Adolescent Psychiatrists Research Articles

Mental health in adolescents with obesity: conflicting views among physicians, a qualitative study.

Mental health issues in adolescents with obesity are multifold, with no explicit screening recommendations. The aim of this research is to explore how this screening is performed by physicians and, thus, how it impacts adolescents' care pathways, offering insights into how to improve itthrough a qualitative study using interpretative phenomenological analysis. Twenty physicians (non-psychiatrist physicians and child and adolescent psychiatrists) involved at various stages in the care pathway were interviewed with semi-structured questionnaires. The findings connect 2 meta-themes. Non-psychiatrist physicians perceive widespread but ill-defined suffering in adolescents with obesity. Non-psychiatrist physicians see screening for mental conditions as mandatory. Unlike child and adolescent psychiatrists, they are not experts in distinguishing psychosocial suffering from psychiatric disorders. Screening is clinical. Adolescents' demand to lose weight in a context of shaming and alexithymia limits their access to psychiatric care. Child and adolescent psychiatrists then redefine the medical response to polymorphous symptoms. Psychiatric diagnoses mainly involve anxiety and depression symptoms, seldom eating disorders. Conclusion: Physicians have overtly conflicting perspectives over the intensity of mental conditions. Non-psychiatrists, sensitive to perceived distress, seek to have it quickly appraised if they detect a significant suffering. Child and adolescent psychiatrists find appraisal complex to perform in the absence of means, interest, and/or experience. Improving screening requires training health professionals and using multidisciplinary assessment means. What is Known: • Mental health and eating disorders are contributing factors of obesity but their relationship remains complex between cause and consequence. • Mental health conditions and psychosocial suffering are the main complications among adolescents suffering from obesity with guilt, sadness, or stigma. What is New: • Non-psychiatric physicians express their need of a specialized diagnosis to define this suffering, but the lack of availability of psychiatrists and the necessity of time and of a multidisciplinary team lead to a delayed assessment. • For psychiatrists, this suffering is often not a psychiatric condition. Though requiring attention, this can lead to a misunderstanding between professionals.

Common Issues for General Practitioners in the Medical Management of Child and Adolescent Psychiatric Care.

With a limited number of child and adolescent psychiatrists available to see youth patients, many common psychiatric problems in youth are managed by other providers. Clinical pearls from experts in child and adolescent psychiatry can help general practitioners with this management. Some common issues are discussed here for which practical guidance is offered, ranging from approaches to assessment and how to start and titrate medications for the treatment of attention deficit hyperactivity disorder, depression, and sleep problems.

Investigating the effects and side effects of two antipsychotic drugs in the treatment of children and adolescents with Tourette syndrome: a semi-experimental research.

Due to the high prevalence of Tourette's disorder among children and adolescents and its negative consequences, an appropriate and effective medical treatment with minimal complications is necessary. Therefore, this study was conducted to compare the effects of Aripiprazole and Risperidone on Tourette's disorders in children and adolescents. The statistical population of this semi-experimental study was children and adolescents aged seven to eighteen years old. They were diagnosed with Tourette's disorder based on the DSM-V criteria by the clinical interview of a child and adolescent psychiatrist in the child Psychiatry clinic of Ibn-e-Sina's Psychiatric Hospital (Mashhad-Iran) in 2018. A total of forty participants were selected by the convenience sampling method, and they were randomly divided into two groups treated with medicines, Risperidone or Aripiprazole, for two months. Then, the demographic information questionnaire was completed. The Y-GTSS Scale was completed. The clinical Effect Rating Scale (CGI-Tics Scale) was completed. Calculation of body mass index and medical side effects complications were completed. The evaluation was carried out at the beginning and on the second, fourth, and eighth weeks, and the results were compared. The data were analyzed using SPSS software. 14, descriptive statistics, Chi-square, and variance analysis. The two groups were homogeneous in terms of demographic variables and body mass index. Despite the positive effect of both medicines, no significant difference was observed among the general scores of such disorders, the overall score of severity, Tourette's recovery, and BMI of these two groups at the intervals and the end of treatments. (p <0.05). Due to the low number of complications reported, statistical comparisons of the medical side effects were not made. According to the results, the two medicines, Aripiprazole and Risperidone, effectively improved the symptoms of Tourette's disorder and its overall severity. However, there were no significant statistical differences between them. Furthermore, in terms of the medical side effects, the statistical comparison between the two medicines was impossible due to the small number of complications.

