Child Psychiatry Research Articles

Global research trends on psychological well‑being of children in foster care homes from 2003 to 2023: a bibliometric analysis using Scopus database.

The study focuses on contemporary trends in the psychological well‑being of foster children residing in care homes over the past two decades. Moreover, it aims to predict future research directions by analyzing hotspots, offering valuable references for academics engaged in further studies in this field. A quantitative analysis was conducted on nine hundred and twelve documents, including research papers and reviews, from 2003 to 2023. These publications focused on the psychological well‑being of foster children and were incorporated from the Scopus database. For visual analysis, we utilized the bibliometric analytical tool VOSviewer to generate a map of information on the authors, journals, organizations, nations, citations, and keywords. We also employed Microsoft Excel tables to record the essential details. The psychological well‑being of children and adolescents residing in foster homes is an emerging area of research. The findings show that there has been an ongoing rise in relevant research publications over time. The United States (416) and Harvard Medical School (56) were the most active countries and organizations in this study. AIDS Care: Psychological and Socio-Medical Aspects of AIDS/HIV (91 articles) and Vulnerable Children and Youth Studies (86 articles) are two prominent journals, while the Journal of Child Psychology and Psychiatry had the most co-citations (630). Nelson (52 publications) and Zeanah (50 publications) are the top two leading authors based on citation counts. Institutional care, orphans, HIV/AIDS orphans, psychological well‑being, and mental health, resilience are popular research keywords in this study. This study indicates the prevailing interest in the specified domains over the past two decades. Our findings primarily indicate that addressing mental health concerns, along with understanding the needs of children in foster care homes, can enhance their psychological well‑being. Developing effective interventions to enhance the psychological well‑being of children in foster care is bound to have a profound effect on them and will serve as a key focus for future research in this field.

Assessing service usage and protective factors in a pediatric psychiatry clinic during the COVID-19 pandemic.

Youth with developmental and pre-existing mental health conditions have been particularly vulnerable to declines in psychological functioning during the COVID-19 pandemic. This study aimed to first, analyze service usage within an outpatient child and adolescent psychiatry clinic in the months preceding and during the COVID-19 pandemic, and second, to examine associations with potential protective factors against mental health concerns in a treatment-engaged sample. Service usage was examined using clinic billing data, and reports on protective factors were gathered via parent survey of 81 children ages 6-17 years who received mental health treatment in an outpatient psychiatry clinic during the pandemic. Protective factors were assessed at the individual, family, and community levels, and included children's use of coping strategies, parental resilience, and parents' perceived social supports. Study outcomes, including mental health concerns, mental health emergencies, pandemic-related distress, and social impact of the pandemic, were analyzed via Pearson correlations and simultaneous multiple linear regressions. Findings suggest increased service usage and child coping, parental resilience, and social connectedness as factors associated with fewer mental health concerns in youth with psychiatric concerns during the pandemic. This study lends support for expanding psychiatric services with continued use of telemedicine platforms. Further, findings suggest a mental health benefit to optimizing individual, parental, and community-based resources to enhance children's psychological functioning, particularly for youth with pre-existing mental health conditions.

Body Mass Index Changes in Children and Adolescents Treated with Methylphenidate for Attention Deficit Hyperactivity Disorder.

Attention Deficit Hyperactivity Disorder (ADHD) and obesity are major pediatric public health problems. The present study aimed to examine the association between these two health parties in our pediatric populations. This study is a single group retrospective cohort study about Body Mass Index (BMI) changes in 149 children and adolescents between 3-18 years old with a diagnosis of ADHD based on one child and adolescent psychiatrist interview according to the Diagnostic and Statistical Manual of Mental Disorders 4th edition criteria (DSM-IV-TR). All participants were treated with methylphenidate. Besides, they were reassessed by the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Persian version (K-SADS-PL-P). Furthermore, the height, weight, and BMI of participants were calculated. The data were analyzed by descriptive statistics, repeated measures, and Wilks' lambda analysis using IBMSPSSStatisticsversion 23. The mean age of patients was 8.2±2.6 years, and 71.8% were boys. The obtained results showed that those treated with methylphenidate for more extended periods had higher BMI increases (p <0.001). The change in BMI was not related to the age at the start of treatment (p = 0.125), but this index was significantly different based on the years under treatment (p = 0.002). Moreover, changes in BMI were not significant based on gender (p = 0.850), the type of ADHD specifiers (p= 0.686), and concomitant drugs (p = 0.783). This study's findings suggest that long-term use of ADHD medications could raise the risk of obesity in children.

