukawa, Toshi A; Yamawaki, Shigeto

    2016-11-01

    The main behavioral characteristic of subthreshold depression that is observed in adolescents is the low frequency of exposure to environmental rewards. Therefore, it was considered that a simple intervention conducted in short sessions, focusing on increasing access to positively reinforcing activities, would be efficacious in increasing the availability of rewards. We conduct a randomized controlled trial to examine the efficacy of such a behavioral activation program that was conducted weekly for 5 weeks in 60-min sessions. Late adolescent university students aged 18-19 years with subthreshold depression were randomly allocated to a treatment (n = 62) or a control group (n = 56). The primary outcome of the study was the Beck Depression Inventory-II score. Results indicated that late adolescent students in the treatment group showed significant improvements in their depressive symptoms (effect size -0.90, 95 % CI -1.28 to -0.51) compared to the control group. Students in the treatment group also showed significant improvements in self-reported rating of quality of life and in behavioral characteristics. It is concluded that this intervention had a large and significant effect despite being short and simple and that this low-intensity cognitive behavioral therapy program could be conducted in many different types of institutions. It is suggested that the long-term effects of the treatment program should be targeted for investigation in future studies.

  10. Understanding Adolescent Nonresponsiveness to Text Messages: Lessons from the DepoText Trial.

    Science.gov (United States)

    Irons, Mallory; Tomaszewski, Kathy; Muñoz Buchanan, Cara R; Trent, Maria

    2015-06-01

    Urban adolescents face economic, social, and behavioral challenges in adhering to long-term contraceptive use. Use of text messaging reminders has the potential to increase adherence to family planning appointments and to educate patients about safe sexual health practices; however, nonresponsiveness to messages is difficult to interpret and may jeopardize programmatic success. We aimed to understand why adolescent girls enrolled in a randomized, controlled pilot trial (DepoText) designed to increase attendance at family planning visits were periodically nonresponsive to text messages through conducting structured interviews with participants whose text reply rates were less than 100 % during the trial period. Qualitative and quantitative data were collected and classified using descriptive data analysis. Reasons for nonresponsiveness, barriers to continuous cell phone coverage, cell phone plan characteristics, and attitudes toward the DepoText program were the primary endpoints of interest. Most participants (78%) attributed instances of nonresponsiveness to being away from the phone or due to a personal conflict such as school or work. Service interruption due to bill nonpayment (44%), phone loss (28%), and cell phone number change (28%) were significant barriers to continuous coverage during the trial period, and many respondents indicated that the downturn in the economy made it more difficult to maintain their cell phone plan. Almost a third reported having to choose between cell phone and other payments, but the vast majority (88%) considered their cell phone a "need" rather than a "want." Participants universally expressed satisfaction with the text messaging program and reported feeling more connected to the clinic (96%) through the messages serving as reminders (64%), encouragement to assume personal responsibility for their health care (12%), and enhanced personal connection with the clinic staff (4%). Our study suggests that a text messaging program can

  11. Cognitive bias modification versus CBT in reducing adolescent social anxiety: a randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    B Esther Sportel

    Full Text Available UNLABELLED: Social anxiety is a common mental disorder among adolescents and is associated with detrimental long term outcomes. Therefore, this study investigated the efficacy of two possible early interventions for adolescent social anxiety and test anxiety. An internet-based cognitive bias modification (CBM; n = 86 was compared to a school-based cognitive behavioral group training (CBT; n = 84 and a control group (n = 70 in reducing symptoms of social and test anxiety in high socially and/or test anxious adolescents aged 13-15 years. Participants (n = 240 were randomized at school level over the three conditions. CBM consisted of a 20-session at home internet-delivered training; CBT was a 10-session at school group training with homework assignments; the control group received no training. Participants were assessed before and after the intervention and at 6 and 12 month follow-up. At 6 month follow-up CBT resulted in lower social anxiety than the control condition, while for CBM, this effect was only trend-significant. At 12 month follow-up this initial benefit was no longer present. Test anxiety decreased more in the CBT condition relative to the control condition in both short and long term. Interestingly, in the long term, participants in the CBM condition improved more with regard to automatic threat-related associations than both other conditions. The results indicate that the interventions resulted in a faster decline of social anxiety symptoms, whereas the eventual end point of social anxiety was not affected. Test anxiety was influenced in the long term by the CBT intervention, and CBM lead to increased positive automatic threat-related associations. TRIAL REGISTRATION: TrialRegister.nl NTR965.

  12. Internet-delivered cognitive behavior therapy for adolescents with obsessive-compulsive disorder: an open trial.

    Directory of Open Access Journals (Sweden)

    Fabian Lenhard

    Full Text Available BACKGROUND: International guidelines recommend Cognitive Behavior Therapy (CBT as the first line treatment for pediatric obsessive-compulsive disorder (OCD. However, a substantial proportion of patients do not have access to such treatment. We developed and tested the feasibility, efficacy and acceptability of a novel therapist-guided, Internet-delivered CBT (ICBT platform for adolescents with OCD. METHODS: An interactive, age-appropriate ICBT platform ("BiP OCD" was developed. Twenty-one adolescents (12-17 years with a DSM-IV diagnosis of OCD and their parents were enrolled in the study. All participants received 12 weeks of ICBT with therapist support. The primary outcome measure was the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS. Acceptability was assessed at post-treatment. RESULTS: Participants completed on average 8.29 (SD = 3.0 of the 12 treatment chapters. Treatment yielded significant improvements on all clinician-, parent- and most self-administered outcome measures, with a large effect size of d = 2.29 (95% CI 1.5-3.07 on the CY-BOCS. Patients continued to improve at follow-up. At 6-month follow-up, 71% were classified as responders (≥35% decrease on the CY-BOCS and 76% as being in remission (CY-BOCS score ≤12. Average clinician support time was less than 20 minutes per patient per week. The majority of participants felt that BiP OCD was age-appropriate and rated the treatment as good or very good. CONCLUSIONS: ICBT could be efficacious, acceptable, and cost-effective for adolescents with OCD. More rigorously controlled studies are needed to further evaluate the treatment. TRIAL REGISTRATION: ClinicalTrials.gov; NCT01809990.

  13. Internet-Delivered Cognitive Behavior Therapy for Adolescents with Obsessive-Compulsive Disorder: An Open Trial

    Science.gov (United States)

    Lenhard, Fabian; Vigerland, Sarah; Andersson, Erik; Rück, Christian; Mataix-Cols, David; Thulin, Ulrika; Ljótsson, Brjánn; Serlachius, Eva

    2014-01-01

    Background International guidelines recommend Cognitive Behavior Therapy (CBT) as the first line treatment for pediatric obsessive-compulsive disorder (OCD). However, a substantial proportion of patients do not have access to such treatment. We developed and tested the feasibility, efficacy and acceptability of a novel therapist-guided, Internet-delivered CBT (ICBT) platform for adolescents with OCD. Methods An interactive, age-appropriate ICBT platform (“BiP OCD”) was developed. Twenty-one adolescents (12–17 years) with a DSM-IV diagnosis of OCD and their parents were enrolled in the study. All participants received 12 weeks of ICBT with therapist support. The primary outcome measure was the Children’s Yale-Brown Obsessive-Compulsive Scale (CY-BOCS). Acceptability was assessed at post-treatment. Results Participants completed on average 8.29 (SD = 3.0) of the 12 treatment chapters. Treatment yielded significant improvements on all clinician-, parent- and most self-administered outcome measures, with a large effect size of d = 2.29 (95% CI 1.5–3.07) on the CY-BOCS. Patients continued to improve at follow-up. At 6-month follow-up, 71% were classified as responders (≥35% decrease on the CY-BOCS) and 76% as being in remission (CY-BOCS score ≤12). Average clinician support time was less than 20 minutes per patient per week. The majority of participants felt that BiP OCD was age-appropriate and rated the treatment as good or very good. Conclusions ICBT could be efficacious, acceptable, and cost-effective for adolescents with OCD. More rigorously controlled studies are needed to further evaluate the treatment. Trial Registration ClinicalTrials.gov; NCT01809990. PMID:24949622

  14. ["Euthanasia" of children in Nazi Germany - the case of Günter Nevermannn. On the responsibility of childhood and adolescent psychiatry in the past, the present, and the future].

    Science.gov (United States)

    Haack, Kathleen; Häßler, Frank; Kumbier, Ekkehardt

    2013-05-01

    «Euthanasia» was the cynical euphemism used by the Nazis to refer to the systematic murder of hundreds of thousands of mentally sick and handicapped people between 1939 and 1945, at least 6,000 of whom were children. Based on the example of Günter Nevermann, this paper provides insight into the complex acts of registering, selecting, and targeting children labelled as "inferior" and "unworthy to live." This case clearly shows that Nazi doctors were not necessarily enmeshed in some tragic conflict. Rather, apparently without any qualms, they sacrificed the sick children who had been entrusted to their care, for the ideal of obtaining a "racially healthy corpus," a term used without being questioned. Most of the perpetrators were never brought to justice, and not a few of them later held managerial positions in child and adolescent psychiatry in the two German states. Many of them were members or even honorary members of the "Deutsche Gesellschaft für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie e. V." in its present or previous form. We feel it is necessary to inform the public effectively about this state of affairs, to discover what really happened and to determine who was responsible.

  15. Molecular psychiatry of zebrafish.

    Science.gov (United States)

    Stewart, A M; Ullmann, J F P; Norton, W H J; Parker, M O; Brennan, C H; Gerlai, R; Kalueff, A V

    2015-02-01

    Due to their well-characterized neural development and high genetic homology to mammals, zebrafish (Danio rerio) have emerged as a powerful model organism in the field of biological psychiatry. Here, we discuss the molecular psychiatry of zebrafish, and its implications for translational neuroscience research and modeling central nervous system (CNS) disorders. In particular, we outline recent genetic and technological developments allowing for in vivo examinations, high-throughput screening and whole-brain analyses in larval and adult zebrafish. We also summarize the application of these molecular techniques to the understanding of neuropsychiatric disease, outlining the potential of zebrafish for modeling complex brain disorders, including attention-deficit/hyperactivity disorder (ADHD), aggression, post-traumatic stress and substance abuse. Critically evaluating the advantages and limitations of larval and adult fish tests, we suggest that zebrafish models become a rapidly emerging new field in modern molecular psychiatry research.

  16. Training in psychiatry throughout Europe

    NARCIS (Netherlands)

    Brittlebank, A.; Hermans, M.; Bhugra, D.; Costa, M.; Rojnic-Kuzman, M.; Fiorillo, A.; Kurimay, T.; Hanon, C.; Wasserman, D.; Gaag, R.J. van der

    2016-01-01

    Psychiatry is the largest medical specialty in Europe. Despite efforts to bring harmonisation, training in psychiatry in Europe continues to be very diverse. The Union Europeenne des Medecins Specialistes (UEMS) has issued as from 2000 a charter of requirements for the training in psychiatry with an

  17. SPECT in psychiatry. SPECT in der Psychiatrie

    Energy Technology Data Exchange (ETDEWEB)

    Barocka, A. (Psychiatrische Klinik und Poliklinik, Erlangen (Germany)); Feistel, H. (Nuklearmedizinische Klinik, Erlangen (Germany)); Ebert, D. (Psychiatrische Klinik und Poliklinik, Erlangen (Germany)); Lungershausen, E. (Psychiatrische Klinik und Poliklinik, Erlangen (Germany))

    1993-08-13

    This review presents Single Photon Emission Computed Tomography (SPECT) as a powerful tool for clinical use and research in psychiatry. Its focus is on regional cerebral blood flow, measured with technetium labelled HMPAO. In addition, first results with brain receptor imaging, concerning dopamin-D[sub 2] and benzodiazepine receptors, are covered. Due to major improvements in image quality, and impressive number of results has been accumulated in the past three years. The authors caution against using SPECT results as markers for disease entities. A finding like 'hypofrontality' is considered typical of a variety of mental disorders. Clearly both, more experience with SPECT and contributions from psychopathology, are needed. (orig.)

  18. Child Psychiatry Takes to the Streets: A Developmental Partnership between a University Institute and Children and Adolescents from the Streets of Sao Paulo, Brazil

    Science.gov (United States)

    Scivoletto, Sandra; da Silva, Thiago Fernando; Rosenheck, Robert Alan

    2011-01-01

    Objective: High levels of domestic violence, mental illness, and alienation from authorities are associated with high incidence of children/adolescents living on the streets in low and middle income countries. The Equilibrium Project (Programa Equilibrio) was created to facilitate social reintegration through a virtual partnership between an…

  19. Randomized Trial Outcomes of a TTM-Tailored Condom Use and Smoking Intervention in Urban Adolescent Females

    Science.gov (United States)

    Redding, Colleen A.; Prochaska, James O.; Armstrong, Kay; Rossi, Joseph S.; Hoeppner, Bettina B.; Sun, Xiaowu; Kobayashi, Hisanori; Yin, Hui-Qing; Coviello, Donna; Evers, Kerry; Velicer, Wayne F.

    2015-01-01

    Smoking and sexual risk behaviors in urban adolescent females are prevalent and problematic. Family planning clinics reach those who are at most risk. This randomized effectiveness trial evaluated a transtheoretical model (TTM)-tailored intervention to increase condom use and decrease smoking. At baseline, a total of 828 14- to 17-year-old females…

  20. Brief Cognitive-Behavioral Depression Prevention Program for High-Risk Adolescents Outperforms Two Alternative Interventions: A Randomized Efficacy Trial

    Science.gov (United States)

    Stice, Eric; Rohde, Paul; Seeley, John R.; Gau, Jeff M.

    2008-01-01

    In this depression prevention trial, 341 high-risk adolescents (mean age = 15.6 years, SD = 1.2) with elevated depressive symptoms were randomized to a brief group cognitive-behavioral (CB) intervention, group supportive-expressive intervention, bibliotherapy, or assessment-only control condition. CB participants showed significantly greater…

  1. Guanfacine Extended Release in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder: A Placebo-Controlled Trial

    Science.gov (United States)

    Sallee, Floyd R.; McGough, James; Wigal, Tim; Donahue, Jessica; Lyne, Andrew; Biederman, Joseph

    2009-01-01

    A double-blind, 9-week, randomized trial was done to compare the efficacy of guanfacine extended release (GXR) with a placebo in treating children and adolescents with attention-deficit/hyperactivity disorders (ADHD). Results find a significant reduction in ADHD from baseline to endpoint for all daily doses of GXR which were measured at 1-, 2-,…

  2. [Sophrology and psychiatry].

    Science.gov (United States)

    Diehr, Jan

    2016-01-01

    A relatively new discipline in the field of human sciences, sophrology seeks, through a physical as well as mental approach, to awaken awareness while energising the patient's resources and capacities. In psychiatry, it favours the development of body awareness and the positive activation of the mental structures, for the greater wellbeing of the patient.

  3. Artificial intelligence and psychiatry.

    Science.gov (United States)

    Servan-Schreiber, D

    1986-04-01

    This paper provides a brief historical introduction to the new field of artificial intelligence and describes some applications to psychiatry. It focuses on two successful programs: a model of paranoid processes and an expert system for the pharmacological management of depressive disorders. Finally, it reviews evidence in favor of computerized psychotherapy and offers speculations on the future development of research in this area.

  4. What Is Psychiatry?

    Medline Plus

    Full Text Available ... Meeting Psychiatric News PsychiatryOnline Workplace Mental Health Sign In Join General Residents and Fellows Medical Students International ... an M.D. or D.O.) who specializes in mental health, including substance use disorders. Psychiatrists are ...

  5. Epistemology of psychiatry.

    Science.gov (United States)

    Marková, Ivana S; Berrios, German E

    2012-01-01

    In historical and epistemological terms, psychiatry is a new discipline born during the 19th century. Rooted in both the natural and social sciences, psychiatric objects of inquiry, namely mental symptoms and mental disorders, are hybrid, constituted by the blending of components arising from disparate sources of knowledge ranging from the biological to the semantic in its widest sense. This poses problems for psychiatric research and therapy. Whilst conventional pluralism may be a convenient approach to manage aspects of psychiatric practice, it lacks the capacity to analyse psychiatric objects in their entirety. For the latter, psychiatry demands a new, tailored regional epistemology. This paper outlines the main features of an epistemology specific to the needs of psychiatry. It highlights the relational approach that needs to be taken and illustrates the usefulness of this approach by analysing the structure of psychiatric objects, exploring the manner in which they may be inscribed in the brain, and identifying the need to periodically recalibrate the language of psychiatry.

  6. Psychiatrie en reclassering

    NARCIS (Netherlands)

    Goudsmit, Walter

    1967-01-01

    Het doel van dit onderzoek is geweest de bestudering van de bijdrage die de hedendaagse psychiatrie aan de reclassering van met de justitie in aanraking gekomen delinquenten kan leveren. In de inleiding wordt erop gewezen hoe de reclassering zich in ons land heeft ontwikkeld van een persoonlijk init

  7. Evaluating a selective prevention programme for binge drinking among young adolescents: study protocol of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Wiers Reinout

    2011-02-01

    Full Text Available Abstract Background In comparison to other Europe countries, Dutch adolescents are at the top in drinking frequency and binge drinking. A total of 75% of the Dutch 12 to 16 year olds who drink alcohol also engage in binge drinking. A prevention programme called Preventure was developed in Canada to prevent adolescents from binge drinking. This article describes a study that aims to assess the effects of this selective school-based prevention programme in the Netherlands. Methods A randomized controlled trial is being conducted among 13 to 15-year-old adolescents in secondary schools. Schools were randomly assigned to the intervention and control conditions. The intervention condition consisted of two 90 minute group sessions, carried out at the participants' schools and provided by a qualified counsellor and a co-facilitator. The intervention targeted young adolescents who demonstrated personality risk for alcohol abuse. The group sessions were adapted to four personality profiles. The control condition received no further intervention above the standard substance use education sessions provided in the Dutch national curriculum. The primary outcomes will be the percentage reduction in binge drinking, weekly drinking and drinking-related problems after three specified time periods. A screening survey collected data by means of an Internet questionnaire. Students have completed, or will complete, a post-treatment survey after 2, 6, and 12 months, also by means of an online questionnaire. Discussion This study protocol presents the design and current implementation of a randomized controlled trial to evaluate the effectiveness of a selective alcohol prevention programme. We expect that a significantly lower number of adolescents will binge drink, drink weekly, and have drinking-related problems in the intervention condition compared to the control condition, as a result of this intervention. Trial registration This trial is registered in the Dutch

  8. A Randomized Controlled Trial to Test the Effectiveness of an Immersive 3D Video Game for Anxiety Prevention among Adolescents.

    Science.gov (United States)

    Scholten, Hanneke; Malmberg, Monique; Lobel, Adam; Engels, Rutger C M E; Granic, Isabela

    2016-01-01

    Adolescent anxiety is debilitating, the most frequently diagnosed adolescent mental health problem, and leads to substantial long-term problems. A randomized controlled trial (n = 138) was conducted to test the effectiveness of a biofeedback video game (Dojo) for adolescents with elevated levels of anxiety. Adolescents (11-15 years old) were randomly assigned to play Dojo or a control game (Rayman 2: The Great Escape). Initial screening for anxiety was done on 1,347 adolescents in five high schools; only adolescents who scored above the "at-risk" cut-off on the Spence Children Anxiety Survey were eligible. Adolescents' anxiety levels were assessed at pre-test, post-test, and at three month follow-up to examine the extent to which playing Dojo decreased adolescents' anxiety. The present study revealed equal improvements in anxiety symptoms in both conditions at follow-up and no differences between Dojo and the closely matched control game condition. Latent growth curve models did reveal a steeper decrease of personalized anxiety symptoms (not of total anxiety symptoms) in the Dojo condition compared to the control condition. Moderation analyses did not show any differences in outcomes between boys and girls nor did age differentiate outcomes. The present results are of importance for prevention science, as this was the first full-scale randomized controlled trial testing indicated prevention effects of a video game aimed at reducing anxiety. Future research should carefully consider the choice of control condition and outcome measurements, address the potentially high impact of participants' expectations, and take critical design issues into consideration, such as individual- versus group-based intervention and contamination issues.

  9. A Randomized Controlled Trial to Test the Effectiveness of an Immersive 3D Video Game for Anxiety Prevention among Adolescents.

    Directory of Open Access Journals (Sweden)

    Hanneke Scholten

    Full Text Available Adolescent anxiety is debilitating, the most frequently diagnosed adolescent mental health problem, and leads to substantial long-term problems. A randomized controlled trial (n = 138 was conducted to test the effectiveness of a biofeedback video game (Dojo for adolescents with elevated levels of anxiety. Adolescents (11-15 years old were randomly assigned to play Dojo or a control game (Rayman 2: The Great Escape. Initial screening for anxiety was done on 1,347 adolescents in five high schools; only adolescents who scored above the "at-risk" cut-off on the Spence Children Anxiety Survey were eligible. Adolescents' anxiety levels were assessed at pre-test, post-test, and at three month follow-up to examine the extent to which playing Dojo decreased adolescents' anxiety. The present study revealed equal improvements in anxiety symptoms in both conditions at follow-up and no differences between Dojo and the closely matched control game condition. Latent growth curve models did reveal a steeper decrease of personalized anxiety symptoms (not of total anxiety symptoms in the Dojo condition compared to the control condition. Moderation analyses did not show any differences in outcomes between boys and girls nor did age differentiate outcomes. The present results are of importance for prevention science, as this was the first full-scale randomized controlled trial testing indicated prevention effects of a video game aimed at reducing anxiety. Future research should carefully consider the choice of control condition and outcome measurements, address the potentially high impact of participants' expectations, and take critical design issues into consideration, such as individual- versus group-based intervention and contamination issues.

  10. A physical education trial improves adolescents' cognitive performance and academic achievement: the EDUFIT study.

    Science.gov (United States)

    Ardoy, D N; Fernández-Rodríguez, J M; Jiménez-Pavón, D; Castillo, R; Ruiz, J R; Ortega, F B

    2014-02-01

    To analyze the effects of an intervention focused on increasing the time and intensity of Physical Education (PE), on adolescents' cognitive performance and academic achievement. A 4-month group-randomized controlled trial was conducted in 67 adolescents from South-East Spain, 2007. Three classes were randomly allocated into control group (CG), experimental group 1 (EG1) and experimental group 2 (EG2). CG received usual PE (two sessions/week), EG1 received four PE sessions/week and EG2 received four PE sessions/week of high intensity. Cognitive performance (non-verbal and verbal ability, abstract reasoning, spatial ability, verbal reasoning and numerical ability) was assessed by the Spanish Overall and Factorial Intelligence Test, and academic achievement by school grades. All the cognitive performance variables, except verbal reasoning, increased more in EG2 than in CG (all P performance and academic achievement. This study contributes to the current knowledge by suggesting that the intensity of PE sessions might play a role in the positive effect of physical activity on cognition and academic success. Future studies involving larger sample sizes should confirm or contrast these preliminary findings.

  11. Relation of depression to perceived social support: results from a randomized adolescent depression prevention trial.

    Science.gov (United States)

    Stice, Eric; Rohde, Paul; Gau, Jeff; Ochner, Chris

    2011-05-01

    Theorists posit that certain behaviors exhibited by depressed individuals (e.g., negative self-statements, dependency, reassurance seeking, inappropriate or premature disclosures, passivity, social withdrawal) reduce social support, yet there have been few experimental tests of this hypothesis. Using data from a randomized depression prevention trial (N=253) involving adolescents (M age=15.5, SD=1.2), we tested whether a cognitive behavioral group intervention that significantly reduced depressive symptoms relative to bibliotherapy and educational brochure control conditions through 2-year follow-up produced improvements in perceived parental and friend social support and whether change in depressive symptoms mediated the effect on change in social support. Cognitive behavioral group participants showed significantly greater increases in perceived friend social support through 1-year follow-up relative to bibliotherapy and brochure controls, but there were no significant effects for perceived parental support. Further, change in depressive symptoms appeared to mediate the effects of the intervention on change in perceived friend support. Results provide experimental support for the theory that depressive symptoms are inversely related to perceived social support, but imply that this effect may be specific to friend vs. parental support for adolescents.

  12. Improving health-related fitness in adolescents: the CrossFit Teens™ randomised controlled trial.

    Science.gov (United States)

    Eather, Narelle; Morgan, Philip James; Lubans, David Revalds

    2016-01-01

    The aim of this study was to evaluate the preliminary efficacy and feasibility of the CrossFit Teens™ resistance training programme for improving health-related fitness and resistance training skill competency in adolescents. This assessor-blinded randomised controlled trial was conducted in one secondary school in the Hunter Region, Australia, from July to September 2013. Ninety-six (96) students (age = 15.4 (.5) years, 51.5% female) were randomised into intervention (n = 51) or control (n = 45) conditions for 8-weeks (60 min twice per week). Waist circumference, body mass index (BMI), BMI-Z score (primary outcomes), cardiorespiratory fitness (shuttle run test), muscular fitness (standing jump, push-up, handgrip, curl-up test), flexibility (sit and reach) and resistance training skill competency were measured at baseline and immediate post-intervention. Feasibility measures of recruitment, retention, adherence and satisfaction were assessed. Significant group-by-time intervention effects were found for waist circumference [-3.1 cm, P CrossFit Teens™ is a feasible and efficacious programme for improving health-related fitness in adolescents.

  13. A randomised controlled trial of tiotropium in adolescents with severe symptomatic asthma

    Science.gov (United States)

    Bernstein, Jonathan A.; Vandewalker, Mark; Moroni-Zentgraf, Petra; Verri, Daniela; Unseld, Anna; Engel, Michael; Boner, Attilio L.

    2017-01-01

    We present results from the first phase III trial of once-daily tiotropium add-on to inhaled corticosteroids (ICS) plus one or more controller therapies in adolescents with severe symptomatic asthma. In this double-blind, parallel-group trial (NCT01277523), 392 patients aged 12–17 years were randomised to receive once-daily tiotropium 5 µg or 2.5 µg, or placebo, as an add-on to ICS plus other controller therapies over 12 weeks. The primary and key secondary end-points were change from baseline (response) in peak forced expiratory volume in 1 s (FEV1) within 3 h post-dosing (FEV1(0–3h)) and trough FEV1, respectively, after 12 weeks of treatment. Tiotropium 5 µg provided numerical improvements in peak FEV1(0–3h) response, compared with placebo (90 mL; p=0.104), and significant improvements were observed with tiotropium 2.5 µg (111 mL; p=0.046). Numerical improvements in trough FEV1 response and asthma control were observed with both tiotropium doses, compared with placebo. The safety and tolerability of tiotropium were comparable with those of placebo. Once-daily tiotropium Respimat add-on to ICS plus one or more controller therapies in adolescents with severe symptomatic asthma was well tolerated. The primary end-point of efficacy was not met, although positive trends for improvements in lung function and asthma control were observed. PMID:27811070

  14. School-based strategies for oral health education of adolescents- a cluster randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Haleem Abdul

    2012-12-01

    Full Text Available Abstract Background Oral health education (OHE in schools has largely been imparted by dental professionals. Considering the substantial cost of this expert-led approach, the strategies relying on teachers, peer-leaders and learners themselves have also been utilized. However the evidence for comparative effectiveness of these strategies is lacking in the dental literature. The present study was conducted to compare the effectiveness of dentist-led, teacher-led, peer-led and self-learning strategies of oral health education. Methods A two-year cluster randomized controlled trial following a parallel design was conducted. It involved five groups of adolescents aged 10-11 years at the start of the study. The trial involved process as well as four outcome evaluations. The present paper discusses the findings of the study pertaining to the baseline and final outcome evaluation, both comprising of a self-administered questionnaire, a structured interview and clinical oral examination. The data were analyzed using Generalized Estimating Equations. Results All the three educator-led strategies of OHE had statistically higher mean oral health knowledge (OHK, oral health behavior (OHB, oral hygiene status (OHS and combined knowledge, behavior and oral hygiene status (KBS scores than the self-learning and control groups (p Conclusions The dentist-led, teacher-led and peer-led strategies of oral health education are equally effective in improving the oral health knowledge and oral hygiene status of adolescents. The peer-led strategy, however, is almost as effective as the dentist-led strategy and comparatively more effective than the teacher-led and self-learning strategies in improving their oral health behavior. Trail registration SRCTN39391017

  15. Psychiatry in former socialist countries: implications for north korean psychiatry.

    Science.gov (United States)

    Park, Young Su; Park, Sang Min; Jun, Jin Yong; Kim, Seog Ju

    2014-10-01

    Very little information is available regarding psychiatry in North Korea, which is based on the legacy of Soviet psychiatry. This paper reviews the characteristics of psychiatry in former socialist countries and discusses its implications for North Korean psychiatry. Under socialism, psychiatric disorders were attributed primarily to neurophysiologic or neurobiological origins. Psychosocial or psychodynamic etiology was denied or distorted in line with the political ideology of the Communist Party. Psychiatry was primarily concerned with psychotic disorders, and this diagnostic category was sometimes applied based on political considerations. Neurotic disorders were ignored by psychiatry or were regarded as the remnants of capitalism. Several neurotic disorders characterized by high levels of somatization were considered to be neurological or physical in nature. The majority of "mental patients" were institutionalized for a long periods in large-scale psychiatric hospitals. Treatment of psychiatric disorders depended largely on a few outdated biological therapies. In former socialist countries, psychodynamic psychotherapy was not common, and psychiatric patients were likely to experience social stigma. According to North Korean doctors living in South Korea, North Korean psychiatry is heavily influenced by the aforementioned traditions of psychiatry. During the post-socialist transition, the suicide rate in many of these countries dramatically increased. Given such mental health crises in post-socialist transitional societies, the field of psychiatry may face major challenges in a future unified Korea.

  16. Psychiatry in Former Socialist Countries: Implications for North Korean Psychiatry

    Science.gov (United States)

    Park, Young Su; Park, Sang Min; Jun, Jin Yong

    2014-01-01

    Very little information is available regarding psychiatry in North Korea, which is based on the legacy of Soviet psychiatry. This paper reviews the characteristics of psychiatry in former socialist countries and discusses its implications for North Korean psychiatry. Under socialism, psychiatric disorders were attributed primarily to neurophysiologic or neurobiological origins. Psychosocial or psychodynamic etiology was denied or distorted in line with the political ideology of the Communist Party. Psychiatry was primarily concerned with psychotic disorders, and this diagnostic category was sometimes applied based on political considerations. Neurotic disorders were ignored by psychiatry or were regarded as the remnants of capitalism. Several neurotic disorders characterized by high levels of somatization were considered to be neurological or physical in nature. The majority of "mental patients" were institutionalized for a long periods in large-scale psychiatric hospitals. Treatment of psychiatric disorders depended largely on a few outdated biological therapies. In former socialist countries, psychodynamic psychotherapy was not common, and psychiatric patients were likely to experience social stigma. According to North Korean doctors living in South Korea, North Korean psychiatry is heavily influenced by the aforementioned traditions of psychiatry. During the post-socialist transition, the suicide rate in many of these countries dramatically increased. Given such mental health crises in post-socialist transitional societies, the field of psychiatry may face major challenges in a future unified Korea. PMID:25395966

  17. [Psychiatry and criminology in Criminal Justice: Jury Trial Courts and Appellate Courts in the Federal District of Rio de Janeiro, during the 1930s].

    Science.gov (United States)

    Dias, Allister Andrew Teixeira

    2015-01-01

    As part of a research study on the 1930s and 1940s medical-criminological debate in Brazil, this research paper analyzes some of the uses and criticisms of arguments of a psychiatric and criminological nature, among certain jurists who carried out important work in the city of Rio de Janeiro during the 1930s. In this context, these magistrates, tended to have significant psychiatric and criminological knowledge, in spite of all the heterogeneity, plurality and differences in perspectives that existed among them. We selected two principal areas to conduct an analysis of the activities of these jurists: the Appellate Court of the Federal District of Rio de Janeiro and Jury Trial Courts.

  18. What psychiatry means to us

    Directory of Open Access Journals (Sweden)

    J.K. Trivedi

    2006-03-01

    Full Text Available Psychiatry has come up as one of the most dynamic branches of medicine in recent years. There are a lot of controversies regarding concepts, nosology, definitions and treatments in psychiatry, all of which are presently under a strict scanner. Differences are so many that even the meaning of psychiatry varies amongst individual psychiatrists. For us, it is an art to practice psychiatry and give the patient what he needs. Still, it should be practiced with great caution and utmost sincerity towards the patient, based on scientific knowledge and not to be guided by individual conceptions alone. Ethics in psychiatry forms an integral part of its basic concept and meaning, and a tight balance should be maintained between professional advancement and patient benefit. In recent years, the scope of psychiatry has enlarged considerably, with wide ranging influences from Sociology, Anthropology and Philosophy on the one hand, and Neurology and Medicine on the other.

  19. Randomized Controlled Trial of Therapeutic Horseback Riding in Children and Adolescents With Autism Spectrum Disorder

    Science.gov (United States)

    Gabriels, Robin L.; Pan, Zhaoxing; Dechant, Briar; Agnew, John A.; Brim, Natalie; Mesibov, Gary

    2015-01-01

    Objective This study expands previous equine-assisted intervention research by evaluating the effectiveness of therapeutic horseback riding (THR) on self-regulation, socialization, communication, adaptive, and motor behaviors in children with autism spectrum disorder (ASD). Method Participants with ASD (ages 6–16 years; N=127) were stratified by nonverbal IQ standard scores (≤ 85 or > 85) and randomized to one of two groups for 10 weeks: THR intervention or a barn activity (BA) control group without horses that employed similar methods. The fidelity of the THR intervention was monitored. Participants were evaluated within one month pre- and post-intervention by raters blind to intervention conditions and unblinded caregiver questionnaires. During the intervention, caregivers rated participants’ behaviors weekly. Results Intent-to-treat analysis conducted on the 116 participants who completed a baseline assessment (THR n = 58; BA control n = 58) revealed significant improvements in the THR group compared to the control on measures of irritability (primary outcome) (p=.002; effect size [ES]=.50) and hyperactivity (p=.001; ES=0.53), beginning by week five of the intervention. Significant improvements in the THR group were also observed on a measure of social cognition (p=.05, ES=.41) and social communication (p=.003; ES =.63), along with the total number of words (p=.01; ES=.54) and new words (p=.01; ES=.54) spoken during a standardized language sample. Sensitivity analyses adjusting for age, IQ, and per-protocol analyses produced consistent results. Conclusion This is the first large-scale randomized, controlled trial demonstrating efficacy of THR for the ASD population, and findings are consistent with previous equine-assisted intervention studies. Clinical trial registration information Trial of Therapeutic Horseback Riding in Children and Adolescents With Autism Spectrum Disorder; http://clinicaltrials.gov/; NCT02301195. PMID:26088658

  20. [Psychiatry and neuroethics].

    Science.gov (United States)

    Suárez Richards, Manuel

    2013-01-01

    Neuroscientific knowledge have enter to psychiatry in a new era, however, new technology for viewing images, brain function, psychopharmacology, non-invasive methodology requires an ethical approach, framed in the bioethical environment. The field of neuroethics has evolved to address many of the specific concerns and what neuroenhancement and neuroimaging provide us, is necessary to extend the scope of ethical things to consider the clinical implications for the psychiatric work.

  1. Mumbai Psychiatry: Current Obstacles

    Directory of Open Access Journals (Sweden)

    Sanjay V Bagadia

    2015-01-01

    Full Text Available Mumbai, like any other Metro city, has its own share of contentious issues influencing psychiatric management. These could be old ongoing issues like myths about medications, electroconvulsive therapy and counselling, or newer ones like our stand on homosexuality and crime related to psychosocial factors. A range of these issues is considered in this paper along with some possible solutions. Getting due credit and status for psychiatry as a medical branch is also a challenge we need to address.

  2. Reflexions on the identity and the practice of child psychiatry.

    Science.gov (United States)

    Terziev, D

    2013-01-01

    Τhe issue of the professional identity is salient for any medical discipline but especially for these, like child psychiatry and perhaps psychiatry, where the professional is the principal "instrument" in the assessment and in providing interventions. The Ericksonian view on identity implies self-sameness, continuity and synthesis which the child psychiatry as a specialty and child psychiatrists as professionals are to achieve more or less successfully. As a professional, the child psychiatrist is directed to the prevention, diagnosis and treatment of psychiatric disorders and associated problems in children and adolescents viewing children as developing biopsychological entities being in ongoing co-influencing interaction with their immediate and wider societal contexts. As a discipline, child and adolescent psychiatry needs to integrate developmental biological and psychological aspects, and holistic child-centered and family-focused perspectives. Child psychiatry is to integrate not only various aspects of the child as individual and of his environments as they are, but also in their diachronic dimension. As child psychiatrists, in my view, we must keep integrated in our professional armamentarium the consideration for intra- and interpersonal processes. In that perspective, of special value is the appreciation of setting, of timing, and of interpersonal processes in their interaction with intrapersonal ones. In addition, being both child-centered and family-focused, we need a systemic literacy to look at the families and of children as part of them. Apart from evidence-based information and clinical skills, we need some mature attitude to helpfully use our knowledge and skills. This attitude can transcend the state of the art professional algorithms; rather it integrates and not just imitates them. It cautions against too much enthusiasm in following the pendulum. It implies awareness of some reasonable limit to the urge to change the children and families. In

  3. Psychiatry beyond the current paradigm.

    LENUS (Irish Health Repository)

    Bracken, Pat

    2012-12-01

    A series of editorials in this Journal have argued that psychiatry is in the midst of a crisis. The various solutions proposed would all involve a strengthening of psychiatry\\'s identity as essentially \\'applied neuroscience\\'. Although not discounting the importance of the brain sciences and psychopharmacology, we argue that psychiatry needs to move beyond the dominance of the current, technological paradigm. This would be more in keeping with the evidence about how positive outcomes are achieved and could also serve to foster more meaningful collaboration with the growing service user movement.

  4. Biological Psychiatry, Research And Industry

    Directory of Open Access Journals (Sweden)

    Ajai R. Singh

    2007-01-01

    Full Text Available In this section, we look at how the biological paradigm shift in psychiatry has been aided and abetted by industry for serving its own needs; which stymies other promising approaches; but which, nonetheless, can serve to advance biomedicine if checks and balances are in place. Industry, Biological Psychiatry And Non-pharmacological Advance The larger issue of benefit to society also concerns us when we realize that industry sponsorship is mainly for potential medications, not for trying to determine whether there may be non-pharmacological interventions that may be equally good, if not better. …a lack of balance in research activities, with a focus mainly on potential medications, is likely to divert talented researchers from the pursuit of profound scientific questions or divert them from the pursuit of questions without market relevance but with an aspect of public good. A company has little incentive to support trials evaluating whether inexpensive, off-patent drugs or whether non-pharmaceutical interventions, could replace their profitable patented drug (Baird, 2003 This is the reason why methods like yoga, psychotherapy, meditation, non-medicated non-mechanised relaxation will not find industry sponsors readily and may never be proved useful apart from anecdotal reporting.In which case to expect industry sponsorship to develop a larger therapeutic armamentarium, especially non-drug based, is wishful thinking. Moreover, non-pharmacological treatment procedures may not get desirable funding. This may not be as much of a problem in other branches of medicine as in psychiatry, wherein non-pharmacological interventions like psychotherapy still hold promise of therapeutic relief.If we do not see rigorous experimental research in psychotherapy or other non-drug modalities to the extent that we should, let us be careful before blaming the researchers for it. Where are the funds? Also, let us note that behind the great thrust towards Biological

  5. Alterations in left ventricular, left atrial, and right ventricular structure and function to cardiovascular risk factors in adolescents with type 2 diabetes participating in the TODAY clinical trial

    Science.gov (United States)

    Data on cardiovascular disease (CVD) risk in adolescents with type 2 diabetes (T2D) are limited. Echocardiography was performed in the last year of the Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY) clinical trial (median 4.5 yr from diagnosis of T2D, average age 18 yr), incl...

  6. Impact of a psychiatry clerkship on stigma, attitudes towards psychiatry, and psychiatry as a career choice

    OpenAIRE

    Lyons, Zaza; Janca, Aleksandar

    2015-01-01

    Background Mental illnesses are a major public health problem around the world and the prevalence and burden of common mental disorders is growing. Psychiatry is an unpopular career choice for many medical students and this impacts negatively on the supply of psychiatrists to the workforce. The psychiatry clerkship can play an important role in influencing students’ attitudes towards psychiatry, either positively or negatively. However, stigma towards mental illness detracts students from con...

  7. Psychiatry and the death penalty: the landmark Supreme Court cases and their ethical implications for the profession.

    Science.gov (United States)

    Kermani, E J; Kantor, J E

    1994-01-01

    The U.S. Supreme Court has made a number of recent rulings in regard to the death penalty that will likely have the effect of increasing the use of psychiatry during the trial and sentencing process in capital cases. Any such changes are bound to increase the number of ethical dilemmas faced by psychiatrists involved in such work. The rulings affecting psychiatry include: (1) The Eighth Amendment forbids the execution of persons who are mentally incompetent in regard to their ability to appreciate the reasons for punishment. (2) A mentally-ill prisoner may be forcibly given neuroleptics if he presents a danger to himself or others. (3) Forced medication may not be used during the trial and sentencing phase if it has the potential to change the defendant's demeanor significantly enough to affect his defense. (4) Aggravating psychological factors affecting a convictee may be balanced against mitigating factors in considering whether death sentence should be imposed. (5) The psychosocial impact of the crime upon the victim's family may be presented during the sentencing phase as factors relevant to sentencing. (6) Adolescents and retarded individuals are not immune from the death penalty simply by virtue of their age or level of intelligence.

  8. A Randomized Controlled Trial to Test the Effectiveness of an Immersive 3D Video Game for Anxiety Prevention among Adolescents

    Science.gov (United States)

    Scholten, Hanneke; Malmberg, Monique; Lobel, Adam; Engels, Rutger C. M. E.; Granic, Isabela

    2016-01-01

    Adolescent anxiety is debilitating, the most frequently diagnosed adolescent mental health problem, and leads to substantial long-term problems. A randomized controlled trial (n = 138) was conducted to test the effectiveness of a biofeedback video game (Dojo) for adolescents with elevated levels of anxiety. Adolescents (11–15 years old) were randomly assigned to play Dojo or a control game (Rayman 2: The Great Escape). Initial screening for anxiety was done on 1,347 adolescents in five high schools; only adolescents who scored above the “at-risk” cut-off on the Spence Children Anxiety Survey were eligible. Adolescents’ anxiety levels were assessed at pre-test, post-test, and at three month follow-up to examine the extent to which playing Dojo decreased adolescents’ anxiety. The present study revealed equal improvements in anxiety symptoms in both conditions at follow-up and no differences between Dojo and the closely matched control game condition. Latent growth curve models did reveal a steeper decrease of personalized anxiety symptoms (not of total anxiety symptoms) in the Dojo condition compared to the control condition. Moderation analyses did not show any differences in outcomes between boys and girls nor did age differentiate outcomes. The present results are of importance for prevention science, as this was the first full-scale randomized controlled trial testing indicated prevention effects of a video game aimed at reducing anxiety. Future research should carefully consider the choice of control condition and outcome measurements, address the potentially high impact of participants’ expectations, and take critical design issues into consideration, such as individual- versus group-based intervention and contamination issues. PMID:26816292

  9. Treatment resistance and psychodynamic psychiatry: concepts psychiatry needs from psychoanalysis.

    Science.gov (United States)

    Plakun, Eric

    2012-06-01

    Over the last 30 years psychiatry and psychoanalysis have moved in substantially divergent directions. Psychiatry has become rich in methodology but conceptually limited, with a drift toward biological reductionism. Psychoanalysis has remained relatively limited in methodology, but conceptually rich. The rich methodology of psychiatry has led to major contributions in discovering gene by environment interactions, the importance of early adversity, and to recognition of the serious problem posed by treatment resistance. However, psychiatry's biologically reductionistic conceptual focus interferes with the development of a nuanced clinical perspective based on emerging knowledge that might help more treatment resistant patients become treatment responders. This article argues that recognition of the problem of treatment resistance in psychiatry creates a need for it to reconnect with the conceptual richness of psychoanalysis in order to improve patient care. Psychodynamic psychiatry is defined as the relevant intersection of psychiatry and psychoanalysis where this reconnection can occur. I will suggest selected aspects of psychoanalysis that are especially relevant to psychiatry in improving outcomes in work with treatment resistant patients.

  10. Neurofeedback for the treatment of children and adolescents with ADHD: a randomized and controlled clinical trial using parental reports

    Directory of Open Access Journals (Sweden)

    Duric Nezla S

    2012-08-01

    Full Text Available Abstract Background A randomized and controlled clinical study was performed to evaluate the use of neurofeedback (NF to treat attention-deficit/hyperactivity disorder (ADHD in children and adolescents. Methods The ADHD population was selected from an outpatient clinic for Child and Adolescent Mental Health in Norway. Ninety-one of the 275 children and adolescents ranging in age from 6 to 18 years (10.5 years participated in 30 sessions of an intensive NF program. The reinforcement contingency was based on the subjects’ production of cortical beta1 activity (15–18 Hz. The ADHD participants were randomized into three groups, with 30 in the NF group, 31 controls in a group that was given methylphenidate, and 30 in a group that received NF and methylphenidate. ADHD core symptoms were reported by parents using the parent form of the Clinician’s Manual for Assessment by Russell A. Barkley. Results Ninety-one children and adolescents were effectively randomized by age, sex, intelligence and distribution of ADHD core symptoms. The parents reported significant effects of the treatments, but no significant differences between the treatment groups were observed. Conclusions NF was as effective as methylphenidate at treating the attentional and hyperactivity symptoms of ADHD, based on parental reports. Trial registration Current Controlled Trials NCT01252446

  11. The In Vivo Adherence Intervention For at Risk Adolescents With Asthma: Report of a Randomized Pilot Trial

    OpenAIRE

    Seid, Michael; D'Amico, Elizabeth J.; Varni, James W; Munafo, Jennifer K.; Britto, Maria T.; Kercsmar, Carolyn M.; Drotar, Dennis; King, Eileen C.; Darbie, Lynn

    2011-01-01

    Objective Low-income and minority adolescents are at high risk for poor asthma outcomes, due in part to adherence. We tested acceptability, feasibility, and effect sizes of an adherence intervention for low socioeconomic status (SES) minority youth with moderate- and severe-persistent asthma. Design and Methods Single-site randomized pilot trial: intervention (n = 12; asthma education, motivational interviewing, problem-solving skills training, 1 month cell-phone with tailored text messaging)...

  12. Peer mentorship to promote effective pain management in adolescents: study protocol for a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Hayes Loran P

    2011-05-01

    Full Text Available Abstract Background This protocol is for a study of a new program to improve outcomes in children suffering from chronic pain disorders, such as fibromyalgia, recurrent headache, or recurrent abdominal pain. Although teaching active pain self-management skills through cognitive-behavioral therapy (CBT or a complementary program such as hypnotherapy or yoga has been shown to improve pain and functioning, children with low expectations of skill-building programs may lack motivation to comply with therapists' recommendations. This study will develop and test a new manualized peer-mentorship program which will provide modeling and reinforcement by peers to other adolescents with chronic pain (the mentored participants. The mentorship program will encourage mentored participants to engage in therapies that promote the learning of pain self-management skills and to support the mentored participants' practice of these skills. The study will examine the feasibility of this intervention for both mentors and mentored participants, and will assess the preliminary effectiveness of this program on mentored participants' pain and functional disability. Methods This protocol will recruit adolescents ages 12-17 with chronic pain and randomly assign them to either peer mentorship or a treatment-as-usual control group. Mentored participants will be matched with peer mentors of similar age (ages 14-18 who have actively participated in various treatment modalities through the UCLA Pediatric Pain Program and have learned to function successfully with a chronic pain disorder. The mentors will present information to mentored participants in a supervised and monitored telephone interaction for 2 months to encourage participation in skill-building programs. The control group will receive usual care but without the mentorship intervention. Mentored and control subjects' pain and functioning will be assessed at 2 months (end of intervention for mentored participants and

  13. Early intervention for adolescents with Patellofemoral Pain Syndrome - a pragmatic cluster randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Rathleff Michael S

    2012-01-01

    Full Text Available Abstract Background Self-reported knee pain is highly prevalent among adolescents. As much as 50% of the non-specific knee pain may be attributed to Patellofemoral Pain Syndrome (PFPS. In the short term, exercise therapy appears to have a better effect than patient education consisting of written information and general advice on exercise or compared with placebo treatment. But the long-term effect of exercise therapy compared with patient education is conflicting. The purpose of this study is to examine the short- and long-term effectiveness of patient education compared with patient education and multimodal physiotherapy applied at a very early stage of the condition among adolescents. Methods/Design This study is a single blind pragmatic cluster randomised controlled trial. Four upper secondary schools have been invited to participate in the study (approximately 2500 students, aged 15-19 years. Students are asked to answer an online questionnaire regarding musculoskeletal pain. The students who report knee pain are contacted by telephone and offered a clinical examination by a rheumatologist. Subjects who fit the inclusion criteria and are diagnosed with PFPS are invited to participate in the study. A minimum of 102 students with PFPS are then cluster-randomised into two intervention groups based on which school they attend. Both intervention groups receive written information and education. In addition to patient education, one group receives multimodal physiotherapy consisting primarily of neuromuscular training of the muscles around the foot, knee and hip and home exercises. The students with PFPS fill out self-reported questionnaires at baseline, 3, 6, 12 and 24 months after inclusion in the study. The primary outcome measure is perception of recovery measured on a 7-point Likert scale ranging from "completely recovered" to "worse than ever" at 12 months. Discussion This study is designed to investigate the effectiveness of patient

  14. [Forensic psychiatry. Its relations to clinical psychiatry and criminology].

    Science.gov (United States)

    Kröber, H-L

    2005-11-01

    A basic task of psychiatry is to identify and treat mentally disordered persons at risk of committing crimes. Psychiatry has an important function in preserving social peace, law, and order. How the psychiatric world handles this duty has changed with time. There have been very important changes from asylums to mental hospitals and from voluntary or involuntary inpatient treatment to outpatient care; but clinical psychiatry cannot give up forensic psychiatry. As a result of developments, inpatient care in mental hospitals often concentrates on crisis management, risk assessment, and risk management. On the other hand, forensic psychiatry has made great efforts in recent decades with special therapies for mentally disturbed criminals and collaborated closely with criminologists in developing instruments for risk assessment and prognosis of repeat offenses.

  15. The Effects of Triggers’ Modifying on Adolescent Self-Efficacy with Asthma: A Randomized Controlled Clinical Trial

    Directory of Open Access Journals (Sweden)

    Leila Valizadeh

    2014-06-01

    Full Text Available Introduction: The management of asthma during adolescence has specific challenges and is likely influenced, to some extent, by the patient's belief in their ability to affect change, their self-efficacy. Bolstering self-efficacy could potentially improve an adolescent’s ability to self-manage their asthma. The aim of this study was to examine the effects of a triggers’ educational-modifying intervention on self-efficacy among adolescents diagnosed with asthma living in Iran. Methods: Sixty adolescents, aged 12 to 18 years, diagnosed with asthma participated in this randomized clinical trial. Participants randomly assigned to the control group received standard care while those assigned to the experimental group participated in a 5 week, nurse led, triggers modifying educational intervention in specialized clinics of lung in Tabriz, Iran. The self-efficacy scale developed by Bursh et al., was used for data collection. Results: The level of self- efficacy in two groups before intervention was not statistically significant, while the post intervention measures were statistically significant. Intervention was effective in improving adolescents’ self-efficacy. Conclusion: Since this type of intervention has the potential to improve Self- efficacy in adolescents with asthma, it is suggested that adolescence directly education about asthma triggers along with modulating triggers will be of value and parent‐centered could be diminished. The need for such interventions emphasizes in clinic and outpatient clinics.

  16. Financing Academic Departments of Psychiatry

    Science.gov (United States)

    Liptzin, Benjamin; Meyer, Roger E.

    2011-01-01

    Objective: The authors describe the many financial challenges facing academic departments of psychiatry and the resulting opportunities that may arise. Method: The authors review the history of financial challenges, the current economic situation, and what may lie ahead for academic departments of psychiatry. Results: The current environment has…

  17. The relationship between parental stress and postpartum depression among adolescent mothers enrolled in a randomized controlled prevention trial.