Staging's determinants in early intervention youth: a retrospective study

ObjectivesSince 2019 our early intervention unit has assessed help-seekers, mainly referred by psychiatric departments, and we have conducted a descriptive retrospective study. Our objective was to identify clinical determinants associated to staging at assessment for our three groups: “no psychosis”, “ultra-high risk” and “first episode psychosis”. MethodsOne hundred and thirteen participants (mean age 20.05±3.28) were enrolled, mainly referred by adult psychiatry (81.4%). We tested the association of each group with the following determinants: age, gender, family history of psychosis, referral (adolescent or adult psychiatry), cognitive, depressive complaint, cannabis active consumption, and current activity (scholar or employment). ResultsMultivariate analyses showed significant association with depressive symptoms (P=0.019) but an absence of family history of psychosis (P=0.002) or current activity (P=0.09) for “no psychosis” group. “Ultra-high risk” was significantly correlated with a family history of psychosis (P=0.001) and adolescent psychiatry referral (P=0.044) but an absence of depressive complaint (P=0.04). As for “first episode psychosis”, we found significant cognitive complaint (P=0.026), family history (P=0.024) and current activity (0.026). ConclusionsAs all our participants were seen in tertiary care, adolescent psychiatrists were more efficient in detecting a high-risk state. “No psychosis” help-seekers presented in fact mood issues, which have been confused with attenuated psychotic symptoms by their addressers, who have probably been misled by their absence of activity integration. High-risk and characterized psychotic episodes were logically correlated with family history. Surprisingly, “first episode psychosis” youth were currently integrated in scholarly or professional life despite an active cognitive complaint. Robust studies, especially prospective cohorts, are needed to test these associations.

Understanding Psychiatrists' Knowledge and Attitudes to Suicidality in Individuals with Autism Spectrum Disorder.

Several studies have demonstrated that individuals with autism spectrum disorder (ASD) are at a significantly higher risk of suicide, with over 7.5 times increased likelihood of dying by suicide and higher rates of suicidal ideation. The present study aimed to examine the perspectives and awareness of psychiatrists regarding suicidal behavior in individuals with ASD. To achieve this, an online survey was developed to assess clinicians' practices in evaluating suicidal thoughts and behaviors in individuals with ASD. A total of 143 psychiatrists, including 55 general adult psychiatrists and 88 child and adolescent psychiatrists, completed the cross-sectional survey. The results of the study revealed that clinicians reported lower rates of suicidal ideation and behavior in individuals with ASD compared to those without ASD (P < .05). Furthermore, it was found that the usage of screening tools for assessing suicidal behavior was significantly lower in the ASD group (P < .05). The study aimed to investigate psychiatrists' knowledge and screening practices regarding ASD and emphasize the importance of increasing knowledge and implementing effective screening and intervention practices to address the risk of suicidality in individuals with ASD.

Family dyads, emotional labor, and holding environments in the simulated encounter: co-constructive patient simulation as a reflective tool in child and adolescent psychiatry training

BackgroundPatient simulation has been used in medical education to provide a safe and supportive learning environment for learners to practice clinical and interpersonal skills. However, simulation involving pediatric populations, particularly in child and adolescent psychiatry, is rare and generally does not reflect the child-caregiver dyad or the longitudinal aspects of this care, nor does it provide learners with an opportunity to engage with and reflect on these dynamics.MethodsWe organized as an educational opportunity a series of seven observed patient simulation sessions with a cohort of a dozen child and adolescent psychiatrists (eight fellows approaching graduation and four senior educators). In these sessions, we utilized the co-constructive patient simulation model to create the simulation cases. We included the use of at least two patient actors in most sessions, and two of the case narratives were longitudinally followed across multiple simulation sessions. We approached the data collected during the simulations and their respective debriefings by using thematic analysis informed by a symbolic interactionist approach.ResultsBased on data from the debriefing sessions and longitudinal narratives, we identified four overarching themes: (1) Reflecting on dyadic challenges: role reversal and individuation; (2) Centering the child, allying with the parent, and treating the family system; (3) Ambivalence in and about the parent-child dyad; and (4) Longitudinal narratives and ambivalence over time.ConclusionThe emotional experience of the simulations, for interviewers and observers alike, provided an opportunity to reflect on personal and professional experiences and triggered meaningful insights and connections between participants. These simulated cases called for emotional labor, particularly in the form of creating holding environments; in this way, the simulated encounters and the debriefing sessions became dialogic experiences, in which the patient and provider, parent and child, and learner and instructor could co-construct meaning and foster professional development as reflective practitioners.

2.2 “Black and Blue”—Taking a Deeper Look Into the Impact of Systematic Racism on Black and Brown Youth and the Role of the Child and Adolescent Psychiatrist in Dismantling Barriers to Care

2.2 “Black and Blue”—Taking a Deeper Look Into the Impact of Systematic Racism on Black and Brown Youth and the Role of the Child and Adolescent Psychiatrist in Dismantling Barriers to Care

A Survey on the Journal of the Korean Academy of Child and Adolescent Psychiatry: Implications for Growth and Development.

