European Child & Adolescent Psychiatry
1435-165X
1018-8827
Cơ quản chủ quản: D. Steinkopff-Verlag , SPRINGER
Lĩnh vực:
Developmental and Educational PsychologyPsychiatry and Mental HealthPediatrics, Perinatology and Child HealthMedicine (miscellaneous)Philosophy
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Electroconvulsive therapy in children and adolescents: results from a population‑based study utilising the Swedish National Quality Register Abstract Electroconvulsive therapy (ECT) is effective and safe for adults with severe depression, but less studied in adolescents. Here, we examined the indications, prevalence, practice, response and remission rates, and side effects in young people treated with ECT in Sweden. We also examined the usage of ECT in the transition to adult psychiatry. Using data from national patient registers and the Swedish National Quality Register for ECT (Q-ECT), we identified patients aged up to 19 years treated with ECT over a 5-year study period. Response and remission rates were analysed using the Clinical Global Impression (7-point scale)-Improvement (CGI-I) and Severity (CGI-S). A total of 118 individuals were identified, of which 105 were also enrolled in the Q-ECT. The most common indication for ECT was depression (68%; n = 80). Adolescents aged < 18 years were more severely ill before treatment than those aged 18 years (P < 0.01). Three of the hospitals in Sweden treated the majority of adolescents < 18 years old. The median number of sessions in each ECT series was seven. Unilateral placement of the electrodes was the most common (88%; n = 99). Fifty-seven percent (n = 54) of the patients responded (CGI-I, 1–2) to the treatment; remission (CGI-S, 1–2) was achieved by 32% (n = 30). Psychotic symptoms were associated with a higher response rate in patients with depression (P = 0.038). A deterioration of memory compared to pre-treatment was reported in six patients. ECT was associated with high response and remission rates in adolescents with severe psychiatric disorders after non-response to medication.
Tập 32 Số 12 - Trang 2649-2656 - 2023
The persistent effects of foetal growth on child and adolescent mental health: longitudinal evidence from a large population-based cohort Abstract Low birth weight for one’s gestational age is associated with higher rates of child psychopathology, however, most studies assess psychopathology cross-sectionally. The effect of such foetal growth restriction appears to be strongest for attention problems in childhood, although adult studies have found associations with a range of outcomes, from depression to psychosis. We explore how associations between foetal growth and psychopathology change across age, and whether they vary by sex. We used a large nationally representative cohort of children from Ireland (N ~ 8000). Parents completed the Strengths and Difficulties Questionnaire (SDQ) at 3 time points (age 9, 13 and 17). Outcomes included a total problems scale and subscales measuring attention/hyperactivity, peer, conduct and emotional problems. Foetal growth had significant associations with all problem scales, even after controlling for sex, socioeconomic factors and parental mental health. The magnitude of these effects was small but relatively stable across ages 9–17. In males, foetal growth had the strongest associations with attention/hyperactivity and peer problems, whereas females showed more widespread associations with all four subscales. There was a trend for the association between foetal growth and emotional problems to increase with advancing age, approaching the borderline-abnormal threshold by age 17. Reduced foetal growth predicted persistently higher scores on all measured aspects of child and adolescent psychopathology. Associations with child attention/hyperactivity may generalize to a wider array of adult psychopathologies via adolescent-onset emotional problems. Future studies should explore potential age-dependent effects of foetal growth into the early 20s.
- 2023
Depression-related distortions in maternal reports of child behaviour problems
Tập 29 Số 3 - Trang 275-285 - 2020
Suicidal behaviors and irritability in children and adolescents: a systematic review of the nature and mechanisms of the association
Tập 28 - Trang 667-683 - 2018
While many psychiatric disorders are associated with an increased risk for suicidal behaviors (SB) in children and adolescents, a few studies have explored the role of clinical symptoms based on a dimensional approach. Irritability is seen as a marker, a general psychopathology, and a symptom of both externalizing and internalizing disorders. In this review, we are interested in determining whether and how irritability can predict SB in youth. First, we reviewed consistencies and variation in the literature linking irritability to suicidal ideation (SI) and suicide attempt (SA). Second, based on the available models, we proposed specific mechanistic pathways, whereby irritability may modulate the risk for SB. Irritability has been found associated with SB both in cross-sectional and in longitudinal studies. The relation is consistent in different settings (i.e., general population and clinical settings) and across psychiatric disorders. The association is reduced but persists after adjusting for psychiatric disorder, including depression. On one hand, irritability constitutes a risk factor for SI via the onset of internalized disorder. On the other hand, irritable youth may be more prone to attempt suicide when experiencing SI. The measures for irritability were heterogeneous. A limited number of studies were designed to explore the role of mediators and/or moderators. Recognizing irritability in children and adolescents is a key issue with regards to suicide prevention.
Abnormal functional network centrality in drug-naïve boys with attention-deficit/hyperactivity disorder
Tập 28 - Trang 1321-1328 - 2019
Attention-deficit/hyperactivity disorder (ADHD) is the most commonly diagnosed neurodevelopmental disorder in childhood and is characterized by inattention, impulsivity, and hyperactivity. Observations of distributed functional abnormalities in ADHD suggest aberrant large-scale brain network connectivity. However, few studies have measured the voxel-wise network centrality of boys with ADHD, which captures the functional relationships of a given voxel within the entire connectivity matrix of the brain. Here, to examine the network patterns characterizing children with ADHD, we recruited 47 boys with ADHD and 21 matched control boys who underwent resting-state functional imaging scanning in a 3.0 T MRI unit. We measured voxel-wise network centrality, indexing local functional relationships across the entire brain connectome, termed degree centrality (DC). Then, we chose the brain regions with altered DC as seeds to examine the remote functional connectivity (FC) of brain regions. We found that boys with ADHD exhibited (1) decreased centrality in the left superior temporal gyrus (STG) and increased centrality in the left superior occipital lobe (SOL) and right inferior parietal lobe (IPL); (2) decreased FC between the STG and the putamen and thalamus, which belong to the cognitive cortico-striatal–thalamic–cortical (CSTC) loop, and increased FC between the STG and medial/superior frontal gyrus within the affective CSTC loop; and (3) decreased connectivity between the SOL and cuneus within the dorsal attention network. Our results demonstrated that patients with ADHD show a connectivity-based pathophysiological process in the cognitive and affective CSTC loops and attention network.