    Science.gov (United States)

    Venkatesh, Kartik K; Phipps, Maureen G; Triche, Elizabeth W; Zlotnick, Caron

    2014-08-01

    Given the high co-occurrence of depression and parental stress among adolescent mothers, we evaluated the relationship between parental stress and postpartum depression among primiparous adolescent mothers. We conducted an observational analysis among a cohort of 106 adolescent mothers at 289 postpartum visits who were enrolled in a randomized controlled trial to prevent postpartum depression. Parental stress was measured using the Parenting Stress Index, short form. The Structured Clinical Interview for DSM-IV Childhood Diagnoses was administered to assess for postpartum depression; subthreshold depression was assessed using the Children's Depression Rating Scale, revised version. Generalized estimating equations were utilized to assess the relationship of parental stress on postpartum depression during the first 6 months postpartum. We present adjusted odds ratios (AOR) controlling for study arm, age, born in the United States, prior history of depression, and number of study visits. The median age was 16 years, 53% were Latina, and 16% reported a past history of depression. Nineteen adolescents (19%) were diagnosed with postpartum depression and 25% experienced high levels of parental stress through 6 months postpartum. Adolescent mothers who reported higher levels of parental stress were at significantly increased risk for postpartum depression [AOR 1.06 (95% CI 1.04-1.09); p stress predicted subsequent postpartum depression when assessing parental stress at visits prior to a depression diagnosis to determine whether we could establish a temporal association [AOR 1.06 (95% CI 1.02-1.09); p stress was also a risk factor for subthreshold depression [AOR 1.04 (95% CI 1.01-1.07); p stress was a significant risk factor for developing both postpartum depression as well as subthreshold depression among adolescent mothers. Interventions that target a reduction in parental stress may lead to less depression severity among primiparous adolescent mothers.

  18. Personalized medicine in psychiatry

    DEFF Research Database (Denmark)

    Wium-Andersen, Ida Kim; Vinberg, Maj; Kessing, Lars Vedel

    2016-01-01

    BACKGROUND: Personalized medicine is a model in which a patient's unique clinical, genetic, and environmental characteristics are the basis for treatment and prevention. Aim, method, and results: This review aims to describe the current tools, phenomenological features, clinical risk factors......, and biomarkers used to provide personalized medicine. Furthermore, this study describes the target areas in which they can be applied including diagnostics, treatment selection and response, assessment of risk of side-effects, and prevention. DISCUSSION AND CONCLUSION: Personalized medicine in psychiatry....... The discussion proposes possible solutions to narrow this gap and to move psychiatric research forward towards personalized medicine....

  19. BIOETHICS AND FORENSIC PSYCHIATRY

    Directory of Open Access Journals (Sweden)

    Călin SCRIPCARU

    2016-03-01

    Full Text Available The recent laws on mental health define psychiatric illness as a loss of consciousness and understanding of consequences of self-behavioral acts, evaluated by loss of discernment. As discernment represents the main criteria of responsibility towards personal actions, this study attempts at presenting the ethical issues related to discernment evaluation from the perspective of forensic medicine. We propose a "mint" representation of the content and consequences of one’s own actions as a new criteria of evaluation, taking into account the modern principles of psychology and psychiatry.

  20. Proposed trial: safety and efficacy of resveratrol for the treatment of non-alcoholic fatty liver disease (NAFLD) and associated insulin resistance in adolescents who are overweight or obese adolescents - rationale and protocol.

    Science.gov (United States)

    Wicklow, Brandy; Wittmeier, Kristy; T' Jong, Geert W; McGavock, Jonathon; Robert, Marni; Duhamel, Todd; Dolinsky, Vernon W

    2015-10-01

    Non-alcoholic fatty liver (NAFL) disease (NAFLD) affects 30% of overweight adolescents and increases the risk of type 2 diabetes mellitus (T2D). Resveratrol is a naturally occurring compound with potential to reverse NAFL and its associated insulin resistance in adults. The use of resveratrol to reduce risk for T2D through its effect on NAFL has not been examined to date in youth. This paper provides a literature review and protocol for a 30 day proof of principle trial of resveratrol in a population of adolescents at risk for T2D. This randomized double-blind controlled trial is designed with the primary objective of evaluating a twice daily supplementation of 75 mg of resveratrol for safety and tolerability in overweight and obese adolescent subjects (13 to physical activity, and nutritional assessment. This study will determine the safety and tolerability of resveratrol in an overweight adolescent population and inform the design of a larger randomized controlled trial.

  1. A Randomized Controlled Trial of Online versus Clinic-Based CBT for Adolescent Anxiety

    Science.gov (United States)

    Spence, Susan H.; Donovan, Caroline L.; March, Sonja; Gamble, Amanda; Anderson, Renee E.; Prosser, Samantha; Kenardy, Justin

    2011-01-01

    Objective: The study examined the relative efficacy of online (NET) versus clinic (CLIN) delivery of cognitive behavior therapy (CBT) in the treatment of anxiety disorders in adolescents. Method: Participants included 115 clinically anxious adolescents aged 12 to 18 years and their parent(s). Adolescents were randomly assigned to NET, CLIN, or…

  2. Acetyl-L-Carnitine as an Adjunctive Therapy in the Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents: A Placebo-Controlled Trial

    Science.gov (United States)

    Abbasi, Seyed-Hesameddin; Heidari, Shahram; Mohammadi, Mohammad-Reza; Tabrizi, Mina; Ghaleiha, Ali; Akhondzadeh, Shahin

    2011-01-01

    The objective of this study was to test whether a previous observed Acetyl-L-carnitine (ALC) treatment effect could be repeated in an ALC adjunctive therapy treatment trial of attention-deficit/hyperactivity disorder (ADHD) in children and adolescents. This was a six-week, randomized clinical trial undertaken in an outpatient child and adolescent…

  3. Intertwining Psychiatry Residency Training and Ethics in the College Setting.

    Science.gov (United States)

    Sondheimer, Adrian

    2015-10-01

    An ethical responsibility exists, currently unaddressed, for mandated psychiatry residency training with college student populations. Such training brings numerous potential benefits, including exposure to specific disorders and administrative structures. As well, individual cases pose ethical dilemmas unique to this developmental stage, which segues seamlessly from that of adolescence. Relevant case illustrations are employed. Likewise, psychiatric education oversight bodies are urged to fulfill their ethical obligations to provide pertinent training.

  4. Telephone Cognitive-Behavioral Therapy for Adolescents With Obsessive-Compulsive Disorder: A Randomized Controlled Non-inferiority Trial

    Science.gov (United States)

    Turner, Cynthia M.; Mataix-Cols, David; Lovell, Karina; Krebs, Georgina; Lang, Katie; Byford, Sarah; Heyman, Isobel

    2014-01-01

    Objective Many adolescents with obsessive-compulsive disorder (OCD) do not have access to evidence-based treatment. A randomized controlled non-inferiority trial was conducted in a specialist OCD clinic to evaluate the effectiveness of telephone cognitive-behavioral therapy (TCBT) for adolescents with OCD compared to standard clinic-based, face-to-face CBT. Method Seventy-two adolescents, aged 11 through 18 years with primary OCD, and their parents were randomized to receive specialist TCBT or CBT. The intervention provided differed only in the method of treatment delivery. All participants received up to 14 sessions of CBT, incorporating exposure with response prevention (E/RP), provided by experienced therapists. The primary outcome measure was the Children’s Yale–Brown Obsessive-Compulsive Scale (CY-BOCS). Blind assessor ratings were obtained at midtreatment, posttreatment, 3-month, 6-month, and 12-month follow-up. Results Intent-to-treat analyses indicated that TCBT was not inferior to face-to-face CBT at posttreatment, 3-month, and 6-month follow-up. At 12-month follow-up, there were no significant between-group differences on the CY-BOCS, but the confidence intervals exceeded the non-inferiority threshold. All secondary measures confirmed non-inferiority at all assessment points. Improvements made during treatment were maintained through to 12-month follow-up. Participants in each condition reported high levels of satisfaction with the intervention received. Conclusion TCBT is an effective treatment and is not inferior to standard clinic-based CBT, at least in the midterm. This approach provides a means of making a specialized treatment more accessible to many adolescents with OCD. Clinical trial registration information–Evaluation of telephone-administered cognitive-behaviour therapy (CBT) for young people with obsessive-compulsive disorder (OCD); http://www.controlled-trials.com; ISRCTN27070832. PMID:25457928

  5. Ethics Training in Psychiatry

    Directory of Open Access Journals (Sweden)

    Sinan Guloksuz

    2009-09-01

    Full Text Available Although ethics training is one of the core components of psychiatric education, it is not sufficiently addressed in the curricula of many educational institutions. It is shown that many of the psychiatry residents received no ethics training in both residency and medical school. Predictably, over half of the psychiatry residents had faced an ethical dilemma that they felt unprepared to meet, and nearly all of them indicated ethics education would have helped them to solve this dilemma. In addition to learning about the fundamental topics of ethics like confidentiality, boundary violations, justice, benefience and nonmaleficence, psychiatrists must also learn to deal with other hidden ethical dilemmas which are mostly due to the changing world order. It is obvious that residency training should include a well developed ethics curriculum. However, some still believe that ethical principles cannot be taught and are formed in one’s early moral development. Accepting the fact that teaching ethics is difficult, we believe that it is getting easier with the new methods for teaching in medicine. These methods are clinical supervisions, rol-models, case studies, role playing, small group discussions, team based learning and “let’s talking medicine” groups which is a useful methods for discussing ethics dilemmas on daily practice and C.A.R.E (Core Beliefs, Actions, Reasons, Experience which is a special training method for teaching ethics. In this review, the need of ethics training in residency curriculum will be discussed and new methods for teaching ethics will be proposed.

  6. Quetiapine versus aripiprazole in children and adolescents with psychosis--protocol for the randomised, blinded clinical Tolerability and Efficacy of Antipsychotics (TEA) trial

    DEFF Research Database (Denmark)

    Pagsberg, Anne Katrine; Jeppesen, Pia; Klauber, Dea Gowers

    2014-01-01

    aripiprazole in children and adolescents with psychosis in order to inform rational, effective and safe treatment selections. METHODS/DESIGN: The TEA trial is a Danish investigator-initiated, independently funded, multi-centre, randomised, blinded clinical trial. Based on sample size estimation, 112 patients...... about head-to-head differences in efficacy and tolerability of antipsychotics are scarce in children and adolescents. The TEA trial aims at expanding the evidence base for the use of antipsychotics in early onset psychosis in order to inform more rational treatment decisions in this vulnerable......BACKGROUND: The evidence for choices between antipsychotics for children and adolescents with schizophrenia and other psychotic disorders is limited. The main objective of the Tolerability and Efficacy of Antipsychotics (TEA) trial is to compare the benefits and harms of quetiapine versus...

  7. A Randomized Depression Prevention Trial Comparing Interpersonal Psychotherapy--Adolescent Skills Training to Group Counseling in Schools.

    Science.gov (United States)

    Young, Jami F; Benas, Jessica S; Schueler, Christie M; Gallop, Robert; Gillham, Jane E; Mufson, Laura

    2016-04-01

    Given the rise in depression disorders in adolescence, it is important to develop and study depression prevention programs for this age group. The current study examined the efficacy of Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST), a group prevention program for adolescent depression, in comparison to group programs that are typically delivered in school settings. In this indicated prevention trial, 186 adolescents with elevated depression symptoms were randomized to receive IPT-AST delivered by research staff or group counseling (GC) delivered by school counselors. Hierarchical linear modeling examined differences in rates of change in depressive symptoms and overall functioning from baseline to the 6-month follow-up assessment. Cox regression compared rates of depression diagnoses. Adolescents in IPT-AST showed significantly greater improvements in self-reported depressive symptoms and evaluator-rated overall functioning than GC adolescents from baseline to the 6-month follow-up. However, there were no significant differences between the two conditions in onset of depression diagnoses. Although both intervention conditions demonstrated significant improvements in depressive symptoms and overall functioning, results indicate that IPT-AST has modest benefits over groups run by school counselors which were matched on frequency and duration of sessions. In particular, IPT-AST outperformed GC in reduction of depressive symptoms and improvements in overall functioning. These findings point to the clinical utility of this depression prevention program, at least in the short-term. Additional follow-up is needed to determine the long-term effects of IPT-AST, relative to GC, particularly in preventing depression onset.

  8. YouTube and 'psychiatry'.

    Science.gov (United States)

    Gordon, Robert; Miller, John; Collins, Noel

    2015-12-01

    YouTube is a video-sharing website that is increasingly used to share and disseminate health-related information, particularly among younger people. There are reports that social media sites, such as YouTube, are being used to communicate an anti-psychiatry message but this has never been confirmed in any published analysis of YouTube clip content. This descriptive study revealed that the representation of 'psychiatry' during summer 2012 was predominantly negative. A subsequent smaller re-analysis suggests that the negative portrayal of 'psychiatry' on YouTube is a stable phenomenon. The significance of this and how it could be addressed are discussed.

  9. The state of psychiatry in Spain.

    Science.gov (United States)

    Bobes, Julio; Garcia-Portilla, Maria Paz; Bobes-Bascaran, Maria-Teresa; Parellada, Mara; Bascaran, Maria-Teresa; Saiz, Pilar Alejandra; Bousoño, Manuel; Arango, Celso

    2012-08-01

    The 1986 General Health Act and the so-called 'psychiatric reform' were key issues in the development of the mental healthcare system (MHCS) in Spain. The World Health Organization Declaration and Action Plan on Mental Health in 2005 gave it a revitalizing impetus and resulted in the first National Health System (NHS) Mental Health Strategy in 2006. A literature search was performed using MEDLINE, Spanish journals, reference lists, national databases, and European and Spanish official documents to describe the current state of the MHCS in Spain. The main results were: (1) existence of great variability among the autonomous communities with respect to mental health resources and provision of care; (2) lack of national epidemiological information on mental disorders with the exception of substance use disorders and suicide, which comprise powerful longitudinal national data, (3) training in psychiatry is well established, although there is no specialism of child and adolescent psychiatry, and (4) a dramatic increase in scientific productivity in the last decade among research groups, in part due to the creation of the Spanish Mental Health Network, the Centro de Investigación Biomédica en Red en el Área de Salud Mental (CIBERSAM). Quantifiable and reliable indicators are needed to provide efficient monitoring and analysis of epidemiological events and subsequently to understand the status of the Spanish MHCS.

  10. MRI in psychiatry

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    Mulert, Christoph [UKE, Hamburg (Germany). Psychiatry Neuroimaging Branch; Shenton, Martha E. (ed.) [Harvard Medical School, Boston, MA (United States). Dept. of Psychiatry and Radiology

    2014-07-01

    This is the first comprehensive textbook on the use of MRI in psychiatry covering imaging techniques, brain systems and a review of findings in different psychiatric disorders. The book is divided into three sections, the first of which covers in detail all the major MRI-based methodological approaches available today, including fMRI, EEG-fMRI, DTI, and MR spectroscopy. In addition, the role of MRI in imaging genetics and combined brain stimulation and imaging is carefully explained. The second section provides an overview of the different brain systems that are relevant for psychiatric disorders, including the systems for perception, emotion, cognition, and reward. The final part of the book presents the MRI findings that are obtained in all the major psychiatric disorders using the previously discussed techniques. Numerous carefully chosen images support the informative text, making this an ideal reference work for all practitioners and trainees with an interest in this flourishing field.

  11. Computational neurology and psychiatry

    CERN Document Server

    Bhattacharya, Basabdatta; Cochran, Amy

    2017-01-01

    This book presents the latest research in computational methods for modeling and simulating brain disorders. In particular, it shows how mathematical models can be used to study the relationship between a given disorder and the specific brain structure associated with that disorder. It also describes the emerging field of computational psychiatry, including the study of pathological behavior due to impaired functional connectivity, pathophysiological activity, and/or aberrant decision-making. Further, it discusses the data analysis techniques that will be required to analyze the increasing amount of data being generated about the brain. Lastly, the book offers some tips on the application of computational models in the field of quantitative systems pharmacology. Mainly written for computational scientists eager to discover new application fields for their model, this book also benefits neurologists and psychiatrists wanting to learn about new methods.

  12. Psychiatry and terrorism.

    Science.gov (United States)

    Stoddard, Frederick J; Gold, Joel; Henderson, Schuyler W; Merlino, Joseph P; Norwood, Ann; Post, Jerrold M; Shanfield, Stephen; Weine, Stevan; Katz, Craig L

    2011-08-01

    Terrorism has dominated the domestic and international landscape since 9/11. Like other fields, psychiatry was not well prepared. With the 10th anniversary of the 9/11 attack approaching, it is timely to consider what can be done to prepare before the next event. Much has been learned to provide knowledge and resources. The roles of psychiatrists are challenged by what is known of the causes of, consequences of, and responses to terrorism. Reflecting on knowledge from before and since 9/11 introduces concepts, how individuals become terrorists, how to evaluate the psychiatric and behavioral effects of terrorism, and how to expand treatments, behavioral health interventions, public policy initiatives, and other responses for its victims. New research, clinical approaches, and policy perspectives inform strategies to reduce fear and cope with the aftermath. This article identifies the psychiatric training, skills and services, and ethical considerations necessary to prevent or reduce terrorism and its tragic consequences and to enhance resilience.

  13. Forensic psychiatry in Pakistan.

    Science.gov (United States)

    Hassan, Tariq; Nizami, Asad Tamizuddin; Hirji, Sarah

    2015-01-01

    This article reviews existing forensic psychiatric services in Pakistan highlighting the role played by the judicial and the medical fraternity in managing the legal and forensic issues of the population of patients with mental illnesses. Until 2001, all legal and forensic issues were dealt with the mental health legislation of 1912, the Lunacy Act of 1912. This was inherited from the British rulers in the Sub-Continent at the time. The Mental Health Ordinance of 2001 could not sustain following the 18th constitutional amendment in 2010, whereby psychiatric healthcare was devolved to the provinces from the previous federal authority. The article also highlights the difficulties and the barriers in implementation of the forensic psychiatric services in Pakistan at various levels within the healthcare system. This article also delves into the current framework of training in forensic psychiatry for postgraduates as well as the assessments and management schedules for the mentally ill offenders at tertiary care institutions in Pakistan.

  14. A randomized trial of the Positive Thoughts and Action program for depression among early adolescents.

    Science.gov (United States)

    McCarty, Carolyn A; Violette, Heather D; Duong, Mylien T; Cruz, Rick A; McCauley, Elizabeth

    2013-01-01

    This study was conducted to compare the outcomes of a group-based cognitive-behavioral preventive intervention (Positive Thoughts and Actions [PTA]) tailored to youth in middle school with a brief, individually administered supportive intervention (Individual Support Program [ISP]). A randomized, controlled trial was conducted with 120 early adolescents (72 girls, 48 boys; age = 11-15 years) who had elevated depressive symptoms and were selected from a school-based population. Measures of internalizing problems, externalizing problems, personal adjustment, school problems, and interpersonal relations were obtained from parents, youth, and/or teachers at preintervention (Time 1) and postintervention (Time 2, 5-7 months after preintervention). General linear model repeated measures analyses yielded a significant Group × Time interaction on youth-reported, but not parent-reported, depressive symptoms and internalizing symptoms. Youth in the PTA group showed greater decreases following intervention compared to youth who received ISP, yielding effect sizes (Cohen's d) of 0.36 for depressive symptoms, 95% CI [-.02, .73], and 0.44, 95% CI [.05, .82], for internalizing symptoms. PTA youth also showed improvements in their personal adjustment (sense of inadequacy, self-esteem), and parent-reported social skills, but no differences emerged between groups for externalizing symptoms, school problems, or interpersonal relationships. Cognitive-behavioral preventive interventions in which youth engage in personal goal-setting and practice social-emotional skills, such as PTA, may be beneficial for the reduction of depressive symptoms over and above general support and empathy.

  15. Cultural psychiatry: a general perspective.

    Science.gov (United States)

    Alarcón, Renato D

    2013-01-01

    The current scene in the field of cultural psychiatry shows a vigorous growth, multifaceted conceptual and research developments and more relevant clinical presence. After a pertinent definition of the discipline, this chapter examines the contribution of cultural psychiatry to the etiopathogenesis of mental disorders, to the variations of clinical presentations in numerous entities, to psychiatric diagnosis and treatment and to the relatively unexplored rubric of preventive psychiatry. Advanced concepts of neurosciences and technology-based research can find a place in the realm of biocultural correlates. The role of culture in the definition of mental illness, the renewed notions of the old 'culture-bound syndromes', hope, cognition and culture in psychiatric treatments (including the so-called 'cultural therapies'), and resiliency are areas duly examined and discussed. Cultural psychiatry has re-emerged as a reliable body of knowledge aimed at a comprehensive assessment of human beings as patients.

  16. [Psychiatry and the Great War].

    Science.gov (United States)

    Fras, Ivan

    2002-01-01

    During the World War I, the high rate of psychiatric casualties was differently tackled according to the nations: the Central Powers carried an authoritarian approach with prevailing physical treatment methods whereas the Allies' attitude reflected their democratic background. Particularly French psychiatry demonstrated a real willingness and ability to respond to the clinical realities. The conceptual problem of what DSM IV now classified as acute stress disorder was resolved so successfully that this disorder deserves the eponym "Viovenel's Syndrome". American Military Psychiatry followed the French methods of precise diagnosis and expeditious treatment close to the front and amplified them by creating effective treatment methods : brief psychotherapy methods and group psychotherapy within a therapeutic environment. Franco-American psychiatry thereby created the foundation for modern community psychiatry.

  17. American Association for Geriatric Psychiatry

    Science.gov (United States)

    ... in your area. Read more » AAGP Journal Official Journal of the American Association for Geriatric Psychiatry. Read more ... RESEARCHERS GMHF Scholars Since my program is so small and there is not much interest among my ...

  18. Empirical evidence on the use and effectiveness of telepsychiatry via videoconferencing: implications for forensic and correctional psychiatry.

    Science.gov (United States)

    Antonacci, Diana J; Bloch, Richard M; Saeed, Sy Atezaz; Yildirim, Yilmaz; Talley, Jessica

    2008-01-01

    A growing body of literature now suggests that use of telepsychiatry to provide mental health services has the potential to solve the workforce shortage problem that directly affects access to care, especially in remote and underserved areas. Live interactive two-way audio-video communication-videoconferencing-is the modality most applicable to psychiatry and has become synonymous with telepsychiatry involving patient care, distance education, and administration. This article reviews empirical evidence on the use and effectiveness of videoconferencing in providing diagnostic and treatment services in mental health settings that serve child, adolescent, and adult populations. Descriptive reports, case studies, research articles, and randomized controlled trials related to clinical outcomes were identified and reviewed independently by two authors. Articles related to cost-effectiveness, technological issues, or legal or ethical aspects of telepsychiatry were excluded. The review of the evidence broadly covers mental health service provision in all settings, including forensic settings. Given the sparse literature on telepsychiatry in forensic settings, we discuss implications for mental health care across settings and populations and comment on future directions and potential uses in forensic or correctional psychiatry.

  19. Developing Treatment for Adolescents Who Stutter: A Phase I Trial of the Camperdown Program

    Science.gov (United States)

    Hearne, Anna; Packman, Ann; Onslow, Mark; O'Brian, Sue

    2008-01-01

    Purpose: To investigate in detail how adolescents who stutter perform during treatment, with the aim of informing treatment development for this age group. Method: The Camperdown Program was conducted with 3 adolescents who stutter. Their performance during treatment was recorded in detail, and outcome measures were collected before treatment and…

  20. Preventing Adolescent Social Anxiety and Depression and Reducing Peer Victimization: Intervention Development and Open Trial

    Science.gov (United States)

    La Greca, Annette M.; Ehrenreich-May, Jill; Mufson, Laura; Chan, Sherilynn

    2016-01-01

    Background: Social anxiety disorder (SAD) and depression are common among adolescents, frequently comorbid, and resistant to change. Prevention programs for adolescent SAD are scant, and depression prevention programs do not fully address peer-risk factors. One critical peer-risk factor for SAD and depression is peer victimization. We describe the…

  1. Emotion Regulation Training for Adolescents With Borderline Personality Disorder Traits : A Randomized Controlled Trial

    NARCIS (Netherlands)

    Schuppert, H. Marieke; Timmerman, Marieke E.; Bloo, Josephine; van Gemert, Tonny G.; Wiersema, Herman M.; Minderaa, Ruud B.; Emmelkamp, Paul M. G.; Nauta, Maaike H.

    2012-01-01

    Objective: To evaluate the effectiveness of Emotion Regulation Training (ERT), a 17-session weekly group training for adolescents with borderline personality disorder (BPD) symptoms. Method: One hundred nine adolescents with borderline traits (73% meeting the full criteria for BPD) were randomized t

  2. Cognitive Bias Modification versus CBT in Reducing Adolescent Social Anxiety : A Randomized Controlled Trial

    NARCIS (Netherlands)

    Sportel, B. Esther; de Hullu, Eva; de Jong, Peter J.; Nauta, Maaike H.

    2013-01-01

    Social anxiety is a common mental disorder among adolescents and is associated with detrimental long term outcomes. Therefore, this study investigated the efficacy of two possible early interventions for adolescent social anxiety and test anxiety. An internet-based cognitive bias modification (CBM;

  3. Strength and Agility Training in Adolescents with Down Syndrome: A Randomized Controlled Trial

    Science.gov (United States)

    Lin, Hsiu-Ching; Wuang, Yee-Pay

    2012-01-01

    The purpose of this study was to investigate the effects of a proposed strength and agility training program of adolescents with Down syndrome. Ninety-two adolescents were recruited and evenly randomized to two intervention groups (exercise group vs. control group). The mean age for the exercise and the control group was 10.6 plus or minus 3.2 and…

  4. Longitudinal research in child and adolescent psychiatry.

    Science.gov (United States)

    Verhulst, F C; Koot, H M

    1991-05-01

    An indispensable approach to the study of variations in individual development and of causal mechanisms and processes underlying the course of psychopathology is the longitudinal method. In this introductory review, the strengths and weaknesses of longitudinal research are discussed, and factors hampering progress in this field are outlined. The many advantages of this approach warrant continuing efforts to develop strategies that minimize its drawbacks.

  5. Child and adolescent psychiatry and family status

    DEFF Research Database (Denmark)

    Esbjørn, Barbara Hoff; Levin, Eline; Høyer, Mette;

    2008-01-01

    BACKGROUND: Much attention has been given to parental separation as a possible risk factor for adverse child development; however, little information is available regarding the family status of children referred to psychiatric facilities. AIMS: To assess the association between psychiatric illnes...

  6. Brazil nuts intake improves lipid profile, oxidative stress and microvascular function in obese adolescents: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Koury Josely C

    2011-05-01

    Full Text Available Abstract Background Obesity is a chronic disease associated to an inflammatory process resulting in oxidative stress that leads to morpho-functional microvascular damage that could be improved by some dietary interventions. In this study, the intake of Brazil nuts (Bertholletia excelsa, composed of bioactive substances like selenium, α- e γ- tocopherol, folate and polyunsaturated fatty acids, have been investigated on antioxidant capacity, lipid and metabolic profiles and nutritive skin microcirculation in obese adolescents. Methods Obese female adolescents (n = 17, 15.4 ± 2.0 years and BMI of 35.6 ± 3.3 kg/m2, were randomized 1:1 in two groups with the diet supplemented either with Brazil nuts [BNG, n = 08, 15-25 g/day (equivalent to 3 to 5 units/day] or placebo [PG (lactose, n = 09, one capsule/day] and followed for 16 weeks. Anthropometry, metabolic-lipid profiles, oxidative stress and morphological (capillary diameters and functional [functional capillary density, red blood cell velocity (RBCV at baseline and peak (RBCVmax and time (TRBCVmax to reach it during post-occlusive reactive hyperemia, after 1 min arterial occlusion] microvascular variables were assessed by nailfold videocapillaroscopy at baseline (T0 and after intervention (T1. Results T0 characteristics were similar between groups. At T1, BNG (intra-group variation had increased selenium levels (p = 0.02, RBCV (p = 0.03 and RBCVmax (p = 0.03 and reduced total (TC (p = 0.02 and LDL-cholesterol (p = 0.02. Compared to PG, Brazil nuts intake reduced TC (p = 0.003, triglycerides (p = 0.05 and LDL-ox (p = 0.02 and increased RBCV (p = 0.03. Conclusion Brazil nuts intake improved the lipid profile and microvascular function in obese adolescents, possibly due to its high level of unsaturated fatty acids and bioactive substances. Trial Registration Clinical Trials.gov NCT00937599

  7. Nocebo effect in randomized clinical trials of antidepressants in children and adolescents: systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Johanna Carolina Rojas Mirquez

    2014-11-01

    Full Text Available Objective: To compare the incidence of adverse events between active and placebo arms of randomized clinical trials in depressive children and adolescents with antidepressant treatments, in order to look for similarities in both groups that allow to establish a possible nocebo effect.Methods: Systematic search strategy (January 1974-March 2013 in electronic databases, conference abstracts and reference list of systematic reviews and included studies to identify parallel randomized placebo-controlled trials of antidepressants in children and adolescents (<19 years with Major Depressive Disorder, and one or more interventions of any orally administered antidepressant. The pooled adverse events were calculated based on a fixed-effect model and statistical analysis involved the Risk Ratio (RR of adverse events, with 95% confidence intervals (95%CI.Results: Sixteen studies were included in the review, of which seven studies with a sample of 1911 patients had data to include in the meta-analysis. There was similar risk for the incidence of adverse events between non-active and active group (global Risk Ratio 1.04, 95% Confidence Interval: 0.97-1.11. Conclusions: Depressive children and adolescents allocated to placebo or active group had similar risk to develop adverse events. These similarities in both groups are attributed to the nocebo effect. It is of note that defining nocebo effects is challenging in clinical populations because adverse effects may be attributed to the intervention or may be manifestation of the disease itself. The inclusion of a no treatment arm may be warranted. Nocebo effects are likely when adverse events of placebo mimic the adverse events of active treatment, as was the case here.

  8. INCANT: a transnational randomized trial of Multidimensional Family Therapy versus treatment as usual for adolescents with cannabis use disorder

    Directory of Open Access Journals (Sweden)

    Grichting Esther

    2010-04-01

    Full Text Available Abstract Background In 2003, the governments of Belgium, France, Germany, the Netherlands and Switzerland agreed that there was a need in Europe for a treatment programme for adolescents with cannabis use disorders and other behavioural problems. Based on an exhaustive literature review of evidence-based treatments and an international experts meeting, Multidimensional Family Therapy (MDFT was selected for a pilot study first, which was successful, and then for a joint, transnational randomized controlled trial named INCANT (INternational CAnnabis Need for Treatment. Methods/design INCANT is a randomized controlled trial (RCT with an open-label, parallel group design. This study compares MDFT with treatment as usual (TAU at and across sites in Brussels, Berlin, Paris, The Hague and Geneva. Assessments are at baseline and at 3, 6, 9 and 12 months after randomization. A minimum of 450 cases in total is required; sites will recruit 60 cases each in Belgium and Switzerland, and a maximum of 120 each in France, Germany and the Netherlands. Eligible for INCANT are adolescents from 13 through 18 years of age with a cannabis use disorder (dependence or abuse, with at least one parent willing to take part in the treatment. Randomization is concealed to, and therefore beyond control by, the researcher/site requesting it. Randomization is stratified as to gender, age and level of cannabis consumption. Assessments focus on substance use; mental function; behavioural problems; and functioning regarding family, school, peers and leisure time. For outcome analyses, the study will use state of the art latent growth curve modelling techniques, including all randomized participants according to the intention-to-treat principle. INCANT has been approved by the appropriate ethical boards in Belgium, France, Germany, the Netherlands, Switzerland, and the University of Miami Miller School of Medicine. INCANT is funded by the (federal Ministries of Health of Belgium

  9. Effects of a brief school-based media literacy intervention on digital media use in adolescents: cluster randomized controlled trial.

    Science.gov (United States)

    Walther, Birte; Hanewinkel, Reiner; Morgenstern, Matthis

    2014-09-01

    The aim of this study was to evaluate the effects of a four-session school-based media literacy curriculum on adolescent computer gaming and Internet use behavior. The study comprised a cluster randomized controlled trial with three assessments (baseline, posttest, and 12-month follow-up). At baseline, a total of 2,303 sixth and seventh grade adolescents from 27 secondary schools were assessed. Of these, 1,843 (80%) could be reached at all three assessments (Mage=12.0 years; SD=0.83). Students of the intervention group received the media literacy program Vernetzte www.Welten ("Connected www.Worlds ") implemented by trained teachers during class time. The control group attended regular class. Main outcome measures were adolescents' computer gaming and Internet use: days per month, hours per day, and addictive use patterns. Parental media monitoring and rules at home were assessed as secondary outcomes. Results of multilevel growth-curve models revealed a significant intervention effect in terms of a lower increase in self-reported gaming frequency (β = -1.10 [95% CI -2.06, -0.13]), gaming time (β = -0.27 [95% CI -0.40, -0.14]), and proportion of excessive gamers (AOR=0.21 [95% CI 0.08, 0.57]) in the intervention group. There were also significant group-time interactions for the addictive gaming scale (β=-0.08 [95% CI -0.12, -0.04]), and the Internet Addiction Scale (β = -0.06 [95% CI -0.10, -0.01]). No effect was found for days and hours of Internet use or parental media behavior. The study shows that the program Vernetzte www.Welten can influence adolescents' media use behavior. Future research should address mediating and moderating variables of program effects.

  10. Effects of serotonin reuptake inhibitors on aggressive behavior in psychiatrically hospitalized adolescents: results of an open trial.

    Science.gov (United States)

    Constantino, J N; Liberman, M; Kincaid, M

    1997-01-01

    Low concentrations of the neurotransmitter serotonin and its 5-hydroxyindoleacetic acid metabolite in the central nervous system have been associated with increased aggressive behavior in animals and humans. Controlled clinical trials of serotonin agonists in depressed adults have suggested that aggressive behavior is less likely during treatment with these medications than with placebo, but there have been no previous studies of selective serotonin reuptake inhibitors (SSRIs) and aggression in children. We prospectively followed the course of aggressive behavior in 19 psychiatrically hospitalized adolescents (not selected for aggressiveness) who received open clinical trials of fluoxetine, paroxetine, or sertraline. The patients received standard doses (equivalent to fluoxetine 10-40 mg daily) for a minimum of 5 weeks. The starting dose was 15 +/- 5 mg, and dosages were raised at a mean rate of 5 mg every 4 days up to a mean dose of 25 +/- 10 mg daily. Results from trials of the three SSRIs were clustered because the sample sizes were not sufficient for separate analyses. Overall, there were no statistically meaningful improvements in the level of aggressive behavior, as measured on a modified version of the Overt Aggression Scale, over the course of these patients' SSRI trials. Symptoms of physical aggression toward others or self were manifest in 12 of the 19 patients while on SSRIs. Of the 19 patients, 13 were assessed both on and off SSRIs: verbal aggression (p = 0.04), physical aggression toward objects (p = 0.05), and physical aggression toward self (p < 0.02) occurred significantly more frequently on SSRIs than off; no increase was observed in physical aggression toward others. Patients with the highest baseline aggressivity scores did not show greater improvement during SSRI treatment. Further research is warranted, particularly to explore whether SSRIs may have therapeutic effects on aggression at higher (or lower) doses than were administered in this

  11. Protocol for: Sheffield Obesity Trial (SHOT: A randomised controlled trial of exercise therapy and mental health outcomes in obese adolescents [ISRCNT83888112

    Directory of Open Access Journals (Sweden)

    Wright Neil P

    2005-10-01

    Full Text Available Abstract Background While obesity is known to have many physiological consequences, the psychopathology of this condition has not featured prominently in the literature. Cross-sectional studies have indicated that obese children have increased odds of experiencing poor quality of life and mental health. However, very limited trial evidence has examined the efficacy of exercise therapy for enhancing mental health outcomes in obese children, and the Sheffield Obesity Trial (SHOT will provide evidence of the efficacy of supervised exercise therapy in obese young people aged 11–16 years versus usual care and an attention-control intervention. Method/design SHOT is a randomised controlled trial where obese young people are randomised to receive; (1 exercise therapy, (2 attention-control intervention (involving body-conditioning exercises and games that do not involve aerobic activity, or (3 usual care. The exercise therapy and attention-control sessions will take place three times per week for eight weeks and a six-week home programme will follow this. Ninety adolescents aged between 11–16 years referred from a children's hospital for evaluation of obesity or via community advertisements will need to complete the study. Participants will be recruited according to the following criteria: (1 clinically obese and aged 11–16 years (Body Mass Index Centile > 98th UK standard (2 no medical condition that would restrict ability to be active three times per week for eight weeks and (3 not diagnosed with insulin dependent diabetes or receiving oral steroids. Assessments of outcomes will take place at baseline, as well as four (intervention midpoint and eight weeks (end of intervention from baseline. Participants will be reassessed on outcome measures five and seven months from baseline. The primary endpoint is physical self-perceptions. Secondary outcomes include physical activity, self-perceptions, depression, affect, aerobic fitness and BMI.

  12. Lessons from writing sessions: a school-based randomized trial with adolescent orphans in Rwanda

    Directory of Open Access Journals (Sweden)

    Johanna Unterhitzenberger

    2014-12-01

    Full Text Available Background: Treatments for adolescents affected by long-term loss in low- and middle-income countries are lacking. As school-based interventions are cost-efficient and easy to disseminate, an evaluation of this treatment setting for adolescents is worthwhile. Objective: Examining the effect of a school-based unstructured emotional writing intervention (sensu Pennebaker, group 1 about the loss of a parent to reduce adaptation problems to loss, compared to writing about a hobby (group 2, and non-writing (group 3. Method: We randomly assigned 14–18-year-old Rwandan orphans to one of the three conditions (n=23 per condition. Before and after the intervention, subjects completed the Prolonged Grief Questionnaire for Adolescents and the Mini International Neuropsychiatric Interview for Children and Adolescents, Part A, on depression as self-report measures of long-term effects of early parental loss. Results: Repeated measures analyses of variance showed no differential effect for any of the three conditions but revealed a significant effect of time at posttest regarding grief severity. Reduction of grief symptoms was significantly higher in subjects with elevated grief. Depressive symptoms showed no significant change from pre- to posttest in the emotional writing condition, whereas they significantly decreased in the control condition. Conclusions: Results imply that unstructured, brief emotional writing might not be indicated in adolescents affected by early parental loss who show severe and long-term distress; a more structured approach seems recommendable.

  13. Muscles in motion : a randomized controlled trial on the feasibility, safety and efficacy of an exercise training programme in children and adolescents with juvenile dermatomyositis

    NARCIS (Netherlands)

    Habers, G Esther A; Bos, G J F Joyce; van Royen-Kerkhof, Annet; Lelieveld, Otto T H M; Armbrust, Wineke; Takken, Tim; van Brussel, Marco

    2016-01-01

    OBJECTIVE: To study for the first time in a randomized controlled trial the feasibility, safety and efficacy of an exercise training programme in children and adolescents with JDM. METHODS: Patients were randomly assigned to the Intervention Group (IG; n = 14) or Waiting Control Group (WCG; n = 12).

  14. A Randomised Controlled Treatment Trial of Two Forms of Family Therapy in Adolescent Anorexia Nervosa: A Five-Year Follow-Up

    Science.gov (United States)

    Eisler, Ivan; Simic, Mima; Russell, Gerald F. M.; Dare, Christopher

    2007-01-01

    Background: There is growing evidence that family therapy is an effective treatment for adolescent anorexia nervosa. This study aimed to ascertain the long-term impact of two forms of outpatient family intervention previously evaluated in a randomised controlled trial (RCT). Method: A five-year follow-up was conducted on a cohort of 40 patients…

  15. Efficacy of Cognitive Behavioral Therapy for insomnia in adolescents: A randomized controlled trial with internet therapy, group therapy and a waiting list condition

    NARCIS (Netherlands)

    de Bruin, E.J.; Bögels, S.M.; Oort, F.J.; Meijer, A.M.

    2015-01-01

    Study Objectives: To investigate the efficacy of cognitive behavioral therapy for insomnia (CBTI) in adolescents. Design: A randomized controlled trial of CBTI in group therapy (GT), guided internet therapy (IT), and a waiting list (WL), with assessments at baseline, directly after treatment (post-t

  16. Cost-Effectiveness of Classroom-Based Cognitive Behaviour Therapy in Reducing Symptoms of Depression in Adolescents: A Trial-Based Analysis

    Science.gov (United States)

    Anderson, Rob; Ukoumunne, Obioha C.; Sayal, Kapil; Phillips, Rhiannon; Taylor, John A.; Spears, Melissa; Araya, Ricardo; Lewis, Glyn; Millings, Abigail; Montgomery, Alan A.; Stallard, Paul

    2014-01-01

    Background: A substantial minority of adolescents suffer from depression and it is associated with increased risk of suicide, social and educational impairment, and mental health problems in adulthood. A recently conducted randomized controlled trial in England evaluated the effectiveness of a manualized universally delivered age-appropriate CBT…

  17. The effectiveness of family interventions in preventing adolescent illicit drug use: A systematic review and meta-analysis of randomized controlled trials

    NARCIS (Netherlands)

    Smit, E.; Verdurmen, J.E.E.; Engels, R.C.M.E.

    2015-01-01

    In order to quantify the effectiveness of family interventions in preventing and reducing adolescent illicit drug use, we conducted a systematic review and meta-analysis of randomized controlled trials. We searched the Cochrane Database of Systematic Reviews, Educational Research Information Centre

  18. Evaluation of a School-Based Depression Prevention Program among Adolescents from Low-Income Areas: A Randomized Controlled Effectiveness Trial

    NARCIS (Netherlands)

    Kindt, K.C.M.; Kleinjan, M.; Janssens, J.M.A.M.; Scholte, R.H.J.

    2014-01-01

    A randomized controlled trial was conducted among a potential high-risk group of 1,343 adolescents from low-income areas in The Netherlands to test the effectiveness of the depression prevention program Op Volle Kracht (OVK) as provided by teachers in a school setting. The results showed no main eff

  19. Efficacy Trial of a Brief Cognitive-Behavioral Depression Prevention Program for High-Risk Adolescents: Effects at 1- and 2-Year Follow-Up

    Science.gov (United States)

    Stice, Eric; Rohde, Paul; Gau, Jeff M.; Wade, Emily

    2010-01-01

    Objective: To evaluate the effects of a brief group cognitive-behavioral (CB) depression prevention program for high-risk adolescents with elevated depressive symptoms at 1- and 2-year follow-up. Method: In this indicated prevention trial, 341 at-risk youths were randomized to a group CB intervention, group supportive expressive intervention, CB…

  20. Effects of exercise intensity and nutrition advice on myocardial function in obese children and adolescents: a multicentre randomised controlled trial study protocol

    Science.gov (United States)

    Dias, Katrin A; Coombes, Jeff S; Green, Daniel J; Gomersall, Sjaan R; Keating, Shelley E; Tjonna, Arnt Erik; Hollekim-Strand, Siri Marte; Hosseini, Mansoureh Sadat; Ro, Torstein Baade; Haram, Margrete; Huuse, Else Marie; Davies, Peter S W; Cain, Peter A; Leong, Gary M; Ingul, Charlotte B

    2016-01-01

    Introduction The prevalence of paediatric obesity is increasing, and with it, lifestyle-related diseases in children and adolescents. High-intensity interval training (HIIT) has recently been explored as an alternate to traditional moderate-intensity continuous training (MICT) in adults with chronic disease and has been shown to induce a rapid reversal of subclinical disease markers in obese children and adolescents. The primary aim of this study is to compare the effects of HIIT with MICT on myocardial function in obese children and adolescents. Methods and analysis Multicentre randomised controlled trial of 100 obese children and adolescents in the cities of Trondheim (Norway) and Brisbane (Australia). The trial will examine the efficacy of HIIT to improve cardiometabolic outcomes in obese children and adolescents. Participants will be randomised to (1) HIIT and nutrition advice, (2) MICT and nutrition advice or (3) nutrition advice. Participants will partake in supervised exercise training and/or nutrition sessions for 3 months. Measurements for study end points will occur at baseline, 3 months (postintervention) and 12 months (follow-up). The primary end point is myocardial function (peak systolic tissue velocity). Secondary end points include vascular function (flow-mediated dilation assessment), quantity of visceral and subcutaneous adipose tissue, myocardial structure and function, body composition, cardiorespiratory fitness, autonomic function, blood biochemistry, physical activity and nutrition. Lean, healthy children and adolescents will complete measurements for all study end points at one time point for comparative cross-sectional analyses. Ethics and dissemination This randomised controlled trial will generate substantial information regarding the effects of exercise intensity on paediatric obesity, specifically the cardiometabolic health of this at-risk population. It is expected that communication of results will allow for the development of

  1. Mechanisms and Reduction in Psychiatry

    DEFF Research Database (Denmark)

    Andersen, Lise Marie

    2016-01-01

    The view that psychiatry should be elucidating the mechanisms behind mental phenomena is gaining momentum. This view, coupled with an intuition that such mechanisms must, by nature, be biological, has inspired the field to look to cognitive neuroscience for classification of mental illnesses. One...... of causation and mechanism to bridge the gab between mechanistic explanations and multilevel models of mental disorders....

  2. State of psychiatry in Denmark

    DEFF Research Database (Denmark)

    Bauer, Jeanett Østerby; Okkels, Niels; Munk-Jørgensen, Povl

    2012-01-01

    of the statistics. Over the same 30 years, the number of available beds has been reduced by 60-70%; however, as the length of stay of inpatients has been reduced markedly, the departments are still able to treat a high number of patients. The financial budgeting of psychiatry is not increasing equivalently...

  3. Historical aspects of Mexican psychiatry.

    Science.gov (United States)

    Bayardo, Sergio Javier Villaseñor

    2016-04-01

    Mexican psychiatry initiated since pre-Hispanic times. Historically, treatments were a mixture of magic, science and religion. Ancient Nahuas had their own medical concepts with a holistic view of medicine, considering men and cosmos as a whole. The first psychiatric hospital appeared in 1566 and a more modern psychiatric asylum emerged until 1910. International exchanges of theoretical approaches started in the National University with the visit of Pierre Janet. There were other important figures that influenced Mexican psychiatry, such as Erich Fromm, Henri Ey, Jean Garrabé and Yves Thoret. Regarding Mexican psychiatrists, some of the most important contributors to Mexican psychiatry were José Luis Patiño Rojas, Manuel Guevara Oropeza and Ramón de la Fuente Muñiz. This article includes excerpts from "Clinical Psychiatry", a book by Patiño Rojas where he tries to understand and describe the inner world experienced by patients with schizophrenia; also, the thesis conducted by Guevara Oropeza ("Psychoanalisis"), which is a critical comparison between the theories of Janet and Freud. Finally, we include "The study of consciousness: current status" by Ramón de la Fuente, which leads us through the initial investigations concerning consciousness, its evolution, and the contributions made by psychology, philosophy and neurobiology.

  4. Early intervention for adolescents with patellofemoral pain syndrome--a pragmatic cluster randomised controlled trial

    DEFF Research Database (Denmark)

    Rathleff, Michael Skovdal; Roos, Ewa M.; Olesen, Jens;

    2012-01-01

    Self-reported knee pain is highly prevalent among adolescents. As much as 50% of the non-specific knee pain may be attributed to Patellofemoral Pain Syndrome (PFPS). In the short term, exercise therapy appears to have a better effect than patient education consisting of written information...

  5. Fluoxetine in Treatment of Adolescent Patients with Autism: A Longitudinal Open Trial.

    Science.gov (United States)

    Fatemi, S. Hossein; Realmuto, George M.; Khan, Lubna; Thuras, Paul

    1998-01-01

    Retrospective chart reviews of seven adolescents and young adults (ages 9-20) with autistic disorder treated with fluoxetine alone or in combination with other medications were performed. Side effects included initial appetite suppression, vivid dreams, and hyperactivity. Improvement was seen in irritability, lethargy, sterotypy, and inappropriate…

  6. Leveraging microfinance to impact HIV and financial behaviors among adolescents and their mothers in West Bengal: a cluster randomized trial.

    Science.gov (United States)

    Spielberg, Freya; Crookston, Benjamin T; Chanani, Sheila; Kim, Jaewhan; Kline, Sean; Gray, Bobbi L

    2013-01-01

    Microfinance can be used to reach women and adolescent girls with HIV prevention education. We report findings from a cluster-randomized control trial among 55 villages in West Bengal to determine the impact of non-formal education on knowledge, attitudes and behaviors for HIV prevention and savings. Multilevel regression models were used to evaluate differences between groups for key outcomes while adjusting for cluster correlation and differences in baseline characteristics. Women and girls who received HIV education showed significant gains in HIV knowledge, awareness that condoms can prevent HIV, self-efficacy for HIV prevention, and confirmed use of clean needles, as compared to the control group. Condom use was rare and did not improve for women. While HIV testing was uncommon, knowledge of HIV-testing resources significantly increased among girls, and trended in the positive direction among women in intervention groups. Conversely, the savings education showed no impact on financial knowledge or behavior change.

  7. Internet-delivered cognitive-behavioral treatment for adolescents with chronic pain and their parents: a randomized controlled multicenter trial.

    Science.gov (United States)

    Palermo, Tonya M; Law, Emily F; Fales, Jessica; Bromberg, Maggie H; Jessen-Fiddick, Tricia; Tai, Gabrielle

    2016-01-01

    Internet-delivered interventions are emerging as a strategy to address barriers to care for individuals with chronic pain. This is the first large multicenter randomized controlled trial of Internet-delivered cognitive-behavioral therapy (CBT) for pediatric chronic pain. Participants included were 273 adolescents (205 females and 68 males), aged 11 to 17 years with mixed chronic pain conditions and their parents, who were randomly assigned in a parallel-group design to Internet-delivered CBT (n = 138) or Internet-delivered Education (n = 135). Assessments were completed before treatment, immediately after treatment, and at 6-month follow-up. All data collection and procedures took place online. The primary analysis used linear growth models. Results demonstrated significantly greater reduction on the primary outcome of activity limitations from baseline to 6-month follow-up for Internet CBT compared with Internet education (b = -1.13, P = 0.03). On secondary outcomes, significant beneficial effects of Internet CBT were found on sleep quality (b = 0.14, P = 0.04), on reducing parent miscarried helping (b = -2.66, P = 0.007) and protective behaviors (b = -0.19, P = 0.001), and on treatment satisfaction (P values pain, and improvement in parent behavioral responses to pain). In conclusion, our Internet-delivered CBT intervention produced a number of beneficial effects on adolescent and parent outcomes, and could ultimately lead to wide dissemination of evidence-based psychological pain treatment for youth and their families.

  8. Training in psychiatry throughout Europe.

    Science.gov (United States)

    Brittlebank, Andrew; Hermans, Marc; Bhugra, Dinesh; Pinto da Costa, Mariana; Rojnic-Kuzman, Martina; Fiorillo, Andrea; Kurimay, Tamas; Hanon, Cecile; Wasserman, Danuta; van der Gaag, Rutger Jan

    2016-03-01

    Psychiatry is the largest medical specialty in Europe. Despite efforts to bring harmonisation, training in psychiatry in Europe continues to be very diverse. The Union Européenne des Médecins Spécialistes (UEMS) has issued as from 2000 a charter of requirements for the training in psychiatry with an additional European Framework for Competencies in Psychiatry in 2009. Yet these have not been implemented throughout Europe. In this paper, the diversity in training throughout Europe is approached from different angles: the cultural differences between countries with regards to how mental health care is considered and founded on, the cultural differences between people throughout Europe in all states. The position of psychotherapy is emphasised. What once was the cornerstone of psychiatry as medical specialty seems to have become a neglected area. Seeing the patient with mental health problems within his cultural context is important, but considering him within his family context. The purpose of any training is enabling the trainee to gain the knowledge and acquire the competencies necessary to become a well-equipped professional is the subject of the last paragraph in which trainees consider their position and early career psychiatrists look back to see whether what they were trained in matches with what they need in the working situation. Common standard for training and certification are a necessity within Europe, for the benefit of the profession of psychiatrist but also for patient safety. UEMS is advised to join forces with the Council of National Psychiatric Associations (NPAs) within the EPA and trainings and early career psychiatrist, to discuss with the users what standards should be implemented in all European countries and how a European board examination could ensure professional quality of psychiatrists throughout the continent.

