Mini International Neuropsychiatric Interview Kid Research Articles

The Association between Nonsuicidal Self-Injury and Perfectionism in Adolescence: The Role of Mental Disorders.

Previous evidence has drawn attention to the fact that maladaptive perfectionism is a risk factor for engagement in nonsuicidal self-injury (NSSI). Until now, few studies have examined this topic, especially among community adolescents. The aim of this study was to explore the relationship between perfectionism dimensions and NSSI functions to examine the potential mediating effect of mental disorders. Altogether, 146 Hungarian community adolescents (ages 13-18 years) were involved. All participants completed the Hungarian adaptation of the Inventory of Statements about Self-Injury (ISAS), the Frost Multidimensional Perfectionism Scale (FMPS), and the Mini International Neuropsychiatric Interview Kid. To analyse the interrelationships among NSSI, perfectionism, and mental disorders, we conducted regression and network analysis. Of the 146 adolescents, 90 (61.64%, girls: 71.11%) engaged in NSSI. The Concern over Mistakes and Doubts about Action scales of the FMPS significantly and positively predicted both NSSI intrapersonal and interpersonal motivation, with comparable effect sizes, and this association was fully mediated by anxiety disorders. There was a significant direct negative relationship between the FMPS Organisation dimension and both main NSSI functions. This study draws attention to an increasing trend and the extremely high NSSI prevalence rate among community adolescents. Adolescents with perfectionistic concerns are at heightened risk for anxiety disorders, which can increase their vulnerability to NSSI engagement.

Psychiatric disorders in adolescents living with HIV in Botswana

BackgroundAs children living with HIV transition from adolescence into adulthood, they face a considerable burden of psychiatric disorders (PDs) which may vary between the perinatally and behaviorally infected. The knowledge of the pattern of these PDs in relation to the varying needs of the adolescents living with HIV (ALWHIV) is unclear but necessary for maximizing their linkage to care and improving their quality of life in Botswana. AimTo determine the pattern of PDs in ALWHIV in Botswana; to compare and explore the differences in the pattern and their associated factors between congenitally infected adolescents (CIAs) and behaviorally infected adolescents (BIAs).MethodsA cross-sectional survey of 622 ALWHIV (399 CIA and 223 BIA) with the Mini International Neuropsychiatric Interview-Kid Screen.ResultsThe participants' mean age (SD) was 17.71 (1.60) years, with more males (54%), of whom 52.9% had at least one PD, with depression (23.6%) and generalised anxiety disorder (18.0%) being the most prevalent. The externalising disorders were associated with being CIA (OR = 3.99; 95% CI:1.87–8.54), male gender (OR = 3.93; 95% CI:2.02–7.64), and a viral load of 400 and above copies (OR = 3.53; 95%CI:1.92–6.48). Internalising disorders were associated with being BIA (OR = 3.64; 95%; CI: 2.39–5.56), females (OR = 2.59; 95% CI:1.75–3.83), poor counselling (OR = 2.23; 95% CI: 1.42–3.51) and struggling to accept HIV status (OR = 1.73; 95% CI:1.14–2.62).ConclusionsDepression and anxiety disorders were the most prevalent PDs in ALWHIV, who differed in psychiatric presentations, the BIAs being more likely to present with internalizing disorders, while the CIAs had more externalizing disorders. Due to the varying needs of ALWHIV, individualized management plans that consider gender, mode of infection, and other psycho-social needs, should be further studied and encouraged.

The relationship between nonsuicidal self-injury, suicidal behaviour and life events among adolescents

IntroductionNonsuicidal self-injury (NSSI) is highly prevalent in clinical and non-clinical adolescent populations. Non-clinical studies focus on high school students thus vocational school students are underrepresented in research and prevention programs, despite being exposed to higher levels of stressful life events, a factor associated with NSSI and suicide.ObjectivesThis study aimed to explore NSSI, suicidal behavior and life events among adolescents in clinical and non-clinical, i.e. both high school and vocational school settings.MethodsA clinical (n=202) and non-clinical (n=161) sample of 13-18-year-old adolescents were assessed with the Mini International Neuropsychiatric Interview Kid, the Deliberate Self-Harm Inventory, and the Life Events List. Data were analyzed with R version 3.6.1., using Wilcoxon tests and negative binomial regression models.ResultsThe prevalence of suicidal behavior (W=7.306, p<.001), NSSI (W=9.652, p<.001), and life events (W=10.410 p<.001) were significantly higher in the clinical than in the non-clinical group. The relationship between NSSI and suicidal behaviour was significantly stronger in the clinical group (95% CI: [.56,.72]) than in the nonclinical group (95% CI: [.24,.52]). The interaction between NSSI and life events (Χ2(1)=10.49, p<.01) was associated with suicidal behavior. Interpersonal events were associated with both suicidal behavior and had a moderating effect on the NSSI–suicidal behavior relationship.ConclusionsNSSI is highly prevalent and is strongly associated with suicidal behavior in clinical and non-clinical adolescent populations. Our result call attention to the necessity of including adolescents from various educational settings in NSSI research and prevention projects during which life events, especially interpersonal events, might require special attention.DisclosureNo significant relationships.