Telepsychiatry and In-Person Care for Pediatric Patients During COVID-19: Patients’ Perspectives

The COVID-19 pandemic has changed how child and adolescent psychiatrist’s practice. Nationwide restrictions and public health recommendations have reshaped the patient care setting to avoid spread of the virus. A major shift came in the form of telehealth, which allowed patients to attend clinic appointments online. Some of our clinic’s child and adolescent psychiatrists began practicing telehealth in March 2020 and continued completely virtually for one year. Other providers in our practice continued with in-person visits.

Prevalence and risk factors of non-suicidal self-injury behavior

The prevalence of non-suicidal self-injury (NSSI) behavior in adolescents has increased significantly in the early 21st century. The phenomenon of NSSI behavior has become one of the key health problems in the field of adolescent psychiatry and psychology over the past decade worldwide. However, the social characteristics and factors influencing NSSI are very different in different regions of the world. Studies of self-harming behavior indicate that the upward trend is almost equally relevant for developing and developed countries. To date, the methodological basis for the diagnosis of NSSI has not been sufficiently developed in the Russian Federation, there are only some studies of NSSI both from an empirical perspective and in the context of the search for risk factors, causes and functions, models of comorbidity with mental disorders.

Evidence-Based Practices: An Opportunity to Enhance Psychiatric Residency Training

Staring back at me through the Zoom interface was a small, thin-faced boy, too nervous and overwhelmed to tell me anything more than his own name and the name of his dog: Cooper. This was the first child therapy case I was assigned as a resident trainee. He was a young adolescent with acute lymphoblastic leukemia. Two years ago, he was outgoing, playful, and sociable. Now he apprehensively stared at me, underweight and highly anxious. He was experiencing medical trauma through countless hospital admissions for chemotherapy and opportunistic infections during the ongoing global pandemic. At the time he was transferred to my care, he carried multiple psychiatric diagnoses, including generalized anxiety disorder, major depressive disorder, and posttraumatic stress disorder. I had no idea where to begin. Though I was in my third year of Triple Board training, which includes adult psychiatry, pediatrics, and child psychiatry fellowship, I felt unprepared. My education and exposure to psychotherapy had been somewhat limited; but even still, I knew that learning effective, evidence-based therapeutic skills would not be straightforward.

Effectiveness of two systems-level interventions to address perinatal depression in obstetric settings (PRISM): an active-controlled cluster-randomised trial

Perinatal depression is a common and undertreated condition, with potential deleterious effects on maternal, obstetric, infant, and child outcomes. We aimed to compare the effectiveness of two systems-level interventions in the obstetric setting-the Massachusetts Child Psychiatry Access Program (MCPAP) for Moms and the PRogram In Support of Moms (PRISM)-in improving depression symptoms and participation in mental health treatment among women with perinatal depression. In this cluster-randomised, active-controlled trial, obstetric practices across Massachusetts (USA) were allocated (1:1) via covariate adaptive randomisation to either continue participating in the MCPAP for Moms intervention, a state-wide, population-based programme, or to participate in the PRISM intervention, which involved MCPAP for Moms plus a proactive, multifaceted, obstetric practice-level intervention with intensive implementation support. English-speaking women (aged ≥18 years) who screened positive for depression (Edinburgh Postnatal Depression Scale [EPDS] score ≥10) were recruited from the practices. Patients were followed up at 4-25 weeks of gestation, 32-40 weeks of gestation, 0-3 months postpartum, 5-7 months postpartum, and 11-13 months postpartum via telephone interview. Participants were masked to the intervention; investigators were not masked. The primary outcome was change in depression symptoms (EPDS score) between baseline assessment and 11-13 months postpartum. Analysis was done by intention to treat, fitting generalised linear mixed models adjusting for age, insurance status, education, and race, and accounting for clustering of patients within practices. This trial is registered with ClinicalTrials.gov, NCT02760004. Between July 29, 2015, and Sept 20, 2021, ten obstetric practices were recruited and retained; five (50%) practices were randomly allocated to MCPAP for Moms and five (50%) to PRISM. 1265 participants were assessed for eligibility and 312 (24·7%) were recruited, of whom 162 (51·9%) were enrolled in MCPAP for Moms practices and 150 (48·1%) in PRISM practices. Comparing baseline to 11-13 months postpartum, EPDS scores decreased by 4·2 (SD 5·2; p<0·0001) among participants in MCPAP for Moms practices and by 4·3 (SD 4.5; p<0·0001) among those in PRISM practices (estimated difference between groups 0·1 [95% CI -1·2 to 1·4]; p=0·87). Both the MCPAP for Moms and PRISM interventions were equally effective in improving depression symptoms. This finding is important because the 4-point decrease in EPDS score is clinically significant, and MCPAP for Moms has a lower intensity and greater population-based reach than does PRISM. US Centers for Disease Control and Prevention.