  9. Cinnarizine versus Topiramate in Prophylaxis of Migraines among Children and Adolescents: A Randomized, Double-Blind Clinical Trial

    Directory of Open Access Journals (Sweden)

    Mahmoud Reza ASHRAFI

    2014-12-01

    Full Text Available How to Cite This Article: Ashrafi MR, Najafi Z, Shafiei M, Heidari K, Togha M. Cinnarizinev ersus Topiramate in Prophylaxis of Migraines among Children and Adolescents: A Randomized, Double-Blind Clinical Trial. Iran J Child Neurol. 2014 Autumn;8(4: 18-27. AbstractObjectiveMigraines, a common health problem in children and adolescents, still do not have an FDA approved preventive treatment for patients under the age of 18 years. This study compares and contrasts the efficacy and safety of cinnarizine and topiramate in preventing pediatric migraines.Materials & MethodsIn this randomized, double-blind clinical trial 44 migrainous (from 4–15 years of age were equally allocated to receive cinnarizine or topiramate. The primary efficacy measure was monthly migraine frequency. Secondary efficacy measures were monthly migraine intensity and ≥ 50% responder rate. Efficacy measures were recorded at the baseline and at 4, 8, and 12 weeks of treatment.ResultsDuring the double-blind phase of the study, monthly migraine frequency and intensity were significantly decreased in both the cinnarizine and topiramate groups when compared to the baseline. However, at the end of the study, the cinnarizine group exhibits a significant decrease from the baseline in the mean monthly migraine intensity when compared to the topiramate group (4.7 vs. 3, respectively; 95% CI = -0.8 to -3.2.ConclusionNo significant difference between cinnarizine and topiramate was found for the prevention of pediatric migraines. Both treatments were well tolerated.ReferencesHershey AD, Winner PK. Pediatric Migraine: Recognition and Treatment. J Am Osteopath Assoc. 2005;105:2S-8.Lewis DW, Yonker M, Winner P, Sowell M. The treatment of pediatric migraine. Pediatric Annals. 2005;34:448-460.Abu-Arefeh I, Russell G. Prevalence of headache and migraine in schoolchildren. BMJ. 1994;309:765-769.Linet MS, Stewart WF, Celentano DD, Ziegler D, Sprecher M. An Epidemiologic Study of Headache among

  10. Two-year outcomes of an adjunctive telephone coaching and electronic contact intervention for adolescent weight-loss maintenance: the Loozit randomized controlled trial.

    Science.gov (United States)

    Nguyen, B; Shrewsbury, V A; O'Connor, J; Steinbeck, K S; Hill, A J; Shah, S; Kohn, M R; Torvaldsen, S; Baur, L A

    2013-03-01

    This paper reports the final 24-month outcomes of a randomized controlled trial evaluating the effect of additional therapeutic contact (ATC) as an adjunct to a community-based weight-management program for overweight and obese 13-16-year-olds. ATC involved telephone coaching or short-message-service and/or email communication once per fortnight. Adolescents were randomized to receive the Loozit group program-a two-phase behavioral lifestyle intervention with (n=73), or without (n=78), ATC in Phase 2. Adolescents/parents separately attended seven weekly group sessions (Phase 1), followed by quarterly adolescent sessions (Phase 2). Assessor-blinded, 24-month changes in anthropometry and metabolic health included primary outcomes body mass index (BMI) z-score and waist:height ratio (WHtR). Secondary outcomes were self-reported psychosocial and lifestyle changes. By 24 months, 17 adolescents had formally withdrawn. Relative to the Loozit program alone, ATC largely had no impact on outcomes. Secondary pre-post assessment of the Loozit group program showed mean (95% CI) reductions in BMI z-score (-0.13 (-0.20, -0.06)) and WHtR (-0.02 (-0.03, -0.01)) in both arms, with several metabolic and psychosocial improvements. Adjunctive ATC did not provide further benefits to the Loozit group program. We recommend that further work is needed to optimize technological support for adolescents in weight-loss maintenance. Australian New Zealand Clinical Trials Registry Number ACTRNO12606000175572.

  11. Problems of adolescence

    CERN Multimedia

    Feldmann

    1968-01-01

    Le Prof.Feldmann, Prof. de psychiatrie à l'Université de Genève, donne une suite de la conférence du novembre 1967 en parlant des besoins de l'adolescent et l'aspect pratique, suivi d'une discussion

  12. One-hour after-school exercise ameliorates central adiposity and lipids in overweight Chinese adolescents: a randomized controlled trial

    Institute of Scientific and Technical Information of China (English)

    SUN Ming-xiao; SHI Xiao-cai; LI Jian; XIE Min-hao; HUANG Xiu-qing; YAN Yi; LI Bo-wen; ZHONG Wei-juan; CHEN Jun-fei; ZHANG Yi-min; WANG Zheng-zhen; WANG Lu

    2011-01-01

    Background The prevalence of overweight and obesity in Chinese children and adolescents was increasing during the past few decades. The goal of this study was to investigate the effects of after-school exercise with or without diet restriction on total and central obesity, fitness level, and metabolic profile in overweight Chinese adolescents.Methods A ten-week weight loss trial was performed using a 2×2 block design (exercisexdiet). Ninety-three overweight adolescents (average age:(13.6±0.7) years; body mass index (BMI): 22.4-34.1 kg/m2) were randomly assigned to four groups:1) diet (D); 2) exercise (EX); 3) diet plus exercise (DEX); and 4) overweight control (C). Caloric intake recipes were enacted based on individual age and corresponding ideal body weight. One-hour after-school exercise was performed once per day, four days per week for ten weeks. Changes of anthropometry, body composition, aerobic fitness,and metabolic biomarkers were determined.Results Groups D, EX and DEX had a significant decrease in BMI (P<0.01) after the intervention. The percentage of body and truncal fat, and waist circumference were independently reduced by exercise (P<0.05 and P <0.01), but not diet. The decrease in body fat percentage was positively related with the exercise compliance (r=0.34,P=0.01). Exercise decreased truncal fat percentage and waist circumference, suggesting a reduction of central adiposity, but did not significantly affect body weight and BMI. Exercise significantly reduced serum low-density lipoprotein cholesterol (P=0.037), which was positively correlated with decreases of truncal fat percentage (r=0.222, P=0.048). No significant effects of interventions on insulin sensitivity, early insulin release index, and aerobic fitness were observed.Conclusion At least twice a week of one-hour after-school exercise significantly attenuated central adiposity and had a significant impact on lipid profiles in overweight Chinese adolescents.

  13. Aripiprazole versus risperidone for treating children and adolescents with tic disorder: a randomized double blind clinical trial.

    Science.gov (United States)

    Ghanizadeh, Ahmad; Haghighi, Alireza

    2014-10-01

    There are some uncontrolled studies about the efficacy and safety of both aripiprazole and risperidone for treating tic disorder. Moreover, the efficacy of these medications has never been compared. This is the first double blind randomized clinical trial comparing the safety and efficacy of aripiprazole and risperidone for treating patients with tic disorder. Sixty children and adolescents with tic disorder were randomly allocated into one of the two groups to receive either aripiprazole or risperidone for 2 months. The primary outcome measure was the score of Yale Global Tic Severity Scale. In addition, health related quality of life and adverse events were assessed. Both aripiprazole and risperidone decreased the Yale Global Tic Severity Scale score during this trial. Moreover, both medications increased the health related quality of life score. Both aripiprazole and risperidone were tolerated well. Aripiprazole [3.22 (1.9) mg/day] decreased tic score as much as risperidone [0.6 (0.2) mg/day]. Their adverse effects and their effects on health related quality of life were comparable. However, risperidone increased the patients' social functioning more than aripiprazole in short term.

  14. A trial of d-cycloserine to treat the social deficit in older adolescents and young adults with autism spectrum disorders.

    Science.gov (United States)

    Urbano, Maria; Okwara, Leonore; Manser, Paul; Hartmann, Kathrin; Deutsch, Stephen I

    2015-01-01

    Autism spectrum disorders are difficult for older adolescents and young adults as impaired social communication affects the transition to adult life. d-Cycloserine, a partial glycine agonist at the N-methyl-d-aspartic acid receptor, was tested in a double-blind randomized trial in 20 older adolescents and young adults with autism spectrum disorders using two dosing strategies (50 mg daily versus 50 mg weekly) for 8 weeks with a 2-week follow-up after discontinuation. d-Cycloserine caused statistically and clinically significant improvement with no differentiation between dosing strategies on the Social Responsiveness Scale and the Aberrant Behavior Checklist before and after d-cycloserine administration.

  15. Recommendations for switching antipsychotics. A position statement of the Spanish Society of Psychiatry and the Spanish Society of Biological Psychiatry.

    Science.gov (United States)

    Bernardo, Miquel; Vieta, Eduard; Saiz Ruiz, Jerónimo; Rico-Villademoros, Fernando; Alamo, Cecilio; Bobes, Julio

    2011-07-01

    Switching antipsychotics is common in the clinical practice setting and is associated with potential clinically relevant complications. An expert group selected by Spanish Society of Psychiatry and the Spanish Society of Biological Psychiatry has reviewed the evidence provided by randomized clinical trials and other relevant information to reach consensus recommendations for switching antipsychotics. In this article, we will review all the information that has led to those recommendations and which includes: indications and contraindications for switching antipsychotics, pharmacological issues, switching strategies, switching antipsychotics due to efficacy problems, switching antispychotics due to tolerability issues (including extrapyramidal symptoms and tardive dyskinesia, weight gain, metabolic disorders, hyperprolactinemia, sexual dysfunction, persistent sedation, and QT prolongation), switching antypsychotics due to lack of treatment compliance, and switching antipsychotics in patients with bipolar disorders.

  16. Placebo eff ects in psychiatry: mediators and moderators.

    Science.gov (United States)

    Weimer, Katja; Colloca, Luana; Enck, Paul

    2015-03-01

    A strong placebo response in psychiatric disorders has been noted for the past 50 years and various attempts have been made to identify predictors of it, by use of meta-analyses of randomised controlled trials and laboratory studies. We reviewed 31 meta-analyses and systematic reviews of more than 500 randomised placebo-controlled trials across psychiatry (depression, schizophrenia, mania, attention-deficit hyperactivity disorder, autism, psychosis, binge-eating disorder, and addiction) for factors identified to be associated with increased placebo response. Of 20 factors discussed, only three were often linked to high placebo responses: low baseline severity of symptoms, more recent trials, and unbalanced randomisation (more patients randomly assigned to drug than placebo). Randomised controlled trials in non-drug therapy have not added further predictors, and laboratory studies with psychological, brain, and genetic approaches have not been successful in identifying predictors of placebo responses. This comprehensive Review suggests that predictors of the placebo response are still to be discovered, the response probably has more than one mediator, and that different and distinct moderators are probably what cause the placebo response within psychiatry and beyond.

  17. Secular humanism and "scientific psychiatry".

    Science.gov (United States)

    Szasz, Thomas

    2006-04-25

    The Council for Secular Humanism identifies Secular Humanism as a "way of thinking and living" committed to rejecting authoritarian beliefs and embracing "individual freedom and responsibility ... and cooperation." The paradigmatic practices of psychiatry are civil commitment and insanity defense, that is, depriving innocent persons of liberty and excusing guilty persons of their crimes: the consequences of both are confinement in institutions ostensibly devoted to the treatment of mental diseases. Black's Law Dictionary states: "Every confinement of the person is an 'imprisonment,' whether it be in a common prison, or in private house, or in the stocks, or even by forcibly detaining one in the public streets." Accordingly, I maintain that Secular Humanism is incompatible with the principles and practices of psychiatry.

  18. Secular humanism and "scientific psychiatry"

    Directory of Open Access Journals (Sweden)

    Szasz Thomas

    2006-04-01

    Full Text Available Abstract The Council for Secular Humanism identifies Secular Humanism as a "way of thinking and living" committed to rejecting authoritarian beliefs and embracing "individual freedom and responsibility ... and cooperation." The paradigmatic practices of psychiatry are civil commitment and insanity defense, that is, depriving innocent persons of liberty and excusing guilty persons of their crimes: the consequences of both are confinement in institutions ostensibly devoted to the treatment of mental diseases. Black's Law Dictionary states: "Every confinement of the person is an 'imprisonment,' whether it be in a common prison, or in private house, or in the stocks, or even by forcibly detaining one in the public streets." Accordingly, I maintain that Secular Humanism is incompatible with the principles and practices of psychiatry.

  19. Secular humanism and "scientific psychiatry"

    OpenAIRE

    2006-01-01

    Abstract The Council for Secular Humanism identifies Secular Humanism as a "way of thinking and living" committed to rejecting authoritarian beliefs and embracing "individual freedom and responsibility ... and cooperation." The paradigmatic practices of psychiatry are civil commitment and insanity defense, that is, depriving innocent persons of liberty and excusing guilty persons of their crimes: the consequences of both are confinement in institutions ostensibly devoted to the treatment of m...

  20. Psychiatry and humanism in Argentina.

    Science.gov (United States)

    Niño Amieva, Alejandra

    2016-04-01

    The authors of the present selection of Latin American Psychiatry texts were characterized by a common deep humanistic attitude. These prolific writers were able to establish or extend the scope of the discipline in which they chose to act, questioning the establishment of rigid boundaries within the framework of a rigorous epistemological reflection. Thus the systematizing spirit of Jose Ingenieros' in the context of positivist evolutionism, resulted in the act of founding a discipline that integrated the biological and the social. In the case of Guillermo Vidal his conception of mental health went beyond the biomedical to consider psychotherapies as an emotional commitment, continence and empathic understanding; with regard to César Cabral his formation and extensive clinical practice resulted in a work defined by the inquiring into the theoretical concepts underlying Psychiatry and Clinical Psychology. This brief selection does not exhaust the issues or the level of ideas and discussions of Psychiatry in Argentina, but constitutes a textual corpus representative of a disciplinary conception understood as scientific and humanistic endeavor.

  1. Attitudes of Medical Students toward Psychiatry and Psychiatry as a Career: A Systematic Review

    Science.gov (United States)

    Lyons, Zaza

    2013-01-01

    Objective: The discipline of psychiatry, and psychiatry as a career option, have been negatively regarded by medical students for decades. There is a large amount of literature on attitudes of students and the factors that attract them to and detract from psychiatry. The aim of this article is to systematically review this literature from 1990 to…

  2. A randomised controlled trial of a community-based healthy lifestyle program for overweight and obese adolescents: the Loozit® study protocol

    Directory of Open Access Journals (Sweden)

    Shah Smita

    2009-04-01

    Full Text Available Abstract Background There is a need to develop sustainable and clinically effective weight management interventions that are suitable for delivery in community settings where the vast majority of overweight and obese adolescents should be treated. This study aims to evaluate the effect of additional therapeutic contact as an adjunct to the Loozit® group program – a community-based, lifestyle intervention for overweight and lower grade obesity in adolescents. The additional therapeutic contact is provided via telephone coaching and either mobile phone Short Message Service or electronic mail, or both. Methods and design The study design is a two-arm randomised controlled trial that aims to recruit 168 overweight and obese 13–16 year olds (Body Mass Index z-score 1.0 to 2.5 in Sydney, Australia. Adolescents with secondary causes of obesity or significant medical illness are excluded. Participants are recruited via schools, media coverage, health professionals and several community organisations. Study arm one receives the Loozit® group weight management program (G. Study arm two receives the same Loozit® group weight management program plus additional therapeutic contact (G+ATC. The 'G' intervention consists of two phases. Phase 1 involves seven weekly group sessions held separately for adolescents and their parents. This is followed by phase 2 that involves a further seven group sessions held regularly, for adolescents only, until two years follow-up. Additional therapeutic contact is provided to adolescents in the 'G+ATC' study arm approximately once per fortnight during phase 2 only. Outcome measurements are assessed at 2, 12 and 24 months post-baseline and include: BMI z-score, waist z-score, metabolic profile indicators, physical activity, sedentary behaviour, eating patterns, and psychosocial well-being. Discussion The Loozit® study is the first randomised controlled trial of a community-based adolescent weight management

  3. The use of cognitive behavioral therapy in the treatment of resistant depression in adolescents

    Directory of Open Access Journals (Sweden)

    Prieto-Hicks X

    2012-09-01

    Full Text Available Sarah Hamill-Skoch,1 Paul Hicks,2 Ximena Prieto-Hicks11Department of Psychiatry, 2Department of Family and Community Medicine, University of Arizona, Tuscon, AZ, USAAbstract: Major depressive disorder often begins in adolescence, is chronic and recurrent, and heightens an individual's risk for major depressive disorder in adulthood. Treatment-resistant depression is a problem for a significant minority of adolescents. Few studies have examined treatments for treatment-resistant depression among adolescents, and even fewer have examined the use of cognitive-behavioral therapy as a monotherapy or in combination with pharmacological treatments. Mental health professionals have a strong interest in understanding what treatments are appropriate for adolescents who are treatment resistant. Preliminary evidence from current published trials indicates that the use of cognitive-behavioral therapy in combination with antidepressant medication yields the best outcome for treatment-resistant depression in adolescents. Secondary analyses also suggest that the utility of cognitive behavioral therapy can be increased by ensuring adolescents receive a therapeutic dose of treatment sessions (more than nine sessions and the inclusion of two treatment components: social skills and problem solving training. Guidelines for clinicians as well as areas for future research are discussed.Keywords: cognitive behavior therapy, treatment-resistant depression, adolescent depression

  4. The troubled relationship between psychiatry and sociology.

    Science.gov (United States)

    Pilgrim, David; Rogers, Anne

    2005-09-01

    The alienated relationship between psychiatry and sociology is explored. The two disciplines largely took divergent paths after 1970. On the one side, psychiatry manifested a pre-occupation with methodological questions and sought greater medical respectability, with a biomedical approach returning to the fore. Social psychiatry and its underpinning biopsychosocial model became increasingly marginalised and weakened. On the other side, many sociologists turned away from psychiatry and the epidemiological study of mental health problems and increasingly restricted their interest to social theory and qualitative research. An interdisciplinary void ensued, to the detriment of the investigation of social aspects of mental health.

  5. Positive psychiatry: its time has come.

    Science.gov (United States)

    Jeste, Dilip V; Palmer, Barton W; Rettew, David C; Boardman, Samantha

    2015-06-01

    Traditionally, psychiatry has been defined and practiced as a branch of medicine focused on the diagnosis and treatment of mental illnesses. Based on growing empirical evidence, we believe that this definition warrants expansion to include the concept of positive psychiatry. In the present article, we provide a critical overview of this emerging field and a select review of relevant scientific literature. Positive psychiatry may be defined as the science and practice of psychiatry that seeks to understand and promote well-being through assessment and interventions involving positive psychosocial characteristics (PPCs) in people who suffer from or are at high risk of developing mental or physical illnesses. It can also benefit nonclinical populations. Positive psychiatry has 4 main components: (1) positive mental health outcomes (eg, well-being), (2) PPCs that comprise psychological traits (resilience, optimism, personal mastery and coping self-efficacy, social engagement, spirituality and religiosity, and wisdom-including compassion) and environmental factors (family dynamics, social support, and other environmental determinants of overall health), (3) biology of positive psychiatry constructs, and (4) positive psychiatry interventions including preventive ones. There are promising empirical data to suggest that positive traits may be improved through psychosocial and biological interventions. As a branch of medicine rooted in biology, psychiatry, especially with the proposed conceptualization of positive psychiatry, is well poised to provide major contributions to the positive mental health movement, thereby impacting the overall health care of the population.

  6. Computerised cognitive–behavioural therapy for depression in adolescents: feasibility results and 4-month outcomes of a UK randomised controlled trial

    Science.gov (United States)

    Wright, Barry; Tindall, Lucy; Littlewood, Elizabeth; Allgar, Victoria; Abeles, Paul; Trépel, Dominic; Ali, Shehzad

    2017-01-01

    Objectives Computer-administered cognitive–behavioural therapy (CCBT) may be a promising treatment for adolescents with depression, particularly due to its increased availability and accessibility. The feasibility of delivering a randomised controlled trial (RCT) comparing a CCBT program (Stressbusters) with an attention control (self-help websites) for adolescent depression was evaluated. Design Single centre RCT feasibility study. Setting The trial was run within community and clinical settings in York, UK. Participants Adolescents (aged 12–18) with low mood/depression were assessed for eligibility, 91 of whom met the inclusion criteria and were consented and randomised to Stressbusters (n=45) or websites (n=46) using remote computerised single allocation. Those with comorbid physical illness were included but those with psychosis, active suicidality or postnatal depression were not. Interventions An eight-session CCBT program (Stressbusters) designed for use with adolescents with low mood/depression was compared with an attention control (accessing low mood self-help websites). Primary and secondary outcome measures Participants completed mood and quality of life measures and a service Use Questionnaire throughout completion of the trial and 4 months post intervention. Measures included the Beck Depression Inventory (BDI) (primary outcome measure), Mood and Feelings Questionnaire (MFQ), Spence Children's Anxiety Scale (SCAS), the EuroQol five dimensions questionnaire (youth) (EQ-5D-Y) and Health Utility Index Mark 2 (HUI-2). Changes in self-reported measures and completion rates were assessed by treatment group. Results From baseline to 4 months post intervention, BDI scores and MFQ scores decreased for the Stressbusters group but increased in the website group. Quality of life, as measured by the EQ-5D-Y, increased for both groups while costs at 4 months were similar to baseline. Good feasibility outcomes were found, suggesting the trial process to be

  7. Effective Treatment of Depressive Disorders in Medical Clinics for Adolescents and Young Adults living with HIV: A controlled trial

    Science.gov (United States)

    Brown, Larry K.; Kennard, Betsy D.; Emslie, Graham J.; Mayes, Taryn L.; Whiteley, Laura B.; Bethel, James; Xu, Jiahong; Thornton, Sarah; Tanney, Mary R.; Hawkins, Linda A.; Garvie, Patricia A.; Subramaniam, Geetha A.; Worrell, Carol J.; Stoff, Laura W.

    2015-01-01

    Objective Preliminary test of a manualized, measurement-guided treatment for depression for adolescents and young adults in care at four sites of the Adolescent Trials Network for HIV/AIDS Interventions (ATN). Design The U.S. sites were randomly assigned to either a 24-week, combination cognitive behavioral therapy and medication management algorithm (COMB) tailored for youth living with HIV (YLWH) or to treatment as usual (TAU). Methods Youth at TAU sites had access to therapists and medication management as needed. COMB site clinicians were trained in the manualized intervention and participated in supervision calls to monitor intervention fidelity. Results Over the course of the study with 44 participants, those in COMB, compared to those in TAU, reported fewer depressive symptoms, p<0.01 (as measured by the Quick Inventory for Depression Symptomatology) and were more likely to be in remission, p<0.001, (65% vs.10% at week 24 end of treatment, and 71% vs. 7% at week 48 final follow-up). A greater proportion of COMB participants received psychotherapy (95% vs. 45%, p<0.001) and attended more sessions (12.6 vs. 5, p<0.001) than those in TAU. Viral load decreased in both groups and was associated (p<0.05) with reduction in depressive symptoms. Conclusions A 24-week manualized, measurement-guided psychotherapy and medication management algorithm tailored for YLWH was more effective in achieving and sustaining remission from depression than treatment as usual at HIV care clinic sites. Given observed treatment efficacy, this structured combination treatment could be disseminated to medical clinics in order to successfully treat YLWH, who are at particular risk for depression. PMID:26761270

  8. Seeds of prevention: the impact on health behaviors of young adolescent girls in Uttar Pradesh, India, a cluster randomized control trial.

    Science.gov (United States)

    Kapadia-Kundu, Nandita; Storey, Douglas; Safi, Basil; Trivedi, Geetali; Tupe, Rama; Narayana, G

    2014-11-01

    Of the world's 1.2 billion adolescents (10-19 years), India is home to the largest number globally, about 243 million. However not much is known about the health of young adolescent girls (11-14 years) in India who enter puberty with substantial nutritional and health deficits. Identifying early adolescence as a "gateway" moment, the Saloni pilot study is arandomized control trial (RCT) to improve nutrition, hygiene and reproductive health behaviors in 30 schools in rural Uttar Pradesh (UP), India. A prevention model that includes Sadharanikaran, an ancient Indian theory of communication, guided the development of the intervention. The Saloni strategy includes a 10 session in-school intervention based on compassion, self efficacy, emotional well being, peer and parental support, packaged in the form of short, easy-to-use instructional modules. A diary designed to engage adolescent girls is provided to each girl. The cluster RCT was conducted from January 2010 to October 2011 with adolescent girls (11-14 years of age) in Hardoi district. The trial is a two-level, nested RCT with the unit of randomization being the block with 15 schools in the intervention arm and 15 schools in the control arm. A sample of 1200 girls was randomly selected. The intervention had a significant impact on more than 13 preventive health behaviors. About 65 percent girls in the intervention group had adopted 13 or more health behaviors at end line compared 4.5 percent in the control group at end line and 5 percent at baseline. Behavioral impact was demonstrated in all three areas of nutrition, hygiene and reproductive health. The study provides evidence that early adolescence is indeed a "gateway moment" to build nutritional and health reserves.

  9. How psychiatry journals support the unbiased translation of clinical research. A cross-sectional study of editorial policies.

    Directory of Open Access Journals (Sweden)

    Hannes Knüppel

    Full Text Available INTRODUCTION: Reporting guidelines (e.g. CONSORT have been developed as tools to improve quality and reduce bias in reporting research findings. Trial registration has been recommended for countering selective publication. The International Committee of Medical Journal Editors (ICMJE encourages the implementation of reporting guidelines and trial registration as uniform requirements (URM. For the last two decades, however, biased reporting and insufficient registration of clinical trials has been identified in several literature reviews and other investigations. No study has so far investigated the extent to which author instructions in psychiatry journals encourage following reporting guidelines and trial registration. METHOD: Psychiatry Journals were identified from the 2011 Journal Citation Report. Information given in the author instructions and during the submission procedure of all journals was assessed on whether major reporting guidelines, trial registration and the ICMJE's URM in general were mentioned and adherence recommended. RESULTS: We included 123 psychiatry journals (English and German language in our analysis. A minority recommend or require 1 following the URM (21%, 2 adherence to reporting guidelines such as CONSORT, PRISMA, STROBE (23%, 7%, 4%, or 3 registration of clinical trials (34%. The subsample of the top-10 psychiatry journals (ranked by impact factor provided much better but still improvable rates. For example, 70% of the top-10 psychiatry journals do not ask for the specific trial registration number. DISCUSSION: Under the assumption that better reported and better registered clinical research that does not lack substantial information will improve the understanding, credibility, and unbiased translation of clinical research findings, several stakeholders including readers (physicians, patients, authors, reviewers, and editors might benefit from improved author instructions in psychiatry journals. A first step of

  10. Recruitment of Minority Adolescents and Young Adults into Randomised Clinical Trials: Testing the Design of the Technology Enhanced Community Health Nursing (TECH-N) Pelvic Inflammatory Disease Trial

    Science.gov (United States)

    Trent, Maria; Chung, Shang-en; Gaydos, Charlotte; Frick, Kevin D.; Anders, Jennifer; Huettner, Steven; Rothman, Richard; Butz, Arlene

    2016-01-01

    Purpose Pelvic inflammatory disease (PID) disproportionately affects adolescent and young adult (AYA) women and can negatively influence reproductive health trajectories. Few randomized controlled trials (RCTs) have focused on strategies to improve outpatient adherence or to reduce reproductive morbidity in this population. This paper describes the research methods and preliminary effectiveness of recruitment, retention, and intervention strategies employed in a novel RCT designed to test a technology-enhanced community-health nursing (TECH-N) intervention among urban AYA with PID. Methods AYA women aged 13–25 years were recruited during acute PID visits in outpatient clinics and emergency departments (ED) to participate in this IRB-approved trial. Participants completed an audio-computerized self-interview (ACASI), provided vaginal specimens, and were randomized to standard treatment or the intervention. Intervention participants received text-messaging support for 30 days and a community health nurse (CHN) interventionist performed a home visit with clinical assessment within 5 days after enrollment. All patients received a full course of medications and completed research visits at 14-days (adherence), 30 days and 90 days with by an outreach worker. STI testing performed at the 30-and 90-day visits. Exploratory analyses using descriptive statistics were conducted to examine recruitment, retention, and follow-up data to test the overall design of the intervention. Results In the first 48 months, 64% of 463 patients were eligible for the study and 81.2% of 293 eligible patients were recruited for the study (63.3%); 238 (81.2%) of eligible patients were enrolled. Most participants were African American (95.6%) with a mean age of 18.6 (2.3). Ninety-four percent of individuals assigned to the TECH-N intervention completed the nursing visits. All completed visits have been within the 5-day window and over 90% of patients in both arms have been retained over the 3

  11. Omega-3/Omega-6 Fatty Acids for Attention Deficit Hyperactivity Disorder: A Randomized Placebo-Controlled Trial in Children and Adolescents

    Science.gov (United States)

    Johnson, Mats; Ostlund, Sven; Fransson, Gunnar; Kadesjo, Bjorn; Gillberg, Christopher

    2009-01-01

    Objective: The aim of the study was to assess omega 3/6 fatty acids (eye q) in attention deficit hyperactivity disorder (ADHD). Method: The study included a randomized, 3-month, omega 3/6 placebo-controlled, one-way crossover trial with 75 children and adolescents (8-18 years), followed by 3 months with omega 3/6 for all. Investigator-rated ADHD…

  12. Klapp method effect on idiopathic scoliosis in adolescents: blind randomized controlled clinical trial

    OpenAIRE

    Dantas, Diego de Sousa; Assis, Sanderson José Costa de; Baroni, Marina Pegoraro; Lopes, Johnnatas Mikael; Cacho, Enio Walker Azevedo; Cacho,Roberta de Oliveira; Pereira, Silvana Alves

    2017-01-01

    [Purpose] To estimate the effect of Klapp method on idiopathic scoliosis in school students. [Subjects and Methods] A single-blind randomized clinical trial with 22 students randomly divided into intervention group (n=12) and inactive control group (n=10). Exercise protocol consisted of Klapp method, 20 sessions, three times a week for intervention group, and inactivity for control group. Dorsal muscle strength was measured by dynamometer; body asymmetries and gibbosity angles were measured b...

  13. [Future Psychiatry: a "Think Tank" for the Italian Psychiatry].

    Science.gov (United States)

    Bersani, Giuseppe

    2011-01-01

    The Future Psychiatry Project was founded with the goal to address the critical ratio of research/training / clinic. Ina series of regular meetings, each devoted to a specific clinical topic, data and more advanced models for the clinical area in questionwill be analyzed in an integrated and multidisciplinary approach and the real possibility of extension of development andprospects of scientific advances to the clinic and therapy will be evaluated.The primary methodological objective of the FuturePsychiatry meetings is the training method to overcome the common type of teacher/learner classroom teaching, albeit dividedinto the various possibilities offered by different types of educational meetings.The structure is informal, with features of intensiveseminars and suggested modes for better interaction.The objective is the "Think Tank", a common space for study and exchangeof knowledge, experiences, opinions and expectations, aimed at producing an integrated and shared dynamic result, thatcan provide a real reference point for participants and for all researchers and clinicians engaged in improving their level of updatingand best clinical activity.The first Future Psychiatry meeting was held in Sermoneta (Latina) in the halls of the Castello Caetanion September 16th to 18th 2010.The chosen topic was "The Future of Depression: the development of knowledge, the evolutionof therapies". The currently most advanced data of research were discussed and developed in their potential to reach ashared model taking into account the etiological complexity of Depression and to be a real reference to the possibility of applicationto real clinical experience.The main guidelines of the current research and major prospects for development of this in thefield Depression have been outlined, also in relation to the ongoing evolution and the future outlook of the models and tools oftherapy. Psychiatrists' clinical needs and expectations in front of the development of scientific

  14. Magnetic resonance imaging in psychiatry. Kernspintomographie in der Psychiatrie

    Energy Technology Data Exchange (ETDEWEB)

    Mann, K. (Psychiatrische Universitaetsklinik, Tuebingen (Germany))

    1993-08-13

    Diagnosis and research in psychiatry are increasingly availing themselves of magnetic resonance imaging (MRI). In comparison to computed tomography (CT), this offers the combined benefits of no exposure to radiation, high resolution, artefact-free display of structures near bone, and a sharp contrast between the grey and white brain matter, with freedom to select the section. With the exception of very anxious patients, MRI will gradually replace CT scans for a wide range of differential diagnostic investigations. Its superiority in systematic studies of psychiatric patients with discrete cerebral parenchyma lesions is already considered proven. This is illustrated on the basis of research into schizophrenia and alcoholism. (orig.)

  15. Positron emission tomography (PET) in psychiatry. PET in der Psychiatrie

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    Herholz, K. (Max-Planck-Institut fuer Neurologische Forschung und Neurologische Klinik der Universitaet Koeln (Germany))

    1993-08-13

    Currently, clinical PET is mainly useful in psychiatry and related areas for differential diagnosis of dementia. In dementia of Alzheimer type reductions of glucose metabolism are found mainly in the temporoparietal assocaiton cortex, in Pick's disease mainly in the frontal cortex, and in Huntington's disease in the striatum. Other demential diseases usually show less toposelective metabolic impairment. In the future, new diagnostic possibilities may arise from analysis of functional stimulation of specific brain areas and from the use of ligands for specific neurotransmitter systems. (orig.)

  16. Cranial computed tomography in psychiatry. Kraniale Computertomographie in der Psychiatrie

    Energy Technology Data Exchange (ETDEWEB)

    Falkai, P. (Rheinische Landes- und Hochschulklinik Duesseldorf, Psychiatrische Klinik der Heinrich-Heine-Universitaet (Germany)); Bogerts, B. (Rheinische Landes- und Hochschulklinik Duesseldorf, Psychiatrische Klinik der Heinrich-Heine-Universitaet (Germany))

    1993-08-13

    Computed tomography has gained importance as a diagnostic tool in psychiatry to exclude structural brain pathology, but has passed on its role in research to magnetic resonance tomography. It helps to distinguish between senile dementia of Alzheimer type and multi-infarct dementia. The enlargement of the ventricular system and cortical sulci is well established in schizophrenic and affective psychosis. Some alcohol addicts show a considerable degree of cerebral atrophy, only exceeded by demented patients, but this condition is potentially reversible. To screen psychiatric patients by CT is recommendable, as 2-10% of hospitalized psychiatric patients have structural brain disease. (orig.)

  17. Trials

    Directory of Open Access Journals (Sweden)

    Michele Fornaro

    2010-01-01

    Full Text Available Mental Retardation (MR is a developmental disability characterized by impairments in adaptive daily life skills and difficulties in social and interpersonal functioning. Since multiple causes may contribute to MR, associated clinical pictures may vary accordingly. Nevertheless, when psychiatric disorders as Treatment Resistant Depression (TRD and/or alcohol abuse co-exist, their proper detection and management is often troublesome, essentially due to a limited vocabulary MR people could use to describe their symptoms, feelings and concerns, and the lack of reliable screening tools. Furthermore, MR people are among the most medicated subjects, with (over prescription of antidepressants and/or typical antipsychotics being the rule rather than exception. Thus, treatment resistance or even worsening of depression, constitute frequent occurrences. This report describes the case of a person with MR who failed to respond to repetitive trials of antidepressant monotherapies, finally recovering using aripiprazole to fluvoxamine augmentation upon consideration of a putative bipolar diathesis for “agitated” TRD. Although further controlled investigations are needed to assess a putative bipolar diathesis in some cases of MR associated to TRD, prudence is advised in the long-term prescription of antidepressant monotherapies in such conditions.

  18. Building Resilience After School for Early Adolescents in Urban Poverty: Open Trial of Leaders @ Play.

    Science.gov (United States)

    Frazier, Stacy L; Dinizulu, Sonya Mathies; Rusch, Dana; Boustani, Maya M; Mehta, Tara G; Reitz, Kristin

    2015-11-01

    Leaders @ Play is a park after-school program for urban middle school youth designed to leverage recreational activities for social emotional learning. Mental health and park staff co-facilitated sports and games to teach and practice problem solving, emotion regulation, and effective communication. Additional practice occurred during multi-family groups and summer internships as junior camp counselors. We examined feasibility and promise via an open trial (n = 3 parks, 46 youth, 100 % African American, 100 % low-income, 59 % female, M = 13.09 years old). Improvements in social skills and reductions in problem behaviors lend support to after school programs as a space for mental health promotion.

  19. Putting "Rural" into Psychiatry Residency Training Programs

    Science.gov (United States)

    Nelson, William A.; Pomerantz, Andrew; Schwartz, Jonathan

    2007-01-01

    Objective: Evidence indicates disparities in the number of psychiatrists practicing in rural America compared to urban areas suggesting the need for a greater emphasis on rural psychiatry in residency training programs. The authors offer suggestions for integrating a rural focus in psychiatry residency training to foster greater competency and…

  20. Child Psychiatry Curricula in Undergraduate Medical Education

    Science.gov (United States)

    Sawyer, Michael Gifford; Giesen, Femke; Walter, Garry

    2008-01-01

    A study to review the amount of time devoted to child psychiatry in undergraduate medical education is conducted. Results conclude that relatively low priority is given to child psychiatry in medical education with suggestions for international teaching standards on the subject.

  1. Music Therapy with Adolescents

    Directory of Open Access Journals (Sweden)

    Jukko Tervo

    2005-03-01

    Full Text Available The therapeutic community described in this paper was situated at the University of Oulu Central Hospital Department of Psychiatry, Finland, during the years 1979-1989. The ward consisted of eight beds, four for boys and four for girls. The basic emphasis in the treatment was laid on psychoanalytic psychotherapy and music and art therapies suitable for the stage of adolescent development. Adolescent community therapy (psychoanalytic psychotherapy, music therapy, art therapy, special school etc. creates an environment which supports individual growth of the adolescent and youth culture. This, in turn, simultaneously supports psychotherapy.

  2. The effects of sleep extension and sleep hygiene advice on sleep and depressive symptoms in adolescents: a randomized controlled trial

    NARCIS (Netherlands)

    Dewald-Kaufmann, J.F.; Oort, F.J.; Meijer, A.M.

    2014-01-01

    Objective: Sleep problems are common and persistent during adolescence and can have negative effects on adolescents' mood. To date, studies that investigate the effects of sleep extension on adolescents' sleep and depressive symptoms are still lacking. This study aims to investigate the effects of g

  3. Some gestalt contributions to psychiatry.

    Science.gov (United States)

    Clegg, Kathleen A

    2010-07-01

    Gestalt theory and methods support significant behavioral change and personal growth, yet they have not been widely incorporated into modern psychiatric practice. Challenges to employing Gestalt principles in psychiatric practice exist, such as focus on diagnosis to guide treatment planning, key elements of psychiatric training, primacy of medication management in psychiatric practice, and financial pressures. However, the concepts of the co-created relational field in the here and now, the paradoxical theory of change, the cycle of experience, and the use of experiment are Gestalt concepts and methods that can be effectively applied in the modern practice of clinical psychiatry and psychiatric education.

  4. Polypharmacy in psychiatry: A review

    Directory of Open Access Journals (Sweden)

    Sanjay Kukreja

    2013-01-01

    Full Text Available Psychiatric polypharmacy refers to the prescription of two or more psychiatric medications concurrently to a patient. It can be categorised as same-class, multi-class, adjunctive, augmentation and total polypharmacy. Despite advances in psychopharmacology and a better understanding of the principles of therapeutics, its practice is increasing rapidly. The prevalence of polypharmacy in psychiatry varies between 13%-90%. There are various clinical and pharmaco-economic factors associated with it. Dealing with polypharmacy requires an understanding of its associated factors. Education, guidelines and algorithms for the appropriate management of various conditions are effective ways to avoid irrational polypharmacy.

  5. The history of Italian psychiatry during Fascism.

    Science.gov (United States)

    Piazzi, Andrea; Testa, Luana; Del Missier, Giovanni; Dario, Mariopaolo; Stocco, Ester

    2011-09-01

    Specific features characterized Italian psychiatry during Fascism (1922-45), distinguishing it from Nazi psychiatry and giving rise to different operational outcomes, so we have investigated the state of Italian psychiatry during this period. We review the historical situation that preceded it and describe the social and health policies that Fascism introduced following new legislative and regulatory acts. We examine the preventive and therapeutic role played by psychiatry (the electric shock was an Italian invention) and, thanks to the Enciclopedia Italiano published during those years, we are able to highlight psychiatry's relationship to psychology, psychoanalysis, philosophy and religion. The shortcomings of Italian psychiatric research and practice are also seen in terms of what the State failed to do rather than what it did.

  6. Guided internet-administered self-help to reduce symptoms of anxiety and depression among adolescents and young adults diagnosed with cancer during adolescence (U-CARE: YoungCan): a study protocol for a feasibility trial

    Science.gov (United States)

    Ander, Malin; Wikman, Anna; Ljótsson, Brjánn; Grönqvist, Helena; Ljungman, Gustaf; Woodford, Joanne; Lindahl Norberg, Annika; von Essen, Louise

    2017-01-01

    Introduction A subgroup of adolescents and young adults diagnosed with cancer during adolescence reports elevated levels of anxiety and depressive symptoms and unmet needs for psychological support. Evidence-based psychological treatments tailored for this population are lacking. This protocol describes a feasibility study of a guided-internet-administered self-help programme (YoungCan) primarily targeting symptoms of anxiety and depression among young persons diagnosed with cancer during adolescence and of the planned study procedures for a future controlled trial. Methods/analysis The study is an uncontrolled feasibility trial with a pre-post and 3-month follow-up design. Potential participants aged 15–25 years, diagnosed with cancer during adolescence, will be identified via the Swedish Childhood Cancer Registry. 30 participants will be included. Participants will receive YoungCan, a 12-week therapist-guided, internet-administered self-help programme consisting primarily of cognitive–behavioural therapy organised into individually assigned modules targeting depressive symptoms, worry and anxiety, body dissatisfaction and post-traumatic stress. Interactive peer support and psychoeducative functions are also available. Feasibility outcomes include: recruitment and eligibility criteria; data collection; attrition; resources needed to complete the study and programme; safety procedures; participants' and therapists' adherence to the programme; and participants' acceptability of the programme and study methodology. Additionally, mechanisms of impact will be explored and data regarding symptoms of anxiety, depression, post-traumatic stress, body dissatisfaction, reactions to social interactions, quality of life, axis I diagnoses according to the Mini International Neuropsychiatric Interview and healthcare service use will be collected. Exploratory analyses of changes in targeted outcomes will be conducted. Ethics/dissemination This feasibility protocol was

  7. The 24-h energy intake of obese adolescents is spontaneously reduced after intensive exercise: a randomized controlled trial in calorimetric chambers.

    Directory of Open Access Journals (Sweden)

    David Thivel

    Full Text Available BACKGROUND: Physical exercise can modify subsequent energy intake and appetite and may thus be of particular interest in terms of obesity treatment. However, it is still unclear whether an intensive bout of exercise can affect the energy consumption of obese children and adolescents. OBJECTIVE: To compare the impact of high vs. moderate intensity exercises on subsequent 24-h energy intake, macronutrient preferences, appetite sensations, energy expenditure and balance in obese adolescent. DESIGN: This randomized cross-over trial involves 15 obese adolescent boys who were asked to randomly complete three 24-h sessions in a metabolic chamber, each separated by at least 7 days: (1 sedentary (SED; (2 Low-Intensity Exercise (LIE (40% maximal oxygen uptake, VO(2max; (3 High-Intensity Exercise (HIE (75%VO(2max. RESULTS: Despite unchanged appetite sensations, 24-h total energy intake following HIE was 6-11% lower compared to LIE and SED (p<0.05, whereas no differences appeared between SED and LIE. Energy intake at lunch was 9.4% and 8.4% lower after HIE compared to SED and LIE, respectively (p<0.05. At dinner time, it was 20.5% and 19.7% lower after HIE compared to SED and LIE, respectively (p<0.01. 24-h energy expenditure was not significantly altered. Thus, the 24-h energy balance was significantly reduced during HIE compared to SED and LIE (p<0.01, whereas those of SED and LIE did not differ. CONCLUSIONS: In obese adolescent boys, HIE has a beneficial impact on 24-h energy balance, mainly due to the spontaneous decrease in energy intake during lunch and dinner following the exercise bout. Prescribing high-intensity exercises to promote weight loss may therefore provide effective results without affecting appetite sensations and, as a result, food frustrations. TRIAL REGISTRATION: ClinicalTrial.gov NCT01036360.

  8. Are child and adolescent responses to placebo higher in major depression than in anxiety disorders? A systematic review of placebo-controlled trials.

    Directory of Open Access Journals (Sweden)

    David Cohen

    Full Text Available BACKGROUND: In a previous report, we hypothesized that responses to placebo were high in child and adolescent depression because of specific psychopathological factors associated with youth major depression. The purpose of this study was to compare the placebo response rates in pharmacological trials for major depressive disorder (MDD, obsessive compulsive disorder (OCD and other anxiety disorders (AD-non-OCD. METHODOLOGY AND PRINCIPAL FINDINGS: We reviewed the literature relevant to the use of psychotropic medication in children and adolescents with internalized disorders, restricting our review to double-blind studies including a placebo arm. Placebo response rates were pooled and compared according to diagnosis (MDD vs. OCD vs. AD-non-OCD, age (adolescent vs. child, and date of publication. From 1972 to 2007, we found 23 trials that evaluated the efficacy of psychotropic medication (mainly non-tricyclic antidepressants involving youth with MDD, 7 pertaining to youth with OCD, and 10 pertaining to youth with other anxiety disorders (N = 2533 patients in placebo arms. As hypothesized, the placebo response rate was significantly higher in studies on MDD, than in those examining OCD and AD-non-OCD (49.6% [range: 17-90%] vs. 31% [range: 4-41%] vs. 39.6% [range: 9-53], respectively, ANOVA F = 7.1, p = 0.002. Children showed a higher stable placebo response within all three diagnoses than adolescents, though this difference was not significant. Finally, no significant effects were found with respect to the year of publication. CONCLUSION: MDD in children and adolescents appears to be more responsive to placebo than other internalized conditions, which highlights differential psychopathology.

  9. Qualitative Treatment-Subgroup Interactions in a Randomized Clinical Trial of Treatments for Adolescents with ADHD: Exploring What Cognitive-Behavioral Treatment Works for Whom

    Science.gov (United States)

    Geurts, Hilde M.; Prins, Pier J. M.; Van Mechelen, Iven; Van der Oord, Saskia

    2016-01-01

    Objective This study explored qualitative treatment-subgroup interactions within data of a RCT with two cognitive behavioral treatments (CBT) for adolescents with ADHD: a planning-focused (PML) and a solution-focused CBT (SFT). Qualitative interactions imply that which treatment is best differs across subgroups of patients, and are therefore most relevant for personalized medicine. Methods Adolescents with ADHD (N = 159) received either PML or SFT. Pre-, post- and three-month follow-up data were gathered on parent-rated ADHD symptoms and planning problems. Pretreatment characteristics were explored as potential qualitative moderators of pretest to follow-up treatment effects, using an innovative analyses technique (QUINT; Dusseldorp & Van Mechelen, 2014). In addition, qualitative treatment-subgroup interactions for the therapeutic changes from pre- to posttest and from post- to follow-up test were investigated. Results For the entire time span from pretest to follow-up only a quantitative interaction was found, while from posttest to follow-up qualitative interactions were found: Adolescents with less depressive symptoms but more anxiety symptoms showed more improvement when receiving PML than SFT, while for other adolescents the effects of PML and SFT were comparable. Discussion Whereas subgroups in both treatments followed different trajectories, no subgroup was found for which SFT outperformed PML in terms of the global change in symptoms from pretest to three months after treatment. This implies that, based on this exploratory study, there is no need for personalized treatment allocation with regard to the CBTs under study for adolescents with ADHD. However, for a subgroup with comorbid anxiety symptoms but low depression PML clearly appears the treatment of preference. Trial Registration Nederlands Trial Register NTR2142 PMID:26977602

  10. What Psychiatry Means to Me

    Directory of Open Access Journals (Sweden)

    Helen Herrman

    2007-01-01

    Full Text Available Moving in early career from public health physician to psychiatrist gives me a public health view of psychiatry and an interest in pursuing the goals of widening access to community-based services for people with mental disorders and promoting mental health in communities. Training in social medicine in the UK and psychiatry in Australia lead to studies of homelessness in people living with psychotic disorders, the health of family caregivers, assessing quality of life and mental health promotion. Work with the World Health Organization (WHO in the Western Pacific Region and the World Psychiatric Association (WPA worldwide has given me opportunities to work with psychiatrists, mental health workers, service users and others in governments and non-government organisations implementing the recommendations of the World Health Report 2001 in countries with limited resources. My work as WPA Secretary for Publications seeks to improve information exchange in countries irrespective of their wealth. This is an exciting time to be working in a global village with technical capacity to reach into its furthest corners. Psychiatrists supported by WPA can help ensure that vulnerable people and communities and people living with mental disorders are well served in this new environment and no longer left out and left behind.

  11. Against Explanatory Minimalism in Psychiatry.

    Science.gov (United States)

    Thornton, Tim

    2015-01-01

    The idea that psychiatry contains, in principle, a series of levels of explanation has been criticized not only as empirically false but also, by Campbell, as unintelligible because it presupposes a discredited pre-Humean view of causation. Campbell's criticism is based on an interventionist-inspired denial that mechanisms and rational connections underpin physical and mental causation, respectively, and hence underpin levels of explanation. These claims echo some superficially similar remarks in Wittgenstein's Zettel. But attention to the context of Wittgenstein's remarks suggests a reason to reject explanatory minimalism in psychiatry and reinstate a Wittgensteinian notion of levels of explanation. Only in a context broader than the one provided by interventionism is that the ascription of propositional attitudes, even in the puzzling case of delusions, justified. Such a view, informed by Wittgenstein, can reconcile the idea that the ascription mental phenomena presupposes a particular level of explanation with the rejection of an a priori claim about its connection to a neurological level of explanation.

  12. The effect of an energy restricted low glycemic index diet on blood lipids, apolipoproteins and lipoprotein (a) among adolescent girls with excess weight: a randomized clinical trial.

    Science.gov (United States)

    Rouhani, Mohammad Hossein; Kelishadi, Roya; Hashemipour, Mahin; Esmaillzadeh, Ahmad; Azadbakht, Leila

    2013-12-01

    Some studies focused on the effect of the dietary glycemic index on lipoproteins and apolipoproteins in adults; however, little evidence exists among adolescents regarding the effect of a low glycemic index (LGI) diet on apolipoproteins and lipoprotein (a) (Lpa). This study was conducted to evaluate the effect of an LGI diet on the lipid profile, apolipoproteins and Lpa among overweight and obese adolescent girls. For this parallel designed randomized clinical trial, 50 healthy overweight/obese girls at pubertal ages were randomly allocated to an LGI or a healthy nutritional recommendations (HNR) based diet. Equal macronutrient distributed diets were prescribed to both groups. Biochemical measurements included lipid profile, apolipoprotein A, apolipoprotein B and Lpa were conducted before and after 10 weeks of intervention. Forty one adolescent girls completed the study. The dietary glycemic index in the LGI group was 42.67 ± 0.067. There were no differences in the mean of blood lipid indices baseline and after intervention between two groups. There were no significant differences between the two groups regarding lipid profiles, apolipoproteins and Lpa. There were no significant differences in lipid profiles, apolipoproteins and Lpa between the LGI diet and the HNR-based diet and the impact of these two diets on lipid profile was equal in this trial.

  13. Anxiety status affects nicotine- and baclofen-induced locomotor activity, anxiety, and single-trial conditioned place preference in male adolescent rats.

    Science.gov (United States)

    Falco, Adriana M; McDonald, Craig G; Smith, Robert F

    2014-09-01

    Adolescents have an increased vulnerability to nicotine and anxiety may play a role in the development of nicotine abuse. One possible treatment for anxiety disorders and substance abuse is the GABAB agonist, baclofen. The aim of the present study was to determine the effect of anxiety-like behavior on single-trial nicotine conditioned place preference in adolescent rats, and to assess the action of baclofen. Baclofen was shown to have effects on locomotor and anxiety-like behavior in rats divided into high-anxiety and low-anxiety groups. Baclofen decreased locomotor behavior in high-anxiety rats. Baclofen alone failed to produce differences in anxiety-like behavior, but nicotine and baclofen + nicotine administration were anxiolytic. High- and low-anxiety groups also showed differences in single-trial nicotine-induced place preference. Only high-anxiety rats formed place preference to nicotine, while rats in the low-anxiety group formed no conditioned place preference. These results suggest that among adolescents, high-anxiety individuals are more likely to show preference for nicotine than low-anxiety individuals.