Nonsuicidal self-injury, psychiatric disorders and pathological internet use among adolescents

IntroductionPrevious studies underline the importance of internalising disorders as risk factors of nonsuicidal self-injury (NSSI), meanwhile only a few research draw the attention to the role of externalising disorders. The possible association between NSSI and pathological internet use (PIU) is also understudied.ObjectivesThe purpose of this study was: 1) to investigate the frequency of NSSI among adolescents with different psychopathology and in different internet user groups of adolescents, 2) to understand the mediator role of psychiatric disorders between NSSI and PIU.MethodsAdolescents were enrolled from a clinical (Vadaskert Child Psychiatric Hospital, Budapest, Hungary) and a school based population (high schools in Budapest, Hungary). The used measurements were: Strengths and Difficulties Questionnaire (SDQ), Deliberate Self-Harm Inventory, Young Diagnostic Questionnaire for Internet Addiction, Mini International Neuropsychiatric Interview Kid.ResultsThere was significant difference in the frequencies of NSSI in SDQ subgroups (U=2127.000; z=-6.170; p <0.001). There was also significant difference in NSSI frequency between normal- and pathological internet users (U=2020.000; z=-2,501; p <0.017 p=0.012). According to the mediator model there was no direct association between PIU and NSSI, however it was mediated by different psychiatric disorders (affective disorders, anxiety disorders, attention deficit/hyperactivity disorder, conduct disorder, opposition defiant disorder, psychoactive substance abuse/dependence, psychotic disorders, suicidal behavior).ConclusionsThe results strengthen that both internalising- and externalising psychopathology are associated with NSSI. Moreover this study underlines the importance of careful screening and treating of comorbid disorders with PIU, which can have a role in the prevention of NSSI and suicide as well.DisclosureNo significant relationships.

The effects of peer bullying and poverty on suicidality in Chinese left behind adolescents: The mediating role of psychotic-like experiences.

This study investigated the influence of childhood adversity, such as peer bullying and socioeconomic status, on the suicidal behaviour of left-behind Chinese adolescents to determine whether psychotic-like experiences (PLEs) mediated the associations between these childhood adversities and suicidality; suicidal ideation (serious thoughts about taking one's own life), suicide plans, and suicide attempts. A representative group of rural adolescents (n=3346) was recruited from 16 rural high schools in China. Suicidality was assessed using the suicide module from the Mini International Neuropsychiatric Interview Kid. Participants also completed questionnaires on bullying, socioeconomic status, left-behind characteristics, and PLEs. Structural equation modelling was then employed to explore the relationships between these variables. Peer bullying, poverty, and left-behind status were all found to significantly increase adolescent suicide risk, the relationships between which were mediated by PLEs. Peer bullying was found to play the most significant role in the PLEs and suicidality, with the risk of suicide increasing with the length of time a child had been left behind. Adverse life events can lead to a high risk of PLEs, which in turn can increase the risk of suicide. These results could assist in identifying individuals at risk of suicidality and the design of appropriate interventions. The results also highlighted the role PLEs play in suicidality and highlighted the need for further research in this area.

The Association between Prosocial Behaviour and Peer Relationships with Comorbid Externalizing Disorders and Quality of Life in Treatment-Naïve Children and Adolescents with Attention Deficit Hyperactivity Disorder.