Managing Type 1 Diabetes in an Inpatient Child Psychiatric Care Setting.

Individuals with diabetes are at increased risk for psychological, behavioral, and social problems. Comorbid mental illness and diabetes present a unique set of challenges for people with diabetes and their health care providers, particularly in an inpatient setting. Psychiatric symptoms before admission may affect type 1 diabetes management, and mental status and behavior can affect individuals' ability to cooperate with treatment while they are inpatients. This article describes a clinical protocol to manage type 1 diabetes and maximize patient safety in an acute inpatient child psychiatric unit.

Reducing Prejudices through Architectural Design: Young People’s Experiences at a Child Psychiatric Center

Reducing Prejudices through Architectural Design: Young People’s Experiences at a Child Psychiatric Center

СИСТЕМНЫЙ ПОДХОД К ЛЕЧЕБНО-РЕАБИЛИТАЦИОННОЙ ПОМОЩИ ПАЦИЕНТАМ ВО ВНЕСТАЦИОНАРНОЙ ДЕТСКО-ПОДРОСТКОВОЙ ПСИХИАТРИЧЕСКОЙ СЕТИ

Taking into account the modern understanding of the multifactorial nature of mental pathology, an integrated approach to helping these patients determines the need for psychosocial rehabilitation, in addition to clinical therapy. For child and adolescent psychiatry, the issue of structuring psychosocial rehabilitation seems particularly relevant (due to the severity of the outcomes of child and adolescent mental illnesses) and poorly studied. The purpose of this work was to analyze the results of practical activities on social rehabilitation of minor patients, with the formation of proposals for comprehensive support for these patients in the outpatient network. The study material was a cohort of 1203 patients (m. - 914 (76%), female - 289 (24%)) who initially applied to a psychoneurological clinic in childhood and adolescence. They were followed clinically and follow-up until adulthood (catamnesis was carried out upon reaching the age of 23-25 years (1095 patients - 91%)). Research methods: clinical-psychopathological, psychometric, clinical-follow-up, statistical. Results: Based on the results of the clinical follow-up study, it could be concluded that medical and social assistance to minor patients should be reformatted in the direction of more active identification of initial mental disorders; During the initial contact, it is necessary to build trusting relationships with relatives and the patients themselves, and engage in their psychoeducation. The issues discussed with relatives are similar to those that are subsequently discussed with teenagers. The topic is dealt with in an individually adapted manner for each interlocutor. Identification and discussion with parents of the most problematic areas of the child’s life should culminate in the development of rehabilitation programs to develop lost or undeveloped daily functioning skills. Conclusion: In general, achieving highly functional clinical and social remission in patients suffering from early mental disorders is a complex problem, the final solution of which is associated with future achievements in a number of areas of clinical and social sciences. At the present stage, it is necessary to apply a systematic approach and use the advanced achievements of modern clinical and social psychiatry.