  14. Protocol for a randomised controlled trial of a school based cognitive behaviour therapy (CBT intervention to prevent depression in high risk adolescents (PROMISE

    Directory of Open Access Journals (Sweden)

    Sayal Kapil

    2010-11-01

    Full Text Available Abstract Background Depression in adolescents is a significant problem that impairs everyday functioning and increases the risk of severe mental health disorders in adulthood. Relatively few adolescents with depression are identified and referred for treatment indicating the need to investigate alternative preventive approaches. Study Design A pragmatic cluster randomised controlled trial evaluating the effectiveness of a school based prevention programme on symptoms of depression in "high risk" adolescents (aged 12-16. The unit of allocation is year groups (n = 28 which are assigned to one of three conditions: an active intervention based upon cognitive behaviour therapy, attention control or treatment as usual. Assessments will be undertaken at screening, baseline, 6 months and 12 months. The primary outcome measure is change on the Short Mood and Feeling Questionnaire at 12 months. Secondary outcome measures will assess changes in negative thoughts, self esteem, anxiety, school connectedness, peer attachment, alcohol and substance misuse, bullying and self harm. Discussion As of August 2010, all 28 year groups (n = 5023 had been recruited and the assigned interventions delivered. Final 12 month assessments are scheduled to be completed by March 2011. Trial Registration ISRCTN19083628

  15. Cognitive-behavioral treatment of insomnia and depression in adolescents: A pilot randomized trial.

    Science.gov (United States)

    Clarke, Greg; McGlinchey, Eleanor L; Hein, Kerrie; Gullion, Christina M; Dickerson, John F; Leo, Michael C; Harvey, Allison G

    2015-06-01

    We tested whether augmenting conventional depression treatment in youth by treating sleep issues with cognitive behavioral therapy for insomnia (CBT-I) improved depression outcomes. We randomized youth 12-20 years of age to 10 weekly sessions of a sleep hygiene control condition (SH) combined with CBT for depression (CBT-D) (n = 20), or an experimental condition consisting of CBT-I combined with CBT-D (n = 21). We assessed outcomes through 26 weeks of follow-up and found medium-large effects favoring the experimental CBT-I arm on some sleep outcomes (actigraphy total sleep time and Insomnia Severity Index "caseness") and depression outcomes (higher percentage recovered, faster time to recovery), but little effect on other measures. Total sleep time improved by 99 min from baseline to week 12 in the CBT-I arm, but not in the SH arm. In addition, our pilot yielded important products to facilitate future studies: the youth-adapted CBT-I program; the study protocol; estimates of recruitment, retention, and attrition; and performance and parameters of candidate outcome measures. ClinicalTrials.gov Identifier NCT00949689.

  16. Klapp method effect on idiopathic scoliosis in adolescents: blind randomized controlled clinical trial.

    Science.gov (United States)

    Dantas, Diego De Sousa; De Assis, Sanderson José Costa; Baroni, Marina Pegoraro; Lopes, Johnnatas Mikael; Cacho, Enio Walker Azevedo; Cacho, Roberta De Oliveira; Pereira, Silvana Alves

    2017-01-01

    [Purpose] To estimate the effect of Klapp method on idiopathic scoliosis in school students. [Subjects and Methods] A single-blind randomized clinical trial with 22 students randomly divided into intervention group (n=12) and inactive control group (n=10). Exercise protocol consisted of Klapp method, 20 sessions, three times a week for intervention group, and inactivity for control group. Dorsal muscle strength was measured by dynamometer; body asymmetries and gibbosity angles were measured by biophotogrammetry. Data were obtained by Generalized Estimated Equation, with 5% significance level. Clinical impact for dependent variables was estimated by "d" Cohen. [Results] There was no change in intragroup analysis and intergroup for all postural symmetry variables. However, it was detected intergroup difference in extensor muscle strength and intergroup difference with marginal significance of gibbosity angles. Regarding extensor muscle strength, intervention group produced average improvement of 7.0 kgf compared to control group. Gibbosity angles progressed less in intervention group, with 5.71° average delay compared to control group. [Conclusion] Klapp method was effective for gibbosity stabilization and it improves spine extensor muscle strength.

  17. Adolescents' impressions of antismoking media literacy education: qualitative results from a randomized controlled trial.

    Science.gov (United States)

    Primack, Brian A; Fine, Danielle; Yang, Christopher K; Wickett, Dustin; Zickmund, Susan

    2009-08-01

    Although media literacy represents an innovative venue for school-based antismoking programming, studies have not systematically compared student impressions of these and traditional programs. This study utilized data from a randomized trial comparing these two types of programs. After each program, students responded to three open-ended questions related to their assigned curriculum. Two coders, blinded to student assignments, independently coded these data. Coders had strong inter-rater agreement (kappa = 0.77). Our primary measures were spontaneously noted overall assessment, enjoyment/interest and the likelihood of changing smoking behavior. Of the 531 participants, 255 (48.0%) were randomized to the intervention (media literacy) group. Intervention participants had more net positive responses [rate ratio (RR) = 1.27, 95% confidence interval (CI) = 1.05, 1.54], more responses rating the program as compelling (RR = 1.63, 95% CI = 1.16, 2.29) and fewer responses rating the program as non-compelling (RR = 0.62, 95% CI = 0.39, 0.97). However, the intervention group was not more likely to suggest that the curriculum was likely to change behavior positively (RR = 0.57, 95% CI = 0.30, 1.06). Findings suggest that although media literacy provides a compelling format for the delivery of anti-tobacco programming, integration of components of traditional programming may help media literacy programs achieve maximal efficacy.

  18. Klapp method effect on idiopathic scoliosis in adolescents: blind randomized controlled clinical trial

    Science.gov (United States)

    Dantas, Diego De Sousa; De Assis, Sanderson José Costa; Baroni, Marina Pegoraro; Lopes, Johnnatas Mikael; Cacho, Enio Walker Azevedo; Cacho, Roberta De Oliveira; Pereira, Silvana Alves

    2017-01-01

    [Purpose] To estimate the effect of Klapp method on idiopathic scoliosis in school students. [Subjects and Methods] A single-blind randomized clinical trial with 22 students randomly divided into intervention group (n=12) and inactive control group (n=10). Exercise protocol consisted of Klapp method, 20 sessions, three times a week for intervention group, and inactivity for control group. Dorsal muscle strength was measured by dynamometer; body asymmetries and gibbosity angles were measured by biophotogrammetry. Data were obtained by Generalized Estimated Equation, with 5% significance level. Clinical impact for dependent variables was estimated by “d” Cohen. [Results] There was no change in intragroup analysis and intergroup for all postural symmetry variables. However, it was detected intergroup difference in extensor muscle strength and intergroup difference with marginal significance of gibbosity angles. Regarding extensor muscle strength, intervention group produced average improvement of 7.0 kgf compared to control group. Gibbosity angles progressed less in intervention group, with 5.71° average delay compared to control group. [Conclusion] Klapp method was effective for gibbosity stabilization and it improves spine extensor muscle strength.

  19. The Use of Health Information Technology Within Collaborative and Integrated Models of Child Psychiatry Practice.

    Science.gov (United States)

    Coffey, Sara; Vanderlip, Erik; Sarvet, Barry

    2017-01-01

    There is a consistent need for more child and adolescent psychiatrists. Despite increased recruitment of child and adolescent psychiatry trainees, traditional models of care will likely not be able to meet the need of youth with mental illness. Integrated care models focusing on population-based, team-based, measurement-based, and evidenced-based care have been effective in addressing accessibility and quality of care. These integrated models have specific needs regarding health information technology (HIT). HIT has been used in a variety of different ways in several integrated care models. HIT can aid in implementation of these models but is not without its challenges.

  20. Evaluation of a School-Based Depression Prevention Program among Adolescents from Low-Income Areas: A Randomized Controlled Effectiveness Trial

    Directory of Open Access Journals (Sweden)

    Karlijn C. M. Kindt

    2014-05-01

    Full Text Available A randomized controlled trial was conducted among a potential high-risk group of 1,343 adolescents from low-income areas in The Netherlands to test the effectiveness of the depression prevention program Op Volle Kracht (OVK as provided by teachers in a school setting. The results showed no main effect of the program on depressive symptoms at one-year follow-up. A moderation effect was found for parental psychopathology; adolescents who had parents with psychopathology and received the OVK program had less depressive symptoms compared to adolescents with parents with psychopathology in the control condition. No moderating effects on depressive symptoms were found for gender, ethnical background, and level of baseline depressive symptoms. An iatrogenic effect of the intervention was found on the secondary outcome of clinical depressive symptoms. Based on the low level of reported depressive symptoms at baseline, it seems that our sample might not meet the characteristics of a high-risk selective group for depressive symptoms. Therefore, no firm conclusions can be drawn about the selective potential of the OVK depression prevention program. In its current form, the OVK program should not be implemented on a large scale in the natural setting for non-high-risk adolescents. Future research should focus on high-risk participants, such as children of parents with psychopathology.

  1. Holistic-medical foundations of American psychiatry: a bicentennial.

    Science.gov (United States)

    Lipowski, Z J

    1981-07-01

    American psychiatry has reached its bicentennial. Holistic-medical foundations have been its hallmark, inspiration, and source of preeminence. Incorporated by psychobiology, the American school, they enabled the growth of psychiatry as a medical specialty and scientific discipline and stimulated unparalleled growth of general hospital psychiatry, psychiatric research and teaching, and psychosomatic medicine and liaison psychiatry. Holistic conceptions, a product of a democratic system and the liberal mind, continue to provide the best framework for psychiatry and an antidote to dogma and fanaticism.

  2. A Marxist approach to psychology and psychiatry.

    Science.gov (United States)

    Nahem, J

    1982-01-01

    Marxism considers psychology and psychiatry to be young and complex sciences which are powerfully affected by the nature of society. Marxism contributes to these sciences by applying dialectical and historical materialism to their study and development. The Marxist critique of psychology and psychiatry under capitalism identifies the immense harmful effect on them of capitalist class ideology in a number of areas: anti-working class theories, racism, national chauvinism, sexism, theories of fixed evil human nature, and false or one-sided theories. Socialism is held to provide a healthy environment for individual psychological development and to utilize psychology and psychiatry for scientific and humane ends.

  3. Training Psychiatry Addiction Fellows in Acupuncture

    Science.gov (United States)

    Serafini, Kelly; Bryant, Katurah; Ikomi, Jolomi; LaPaglia, Donna

    2015-01-01

    Objective Acupuncture has been studied as an adjunct for addictions treatment. Because many hospitals, outpatient clinics, and facilities are integrating acupuncture treatment, it is important that psychiatrists remain informed about this treatment. This manuscript describes the National Acupuncture Detoxification Association (NADA) protocol and its inclusion as part of the curriculum for psychiatry addictions fellows. Methods Psychiatry and psychology fellows completed the NADA training (N = 20) and reported on their satisfaction with the training. Results Overall, participants stated that they found the training beneficial and many were integrating acupuncture within their current practice. Conclusions Results support the acceptability of acupuncture training among psychiatry fellows in this program. PMID:26048457

  4. Serum Oxidant and Antioxidant Status Following an All-Out 21-km Run in Adolescent Runners Undergoing Professional Training—A One-Year Prospective Trial

    Directory of Open Access Journals (Sweden)

    Haifeng Zhang

    2013-07-01

    Full Text Available This study investigated the 1-year longitudinal effect of professional training in adolescent runners on redox balance during intense endurance exercise. Changes in selected serum oxidant and antioxidant status in response to a 21-km running time trial in 10 runners (15.5 ± 1.3 years undergoing professional training were evaluated twice in 12 months (pre- and post-evaluation. Venous blood samples were collected immediately before and 4-h following the 21-km run for analysis of serum concentrations of thiobarbituric acid-reactive substances (TBARS, xanthine oxidase (XO, catalase (CAT, reduced glutathione (GSH, superoxide dismutase (SOD, and total antioxidant capacity (T-AOC. In pre-evaluation trial, serum TBARS and SOD decreased after the 21-km run (p < 0.05 while XO, GSH, CAT and TAOC were unchanged. In post-evaluation trial, serum TBARS and SOD decreased, whereas XO and CAT increased post-exercise (p < 0.05. Furthermore, pre-exercise serum T-AOC, post-exercise serum XO, CAT, T-AOC (p < 0.05, and GSH (p = 0.057 appeared to be higher than the corresponding pre-evaluation values. The current findings suggest that a professional training regime in adolescent runners is not likely to jeopardize the development of their antioxidant defense. However, uncertainties in the maintenance of redox balance in runners facing increased exercise-induced oxidative stress as a consequence of training-induced enhancement of exercise capacity await further elucidation.

  5. Effect of the peels of two Citrus fruits on endothelium function in adolescents with excess weight: A triple-masked randomized trial

    Directory of Open Access Journals (Sweden)

    Mohammad Hashemi

    2015-01-01

    Full Text Available Background: Obesity induces endothelial dysfunction even in the pediatric age group. The possible protective effects of fruits and herbal products on the endothelial dysfunction of obese children remain to be determined. This study aims to investigate the effects of lemon and sour orange peels on endothelial function of adolescents with excess weight. Materials and Methods: This triple-masked, randomized placebo-controlled trial was conducted for 1-month among 90 overweight and obese participants, aged 6-18 years. They were randomly assigned into three groups of equal number receiving daily oral capsules containing lemon or sour orange powder or placebo. Flow-mediated dilatation (FMD was compared between three groups by using analysis of covariance. Results: Overall, 30 participants in the lemon group, 27 in the sour orange group and 29 in the control group completed the trial. After the trial, mean FMD was significantly (P < 0.001 higher in the lemon group (11.99 ± 4.05 and in the sour orange group (12.79 ± 5.47 than in the placebo group (6.45 ± 2.79. FMD percent change was 145.02 ± 24.34 in the lemon group, 142.04 ± 16.11 in the sour orange group, and 46.73 ± 5.16 in controls (P < 0.001. Conclusion: This trial showed that consumption of extracts of lemon and sour orange peels, which contain plenty amounts of antioxidants, flavonoids, pectin, and vitamin C, might have significant benefits on endothelial function in children and adolescents with excess weight. Trial registry code: IRCT201311201434N10.

  6. Relational agents in clinical psychiatry.

    Science.gov (United States)

    Bickmore, Timothy; Gruber, Amanda

    2010-01-01

    Relational agents are computational artifacts, such as animated, screen-based characters or social robots, that are designed to establish a sense of rapport, trust, and even therapeutic alliance with patients, using ideal therapeutic relationships between human counselors and patients as role models. We describe the development and evaluation of several such agents designed for health counseling and behavioral-change interventions, in which a therapeutic alliance is established with patients in order to enhance the efficacy of the intervention. We also discuss the promise of using such agents as adjuncts to clinical psychiatry, a range of possible applications, and some of the challenges and ethical issues in developing and fielding them in psychiatric interventions.

  7. [Disaster psychiatry in late life].

    Science.gov (United States)

    Awata, Shuichi

    2013-10-01

    Disaster preparedness in geriatric psychiatry was proposed on the basis of experience of the Great East Japan Earthquake. 1) Frail or demented elderly should be considered as a special population at risk for disaster victims and addressed in local disaster prevention programs. 2) To response to various psychiatric symptoms(delirium, BPSD, depression, anxiety, insomnia, and posttraumatic stress disorder) caused by medical conditions and rapid environmental changes due to disaster, linkage and coordination systems between psychiatric and medical sections should be established. 3) As a medium- and long-term support for the elderly who lost the community familiar to them, creation of a new community should be promoted in order to prevent depression, alcohol dependence, BPSD, and suicide.

  8. Eating Disorders in Child and Adolescents

    Directory of Open Access Journals (Sweden)

    Arzu Onal Sonmez

    2017-09-01

    Full Text Available Eating disorders are relatively common and serious disorders in adolescent and pre-adolescent age. The aim of this review is to update new findings related with mostly seen feeding and eating disorders in child and adolescents. The article focuses specifically on anorexia nervosa and bulimia nervosa. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2017; 9(3.000: 301-316

  9. [Clinical psychiatry and suicide prevention].

    Science.gov (United States)

    Cho, Yoshinori

    2012-01-01

    People do not commit suicide all of a sudden. There is a suicidal process where negative life events are there in the beginning, and social support and help-seeking behavior play an important role in impeding the progress of the process. Mental disturbance would be deeply associated with the suicidal process around the final stage, thinking of the fact that approximately 90% of the suicides suffered from mental disorders at the time of suicide. In considering the strategies for suicide prevention, there are two perspectives: a community model and a medical model. A community model is thought to be related mainly to the first half of the suicidal process and a medical model to the latter half. It is an ideal that both community and medical approaches are put into practice simultaneously. However, if resources available for suicide prevention are limited, a medical-model approach would be more efficient and should be given priority. Starting from a medical model and considering treatment and social resources necessary for suicidal people, the range of suicide prevention activities would be expand more efficiently than starting from a community-model approach. Clinical psychiatry plays a greatly important role in preventing suicide. It is found that approximately 20% of seriously injured suicide attempters were diagnosed as adjustment disorder in Japan, which means that even the mildly depressed can commit suicide. Therefore, no one can take a hands-off approach to suicidality as long as he/she works in the field of clinical psychiatry. It is earnestly desired to detect and treat properly the suicidal patients, but there is no perfect method. It would be helpful to pay attention to patients' personality development, stress-coping style and present suicidal ideation. Besides, as suicide prevention is not completed only in a consulting room, it is important for psychiatrists to look for teamwork.

  10. Psychological treatments for depression in pre-adolescent children (12 years and younger): systematic review and meta-analysis of randomised controlled trials.

    Science.gov (United States)

    Forti-Buratti, M Azul; Saikia, Rupalim; Wilkinson, Esther L; Ramchandani, Paul G

    2016-10-01

    The objective of this study was to evaluate the efficacy of psychological treatments for depression in pre-adolescent children, a disorder affecting 1-2 % of children in this age range. A systematic review of studies of psychological interventions to treat depressive disorder in pre-adolescent children (aged up to 12-years-old) was carried out. The primary outcome was level of depressive symptoms. Studies were found using Medline, PsycINFO, EMBASE and Web of Knowledge databases and selected on several criteria. Only randomised controlled trials were included. Where individual studies covered a broader age range (usually including adolescents up to age 18 years), authors of those studies were contacted and requested to provide individual patient level data for those aged 12 years and younger. 2822 abstracts were reviewed, and from these 124 full text articles were reviewed, yielding 7 studies for which we were able to access appropriate data for this review. 5 of these studies evaluated cognitive behaviour therapy (CBT). Combined results from these studies suggest that there is a lack of evidence that CBT is better than no treatment [standard mean difference -0.342 (95 % confidence interval -0.961, 0.278)], although the number of participants included in the trials was relatively small. The evidence for efficacy of family therapy and psychodynamic therapy is even more limited. The very limited number of participants in randomised controlled trials means that there is inconclusive evidence for the psychological treatment of depression in children aged 12 years and below. Given the prevalence and significant impact of this disorder, there is an urgent need to establish the effectiveness or otherwise of psychological intervention.

  11. [The most important obstacles of the development of Hungarian psychiatry].

    Science.gov (United States)

    Kalmár, Sándor

    2015-06-01

    A quarter of a century ago the change of the political system in Hungary precipitated a serious value-crisis and caused a lot of harmful effects in nurturing and the development of psychiatry. The author establishes that the attack against psychiatry is more intensive than previously but neither the education and health management nor the psychiatric leadership could cope with these difficulties. It can't be denied that the foundation of lifelong mental health begins in the early life years and about 75% of the first Mental Disorder manifests in adolescence and youth. We are not able to ensure the special rights of every child according to the Hungarian Constitution and the Declaration of the Rights of the Child by the United Nations. The large inequalities within the country, the lack of paramount mental education and nurturing, the lack of essential, consistent eternal values, the lack of required psychiatric care system are huge obstacles of the development of healthy individual and leads to self-destructive behaviour and several, serious physical and mental disorders. The purpose of the author is to call psychiatrists' attention to the main obstacles of the development of Hungarian Psychiatric Care System. The main obstacles of the present psychiatric care system: 1. Unclarified notions, confusion of ideas. 2. Somatic, neurologic, mental, cultural-social and spiritual ignorance. 3. Lack of organization in Mental Education and Psychiatric Care System. 4. Value-crisis in our society despite the fact that the "Council of Wise Men" created a "Scale of the Essential Consistent Eternal Values" for the Hungarian Education System in 2008. 5. Lack of mental health prevention both in education system and health care system. There is no teaching of hygiene lessons in the Hungarian schools. 6. Negligence and selfishness among the population. 7. Disinterest among competent authorities. 8. Leaving the most important possibilities out of consideration. The author establishes

  12. The Effect of Wilderness Therapy on Adolescents' Cognitive Autonomy and Self-Efficacy: Results of a Non-Randomized Trial

    Science.gov (United States)

    Margalit, Daniella; Ben-Ari, Amichai

    2014-01-01

    Background: Adolescents participate in decision-making processes involving risky behaviors. Management of these important decisions may be promoted by enhancing adolescents' self-efficacy beliefs and cognitive autonomy. Objective: In order to elucidate the value of wilderness therapy to the successful management of decision making processes among…

  13. Computeen: A Randomized Trial of a Preventive Computer and Psychosocial Skills Curriculum for At-Risk Adolescents

    Science.gov (United States)

    Lang, Jason M.; Waterman, Jill; Baker, Bruce L.

    2009-01-01

    Computeen, a preventive technology and psychosocial skills development program for at-risk adolescents, was designed to improve computer skills, self-esteem, and school attitudes, and reduce behavior problems, by combining elements of community-based and empirically supported prevention programs. Fifty-five mostly Latino adolescents from 12 to 16…

  14. Why is psychiatry prone to fads?

    Science.gov (United States)

    Paris, Joel

    2013-10-01

    Psychiatry has long been prone to fads. The main reason is that mental illness is poorly understood and can be difficult to treat. Most diagnostic fads have involved the extension of well-known categories into broader spectra. The most prominent treatment fads have involved the overuse of pharmacological interventions and a proliferation of methods for psychotherapy. The best antidote to fads is a commitment to evidence-based psychiatry.

  15. Self-reported efficacy of neurofeedback treatment in a clinical randomized controlled study of ADHD children and adolescents

    OpenAIRE

    Duric NS; Aßmus J; Elgen IB

    2014-01-01

    Nezla S Duric,1–3 Jörg Aßmus,4 Irene B Elgen1,5 1Department of Clinical Medicine, University of Bergen, Bergen, Norway; 2Center for Child and Adolescent Mental Health, University of Bergen, Bergen, Norway; 3Department of Child and Adolescent Psychiatry, Helse Fonna Haugesund Hospital, Haugesund, Norway; 4Center for Clinical Research, Haukeland University Hospital, Bergen, Norway; 5Department of Child and Adolescent Psychiatry, Haukeland University Hospital, Berge...

  16. [Challenges for the future of psychiatry and psychiatric medical care].

    Science.gov (United States)

    Higuchi, Teruhiko

    2013-01-01

    In addition to the prolonged economic recession and global financial crisis, the Great East Japan Earthquake of March 2011 has caused great fear and devastation in Japan. In the midst of these, Japanese people have felt to lose the traditional values and common sense they used to share, and it has become necessary to build a new consciousness. Engaged in psychiatry and psychiatric care under these circumstances, we have to analyze the challenges we face and to brainstorm on appropriate prescriptions that can be applied to solve the problems. Five points in particular were brought up: [1] The persistently high number of suicides. [2] The increase in depression and overflowing numbers of patients visiting clinics and outpatient departments at hospitals. [3] The absolute shortage of child psychiatrists. [4] Little progress with the transition from hospitalization-centered to community-centered medical care. [5] The disappearance of beds for psychiatry patients from general hospitals. The situations surrounding these five issues were briefly analyzed and problems were pointed out. The following are five problems that psychiatry is facing: 1) A lack of large clinical trials compared to the rest of the world. 2) The drug lag and handling of global trials. 3) The lack of staff involved in education and research (in the field of psychiatry). 4) Following the DSM diagnostic criteria dogmatically, without differentiating therapeutics. 5) Other medical departments, the industry, patients, and their families are demanding objective diagnostic techniques. After analyzing the problems, and discussing to some extent what kind of prescription may be considered to solve the problems, I gave my opinion. (1) The first problem is the deep-rooted prejudice and discrimination against psychiatric disorders that continue to be present among Japanese people. The second problem is the government's policy of low remuneration (fees) for psychiatric services. The third problem, symbolic of the

  17. Brief Intervention Helps Adolescents Curb Substance Use

    Science.gov (United States)

    ... Helps Adolescents Curb Substance Use Brief Intervention Helps Adolescents Curb Substance Use Email Facebook Twitter Two hour- ... School, in Minneapolis, conducted the trial with 315 adolescent and parent/caregiver pairs. Their findings strengthen evidence, ...

  18. Innovative Training in Pediatrics, General Psychiatry, and Child Psychiatry: Background, Outcomes, and Experiences

    Science.gov (United States)

    Gleason, Mary Margaret; Fritz, Gregory K.

    2009-01-01

    Objectives: The authors describe the history, rationale, and outcomes of combined training programs in pediatrics, psychiatry, and child psychiatry ("triple board"), including narrative feedback from graduates and reflections upon the important components of the program. Methods: This article reviews the background and experiences of triple board…

  19. Attitudes of Medical Students towards Psychiatry: Effects of Training, Courses in Psychiatry, Psychiatric Experience and Gender

    Science.gov (United States)

    Kuhnigk, Olaf; Strebel, Bernd; Schilauske, Joerg; Jueptner, Markus

    2007-01-01

    Objective: The attitudes of medical students towards psychiatry and psychotherapy were examined considering the extent of their education, previous psychiatry experience, the evaluation of the course, their career intentions and socio-demographic variables. Methods: Five hundred and eight medical students in their second, fifth, ninth and tenth…

  20. Divergent Fates of the Medical Humanities in Psychiatry and Internal Medicine: Should Psychiatry Be Rehumanized?

    Science.gov (United States)

    Rutherford, Bret R.; Hellerstein, David J.

    2008-01-01

    Objective: To determine the degree to which the medical humanities have been integrated into the fields of internal medicine and psychiatry, the authors assessed the presence of medical humanities articles in selected psychiatry and internal medicine journals from 1950 to 2000. Methods: The journals searched were the three highest-ranking…

  1. What Value Can Qualitative Research Add to Quantitative Research Design? An Example From an Adolescent Idiopathic Scoliosis Trial Feasibility Study.

    Science.gov (United States)

    Toye, Francine; Williamson, Esther; Williams, Mark A; Fairbank, Jeremy; Lamb, Sarah E

    2016-08-09

    Using an example of qualitative research embedded in a non-surgical feasibility trial, we explore the benefits of including qualitative research in trial design and reflect on epistemological challenges. We interviewed 18 trial participants and used methods of Interpretive Phenomenological Analysis. Our findings demonstrate that qualitative research can make a valuable contribution by allowing trial stakeholders to see things from alternative perspectives. Specifically, it can help to make specific recommendations for improved trial design, generate questions which contextualize findings, and also explore disease experience beyond the trial. To make the most out of qualitative research embedded in quantitative design it would be useful to (a) agree specific qualitative study aims that underpin research design, (b) understand the impact of differences in epistemological truth claims, (c) provide clear thematic interpretations for trial researchers to utilize, and (d) include qualitative findings that explore experience beyond the trial setting within the impact plan.

  2. New image of psychiatry, mass media impact and public relations.

    Science.gov (United States)

    Jakovljević, Miro; Tomić, Zoran; Maslov, Boris; Skoko, Iko

    2010-06-01

    The mass media has a powerful impact on public attitudes about mental health and psychiatry. The question of identity of psychiatry as a medical profession as well as of the future of psychiatry has been the subject of much controversial discussion. Psychiatry today has the historical opportunity to shape the future of mental health care, medicine and society. It has gained in scientific and professional status by the tremendous increase of knowledge and treatment skills. Psychiatry should build up new transdisciplinary and integrative image of a specialized profession, promote it and make it public. Good public relations are very important for the future of psychiatry.

  3. Research into the (Cost- effectiveness of the ketogenic diet among children and adolescents with intractable epilepsy: design of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Hendriksen Jos GM

    2011-01-01

    Full Text Available Abstract Background Epilepsy is a neurological disorder, characterized by recurrent unprovoked seizures which have a high impact on the individual as well as on society as a whole. In addition to the economic burden, epilepsy imposes a substantial burden on the patients and their surroundings. Patients with uncontrolled epilepsy depend heavily on informal care and on health care professionals. About 30% of patients suffer from drug-resistant epilepsy. The ketogenic diet can be a treatment of last resort, especially for children. The beneficial effect of the ketogenic diet has been proven, but information is lacking about its cost-effectiveness. In the current study we will evaluate the (cost- effectiveness of the ketogenic diet in children and adolescents with intractable epilepsy. Methods/Design In a RCT we will compare the ketogenic diet with usual care. Embedded in this RCT will be a trial-based and model-based economic evaluation, looking from a societal perspective at the cost-effectiveness and cost-utility of the ketogenic diet versus usual care. Fifty children and adolescents (aged 1-18 with intractable epilepsy will be screened for eligibility before randomization into the intervention or the usual care group. The primary outcome measure is the proportion of children with a 50% or more reduction in seizure frequency. Secondary outcomes include seizure severity, side effects/complaints, neurocognitive, socio-emotional functioning, and quality of life. Costs and productivity losses will be assessed continuously by a prospective diary and a retrospective questionnaire. Measurements will take place during consults at baseline, at 6 weeks and at 4 months after the baseline period, and 3, 6, 9 and 12 months follow-up after the 4 months consult. Discussion The proposed research project will be the first study to provide data about the cost-effectiveness of the ketogenic diet for children and adolescents with intractable epilepsy, in comparison

  4. A randomised placebo-exercise controlled trial of Kung Fu training for improvements in body composition in overweight/obese adolescents: the “Martial Fitness” study

    Science.gov (United States)

    Tsang, Tracey W.; Kohn, Michael; Chow, Chin Moi; Singh, M Fiatarone

    2009-01-01

    The purpose of the study was to investigate if Chinese martial arts (Kung Fu, KF) might be effective for improving body composition, as well as being an appealing form of physical activity for inexperienced, sedentary, overweight/obese adolescents. Twenty subjects (age: 13.3 ± 1.8 y; BMI percentile: 98.6(86.5 - 99.8); 60% girls) were randomly-assigned to the supervised KF or placebo (Tai Chi, TC) control group 3 d.wk-1 for 6 months. We assessed body composition, including total and regional fat and lean mass, total and regional bone mineral density (BMD), percent lean and fat mass, body mass index and waist circumference, at baseline and after 6 months of training using anthropometry and dual-energy X-ray absorptiometry (DXA). Habitual physical activity and dietary intake were recorded as covariates via self-report at each time-point. As expected due to natural growth, significant increases in height, weight, total and lumbar BMD, and lean mass were seen in the cohort over time, with a trend for increased whole body fat mass, with no difference between groups. By contrast, percent fat and android fat mass via DXA did not increase in either group over time. The absence of a similar expected increase in central adiposity over 6 months could indicate a positive effect of participation in both programs on the metabolically critical abdominal adiposity in this cohort. Further research in this area is warranted to determine ways to increase uptake and compliance, and to see if longer-term martial arts training not only maintains, but improves abdominal fat mass and related metabolic health indices in overweight/ obese adolescents. Key points Participation in our martial arts trial attenuated the increases in body fat mass expected due to growth in our overweight/obese adolescent group. All subjects allocated to the Kung Fu intervention were satisfied with their Kung Fu training, in contrast to our placebo-exercise (Tai Chi) subjects, suggesting that this form of

  5. A randomised placebo-exercise controlled trial of Kung Fu training for improvements in body composition in overweight/obese adolescents: the "Martial Fitness" study.

    Science.gov (United States)

    Tsang, Tracey W; Kohn, Michael; Chow, Chin Moi; Singh, M Fiatarone

    2009-01-01

    The purpose of the study was to investigate if Chinese martial arts (Kung Fu, KF) might be effective for improving body composition, as well as being an appealing form of physical activity for inexperienced, sedentary, overweight/obese adolescents. Twenty subjects (age: 13.3 ± 1.8 y; BMI percentile: 98.6(86.5 - 99.8); 60% girls) were randomly-assigned to the supervised KF or placebo (Tai Chi, TC) control group 3 d.wk(-1) for 6 months. We assessed body composition, including total and regional fat and lean mass, total and regional bone mineral density (BMD), percent lean and fat mass, body mass index and waist circumference, at baseline and after 6 months of training using anthropometry and dual-energy X-ray absorptiometry (DXA). Habitual physical activity and dietary intake were recorded as covariates via self-report at each time-point. As expected due to natural growth, significant increases in height, weight, total and lumbar BMD, and lean mass were seen in the cohort over time, with a trend for increased whole body fat mass, with no difference between groups. By contrast, percent fat and android fat mass via DXA did not increase in either group over time. The absence of a similar expected increase in central adiposity over 6 months could indicate a positive effect of participation in both programs on the metabolically critical abdominal adiposity in this cohort. Further research in this area is warranted to determine ways to increase uptake and compliance, and to see if longer-term martial arts training not only maintains, but improves abdominal fat mass and related metabolic health indices in overweight/ obese adolescents. Key pointsParticipation in our martial arts trial attenuated the increases in body fat mass expected due to growth in our overweight/obese adolescent group.All subjects allocated to the Kung Fu intervention were satisfied with their Kung Fu training, in contrast to our placebo-exercise (Tai Chi) subjects, suggesting that this form of

  6. Serum oxidant and antioxidant status following an all-out 21-km run in adolescent runners undergoing professional training--a one-year prospective trial.

    Science.gov (United States)

    Tong, Tom K; Kong, Zhaowei; Lin, Hua; Lippi, Giuseppe; Zhang, Haifeng; Nie, Jinlei

    2013-07-22

    This study investigated the 1-year longitudinal effect of professional training in adolescent runners on redox balance during intense endurance exercise. Changes in selected serum oxidant and antioxidant status in response to a 21-km running time trial in 10 runners (15.5 ± 1.3 years) undergoing professional training were evaluated twice in 12 months (pre- and post-evaluation). Venous blood samples were collected immediately before and 4-h following the 21-km run for analysis of serum concentrations of thiobarbituric acid-reactive substances (TBARS), xanthine oxidase (XO), catalase (CAT), reduced glutathione (GSH), superoxide dismutase (SOD), and total antioxidant capacity (T-AOC). In pre-evaluation trial, serum TBARS and SOD decreased after the 21-km run (p training regime in adolescent runners is not likely to jeopardize the development of their antioxidant defense. However, uncertainties in the maintenance of redox balance in runners facing increased exercise-induced oxidative stress as a consequence of training-induced enhancement of exercise capacity await further elucidation.

  7. Pragmatic design in randomized controlled trials.

    Science.gov (United States)

    Purgato, M; Barbui, C; Stroup, S; Adams, C

    2015-01-01

    At more than 10 years after the paper by Hotopf and colleagues regarding pragmatic trials in psychiatry, the field has evolved and is evolving further. There have been many developments in our understanding of what pragmatism really means, and excellent examples of truly pragmatic trials in psychiatry are currently available. Funders have helped encourage more emphasis on the need for such studies, but 'local' and trans-national regulations could help more. Consumers of the evidence should have a greater voice in generating the research agenda and, as this happens, the questions generated are more likely to be answered by a pragmatic approach to trials.

  8. PET and SPECT in psychiatry

    Energy Technology Data Exchange (ETDEWEB)

    Dierckx, Rudi A.J.O. [University Medical Center Groningen (Netherlands). Dept. of Nuclear Medicine and Molecular Imaging; Ghent Univ. (Belgium); Otte, Andreas [Univ. of Applied Sciences Offenburg (Germany). Faculty of Electrical Engineering and Information Technology; Vries, Erik F.J. de; Waarde, Aren van (eds.) [University Medical Center Groningen (Netherlands). Dept. of Nuclear Medicine and Molecular Imaging

    2014-09-01

    Covers classical psychiatric disorders as well as other subjects such as suicide, sleep, eating disorders, and autism. Emphasis on a multidisciplinary approach. Written by internationally acclaimed experts. PET and SPECT in Psychiatry showcases the combined expertise of renowned authors whose dedication to the investigation of psychiatric disease through nuclear medicine technology has achieved international recognition. The classical psychiatric disorders as well as other subjects - such as suicide, sleep, eating disorders, and autism - are discussed and the latest results in functional neuroimaging are detailed. Most chapters are written jointly by a clinical psychiatrist and a nuclear medicine expert to ensure a multidisciplinary approach. This state of the art compendium will be valuable to all who have an interest in the field of neuroscience, from the psychiatrist and the radiologist/nuclear medicine specialist to the interested general practitioner and cognitive psychologist. It is the first volume of a trilogy on PET and SPECT imaging in the neurosciences; other volumes will focus on PET and SPECT in neurology and PET and SPECT of neurobiological systems.

  9. Workplace Based Assessment in Psychiatry

    Directory of Open Access Journals (Sweden)

    Ayse Devrim Basterzi

    2009-11-01

    Full Text Available Workplace based assessment refers to the assessment of working practices based on what doctors actually do in the workplace, and is predominantly carried out in the workplace itself. Assessment drives learning and it is therefore essential that workplace-based assessment focuses on important attributes rather than what is easiest to assess. Workplacebased assessment is usually competency based. Workplace based assesments may well facilitate and enhance various aspects of educational supervisions, including its structure, frequency and duration etc. The structure and content of workplace based assesments should be monitored to ensure that its benefits are maximised by remaining tailored to individual trainees' needs. Workplace based assesment should be used for formative and summative assessments. Several formative assessment methods have been developed for use in the workplace such as mini clinical evaluation exercise (mini-cex, evidence based journal club assesment and case based discussion, multi source feedback etc. This review discusses the need of workplace based assesments in psychiatry graduate education and introduces some of the work place based assesment methods.

  10. Neurology and psychiatry in Babylon.

    Science.gov (United States)

    Reynolds, Edward H; Wilson, James V Kinnier

    2014-09-01

    We here review Babylonian descriptions of neurological and psychiatric disorders, including epilepsy, stroke, psychoses, obsessive compulsive disorder, phobias, psychopathic behaviour, depression and anxiety. Most of these accounts date from the first Babylonian dynasty of the first half of the second millennium BC, within a millennium and a half of the origin of writing. The Babylonians were remarkably acute and objective observers of medical disorders and human behaviour. Their detailed descriptions are surprisingly similar to modern 19th and 20th century AD textbook accounts, with the exception of subjective thoughts and feelings which are more modern fields of enquiry. They had no knowledge of brain or psychological function. Some neuropsychiatric disorders, e.g. stroke or facial palsy, had a physical basis requiring the attention of a physician or asû, using a plant and mineral based pharmacology; some disorders such as epilepsy, psychoses, depression and anxiety were regarded as supernatural due to evil demons or spirits, or the anger of personal gods, and thus required the intervention of the priest or ašipu; other disorders such as obsessive compulsive disorder and psychopathic behaviour were regarded as a mystery. The Babylonians were the first to describe the clinical foundations of neurology and psychiatry. We discuss these accounts in relation to subsequent and more modern clinical descriptions.

  11. [Reform of psychiatry in Spain].

    Science.gov (United States)

    Pedrosa Gil, F; Luderer, H J

    2000-11-01

    Since the 1980's psychiatric care in Spain changed considerably (Reforma psiquiátrica española). In the course of this reform, many positive results were achieved. An extensive community network of mental health centres was build up which resulted in the majority of psychiatric patients being integrated in the Spanish general health care system and making a better organized mental health care structure possible. New legislation also improved the care and civil rights of patients. An analysis of the experiences of the Spanish psychiatric reform shows that the tendency to retain the old mental hospitals, alongside the other institutions still exists. The process of deinstitutionalization and the original aims of the psychiatric reform cannot only be satisfied by the closure of large psychiatric hospitals as during the reform new aspects and problems as well the great complexity of the task have become apparent. This article together with the details of the Spanish sources gives the German public a good overview of the developments in Spanish psychiatry.

  12. Cultural competency training in psychiatry.

    Science.gov (United States)

    Qureshi, A; Collazos, F; Ramos, M; Casas, M

    2008-01-01

    Recent reports indicate that the quality of care provided to immigrant and ethnic minority patients is not at the same level as that provided to majority group patients. Although the European Board of Medical Specialists recognizes awareness of cultural issues as a core component of the psychiatry specialization, few medical schools provide training in cultural issues. Cultural competence represents a comprehensive response to the mental health care needs of immigrant and ethnic minority patients. Cultural competence training involves the development of knowledge, skills, and attitudes that can improve the effectiveness of psychiatric treatment. Cognitive cultural competence involves awareness of the various ways in which culture, immigration status, and race impact psychosocial development, psychopathology, and therapeutic transactions. Technical cultural competence involves the application of cognitive cultural competence, and requires proficiency in intercultural communication, the capacity to develop a therapeutic relationship with a culturally different patient, and the ability to adapt diagnosis and treatment in response to cultural difference. Perhaps the greatest challenge in cultural competence training involves the development of attitudinal competence inasmuch as it requires exploration of cultural and racial preconceptions. Although research is in its infancy, there are increasing indications that cultural competence can improve key aspects of the psychiatric treatment of immigrant and minority group patients.

  13. Computeen: a randomized trial of a preventive computer and psychosocial skills curriculum for at-risk adolescents.

    Science.gov (United States)

    Lang, Jason M; Waterman, Jill; Baker, Bruce L

    2009-09-01

    Computeen, a preventive technology and psychosocial skills development program for at-risk adolescents, was designed to improve computer skills, self-esteem, and school attitudes, and reduce behavior problems, by combining elements of community-based and empirically supported prevention programs. Fifty-five mostly Latino adolescents from 12 to 16 years old who were living in affordable housing communities participated in this randomized wait-list control study. Results showed considerable improvements in computer self-efficacy, decreases in internalizing behavior problems, and excellent attendance and consumer satisfaction. Self-esteem and school motivation results were mixed. Computer self-efficacy mediated the relationship between improved computer skills and self-esteem. Younger adolescents showed greater improvement than did older adolescents. EDITORS' STRATEGIC IMPLICATIONS: Although there are limitations to this study's sample size and scope, Computeen appears promising as a developmentally appropriate, strengths-based prevention program.

  14. Evaluation of the efficacy and safety of olanzapine as an adjunctive treatment for anorexia nervosa in adolescent females: a randomized, double-blind, placebo-controlled trial

    Directory of Open Access Journals (Sweden)

    Moher David

    2008-01-01

    Full Text Available Abstract Background Anorexia Nervosa (AN is a serious, debilitating condition that causes significant physical, emotional, and functional impairment. The condition is characterized by destructive weight loss behaviours and a refusal to maintain body weight at or above a minimally normal weight for age and height. AN often develops in adolescence and is a predominantly female disorder. Treatment for AN typically involves medical, nutritional and psychological interventions. Pharmacotherapy is also often used; however, the literature on the effectiveness of these drugs in a pediatric population is very limited. Olanzapine, which is an 'atypical' antipsychotic, is becoming more widespread in the treatment of AN. Olanzapine is hypothesized to facilitate weight gain, while decreasing levels of agitation and decreasing resistance to treatment in young women with AN. This randomized, double-blind placebo-controlled trial seeks to examine the effectiveness and safety of olanzapine in female youth with AN. Methods/Design Adolescent females between the ages of 12 and 17 diagnosed with AN (either restricting or binge/purge type or Eating Disorder Not Otherwise Specified with a Body Mass Index of less than or equal to 17.5, will be offered inclusion in the study. Patients will be randomly assigned to receive either olanzapine or placebo. Patients assigned to receive olanzapine will start at a low dose of 1.25 mg/day for three days, followed by 2.5 mg/day for four days, 5 mg/day for one week, then 7.5 mg/day (the target dose chosen for 10 weeks. After 10 weeks at 7.5 mg the medication will be tapered and discontinued over a period of two weeks. The effectiveness of olanzapine versus placebo will be determined by investigating the change from baseline on measures of eating attitudes and behaviors, depression and anxiety, and change in Body Mass Index at week 12, and after a follow-up period at week 40. It is anticipated that 67 participants will be recruited

  15. Randomized controlled trial of motivational enhancement therapy with nontreatment-seeking adolescent cannabis users: a further test of the teen marijuana check-up.

    Science.gov (United States)

    Walker, Denise D; Stephens, Robert; Roffman, Roger; Demarce, Josephine; Lozano, Brian; Towe, Sheri; Berg, Belinda

    2011-09-01

    Cannabis use adversely affects adolescents and interventions that are attractive to adolescents are needed. This trial compared the effects of a brief motivational intervention for cannabis use with a brief educational feedback control and a no-assessment control. Participants were randomized into one of three treatment conditions: Motivational Enhancement Therapy (MET), Educational Feedback Control (EFC), or Delayed Feedback Control (DFC). Those who were assigned to MET and EFC were administered a computerized baseline assessment immediately following randomization and completed assessments at the 3- and 12-month follow-up periods. Participants in the DFC condition were not assessed until the 3-month follow-up. Following the completion of treatment sessions, all participants were offered up to four optional individual treatment sessions aimed at cessation of cannabis use. The research was conducted in high schools in Seattle, Washington. The participant s included 310 self-referred adolescents who smoked cannabis regularly. The main outcome measures included days of cannabis use, associated negative consequences, and engagement in additional treatment. At the 3-month follow-up, participants in both the MET and EFC conditions reported significantly fewer days of cannabis use and negative consequences compared to those in the DFC. The frequency of cannabis use was less in MET relative to EFC at 3 months, but it did not translate to differences in negative consequences. Reductions in use and problems were sustained at 12 months, but there were no differences between MET and EFC interventions. Engagement in additional treatment was minimal and did not differ by condition. Brief interventions can attract adolescent cannabis users and have positive impacts on them, but the mechanisms of the effects are yet to be identified.

  16. Emergency in pediatric and adolescent psychiatry. Note taking for the primary health assistance. Urgencias en psiquiatría infantil y adolescente. Apuntes para el nivel primario de atención.

    Directory of Open Access Journals (Sweden)

    Zenaida María Sáez

    Full Text Available The psyquiatric emergences in children and adolescents are usually manifested as alterations of the feelings, behavior or in the school efficiency and its origin is found in the physical tensions, contradictions in the breeding, marital conflicts, bad interpersonal relationships, negligence, loss of the significant model at home, etc. It is important to address that there is no direct relationship between the causal factor and the onset of the symptoms. This largely depends on variables such as temperament, levels of development, nature and duration of the stress, past experience and family capacity/ability of the family to get adapted to new situations.

    Parents frequently come to visit General Comprehensive doctor because they are worried about their children´s behaviors, i.e.; if they are normal or require certain intervention.

    In the current review we make reference to the psychosocial issues that may bring about psychopathological manifestations which need a timely intervention. Otherwise, there is a risk for the physical integrity of the kid, adolescent or another people which may result into a remarkable complications and suffering for the patients or their relatives. We are going to make reference to the abuse of some substances, adoption, nervous anorexia, suicide attempt, infant abuse, fire provocation and mourning reaction.

    We are making emphasis on the clinical assessment of the risk factors which contribute to the appearance of these issues and the management in the primary level of assistance to prevent further complications.

    Las urgencias psiquiátricas en el niño y el adolescente se manifiestan usualmente como alteraciones de los sentimientos, de la conducta o del rendimiento escolar y tienen su origen en tensiones físicas, contradicciones en la crianza, conflictos maritales, malos tratos, negligencia, pérdida de figuras significativas, etc. Es importante señalar que no existe una relación directa entre

  17. Attitudes of psychiatry residents toward mental illness

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    Pejović-Milovančević Milica

    2007-01-01

    Full Text Available Introduction. Attitudes of lay people and physicians towards mentally ill patients are frequently highly biased. The aim of this study was to investigate differences in attitudes of psychiatry and internal medicine residents toward mental illness and to establish the relationship between their attitudes and their personal characteristics. Material and methods. The sample consisted of 45 psychiatry and 36 internal medicine residents. The attitudes toward mental illness were assessed using Opinions about Mental Illness Questionnaire (OMI and personality traits were examined using the Eysenck Personality Questionnaire (EPQ. Results. Our findings showed that in regard to internal medicine residents, psychiatry residents do not consider mentally ill patients to be inferior and dangerous. Psychiatry residents have a benevolent attitude toward the mentally ill. Personality traits of psychiatry residents were not related to their opinions about mental illness. Discussion. The results suggest that there is a need to develop strategies that would bring about changes in the curriculum of training programs for medical residents, including proper training in mental health issues. Such strategies should help in destigmatization of persons with mental disorders and increase the competence of physicians to deal with mentally ill. .

  18. [Where is going philosophy of psychiatry ?].

    Science.gov (United States)

    Basso, Elisabetta

    2016-12-01

    This contribution provides a critical outline of the current trends in the field of "philosophy of psychiatry" by following their developments in the last decade. The first part of the paper focuses on the evolution of this field from a strictly conceptual approach to a perspective more attentive to the social, practical, and clinical dimension of psychiatry. The second part of the paper points out that the need of a mutual commitment of philosophy and psychiatry is perceived according to different ways by the countries involved in this research area. The paper deals especially with the case of France, where the enthusiasm for the "new philosophy of psychiatry" has not had the same impact on the philosophical scene as in the English speaking countries. In conclusion, the paper shows that the field of philosophy of psychiatry stands as a fertile ground for new forms of interaction between the analytic, and the continental philosophical traditions. This interaction takes place, more particularly, as regards such topics as normativity, language, and interpretation.

  19. Gender differences in career paths in psychiatry.

    Science.gov (United States)

    Krener, P

    1994-03-01

    Although psychiatry has one of the highest proportions of women entering its residency programs, women have not assumed a proportionate amount of academic or research leadership positions in the field. This literature review identifies three general groups of models that explain disparities between men's and women's careers, but these do not fully account for observed differences in psychiatric practice and academic progression of women in psychiatry. Gender differences in career paths in psychiatry are not only affected by individual traits and choices, but also by economic factors. Theories based on organizational discrimination, and systems and market factors are also reviewed. No single explanatory model accounts for disparities between the careers of men and those of women. Because psychiatric practice patterns may be broadly distributed across labor sectors, more diverse career patterns are possible in psychiatry than in more constrained and traditional fields. Research on gender differences in psychiatry careers must consider not only the individual work style and choice, but also the position of individuals within the organization and the position of those organizations across the labor market.

  20. Neurology referrals to a liaison psychiatry service.

    LENUS (Irish Health Repository)

    Fitzgerald, P

    2012-02-03

    The objective of the present study was to assess the activity of the Liaison Psychiatry service of Cork University Hospital in relation to all in-patient neurology referrals over a 12-month period. Of 1685 neurology admissions, 106 (6%) were referred to liaison psychiatry for assessment. 91 referrals (86%) met criteria for a psychiatric disorder according to DSM-IV, the commonest being major depression (24%) and somatoform disorder (23%). Patients with multiple sclerosis or epilepsy comprised nearly half of all referrals (48 cases; 45%). Approximately 20% of M.S. in-patients (21 cases) were referred for psychiatric assessment, with the corresponding figure in epilepsy being 25% (18 cases). Although only 106 (6%) neurology in-patients were referred to liaison psychiatry, psychiatric diagnoses were documented in 327 (20%) discharge forms, presumably reflecting previous diagnosis. The above findings indicate that psychiatric illness is common among neurology inpatients screened by liaison psychiatry yet referral rates are relatively low in terms of the overall number of neurology in-patients. Psychiatric disorders were diagnosed in 86% of referrals indicating high concordance between neurologists and liaison psychiatry regarding the presence of a psychiatric disorder.

  1. The Nutrition and Enjoyable Activity for Teen Girls (NEAT girls randomized controlled trial for adolescent girls from disadvantaged secondary schools: rationale, study protocol, and baseline results

    Directory of Open Access Journals (Sweden)

    Okely Anthony D

    2010-10-01

    Full Text Available Abstract Background Child and adolescent obesity predisposes individuals to an increased risk of morbidity and mortality from a range of lifestyle diseases. Although there is some evidence to suggest that rates of pediatric obesity have leveled off in recent years, this has not been the case among youth from low socioeconomic backgrounds. The purpose of this paper is to report the rationale, study design and baseline findings of a school-based obesity prevention program for low-active adolescent girls from disadvantaged secondary schools. Methods/Design The Nutrition and Enjoyable Activity for Teen Girls (NEAT Girls intervention will be evaluated using a group randomized controlled trial. NEAT Girls is a 12-month multi-component school-based intervention developed in reference to Social Cognitive Theory and includes enhanced school sport sessions, interactive seminars, nutrition workshops, lunch-time physical activity (PA sessions, PA and nutrition handbooks, parent newsletters, pedometers for self-monitoring and text messaging for social support. The following variables were assessed at baseline and will be completed again at 12- and 24-months: adiposity, objectively measured PA, muscular fitness, time spent in sedentary behaviors, dietary intake, PA and nutrition social-cognitive mediators, physical self-perception and global self-esteem. Statistical analyses will follow intention-to-treat principles and hypothesized mediators of PA and nutrition behavior change will be explored. Discussion NEAT Girls is an innovative intervention targeting low-active girls using evidence-based behavior change strategies and nutrition and PA messages and has the potential to prevent unhealthy weight gain and reduce the decline in physical activity and poor dietary habits associated with low socio-economic status. Few studies have reported the long-term effects of school-based obesity prevention programs and the current study has the potential to make an

  2. Recent Stressful Life Events among Bahraini Adolescents with Adjustment Disorder.

    Science.gov (United States)

    Al-Ansari, Ahmed; Matar, Ali M.