Several recent studies confirmed that Attention Deficit Hyperactivity Disorder (ADHD) has a negative influence on peer relationship and quality of life in children. The aim of the current study is to investigate the association between prosocial behaviour, peer relationships and quality of life in treatment naïve ADHD samples. The samples included 79 children with ADHD (64 boys and 15 girls, mean age = 10.24 years, SD = 2.51) and 54 healthy control children (30 boys and 23 girls, mean age = 9.66 years, SD = 1.73). Measurements included: The “Mini International Neuropsychiatric Interview Kid; Strengths and Difficulties Questionnaire” and the “Inventar zur Erfassung der Lebensqualität bei Kindern und Jugendlichen”. The ADHD group showed significantly lower levels of prosocial behaviour and more problems with peer relationships than the control group. Prosocial behaviour has a weak positive correlation with the rating of the child’s quality of life by the parents, both in the ADHD group and in the control group. The rating of quality of life and peer relationship problems by the parents also showed a significant negative moderate association in both groups. The rating of quality of life by the child showed a significant negative weak relationship with peer relationships in the ADHD group, but no significant relationship was found in the control group. Children with ADHD and comorbid externalizing disorders showed more problems in peer relationships than ADHD without comorbid externalizing disorders. Based on these results, we conclude that therapy for ADHD focused on improvement of prosocial behaviour and peer relationships as well as comorbid externalizing disorders could have a favourable effect on the quality of life of these children.

The Association of Nonsuicidal Self-Injury with Quality of Life and Mental Disorders in Clinical Adolescents-A Network Approach.

Although earlier research has highlighted that psychiatric disorders significantly impair patients’ quality of life (QoL), few studies have examined the relationship between nonsuicidal self-injury (NSSI) and QoL. Our aim was to investigate whether QoL mediates the mental disorder–NSSI relationship, and to study the QoL ratings agreement of self and parents in a clinical population of adolescents. We involved 202 adolescents from Vadaskert Child Psychiatric Hospital and Outpatient Clinic, Budapest, aged 13–18 years. All participants completed the Deliberate Self-Harm Inventory, Inventar zur Erfassung der Lebensqualität bei Kindern und Jugendlichen, and the Mini International Neuropsychiatric Interview Kid. To map the interrelationship between the NSSI, mental disorders, and QoL dimensions, Mixed Graphical Models were estimated. Adolescents with a history of NSSI rated their QoL to be significantly lower than adolescents without NSSI. Self and parents’ QoL ratings are closer in the NSSI sample than in the no-NSSI sample. Among all QoL dimensions, only family problems had a direct significant association with NSSI engagement. Our results highlight that, contrary to our hypothesis, the presence of mental disorders mediates the relationship between most QoL dimensions and the occurrence of NSSI. Our results draw attention to the potential causal effect of environmental factors (e.g., peer problems) on mental disorders that, in turn, result in NSSI. The present paper highlights the importance of network modelling in clinical research.

Sociodemographic, clinical profile, and psychiatric morbidities among patients with attempted suicide in a tertiary care center: A study from Central India.

Background:Suicide is a major public health concern and is considered one of the leading causes of death globally. Previous suicidal attempts can be considered as a predictor of underlying psychiatric illness. Identifying factors behind suicidal attempt can help mental health professionals for early diagnosis and treatment as well as designing effective suicide prevention strategies.Aim:The aim of the study is to assess sociodemographic, clinical characteristics, and prevalence of psychiatric morbidities among patients with attempted suicide.Methods:A cross-sectional study was conducted in the emergency department of tertiary care hospital; patients of attempted suicide attending emergency from January 1, 2014, to January 1, 2020, constituted the sample for the study. Data were collected using semi-structured questionnaire which contained sociodemographic and clinical variables. All the subjects were administered mini-international neuropsychiatric interview (MINI), MINI Kid was applied for subjects <18 years, and MINI Plus was applied for subjects above 18 years. Patients were diagnosed according to the ICD-10 Classification of Mental and Behavioral Disorders for research.Results:Suicide attempt was seen more commonly in males, and the most common age group is between 21 and 40 years residing in urban settings. The most common method was consumption of unknown substances (75.35%). Factors leading to suicide are multidimensional in nature. 30.4% of the patients had impulsive traits. 86.5% of people who attempted suicide had a history of psychiatric illness. Detailed assessment of patients for psychiatric illness and psychosocial factors is crucial for planning suicide prevention strategies and policymaking.Conclusions:Young population is at high risk for suicide. More than 80% of these have diagnosable psychiatric illness.

Nonsuicidal Self-Injury: Its Associations With Pathological Internet Use and Psychopathology Among Adolescents.