아동기 애착 외상이 여자 청소년의 자해 경험에 미치는 영향

The purpose of this study was to examine the mediating effect of mentalization on the effectsof childhood attachment trauma on self-injurious behavior in adolescent girls. The participantsof the study were 192 female adolescents who visited the youth counseling welfare center andchild and adolescent psychiatry, and they responded to the childhood traumaquestionnaire-short form, mentalization scale, and the functional assessment of self-mutilation. The result of this study was that mentalization has been shown to partially mediate therelationship between attachment trauma and self-harm. These results showed that attachmenttraumatic experiences made difficult for children to develop mentalization, and deficiencies orweakening of mentalization skills could significant impact on self-injurious behavior. The resultsof this study suggest that mentalization-based counseling interventions can prevent self-injuriousbehaviors in adolescent girls by developing mentalization skills.

The Combination of Mind and Brain Alteration in A Resource-Limited Country: Autism Spectrum Disorders and Epilepsy in A Child Psychiatry Unit in Dakar

Purpose of the study: Autism spectrum disorders (ASD) and epilepsy can coexist in the same person, constituting poor bilateral prognosis factors. This study describes the sociodemographic elements of patients with ASD and studies the clinico-paraclinical aspects of their epilepsy and its evolution in 2003. Patients and Methods: Cross-sectional and descriptive study in Child psychiatry at CHNU Fann, with analysis of the files of all patients followed between January 2004 and September 2018 for ASD with/without epilepsy. We used a standardized survey with several items. Results: Forty -five patients with ASD collected, with an epileptic frequency of 37.8%. The main history was fetal suffering (24.4%) and parental inbreeding (22.2%). Most of the symptoms of ASD were seen before 3 years old (66.6%) and epilepsy started before 5 years (94%). Seizures were generalized (58.8%), mainly tonic-clonic (80%) or focal (35.3%), with a frequency of 2 seizures / day at 1 seizure / week. The EEG showed abnormalities in frontal areas in 60%, and Centro-parietal in 26.6%. Brain imaging and evoked auditory potential were normal respectively in 93.9%, and 87.2%. Management was multimodal for ASD (neuropsychological, psychomotor, speech therapy) and medicated for epilepsy, mainly by monotherapy (82.4%) with Valproate (58.8%), Phenobarbital (17.6). Forty percent of patients were out of school and 55.6% in primary school. Twenty-five patients were self-reliant to moderately independent, mainly the epileptics (60%). The 2023 evaluation of this cohort concerns 60% of patients with epilepsy in complete remission and behavioral and language stability under continuous management. Conclusion: We find a statistic difference by age between epilepsy and ASD with a genetic predisposition related to parental inbreeding and a family history of ASD and epilepsy and to a lesser extent the existence of acute fetal suffering. The contribution of EEG was significant with a predilection of frontal abnormalities whose epileptic treatment appears to improve the impact in children's behavioral disorders.

Adaptive behavior of school-aged children with Autism Spectrum Disorder

Children with Autism Spectrum Disorder (ASD) face challenges related to their functioning, also known as adaptive behavior. Studies in recent literature explore the association between adaptive behavior and cognitive ability in children with ASD. Aim: The present study investigates adaptive behavior and adaptive skills in children with ASD in relation to their cognitive ability. Methods: In the present study, the sample consisted of 54 children with ASD, with a minimum Intelligence Quotient-IQ of “70”, who were admitted to a Child Psychiatric Hospital Clinic. Screening of functional and cognitive difficulties was performed by administering the Vineland Adaptive Behavior Scales (VABS) and Wechsler's Intelligence Scale for children-III (WISC-III), respectively. Results: Children with ASD exhibited deviations in adaptive behavior, with a pattern of deficits in adaptive skills (p&lt;0.001). The group with high general cognitive score showed higher performance in the areas of Communication and Socialization, compared to the group with low general cognitive score. Both groups showed significant deficits in Daily Living Skills. The relationship between adaptive behavior/adaptive skills was investigated in relation to general, verbal and performance IQ (VIQ-PIQ). The general cognitive score was found to predict the performance of adaptive behavior. In the high cognitive ability group, the verbal and performance cognitive score predicted performance in Communication and Activities of Daily Living, respectively. Conclusions: The functioning of children with ASD is reflected in adaptive behavior, where a pattern of deficits is presented in relation to the cognitive ability.

Evaluating the Interrater Reliability of the Icelandic Version of K-SADS-PL DSM-5.

The Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version (K-SADS-PL) is a valuable tool for diagnosing mental disorders in children and adolescents. Previous studies have examined its interrater reliability, but there is limited information on individual disorders, on the updated DSM-5 version. This study aims to analyse the interrater reliability of the Icelandic translation of K-SADS-PL, DSM-5 version. K-SADS-PL was administered to a clinical sample of outpatients from the Icelandic Anxiety Centre for Children, Adolescents, and Young Adults, and The Department of Child and Adolescent Psychiatry at Landspítali, the National University Hospital in Reykjavík, Iceland. In total, 135 patients aged 6-18 were included in this study. We assessed the interrater reliability using Cohen's κ, with results ranging from poor to excellent (0.3-1.0), though most disorders showed excellent reliability (κ > 0.75). The Icelandic translation of the DSM-5 K-SADS-PL is generally reliable when used by properly trained post-graduate students, which supports its use in clinical settings.

Predictors and Correlates of Positive Urine Drug Screening in a Retrospective Cohort Analysis of Child and Adolescent Psychiatry Inpatients Throughout the COVID-19 Pandemic.

Youth substance use is associated with significant psychological, neurological, and medical complications. Risk factors for substance use among children and adolescents in the general population include peer and/or parental substance use, certain psychiatric illnesses (eg, Attention-Deficit/Hyperactivity Disorder, depression), and history of maltreatment. Co-occurring substance use and psychiatric illness have been associated with increased suicidality, but few prior studies have characterized substance use among child/adolescent inpatients. As such, it remains unclear how substance use contributing to acute psychiatric presentations has changed since the start of the COVID-19 pandemic. This is a retrospective cohort study of 816 unique child/adolescent psychiatry inpatients with urine drug screening (UDS) results from a diverse urban setting. Charts of patients hospitalized between June 1, 2018 and November 30, 2021 were reviewed for sociodemographic characteristics, indication for admission, psychiatric history, hospital course, treatment plan, and discharge diagnosis. Differences in sociodemographic and clinical characteristics, such as age, race, and diagnoses, between patients with and without positive UDS were explored throughout various periods of the COVID-19 pandemic. Descriptive and comparative statistics were performed, as well as a logistic regression model to identify the predictors of positive UDS. Of the study sample, 18% had a positive UDS. Older age, diagnosis of impulsive or behavioral disorder, and a history of violence were found to be predictors of positive UDS. Asian/South Asian or Hispanic/LatinX race and history of a developmental or intellectual disability were found to be negative predictors. The frequency of positive UDS in this population did not change based on COVID-19. Multiple factors may predispose children and adolescents to substance use. Though no impact of COVID-19 was found in this sample, longer-term studies are needed. This study identifies independent predictors of active substance use in the child and adolescent psychiatric inpatient population.

Differential diagnosis and treatment of idiopathic occipital epilepsy and visual seizures in an adolescent case: Is “hallucination” always “hallucination”?

Epilepsy is the most common childhood neurological disorder that affects 0.5 to 1.0 % of children younger than 16 years of age. Cognitive and behavioral impairments as well as various psychiatric and neurodevelopmental disorders can accompany this condition. Among children and adolescents, occipital epilepsy can be easily overlooked because it can mimic other epileptic syndromes and symptoms may be subtle. The initial complaint of a patient suffering from occipital epilepsy could be visual hallucinations. Child and adolescent psychiatrists must be aware of the difference between these neurological-originated hallucinations and others denoting psychopathologies.

Adolescents with neuropsychiatric symptoms in the turmoil of the service system: The NEPSOS interdisciplinary study of social work, adolescent psychiatry, special education, and expert organisations