    1993-01-01

    Retrospectively examined adolescents from two time periods, diagnosed with adjustment disorder (n=72), for type of life stressors that initiated referrals to child psychiatry unit and compared them to control group of 42 referred adolescents with no psychopathology. Disappointment in relationships with family member or friend of opposite sex was…

  3. Emergent authority and expert knowledge: psychiatry and criminal responsibility in the UK.

    Science.gov (United States)

    Loughnan, Arlie; Ward, Tony

    2014-01-01

    In the UK context, the rise of the discipline and practice of forensic psychiatry is intimately connected with the concurrent development of principles and practices relating to criminal responsibility. In this article, we seek to chart the relationship between psychiatry and the principles and practices of criminal responsibility in the UK over the early modern, modern and late modern periods. With a focus on claims about authority and expert knowledge around criminal responsibility, we suggest that these claims have been in a state of perpetual negotiation and that, as a result, claims to authority over and knowledge about criminal non-responsibility on the part of psychiatrists and psychiatry are most accurately understood as emergent and contingent. The apparent formalism of legal discourse has tended to conceal the extent to which legal policy has been preoccupied with maintaining the primacy of lay judgments in criminal processes of evaluation and adjudication. While this policy has been somewhat successful in the context of the trial - particularly the murder trial - it has been undermined by administrative procedures surrounding the trial, including those that substitute treatment for punishment without, or in spite of, a formal determination of criminal responsibility.

  4. Does Effectiveness of Adolescent Smoking-Cessation Intervention Endure Into Young Adulthood? 7-Year Follow-Up Results from a Group-Randomized Trial.

    Directory of Open Access Journals (Sweden)

    Arthur V Peterson

    Full Text Available The Hutchinson Study of High School Smoking was the first randomized trial to show effectiveness of a smoking cessation intervention on 6-months prolonged smoking abstinence at one year post-intervention in a large population-based sample of adolescent smokers. An important question remains: Do the positive effects from teen smoking cessation interventions seen at up to 12 months post-intervention endure into young adulthood? This study examines for the first time whether such positive early effects from teen smoking cessation intervention can endure into young adulthood in the absence of additional intervention.High school smokers (n = 2,151 were proactively recruited into the trial from fifty randomly selected Washington State high schools randomized to the experimental (Motivational Interviewing + Cognitive Behavioral Skills Training telephone counseling intervention or control (no intervention condition. These smokers were followed to 7 years post high school to ascertain rates of six-year prolonged smoking abstinence in young adulthood. All statistical tests are two-sided.No evidence of intervention impact at seven years post high school was observed for the main endpoint of six-year prolonged abstinence, neither among all smokers (14.2% in the experimental condition vs. 13.1% in the control condition, difference = +1.1%, 95% confidence interval (CI = -3.4 to 5.8, p = .61, nor among the subgroups of daily smokers and less-than-daily smokers, nor among other a priori subgroups. But, observed among males was some evidence of an intervention impact on two endpoints related to progress towards quitting: reduction in number of days smoked in the past month, and increase in the length of the longest quit attempt in the past year.There was no evidence from this trial among adolescent smokers that positive effectiveness of the proactive telephone intervention for smoking abstinence, observed previously at one year post-intervention, was sustained

  5. Trial protocol and preliminary results for a cluster randomised trial of behavioural support versus brief advice for smoking cessation in adolescents

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    Stanton Alan

    2010-12-01

    Full Text Available Abstract Background Many young people report they want to stop smoking and have tried to do so, but most of their quit attempts fail. For adult smokers, there is strong evidence that group behavioural support enhances quit rates. However, it is uncertain whether group behavioural support enhances abstinence in young smokers trying to quit. Findings A cluster randomised trial for young people trying to stop smoking to compare the efficacy of a school-based 9 week intensive group behavioural support course versus a school-based 7 week brief advice only course. Participants were assessed for evidence of tobacco addiction and nicotine replacement therapy (NRT was used if it was deemed appropriate by the therapist. Both types of course aimed to recruit approximately one hundred participants from approximately ten schools. The primary outcome was successful quitting at 4 weeks after quit day judged according to the Russell standard. Had the trial been completed, abstinence at 6 months after quit day and the relationships between successful quit attempts and 1 psychological assessments of dependence prior to quitting 2 salivary cotinine concentration prior to quitting and 3 sociodemographic characteristics would also have been assessed. The proportion of participants who stopped smoking in each arm of the trial were compared using Chi square tests. The trial was stopped shortly after it had started because funding to support the therapists running the stop smoking group behavioural support programme was withdrawn. Only three stop smoking courses were completed (two group support courses and one brief advice pharmacotherapy course. Seventeen participants in total entered the trial. At the end of the courses, one participant (10% attending the group support programme had stopped smoking and no participant attending the brief advice programme had stopped smoking. Discussion The trial was stopped so we were unable to determine whether group support helped

  6. Central registry in psychiatry: A structured review

    Directory of Open Access Journals (Sweden)

    Jyoti Prakash

    2014-01-01

    Full Text Available Background: Central registry in psychiatry is being practiced in few countries and has been found useful in research and clinical management. Role of central registry has also expanded over the years. Materials and Methods: All accessible internet database Medline, Scopus, Embase were accessed from 1990 till date. Available data were systematically reviewed in structured manner and analyzed. Results: Central registry was found useful in epidemiological analysis, association studies, outcome studies, comorbidity studies, forensic issue, effective of medication, qualitative analysis etc., Conclusion: Central registry proves to be effective tool in quantitative and qualitative understanding of psychiatry practice. Findings of studies from central registry can be useful in modifying best practice and evidence based treatment in psychiatry.

  7. Limitations of the biopsychosocial model in psychiatry

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    Benning TB

    2015-05-01

    Full Text Available Tony B Benning Maple Ridge Mental Health Centre, Maple Ridge, BC, Canada Abstract: A commitment to an integrative, non-reductionist clinical and theoretical perspective in medicine that honors the importance of all relevant domains of knowledge, not just “the biological,” is clearly evident in Engel’s original writings on the biopsychosocial model. And though this model’s influence on modern psychiatry (in clinical as well as educational settings has been significant, a growing body of recent literature is critical of it - charging it with lacking philosophical coherence, insensitivity to patients’ subjective experience, being unfaithful to the general systems theory that Engel claimed it be rooted in, and engendering an undisciplined eclecticism that provides no safeguards against either the dominance or the under-representation of any one of the three domains of bio, psycho, or social. Keywords: critique of biopsychosocial psychiatry, integrative psychiatry, George Engel

  8. Educating psychiatry residents in neuropsychiatry and neuroscience.

    Science.gov (United States)

    Benjamin, Sheldon

    2013-06-01

    Neuropsychiatry and psychiatric neuroscience should be part of the general psychiatry curriculum so that graduate psychiatrists will be able to allow their patients the benefit of neuroscientifically informed diagnosis and treatment. Current neurology and neuroscience educational requirements for US psychiatry training are reviewed. The draft milestone requirements for clinical neuroscience training as part of the US Accreditation Council for Graduate Medical Education's Next Accreditation System are also provided. Suggestions for the neuropsychiatric and neuroscience content of psychiatry residency training are made, along with a description of pedagogic methods and resources. Survey data are reviewed indicating agreement by programme directors with the importance of neuroscience training and an increase in the amount of time devoted to this area. Faculty staff development in neuropsychiatry and neuroscience literacy will be needed to provide high quality training in these areas.

  9. Psiquiatria forense e direitos humanos nos pólos da vida: crianças, adolescentes e idosos Forensic psychiatry and human rights along the course of life: children, adolescents and elderly

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    Jerson Laks

    2006-10-01

    Full Text Available OBJETIVO: Crianças/adolescentes e idosos são alvo fácil para atos de violência, seja por sua fragilidade e dependência, seja por não serem considerados testemunhas confiáveis para denunciar os casos de abuso e maus-tratos. Temas como violência, capacidade civil e responsabilidade penal de crianças, adolescentes e idosos guardam correlações interessantes de serem avaliadas. Esse artigo faz uma revisão crítica do tema, compara e discute os Estatutos da Criança e do Adolescente e o Estatuto do Idoso no Brasil. DISCUSSÃO: Os abusos ou maus-tratos podem ser examinados a partir de dois aspectos: 1 fatores preditivos para sua ocorrência (perfil do abusado e do abusador e 2 agravos à saúde física e mental. CONCLUSÃO: O Brasil conta hoje com legislação avançada para proteção dessas populações vulneráveis e o tema de violência e maus tratos contra crianças e idosos deve ser parte da preocupação de clínicos e psiquiatras que tratam desses pacientes.OBJECTIVE: Children/adolescents and elderly are frequent victims of violent acts either because of their frailty and dependency or because they are not considered as reliable subjects to present cases of abuse against the perpetrators. There is an interesting relationship between civil capacities and legal responsibilities of minors and elderly. This is a critical review of minor and elder abuse that also presents and compares the Brazilian laws regarding the rights and responsibilities of elderly and minor subjects. DISCUSSION: Abuse may be examined regarding two aspects: 1 predictive factors of their occurrence (a profile of the abused and of the abuser, and 2 consequences for mental and physical health. CONCLUSION: This legislation is modern and protective of these vulnerable populations. Examining and diagnosing violence and abuse against children and elderly subjects must be part of the clinical and forensic practice of doctors and especially of psychiatrists.

  10. Teaching Psychiatry Residents to Teach: A National Survey

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    Crisp-Han, Holly; Chambliss, R. Bryan; Coverdale, John

    2013-01-01

    Objective: Because there have been no previously published national surveys on teaching psychiatry residents about how to teach, the authors surveyed United States psychiatry program directors on what and how residents are taught about teaching. Methods: All psychiatry training programs across the United States were mailed a semistructured…

  11. Survey of Threats and Assaults by Patients on Psychiatry Residents

    Science.gov (United States)

    Dvir, Yael; Moniwa, Emiko; Crisp-Han, Holly; Levy, Dana; Coverdale, John H.

    2012-01-01

    Objective: The authors sought to determine the prevalence of threats and assaults by patients on psychiatry residents, their consequences, and the perceived adequacy of supports and institutional responses. Method: Authors conducted an anonymous survey of 519 psychiatry residents in 13 psychiatry programs across the United States. The survey…

  12. Profile of aripiprazole in the treatment of bipolar disorder in children and adolescents

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    Kirino E

    2014-11-01

    Full Text Available Eiji Kirino1–3 1Department of Psychiatry, Juntendo University School of Medicine, 2Department of Psychiatry, Juntendo University Shizuoka Hospital, 3Juntendo Institute of Mental Health, Shizuoka, Japan Abstract: Bipolar disorder is a pernicious illness. Compared with the later-onset form, early onset bipolar disorder is associated with worse psychosocial outcomes, and is characterized by rapid cycling and increased risks of substance abuse and suicide attempts. Controlling mood episodes and preventing relapse in this group of pediatric patients requires careful treatment. Here, we review the effectiveness of aripiprazole for bipolar disorder in children and adolescents, with discussion of this drug's unique pharmacological profile and various clinical study outcomes. Aripiprazole acts as a serotonin 5-HT2A receptor antagonist, as well as a partial agonist of the serotonin 5-HT1A and dopamine D2 receptors. It can be safely used in children and adolescents, as it is highly tolerated and shows lower rates of the side effects typically observed with other antipsychotic drugs, including sedation, weight gain, hyperprolactinemia, and extrapyramidal syndrome. The presently reviewed randomized controlled trials (RCTs and non-RCTs generally reported aripiprazole to be effective and well-tolerated in children and adolescents with bipolar disorder. However, due to the limited number of RCTs, the present conclusions must be evaluated cautiously. Furthermore, aripiprazole cannot yet be considered a preferred treatment for children and adolescents with bipolar disorder, as there is not yet evidence that aripiprazole shows greater efficacy compared to other second-generation antipsychotics. Additional data are needed from future head-to-head comparison studies. Keywords: child, mania, mixed state

  13. A school-based intervention to promote physical activity among adolescent girls: Rationale, design, and baseline data from the Girls in Sport group randomised controlled trial

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    Puglisi Lauren

    2011-08-01

    Full Text Available Abstract Background Physical activity levels decline markedly among girls during adolescence. School-based interventions that are multi-component in nature, simultaneously targeting curricular, school environment and policy, and community links, are a promising approach for promoting physical activity. This report describes the rationale, design and baseline data from the Girls in Sport group randomised trial, which aims to prevent the decline in moderate-to-vigorous intensity physical activity (MVPA among adolescent girls. Methods/Design A community-based participatory research approach and action learning framework are used with measurements at baseline and 18-month follow-up. Within each intervention school, a committee develops an action plan aimed at meeting the primary objective (preventing the decline in accelerometer-derived MVPA. Academic partners and the State Department of Education and Training act as critical friends. Control schools continue with their usual school programming. 24 schools were matched then randomized into intervention (n = 12 and control (n = 12 groups. A total of 1518 girls (771 intervention and 747 control completed baseline assessments (86% response rate. Useable accelerometer data (≥10 hrs/day on at least 3 days were obtained from 79% of this sample (n = 1199. Randomisation resulted in no differences between intervention and control groups on any of the outcomes. The mean age (SE of the sample was 13.6 (± 0.02 years and they spent less than 5% of their waking hours in MVPA (4.85 ± 0.06. Discussion Girls in Sport will test the effectiveness of schools working towards the same goal, but developing individual, targeted interventions that bring about changes in curriculum, school environment and policy, and community links. By using community-based participatory research and an action learning framework in a secondary school setting, it aims to add to the body of literature on effective school

  14. The Eat Smart Study: A randomised controlled trial of a reduced carbohydrate versus a low fat diet for weight loss in obese adolescents

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    Truby Helen

    2010-08-01

    Full Text Available Abstract Background Despite the recognition of obesity in young people as a key health issue, there is limited evidence to inform health professionals regarding the most appropriate treatment options. The Eat Smart study aims to contribute to the knowledge base of effective dietary strategies for the clinical management of the obese adolescent and examine the cardiometablic effects of a reduced carbohydrate diet versus a low fat diet. Methods and design Eat Smart is a randomised controlled trial and aims to recruit 100 adolescents over a 2 1/2 year period. Families will be invited to participate following referral by their health professional who has recommended weight management. Participants will be overweight as defined by a body mass index (BMI greater than the 90th percentile, using CDC 2000 growth charts. An accredited 6-week psychological life skills program 'FRIENDS for Life', which is designed to provide behaviour change and coping skills will be undertaken prior to volunteers being randomised to group. The intervention arms include a structured reduced carbohydrate or a structured low fat dietary program based on an individualised energy prescription. The intervention will involve a series of dietetic appointments over 24 weeks. The control group will commence the dietary program of their choice after a 12 week period. Outcome measures will be assessed at baseline, week 12 and week 24. The primary outcome measure will be change in BMI z-score. A range of secondary outcome measures including body composition, lipid fractions, inflammatory markers, social and psychological measures will be measured. Discussion The chronic and difficult nature of treating the obese adolescent is increasingly recognised by clinicians and has highlighted the need for research aimed at providing effective intervention strategies, particularly for use in the tertiary setting. A structured reduced carbohydrate approach may provide a dietary pattern that some

  15. Why do we need a social psychiatry?

    Science.gov (United States)

    Ventriglio, Antonio; Gupta, Susham; Bhugra, Dinesh

    2016-07-01

    Human beings are social animals, and familial or social relationships can cause a variety of difficulties as well as providing support in our social functioning. The traditional way of looking at mental illness has focused on abnormal thoughts, actions and behaviours in response to internal causes (such as biological factors) as well as external ones such as social determinants and social stressors. We contend that psychiatry is social. Mental illness and interventions in psychiatry should be considered in the framework of social context where patients live and factors they face on a daily basis.

  16. How Health Reform is Recasting Public Psychiatry.

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    Shaner, Roderick; Thompson, Kenneth S; Braslow, Joel; Ragins, Mark; Parks, Joseph John; Vaccaro, Jerome V

    2015-09-01

    This article reviews the fiscal, programmatic, clinical, and cultural forces of health care reform that are transforming the work of public psychiatrists. Areas of rapid change and issues of concern are discussed. A proposed health care reform agenda for public psychiatric leadership emphasizes (1) access to quality mental health care, (2) promotion of recovery practices in primary care, (3) promotion of public psychiatry values within general psychiatry, (4) engagement in national policy formulation and implementation, and (5) further development of psychiatric leadership focused on public and community mental health.

  17. An Effectiveness Trial of a Dissonance-Based Eating Disorder Prevention Program for High-Risk Adolescent Girls

    Science.gov (United States)

    Stice, Eric; Rohde, Paul; Gau, Jeff; Shaw, Heather

    2009-01-01

    Efficacy trials indicate that an eating disorder prevention program involving dissonance-inducing activities that decrease thin-ideal internalization reduces risk for current and future eating pathology, yet it is unclear whether this program produces effects under real-world conditions. The present effectiveness trial tested whether this program…

  18. Senior Medical Students' Attitudes toward Psychiatry as a Career Choice before and after an Undergraduate Psychiatry Internship in Iran

    Science.gov (United States)

    Amini, Homayoun; Moghaddam, Yasaman; Nejatisafa, Ali-Akbar; Esmaeili, Sara; Kaviani, Hosein; Shoar, Saeed; Shabani, Amir; Samimi-Ardestani, Mehdi; Akhlaghi, Amir Abbas Keshavarz; Noroozi, Alireza; Mafi, Mostafa

    2013-01-01

    Objectives: The study aimed to assess 1) the attitudes of medical students in the sixth and seventh years (known as interns in Iran) toward psychiatry as a career choice, and 2) the degree of attractiveness of psychiatry as a career choice, with regard to various defined aspects, before and after an undergraduate psychiatry internship (similar to…

  19. INCANT: A transnational randomized trial of Multidimensional Family Therapy versus treatment as usual for adolescents with cannabis use disorder

    NARCIS (Netherlands)

    H. Rigter (Henk); I. Pelc (Isidore); P. Tossmann (Peter); O. Phan (Olivier); E. Grichting (Esther); V. Hendriks (Vincent); C. Rowe (Cindy)

    2010-01-01

    textabstractBackground: In 2003, the governments of Belgium, France, Germany, the Netherlands and Switzerland agreed that there was a need in Europe for a treatment programme for adolescents with cannabis use disorders and other behavioural problems. Based on an exhaustive literature review of evide

  20. Evaluating a selective prevention programme for binge drinking among young adolescents: study protocol of a randomized controlled trial

    NARCIS (Netherlands)

    Lammers, J.; Goossens, F.; Lokman, S.; Monshouwer, K.; Lemmers, L.; Conrod, P.; Wiers, R.; Engels, R.; Kleinjan, M.

    2011-01-01

    Background In comparison to other Europe countries, Dutch adolescents are at the top in drinking frequency and binge drinking. A total of 75% of the Dutch 12 to 16 year olds who drink alcohol also engage in binge drinking. A prevention programme called Preventure was developed in Canada to prevent a

  1. Evaluating a selective prevention programme for binge drinking among young adolescents: Study protocol of a randomized controlled trial

    NARCIS (Netherlands)

    Lammers, J.; Goossens, F.; Lokman, S.; Monshouwer, K.; Lemmers, A.C.J.; Conrod, P.; Wiers, R.W.H.J.; Engels, R.C.M.E.; Kleinjan, M.

    2011-01-01

    Background In comparison to other Europe countries, Dutch adolescents are at the top in drinking frequency and binge drinking. A total of 75% of the Dutch 12 to 16 year olds who drink alcohol also engage in binge drinking. A prevention programme called Preventure was developed in Canada to prevent a

  2. Cost-Effectiveness of Group and Internet Cognitive Behavioral Therapy for Insomnia in Adolescents : Results from a Randomized Controlled Trial

    NARCIS (Netherlands)

    de Bruin, E.J.; van Steensel, F.J.A.; Meijer, A.M.

    2016-01-01

    Study Objectives: To investigate cost-effectiveness of adolescent cognitive behavioral therapy for insomnia (CBTI) in group- and Internet-delivered formats, from a societal perspective with a time horizon of 1 y Methods: Costs and effects data up to 1-y follow-up were obtained from a randomized cont

  3. Physical activity monitoring in adolescents with juvenile fibromyalgia: findings from a clinical trial of cognitive behavioral therapy

    OpenAIRE

    Kashikar-Zuck, Susmita; Flowers, Stacy R.; Strotman, Daniel; Sil, Soumitri; Ting, Tracy V; Schikler, Kenneth N.

    2013-01-01

    Juvenile fibromyalgia (JFM) is a chronic musculoskeletal pain condition that is associated with reduced physical function. Recent research has demonstrated that cognitive-behavioral therapy (CBT) is effective in improving daily functioning among adolescents with JFM. However, it is not known whether these improvements were accompanied by increased physical activity levels.

  4. Combined cognitive and parent training interventions for adolescents with ADHD and their mothers: A randomized controlled trial.

    Science.gov (United States)

    Steeger, Christine M; Gondoli, Dawn M; Gibson, Bradley S; Morrissey, Rebecca A

    2016-01-01

    This study examined the individual and combined effects of two nonpharmacological treatments for attention deficit/hyperactivity disorder (ADHD): Cogmed working memory training (CWMT) for adolescents and behavioral parent training (BPT) for mothers. Ninety-one adolescents (ages 11-15) and their mothers were randomized to one of four CWMT and BPT treatment and active control (placebo) group combinations of 5-week interventions. At pre- and posttest, mothers and teachers completed rating forms, and adolescents completed neuropsychological measures of working memory (WM). Individual intervention effects showed that treatment CWMT significantly improved WM spans, whereas there were no significant differences for treatment or control BPT on reports of parent-related outcomes. Combined treatment effects indicated an overall pattern of greatest improvements for the control CWMT/treatment BPT group, as compared to the other three groups, on adolescent WM deficit, behavioral regulation problems, and global executive deficit. Most significant effects for outcomes were main effects of improvements over time. A combination of CWMT and BPT did not result in increased treatment gains. However, potential effects of combined treatment may have been masked by greater perceived benefits arising from lack of struggle in the nonadaptive, CWMT active control condition. Future combined intervention research should focus on specific, theoretically driven WM deficits among individuals with ADHD, should include possible adaptations to the standard CWMT program, should examine effectiveness of cognitive treatments combined with contextual interventions and should utilize appropriate control groups to fully understand the unique and combined effects of interventions.

  5. The Prevention of Depression and Anxiety in a Sample of High-Risk Adolescents: A Randomized Controlled Trial

    Science.gov (United States)

    Dobson, Keith S.; Hopkins, Jamie Ahnberg; Fata, Ladan; Scherrer, Martin; Allan, Lauren C.

    2010-01-01

    This study investigated the efficacy of cognitive behavioural therapy (CBT) techniques in preventing depression and anxiety in a group of adolescent high school students with elevated risk for developing emotional disorders. Students were screened using a measure of depression severity and clinical interview. Following screening procedures,…

  6. Multidimensional family therapy lowers the rate of cannabis dependence in adolescents: A randomised controlled trial in Western European outpatient settings

    NARCIS (Netherlands)

    H. Rigter (Henk); C.E. Henderson (Craig); I. Pelc (Isidore); P. Tossmann (Peter); O. Phan (Olivier); V. Hendriks (Vincent); M. Schaub (Michael); C. Rowe (Cindy)

    2013-01-01

    textabstractBackground: Noticing a lack of evidence-based programmes for treating adolescents heavily using cannabis in Europe, government representatives from Belgium, France, Germany, The Netherlands, and Switzerland decided to have U.S.-developed multidimensional family therapy (MDFT) tested in t

  7. Impact of duration of psychiatry rotation on medical interns’ attitude towards psychiatry

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    Srikanth Reddy

    2017-01-01

    Full Text Available Background: Medical Council of India allowed the interns to take up an extra 15 days of elective posting in psychiatry along with the mandatory posting of 15 days. The study was planned to assess the effect of the additional period of psychiatry internship on the attitude of interns towards psychiatry. Material and methods: The consenting interns were given a semi structured proforma enquiring about their age and gender and were asked to fill up Attitude Towards Psychiatry (ATP scale. The assessment was done at the beginning and then after 15 days of mandatory posting. Those participants who were willing to do an additional 15 days of elective posting in psychiatry were assessed again on the 30th day of the training. Results: Mean age of the participating interns (n=47 was 25.44±1.52 and the male female ratio was 0.8. Twenty six interns did only the 15 days mandatory psychiatry internship posting (Group 1 and the remaining 21 interns took up the additional elective 15 days posting (Group 2. At the end of the 15 days posting, Mean ATP score of the group 1 increased from 88.34±6.07 to 88.46±6.19 (p=0.80 whereas the same increased from 88.04±7.06 to 88.19±7.65 (p=0.7 in the group 2 and further increased to 91.09±8.3 at the end of the additional 15 days of elective posting (p<0.05. Conclusion: A thirty days exposure of psychiatry during internship had more favourable impact on the attitude of interns towards psychiatry.

  8. The Youth-Nominated Support Team-Version II for suicidal adolescents: A randomized controlled intervention trial.

    Science.gov (United States)

    King, Cheryl A; Klaus, Nicole; Kramer, Anne; Venkataraman, Sanjeev; Quinlan, Paul; Gillespie, Brenda

    2009-10-01

    The purpose of this study was to examine the efficacy of the Youth-Nominated Support Team-Version II (YST-II) for suicidal adolescents, an intervention based on social support and health behavior models, which was designed to supplement standard treatments. Psychiatrically hospitalized and suicidal adolescents, 13-17 years of age, were randomly assigned to treatment-as-usual (TAU) + YST-II (n = 223) or TAU only (n = 225). YST-II provided tailored psychoeducation to youth-nominated adults in addition to weekly check-ins for 3 months following hospitalization. In turn, these adults had regular supportive contact with adolescents. Adolescents assigned to TAU + YST-II had an average of 3.43 (SD = 0.83) nominated adults. Measures included the Suicidal Ideation Questionnaire-Junior (SIQ-JR; W. M. Reynolds, 1988), Children's Depression Rating Scale-Revised (E. O. Poznanski & H. B. Mokros, 1996), Beck Hopelessness Scale (A. T. Beck & R. A. Steer, 1993), and Child and Adolescent Functional Assessment Scale (CAFAS; K. Hodges, 1996). YST-II had very limited positive effects, which were moderated by history of multiple suicide attempts, and no negative effects. It resulted in more rapid decreases in suicidal ideation (SIQ-JR) for multiple suicide attempters during the initial 6 weeks after hospitalization (small-to-moderate effect size). For nonmultiple attempters, it was associated with greater declines in functional impairment (CAFAS) at 3 and 12 months (small effect sizes). YST-II had no effects on suicide attempts and no enduring effects on SIQ-JR scores.

  9. Linking vitamin D status, executive functioning and self-perceived mental health in adolescents through multivariate analysis: A randomized double-blind placebo control trial.

    Science.gov (United States)

    Grung, Bjørn; Sandvik, Asle M; Hjelle, Kay; Dahl, Lisbeth; Frøyland, Livar; Nygård, Irene; Hansen, Anita L

    2017-04-01

    The aim of the present randomized double-blind placebo control trial was to investigate if vitamin D supplementation had an effect on vitamin D status, executive functioning and self-perceived mental health in a group of Norwegian adolescents during winter time. Fifty adolescents were randomly assigned into an intervention group (vitamin D pearls) or a control group (placebo pearls). Before (pre-test in December/January) and after (post-test in April/May) the intervention period the participants were exposed to a test procedure, consisting of blood draw, completion of cognitive tests (Tower of Hanoi and Tower of London), and the Youth Self-report version of the Child Behavior Checklist. Multivariate data analysis showed that participants with low vitamin D status scored worse on the Tower of London tests and the more difficult sub-tasks on the Tower of Hanoi tests. They also had a tendency to report higher frequency of externalizing behavior problems and attention deficit. At pre-test, the overall mean vitamin D status measured as 25-hydroxy vitamin D was 42 nmol/L, defining deficiency (Intervention group = 44 nmol/L, Control group = 39 nmol/L). However, vitamin D supplementation caused a significant increase in vitamin D status resulting in a sufficient level in the Intervention group at post-test (mean 62 nmol/L). The results also revealed that the intervention group improved their performance on the most demanding sub-tasks on the ToH. Overall, the study indicates that vitamin D status in adolescents may be important for both executive functioning and mental health.

  10. Preventing anxiety and depression in adolescents: A randomised controlled trial of two school based Internet-delivered cognitive behavioural therapy programmes

    Directory of Open Access Journals (Sweden)

    Nora Wong

    2014-04-01

    Full Text Available The aims of the current study were to 1 establish the efficacy of two Internet-based prevention programmes to reduce anxiety and depressive symptoms in adolescents; and 2 investigate the distribution of psychological symptoms in a large sample of Australian adolescents prior to the implementation of the intervention. A cluster randomised controlled trial was conducted with 976 Year 9–10 students from twelve Australian secondary schools in 2009. Four schools were randomly allocated to the Anxiety Internet-based prevention programme (n = 372, five schools to the Depression Internet-based prevention programme (n = 380 and three to their usual health classes (n = 224. The Thiswayup Schools for Anxiety and Depression prevention courses were presented over the Internet and consist of 6–7 evidence-based, curriculum consistent lessons to improve the ability to manage anxiety and depressive symptoms. Participants were assessed at baseline and post-intervention. Data analysis was constrained by both study attrition and data corruption. Thus post-intervention data were only available for 265/976 students. Compared to the control group, students in the depression intervention group showed a significant improvement in anxiety and depressive symptoms at the end of the course, whilst students in the anxiety intervention demonstrated a reduction in symptoms of anxiety. No significant differences were found in psychological distress. The Thiswayup Schools Depression and Anxiety interventions appear to reduce anxiety and depressive symptoms in adolescents using a curriculum based, blended online and offline cognitive behavioural therapy programme that was implemented by classroom teachers. Given the study limitations, particularly the loss of post-intervention data, these findings can only be considered preliminary and need to be replicated in future research.

  11. Evaluation of a psychoeducation programme for parents of children and adolescents with ADHD: immediate and long-term effects using a blind randomized controlled trial.

    Science.gov (United States)

    Ferrin, Maite; Moreno-Granados, J M; Salcedo-Marin, M D; Ruiz-Veguilla, M; Perez-Ayala, V; Taylor, E

    2014-08-01

    Recent guidelines for the diagnosis and treatment of attention deficit hyperactivity disorder (ADHD) have claimed the possible benefits of psychoeducational techniques in the comprehensive management of ADHD. To evaluate the efficacy of a psychoeducation programme for parents of children and adolescents with ADHD in a clinical setting using a blind randomized trial. 81 children/adolescents with ADHD were randomly assigned for their families to receive either a well-structured psychoeducation programme (intervention group, n = 44), or a parent counselling and support intervention (control group, n = 37). Measures of child ADHD symptoms, psychopathology, quality of life and family stress were taken before and after intervention and after a year follow-up. Parents and evaluators were unaware of the condition received. Compared to the support control group, the psychoeducation group showed ADHD Index and cognitive/inattention levels significantly reduced after the intervention ended (Mann-Whitney U = 3.34; p = 0.001; Mann-Whitney U = 3.47; p = 0.001). An improvement in the pro-social domain was also observed after 1 year follow-up (Mann-Whitney U = -2.37; p = 0.018), and clinical global impression found a statistically significant effect for severity over the time. Differences were initially found for the impact of the disorder in the family in different domains, including emotional and social functioning; these differences were no longer significant after alpha correction. No significant differences in quality of life or family stress were found in comparison with the control group. This psychoeducation programme is a valuable treatment for parents/carers of children/adolescents with ADHD, which needs to be considered when evaluating different non-pharmacological treatment options. Psychoeducation and other kind of non-pharmacological approaches need to be regarded not as a substitute, but as a complementary treatment to medications; these approaches might help other

  12. A randomized controlled trial testing an adherence-optimized Vitamin D regimen to mitigate bone change in adolescents being treated for acute lymphoblastic leukemia.

    Science.gov (United States)

    Orgel, Etan; Mueske, Nicole M; Sposto, Richard; Gilsanz, Vicente; Wren, Tishya A L; Freyer, David R; Butturini, Anna M; Mittelman, Steven D

    2017-02-20

    Adolescents with acute lymphoblastic leukemia (ALL) develop osteopenia early in therapy, potentially exacerbated by high rates of concurrent Vitamin D deficiency. We conducted a randomized clinical trial testing a Vitamin D-based intervention to improve Vitamin D status and reduce bone density decline. Poor adherence to home supplementation necessitated a change to directly observed therapy (DOT) with intermittent, high-dose Vitamin D3 randomized versus standard of care (SOC). Compared to SOC, DOT Vitamin D3 successfully increased trough Vitamin 25(OH)D levels (p = .026) with no residual Vitamin D deficiency, 100% adherence to DOT Vitamin D3, and without associated toxicity. However, neither Vitamin D status nor supplementation impacted bone density. Thus, this adherence-optimized intervention is feasible and effective to correct Vitamin D deficiency in adolescents during ALL therapy. Repletion of Vitamin D and calcium alone did not mitigate osteopenia, however, and new, comprehensive approaches are needed to address treatment-associated osteopenia during ALL therapy.

  13. Effects of a Six-Week Hip Thrust vs. Front Squat Resistance Training Program on Performance in Adolescent Males: A Randomized Controlled Trial.

    Science.gov (United States)

    Contreras, Bret; Vigotsky, Andrew D; Schoenfeld, Brad J; Beardsley, Chris; McMaster, Daniel T; Reyneke, Jan H T; Cronin, John B

    2017-04-01

    Contreras, B, Vigotsky, AD, Schoenfeld, BJ, Beardsley, C, McMaster, DT, Reyneke, JHT, and Cronin, JB. Effects of a six-week hip thrust vs. front squat resistance training program on performance in adolescent males: A randomized controlled trial. J Strength Cond Res 31(4): 999-1008, 2017-The barbell hip thrust may be an effective exercise for increasing horizontal force production and may thereby enhance performance in athletic movements requiring a horizontal force vector, such as horizontal jumping and sprint running. The ergogenic ability of the squat is well known. The purpose of this study was to compare the effects of 6-week front squat and hip thrust programs in adolescent male athletes. Vertical jump height, horizontal jump distance, 10- and 20-m sprint times, and isometric midthigh pull peak force were among the measured performance variables, in addition to front squat and hip thrust 3 repetition maximum (3RM) strength. Magnitude-based effect sizes revealed potentially beneficial effects for the front squat in both front squat 3RM strength and vertical jump height when compared with the hip thrust. No clear benefit for one intervention was observed for horizontal jump performance. Potentially beneficial effects were observed for the hip thrust compared with the front squat in 10- and 20-m sprint times. The hip thrust was likely superior for improving normalized isometric midthigh pull strength and very likely superior for improving hip thrust 3RM and isometric midthigh pull strength. These results support the force vector theory.

  14. Cognitive-behavioural health-promotion intervention increases fruit and vegetable consumption and physical activity among South African adolescents: a cluster-randomised controlled trial.

    Science.gov (United States)

    Jemmott, John B; Jemmott, Loretta S; O'Leary, Ann; Ngwane, Zolani; Icard, Larry; Bellamy, Scarlett; Jones, Shasta; Landis, J Richard; Heeren, G Anita; Tyler, Joanne C; Makiwane, Monde B

    2011-02-01

    Rates of chronic diseases are high among Black South Africans but few studies have tested cognitive-behavioural health-promotion interventions to reduce this problem. We tested the efficacy of such an intervention among adolescents in a cluster-randomised controlled trial. We randomly selected 9 of 17 matched pairs of schools and randomised one school in each pair to the cognitive-behavioural health-promotion intervention designed to encourage health-related behaviours and the other to a human immunodeficiency virus (HIV)/sexually transmitted disease (STD) risk-reduction intervention that served as the control. Interventions were based on social cognitive theory, the theory of planned behaviour and qualitative data from the target population. Data collectors, blind to participants' intervention, administered confidential assessments at baseline and 3, 6 and 12 months post-intervention. Primary outcomes were fruit and vegetable consumption and physical activity. Participants were 1057 grade 6 learners (mean age = 12.4 years), with 96.7% retained at 12-month follow-up. Generalised estimating equations revealed that averaged over the follow-ups, a greater percentage of health-promotion intervention participants than HIV/STD control participants met 5-a-Day fruit and vegetable and physical activity guidelines. The intervention also increased health-promotion knowledge, attitude and intention, but did not decrease substance use or substance-use attitude and intention. The findings suggest that theory based and contextually appropriate interventions may increase health behaviours among young adolescents in sub-Saharan Africa.

  15. Alpha-Lipoic Acid and Antioxidant Diet Help to Improve Endothelial Dysfunction in Adolescents with Type 1 Diabetes: A Pilot Trial

    Directory of Open Access Journals (Sweden)

    Andrea Scaramuzza

    2015-01-01

    Full Text Available After evaluating the prevalence of early endothelial dysfunction, as measured by means of reactive hyperemia in adolescents with type 1 diabetes, we started a 6-month, double-blind, randomized trial to test the efficacy of an antioxidant diet (± alpha-lipoic acid supplementation to improve endothelial dysfunction. Seventy-one children and adolescents, ages 17 ± 3.9 yrs, with type 1 diabetes since 9.5 ± 5.3 yrs, using intensified insulin therapy, were randomized into 3 arms: (a antioxidant diet 10.000 ORAC + alpha-lipoic acid; (b antioxidant diet 10.000 ORAC + placebo; (c controls. BMI, blood pressure, fasting lipid profile, HbA1c, insulin requirement, dietary habits, and body composition were determined in each patient. An antioxidant diet significantly improved endothelial dysfunction when supplemented with alpha-lipoic acid, unlike diet with placebo or controls. A significant reduction in bolus insulin was also observed. We speculate that alpha-lipoic acid might have an antioxidant effect in pediatric diabetes patients by reducing insulin.

  16. A Randomized Controlled Trial of Two Different Macronutrient Profiles on Weight, Body Composition and Metabolic Parameters in Obese Adolescents Seeking Weight Loss.

    Directory of Open Access Journals (Sweden)

    Helen Truby

    Full Text Available Adolescent obesity is difficult to treat and the optimal dietary pattern, particularly in relation to macronutrient composition, remains controversial. This study tested the effect of two structured diets with differing macronutrient composition versus control, on weight, body composition and metabolic parameters in obese adolescents.A randomized controlled trial conducted in a children's hospital.Eighty seven obese youth (means: age 13.6 years, BMI z-score 2.2, waist: height ratio 0.65, 69% female completed a psychological preparedness program and were then randomized to a short term 'structured modified carbohydrate' (SMC, 35% carbohydrate; 30% protein; 35% fat, n = 37 or a 'structured low fat' (SLF, 55% carbohydrate; 20% protein; 25% fat, n = 36 or a wait listed control group (n = 14. Anthropometric, body composition and biochemical parameters were measured at randomization and after 12 weeks, and analyzed under the intention to treat principle using analysis of variance models.After 12 weeks, data was collected from 79 (91% participants. BMI z-scores were significantly lower in both intervention groups compared to control after adjusting for baseline values, SLF vs. control, mean difference = -0.13 (95%CI = -0.18, -0.07, P<0.001; SMC vs. control, -0.14 (-0.19, -0.09, P<0.001, but there was no difference between the two intervention diet groups: SLF vs. SMC, 0.00 (-0.05, 0.04, P = 0.83.Both dietary patterns resulted in similar changes in weight, body composition and metabolic improvements compared to control. The use of a structured eating system which allows flexibility but limited choices can assist in weight change and the rigid application of a low fat eating pattern is not exclusive in its efficacy.International Clinical Trials Registry ISRCTN49438757.

  17. The group-based social skills training SOSTA-FRA in children and adolescents with high functioning autism spectrum disorder - study protocol of the randomised, multi-centre controlled SOSTA - net trial

    Directory of Open Access Journals (Sweden)

    Freitag Christine M

    2013-01-01

    Full Text Available Abstract Background Group-based social skills training (SST has repeatedly been recommended as treatment of choice in high-functioning autism spectrum disorder (HFASD. To date, no sufficiently powered randomised controlled trial has been performed to establish efficacy and safety of SST in children and adolescents with HFASD. In this randomised, multi-centre, controlled trial with 220 children and adolescents with HFASD it is hypothesized, that add-on group-based SST using the 12 weeks manualised SOSTA–FRA program will result in improved social responsiveness (measured by the parent rated social responsiveness scale, SRS compared to treatment as usual (TAU. It is further expected, that parent and self reported anxiety and depressive symptoms will decline and pro-social behaviour will increase in the treatment group. A neurophysiological study in the Frankfurt HFASD subgroup will be performed pre- and post treatment to assess changes in neural function induced by SST versus TAU. Methods/design The SOSTA – net trial is designed as a prospective, randomised, multi-centre, controlled trial with two parallel groups. The primary outcome is change in SRS score directly after the intervention and at 3 months follow-up. Several secondary outcome measures are also obtained. The target sample consists of 220 individuals with ASD, included at the six study centres. Discussion This study is currently one of the largest trials on SST in children and adolescents with HFASD worldwide. Compared to recent randomised controlled studies, our study shows several advantages with regard to in- and exclusion criteria, study methods, and the therapeutic approach chosen, which can be easily implemented in non-university-based clinical settings. Trial registration ISRCTN94863788 – SOSTA – net: Group-based social skills training in children and adolescents with high functioning autism spectrum disorder.

  18. Educational Supervision Appropriate for Psychiatry Trainee's Needs

    Science.gov (United States)

    Rele, Kiran; Tarrant, C. Jane

    2010-01-01

    Objective: The authors studied the regularity and content of supervision sessions in one of the U.K. postgraduate psychiatric training schemes (Mid-Trent). Methods: A questionnaire sent to psychiatry trainees assessed the timing and duration of supervision, content and protection of supervision time, and overall quality of supervision. The authors…

  19. Imaging-Genetics Applications in Child Psychiatry

    Science.gov (United States)

    Pine, Daniel S.; Ernst, Monique; Leibenluft, Ellen

    2010-01-01

    Objective: To place imaging-genetics research in the context of child psychiatry. Method: A conceptual overview is provided, followed by discussion of specific research examples. Results: Imaging-genetics research is described linking brain function to two specific genes, for the serotonin-reuptake-transporter protein and a monoamine oxidase…

  20. Old age psychiatry in the modern age.

    Science.gov (United States)

    Warner, James P

    2015-11-01

    Old age psychiatry services globally are under threat. The discipline enjoyed its heyday in the two decades bridging the millennium. More recently there has been a move to integrate old age services with those of working age adults, to create 'ageless' services. Evidence is beginning to accumulate that this is a bad idea.

  1. Assisting Undergraduate Physician Assistant Training in Psychiatry: The Role of Academic Psychiatry Departments.

    Science.gov (United States)

    Rakofsky, Jeffrey J; Ferguson, Britnay A

    2015-12-01

    Physician assistants (PAs) are medical professionals who practice medicine with the supervision of a physician through delegated autonomy. PA school accreditation standards provide limited guidance for training PAs in psychiatry. As a result, PA students may receive inconsistent and possibly inadequate exposure to psychiatry. Providing broad and in-depth exposure to the field of psychiatry is important to attract PA students to pursue careers in psychiatry and provide a possible solution to the shortage of psychiatrists nationwide. Additionally, this level of exposure will prepare PA students who pursue careers in other fields of medicine to recognize and address their patient's psychiatric symptoms in an appropriate manner. This training can be provided by an academic department of psychiatry invested in the education of PA students. We describe a training model implemented at our university that emphasizes psychiatrist involvement in the preclinical year of PA school and full integration of PA students into the medical student psychiatry clerkship during the clinical years. The benefits and challenges to implementing this model are discussed as well.

  2. [Shall psychiatry change its target? Reflections on the evolving role of psychiatry].

    Science.gov (United States)

    Pinna, Federica; Del Vecchio, Valeria; Luciano, Mario; Sampogna, Gaia; De Rosa, Corrado; Ferrari, Silvia; Pingani, Luca; Tarricone, Ilaria; Volpe, Umberto; Carrà, Giuseppe; Roncone, Rita; Catapano, Francesco; Fiorillo, Andrea

    2015-01-01

    In this paper we will describe cultural, social and scientific changes occurred in psychiatry in the last years, identifying the new target for mental health professionals. Groups of young psychiatrists from the Italian Psychiatric Association, the European Psychiatric Association and the World Psychiatric Association have established an international network that launched a debate on the future role of psychiatry. In a rapidly changing world, there is the need to: 1) adapt training in psychiatry to the modern world; 2) identify the new target of mental health professionals; 3) enhance the image of psychiatry in the society; 4) overcome stigma towards people with mental disorders. In recent years, socio-cultural and scientific changes have had a significant impact on the psychiatrists' clinical practice. Mental health professionals should deal with these changes appropriately in order to overcome the current "crisis" of psychiatry, which should be considered as a developmental phase rather than a conceptual one. From time to time psychiatry is criticized both from inside and outside the profession. The current crisis was unavoidable due to the recent socio-cultural changes, but it should be considered an opportunity to adapt the profession to modern times.

  3. Cognitive-Behavioral Treatment versus an Active Control for Children and Adolescents with Anxiety Disorders: A Randomized Trial

    Science.gov (United States)

    Hudson, Jennifer L.; Rapee, Ronald M.; Deveney, Charise; Schniering, Carolyn A.; Lyneham, Heidi J.; Bavopoulos, Nataly

    2009-01-01

    Specific delivery of cognitive-behavioral skills is more effective in treating childhood anxiety compared to treatment that contains only nonspecific therapy factors. The findings are based on a randomized trial involving 112 children aged 7-16 years.

  4. Online group-based cognitive-behavioural therapy for adolescents and young adults after cancer treatment: A multicenter randomised controlled trial of Recapture Life-AYA

    Directory of Open Access Journals (Sweden)

    Sansom-Daly Ursula M

    2012-08-01

    Full Text Available Abstract Background A cancer diagnosis is 2.9 times more likely to occur during the adolescent and young adult years than in younger children. This spike in incidence coincides with a life stage characterised by psychological vulnerability as young people strive to attain numerous, critical developmental milestones. The distress young people experience after cancer treatment seriously jeopardises their ability to move into well-functioning adulthood. Methods/Design This article presents the protocol of the Recapture Life study, a phase II three-arm randomised controlled trial designed to evaluate the feasibility and efficacy of a new intervention in reducing distress and improving quality of life for adolescent and young adult cancer survivors. The novel intervention, “ReCaPTure LiFe” will be compared to a both a wait-list, and a peer-support group control. Ninety young people aged 15–25 years who have completed cancer treatment in the past 1–6 months will be recruited from hospitals around Australia. Those randomised to receive Recapture Life will participate in six, weekly, 90-minute online group sessions led by a psychologist, involving peer-discussion around cognitive-behavioural coping skills (including: behavioural activation, thought challenging, communication and assertiveness skills training, problem-solving and goal-setting. Participants randomised to the peer-support group control will receive non-directive peer support delivered in an identical manner. Participants will complete psychosocial measures at baseline, post-intervention, and 12-months post-intervention. The primary outcome will be quality of life. Secondary outcomes will include depression, anxiety, stress, family functioning, coping, and cancer-related identity. Discussion This article reviews the empirical rationale for using group-based, online cognitive-behavioural therapy in young people after cancer treatment. The potential challenges of delivering skills

  5. The outcomes of a 12-week Internet intervention aimed at improving fitness and health-related quality of life in overweight adolescents: the Young & Active controlled trial.

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    Kirsti Riiser

    Full Text Available Overweight and obesity among adolescents may have consequences, with potentially lasting effects on health and health-related quality of life (HRQoL. Excess weight is also associated with decreases in physical activity and cardiorespiratory fitness. The aim of the current study was to investigate the short-term effects of a 12-week Internet intervention in a primary care setting intended to increase cardiorespiratory fitness and HRQoL among overweight and obese adolescents.In this controlled trial, participants (13-15 years were non-randomly allocated to an intervention- or a control group. The intervention group received 12-weeks access to an online program providing tailored physical activity counseling based on principles from Self-determination Theory and Motivational Interviewing. The control group received standard follow-up by the school nurses. The primary outcome measure of cardiorespiratory fitness was determined using a shuttle run test. The secondary outcomes: HRQoL, leisure time exercise, body image and self-determined motivation for physical activity and exercise, were assessed by self-report measures. Age- and gender-adjusted body mass index (BMI was calculated based on measurements of height and weight. To compare pre-to post intervention differences within groups, a paired samples t-test was used while crude differences between groups were analyzed with an independent samples t-test.Of the 120 participants, 108 completed the study, 75 in the intervention group and 33 in the control group. Exposure to the intervention had a small effect on cardiorespiratory fitness (0.14; 95% CI [0.01;0.28]; P = 0.04, and a moderate effect on HRQoL (5.22; 95% CI [0.90; 9.53]; P = 0.02. Moreover, the control group increased significantly in BMI, yielding a moderate preventive effect on BMI (-0.39; 95% CI [-0.74;-0.03]; P = 0.03 for the intervention group.The results suggest that the Internet intervention with tailored physical activity counseling

  6. The effectiveness of a web-based brief alcohol intervention in reducing heavy drinking among adolescents aged 15 to 20 years with a low educational background: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Voogt Carmen V

    2012-06-01

    Full Text Available Abstract Background The serious negative health consequences of heavy drinking among adolescents is cause for concern, especially among adolescents aged 15 to 20 years with a low educational background. In the Netherlands, there is a lack of alcohol prevention programs directed to the drinking patterns of this specific target group. The study described in this protocol will test the effectiveness of a web-based brief alcohol intervention that aims to reduce alcohol use among heavy drinking adolescents aged 15 to 20 years with a low educational background. Methods/design The effectiveness of the What Do You Drink (WDYD web-based brief alcohol intervention will be tested among 750 low-educated, heavy drinking adolescents. It will use a two-arm parallel group cluster randomized controlled trial. Classes of adolescents from educational institutions will be randomly assigned to either the experimental (n = 375: web-based brief alcohol intervention or control condition (n = 375: no intervention. Primary outcomes measures will be: 1 the percentage of participants who drink within the normative limits of the Dutch National Health Council for low-risk drinking, 2 reductions in mean weekly alcohol consumption, and 3 frequency of binge drinking. The secondary outcome measures include the alcohol-related cognitions, attitudes, self-efficacy, and subjective norms, which will be measured at baseline and at one and six months after the intervention. Discussion This study protocol presents the study design of a two-arm parallel-group randomized controlled trial to evaluate the effectiveness of the WDYD web-based brief alcohol intervention. We hypothesized a reduction in mean weekly alcohol consumption and in the frequency of binge drinking in the experimental condition, resulting from the web-based brief alcohol intervention, compared to the control condition. Trial registration Netherlands Trial Register NTR2971

  7. Short-term psychotherapeutic treatment in adolescents engaging in non-suicidal self-injury: a randomized controlled trial

    OpenAIRE

    Fischer, Gloria; Brunner, Romuald; Parzer, Peter; Resch, Franz; Kaess, Michael

    2013-01-01

    Background Worldwide, prevalence rates of adolescent non-suicidal self-injury (NSSI) range between 13 and 45%. In Germany, lifetime prevalence of NSSI is around 25% in non-clinical samples, and the one-year prevalence for repetitive NSSI is 4%. NSSI is present in the context of several axis I and II disorders (for example, affective disorders or borderline personality disorder); however, preliminary evidence suggests that it would be justified to consider NSSI as its own diagnostic category. ...