This study aimed to assess the status of the Journal of the Korean Academy of Child and Adolescent Psychiatry (JKACAP) and propose measures for its growth and development. The study was conducted using a questionnaire survey targeting members of the Korean Academy of Child and Adolescent Psychiatry. The six key elements analyzed were Access to the journal, Convenience following conversion to English, Recognition as an international journal and institutional achievements, Author perspectives on manuscript submission,Transition to an online-only journal, and Content and identity of the journal. The survey revealed that email notification was highly effective for Journal Accessibility, with the website and search engines also frequently being used by members. Conversion to English in 2018 initially impacted readability and submission rates, but these concerns have decreased over time. However, the Recognition of JKACAP as an international academic journal was still not on par with SCIE journals, highlighting the need for further efforts towards SCIE inclusion. Despite these challenges and limited research opportunities, there was an active intention among members to submit manuscripts. Respondents showed a notable preference for the Transition to an online-only journal. Regarding content and identity of the JKACAP, members predominantly favored review articles and perceived the journal as a research and communication platform for Korean child and adolescent psychiatrists. The results indicate the need for JKACAP to enhance its digital accessibility, provide more support for domestic and international authors, and actively seek SCIE indexing. Addressing the varied content preferences of its members, improving the submission process, and transitioning to an online-only format could further its growth and solidify its position as an internationally recognized academic journal in the field of child and adolescent psychiatry.

75.3 Clozapine: Practical Applications for the Child and Adolescent Psychiatrist

75.3 Clozapine: Practical Applications for the Child and Adolescent Psychiatrist

Pediatric Medicine Updates for the Child and Adolescent Psychiatrist: Autonomic Dysfunction, Chronic Pain and Headaches, Concussion, and Epilepsy

Pediatric Medicine Updates for the Child and Adolescent Psychiatrist: Autonomic Dysfunction, Chronic Pain and Headaches, Concussion, and Epilepsy

42.4 Climate Change and Children and Young People's Mental Health: What is the Role for Child and Adolescent Psychiatrists?

42.4 Climate Change and Children and Young People's Mental Health: What is the Role for Child and Adolescent Psychiatrists?

Child and Adolescent Psychiatrists as Catalysts of Equity in Schools and Communities

Child and Adolescent Psychiatrists as Catalysts of Equity in Schools and Communities

Family Therapy Skills Boot Camp for Child and Adolescent Psychiatrists: Strategies to Optimize Your Family-Based Intervention Across Treatment Settings

Family Therapy Skills Boot Camp for Child and Adolescent Psychiatrists: Strategies to Optimize Your Family-Based Intervention Across Treatment Settings

Understanding Video Games: A Child and Adolescent Psychiatrist's Call of Duty

Understanding Video Games: A Child and Adolescent Psychiatrist's Call of Duty

Lifelong Learning Institute: Module 20: Relevant Clinical Updates for Child and Adolescent Psychiatrists

Lifelong Learning Institute: Module 20: Relevant Clinical Updates for Child and Adolescent Psychiatrists

5.56 Be ExPeRT: Collaborating With Child and Adolescent Psychiatrists in Behavioral Health Expansion in Pediatric Residency Training

5.56 Be ExPeRT: Collaborating With Child and Adolescent Psychiatrists in Behavioral Health Expansion in Pediatric Residency Training

69.4 Child and Adolescent Psychiatrists as Climate Advocates: A Toolkit for Using Our Trusted Voices to Foster Hope and Galvanize Action

69.4 Child and Adolescent Psychiatrists as Climate Advocates: A Toolkit for Using Our Trusted Voices to Foster Hope and Galvanize Action

Lab to Smartphone: ADHD Is Relative: Let’s Deal With It

The national shortage of attention-deficit/hyperactivity disorder (ADHD) medications is thought to be due, in large part, to a demand issue, meaning that there simply are more prescriptions being written these days compared to years past. This surge in demand does not come as a surprise to many child and adolescent psychiatrists who have felt the rise in evaluation requests from people, often adolescents and young adults, who think they may qualify for the diagnosis and could benefit from treatment, even if the question never came up when they were younger. When I was a resident, the prevailing teaching was that ADHD affected about 3-5% of the population with most people no longer qualifying for a diagnosis in adulthood. More recently, that prevalence estimate hovers around 10% with at least half continuing to have diagnosable symptoms later in life.1

Child and Adolescent Psychiatrists in Schools: Practical Issues Related to Communication and Learning Deficits

Child and Adolescent Psychiatrists in Schools: Practical Issues Related to Communication and Learning Deficits

Embracing the Infinite Complexity in Child and Adolescent Psychiatry

Reading the articles in this issue of JAACAP Connect reminded me of one of the major reasons why I love being a child and adolescent psychiatrist: the issues are infinitely complicated. I argue that the challenges in child and adolescent psychiatry are as complex and as pressing to the future of our society as any other justice-related issue. Clinically, the work requires theoretical plurality, cultural humility, and historical awareness as well as structural competency. From a population standpoint, the complexities surrounding the mental health and well-being of young individuals requires a multidimensional approach, involving various stakeholders, including mental health professionals, educators, policymakers, and families. In this issue, we delve into several pressing issues that impact the lives of children and adolescents. The articles presented in this issue provide a snapshot into the diverse and dynamic aspects of child mental health, and each article contributes to our understanding of the unique challenges faced by young individuals.