Existing social, health and education services do not respond to the needs of adolescents with neuropsychiatric symptoms. These services are usually fragmented and their professionals’ expertise is insufficient. In this interprofessional context, the integration of specialisations, multidisciplinary expertise and knowledge is a challenge. In the NEPSOS study, we explore the services aimed at and service needs of adolescents with neuropsychiatric symptoms and their families. The NEPSOS study is collaboratively designed and carried out by experts from the University of Turku and the University of Eastern Finland, including researchers of adolescent psychiatry, social work and special education, as well as expert organisations such as the Southwest Finland Centre of Excellence on Social Welfare and the Nationwide Association of Different Learners. These organisations provide their expertise for the implementation and integration of the research results into the service system and the development of recommendations. &#x0D; In this study, the appropriateness of services and service paths are examined from the perspectives of adolescents and families, professionals and interprofessional collaboration. The study has four different lines. Line 1 examines the relationships between a) the socio-economic status of the parent and the situation of the adolescent and b) neuropsychiatric symptoms and child protection support measures. Line 2 examines the experiences and views of adolescents and their parents concerning the functionality of the service system and the functional forms of psychosocial support. Line 3 studies the professionals’ perspectives on the functionality of the service system and interprofessional collaboration in the context of adolescent service paths. Line 4 focuses on communication and interaction activities, including the implementation of the research results.&#x0D; The NEPSOS study will provide knowledge and deepen the understanding of the following topics:&#x0D; •How interprofessional cooperation is implemented in the service paths for adolescents with neuropsychiatric symptoms from the perspective of professionals from the fields of social work, adolescent psychiatry and education.&#x0D; •How existing service networks meet the needs of adolescents and their families, and what kind of psychosocial support is provided to them by the professionals of social work, adolescent psychiatry, and special education. &#x0D; •How psychosocial services and interprofessional collaboration are performed to improve the timeliness, targeting and integration of services for adolescents with neuropsychiatric symptoms and their families.&#x0D; Furthermore, the impact of this study’s findings will be manifested as practical recommendations and training materials for professionals. The NEPSOS study forms part of an interdisciplinary research consortium whose ongoing and future studies specifically aim at strengthening the integration of social care, health care and education for the health and wellbeing of children and families. Our experiences regarding interdisciplinary collaboration and the future results of the study can be applied internationally both in higher education and the integration of child social, health and education services.&#x0D; Keywords: neuropsychiatric symptoms, adolescents, interdisciplinary collaboration, social work, adolescent psychiatry, special education.

Interdisciplinary collaboration in the diagnostic practice of the Integrated Youth Care in Flanders: A focus group study

Background: In 2020, the Flemish Centre of Excellence in Diagnostics (Kwaliteitscentrum voor Diagnostiek vzw) published the General Intersectoral Guidelines for Diagnostics (GIGD). The goal of the GIGD is to aid professionals working in different (mental) health care sectors in Flanders to implement high-quality diagnostic processes. The GIGD defines high-quality diagnostic processes by naming and explaining seven important practices. It is unclear, however, how the GIGD impacted the diagnostic field since its publication and to what extent the practices are implemented. Therefore, this study examined how one of those practices, namely interdisciplinary collaboration, is used in the Integrated Youth Care in Flanders and what the needs are to strengthen this practice further. &#x0D; Methods: Focus groups were organized with professionals in diagnostics working in nine organisations of the Integrated Youth Care in Flanders, among which centers of mental health care, rehabilitation, developmental disability, student guidance, pediatric psychiatry, etc. The number of participants of each organisation ranged from 1 to 15, with no participants from the centers of pediatric psychiatry. In total, 65 professionals participated. In each focus group, an introduction in the GIGD was followed by a structured discussion about the way in which diagnostic processes are carried out in each organisation and how interdisciplinary collaboration is present and which difficulties are met during the process. &#x0D; Results: Participants from all organisations agree that interdisciplinary collaboration is at the heart of good diagnostic trajectories within their own organisation. Important features concern the inclusion of multiple and diverse viewpoints in an interdisciplinary team with members from different backgrounds and levels of experience; a trusting atmosphere to discuss and promote different opinions; time and resources to allow an in-depth discussion; an (external) supervisor to moderate and guide group processes. Participants further highlight the importance of continuous and joint care across organisations in Child- and Youth care. However, several pitfalls were addressed, which seem hard to overcome, such as a lack of trust due to incomplete and erroneous knowledge about each other's professional operations, endless waiting lists thwarting appropriate continuation of care, and rigid policy requirements and restrictions. &#x0D; Conclusion: All participating organisations understand the importance of interdisciplinary collaboration as a prerequisite for high-quality diagnostic processes and integrated care and long for more collaboration. However, several pitfalls and obstacles complicate matters. There is need for practical guidelines, information dissemination, workshops and intervisions, financial aid and more leeway in intersectoral endeavors to help professionals overcome these obstacles.