  8. An open trial of 'grief-help': a cognitive-behavioural treatment for prolonged grief in children and adolescents.

    Science.gov (United States)

    Spuij, Mariken; Dekovic, Maja; Boelen, Paul A

    2015-01-01

    In the past years, there is growing recognition of a syndrome of disturbed grief referred to as prolonged grief disorder (PGD). Although mostly studied in adults, clinically significant PGD symptoms have also been observed in children and adolescents. To date, no effective treatment for childhood PGD yet exists. We recently developed a nine-session cognitive-behavioural treatment for childhood PGD combined with five sessions of parental counselling. In the current article, we present outcomes of treatment of 10 consecutive children and adolescents turning to our university clinic with elevated PGD symptoms as their primary problem and main reason to seek therapy. Patients were significantly improved at post-treatment, with large improvements in self-rated PGD and post-traumatic stress (effect sizes > 0.8) and small to moderate improvement in depression and parent-rated internalizing and externalizing problems (0.2 < effect sizes < 0.8). Additional predictor analysis of outcomes suggested that, among other things, this treatment approach is less efficacious for children and adolescents further removed from loss and those confronted with suicidal loss. That said, the treatment appears promising, and controlled evaluation is clearly indicated.

  9. Online visual search attentional bias modification for adolescents with heightened anxiety and depressive symptoms: A randomized controlled trial.

    Science.gov (United States)

    De Voogd, E L; Wiers, R W; Salemink, E

    2017-05-01

    Anxiety and depression, which are highly prevalent in adolescence, are both characterized by a negative attentional bias. As Attentional Bias Modification (ABM) can reduce such a bias, and might also affect emotional reactivity, it could be a promising early intervention. However, a growing number of studies also report comparable improvements in both active and placebo groups. The current study investigated the effects of eight online sessions of visual search (VS) ABM compared to both a VS placebo-training and a no-training control group in adolescents with heightened symptoms of anxiety and/or depression (n = 108). Attention bias, interpretation bias, and stress-reactivity were assessed pre- and post-training. Primary outcomes of anxiety and depressive symptoms, and secondary measures of emotional resilience were assessed pre- and post-training and at three and six months follow-up. Results revealed that VS training reduced attentional bias compared to both control groups, with stronger effects for participants who completed more training sessions. Irrespective of training condition, an overall reduction in symptoms of anxiety and depression and an increase in emotional resilience were observed up to six months later. The training was evaluated relatively negatively. Results suggest that online ABM as employed in the current study has no added value as an early intervention in adolescents with heightened symptoms.

  10. The Comorbidity of Reduplicative Paramnesia, Intermetamorphosis, Reverse-Intermetamorphosis, Misidentification of Reflection, and Capgras Syndrome in an Adolescent Patient

    OpenAIRE

    Ozden Arısoy; A. Evren Tufan; Rabia Bilici; Sarper Taskiran; Zehra Topal; Nuran Demir; M. Akif Cansız

    2014-01-01

    Case Report The Comorbidity of Reduplicative Paramnesia, Intermetamorphosis, Reverse-Intermetamorphosis, Misidentification of Reflection, and Capgras Syndrome in an Adolescent Patient Ozden ArJsoy,1 A. Evren Tufan,2 Rabia Bilici,3 Sarper Taskiran,4 Zehra Topal,2 Nuran Demir,2 andM. Akif CansJz2 1 Department of Psychiatry, Abant Izzet Baysal University Medical Faculty, 14280 Bolu, Turkey 2Department of Child and Adolescent Psychiatry, Abant Izzet Baysal University Medic...

  11. Cultural psychiatry. Theoretical, clinical, and research issues.

    Science.gov (United States)

    Lewis-Fernández, R; Kleinman, A

    1995-09-01

    As a discipline, cultural psychiatry has matured considerably in recent years and the ongoing quality of its theoretical, clinical, and research development holds great promise. The contemporary emphasis on culture as process permits a deeper analysis of the complexities of sociosomatics--the translation of meanings and social relations into bodily experience--and, thus, of the social course of illness. We also are learning a great deal more about cultural processes that affect therapy, including ethnopharmacologic and culturally valid family interventions that are directly relevant to patient care and mental health policy. And an important set of studies is examining the trauma experienced by refugees and immigrants. But at the same time many disquieting findings still point to the limited impact of cultural psychiatry on knowledge creation and clinical application in psychiatry. The failure of the cultural validation of DSM-IV is only the most dismaying. The persistent misdiagnosis of minority patients and the continued presence of racial bias in some treatment recommendations are also disheartening, as is the seeming contempt of many mainstream psychiatrists for culturally defined syndromes and folk healing systems. Widespread inattention to ethnic issues in medical ethics is another source of dismay. It is for these reasons that the culture of psychiatry itself becomes as important as the culture of patients as a topic for research and intervention. Most of the world still suffers from a terrible lack of basic mental health services, including life-saving medications and hospital beds. In the face of these limitations, and because of the increasing multicultural and pluralistic reality of contemporary life, the growing interpretive bridges linking indigenous systems of illness classification and healing to Western nosologies and therapeutic modalities become even more essential and the reluctance of mainstream clinicians to explore folk healing methods more

  12. Engaging adolescent girls from linguistically diverse and low income backgrounds in school sport: a pilot randomised controlled trial.

    Science.gov (United States)

    Dudley, Dean A; Okely, Anthony D; Pearson, Philip; Peat, Jennifer

    2010-03-01

    The purpose of this study was to determine the feasibility, acceptability, and potential efficacy of a school-based physical activity program delivered during school sport time among adolescent girls from low income predominately linguistically diverse backgrounds in New South Wales, Australia. Using a 3-month, 2-arm, parallel-group pilot RCT design, 38 adolescent girls (Year 11) were recruited to participate in the program and randomised into intervention (n=17) or control groups (n=21). The intervention program aimed to increase physical activity by improving enjoyment, physical self-perception and perceived competence. Baseline and follow-up (12 weeks) assessments included enjoyment of physical activity, physical self-perception, and objectively measured physical activity during school sport sessions. Process data were collected through observations of lessons, attendance records, and interviews with participants and staff. Recruitment (63%) and retention (68%) goals were less than anticipated but similar to other studies. Participation was higher for the intervention (72%) than the control (60%) group and the intervention group reported high levels of satisfaction with the program. At follow-up, girls in the intervention group, compared with the control group, showed greater improvement in their enjoyment of physical activity during school sport (adjusted mean difference=3.8, 95% Confidence Interval [CI] -2.4, 10.1; Cohen's d=0.42 standard deviation units) and body image (adjusted difference mean=1.0, 95% CI -0.4, 2.3; d=0.50). There was a smaller decline in participation in physical activity during school sport (adjusted mean=13.6, 95% CI -21.8, 48.9; d=0.24). This study highlights major barriers confronting adolescent girls' participation in school sport. Some of these include teacher attitudes and support, activities and programming, purpose and distinction, and student input. Negotiating these barriers and overcoming them in a school setting appears

  13. Psychiatry and neurology: from dualism to integration.

    Science.gov (United States)

    Sobański, Jerzy A; Dudek, Dominika

    2013-01-01

    The two objectives of the following paper are: to make few remarks on the topic absorbing neurologists, psychiatrists, and neuropsychiatrists - integration and division of their specialties; and to describe the situation in Poland, reflected in the latest literature. The authors describe the former and present processes of approaches and divisions in psychiatry and neurology. They indicate dissemination of mutual methods of structural and action brain neuroimaging, neurophysiology, neurogenetics, and advanced neurophysiology diagnostics. As it seems, even the effectiveness of psychotherapy, has recently been associated with changes in brain in functional and even structural markers. The authors indicate the value of the strive to join the still divided specialties, reflected worldwide in attempts of common education and clinical cooperation of physicians. It can be expected that subsequent years will bring further triumphs of neuropsychiatry - a field that combines psychiatry and neurology.

  14. Logical and conceptual problems of existential psychiatry.

    Science.gov (United States)

    Hanly, C

    1985-05-01

    The author has argued that existential psychology and psychiatry are not consistent with existential philosophy, from which they derive their basic concepts. Existential philosophy treats consciousness as an epistemic and ontological absolute while existential psychology and psychiatry acknowledge the existence of unconscious mental processes. It is not possible to base a viable concept of psychodynamic psychotherapy, the nature of transference, or the efficacy of interpretation upon the radical concept of freedom, which is basic to existential philosophy. If psychiatrists wish to experiment with nonpsychoanalytic dynamic psychologies, then it is the author's opinion that the advancement of knowledge would be better served either by using existentialist concepts and principles consistently or by explicitly altering them in clearly defined ways for stated reasons, or by formulating psychodynamic hypotheses that do not lay claim to any foundation in existential philosophy.

  15. [Philosophy against psychiatry, right up against it].

    Science.gov (United States)

    Demazeux, Steeves

    2016-12-01

    Since the early 1990s, there has been a tremendous new interest at the international level for researches at the crossroad between philosophy and psychiatry. This interest has been supported and quite stimulated by the foundation of a dedicated association, as well as by the establishment of a journal and the promotion of a new collection. My aim in this paper is to trace the origins of the so-called "new philosophy of psychiatry" field and to reconstruct its global intellectual dynamics during the past two decades. I try to identify, through the big diversity of the individual contributions, its dominant theoretical orientations but also what may appear as some of its philosophical blind spots.

  16. [Malaise in psychiatry and its history].

    Science.gov (United States)

    Chebili, S

    2016-04-01

    The main hypothesis of this paper is the presence of malaise in psychiatry. The malaise has two sides: on one hand, the end of psychiatry hegemony that dominated the theoretical field of psychiatry until the 1990s. The loss of influence of psychoanalysis is due to its inability to be submitted to any kind of assessment. On the other hand, the supremacy of neurosciences. The idea is not to underestimate the importance of neurosciences but rather to affirm that they occupy the whole theoretical field of psychiatry. This is an unusual situation that is specific to our time. Indeed, this monism has succeeded to an epistemological dualism that has existed throughout the history of psychiatry. In this article, we'll try to draw a history of dualism in psychiatry. Firstly, with Pinel, we find a tension between a metaphysical philosophical pole and a physiological one. Pinel's philosophy has something to do with Condillac's ideology as Pinel applies the analytical method to mental diseases. Under Cabanis's influence, the author of the famous Rapports du physique et du moral de l'homme, this ideology is under pressure with physiologism. As a materialist, he gives an essential part to the brain that distributes pieces of information throughout the body because he thinks that mind influences body. Secondly, dualism lies between the doctrine of localizations defended by Gall and the theory of degeneration elaborated by Magnan. Gall, in Anatomie et physiologie du système nerveux en général, seeks to know how bumps or hollows that are found on the skull are shaped. Gall is for the theory of delocalizations. He is the counterpart of Magnan who wrote a work about Les Dégénérés, that takes its part in the physiological trend with the famous theory of degeneration. For him, degeneration means the imperfect state of a subject whose cerebral functions are in a noticeably imperfect state. Thirdly, with Henry Ey, dualism starts to be less important. Indeed, he tends a monist

  17. Neuropsychiatrie of biologische psychiatrie; een toekomstvisie in historisch perspectief.

    Science.gov (United States)

    Verhoeven, W M; Tuinier, S

    1999-06-01

    Neuropsychiatry or Biological Psychiatry There is an urgent need to reconsider the position of psychiatry within the neurosciences because of the exploding knowledge about the relationship between brain and behaviour and the delay in implementation of new findings due to the separation of neurology and psychiatry. Biological psychiatry and psychopharmacology originate from the discovery by chance of psycho-active compounds in the early fifties and have contributed to the scientification of psychiatry. The impact of biological psychiatry for the pathophysiology of psychiatric disorders, however, is limited as a result of its biased orientation on neurotransmitters and receptors. The neuropsychiatric paradigm integrates knowledge from several domains, such as functional neuroanatomy, genetics and endocrinology and opens new vistas for the involvement of neuronal circuits in the initiation and maintenance of behavioural disturbances. In addition, novel and more specific treatment modalities may emerge.

  18. The Third Wave of Biological Psychiatry

    Directory of Open Access Journals (Sweden)

    Henrik eWalter

    2013-09-01

    Full Text Available In this article I will argue that we are witnessing at this moment the third wave of biological psychiatry. This framework conceptualizes mental disorders as brain disorders of a special kind that requires a multilevel approach ranging from genes to psychosocial mechanisms. In contrast to earlier biological psychiatry approaches the mental plays a more prominent role in the third wave. This will become apparent by discussing the recent controversy evolving around the recently published DSM-5 and the competing transdiagnostic Research Domain Criteria approach of the National Institute of Mental Health that is build on concepts of cognitive neuroscience. A look at current conceptualizations in biological psychiatry as well as at some discussions in current philosophy of mind on situated cognition, reveals that the thesis, that mental brain disorders are brain disorders has to be qualified with respect to how mental states are constituted and with respect to multilevel explanations of which factors contribute to stable patterns of psychopathological signs and symptoms.

  19. Women in academic psychiatry in Canada.

    Science.gov (United States)

    Penfold, P S

    1987-11-01

    A comparison of numbers of women psychiatrists with faculty appointments and women residents in Departments of Psychiatry in Canada in 1975 and 1985 showed that the average percentage of women faculty has increased from 11.4% to 14.3% and of women residents from 23.5% to 43.4%. Some departments appeared to be oblivious to the special educational role of women faculty and had not discussed the discrepancy between the numbers of faculty and residents. Only two departments were actively recruiting women faculty. The study also demonstrated a continued concentration of women in the lower ranks. Barriers to recruiting women faculty include lack of academic role models, job advertising not specifically designed to attract women candidates, rigid requirements for appointments, women's lack of access to male corridors of power, pervasive underlying doubts about women's abilities and competence based on cultural stereotypes, female socialization which does not lend itself readily to roles of authority, assertiveness and leadership, and the role strain that ensues when women psychiatrists try to combine career, marriage and motherhood. If women psychiatrists are to fill some of the positions in Departments of Psychiatry, which will fall vacant over the next decade, much more attention must be paid to eliminating or diminishing the multiple obstacles for women who chose a career in academic psychiatry.

  20. A frame of mind from psychiatry.

    Science.gov (United States)

    Vintiadis, Elly

    2015-11-01

    A distinctive characteristic of psychiatry is that it is a discipline that deals with both the physical and the mental lives of individuals. Largely because of this characteristic, different models are used for different disorders, however, there is still a remnant tendency towards reductionist views in the field. In this paper I argue that the available empirical evidence from psychiatry gives us reasons to question biological reductionism and that, in its place, we should adopt a pluralistic explanatory model that is more suited to the needs of the discipline and to the needs of the patients it is meant to help. This will allow us to retain psychiatry as an autonomous science that can productively co-exist with neuroscience while also giving patients the kind of attention they need. I further argue that this same evidence supports a view of the mind that is anti-reductive and that allows that causation can be both bottom-up and top-down and that such a view is available in emergentism coupled with an interventionist model of causation.

  1. Trajectories of change during a randomized controlled trial of internet-delivered psychological treatment for adolescent chronic pain: how does change in pain and function relate?

    Science.gov (United States)

    Palermo, Tonya M; Law, Emily F; Zhou, Chuan; Holley, Amy Lewandowski; Logan, Deirdre; Tai, Gabrielle

    2015-04-01

    Although pain and function improve at immediate posttreatment for youth receiving cognitive behavioral therapy for chronic pain, limited data are available to understand changes that youth make during psychological treatment. We sought to characterize distinct trajectory patterns of change in pain and function to understand the temporal association of these changes during internet-delivered cognitive behavioral therapy (CBT). Weekly repeated assessments of pain and function were conducted during 8 weeks of treatment among 135 adolescents, aged 11 to 17 years, with chronic pain who were randomized to the cognitive behavioral intervention arm of an ongoing trial of internet-delivered CBT (Web-based management of adolescent pain; Web-MAP2). Using random-effects growth mixture models, we characterized pain and functional disability trajectories finding distinct trajectory groups indicating patterns of both linear and quadratic effects. Trajectories of change showed that some patients' pain and functional disability were improving, others worsened or changed minimally. Paired t tests compared the within-subject relative change rate in pain and function demonstrating similar change range for pain and function during the treatment period. There was no support for improvements in either pain or function to precede changes in the other domain. Findings may be useful in informing future studies of psychosocial treatments for pediatric chronic pain to consider how to target treatment strategies to distinct patient response profiles. This may lead to the development of intervention strategies that can both more effectively target children's pain and function during treatment and lead to sustained changes after treatment.

  2. Evolutionary psychiatry: a new College special interest group

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    Abed, Riadh; St John-Smith, Paul

    2016-01-01

    Evolutionary science remains an overlooked area in psychiatry and medicine. The newly established Royal College of Psychiatrists' Evolutionary Psychiatry Special Interest Group aims to reverse this trend by raising the profile of evolutionary thinking among College members and others further afield. Here we provide a brief outline of the importance of the evolutionary approach to both the theory and practice of psychiatry and for future research.

  3. Evaluation of time, attendance of medical staff and resources for radiotherapy in pediatric and adolescent patients. The DEGRO-QUIRO trial

    Energy Technology Data Exchange (ETDEWEB)

    Zabel-du Bois, Angelika; Milker-Zabel, Stefanie; Debus, Juergen [University of Heidelberg, Department of Radiotherapy and RadioOncology, Heidelberg (Germany); Bruns, Frank; Christiansen, Hans [Medical School Hannover, Department of Radiation Oncology, Hannover (Germany); Ernst, Iris; Willich, Normann [University of Muenster, Department of Radiation Oncology, Muenster (Germany); Popp, Wolfgang [Prime Networks AG, Basel (Switzerland); Sack, Horst [University of Essen, Department of Radiation Oncology, Essen (Germany)

    2014-06-15

    The German Society of Radiation Oncology (DEGRO) initiated a multicenter trial to develop and evaluate adequate modules to assert core procedures in radiotherapy. The aim of this prospective evaluation was to methodical assess the required resources for radiotherapy in pediatric and adolescent patients. At three radiotherapy centers of excellence (University Hospitals of Heidelberg and Muenster, the Medical School of Hannover), the manpower and time required for radiotherapy in pediatric and adolescent patients was prospectively documented consistently over a 2-year period. The data were collected using specifically developed standard forms and were evaluated using specific process analysis tools. A total number of 1914 data sets were documented and carefully analyzed. The personnel time requirements for all occupational groups were calculated as total time needed for a specific procedure and mean time per person. Regarding radiotherapy in general anesthesia, the required manpower was higher. The personnel time requirements in these cases were also longer, mainly due to longer room occupancy. Overall, the required resources were remarkably similar between the three different departments and may, therefore, be considered as representative. For the first time, the personnel time requirements of a radiotherapy department for the maintenance, protection, and optimization of operational readiness for radiotherapy in pediatric and adolescent patients with and without general anesthesia were determined methodically. (orig.) [German] Die deutsche Gesellschaft fuer Radioonkologie (DEGRO) initiierte eine Multizenterstudie zur Entwicklung und Anwendung geeigneter Module zur Erhebung und Analyse von Kernprozessen bei der Radiotherapie von Kindern und Jugendlichen. Ziel dieser prospektiven Erhebung war es, die erforderlichen Ressourcen bei der Radiotherapie im Kindesalter systematisch zu evaluieren. An drei strahlentherapeutischen Kompetenzzentren (Universitaetskliniken

  4. In India, Psychiatry Has Come a Long Way

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    Rajesh Parikh

    2015-01-01

    Full Text Available This Presidential Address of the Bombay Psychiatry Society covers the state of psychiatry in India in 1997. It posits that with the advent of newer brain imaging technologies in India such as computerised tomography, magnetic resonance imaging, single photon emission computerised tomography and brain electrical activity mapping, an era of evidence-based psychiatry in India has arrived. The Address cautions against the dehumanising potential of excessive reliance on technology. The need for a greater emphasis on psychiatry during undergraduate medical education is discussed along with the need to destigmatise psychiatric disorders. Finally, the need to encourage quality research in psychiatric disorders is stressed.

  5. Initiatives in biological research in Indian psychiatry.

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    Shrivatava, Amresh

    2010-01-01

    Biological psychiatry is an exploratory science for mental health. These biological changes provide some explicit insight into the complex area of 'brain-mind and behavior'. One major achievement of research in biological field is the finding to explain how biological factors cause changes in behavior. In India, we have a clear history of initiatives in research from a biological perspective, which goes back to 1958. In the last 61 years, this field has seen significant evolution, precision and effective utilization of contemporary technological advances. It is a matter of great pride to see that in spite of difficult times in terms of challenges of practice and services, administration, resource, funding and manpower the zest for research was very forthcoming. There was neither dedicated time nor any funding for conducting research. It came from the intellectual insight of our fore fathers in the field of mental health to gradually grow to the state of strategic education in research, training in research, international research collaborations and setting up of internationally accredited centers. During difficult economic conditions in the past, the hypothesis tested and conclusions derived have not been so important. It is more important how it was done, how it was made possible and how robust traditions were established. Almost an entire spectrum of biological research has been touched upon by Indian researchers. Some of these are electroconvulsive therapy, biological markers, neurocognition, neuroimaging, neuroendocrine, neurochemistry, electrophysiology and genetics. A lot has been published given the limited space in the Indian Journal of Psychiatry and other medical journals published in India. A large body of biological research conducted on Indian patients has also been published in International literature (which I prefer to call non-Indian journals). Newer research questions in biological psychiatry, keeping with trend of international standards are

  6. [Perspectives on researches in disaster psychiatry].

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    Tomita, Hiroaki

    2014-01-01

    After experiencing the catastrophic Great East Japan Earthquake and Tsunami disaster in 2011, Tohoku University founded the International Research Institute of Disaster Science (IRIDeS) in April, 2012. IRIDeS, comprising 7 divisions and 36 laboratories with broad areas of specialization, from the humanities to natural sciences, aims to become a global center for the study of disasters and disaster mitigation, learning from and building upon past lessons in disaster management from Japan and around the world. In IRIDeS, the Department of Disaster Psychiatry is in charge of dealing with issues related to disaster psychiatry, including the psychosocial impact of disasters. Now, at more than 2 and a half years after the catastrophic disaster, the psychological impact actually seems to be getting stronger and wider, whereas the memory of the disaster seems to be waning in other areas of the country. In such a situation, where a number of problems need to be resolved, what can/should we do as psychiatrists? On the other hand, other natural disasters, such as storms and floods, have kept hitting Japan, and catastrophes seem to strike somewhere in the world every year. In addition, we need to prepare for the possibility of a Nankai Trough Quake and an earthquake directly hitting the Tokyo area, which may occur sometime in the future. Considering the situation, we need to establish an education system for disaster psychiatry, and proceed with research to collect useful information to prepare for coming disasters. The aim of our department is to integrate multi-faceted basic and clinical research approaches to investigate the following topics: 1) to identify social, psychological, and biological factors involved in the pathophysiology of and recovery from disaster-related mental health problems; 2) to develop systems for disaster prevention, disaster response, and recovery, considering disaster-related psychiatric and psychological issues; 3) to develop useful tools for the

  7. Effects of sixty six adolescent tobacco use cessation trials and seventeen prospective studies of self-initiated quitting

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    Sussman S

    2002-01-01

    Full Text Available Abstract This paper provides a review of the last two and a half decades of research in adolescent and young-adult tobacco use cessation. A total of 66 tobacco cessation intervention studies – targeted or population – are reviewed. In addition, an exhaustive review is completed of adolescent self-initiated tobacco use cessation, involving 17 prospective survey studies. Average reach and retention across the intervention studies was 61% and 78%, respectively, and was higher when whole natural units were treated (e.g., classrooms, than when units created specifically for the program were treated (e.g., school-based clinics. The mean quit-rate at a three to 12-month average follow-up among the program conditions was 12%, compared to approximately 7% across control groups. A comparison of intervention theories revealed that motivation enhancement (19% and contingency-based reinforcement (16% programs showed higher quit-rates than the overall intervention cessation mean. Regarding modalities (channels of change, classroom-based programs showed the highest quit rates (17%. Computer-based (expert system programs also showed promise (13% quit-rate, as did school-based clinics (12%. There was a fair amount of missing data and wide variation on how data points were measured in the programs' evaluations. Also, there were relatively few direct comparisons of program and control groups. Thus, it would be difficult to conduct a formal meta-analysis on the cessation programs. Still, these data suggest that use of adolescent tobacco use cessation interventions double quit rates on the average. In the 17 self-initiated quitting survey studies, key predictors of quitting were living in a social milieu that is composed of fewer smokers, less pharmacological or psychological dependence on smoking, anti-tobacco beliefs (e.g., that society should step in to place controls on smoking and feeling relatively hopeful about life. Key variables relevant to the quitting

  8. Effects of sixty six adolescent tobacco use cessation trials and seventeen prospective studies of self-initiated quitting

    Directory of Open Access Journals (Sweden)

    Sussman S

    2003-01-01

    Full Text Available Abstract This paper provides a review of the last two and a half decades of research in adolescent and young-adult tobacco use cessation. A total of 66 tobacco cessation intervention studies – targeted or population – are reviewed. In addition, an exhaustive review is completed of adolescent self-initiated tobacco use cessation, involving 17 prospective survey studies. Average reach and retention across the intervention studies was 61% and 78%, respectively, and was higher when whole natural units were treated (e.g., classrooms, than when units created specifically for the program were treated (e.g., school-based clinics. The mean quit-rate at a three to 12-month average follow-up among the program conditions was 12%, compared to approximately 7% across control groups. A comparison of intervention theories revealed that motivation enhancement (19% and contingency-based reinforcement (16% programs showed higher quit-rates than the overall intervention cessation mean. Regarding modalities (channels of change, classroom-based programs showed the highest quit rates (17%. Computer-based (expert system programs also showed promise (13% quit-rate, as did school-based clinics (12%. There was a fair amount of missing data and wide variation on how data points were measured in the programs' evaluations. Also, there were relatively few direct comparisons of program and control groups. Thus, it would be difficult to conduct a formal meta-analysis on the cessation programs. Still, these data suggest that use of adolescent tobacco use cessation interventions double quit rates on the average. In the 17 self-initiated quitting survey studies, key predictors of quitting were living in a social milieu that is composed of fewer smokers, less pharmacological or psychological dependence on smoking, anti-tobacco beliefs (e.g., that society should step in to place controls on smoking and feeling relatively hopeful about life. Key variables relevant to the quitting

  9. The SAFETY Program: a treatment-development trial of a cognitive-behavioral family treatment for adolescent suicide attempters.

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    Asarnow, Joan Rosenbaum; Berk, Michele; Hughes, Jennifer L; Anderson, Nicholas L

    2015-01-01

    The purpose of this article is to describe feasibility, safety, and outcome results from a treatment development trial of the SAFETY Program, a brief intervention designed for integration with emergency services for suicide-attempting youths. Suicide-attempting youths, ages 11 to 18, were enrolled in a 12-week trial of the SAFETY Program, a cognitive-behavioral family intervention designed to increase safety and reduce suicide attempt (SA) risk (N = 35). Rooted in a social-ecological cognitive-behavioral model, treatment sessions included individual youth and parent session-components, with different therapists assigned to youths and parents, and family session-components to practice skills identified as critical in the pathway for preventing repeat SAs in individual youths. Outcomes were evaluated at baseline, 3-month, and 6-month follow-ups. At the 3-month posttreatment assessment, there were statistically significant improvements on measures of suicidal behavior, hopelessness, youth and parent depression, and youth social adjustment. There was one reported SA by 3 months and another by 6 months, yielding cumulative attempt rates of 3% and 6% at 3 and 6 months, respectively. Treatment satisfaction was high. Suicide-attempting youths are at high risk for repeat attempts and continuing mental health problems. Results support the value of a randomized controlled trial to further evaluate the SAFETY intervention. Extension of treatment effects to parent depression and youth social adjustment are consistent with our strong family focus and social-ecological model of behavior change.

  10. Teaching adolescents about changing bodies: Randomized controlled trial of an Internet puberty education and body dissatisfaction prevention program.

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    Cousineau, Tara M; Franko, Debra L; Trant, Meredith; Rancourt, Diana; Ainscough, Jessica; Chaudhuri, Anamika; Brevard, Julie

    2010-09-01

    This study tested the efficacy of an Internet-based prevention program, Trouble on the Tightrope: In Search of Skateboard Sam, on pubertal knowledge, body esteem, and self-esteem. One hundred and ninety participants (mean age 11.6 years) were randomized to either an intervention or attention placebo control condition and were assessed at baseline, after three Internet-based sessions, and at 3-month follow-up. Although the primary hypotheses were not supported, exploratory moderator analyses indicated that the intervention was beneficial for select students. Specifically, pubertal status moderated the effects on weight-related body esteem and several domains of self-esteem, resulting in positive effects for participants in the intervention group who had begun puberty. Gender differences were found on self-esteem subscales, indicating more robust effects for girls than boys. Tailored Internet programs based on personal characteristics such as gender and pubertal status may be a fruitful area for future research with adolescents.

  11. Intelligence and Birth Order among Children and Adolescents in Psychiatric Care

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    Kirkcaldy, Bruce; Furnham, Adrian; Siefen, Georg

    2009-01-01

    A sample of around 2,500 adolescents in a child and adolescent psychiatry clinic in the region of Munster, Germany had their intelligence assessed. Family size (total number of siblings within a family) was significantly correlated with intelligence score categories (-0.08 and -0.19 for males and females). First borns and only children displayed…

  12. Olanzapine approved for the acute treatment of schizophrenia or manic/mixed episodes associated with bipolar I disorder in adolescent patients

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    Ann E Maloney

    2010-11-01

    Full Text Available Ann E Maloney1,2, Linmarie Sikich31Maine Medical Center Research Institute, Scarborough, ME, USA; 2Department of Psychiatry, Tufts University School of Medicine, Boston, MA, USA; 3Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USABackground: Severe and persistent mental illnesses in children and adolescents, such as early-onset schizophrenia spectrum (EOSS disorders and pediatric bipolar disorder (pedBP, are increasingly recognized. Few treatments have demonstrated efficacy in rigorous clinical trials. Enduring response to current medications appears limited. Recently, olanzapine was approved for the treatment of adolescents with schizophrenia or acute manic/mixed episodes in pedBP.Methods: PubMed searches were conducted for olanzapine combined with pharmacology, schizophrenia, or bipolar disorder. Searches related to schizophrenia and bipolar disorder were limited to children and adolescents. The bibliographies of the retrieved articles were hand-checked for additional relevant studies. The epidemiology, phenomenology, and treatment of EOSS and pedBP, and olanzapine’s pharmacology are reviewed. Studies of olanzapine treatment in youth with EOSS and pedBP are examined.Results: Olanzapine is efficacious for EOSS and pedBP. However, olanzapine is not more efficacious than risperidone, molindone, or haloperidol in EOSS and is less efficacious than clozapine in treatment-resistant EOSS. No comparative trials have been done in pedBP. Olanzapine is associated with weight gain, dyslipidemia, and transaminase elevations in youth. Extrapyramidal symptoms, neuroleptic malignant syndrome, and blood dyscrasias have also been reported but appear rare.Conclusions: The authors conclude that olanzapine should be considered a second-line agent in EOSS and pedBP due to its risks for significant weight gain and lipid dysregulation. Awareness of the consistent weight and metabolic changes observed in olanzapine

  13. Comparison of Stimdate with Ritalin in Children and Adolescents with Attention Deficit Hyperactivity Disorder: a Double-Blind, Randomized Clinical Trial

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    Najmeh Khosrovan Mehr

    2009-02-01

    Full Text Available "nObjectives: The aim of this randomized clinical trial was to assess the efficacy of stimdate compared to ritalin in the treatment of children with attention deficit hyperactivity disorder (ADHD. "nMethod: Sixty four subjects (45 boys and 15 girls aged 5-13 who were diagnosed with ADHD based on (DSM-IV-TR criteria were selected for this study. The subjects were randomly assigned to two groups: one group with 30 subjects received stimdate and the other group of 30 subjects received ritalin for 6 weeks. Treatment outcomes were assessed using the Attention Deficit Hyperactivity Rating Scale administered at baseline and on weeks 2, 4 and 6 following the treatment. A two-way repeated measures analysis of variance (time- treatment interaction was used. "nResults: There were no significant differences between sex, age, weight, and ethnicity of the participants in the 2 groups. Both groups showed a significant improvement during the 6 weeks of the treatment period, and this improvement was due to the parents' ADHD Rating Scale during the treatment. "nConclusion: Based on the results of this study, no significant difference was observed between the two medications, and it seems both drugs behave[M1]  in a similar way. In addition, stimdate appears to be effective and well tolerated for ADHD in children and adolescents in Iran. "n 

  14. The meaningful assessment of therapy outcomes: Incorporating a qualitative study into a randomized controlled trial evaluating the treatment of adolescent depression.

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    Midgley, Nick; Ansaldo, Flavia; Target, Mary

    2014-03-01

    For many years, there have been heated debates about the best way to evaluate the efficacy and effectiveness of psychological therapies. On the one hand, there are those who argue that the randomized controlled trial (RCT) is the only reliable and scientifically credible way to assess psychological interventions. On the other hand, there are those who have argued that psychological therapies cannot be meaningfully assessed using a methodology developed to evaluate the impact of drug treatments, and that the findings of RCTs lack "external validity" and are difficult to translate into routine clinical practice. In this article, we advocate the use of mixed-method research designs for RCTs, combining the rigor of quantitative data about patterns of change with the phenomenological contextualized insights that can be derived from qualitative data. We argue that such an approach is especially important if we wish to understand more fully the impact of therapeutic interventions within complex clinical settings. To illustrate the value of a mixed-method approach, we describe a study currently underway in the United Kingdom, in which a qualitative study (IMPACT-My Experience [IMPACT-ME]) has been "nested" within an RCT (the Improving Mood With Psychoanalytic and Cognitive Behavioral Therapy [IMPACT] study) designed to evaluate the effectiveness of psychological therapies in the treatment of adolescent depression. We argue that such a mixed-methods approach can help us to evaluate the effectiveness of psychological therapies and support the real-world implementation of our findings within increasingly complex and multidisciplinary clinical contexts.

  15. Editorial: Ingenious designs and causal inference in child psychology and psychiatry.

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    Green, Jonathan

    2016-05-01

    The embryology of behavior--This title of a book by the great developmental psychologist Arnold Gesell (Gesell, 1945) continues nicely to encapsulate for me a core endeavour in child psychology and psychiatry; in the use of scientific method to tease out causes and processes within developmental science and psychopathology. This edition of JCPP includes some tremendous examples of the increasing rigour and sophistication with which such questions are being addressed. Particularly encouraging for me, as primarily an interventionist, is the use of well-designed randomized controlled trials (RCTs) for that end.

  16. Shorter Psychiatry Clerkship Length Is Associated with Lower NBME Psychiatry Shelf Exam Performance

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    Bostwick, J. Michael; Alexander, Cara

    2012-01-01

    Objective: The goal of this study was to evaluate a recent medical school curriculum change at our institution 3 years ago; specifically: shortening the Psychiatry core clerkship from 4 to 3 weeks and adding an optional 6-week core/elective combination rotation in lieu of the 3-week core. The authors aimed to determine whether clerkship length was…

  17. Co-opting psychiatry: the alliance between academic psychiatry and the pharmaceutical industry.

    Science.gov (United States)

    Moncrieff, Joanna

    2007-01-01

    The editorial presents the arguments that an alliance between academic psychiatry and the pharmaceutical industry is harmful through a critical review of the academic literature and media coverage of activities of the pharmaceutical industry. The industry and the psychiatric profession both gain advantages from promoting biomedical models of psychiatric disturbance and pharmacological treatment. This confluence of interests has lead to the exaggeration of the efficacy of psychiatric drugs and neglect of their adverse effects and has distorted psychiatric knowledge and practice. Academic psychiatry has helped the industry to colonise more and more areas of modern life in order to expand the market for psychotropic drugs. Persuading people to understand their problems as biological deficiencies obscures the social origin and context of distress and prevents people from seeking social or political solutions. Psychiatry has the power to challenge the dominance of the pharmaceutical industry and should put its efforts into developing alternatives to routine drug treatment. Psychiatry needs to disengage from the industry if it wants to make genuine advances in understanding psychiatric disorder and help reverse the harmful social consequences of the widening med-icalisation of human experience.

  18. Encompassing Sexual Medicine within Psychiatry: Pros and Cons

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    Segraves, Robert Taylor

    2010-01-01

    Objective: This article examines the positive and negative aspects of psychiatry encompassing sexual medicine within its purview. Methods: MEDLINE searches for the period between 1980 to the present were performed with the terms "psychiatry," "sexual medicine," and "sexual dysfunction." In addition, sexual medicine texts were reviewed for chapters…

  19. The Triple Jump: Assessing Problem Solving in Psychiatry.

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    O'Gorman, Ethna C.; Trimble, Peter; Smyth, Joe

    1998-01-01

    Describes an attempt to assess a final-year course in psychiatry using the Triple Jump. In this course, students on placement in psychiatric units perfect psychiatry skills that were acquired during the previous year by direct contact with patients. The Triple Jump is used to assess problem-solving skills in management strategy on cases. (PVD)

  20. Evaluation of Professional Role Competency during Psychiatry Residency

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    Grujich, Nikola N.; Razmy, Ajmal; Zaretsky, Ari; Styra, Rima G.; Sockalingam, Sanjeev

    2012-01-01

    Objective: The authors sought to determine psychiatry residents' perceptions on the current method of evaluating professional role competency and the use of multi-source feedback (MSF) as an assessment tool. Method: Authors disseminated a structured, anonymous survey to 128 University of Toronto psychiatry residents, evaluating the current mode of…

  1. An Investigation of Psychiatry Residents' Important Experiences

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    Long, Jody

    2011-01-01

    This research study was conducted to explore the phenomenon of the third-year experiences of the psychiatry residents. A review of the literature identified themes and subthemes related to the third-year of psychiatry education. The study was conducted at a university health science center. Data were collected from five residents using participant…

  2. Burden and Stress among Psychiatry Residents and Psychiatric Healthcare Providers

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    Zuardi, Antonio Waldo; Ishara, Sergio; Bandeira, Marina

    2011-01-01

    Purpose: The authors compared the levels of job burden and stress in psychiatry residents with those of other healthcare professionals at inpatient and outpatient psychiatric hospitals in a medium-sized Brazilian city. Method: In this study, the levels of job burden and stress of 136 healthcare workers and 36 psychiatry residents from six various…

  3. Psychiatry Residency Education in Canada: Past, Present and Future

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    Saperson, Karen

    2013-01-01

    Objective: This article provides a brief overview of the history of psychiatry residency training in Canada,and outlines the rationale for the current training requirements, changes to the final certification examination,and factors influencing future trends in psychiatry education and training. Method: The author compiled findings and reports on…

  4. Turnover of First-Time Chairs in Departments of Psychiatry

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    Buckley, Peter F.; Rayburn, William F.

    2011-01-01

    Objective: The authors examine the tenure of first-time Chairs in academic departments of psychiatry in order to stimulate discussion on extant workforce and leadership issues. Method: Data on tenure of Chairs in psychiatry and other nonsurgical specialties were derived from the longitudinal database of the Association of American Medical Colleges…

  5. The Recruitment Problem in Psychiatry: A Critical Commentary

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    Stampfer, Hans

    2011-01-01

    The continuing shortfall in recruitment to Psychiatry is examined with suggestions for affirmative action. Recruitment may improve in the near future because of the high demand for psychiatrists, the incentives offered, greater competition for other specialties and a pool of international graduates willing to work in Psychiatry. There remains the…

  6. Using the Technique of Journal Writing to Learn Emergency Psychiatry

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    Bhuvaneswar, Chaya; Stern, Theodore; Beresin, Eugene

    2009-01-01

    Objective: The authors discuss journal writing in learning emergency psychiatry. Methods: The journal of a psychiatry intern rotating through an emergency department is used as sample material for analysis that could take place in supervision or a resident support group. A range of articles are reviewed that illuminate the relevance of journal…

  7. Screening for Psychopathology Symptoms in Mexican Psychiatry Residents

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    Rios, Francisco Javier Mesa; Munoz, Maria Del Carmen Lara

    2011-01-01

    Background: Various rates of alcoholism, drug abuse, mental illness, and suicide among physician have been reported, generally higher than those in the general population. Psychiatry residents, as other specializing physicians, seem to be prone to suffering them. The prevalence of psychological symptoms among psychiatry residents has not been…

  8. Medical School Research Pipeline: Medical Student Research Experience in Psychiatry

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    Balon, Richard; Heninger, George; Belitsky, Richard

    2006-01-01

    Objective: The authors discuss the importance of introducing research training in psychiatry and neurosciences to medical students. Methods: A review of existing models of research training in psychiatry with focus on those providing research training to medical students is presented. Results: Two research-training models for medical students that…

  9. EPA guidance on improving the image of psychiatry.

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    Möller-Leimkühler, A M; Möller, H-J; Maier, W; Gaebel, W; Falkai, P

    2016-03-01

    This paper explores causes, explanations and consequences of the negative image of psychiatry and develops recommendations for improvement. It is primarily based on a WPA guidance paper on how to combat the stigmatization of psychiatry and psychiatrists and a Medline search on related publications since 2010. Furthermore, focussing on potential causes and explanations, the authors performed a selective literature search regarding additional image-related issues such as mental health literacy and diagnostic and treatment issues. Underestimation of psychiatry results from both unjustified prejudices of the general public, mass media and healthcare professionals and psychiatry's own unfavourable coping with external and internal concerns. Issues related to unjustified devaluation of psychiatry include overestimation of coercion, associative stigma, lack of public knowledge, need to simplify complex mental issues, problem of the continuum between normality and psychopathology, competition with medical and non-medical disciplines and psychopharmacological treatment. Issues related to psychiatry's own contribution to being underestimated include lack of a clear professional identity, lack of biomarkers supporting clinical diagnoses, limited consensus about best treatment options, lack of collaboration with other medical disciplines and low recruitment rates among medical students. Recommendations are proposed for creating and representing a positive self-concept with different components. The negative image of psychiatry is not only due to unfavourable communication with the media, but is basically a problem of self-conceptualization. Much can be improved. However, psychiatry will remain a profession with an exceptional position among the medical disciplines, which should be seen as its specific strength.

  10. Evolutionary Psychiatry and Nosology: Prospects and Limitations

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    Luc Faucher

    2012-11-01

    Full Text Available In this paper, I explain why evolutionary psychiatry is not where the next revolution in psychiatry will come from. I will proceed as follows. Firstly, I will review some of the problems commonly attributed to current nosologies, more specifically to the DSM. One of these problems is the lack of a clear and consensual definition of mental disorder; I will then examine specific attempts to spell out such a definition that use the evolutionary framework. One definition that deserves particular attention (for a number of reasons that I will mention later, is one put forward by Jerome Wakefield. Despite my sympathy for his position, I must indicate a few reasons why I think his attempt might not be able to resolve the problems related to current nosologies. I suggest that it might be wiser for an evolutionary psychiatrist to adopt the more integrative framework of “treatable conditions” (Cosmides and Tooby, 1999. As it is thought that an evolutionary approach can contribute to transforming the way we look at mental disorders, I will provide the reader with a brief sketch of the basic tenets of evolutionary psychology. The picture of the architecture of the human mind that emerges from evolutionary psychology is thought by some to be the crucial backdrop to identifying specific mental disorders and distinguishing them from normal conditions. I will also provide two examples of how evolutionary thinking is supposed to change our thinking about some disorders. Using the case of depression, I will then show what kind of problems evolutionary explanations of particular psychopathologies encounter. In conclusion, I will evaluate where evolutionary thinking leaves us in regard to what I identify as the main problems of our current nosologies. I’ll then argue that the prospects of evolutionary psychiatry are not good.

  11. Adult and adolescent livestock productive asset transfer programmes to improve mental health, economic stability and family and community relationships in rural South Kivu Province, Democratic Republic of Congo: a protocol of a randomised controlled trial

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    Kohli, Anjalee; Perrin, Nancy A; Remy, Mitima Mpanano; Alfred, Mirindi Bacikenge; Arsene, Kajabika Binkurhorhwa; Nadine, Mwinja Bufole; Heri, Banyewesize Jean; Clovis, Mitima Murhula; Glass, Nancy

    2017-01-01

    Introduction People living in poverty have limited access to traditional financial institutions. Microfinance programmes are designed to meet this gap and show promise in improving income, economic productivity and health. Our Congolese–US community academic research partnership developed two livestock productive asset transfer programmes, Pigs for Peace (PFP) and Rabbits for Resilience (RFR), to address the interlinked health, social and economic well-being of individuals, their families and communities. The community-based randomised controlled trials examine the effectiveness of PFP and RFR to improve health, economic stability, and family and community relationships among male and female adults and adolescents living in 10 rural, postconflict villages of eastern Democratic Republic of Congo. Methods and analysis PFP participants include adult permanent residents of rural villages; adolescent participants in RFR include male and female adolescents 10–15 years old living in the selected rural villages. Participants were randomised to intervention or delayed control group. Participants in PFP completed baseline interview prior to intervention and follow-up interview at 6, 12 and 18 months postintervention. In RFR, participants completed baseline interview prior to intervention and follow-up interview at 6, 12 and 18 months postbaseline. The primary outcome of both trials, the change in baseline mental health distress at 18 months in the intervention group (adults, adolescents) compared to control group, is used to calculate sample size. Ethics and dissemination The Johns Hopkins Medical Institute Internal Review Board approved this protocol. A committee of respected Congolese educators and community members (due to lack of local ethics review board) approved the study. The findings will provide important information on the potential for community-led sustainable development initiatives to build on traditional livelihood (livestock raising, agriculture

  12. A Health Belief Model-Social Learning Theory approach to adolescents' fertility control: findings from a controlled field trial.

    Science.gov (United States)

    Eisen, M; Zellman, G L; McAlister, A L

    1992-01-01

    We evaluated an 8- to 12-hour Health Belief Model-Social Learning Theory (HBM-SLT)-based sex education program against several community- and school-based interventions in a controlled field experiment. Data on sexual and contraceptive behavior were collected from 1,444 adolescents unselected for gender, race/ethnicity, or virginity status in a pretest-posttest design. Over 60% completed the one-year follow-up. Multivariate analyses were conducted separately for each preintervention virginity status by gender grouping. The results revealed differential program impacts. First, for preintervention virgins, there were no gender or intervention differences in abstinence maintenance over the follow-up year. Second, female preintervention Comparison program virgins used effective contraceptive methods more consistently than those who attended the HBM-SLT program (p less than 0.01); among males, the intervention programs were equally effective. Third, both interventions significantly increased contraceptive efficiency for teenagers who were sexually active before attending the programs. For males, the HBM-SLT program led to significantly greater follow-up contraceptive efficiency than the Comparison program with preintervention contraceptive efficiency controlled (p less than 0.05); for females, the programs produced equivalent improvement. Implications for program planning and evaluation are discussed.

  13. School-based oral health-education program using experiential learning or traditional lecturing in adolescents: a clinical trial.

    Science.gov (United States)

    Angelopoulou, Matina V; Oulis, Constantine J; Kavvadia, Katerina

    2014-10-01

    The aim of this project was to compare the effectiveness of experiential learning (EL) and traditional lecturing (TL) school-based oral health education on the oral health knowledge, attitude, habits, oral hygiene, gingival health and caries incidence of 13-year-old Greek children. Eighty-seven children for the EL group and 80 for the TL group were selected from two areas of Greece. Information on oral health knowledge, attitude and behaviours were obtained using a questionnaire. Dental plaque was recorded using a modified hygiene index, gingivitis was assessed using the simplified gingival index and dental caries was measured by recording the number of Decayed, Missing and Filled teeth (DMFT) using the British Association for the Study of Community Dentistry (BASCD) criteria. All children were examined by two calibrated dentists, using a World Health Organisation (WHO) periodontal probe and artificial light. Questionnaires were delivered and clinical examinations were performed at baseline and at 6 and 18 months post-intervention. The EL oral health educational programme was implemented by teachers using the programme's manual. Oral health knowledge had improved significantly (P Oral health behaviour (P oral hygiene and gingival health had improved significantly at both 6 (P oral health EL for adolescents was found to be more effective than TL in improving oral health attitude and behaviour at 6 months, in improving oral hygiene and gingival health at both 6 and 18 months and in reducing caries incidence 18 months post-intervention.

  14. A randomized controlled trial of Kung Fu training for metabolic health in overweight/obese adolescents: the "martial fitness" study.

    Science.gov (United States)

    Tsang, Tracey W; Kohn, Michael; Chow, Chin Moi; Singh, Maria Fiatarone

    2009-07-01

    Twenty overweight/obese adolescents underwent six months of Kung Fu or placebo (Tai Chi) training, 3x.wk(-1). Outcomes included fasting insulin and insulin resistance, lipids, glucose and HbA(1c), and C-reactive protein (CRP). CRP decreased significantly (p = 0.03) in both groups over time at six months. Although insulin sensitivity did not change, HbA(1c) tended to decrease over time (p = 0.09), again with no group difference (p = 0.60). Reduced CRP was related to increased upper body strength (p = 0.01). Increased lean body mass was related to reductions in HbA(1c), insulin resistance, triglycerides, and total cholesterol. Improvements in lean body mass appear to have a potential role in favorable metabolic outcomes, independent of changes in fat mass. Further research in this area is warranted before definite conclusions can be drawn about the efficacy of martial arts training for metabolic outcomes in this cohort.

  15. Optogenetics in psychiatry: The light ahead

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    Jyoti Prakash

    2012-01-01

    Full Text Available Complexities of the human mind have been beyond the scope of understanding because a intricate neuronal network and difficulty in specific localization and assessment of area responsible for a specific behavior; more so in a freely moving living being. Optogenetics off late has been able to address this issue to great extent and holds promises for future. Relevant literatures in this direction were looked into and the salient aspects of this science is being discussed here with specific relevance to psychiatry.

  16. Notes on a Few Issues in the Philosophy of Psychiatry

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    Singh Ajai

    2009-01-01

    Full Text Available The first part called the Preamble tackles: (a the issues of silence and speech, and life and disease; (b whether we need to know some or all of the truth, and how are exact science and philosophical reason related; (c the phenomenon of Why, How, and What; (d how are mind and brain related; (e what is robust eclecticism, empirical/scientific enquiry, replicability/refutability, and the role of diagnosis and medical model in psychiatry; (f bioethics and the four principles of beneficence, non-malfeasance, autonomy, and justice; (g the four concepts of disease, illness, sickness, and disorder; how confusion is confounded by these concepts but clarity is imperative if we want to make sense out of them; and how psychiatry is an interim medical discipline. The second part called The Issues deals with: (a the concepts of nature and nurture; the biological and the psychosocial; and psychiatric disease and brain pathophysiology; (b biology, Freud and the reinvention of psychiatry; (c critics of psychiatry, mind-body problem and paradigm shifts in psychiatry; (d the biological, the psychoanalytic, the psychosocial and the cognitive; (e the issues of clarity, reductionism, and integration; (f what are the fool-proof criteria, which are false leads, and what is the need for questioning assumptions in psychiatry. The third part is called Psychiatric Disorder, Psychiatric Ethics, and Psychiatry Connected Disciplines. It includes topics like (a psychiatric disorder, mental health, and mental phenomena; (b issues in psychiatric ethics; (c social psychiatry, liaison psychiatry, psychosomatic medicine, forensic psychiatry, and neuropsychiatry. The fourth part is called Antipsychiatry, Blunting Creativity, etc. It includes topics like (a antipsychiatry revisited; (b basic arguments of antipsychiatry, Szasz, etc.; (c psychiatric classification and value judgment; (d conformity, labeling, and blunting creativity. The fifth part is called The Role of Philosophy

  17. Long-term biological and behavioural impact of an adolescent sexual health intervention in Tanzania: follow-up survey of the community-based MEMA kwa Vijana Trial.

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    Aoife M Doyle

    2010-06-01

    Full Text Available BACKGROUND: The ability of specific behaviour-change interventions to reduce HIV infection in young people remains questionable. Since January 1999, an adolescent sexual and reproductive health (SRH intervention has been implemented in ten randomly chosen intervention communities in rural Tanzania, within a community randomised trial (see below; NCT00248469. The intervention consisted of teacher-led, peer-assisted in-school education, youth-friendly health services, community activities, and youth condom promotion and distribution. Process evaluation in 1999-2002 showed high intervention quality and coverage. A 2001/2 intervention impact evaluation showed no impact on the primary outcomes of HIV seroincidence and herpes simplex virus type 2 (HSV-2 seroprevalence but found substantial improvements in SRH knowledge, reported attitudes, and some reported sexual behaviours. It was postulated that the impact on "upstream" knowledge, attitude, and reported behaviour outcomes seen at the 3-year follow-up would, in the longer term, lead to a reduction in HIV and HSV-2 infection rates and other biological outcomes. A further impact evaluation survey in 2007/8 ( approximately 9 years post-intervention tested this hypothesis. METHODS AND FINDINGS: This is a cross-sectional survey (June 2007 through July 2008 of 13,814 young people aged 15-30 y who had attended trial schools during the first phase of the MEMA kwa Vijana intervention trial (1999-2002. Prevalences of the primary outcomes HIV and HSV-2 were 1.8% and 25.9% in males and 4.0% and 41.4% in females, respectively. The intervention did not significantly reduce risk of HIV (males adjusted prevalence ratio [aPR] 0.91, 95%CI 0.50-1.65; females aPR 1.07, 95%CI 0.68-1.67 or HSV-2 (males aPR 0.94, 95%CI 0.77-1.15; females aPR 0.96, 95%CI 0.87-1.06. The intervention was associated with a reduction in the proportion of males reporting more than four sexual partners in their lifetime (aPR 0.87, 95%CI 0

  18. Vitamins in psychiatry. Do they have a role?

    Science.gov (United States)

    Petrie, W M; Ban, T A

    1985-07-01

    Deficiencies of specific vitamins produce consistent symptoms of psychiatric disorder. Thiamine deficiency, which is common in alcoholism, can produce confusion and psychotic symptoms, in addition to neurological signs. Vitamin B12 and folate deficiency may contribute symptoms of disorientation, depression or psychosis; their measurement is a part of routine dementia work-ups. Pyridoxine deficiency results in seizures, although the effects of exogenously administered pyridoxine are not clearly understood in depression and anxiety - the disorders in which it is most frequently used clinically. The use of vitamins has been most prominent in psychiatry in the treatment of schizophrenia, where large doses of nicotinic acid were initially given alone and later combined with other vitamins and minerals. Several theoretical models were described to support the use of vitamins in schizophrenia. These included: the parallels of schizophrenia to the psychiatric symptoms of pellagra; hypotheses of a defect in adrenaline metabolism; and the accumulation of psychotoxic substances which produce psychotic symptoms. Initially, positive results were reported over 30 years ago, but have not been replicated by thorough investigations. An extensive series of comprehensive placebo-controlled trials failed to show efficacy for any of the vitamin therapies tested. Although clearly less effective than antipsychotic drug treatment, vitamin therapy is not without risks - adverse effects have been reported with nicotinic acid, pyridoxine and vitamin C.(ABSTRACT TRUNCATED AT 250 WORDS)

  19. Diagnosis of pulmonary tuberculosis by score system in children and adolescents: a trial in a reference center in Bahia, Brazil

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    Clemax Couto Sant'Anna

    2004-08-01

    Full Text Available Since 2002, the Brazilian Ministry of Health has recommended a score system for tuberculosis diagnosis of children and adolescents that does not need bacteriological positivity, because most cases in this age group have few bacteria. An observational, transversal study was carried out at the outpatient health care service of the reference medical service in Salvador, Bahia, including 164 patients with pulmonary tuberculosis, with ages ranging between 1 and 15 years of age, who were treated from 1990 to 2001. The gold standard used to establish the diagnosis was clinical, radiological, epidemiological and based on follow-up data. The score system for diagnosis purposes was tested retrospectively. The median age and the average age of the 164 patients were 6 and 6.62 years (SD ± 4.33, respectively. About 65% of the sample reported a history of close contact with a tuberculous adult. The BCG vaccine coverage was 70.7% (116/164. It was found that 26% (43/164 of the patients had severe malnutrition. Out of this group, 26/43 (60.47% were < 5mm reactive to the tuberculin test. On the other hand, out of the 91 patients with tuberculin test < 5mm, 29% (26/ 91 had severe malnutrition. The use of the score gave the following distribution: a TB very likely in 81.7% (134/164 of the patients; b possible TB in 15.9% (26/164 and TB unlikely in 2.4% (4/164. Among patients who had been vaccinated more than 2 years before, there was a 9 times higher risk of finding a tuberculin test above 10 mm in individuals with probable TB in comparison with the patients with possible or unlikely TB.

  20. The short-term safety and efficacy of fluoxetine in depressed adolescents with alcohol and cannabis use disorders: a pilot randomized placebo-controlled trial

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    Lingler Jacqui

    2009-03-01

    Full Text Available Abstract Background The objective of this study was to examine whether fluoxetine was superior to placebo in the acute amelioration of depressive symptomatology in adolescents with depressive illness and a comorbid substance use disorder. Methods Eligible subjects ages 12–17 years with either a current major depressive disorder (MDD or a depressive disorder that were also suffering from a comorbid substance-related disorder were randomized to receive either fluoxetine or placebo in this single site, 8-week double-blind, placebo-controlled study. The primary outcome analysis was a random effects mixed model for repeated measurements of Children's Depression Rating Scale-Revised (CDRS-R scores compared between treatment groups across time. Results An interim analysis was performed after 34 patients were randomized. Based on the results of a futility analysis, study enrollment was halted. Twenty-nine males and 5 females were randomized to receive fluoxetine (n = 18 or placebo (n = 16. Their mean age was 16.5 (1.1 years. Overall, patients who received fluoxetine and placebo had a reduction in CDRS-R scores. However, there was no significant difference in mean change in CDRS-R total score in those subjects treated with fluoxetine and those who received placebo (treatment difference = 0.19, S.E. = 0.58, F = 0.14, p = .74. Furthermore, there was not a significant difference in rates of positive urine drug toxicology results between treatment groups at any post-randomization visit (F = 0.22, df = 1, p = 0.65. The main limitation of this study is its modest sample size and resulting low statistical power. Other significant limitations to this study include, but are not limited to, the brevity of the trial, high placebo response rate, limited dose range of fluoxetine, and the inclusion of youth who met criteria for depressive disorders other than MDD. Conclusion Fluoxetine was not superior to placebo in alleviating depressive symptoms or in decreasing

  1. What kind of science for psychiatry?

    Directory of Open Access Journals (Sweden)

    Laurence J Kirmayer

    2014-06-01

    Full Text Available Psychiatry has invested its hopes in neuroscience as a path to understanding mental disorders and developing more effective treatments and ultimately cures. Recently, the U.S. NIMH has elaborated this vision through a new framework for mental health research, the Research Domain Criteria (RDoC. This framework aims to orient mental health research toward the discovery of underlying neurobiological and biobehavioral mechanisms of mental disorders that will eventually lead to definitive treatments. In this article we consider the rationale of the RDoC and what it reveals about implicit models of mental disorders. As an overall framework for understanding mental disorders, RDoC is impoverished and conceptually flawed. These limitations are not accidental but stem from disciplinary commitments and interests that are at odds with the larger concerns of psychiatry. A multilevel, ecosocial approach to biobhavioral systems is needed both to guide relevant neuroscience research and insure the inclusion of social processes that may be fundamental contributors to psychopathology and recovery.

  2. [Psychiatry periodicals in Spain up to 1931].

    Science.gov (United States)

    Bertolín Guillén, J M

    1992-01-01

    The development of psychiatry, as it happens with other medical specialties, has been linked to that of the journals dedicated to it. They are a good exponent of its state of growing or consolidation. The first psychiatric journal in Spain appeared in 1865 and 27 years later the next one was founded. None of the three journals which existed in the 19th century continued at the beginning of the 20th century. During the first three decades of this century, nine specialized journals were founded, among which the "Revista Frenopática Española" in the first place, and the "Archivos de Neurobiología" afterwards, were the most outstanding in our country and the "Revista Frenopática Española" was that of the greatest international projection. Although the importance of a constellation of prestigious journals which were not dedicated to psychiatry was decisive for the development of this discipline in our country, the professionals organized themselves in the monographic journals about this subject, linked to mental hospitals.

  3. Assessing competencies during education in psychiatry.

    Science.gov (United States)

    Humphrey, Holly J; Marcangelo, Michael; Rodriguez, Elizabeth R; Spitz, Deborah

    2013-06-01

    The utilization of competencies in medical education is relatively recent. In 1999 the United States Accreditation Council for Graduate Medical Education (ACGME) established six main competencies. Since then, the American Board of Psychiatry and Neurology have approved a specific list of competencies for their specialities in each of the ACGME's core competency areas. Assessment of competencies in both medical students and residents can be achieved through such methods as structured case discussion, direct observation, simulation, standardized patients, and 360-degree assessments, etc. Each assessment methodology has specific applications in the discipline of psychiatry. This paper reviews the different methods for assessing competencies with specific examples in psychiatric education. It is not intended as a comprehensive review of all assessment methods, but to provide examples and strategies to guide psychiatric educators in their practice. Students and residents were intentionally separated because there are differences in the teaching goals and objectives, and thus in the assessment purposes and design. Students are general, undifferentiated physicians-in-training who need to learn about psychiatric nosology, examinations, and treatment. Residents are mental health professionals who need more in-depth supervision in order to hone skills in all the specialized areas that arise in psychiatric practices, making supervision a vital part of residency programs.

  4. Diagnosis and causal explanation in psychiatry.

    Science.gov (United States)

    Maung, Hane Htut

    2016-12-01

    In clinical medicine, a diagnosis can offer an explanation of a patient's symptoms by specifying the pathology that is causing them. Diagnoses in psychiatry are also sometimes presented in clinical texts as if they pick out pathological processes that cause sets of symptoms. However, current evidence suggests the possibility that many diagnostic categories in psychiatry are highly causally heterogeneous. For example, major depressive disorder may not be associated with a single type of underlying pathological process, but with a range of different causal pathways, each involving complex interactions of various biological, psychological, and social factors. This paper explores the implications of causal heterogeneity for whether psychiatric diagnoses can be said to serve causal explanatory roles in clinical practice. I argue that while they may fall short of picking out a specific cause of the patient's symptoms, they can nonetheless supply different sorts of clinically relevant causal information. In particular, I suggest that some psychiatric diagnoses provide negative information that rules out certain causes, some provide approximate or disjunctive information about the range of possible causal processes, and some provide causal information about the relations between the symptoms themselves.

  5. [Hundred years' psychiatry in Korea (1899-1999)].

    Science.gov (United States)

    Rhi, B Y

    1999-01-01

    The western medical knowledges of the human anatomy and physiology including knowledges of central nervous system have probably been introduced into Korea by Prince Sohyŏn Seja in 1645. The authentic education for the western medicine at the governmental and private medical schools, however, originated from 1899 and the education of mental disease was included in curriculum of Tai-Han-uiwon, the governmental medical school before 1910. In 1913 the first department of psychiatry (Department of Mental Disease) was established at the Chongdokbu-uiwon, the clinic of the Japanese colonial government, the former Korean governmental hospital which has later developed to the Kyŏngs ŏng Imperial University Hospital. On the other hand, there was in Severance Hospital Medical College, one Australian missionary psychiatrist McLaren, who has served at Paton Memorial Hospital in Jinju, Korea from 1911, taught neurology and psychiatry from 1913 at Severance Hospital Medical College, established psychiatry ward in 1923 at the Hospital, conducted the ward in humanistic way until 1940. It was the German psychiatry which the Japanese psychiatrists have brought to the Korean peninsula and it remained as major trends of psychiatry in Korea during the Japanese occupation between 1911 and 1945. The academic levels of Kyŏngsŏng Imperial University in psychiatry as well as the quality of mental care seemed to be almost equivocal to the psychiatry in Japan. However, psychiatrists scope of social psychiatric issues and of the research interests seemed to be somewhat narrow. Due to the political discrimination for the Korean students, the Koreans had less opportunity for the promotion at the university than Japanese residents in Korea. In 1945, after the end of the Pacific War only about 11 Korean psychiatrists were left in Korea, who organized Korean Neuropsychiatric Association. The Department of Neuropsychiatry of Seoul National University (former Department of Neurology and

  6. World wide use of psychotropic drugs in child and adolescent psychiatric disorders.

    Science.gov (United States)

    Simeon, J G; Wiggins, D M; Williams, E

    1995-05-01

    1. Questionnaires were mailed to child psychiatrists world wide to obtain more precise information on views and approaches to the diagnosis and treatment of childhood psychiatric disorders. 2. Results indicated important problems related to the management of child psychiatry practice both overseas and in Canada. 3. The choice of medication was frequently restricted by lack of availability, and political or social attitudes. 4. A consensus on diagnosis and treatment guidelines in child and adolescent psychiatry remains an important issue.

  7. The Effect of Fixed Orthodontic Appliances and Fluoride Mouthwash on the Oral Microbiome of Adolescents - A Randomized Controlled Clinical Trial.

    Directory of Open Access Journals (Sweden)

    Jessica E Koopman

    Full Text Available While the aesthetic effect of orthodontic treatment is clear, the knowledge on how it influences the oral microbiota and the consequential effects on oral health are limited. In this randomized controlled clinical trial we investigated the changes introduced in the oral ecosystem, during and after orthodontic treatment with fixed appliances in combination with or without a fluoride mouthwash, of 10-16.8 year old individuals (N = 91. We followed several clinical parameters in time, in combination with microbiome changes using next-generation sequencing of the bacterial 16S rRNA gene. During the course of our study, the oral microbial community displayed remarkable resilience towards the disturbances it was presented with. The effects of the fluoride mouthwash on the microbial composition were trivial. More pronounced microbial changes were related to gingival health status, orthodontic treatment and time. Periodontal pathogens (e.g. Selenomonas and Porphyromonas were highest in abundance during the orthodontic treatment, while the health associated Streptococcus, Rothia and Haemophilus gained abundance towards the end and after the orthodontic treatment. Only minor compositional changes remained in the oral microbiome after the end of treatment. We conclude that, provided proper oral hygiene is maintained, changes in the oral microbiome composition resulting from orthodontic treatment are minimal and do not negatively affect oral health.

  8. Memantine versus Methylphenidate in Children and Adolescents with Attention Deficit Hyperactivity Disorder: A Double-Blind, Randomized Clinical Trial

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    MohammadReza Mohammadi

    2015-10-01

    Full Text Available Objectives: The aim of this randomized clinical trial was to assess the efficacy of memantine versus methylphenidate in the treatment of children with attention deficit hyperactivity disorder.Method: Forty participants (34 boys and 6 girls aged 6-11 who were diagnosed with attention deficit hyperactivity disorder based on (DSM-IV-TR criteria were selected for this study. The participants were randomly assigned to two groups: group one (n = 22 received memantine and the other group (n = 18 received methylphenidate for six weeks. Treatment outcomes were assessed using the Attention Deficit Hyperactivity Rating Scale and Clinical Global Impression- Severity Scale administered at baseline and at weeks 3 and 6 following the treatment. Also, a two-way repeated measures analysis of variance (time- treatment interaction was used.Results: At 6 weeks, methylphenidate produced a significantly better outcome on the Parent Rating Scale scores and Clinical Global Impression- Severity than memantine. Side effects were observed more often in the memantine group. However, with respect to the frequency of side effects, the difference between the memantine and methylphenidate groups was not significant. The most common side effects associated with memantine are appetite suppression, headache, vomiting, nausea and fatigue.Conclusion: The results of this study revealed that although memantine was less effective than methylphenidate in the treatment of attention deficit hyperactivity disorder, it may be considered as an alternative treatment.

  9. A residents' program for educating adolescents about mental health issues.

    Science.gov (United States)

    Coverdale, J H; Battaglia, J; Bushong, C P

    1991-09-01

    This paper describes a school-based program in which psychiatry residents educate adolescents about a variety of mental health topics. Adolescents responded positively to the program and were principally concerned about drugs, depression, suicide, and family problems. Residents also liked presenting in the schools. Participation in this program allowed residents to learn about agency consultation and secondary prevention. Possibilities for program expansion are discussed.

  10. Practice Parameter for Telepsychiatry with Children and Adolescents

    Science.gov (United States)

    Journal of the American Academy of Child & Adolescent Psychiatry, 2008

    2008-01-01

    Parameter for the usage of telepsychiatry to provide services to children and adolescents is developed using clinical consensus and existing scientific evidence. Telepsychiatry is the result of applying telemedicine, a mode of health care delivery that uses telecommunications, to psychiatry. The parameter's use for determining best practices in…

  11. Effectiveness of Facebook-Delivered Lifestyle Counselling and Physical Activity Self-Monitoring on Physical Activity and Body Mass Index in Overweight and Obese Adolescents: A Randomized Controlled Trial

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    Heidi Ruotsalainen

    2015-01-01

    Full Text Available Background. The aim was to evaluate the effects of a 12-week, Facebook-delivered lifestyle counselling intervention, with or without physical activity self-monitoring, on physical activity and body mass index (BMI in overweight and obese 13–16-year-old adolescents. Methods. Three-arm randomized controlled trial. Participants (n=46 were randomly assigned to intervention and control groups: one group received Facebook-delivered lifestyle counselling and monitoring of their physical activity (Fb + Act, n=15, whereas a second experimental group received the same Facebook-delivered lifestyle counselling without self-monitoring (Fb, n=16 and a third group served as the control group (n=15. Objective and self-reported physical activity assessment were used. Nonparametric statistical tests were used. Results. There were no significant intervention effects in terms of changes in physical activity levels or BMI from baseline to the 12-week postintervention measurements between the intervention and control groups. The Fb + Act group had lower sedentary time on weekdays compared to the control group during postintervention measurements (p=0.021, but there was no interaction between time and group. Conclusions. Interventions were not effective at increasing physical activity in overweight and obese adolescents. Before implementing such interventions, more evaluations on their effectiveness are needed. This trial is registered with ClinicalTrials.gov identifier NCT02295761 (2014-11-17.

  12. Improving adolescent social competence and behavior: a randomized trial of an 11-week equine facilitated learning prevention program.

    Science.gov (United States)

    Pendry, Patricia; Carr, Alexa M; Smith, Annelise N; Roeter, Stephanie M

    2014-08-01

    There is growing evidence that promoting social competence in youth is an effective strategy to prevent mental, emotional, and behavioral disorders in adulthood. Research suggests that programs delivered in collaboration with schools are particularly effective when they target social and emotional skill building, utilize an interactive instructional style, provide opportunities for youth participation and self-direction, and include explicit attempts to enhance youth social competence. A relatively new but popular approach that incorporates these characteristics is human animal interaction, which can be implemented in educational settings. We report the results from a randomized clinical trial examining the effects of an 11-week equine facilitated learning (EFL) program on the social competence and behavior of 5th-8th grade children. Children (N = 131) were recruited through referral by school counselors and school-based recruitment and then screened for low social competence. Researchers randomly assigned children to an experimental (n = 53) or waitlisted control group (n = 60). Children in the experimental group participated in an 11-week EFL program consisting of once-weekly, 90-min sessions of individual and team-focused activities, whereas children in the control group served as a wait-listed control and participated 16 weeks later. Parents of children in both groups rated child social competence at pretest and posttest. Three independent raters observed and reported children's positive and negative behavior using a validated checklist during each weekly session. Results indicated that program participation had a moderate treatment effect (d = .55) on social competence (p = .02) that was independent of pretest levels, age, gender, and referral status. Results showed that higher levels of program attendance predicted children's trajectories of observed positive (β = .500; p = .003) and negative behavior (β = -.062; p < .001) over the 11-week program.

  13. How new is the new philosophy of psychiatry?

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    Denys Damiaan

    2007-10-01

    Full Text Available Abstract In their recent paper, Natalie Banner and Tim Thornton evaluate seven volumes of the Oxford University Press series “International Perspectives in Philosophy and Psychiatry,” an international book series begun in 2003 focusing on the emerging interdisciplinary field at the interface of philosophy and psychiatry. According to Natalie Banner and Tim Thornton, the series represents a clear indication that the interdisciplinary field of philosophy of psychiatry has been flourishing lately. Philosophers and psychiatrists face a “new philosophy of psychiatry”. However, the optimism which the “new” philosophy of psychiatry celebrates is precisely the exiling of philosophy from the foundations of psychiatry. The 150 year old belief that psychopathology cannot do without philosophical reflection has virtually disappeared from common psychiatric education and daily clinical practice. Though the discipline of psychiatry is particularly suited to contributions from philosophy, the impact of philosophy on psychiatry nowadays remains limited. With some exceptions, philosophical papers are embedded in a philosophical context inscrutable to ordinary psychiatrists. Much current philosophical work is perceived by psychiatrists as negativistic. I would encourage the field of psychiatry to incorporate once again basic philosophical attitudes which render possible true dialogue with philosophy and enrich both disciplines. The views developed here should not discredit the value and importance of Natalie Banner and Tim Thornton’s paper and the excellent series “International Perspectives in Philosophy and Psychiatry.” As Jaspers said “Everybody inclined to disregard philosophy will be overwhelmed by philosophy in an unperceived way”.

  14. Effectiveness of group cognitive–behavioral treatment for childhood anxiety disorders in community clinics: benchmarking against an efficacy trial at a university clinic

    DEFF Research Database (Denmark)

    Jónsson, Hjalti; Arendt, Kristian Bech; Jørgensen, Lisbeth

    Background: The efficacy of a group cognitive behavioural therapy program (Cool Kids) of childhood anxiety has been demonstrated in a university-clinic setting in Australia (Hudson et al., 2009) and findings from a randomized controlled trial (RCT) at a University-clinic supports its efficacy...... Service in Denmark. Method: Psychologists and psychiatrists from three Child and Adolescent Psychiatry clinics and four community bases School Counselling Services are trained and supervised in a manualized group CBT treatment program (Cool Kids) for Childhood anxiety. Ninety-six children with anxiety...... disorders aged between 7 - 14 are expected to be included, equally divided between Psychiatric clinics (n = 48) and School Counselling services (n =48). The treatment consists of 10 2-hour group sessions with 5-6 children and their parents. Results are measured by independent diagnostic interviews...

  15. [Some reflections on evidence based psychiatry and its impact on contemporary psychiatry].

    Science.gov (United States)

    Conti, Norberto A

    2010-01-01

    In this work, the proposal of evidence based psychiatry (EBP) is presented together with a critical reflection about its paradigmatic perspective, taking into account Thomas S. Khun's epistemological lineaments. It is also shown how blurring of language in its approximation to the human behavioral disorders is EBP point of major inconsistency, as demonstrates a marked epistemological reductionism. Finally, consequences of its restrictive employment both to psychiatrists teaching and to the treatments they provide to their patients are also discussed.

  16. Functional MRT in psychiatry and neurology; Funktionelle MRT in Psychiatrie und Neurologie

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, F. [Universitaetsklinikum der RWTH Aachen (Germany). Klinik fuer Psychiatrie und Psychotherapie; Fink, G.R. (eds.) [Koeln Univ. (Germany). Klinik und Poliklinik fuer Neurologie

    2007-07-01

    Almost no other method has reach such an interest as the functional imaging in psychiatric and neurological science; it is fascinating to observe the brain at work. The fundamentals of functional magnetic resonance tomography (fMRT) and the interpretation of MRT images are explained; the state-of-the-art is discussed. The book is focussed on the functional imaging within psychiatry and neurology. The book contains 45 contributions within the following chapters: fundamentals, higher brain accomplishments, disease pattern, examinatory examples, perspectives.

  17. Psychiatry in the U.S. Army: Lessons for Community Psychiatry

    Science.gov (United States)

    2005-01-01

    Development of Nostalgia Nostalgia Before and During the Civil War Functional Heart Disease Constipation, Headache, and Neuralgia NEUROLOGY IN THE CIVIL WAR...Annual Reports of the Surgeon General, U.S. Army Military Psychiatry Insanity Alcoholism Headache and Neuralgia Preventive Medicine HEALTH OF THE ARMY...improved sufficiently to be discharged to less strenuous duties. 24(pp863-864) Constipation, Headache, and Neuralgia As indicated, participants of

  18. Applied psychometrics in clinical psychiatry: the pharmacopsychometric triangle

    DEFF Research Database (Denmark)

    Bech, P

    2009-01-01

    OBJECTIVE: To consider applied psychometrics in psychiatry as a discipline focusing on pharmacopsychology rather than psychopharmacology as illustrated by the pharmacopsychometric triangle. METHOD: The pharmacopsychological dimensions of clinically valid effects of drugs (antianxiety, antidepress......OBJECTIVE: To consider applied psychometrics in psychiatry as a discipline focusing on pharmacopsychology rather than psychopharmacology as illustrated by the pharmacopsychometric triangle. METHOD: The pharmacopsychological dimensions of clinically valid effects of drugs (antianxiety...... psychometrics in psychiatry have been found to cover a pharmacopsychometric triangle illustrating the measurements of wanted and unwanted effects of pharmacotherapeutic drugs as well as health-related quality of life....

  19. [Interdisciplinarity and psychiatry: is it time not to know?].

    Science.gov (United States)

    de Menezes, Mardônio Parente; Yasui, Silvio

    2013-06-01

    This article deals with interdisciplinarity as well as psychiatric and psychosocial care. Throughout the text, a historical account of the constitution and the crisis of scientific knowledge is presented and organized into disciplines. The theoretical difficulty of conceptualizing interdisciplinarity is analyzed and, in the concluding remarks, psychiatry and its relationship to psychosocial care is discussed. The argument is that, because of its history, psychiatry has singularities that differentiate it from other medical specialties and these singularities could initially cause psychiatry to go in the opposite direction in relation to interdisciplinarity. The conclusion is that because of their inherent characteristics psychosocial care services are privileged places for psychiatric training with interdisciplinary characteristics.

  20. Psychiatrie in meervoud. De wetenschappelijke oriëntaties van de Nederlandse psychiatrie in het interbellum (1918-1940

    Directory of Open Access Journals (Sweden)

    Joost Vijselaar

    2010-09-01

    Full Text Available Psychiatry in multiplicity According to a widespread interpretation, the history of psychiatry is characterized by a strong opposition between biological and psychological paradigms, which would dominate consecutive periods in history. The image of a swinging pendulum is a popular metaphor to describe this idea. The culture of Dutch psychiatry in the interwar years (1918-1940 seems to gainsay this image. Psychological, biological and socials models of explanation and therapy were used alongside each other without apparent debate and conflict. Influential professors of psychiatry like H.C. Rümke (Utrecht University even pleaded for a conscious integration of these approaches. Some historians have interpreted this stance as a sign of scientific ‘vagueness’ and ‘anarchy’. Analyzing the work of three major representatives of Dutch psychiatry in the Interbellum (Leendert Bouman, Han Rümke and Lammert van der Horst, the authors (former students of the master Historical and Comparative Studies of the Sciences and the Humanities shed light on the psychiatric climate of this era, dealing with themes like the openness of psychiatry to other sciences, the interactions of psychiatry and literature, and the relationship between theory and clinical practice. As a result a further qualification of the image of the pendulum is argued for.

  1. Learn 2 Move 16-24: effectiveness of an intervention to stimulate physical activity and improve physical fitness of adolescents and young adults with spastic cerebral palsy; a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Reinders- Messelink Heleen A

    2010-11-01

    Full Text Available Abstract Background Persons with cerebral palsy (CP are at risk for developing an inactive lifestyle and often have poor fitness levels, which may lead to secondary health complications and diminished participation and quality of life. However, persons with CP also tend not to receive structural treatment to improve physical activity and fitness in adolescence, which is precisely the period when adult physical activity patterns are established. Methods We aim to include 60 adolescents and young adults (16-24 years with spastic CP. Participants will be randomly assigned to an intervention group or a control group (no treatment; current policy. The intervention will last 6 months and consist of three parts; 1 counselling on daily physical activity; 2 physical fitness training; and 3 sports advice. To evaluate the effectiveness of the intervention, all participants will be measured before, during, directly after, and at 6 months following the intervention period. Primary outcome measures will be: 1 physical activity level, which will be measured objectively with an accelerometry-based activity monitor during 72 h and subjectively with the Physical Activity Scale for Individuals with Physical Disabilities; 2 aerobic fitness, which will be measured with a maximal ramp test on a bicycle or armcrank ergometer and a 6-minute walking or wheelchair test; 3 neuromuscular fitness, which will be measured with handheld dynamometry; and 4 body composition, which will be determined by measuring body mass, height, waist circumference, fat mass and lipid profile. Conclusions This paper outlines the design, methodology and intervention of a multicenter randomized controlled trial (LEARN 2 MOVE 16-24 aimed at examining the effectiveness of an intervention that is intended to permanently increase physical activity levels and improve fitness levels of adolescents and young adults with CP by achieving a behavioral change toward a more active lifestyle. Trial

  2. Learn 2 Move 16-24: effectiveness of an intervention to stimulate physical activity and improve physical fitness of adolescents and young adults with spastic cerebral palsy; a randomized controlled trial

    Science.gov (United States)

    2010-01-01

    Background Persons with cerebral palsy (CP) are at risk for developing an inactive lifestyle and often have poor fitness levels, which may lead to secondary health complications and diminished participation and quality of life. However, persons with CP also tend not to receive structural treatment to improve physical activity and fitness in adolescence, which is precisely the period when adult physical activity patterns are established. Methods We aim to include 60 adolescents and young adults (16-24 years) with spastic CP. Participants will be randomly assigned to an intervention group or a control group (no treatment; current policy). The intervention will last 6 months and consist of three parts; 1) counselling on daily physical activity; 2) physical fitness training; and 3) sports advice. To evaluate the effectiveness of the intervention, all participants will be measured before, during, directly after, and at 6 months following the intervention period. Primary outcome measures will be: 1) physical activity level, which will be measured objectively with an accelerometry-based activity monitor during 72 h and subjectively with the Physical Activity Scale for Individuals with Physical Disabilities; 2) aerobic fitness, which will be measured with a maximal ramp test on a bicycle or armcrank ergometer and a 6-minute walking or wheelchair test; 3) neuromuscular fitness, which will be measured with handheld dynamometry; and 4 body composition, which will be determined by measuring body mass, height, waist circumference, fat mass and lipid profile. Conclusions This paper outlines the design, methodology and intervention of a multicenter randomized controlled trial (LEARN 2 MOVE 16-24) aimed at examining the effectiveness of an intervention that is intended to permanently increase physical activity levels and improve fitness levels of adolescents and young adults with CP by achieving a behavioral change toward a more active lifestyle. Trial registration Dutch Trial

  3. Psychiatry, religion, positive emotions and spirituality.

    Science.gov (United States)

    Vaillant, George E

    2013-12-01

    This paper proposes that eight positive emotions: awe, love/attachment, trust/faith, compassion, gratitude, forgiveness, joy and hope constitute what we mean by spirituality. These emotions have been grossly ignored by psychiatry. The two sciences that I shall employ to demonstrate this definition of spirituality will be ethology and neuroscience. They are both very new. I will argue that spirituality is not about ideas, sacred texts and theology. Rather, spirituality is all about emotion and social connection that are more dependent on the limbic system than the cortex. Specific religions, for all their limitations, are often the portal through which positive emotions are brought into conscious attention. Neither Freud nor psychiatric textbooks ever mention emotions like joy and gratitude. Hymns and psalms give these emotions pride of place. Our whole concept of psychotherapy might change, if clinicians set about enhancing positive emotions, rather than focusing only on the negative ones.

  4. [The cultural psychiatry in Latin America].

    Science.gov (United States)

    Villaseñor-Bayardo, Sergio J; Rojas-Malpica, Carlos; Aceves-Pulido, Martha P

    2014-01-01

    This paper presents only some of the most important contributions in the development of cultural psychiatry in Latin America. The continental efforts to understand the role that culture plays in the manifestation and treatment of mental disorders have been fruitful. The authors included are: Fernando Pagés of Argentina; Mario G. Hollweg of Bolivia; Rubim Alvaro de Pinho and Adalberto Barreto of Brazil; Carlos A. Leon and Carlos A. Uribe of Colombia; Antonio José A. Bustamante and Santa Cruz de Cuba, Carlos Leon Andrade of Ecuador, Guatemala Cristina Chavez; Sergio Villasenor J. Bayardo of Mexico; Carlos A. Seguin, Hermilio Valdizán and Javier Mariátegui in Peru; Y. Bespaldi of Consens of Uruguay; Rojas and Carlos Malpica and Jacqueline Briceño Clarac of Venezuela.

  5. Use of Telepsychiatry in Psychodynamic Psychiatry.

    Science.gov (United States)

    Saeed, Sy Atezaz; Anand, Vivek

    2015-12-01

    This article reviews the organization, infrastructure basics, applications, effectiveness, outreach, and implementation barriers related to telepsychiatry. We highlight the tremendous potential and promise that this technology holds and also discuss the importance that telepsychiatry may play in the field of psychodynamic psychiatry. Given the growing effectiveness evidence base for therapy delivered over the Internet, telepsychiatry holds a large unexplored territory to help psychodynamically minded patients connect with psychodynamically oriented psychiatrists. This economically advantageous medium can be utilized to deliver psychodynamically guided approaches to the patient, alone or in combination with pharmacological and other psychosocial interventions. We hope, this article will help psychodynamically trained psychiatrists to consider bridging the gap with the remotely located, chronically mentally ill population which oftentimes has scarcity of resources.

  6. Descartes' dogma and damage to Western psychiatry.

    Science.gov (United States)

    Ventriglio, A; Bhugra, D

    2015-10-01

    René Descartes described the concept of mind-body dualism in the 16th century. This concept has been called his error but we prefer to call it his dogma because the error was recognised much later. We studied the original writings translated by various scholars. We believe that his dogma has caused tremendous amount of damage to Western psychiatry. This dualism has created boundaries between mind and body but as we know they are inextricably interlinked and influence each other. This has affected clinical practice and has increased the dichotomy between psychiatric services and the physical health care services in the West at least. This dualism has also contributed to stigma against mental illness, the mentally ill and the psychiatric services. We propose that it is time to abandon this mind-body dualism and to look at the whole patient and their illness experiences as is done in some other health care systems such as Ayurveda.

  7. [Biologism controversy: ethical implications for psychiatry].

    Science.gov (United States)

    Stier, M; Muders, S; Rüther, M; Schöne-Seifert, B

    2013-10-01

    Current biological psychiatry, it is frequently claimed by its opponents, is "biologistic" and unduly narrows psychological disorders to neurobiology and molecular biology. They deem a complete neuroscientific reduction of the mental phenomena to be impossible because of the impossibility of reducing certain phenomena, such as the individual subjective experience. If such a reduction is nevertheless undertaken it is ultimately to the disadvantage of the patients. We argue in this article that the very term "biologism" has to be put under scrutiny in the first place. As a result it becomes obvious that "biologism", as a subclass of "philosophical naturalism", is ultimately quite unproblematic. Biologism is dangerous only if it implies an eliminative rejection or an inappropriate underestimation of the relevance of the psyche. On closer examination it gets evident that such implications do not follow necessarily from biologism but cannot be precluded either. To better identify and possibly prevent such dangers, a more differentiated terminology seems helpful.

  8. The genomic psychiatry cohort: partners in discovery.

    Science.gov (United States)

    Pato, Michele T; Sobell, Janet L; Medeiros, Helena; Abbott, Colony; Sklar, Brooke M; Buckley, Peter F; Bromet, Evelyn J; Escamilla, Michael A; Fanous, Ayman H; Lehrer, Douglas S; Macciardi, Fabio; Malaspina, Dolores; McCarroll, Steve A; Marder, Stephen R; Moran, Jennifer; Morley, Christopher P; Nicolini, Humberto; Perkins, Diana O; Purcell, Shaun M; Rapaport, Mark H; Sklar, Pamela; Smoller, Jordan W; Knowles, James A; Pato, Carlos N

    2013-06-01

    The Genomic Psychiatry Cohort (GPC) is a longitudinal resource designed to provide the necessary population-based sample for large-scale genomic studies, studies focusing on Research Domain Criteria (RDoC) and/or other alternate phenotype constructs, clinical and interventional studies, nested case-control studies, long-term disease course studies, and genomic variant-to-phenotype studies. We provide and will continue to encourage access to the GPC as an international resource. DNA and other biological samples and diagnostic data are available through the National Institute of Mental Health (NIMH) Repository. After appropriate review and approval by an advisory board, investigators are able to collaborate in, propose, and co-lead studies involving cohort participants.

  9. [Development of forensic psychiatry in Serbia].

    Science.gov (United States)

    Milovanović, Srdjan; Jovanović, Aleksandar; Jasović-Gasić, Miroslava; Ilanković, Nikola; Dunjić, Dusan; Lakić, Aneta; Djukić-Dejanović, Slavica; Nenadović, Milutin; Randjelović, Dragisa; Milovanović, Dimitrije

    2013-01-01

    The development of legislation in the field of mental health in our region is linked with the emergence and development of the oldest psychiatric hospitals in Serbia.The principle that the mentally ill who committed a criminal offense need to be placed in a psychiatric hospital instead of a prison was introduced at the same time as in the most developed European countries. The founders of the Serbian forensic psychiatry, Dr. Jovan Danić, Dr.Vojislav Subotić Jr. and Dr. Dusan Subotić, were all trained at the first Serbian Psychiatric Hospital ("Home for the Unsound of Mind") that was founded in 1861 in the part of Belgrade called Guberevac. Their successors were psychiatric enthusiasts Prof. Dr.Vladimir F.Vujić and Prof. Dr. Laza Stanojević. A formal establishment of the School of Medicine of Belgrade, with acquirement of new experience and positive shifts within this field, based on the general act of the University in 1932, led to the formation of the Council of the School of Medicine, which, as a collective body passed expert opinions. Thus, the first Forensic Medicine Committee of the School of Medicine was formed and started its activities in 1931 when Forensic Medicine Committee Regulations were accepted. After the World War II prominent educators in the field of mental health, and who particularly contributed to further development of forensic psychiatry in Serbia were Prof. Dr. Uros Jekić, Prof Dr. Dusan Jevtić, Dr. Stevan Jovanović, Prof. Dr. Borislav Kapamadzija, Prof. Dr. Maksim Sternić, Prof. Dr. Josif Vesel and Prof. Dr. Dimitrije Milovanović.

  10. Effect of metformin added to insulin on glycemic control among overweight/obese adolescents with type 1 diabetes: A randomized clinical trial

    Science.gov (United States)

    Previous studies assessing the effect of metformin on glycemic control in adolescents with type 1 diabetes have produced inconclusive results. To assess the efficacy and safety of metformin as an adjunct to insulin in treating overweight adolescents with type 1 diabetes. Multicenter (26 pediatric en...

  11. Effect of Schroth exercises on curve characteristics and clinical outcomes in adolescent idiopathic scoliosis: protocol for a multicentre randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Sanja Schreiber

    2014-12-01

    Discussion: The results will demonstrate whether Schroth exercises combined with standard of care can improve outcomes in adolescents with idiopathic scoliosis. This study has potential to influence clinical practice worldwide, where exercises are not routinely prescribed for adolescents with idiopathic scoliosis.

  12. Validity and reliability of the Turkish version of CRAFFT Substance Abuse Screening Test among adolescents

    Directory of Open Access Journals (Sweden)

    Kandemir H

    2015-06-01

    Full Text Available Hasan Kandemir,1 Ömer Aydemir,2 Suat Ekinci,3 Salih Selek,4 Sultan B Kandemir,5 Hüseyin Bayazit61Department of Child and Adolescent Psychiatry, School of Medicine, Harran University, Sanliurfa, 2Department of Psychiatry, School of Medicine, Celal Bayar University, Manisa, 3Balikli Rum Hospital, Istanbul, 4Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center, Houston, Texas, USA; 5Department of Psychiatry, Balikligol State Hospital, Sanliurfa, 6Department of Psychiatry, School of Medicine, Harran University, Sanliurfa, TurkeyAim: This study aimed to validate the CRAFFT diagnostic test, against the Diagnostic and Statistical Manual of Mental Disorders – Fourth Edition, Axis 1-based diagnostic inventory in a Turkish population of adolescents.Method: The 124 adolescents who were 15–18 years old were enrolled to this study. CRAFFT was self-administered. Interviews took approximately 30 minutes, including the DSM-IV diagnostic interview for alcohol/drug dependence.Results: The mean age of subjects was 16.653 years (minimum: 15 years, maximum: 18 years. A score of 2 or higher in part B was found to be optimal for detecting youths with substance dependence problems (sensitivity: 0.82; specificity: 0.88 and it was sufficiently discriminative.Conclusion: The CRAFFT is a valid and reliable instrument for identifying Turkish-speaking youths at risk for substance use disorders.Keywords: CRAFFT, substance abuse, validity, Turkish, adolescent

  13. Editorial cognition, neurology, psychiatry: golden triangle or bermuda triangle?

    Science.gov (United States)

    Baddeley, A D

    1996-08-01

    Cognitive neuropsychiatry occupies the comparatively neglected research region that lies between neurology, psychiatry, and cognitive psychology. Reasons for this neglect are discussed, together with arguments as to why it may be timely to focus on this intellectual no man's land.

  14. [An approach to DSM-5: a breakthrough in psychiatry?].

    Science.gov (United States)

    Heerlein, Andrés L

    2014-01-01

    One of the main problems of current psychiatry is that its diagnostic classification systems are not precise and reliable, they do not help to identify with certainty a specific type of mental disorder and they frequently overlap two or more diagnoses. This may conduce to over diagnosis and overtreatment, which is the main criticism of the DSM system. The American Psychiatric Association (APA) launched recently the DSM-5, the fifth edition of its diagnostic manual, which provides diagnostic criteria for thousands of psychiatrist, psychologist and researchers and who will be using it in the next coming years. DSM-5, like the preceding editions, placed disorders in discrete categories such as bipolar disorder or schizophrenia. The problem is that scientists have been unable to find yet a genetic or neurobiological evidence to support the theory of mental disorders as separate categories. Several authors wanted the latest DSM to move away from the category model towards a new "dimensional approach", where disorders can be measured and mental illnesses overlapping can be reduced. Recent findings supports this new dimensional strategy, suggesting that the disorders are a product of shared risk factors that lead to abnormalities in specific drives, which can be measured and used to place persons on one of several spectra. In some parts the DSM-5 entered changes aiming to achieve a greater objectivity. The door for new changes in each category, dimension or criteria has been opened, favoring an evidence-based development of the future versions. DSM-5 is presented as a "living document" that can be updated easily. However, the category model still remains for many disorders. The future research in psychiatric diagnostic systems requires more genetic-molecular and neurophysiological evidence and more objective multinational field trials, in order to confirm the existence of the new diagnostic entities, spectrums or dimensions. This approach may provide us reliable

  15. A Novel Behavioral Intervention in Adolescents with Type 1 Diabetes Mellitus Improves Glycemic Control: Preliminary Results from a Pilot Randomized Control Trial

    Science.gov (United States)

    Maranda, Louise; Lau, May; Stewart, Sunita M; Gupta, Olga T

    2015-01-01

    Purpose The purpose of this study is to develop and pilot an innovative behavioral intervention in adolescents with type 1 diabetes mellitus (T1DM) incorporating structured care of a pet to improve glycemic control. Methods Twenty-eight adolescents with A1C > 8.5% (69 mmol/mol) were randomly assigned to either the intervention group (care of a Betta splendens pet fish) or the control group (usual care). Adolescents in the intervention group were given instructions to associate daily and weekly fish care duties with diabetes self-management tasks including blood glucose testing and parent-adolescent communication. Results After 3 months the participants in the intervention group exhibited a statistically significant decrease in A1C levels (−0.5%) compared to their peers in the control group who had an increase in A1C levels (0.8%)(p = 0.04). The younger adolescents (ages 10–13) demonstrated a greater response to the intervention which was statistically significant (−1.5% vs. 0.6%, p = 0.04) compared with the older adolescents (ages 14–17). Conclusions Structured care of a pet fish can improve glycemic control in adolescents with T1DM, likely by providing cues to perform diabetes self-management behaviors. PMID:25614529

  16. Differences between children and adolescents in treatment response to atomoxetine and the correlation between health-related quality of life and Attention Deficit/Hyperactivity Disorder core symptoms: Meta-analysis of five atomoxetine trials

    Directory of Open Access Journals (Sweden)

    Schacht Alexander

    2010-12-01

    Full Text Available Abstract Objectives To explore the influence of age on treatment responses to atomoxetine and to assess the relationship between core symptoms of attention deficit/hyperactivity disorder (ADHD and health-related quality of life (HR-QoL outcomes. Data Sources Data from five similar clinical trials of atomoxetine in the treatment of children and adolescents with ADHD were included in this meta-analysis. Study Selection Atomoxetine studies that used the ADHD Rating Scale (ADHD-RS and the Child Health and Illness Profile Child Edition (CHIP-CE as outcome measures were selected. Interventions Treatment with atomoxetine. Main Outcome Measures Treatment group differences (atomoxetine vs placebo in terms of total score, domains, and subdomains of the CHIP-CE were compared across age groups, and correlations between ADHD-RS scores and CHIP-CE scores were calculated by age. Results Data of 794 subjects (611 children, 183 adolescents were pooled. At baseline, adolescents showed significantly (p Conclusions Atomoxetine was effective in improving some aspects of HR-QoL in both age groups. Correlations between core symptoms of ADHD and HR-QoL were low to moderate.

  17. [Use of informatics technology in psychiatry].

    Science.gov (United States)

    Margariti, M; Papadimitriou, G N

    2012-01-01

    Computer technology dominates our daily lives and has become an integral professional tool in medical practice and by extension, in psychiatry as well. The widespread use of internet technology has taken place with unprecedented speed in the history of human civilization, spreading in a few decades to all countries of the world, offering novel possibilities for transmitting information, and leading to the globalization of knowledge. However, the speed with which computer technology is becoming a part of our lives is accompanied by difficulties in integration. The continued evolution of applications often leads to the impression that to be modern and efficient we have to run continuously after developments, dedicating time and effort that we cannot often afford. At the same time, its widespread use alters the needs of our patients, and our efficiency is constantly judged in a globalized environment which, while offering new possibilities, also has new demands. The initial impression that computer technology is simply a tool that can facilitate the work of those who are willing and able to use it has been replaced by the perception that the practice of medicine, in both clinical and academic level, requires sufficient knowledge of modern technology and the development of relevant skills for ongoing training and following innovative applications. The result of this assumption is the introduction of technology courses in the curricula of medical schools in the country. This article offers a brief description of the uses of information technology in psychiatry. In particular, e-mail is one of the most popular Internet services and there is internationally an increasing pressure from the public to be able to contact their doctor by e-mail. Furthermore, almost all psychiatric journals now have a digital electronic edition, thus increasing the volume of articles published, the ease of accessing the required information, and ultimately the reduction of the time it takes a

  18. Psychiatry and the military: an update.

    Science.gov (United States)

    Ritchie, Elspeth Cameron; Benedek, David; Malone, Ricky; Carr-Malone, Rosemary

    2006-09-01

    The United States has historically been concerned about the successful adjustment of its military members returning from war. These concerns are based on the recognition that war-zone exposures may have considerable negative emotional or behavior consequences. As the global war on terror continues, the United States military medical system will be required to address issues at the interface of psychiatry and the law. Despite clinical advances within the theater of war and at tertiary facilities in the United States, some military members will develop chronic and disabling mental illness as a result of traumatic exposure and exacerbated by the demands of the austere and dangerous operational environment. The extent to which violent and aggressive behavior in the aftermath of deployment can be attributed to combat experience remains an area of debate and ongoing investigation. However, experience suggests that a very small subgroup of the hundreds of thousands of war veterans deployed in conjunction with the current conflict in Iraq has already been involved in violent crimes. For this group, military forensic psychiatrists will be called on to make determinations of competency and criminal responsibility and to inform the courts about the potential contributions of war-related distress or disorder to criminal behavior. Though the overwhelming majority of war veterans will not be involved in criminal proceedings, a minority will develop career-ending (and in rare instances, life-ending) disabilities as a result of mental illness. For those who are no longer fit for duty, the military Physical Disability Evaluation System must make determinations of the extent to which future military performance and future civilian social and occupational function have been compromised. For a small yet highly visible minority of returning veterans, questions about the cause, precipitants, and manner of death will necessitate psychological autopsies. This article highlighted recent

  19. Frequency of anemia in chronic psychiatry patients

    Directory of Open Access Journals (Sweden)

    Korkmaz S

    2015-10-01

    Full Text Available Sevda Korkmaz,1 Sevler Yildiz,1 Tuba Korucu,1 Burcu Gundogan,1 Zehra Emine Sunbul,1 Hasan Korkmaz,2 Murad Atmaca1 1Department of Psychiatry, 2Department of Cardiology, Faculty of Medicine, Firat University, Elazig, Turkey Purpose: Anemia could cause psychiatric symptoms such as cognitive function disorders and depression or could deteriorate an existing psychiatric condition when it is untreated. The objective of this study is to scrutinize the frequency of anemia in chronic psychiatric patients and the clinical and sociodemographic factors that could affect this frequency.Methods: All inpatients in our clinic who satisfied the study criteria and received treatment between April 2014 and April 2015 were included in this cross-sectional study. Sociodemographic data for 378 patients included in the study and hemoglobin (Hb and hematocrit values observed during their admission to the hospital were recorded in the forms. Male patients with an Hb level of <13 g/dL and nonpregnant female patients with an Hb level of <12 g/dL were considered as anemic.Findings: Axis 1 diagnoses demonstrated that 172 patients had depressive disorder, 51 patients had bipolar disorder, 54 patients had psychotic disorder, 33 patients had conversion disorder, 19 patients had obsessive-compulsive disorder, 25 patients had generalized anxiety disorder, and 24 patients had other psychiatric conditions. It was also determined that 25.4% of the patients suffered from anemia. Thirty-five percent of females and 10% of males were considered as anemic. The frequency of anemia was the highest among psychotic disorder patients (35%, followed by generalized anxiety disorder patients (32%, and obsessive-compulsive disorder patients (26%. Anemia was diagnosed in 22% of depressive disorder patients, 25% of bipolar disorder patients, and 24% of conversion disorder patients.Results: The prevalence of anemia among chronic psychiatry patients is more frequent than the general population

  20. Biologism in Psychiatry: A Young Man’s Experience of Being Diagnosed with “Pediatric Bipolar Disorder”

    Directory of Open Access Journals (Sweden)

    Peter Parry

    2014-03-01

    Full Text Available Pediatric bipolar disorder is a diagnosis that arose in the mid 1990s in the USA and has mostly remained confined to that nation. In this article a young American man (under a pseudonym describes his experience of having the diagnosis throughout his adolescent years. His story was conveyed via correspondence and a meeting with the author, an Australian child psychiatrist. The young American’s story reveals several issues that afflict contemporary psychiatry, particularly in the USA, where social and economic factors have contributed to the rise of a dominant biomedical paradigm—or “biologism”. This focus on the “bio” to the relative exclusion of the “psychosocial” in both diagnosis and treatment can have serious consequences as this young man’s story attests. The author explores aspects of his tale to analyze how the pediatric bipolar disorder “epidemic” arose and became emblematic of a dominant biologism. This narrative points to the need, depending on the service and country, to return to or retain/improve a balanced biopsychosocial perspective in child and adolescent mental health. Child psychiatry needs to advocate for health systems that support deeper listening to our patients. Then we can explore with them the full range of contextual factors that contribute to symptoms of individual and family distress.

  1. Adolescent development

    Science.gov (United States)

    Development - adolescent; Growth and development - adolescent ... During adolescence, children develop the ability to: Understand abstract ideas. These include grasping higher math concepts, and developing moral ...

  2. [The "Psychiatrie-Enquete" - the German Report on the State of Psychiatry in 1975].

    Science.gov (United States)

    Finzen, Asmus

    2015-10-01

    Forty years ago an expert-commission submitted a report on the deplorable state of German psychiatric care, called the "Psychiatrie-Enquete" to the Bundestag, the German parliament. The Report initiated a substantial change of Psychiatric services in the country. Inhuman treatment and living conditions were superseded. Mental hospitals were not completely abolished. But they lost their importance in favour of decentralized psychiatric services including departments at general hospitals, day hospitals and outpatient services. Custodial care was largely successfully developed into therapeutic and rehabilitative care. This article attempts a mildly critical evaluation of the Enquête 40 years after.

  3. Cultural psychiatry: research strategies and future directions.

    Science.gov (United States)

    Kirmayer, Laurence J; Ban, Lauren

    2013-01-01

    This chapter reviews some key aspects of current research in cultural psychiatry and explores future prospects. The first section discusses the multiple meanings of culture in the contemporary world and their relevance for understanding mental health and illness. The next section considers methodological strategies for unpacking the concept of culture and studying the impact of cultural variables, processes and contexts. Multiple methods are needed to address the many different components or dimensions of cultural identity and experience that constitute local worlds, ways of life or systems of knowledge. Quantitative and observational methods of clinical epidemiology and experimental science as well as qualitative ethnographic methods are needed to capture crucial aspects of culture as systems of meaning and practice. Emerging issues in cultural psychiatric research include: cultural variations in illness experience and expression; the situated nature of cognition and emotion; cultural configurations of self and personhood; concepts of mental disorder and mental health literacy; and the prospect of ecosocial models of health and culturally based interventions. The conclusion considers the implications of the emerging perspectives from cultural neuroscience for psychiatric theory and practice.