An integrated, stepped care organizational model for diagnostic evaluations along the care trajectory of children with a developmental disorder.

Introduction: The field of multidisciplinary diagnostic evaluations for children with a developmental disorder in Flanders, Belgium, is heterogeneous and characterized by severe accessibility problems. However, children with a developmental disorder need timely and adequate diagnostics during their trajectory of care and support. This policy support research project develops an organizational model of integrated of care and networking adapted to diagnostic needs in different phases as well as the particularities of the Flemish institutional field. &#x0D; Methods: Homogeneous focus groups were performed with stakeholders from six types of governmental regulated organizations offering specialized diagnostic evaluations in Flanders (Centres for Developmental Disorders, Centres for Ambulatory Rehabilitation, Autism Reference Centres, Mental Healthcare Centres, Pupil Guidance Centres, and Ambulatory Services for Paediatric Psychiatry). A topic list was developed, based on a literature review on relevant themes. Qualitative data was categorized and iteratively compared per theme between focus groups by researcher and data triangulation. A member check validation was organized. &#x0D; Results: 59 experts participated in 6 focus groups. Because of poor participation, the focus group with stakeholders from paediatric psychiatry was cancelled. The focus groups learn that it currently lacks coordination of activities, there is no shared vision on the content and goals diagnostic evaluation, there is an unequal regional distribution of organizations. Interorganizational and interprofessional collaboration is restricted to referral, without integration of care. There is poor mutual trust in the quality of the diagnostic assessments between organizations. Mutual knowledge on activities and expertise, lacks. Regulations hamper interorganizational collaborations as well as different financing mechanisms between organizations. Current organization of the field focuses on organizations’ interests and do not take into account the specific children’s and context’s diagnostic needs during their trajectory. &#x0D; Conclusion: A patient-centred, integrated, stepped care, network model integrating general specialized and highly specialized knowledge and expertise (for different developmental disorders) across organizations borders in a well thought regional approach, is expected by all stakeholders to improve accessibility to specialized diagnostic evaluations adapted to the care trajectory of the child with a developmental disorder. &#x0D;

Engaging youth in research, education, and practice: a workshop on various forms of youth participation

To improve integrated care for youth with multiple and complex needs, it is crucial to actively collaborate with youth in research, education and practice. Only by combing scientific evidence, clinical expertise, and patient values, we are able to organize care that fit the needs of youth [1].&#x0D; However, engaging youth can be challenging for both professionals and youth. For example, youth participation often fails due to a lack of knowledge on the various roles they can play, problems in collaboration, or a lack of preconditions such as insufficient rewards and minimal supervision. Questions that often arise are: how do we actively engage youth in research, education and practice? What roles can youth play to improve integrated care programs? And what conditions are needed to optimize youth engagement and collaboration? &#x0D; This workshop is for all researchers, policy makers and practitioners, working in youth (mental health) care, interested in improving (youth) engagement in their own practice. Also, this workshop is interesting for youth who want to be involved in improving integrated care. &#x0D; The workshop is based on the results of a systematic review on youth peer support [2] and experiences from multiple projects (i.e., research, education and treatment) in child and youth psychiatry in The Netherlands. Participants will learn about the various roles youth can play and preconditions that should be met to optimize collaboration in practice. The workshop starts with an introduction (15 min.) explaining different forms of experiential knowledge and the added value of including all perspectives in research, education and practice. Then, the various roles youth can play will be presented. Also, opportunities and challenges within these roles will be discussed by a youth representative based on examples from practice. &#x0D; Following the introduction, the workshop participants will get the opportunity to reflect on youth participation in their own context (30 min. in total). First, participants are asked to answer questions which stimulate individual reflection on the theory presented (10 min.). Then, participants will discuss their successes, opportunities and challenges in groups (20 min.). An experienced participatory researcher and a youth representative will provide real-time feedback on the participants’ experiences and support them to formulate points of action to improve their practice.&#x0D; At the end of the workshop, participants will have insight into various forms of youth engagement, they will be inspired by examples from other participants, and are equipped with specific points of action to improve their own practice (15 min.).