  4. Deep pharma: psychiatry, anthropology, and pharmaceutical detox.

    Science.gov (United States)

    Oldani, Michael

    2014-06-01

    Psychiatric medication, or psychotropics, are increasingly prescribed for people of all ages by both psychiatry and primary care doctors for a multitude of mental health and/or behavioral disorders, creating a sharp rise in polypharmacy (i.e., multiple medications). This paper explores the clinical reality of modern psychotropy at the level of the prescribing doctor and clinical exchanges with patients. Part I, Geographies of High Prescribing, documents the types of factors (pharmaceutical-promotional, historical, cultural, etc.) that can shape specific psychotropic landscapes. Ethnographic attention is focused on high prescribing in Japan in the 1990s and more recently in the Upper Peninsula of Michigan, in the US. These examples help to identify factors that have converged over time to produce specific kinds of branded psychotropic profiles in specific locales. Part II, Pharmaceutical Detox, explores a new kind of clinical work being carried out by pharmaceutically conscious doctors, which reduces the number of medications being prescribed to patients while re-diagnosing their mental illnesses. A high-prescribing psychiatrist in southeast Wisconsin is highlighted to illustrate a kind of med-checking taking place at the level of individual patients. These various examples and cases call for a renewed emphasis by anthropology to critically examine the "total efficacies" of modern pharmaceuticals and to continue to disaggregate mental illness categories in the Boasian tradition. This type of detox will require a holistic approach, incorporating emergent fields such as neuroanthropology and other kinds of creative collaborations.

  5. [Intercommunication psychiatry in a burn center].

    Science.gov (United States)

    Ravella, P; Prallet, J P; Latarjet, J; Parizot, S; Bouchet, P

    1990-01-01

    The support of psychiatric disorders in a burn centre has been effected since three years, in Saint Luc Hospital (Lyon) thanks to a liaison group. One hour a week, several cases of patients are approached in this group which gathers two psychiatrists and the team dealing with burnt patients. Psychiatrists are attached to clarify the relation between people who attend and patients, to give a diagnosis and propose a strategy in front of difficulties they meet. The psychiatric care is reintegrated in the somatic support and assured by people who are daily effectively in contact with patients. This paper describes the advantages of the liaison psychiatry with regard to a direct intervention of the psychiatrist on the patient. It defines the targets these therapeutic weapon can aim and details the obtained results: for 3 years, the group has met 104 times for 241 "indirect consultations" concerning 99 different patients and count 50 good results on site and 5 specialized orientations; 10 deaths and 11 quick departures exclude 21 patients from the study; 17 cases have been stayed without continuation and 6 without any change.

  6. [The potential use of ayahuasca in psychiatry].

    Science.gov (United States)

    Frecska, Ede; Bokor, Petra; Andrassy, Gabor; Kovacs, Attila

    2016-06-01

    Ayahuasca is a decoctum made of admixture plants containing dimethyltryptamine and harmine. For millennia it has been used as a central element of spiritual, religious, initiation, and other - foremost healing - rituals, originally by the indigenous groups of the Amazon basin and later by the mestizo populations of the region. During the last two decades the brew has raised increased scientific and lay interest about its healing potentials within the framework of Western therapeutic settings. The typical ayahuasca effects consist of strong somatic reactions, vivid visions, relived personal memories, cathartic emotions, and insightful, introspective experiences when the emerging mental contents take different context and get deeper perspectives. The ayahuasca-experience can be exhausting necessitating the presence of an experienced leader for helping participants to pass difficult phases and for maximizing therapeutic benefits. No health damaging adverse effect has been confirmed thus far as result of its well-structured, institutionalized use. The scientific investigation of ayahuasca is hindered by legal issues, methodical problems, and sociocultural preconceptions. The present review outlines the therapeutic potentials of ayahuasca use in psychiatry with its psychobiological and spiritual background.

  7. The relevance of medical sociology to psychiatry: a historical view.

    Science.gov (United States)

    Bloom, Samuel W

    2005-02-01

    Collaboration between sociology and psychiatry is traced to the 1920s when, stimulated by Harry Stack Sullivan and Adolph Meyer, the relationship was activated by common theoretical and research interests. Immediately after World War II, this became a true partnership, stimulated by the National Institute of Mental Health, the Group for the Advancement of Psychiatry, and the growing influence of psychoanalytic theory. The effects of a sociology that focused on issues of health and illness proceeded to grow in medical education, research, and the treatment of mental illness until 1980, when a distinct shift of emphasis in psychiatry occurred. In its role as educator of future physicians, postwar psychiatry developed a paradigm of biopsychosocial behavior but, after 3 decades, changed to a biopharmacological model. The definition of mental illness as a deviant extreme in developmental and interpersonal characteristics lost favor to nosological diagnoses of discrete or dichotomous models. Under a variety of intellectual, socioeconomic, and political pressures, psychiatry reduced its interest in and relationship with sociology, replacing it in part with bioethics and economics. In this article, the detailed underpinnings of these changes are described and interpreted.

  8. Centenary of Karl Jaspers's general psychopathology: implications for molecular psychiatry.

    Science.gov (United States)

    Thome, Johannes

    2014-01-01

    Modern molecular psychiatry benefits immensely from the scientific and technological advances of general neuroscience (including genetics, epigenetics, and proteomics). This "progress" of molecular psychiatry, however, will be to a degree "unbalanced" and "epiphytic" should the development of the corresponding theoretical frameworks and conceptualization tools that allow contextualization of the individual neuroscientific findings within the specific perspective of mental health care issues be neglected. The General Psychopathology, published by Karl Jaspers in 1913, is considered a groundbreaking work in psychiatric literature, having established psychopathology as a space of critical methodological self-reflection, and delineating a scientific methodology specific to psychiatry. With the advance of neurobiology and molecular neuroscience and its adoption in psychiatric research, however, a growing alienation between current research-oriented neuropsychiatry and the classical psychopathological literature is evident. Further, consensus-based international classification criteria, although useful for providing an internationally accepted system of reliable psychiatric diagnostic categories, further contribute to a neglect of genuinely autonomous thought on psychopathology. Nevertheless, many of the unsolved theoretical problems of psychiatry, including those in the areas of nosology, anthropology, ethics, epistemology and methodology, might be fruitfully addressed by a re-examination of classic texts, such as Jaspers's General Psychopathology, and their further development and adaptation for 21st century psychiatry.

  9. [Irrationality in psychiatry. I. Irrationality in analytical psychology].

    Science.gov (United States)

    Vacek, J

    1991-02-01

    In the author's opinion the contemporary western world is experiencing an offensive of irrationality which affects also psychiatry. When psychiatry got rid of irrational illusions of preceding centuries, analytical psychology contributed to the introduction of irrationality into psychiatry. In the first part of his paper he maintains that Freud's share was not substantial in this respect and that in particular Jung contributed towards the development of irrational trends in psychiatry by this concept of collective unconscious. In the second part of his paper the author deals with so-called transpersonal, psychology, in particular the contribution made by the Czech psychiatrist Grof who, based on his experiments with LSD, created the theory of three levels of experience from unconscious (psychodynamic, perinatal, and transpersonal). His interpretation is a relapse of neoplatonism and represents antirational agnostic spiritualism with utopic antipsychiatric elements. In the third part of his paper the author deals with Capro's ideology of the New Age Movement to the establishment of which Ghof contributed in an important way. The New Age ideology is an irrational conglomeration of anti-civilization trends which negate modern thinking. The chances of manking are fallaciously seen in alienation from science and an approach to mysticism and irrational Asian traditions. Contemporary popularity of irrational trends, incl. transpersonal psychology, is a reaction of the overationalized society. Consequential enforcement of transpersonal psychology would imply a negation of the entire arsenal of thinking in psychiatry as a medial discipline.

  10. Cyclical swings: The bête noire of psychiatry.

    Science.gov (United States)

    Decker, Hannah S

    2016-02-01

    Progress in psychiatry in the West has been retarded by the proclivity of the discipline to swing violently between 2 approaches to viewing mental illness; that is, emphasizing-to the exclusion of the other-the material-somatic vs the psychical-experiential avenues to knowledge. Each time a shift occurs, the leaders of the new dominant approach emotionally denounce the principles and ideas that came before. We can examine this phenomenon historically by looking at Romantic psychiatry, mid-/late-19th century empirical psychiatry, psychoanalysis, and modern biological psychiatry. Looking at the 2 approaches in treatment today, the gold standard of patient care involves combining empirical/psychological care in 1 person (the psychiatrist) or shared between 2 clinicians working intimately with each other (psychiatrist with psychologist or social worker.) Yet as regards psychiatrists, they are discouraged from paying full attention to the psychological side by the way managed care and third-party payment have combined to remunerate them. Finally, how do we account for the intense swings and denunciations in psychiatry? The author speculates on possible explanations but leaves the question open for her readers.

  11. Randomized controlled trial testing the effectiveness of a depression prevention program ('Op Volle Kracht') among adolescent girls with elevated depressive symptoms.

    Science.gov (United States)

    Wijnhoven, Lieke A M W; Creemers, Daan H M; Vermulst, Ad A; Scholte, Ron H J; Engels, Rutger C M E

    2014-02-01

    Depression rates rise dramatically from the early to late adolescence. Especially young adolescent girls with elevated depressive symptoms are at high risk for developing a depression during adolescence or adulthood. Therefore, the prevention of depression is important especially in this high-risk group. The aim of the present study was to examine the effectiveness of the Cognitive Behavioral Therapy (CBT) component of the depression prevention program 'Op Volle Kracht' (OVK) among Dutch adolescent girls with elevated depressive symptoms. In total, 102 adolescent girls (11-15 years) in the first and second year of secondary school participated in this study. The girls in the experimental group (n = 50) followed the eight CBT-lessons of OVK and reported depressive symptoms 1 week prior to the start of the lessons, after every lesson, at one-month and 6-months follow-up. The girls in the control group (n = 52) exclusively reported depressive symptoms at the same time points. Latent Growth Curve Modeling showed that the decrease in depressive symptoms was significantly larger for girls in the experimental group compared to the girls in the control group. Furthermore, it was found that at 6-months follow-up, the girls in the experimental group had significantly lower levels of depressive symptoms compared to the girls in the control group. These findings indicate that the CBT-component of OVK effectively reduces depressive symptoms in short term and possibly prevents the development of a clinical depression.

  12. Attachment-based family therapy for suicidal lesbian, gay, and bisexual adolescents: a treatment development study and open trial with preliminary findings.

    Science.gov (United States)

    Diamond, Gary M; Diamond, Guy S; Levy, Suzanne; Closs, Cynthia; Ladipo, Tonya; Siqueland, Lynne

    2012-03-01

    The objective of this paper is to adapt attachment-based family therapy (ABFT) for use with suicidal lesbian, gay, and bisexual (LGB) adolescents and to obtain preliminary data on the feasibility and efficacy of the treatment with this population. In Phase I, a treatment development team modified ABFT to meet the unique needs of LGB suicidal youth. In Phase II, 10 suicidal LGB youth were offered 12 weeks of LGB sensitive ABFT. Adolescents' report of suicidal ideation, depressive symptoms, and maternal attachment-related anxiety and avoidance were gathered at pretreatment, 6 weeks, and 12 weeks (posttreatment). In Phase I, the treatment was adapted to: (a) include more individual time working with parents in order to process their disappointments, pain, anger, and fears related to their adolescent's minority sexual orientation; (b) address the meaning, implications, and process of acceptance; and (c) heighten parents' awareness of subtle yet potent invalidating responses to their adolescents' sexual orientation. Results of Phase II suggest this population can be recruited and successfully treated with a family based therapy, evidenced by high levels of treatment retention and significant decreases in suicidal ideation, depressive symptoms, and maternal attachment-related anxiety and avoidance. This is the first family-based treatment adapted and tested specifically for suicidal LGB adolescents. Though promising, the results are preliminary and more research on larger samples is warranted.

  13. Assessing the efficacy of the healthy eating and lifestyle programme (HELP compared with enhanced standard care of the obese adolescent in the community: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Christie Deborah

    2011-11-01

    Full Text Available Abstract Background The childhood obesity epidemic is one of the foremost UK health priorities. Childhood obesity tracks into adult life and places individuals at considerable risk for diabetes, cardiovascular disease, liver disease and other morbidities. There is widespread need for paediatric lifestyle programmes as change may be easier to accomplish in childhood than later in life. Study Design/Method The study will evaluate the management of adolescent obesity by conducting a Medical Research Council complex intervention phase III efficacy randomised clinical trial of the Healthy Eating Lifestyle Programme within primary care. The study tests a community delivered multi-component intervention designed for adolescents developed from best practice as identified by National Institute for Health and Clinical Excellence. The hospital based pilot reduced body mass index and improved health-related quality of life. Subjects will be individually randomised to receiving either the Healthy Eating Lifestyle Programme (12 fortnightly family sessions or enhanced standard care. Baseline and follow up assessments will be undertaken blind to allocation status. A health economic evaluation is also being conducted. 200 obese young people (13-17 years, body mass index > 98th centile for age and sex will be recruited from primary care within the greater London area. The primary hypothesis is that a motivational and solution-focused family-based weight management programme delivered over 6 months is more efficacious in reducing body mass index in obese adolescents identified in the community than enhanced standard care. The primary outcome will be body mass index at the end of the intervention, adjusted for baseline body mass index, age and sex. The secondary hypothesis is that the Healthy Eating Lifestyle Programme is more efficacious in improving quality of life and psychological function and reducing waist circumference and cardiovascular risk factors in

  14. PET application in psychiatry and psychopharmacology

    Energy Technology Data Exchange (ETDEWEB)

    Suhara, Tetsuya [National Inst. of Radiological Sciences, Chiba (Japan)

    1999-07-01

    In the last few decades diagnostic and research tools in the medical field have made great advances, yet psychiatry has lacked sufficiently sensitive tools to measure the aberration of brain functions. Recently however, the development of Positron emission tomography (PET) techniques has made it possible to measure changes in neurochemical components in mental disorders and the effect of psychoactive drugs in living human brain. Most of the advancement in the psychiatric field has came from the development psychoactive drugs. Brain research involving identification of neurotransmission is largely based on compounds developed in psychopharmacology. Some of these compounds have been radiolabelled and used as radioligands for quantitative examination of neuroreceptors and other aspects of neurotransmission. Using PET, radioligand binding can now be examined in the human brain in vivo. PET techniques also allow examination of an unlabelled drug by examination of its interaction with a radioligand. So one potential of PET in psychiatry is to investigate the mechanism of psychoactive drugs. Antidepressants modulate serotonin transmission by inhibiting serotonin reuptake from the synaptic cleft. High affinity [{sup 3}H]imipramine binding sites in mammalian brain have been labelled to investigate serotonin transporters in living human brain by PET. Cyanoimipramine which is described as a potent serotonin reuptake inhibitor, was labelled with {sup 11}C. In a PET experiment with 6 healthy human subjects, a high accumulation of [{sup 11}C]cyanoimipramine was found in the thalamus and striatum and lowest accumulation was observed in the cerebellum, a region relatively void of serotonin transporters. The thalamus to cerebellum ratio was about 2 at 90 min after the injection of the tracer. Recently, [{sup 11}C]McN5652-X has been introduced as a better tracer for serotonin transporter imaging. Employing [{sup 11}C]McN5652-X in a PET study of 7 healthy human subjects, a high

  15. Public health system and psychiatry in the treatment of 'dangerous' young offenders in Brazil.

    Science.gov (United States)

    Ribeiro, Rafael Bernardon; Cordeiro, Quirino; Taborda, José G V

    2015-01-01

    We describe the Experimental Health Unit, a special forensic mental health facility in Brazil, created by court order and administered by the São Paulo Department of Health. It was designed for young offenders receiving compulsory inpatient treatment for severe personality disorders. All nine patients admitted to date came from Foundation CASA (a socio-educational centre of assistance for adolescents, the juvenile correctional centres managed by the São Paulo state Department of Justice). The court decision is questionable, relying on a new interpretation of the Child and Adolescent Statute and the law that regulates psychiatric treatment in Brazil. The public health system and psychiatry have been supporting the isolation of some individuals from society, based on the seriousness of their crimes and possession of particular personality characteristics. The decision to commit and send a small group of personality disordered individuals to this unit as inpatients is an unfair decision, since jails and correctional centres hold a high number of psychopathic who have also committed barbaric crimes. The central mental health issue is the role that the public health system should play in the custody of dangerous people; the cost-effectiveness of this model, the accuracy of risk assessment and tractability of people with severe personality disorders are also debatable. From a legal perspective, the operation of this facility raises questions about age of legal majority, the maximum period of incarceration of young offenders and use of whole-life sentences for certain types of crimes and criminals in Brazil.

  16. Self-reported efficacy of neurofeedback treatment in a clinical randomized controlled study of ADHD children and adolescents

    Directory of Open Access Journals (Sweden)

    Duric NS

    2014-09-01

    Full Text Available Nezla S Duric,1–3 Jörg Aßmus,4 Irene B Elgen1,5 1Department of Clinical Medicine, University of Bergen, Bergen, Norway; 2Center for Child and Adolescent Mental Health, University of Bergen, Bergen, Norway; 3Department of Child and Adolescent Psychiatry, Helse Fonna Haugesund Hospital, Haugesund, Norway; 4Center for Clinical Research, Haukeland University Hospital, Bergen, Norway; 5Department of Child and Adolescent Psychiatry, Haukeland University Hospital, Bergen, Norway Background: Many non-pharmacological treatments for children and adolescents with attention-deficit/hyperactivity disorder (ADHD have been attempted, but reports indicate that most are ineffective. Although neurofeedback (NF is a treatment approach for children with ADHD that remains promising, a variety of appropriate measures have been used in reporting and evaluating its effect. Objective: To report the self-evaluations of NF treatment by children and adolescents with ADHD. Methods: Randomized controlled trial in 91 children and adolescents with ADHD, aged less than 18 years (mean, 11.2 years participated in a 30-session program of intensive NF treatment. Participants were randomized and allocated by sequentially numbered sealed envelopes into three groups: methylphenidate (MPH as an active control group, and two trial groups NF with MPH, and NF alone. ADHD core symptoms and school performance were given on a scale of 1 to 10 using a self-reporting questionnaire, and the changes in these scores after treatment were used as the self-reported evaluation. Basic statistical methods (descriptive, analyses of variance, exact χ2 test, and paired t-test were used to investigate the baseline data. Changes in ADHD core symptoms and treatment effects were investigated using a general linear model for repeated measures. Results: Eighty participants completed the treatment study and 73 (91% responded sufficiently on the self-reporting questionnaires. The treatment groups were

  17. Fatigue In Teenagers on the interNET--the FITNET Trial. A randomized clinical trial of web-based cognitive behavioural therapy for adolescents with chronic fatigue syndrome: study protocol. [ISRCTN59878666

    NARCIS (Netherlands)

    Nijhof, S.L.; Bleijenberg, G.; Uiterwaal, C.S.; Kimpen, J.L.L.; Putte, E.M. van de

    2011-01-01

    BACKGROUND: Chronic Fatigue Syndrome (CFS) is increasingly recognized as a cause of disability and inactivity in adolescents in the Netherlands. CFS is characterized by unexplained fatigue lasting more than 6 months. Cognitive Behavioural Therapy (CBT) has proven to be effective. However, CBT availa

  18. Cultural psychiatry in the French-speaking world.

    Science.gov (United States)

    Westermeyer, Joseph

    2013-01-01

    For the last five centuries, France's international influence has been constant. This has been particularly evident in the areas of general culture, history and science. In psychiatry, the role of Pinel during the French Revolution, and the discovery of the first psychotropic agent, chlorpromazine, by Delay and Deniker are two outstanding historical facts. This chapter examines the contributions of French social scientists in the understanding of the sequelae of colonial exploitation, racism and political oppression. The establishment of a multi-ethnic society in France and Francophile regions of the world has led to the gradual creation of a cultural psychiatry rich in terminological influences, clinical understanding, training programs and research. Closer connections between French psychiatric thought and Anglophile psychiatry is likely to produce beneficial effects.

  19. A new ethics of psychiatry: neuroethics, neuroscience, and technology.

    Science.gov (United States)

    Cheung, Erick H

    2009-09-01

    Neuroethics is a new subset of bioethics that addresses ethical issues pertaining to the brain, primarily in the fields of neuroscience, cognitive science, and neuroradiology. Research in brain science is progressing at a phenomenal rate and, as a result, the acquisition and application of knowledge and technology raises ethical questions of a practical and philosophical nature. While neuroethics is developing as a distinct field of study, one area that should be addressed in greater depth is the relevance and potential impact of neurotechnology in psychiatry. New knowledge in the mind-brain conundrum and increasingly sophisticated techniques for imaging and intervening in human cognition, emotion, and behavior pose ethical issues at the intersection of technology and psychiatry. This article presents a broad survey of the new directions in neuroethics, neuroscience, and technology and considers the implications of technological advances for the practice of psychiatry in the new millennium. (Journal of Psychiatric Practice 2009;15:391-401).

  20. [Human dignity as foundation of an ethics in psychiatry].

    Science.gov (United States)

    Achatz, Johannes; Knoepffler, Nikolaus

    2014-07-01

    Psychiatry is distinguished from other fields of medical expertise and bears a particular kind of responsibility, namely the treatment of persons incapable of informed consent per se. The History of psychiatry shows that much too often inhuman abuse was happening in psychiatric facilities. An ethics of psychiatry therefore requires a reliable and stable foundation for values that allow justifying normative claims embracing both characteristics. Such a basic foundation already exists in form of the pluralistic and international recognition of human dignity. We argue that human dignity does and has to go beyond "respect for autonomy" and by that it can function as highest authority on questions concerning value judgments on critical cases in psychiatric bioethics.

  1. Link prediction boosted psychiatry disorder classification for functional connectivity network

    Science.gov (United States)

    Li, Weiwei; Mei, Xue; Wang, Hao; Zhou, Yu; Huang, Jiashuang

    2017-02-01

    Functional connectivity network (FCN) is an effective tool in psychiatry disorders classification, and represents cross-correlation of the regional blood oxygenation level dependent signal. However, FCN is often incomplete for suffering from missing and spurious edges. To accurate classify psychiatry disorders and health control with the incomplete FCN, we first `repair' the FCN with link prediction, and then exact the clustering coefficients as features to build a weak classifier for every FCN. Finally, we apply a boosting algorithm to combine these weak classifiers for improving classification accuracy. Our method tested by three datasets of psychiatry disorder, including Alzheimer's Disease, Schizophrenia and Attention Deficit Hyperactivity Disorder. The experimental results show our method not only significantly improves the classification accuracy, but also efficiently reconstructs the incomplete FCN.

  2. A Thorn in the Flesh? Forensic Inpatients in General Psychiatry

    DEFF Research Database (Denmark)

    Møllerhøj, Jette; Stølan, Liv Os; Brandt-Christensen, Anne Mette

    2016-01-01

    of staff identify the care of mentally disordered offenders in general psychiatric units as either "a parking space" or a very difficult or frightening course, where staff members tend to behave like pleasers in order to avoid risks of conflict or physical violence. Either way, it seems hard to provide......PURPOSE: To illuminate whether and how taking care of forensic inpatients is experienced as a burden among staff and managers in general psychiatry. DESIGN AND METHODS: Qualitative analytical strategies based on interviews and questionnaires. FINDINGS: The interplay between physical environment...... sufficient mental health care. PRACTICE IMPLICATIONS: Nationwide training and teaching as well as knowledge exchange between specialized forensic psychiatry and general psychiatry are recommended. Further exploration is needed on patient perspectives and on avenues to increase efficiency and decrease...

  3. [Karl Jaspers and the challenges of social psychiatry].

    Science.gov (United States)

    Jäger, Markus; Lang, Fabian U; Becker, Thomas

    2015-01-01

    Karl Jaspers, in his book "General Psychopathology", argued for methodological pluralism rather than theoretical dogmatism. He formulated a methodological order of psychopathology with a distinction between "explanation" (objective psychopathology) and "understanding" (subjective psychopathology, psychopathology of meaning). The latter approach focused on patients' subjective experience and biographical issues. Karl Jaspers emphasised social factors in the genesis and course of mental disorders. Following a multiperspective concept, from Jaspers' viewpoint social psychiatry should consider itself of equal importance with biological and psychotherapeutic psychiatry. Therefore, uncritical generalization of one of these perspectives should be avoided. Personalized psychiatry, apart from searching biological markers to tailor treatment should identify psychosocial factors and subjective meaning. Concepts of recovery should not ignore biological foundations in mental disorders.

  4. Aacap 2002 Research Forum: Placebo and Alternatives to Placebo in Randomized Controlled Trials in Pediatric Psychopharmacology

    Science.gov (United States)

    March, John; Kratochvil, Christopher; Clarke, Gregory; Beardslee, William; Derivan, Albert; Emslie, Graham; Green, Evelyn P.; Heiligenstein, John; Hinshaw, Stephen; Hoagwood, Kimberly; Jensen, Peter; Lavori, Philip; Leonard, Henrietta; McNulty, James; Michaels, M. Alex; Mossholder, Andrew; Osher, Trina; Petti, Theodore; Prentice, Ernest; Vitiello, Benedetto; Wells, Karen

    2004-01-01

    Objective: The use of placebo in the pediatric age group has come under increasing scrutiny. At the 2002 Annual Meeting of the American Academy of Child and Adolescent Psychiatry, the Academy's Workgroup on Research conducted a research forum. The purpose was to identify challenges and their solutions regarding the use of placebo in randomized…

  5. Influence of Clerkship on Attitudes of Medical Students toward Psychiatry across Cultures: United States and Qatar

    Science.gov (United States)

    Burgut, F. Tuna; Polan, H. Jonathan

    2013-01-01

    Objective: To assure adequate treatment for patients with mental illness worldwide, medical schools must impart positive attitudes toward psychiatry. The authors examined the effect of culture on changes in attitudes toward psychiatry among medical students receiving the same psychiatry clerkship curriculum in two different countries. Methods: A…

  6. What Do Psychiatric Residents Think of Addiction Psychiatry as a Career?

    Science.gov (United States)

    Renner, John A., Jr.; Karam-Hage, Maher; Levinson, Marjorie; Craig, Thomas; Eld, Beatrice

    2009-01-01

    Objective: The authors attempt to better understand the recent decline in the number of applicants to addiction psychiatry training. Methods: The Corresponding Committee on Training and Education in Addiction Psychiatry of APA's Council on Addiction Psychiatry sent out a 14-question anonymous e-mail survey to all postgraduate-year 2 (PGY-2)…

  7. Evaluating the Workload of On-Call Psychiatry Residents: Which Activities Are Associated with Sleep Loss?

    Science.gov (United States)

    Cooke, Brian K.; Cooke, Erinn O.; Sharfstein, Steven S.

    2012-01-01

    Objective: The purpose of this study was to review the workload inventory of on-call psychiatry residents and to evaluate which activities were associated with reductions in on-call sleep. Method: A prospective cohort study was conducted, following 20 psychiatry residents at a 231-bed psychiatry hospital, from July 1, 2008 through June 30, 2009.…

  8. Evaluating Psychiatry Residents as Physician-Managers: Development of an Assessment Tool

    Science.gov (United States)

    Sockalingam, Sanjeev; Stergiopoulos, Vicky; Maggi, Julie D.; Zaretsky, Ari; Stovel, Laura; Hodges, Brian

    2013-01-01

    Objectives: With the emergence of physician-manager (PM) curricula in medical education, more effective assessment tools are needed to evaluate psychiatry trainees in this role. The aim of this study was to determine psychiatry residents', program directors', and PM educators' perceptions about PM role-assessment. Methods: Psychiatry residents at…

  9. A Survey of the Interactions between Psychiatry Residency Programs and the Pharmaceutical Industry

    Science.gov (United States)

    Varley, Christopher K.; Jibson, Michael D.; McCarthy, Mary; Benjamin, Sheldon

    2005-01-01

    OBJECTIVE: The authors report a survey of the American Association of Directors of Psychiatry Residency Training (AADPRT) on interactions between the pharmaceutical industry and psychiatry residency programs. METHODS: American Association of Directors of Psychiatry Residency Training membership was anonymously surveyed by e-mail and by paper…

  10. Incorporating Active Learning into a Psychiatry Clerkship: Does It Make a Difference?

    Science.gov (United States)

    Morreale, Mary; Arfken, Cynthia; Bridge, Patrick; Balon, Richard

    2012-01-01

    Objective: Medical students' satisfaction with the psychiatry clerkship, sense of preparedness for an institutional Objective Structured Clinical Exam (OSCE), expressed likelihood of choosing psychiatry as a specialty, and National Board of Medical Examiners (NBME) psychiatry shelf-examination scores were compared after a curriculum based on…

  11. Kandinsky-Clerambault's Syndrome: concept of use for Western psychiatry.

    Science.gov (United States)

    Lerner, Vladimir; Kaptsan, Alexander; Witztum, Eliezer

    2003-01-01

    The aim of our paper is to describe Kandinsky-Clerambault's Syndrome, which has important cultural-historical value in the history of psychiatry, and to illustrate the syndrome by means of a case report. Although its component symptoms are known among Western psychiatrists, the syndrome's specific name is generally unknown. The authors suggest that detailed clinical descriptions of some specific conditions may contribute to a more detailed knowledge of psychopathology, a more colorful and memorable view of conditions, with an increased awareness of the historical and cultural origins of psychiatry.

  12. Sound and Music Interventions in Psychiatry at Aalborg University Hospital

    DEFF Research Database (Denmark)

    Nystrup Lund, Helle; Bertelsen, Lars Rye; Bonde, Lars Ole

    2016-01-01

    This article reports on the ongoing project development and research study called “A New Sound and Music Milieu at Aalborg University Hospital”. Based on a number of pilot studies in AUH Psychiatry, investigating how special playlists and sound equipment (“sound pillows” and portable players) can...... in music medicine and music therapy. A special design of software and hardware - ”The Music Star” and directional line array speakers for the patient room – has been developed and recently implemented on two wards at AUH Psychiatry. The aim of the project is to empower patients to choose music suited...

  13. Maurycy Urstein: forgotten Polish contributor to German psychiatry

    Directory of Open Access Journals (Sweden)

    Marcinowski, Filip

    2014-02-01

    Full Text Available Polish psychiatrist Maurycy Urstein (1872–1940 is nowadays almost forgotten. He is not mentioned in the history of Polish psychiatry which only partially may be explained by the fact that his most essential works were published in German language. His scientific oeuvre contains dozens of publications, including four monographs on catatonia. Urstein was an ardent advocate of the autointoxication theory of psychiatric disorders, fierce opponent of psychoanalysis and enthusiast of the use of biological methods of treatment in psychiatry. Both some eccentric views and specific personality probably equally contributed to his almost complete isolation among psychiatrists in the interwar Poland.

  14. [Maurycy Urstein: forgotten Polish contributor to German psychiatry].

    Science.gov (United States)

    Marcinowski, Filip

    2014-01-01

    Polish psychiatrist Maurycy Urstein (1872-1940) is nowadays almost forgotten. He is not mentioned in the history of Polish psychiatry which only partially may be explained by the fact that his most essential works were published in German language. His scientific oeuvre contains dozens of publications, including four monographs on catatonia. Urstein was an ardent advocate of the autointoxication theory of psychiatric disorders, fierce opponent of psychoanalysis and enthusiast of the use of biological methods of treatment in psychiatry. Both some eccentric views and specific personality probably equally contributed to his almost complete isolation among psychiatrists in the interwar Poland.

  15. Big data are coming to psychiatry: a general introduction.

    Science.gov (United States)

    Monteith, Scott; Glenn, Tasha; Geddes, John; Bauer, Michael

    2015-12-01

    Big data are coming to the study of bipolar disorder and all of psychiatry. Data are coming from providers and payers (including EMR, imaging, insurance claims and pharmacy data), from omics (genomic, proteomic, and metabolomic data), and from patients and non-providers (data from smart phone and Internet activities, sensors and monitoring tools). Analysis of the big data will provide unprecedented opportunities for exploration, descriptive observation, hypothesis generation, and prediction, and the results of big data studies will be incorporated into clinical practice. Technical challenges remain in the quality, analysis and management of big data. This paper discusses some of the fundamental opportunities and challenges of big data for psychiatry.

  16. Transfers to psychiatry through the consultation-liaison psychiatry service: 11 years of experience

    Directory of Open Access Journals (Sweden)

    Michopoulos Ioannis

    2008-08-01

    Full Text Available Abstract Background There are only a few reports on issues related to patient transfer from medical and surgical departments to the psychiatric ward by the consultation-liaison psychiatry service, although it is a common practice. Here, we present a study assessing the factors that influence such transfers. Method We examined the demographic and clinical backgrounds of a group of patients transferred from internal medicine and surgery to the psychiatric ward over an 11-year period. A comparison was made of this data with data obtained from a group of non-transferred patients, also seen by the same consultation-liaison psychiatry service. Results According to our findings, the typical transferred patient, either female or male, is single, divorced or widowed, lives alone, belongs to a lower socioeconomic class, presents initially with (on the whole a disturbed and disruptive behaviour, has had a recent suicide attempt with persistent suicidal ideas, suffers from a mood disorder (mainly depressive and dysthymic disorders, has a prior psychiatric history as well as a prior psychiatric inpatient treatment, and a positive diagnosis on axis II of the five axis system used for mental health diagnosis. Conclusion The transfer of a patient to the psychiatric ward is a decision depending on multiple factors. Medical diagnoses do not seem to play a major role in the transfer to the psychiatric ward. From the psychiatric diagnosis, depressive and dysthymic disorders are the most common in the transferred population, whilst the transfer is influenced by social factors regarding the patient, the patient's behaviour, the conditions in the ward she/he is treated in and any recent occurrence(s that increase the anxiety of the staff.

  17. Study protocol for a multicentre randomized controlled trial on effectiveness of an outpatient multimodal rehabilitation program for adolescents with chronic musculoskeletal pain (2B Active)

    NARCIS (Netherlands)

    Dekker, Carolien; Goossens, Mariëlle E J B; Bastiaenen, Caroline H.G.; Verbunt, Jeanine A M C F

    2016-01-01

    BACKGROUND: Chronic musculoskeletal pain (CMP) in adolescents can influence functioning and well-being, and has negative consequences for families and society as well. According to the Fear Avoidance Model, fear of movement and pain catastrophizing can influence the occurrence and maintenance of chr

  18. Metabolic and endocrine adverse effects of second-generation antipsychotics in children and adolescents : A systematic review of randomized, placebo controlled trials and guidelines for clinical practice

    NARCIS (Netherlands)

    De Hert, M.; Dobbelaere, M.; Sheridan, E. M.; Cohen, D.; Correll, C. U.

    2011-01-01

    Second-generation antipsychotics (SGA) are being used more often than ever before in children and adolescents with psychotic and a wide range of non-psychotic disorders. Several SGA have received regulatory approval for some paediatric indications in various countries, but off-label use is still fre

  19. Psychological and behavioral interventions to reduce HIV risk: evidence from a randomized control trial among orphaned and vulnerable adolescents in South Africa.

    Science.gov (United States)

    Thurman, T R; Kidman, R; Carton, T W; Chiroro, P

    2016-01-01

    Evidence-based approaches are needed to address the high levels of sexual risk behavior and associated HIV infection among orphaned and vulnerable adolescents. This study recruited adolescents from a support program for HIV-affected families and randomly assigned them by cluster to receive one of the following: (1) a structured group-based behavioral health intervention; (2) interpersonal psychotherapy group sessions; (3) both interventions; or (4) no new interventions. With 95% retention, 1014 adolescents were interviewed three times over a 22-month period. Intent-to-treat analyses, applying multivariate difference-in-difference probit regressions, were performed separately for boys and girls to assess intervention impacts on sexual risk behaviors. Exposure to a single intervention did not impact behaviors. Exposure to both interventions was associated with risk-reduction behaviors, but the outcomes varied by gender: boys reported fewer risky sexual partnerships (β = -.48, p = .05) and girls reported more consistent condom (β = 1.37, p = .02). There was no difference in the likelihood of sexual debut for either gender. Providing both psychological and behavioral interventions resulted in long-term changes in sexual behavior that were not present when either intervention was provided in isolation. Multifaceted approaches for reducing sexual risk behaviors among vulnerable adolescents hold significant promise for mitigating the HIV epidemic among this priority population.

  20. Effect of bracing and other conservative interventions in the treatment of idiopathic scoliosis in adolescents : A systematic review of clinical trials

    NARCIS (Netherlands)

    Lenssinck, MLB; Frijlink, AC; Berger, MY; Bierma-Zeinstra, SMA; Verkerk, K; Verhagen, AP

    2005-01-01

    Background and Purpose. Many conservative treatments are available for adolescents with idiopathic scoliosis, but the evidence for their accepted use is still unclear. The purpose of this study was to evaluate the effectiveness of braces and other conservative treatments of idiopathic scoliosis in a

  1. Help Seeking Process among Children Attending Psychiatry Clinic in Tirana, Albania

    Directory of Open Access Journals (Sweden)

    Anastas Suli MD, Prof

    2011-09-01

    Full Text Available Objective: The goal of this study was to investigate all the potential routes to Child/Adolescent Psychiatry Clinic-University Hospital Center (CAPC-UHC in Tirana. The article provides demographic data, as well as further information on the types and amounts of services children/adolescents received during the process of seeking help related to different diagnoses .Method: The study was conducted in CAPC-UHC in Tirana, during September 2006-September 2007. Data were collected from 162 children and their parents using Strengths and Difficulties Questionnaire (SDQ and Pathways Encounter Form. The sample consisted of 53.1% (86 males and 46.9% (76 females. The mean age was 9.5 + 4.4 years .Results: Out of the total number of cases that sought care to CAPC; 55, 6% were referred by parents themselves, while the rest were referred by others. There was a significant effect of gender to intervals from the onset of problem to the first career (F = 10.803, p=0.001, as well as a significant effect of gender to total time intervals from the onset till the specialist of child mental health problem (F = 6.742, p=0.01.Conclusions: This is the first study investigating the help seeking process to psychiatric care in CAPC Tirana-Albania and may serve as a good start in generating evidence based on child/adolescent mental health service. Further multicentre studies will enhance the values of the findings, since the present study was performed in a single service, and in a setting lacking previous works with similar scope that could have served as references.

  2. Strengthening the Paediatricians Project 2: The effectiveness of a workshop to address the Priority Mental Health Disorders of adolescence in low-health related human resource countries

    Directory of Open Access Journals (Sweden)

    Russell Paul SS

    2010-02-01

    Full Text Available Abstract Background Paediatricians can be empowered to address the Priority Mental Health Disorders at primary care level. To evaluate the effectiveness of a collaborative workshop in enhancing the adolescent psychiatry knowledge among paediatricians. Methods A 3-day, 27-hours workshop was held for paediatricians from different regions of India under the auspices of the National Adolescent Paediatric Task Force of the Indian Academy of Paediatrics. A 5-item pretest-posttest questionnaire was developed and administered at the beginning and end of the workshop to evaluate the participants' knowledge acquisition in adolescent psychiatry. Bivariate and multivariate analyses were performed on an intention-to-participate basis. Results Forty-eight paediatricians completed the questionnaire. There was significant enhancement of the knowledge in understanding the phenomenology, identifying the psychopathology, diagnosing common mental disorder and selecting the psychotropic medication in the bivariate analysis. When the possible confounders of level of training in paediatrics and number of years spent as paediatrician were controlled, in addition to the above areas of adolescent psychiatry, the diagnostic ability involving multiple psychological concepts also gained significance. However, both in the bivariate and multivariate analyses, the ability to refer to appropriate psychotherapy remained unchanged after the workshop. Conclusions This workshop was effective in enhancing the adolescent psychiatry knowledge of paediatricians. Such workshops could strengthen paediatricians in addressing the priority mental health disorders at the primary-care level in countries with low-human resource for health as advocated by the World Health Organization. However, it remains to be seen if this acquisition of adolescent psychiatry knowledge results in enhancing their adolescent psychiatry practice.

  3. Social, Family and Psychological Predictors of Obsessive-Compulsive Behaviour among Children and Adolescents

    Science.gov (United States)

    Kirkcaldy, B. D.; Furnham, A. F.; Siefen, R. G.

    2010-01-01

    The incidence of "pure" obsessive-compulsive disorders in the clinical population was found to be around 1.2 percent for a clinical sample record--stretching over a 2.5-year period--of around 2500 adolescents in a German child and adolescent psychiatry clinic. Over a 3-month period (time-frame) a sample of 350 new entries to the clinic…

  4. In Search of HPA Axis Dysregulation in Child and Adolescent Depression

    Science.gov (United States)

    Guerry, John D.; Hastings, Paul D.

    2011-01-01

    Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis in adults with major depressive disorder is among the most consistent and robust biological findings in psychiatry. Given the importance of the adolescent transition to the development and recurrence of depressive phenomena over the lifespan, it is important to have an integrative…

  5. A Profile on Emergency Department Utilization in Adolescents and Young Adults with Autism Spectrum Disorders

    Science.gov (United States)

    Liu, Guodong; Pearl, Amanda M.; Kong, Lan; Leslie, Douglas L.; Murray, Michael J.

    2017-01-01

    There has been an increase in utilization of the Emergency Department (ED) in individuals with autism spectrum disorder (ASD) which may reflect a deficit of services (Green et al., "Journal of the American Academy of Child and Adolescent Psychiatry" 40(3):325-332, 2001; Gurney et al., "Archives of Pediatric and Adolescent…

  6. Practice Parameter for the Assessment and Treatment of Children and Adolescents with Oppositional Defiant Disorder

    Science.gov (United States)

    Journal of the American Academy of Child and Adolescent Psychiatry, 2007

    2007-01-01

    Oppositional defiant disorder (ODD) is a common clinical problem in children and adolescents. Oppositionality and associated types of aggressive behavior are among the most common referral problems in child psychiatry. Grouped among the disruptive behavior disorders, ODD is frequently comorbid with other psychiatric conditions and often precedes…

  7. Food2Learn: Randomized control trial investigating influence of krill oil supplementation on learning, cognition, and behaviour in healthy adolescents. Design presentation

    NARCIS (Netherlands)

    Van der Wurff, Inge; Von Schacky, Clemens; Berge, Kjetil; Kirschner, Paul A.; De Groot, Renate

    2014-01-01

    Food2Learn is a double blind randomized controlled trial which looks at the influence of Krill oil (rich in LCPUFA) on the cognitive performance, academic performance and mental well-being of student of lower vocational schools.

  8. The new philosophy of psychiatry: its (recent) past, present and future: a review of the Oxford University Press series International Perspectives in Philosophy and Psychiatry

    Science.gov (United States)

    Banner, Natalie F; Thornton, Tim

    2007-01-01

    There has been a recent growth in philosophy of psychiatry that draws heavily (although not exclusively) on analytic philosophy with the aim of a better understanding of psychiatry through an analysis of some of its fundamental concepts. This 'new philosophy of psychiatry' is an addition to both analytic philosophy and to the broader interpretation of mental health care. Nevertheless, it is already a flourishing philosophical field. One indication of this is the new Oxford University Press series International Perspectives in Philosophy and Psychiatry seven volumes of which (by Bolton and Hill; Bracken and Thomas; Fulford, Morris, Sadler, and Stanghellini; Hughes, Louw, and Sabat; Pickering; Sadler; and Stanghellini) are examined in this critical review.

  9. Psychiatry Trainees' Training and Experience in Fetal Alcohol Spectrum Disorders

    Science.gov (United States)

    Eyal, Roy; O'Connor, Mary J.

    2011-01-01

    Background/Objective: Alcohol is a teratogen. Fetal alcohol spectrum disorders (FASDs) affect about 1% of live births, causing severe impairment. Individuals affected by FASDs are overrepresented in psychiatric settings. This study reports on the education and experience of psychiatry trainees in approaching FASDs. Method: Data were collected from…

  10. Trends in cultural psychiatry in the United kingdom.

    Science.gov (United States)

    Bhui, Kamaldeep

    2013-01-01

    Cultural psychiatry in the United Kingdom exhibits unique characteristics closely related to its history as a colonial power, its relationship with Commonwealth countries and the changing socio-demographic characteristics of its diverse population throughout the centuries. It is not surprising, therefore, that the emergence of this discipline was centred around issues of race and religion. After a brief historical review of the development of cultural psychiatry and the mention of pioneering intellectual and academic figures, as well as the evolvement of the field in organizations such as the Royal College of Psychiatrists, this chapter examines the need of a critical cultural psychiatry, more than a narrative social science distanced from the realities of clinical practice. In such context, issues such as policies and experience with efforts to delivering race equality, and address inequities in a renewed public health approach seem to confer British cultural psychiatry with a defined socially active role aimed at the pragmatic management, understanding and improvement of diverse and alternative systems of care and care practices.

  11. The American Psychiatric Association and the history of psychiatry.

    Science.gov (United States)

    Hirshbein, Laura

    2011-09-01

    The history committee within the American Psychiatric Association was actively involved in the history of psychiatry in the early decades of the twentieth century, as well as from 1942 to 2009.This paper explores the role of this committee in the context of changes in the psychiatric profession over the twentieth century.

  12. Current research in transcultural psychiatry in the Nordic countries

    DEFF Research Database (Denmark)

    Ekblad, Solvig; Kastrup, Marianne Carisius

    2013-01-01

    anthropologists, as well as other clinicians and policy planners. Research includes work with migrants and indigenous minorities in the Nordic countries, as well as comparisons with mental health in postconflict countries. We conclude by suggesting future directions for transcultural psychiatry research...

  13. Education and Training in Psychiatry in the U.K.

    Science.gov (United States)

    Carney, Stuart; Bhugra, Dinesh K.

    2013-01-01

    Background/Objective: Recent training and education changes have raised important issues in delivery of psychiatric education at all levels. In this article, the authors describe the current status of mental health education in the training of all doctors and postgraduate training and education in psychiatry in the U.K. Method: The authors explore…

  14. A Novel Approach to Medicine Training for Psychiatry Residents

    Science.gov (United States)

    Onate, John; Hales, Robert; McCarron, Robert; Han, Jaesu; Pitman, Dorothy

    2008-01-01

    Objective: A unique rotation was developed to address limited outpatient internal medicine training in psychiatric residency by the University of California, Davis, Department of Psychiatry and Behavioral Sciences, which provides medical care to patients with mental illness. Methods: The number of patients seen by the service and the number of…

  15. The role of lead and cadmium in psychiatry

    Directory of Open Access Journals (Sweden)

    Orish Ebere Orisakwe

    2014-01-01

    Full Text Available Psychiatric disorders are associated with long-term disability and huge social and economic costs. The possible influence of heavy metals exposure on public health remains a matter of concern. A recurring research question that persisted among researchers in neuropsychiatry has been "are psychiatric patients more likely to have a high body burden of lead or other heavy metals?" This is an update account on the role of lead and cadmium in psychiatry. This review, which has employed search words like "lead and cadmium in psychiatry" , "lead and cadmium in schizophrenia", "lead and cadmium in psychosis" in citation indices such as PubMed, Google Scholar, Scirus, and Scopus. A total of 415 articles were found; 60 fulfiled the inclusion criteria. Evidence-based information suggests that lead and cadmium may be involved in psychiatry. Should environmental lead and cadmium be implicated in the etiogenesis of psychiatry given the characteristic high environmental pollution in Sub Sahara Africa, it is worthwhile for toxicologists and scientists in Sub-Sahara Africa to investigate if lead and cadmium can become additional biomarkers in the diagnosis of psychiatric disorders.

  16. The computational psychiatry of reward: Broken brains or misguided minds?

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    Michael eMoutoussis

    2015-09-01

    Full Text Available Research into the biological basis of emotional and motivational disorders is in danger of riding roughshod over a patient-centred psychiatry and falling into the dualist errors of the past, i.e. by treating mind and brain as conceptually distinct. We argue that a psychiatry informed by computational neuroscience, computational psychiatry, can obviate this danger. Through a focus on the reasoning processes by which humans attempt to maximise reward (and minimise punishment, and how such reasoning is expressed neurally, computational psychiatry can render obsolete the polarity between biological and psychosocial conceptions of illness. Here, the term 'psychological' comes to refer to information processing performed by biological agents, seen in light of underlying goals. We reflect on the implications of this perspective for a definition of mental disorder, including what is entailed in asserting that a particular disorder is ‘biological’ or ‘psychological’ in origin. We propose that a computational approach assists in understanding the topography of mental disorder, while cautioning that the point at which eccentric reasoning constitutes disorder often remains a matter of cultural judgement.

  17. Improving social functioning and challenging behaviors in adolescents with ASD and significant ID: A randomized pilot feasibility trial of reciprocal imitation training in a residential setting.

    Science.gov (United States)

    Ingersoll, Brooke; Berger, Natalie; Carlsen, Danielle; Hamlin, Theresa

    2016-08-11

    There is a lack of effective social interventions for youths with ASD and co-morbid intellectual disability (ID). A previous single-case design study indicated that reciprocal imitation training (RIT) may improve social interaction and challenging behavior in this population. The current pilot study examined the feasibility of conducting an RCT to investigate the effectiveness of RIT for improving social functioning and challenging behaviors in 20 adolescents with ASD and severe ID in a residential program. The assessment protocol was feasible. RIT was well-tolerated by the adolescents and implemented with fidelity by teaching staff. Preliminary findings indicate that treatment had moderate to large effects on social functioning and challenging behavior, with mixed findings for imitation skills. A larger RCT of RIT for this population is feasible and warranted.

  18. A randomised controlled trial of a theory-based intervention to improve sun protective behaviour in adolescents ('you can still be HOT in the shade': study protocol

    Directory of Open Access Journals (Sweden)

    Hawkes Anna L

    2012-01-01

    Full Text Available Abstract Background Most skin cancers are preventable by encouraging consistent use of sun protective behaviour. In Australia, adolescents have high levels of knowledge and awareness of the risks of skin cancer but exhibit significantly lower sun protection behaviours than adults. There is limited research aimed at understanding why people do or do not engage in sun protective behaviour, and an associated absence of theory-based interventions to improve sun safe behaviour. This paper presents the study protocol for a school-based intervention which aims to improve the sun safe behaviour of adolescents. Methods/design Approximately 400 adolescents (aged 12-17 years will be recruited through Queensland, Australia public and private schools and randomized to the intervention (n = 200 or 'wait-list' control group (n = 200. The intervention focuses on encouraging supportive sun protective attitudes and beliefs, fostering perceptions of normative support for sun protection behaviour, and increasing perceptions of control/self-efficacy over using sun protection. It will be delivered during three × one hour sessions over a three week period from a trained facilitator during class time. Data will be collected one week pre-intervention (Time 1, and at one week (Time 2 and four weeks (Time 3 post-intervention. Primary outcomes are intentions to sun protect and sun protection behaviour. Secondary outcomes include attitudes toward performing sun protective behaviours (i.e., attitudes, perceptions of normative support to sun protect (i.e., subjective norms, group norms, and image norms, and perceived control over performing sun protective behaviours (i.e., perceived behavioural control. Discussion The study will provide valuable information about the effectiveness of the intervention in improving the sun protective behaviour of adolescents.

  19. The effect of ‘sleep high and train low’ on weight loss in overweight Chinese adolescents: study protocol for a randomized controlled trial

    OpenAIRE

    Wang, Ru; Liu, Dongmei; Wang, Xueqiang; Xiao, Weihua; Wu, Nana; Gao, Binghong; Chen, Peijie

    2014-01-01

    Background Exercise and diet are the cornerstones for the treatment of obesity in obese children and adolescents. However, compensatory changes in appetite and energy expenditure elicited by exercise and dieting make it hard to maintain a reduced weight over the longterm. The anorexic effect of hypoxia can be potentially utilized to counteract this compensatory increase, thereby enhancing the success of weight loss. The purpose of the study is to assess the effectiveness of four week intermit...

  20. Psychiatry in the Deep South: A Pilot Study of Integrated Training for Psychiatry Residents and Seminary Students

    Science.gov (United States)

    Stuck, Craig; Campbell, Nioaka; Bragg, John; Moran, Robert

    2012-01-01

    Objective: The authors describe an interdisciplinary training experience developed for psychiatry residents and seminary students that assessed each group's beliefs and attitudes toward the other's profession. The training was designed to enhance awareness, positive attitudes, and interaction between the disciplines. Methods: From 2005 to 2008,…