Background/HypothesesAs risk factors for nonsuicidal self-injury (NSSI), most studies highlight the importance of internalising disorders, while only a few researches show the connection between externalising disorders and NSSI. Although some papers have introduced the idea that increasing prevalence rates of NSSI are connected to the broader use of the internet, associations between NSSI and pathological internet use (PIU) are understudied. According to our hypothesis, there is a connection between PIU and NSSI, but this is mediated by psychopathological factors from both internalising and externalising dimensions.MethodsIn line with the dimensional approach of psychiatric disorders, participants (N = 363) were recruited from both clinical (N = 202 psychiatric inpatient) and nonclinical (N = 161 adolescents from secondary schools) settings. Measurements: Demographic Questionnaire; Strengths and Difficulties Questionnaire (SDQ); Deliberate Self-Harm Inventory (DSHI); Young Diagnostic Questionnaire for Internet Addiction (YDQ), Mini International Neuropsychiatric Interview Kid (M.I.N.I. Kid).ResultsThere was high NSSI frequency (39.9%–71% of them were girls) in our sample. NSSI was significantly more frequent among those who showed threshold symptoms on SDQ than in the subthreshold group [H(3) = 53.293, p <.001]. In the NSSI frequency, there was also a significant difference between ‘normal’ internet users and both ‘maladaptive’ and ‘pathological’ internet users [H(2) = 10.039, p <.05 p = .007]. According to the mediator models, the relationship between PIU and NSSI is not a direct association; it is mediated by all examined psychopathological factors (M.I.N.I. kid diagnoses) except for obsessive-compulsive disorder (OCD), alcohol abuse and dependence, and adjustment disorder.ConclusionsWe found a high frequency of NSSI. According to our results, PIU in itself is not a risk factor for NSSI but might become a risk factor in the presence of comorbid psychiatric disorders. All of these findings draw the attention of clinicians to the importance of careful screening of comorbid disorders with PIU.

Nonsuicidal Self-Injury and Suicide: The Role of Life Events in Clinical and Non-Clinical Populations of Adolescents.

BackgroundNonsuicidal self-injury (NSSI) is highly prevalent in clinical and non-clinical populations of adolescents. Several studies have supported both the distinction and the strong association between NSSI and suicidal behavior. Although there is a great deal of data on the role of life events in both suicidal behavior and NSSI, few studies have assessed the role of life events in the NSSI–suicidal behavior relationship. Our aims were to explore the relationship between NSSI and suicidal behavior, and the possible moderating role of stressful life events in a clinical and non-clinical adolescent population.MethodA clinical (n = 202) and a nonclinical (n = 161) population of adolescents, aged 13–18 years were assessed. The Mini International Neuropsychiatric Interview Kid, Deliberate Self-Harm Inventory and the Life Events List were used. Group differences related to suicidal behavior, NSSI, and life events were tested with Wilcoxon tests. Two- and three-way interactions were tested with negative binomial regression models including zero-inflation parameter.ResultsThe prevalence of suicidal behavior (W = 7,306, p < .001), NSSI (W = 9,652, p < .001) and life events (W = 10,410 p < .001) were significantly higher in the clinical than in the non-clinical group. Between number of life events and NSSI, a moderate effect size (.38, 95%CI [.28,.46]) was found. The main effect of NSSI (χ2(1) = 109.65, p < .001) and group membership (χ2(1) = 39.13, p < .001) predicted suicidal behavior; the main effect of quantity of life events did not explain suicidal behavior. The interaction between NSSI and number of life events (χ2(1) = 10.49, p < .01) was associated with suicidal behavior. Among interpersonal, non-interpersonal events and adverse childhood circumstances, only interpersonal events were associated with both suicidal behavior (χ2(1) = 6.08, p < .05) and had a moderating effect (χ2(1) = 8.59, p < .01) on the NSSI–suicidal behavior relationship. Patterns of the effects of life events on the NSSI–suicidal behavior relationship did not differ in the two groups.ConclusionOur results confirm the importance of prevention and intervention of NSSI, considering its high prevalence and frequent co-occurrence with suicidal behavior in both clinical and non-clinical adolescent populations. Moreover, to support NSSI and suicide prevention, we would like to highlight the importance of stressful life events, especially those associated with interpersonal conflicts, require special attention.

Identifying epilepsy psychiatric comorbidities with machine learning.

People with epilepsy are at increased risk for mental health comorbidities. Machine-learning methods based on spoken language can detect suicidality in adults. This study's purpose was to use spoken words to create machine-learning classifiers that identify current or lifetime history of comorbid psychiatric conditions in teenagers and young adults with epilepsy. Eligible participants were >12years old with epilepsy. All participants were interviewed using the Mini International Neuropsychiatric Interview (MINI) or the MINI Kid Tracking and asked five open-ended conversational questions. N-grams and Linguistic Inquiry and Word Count (LIWC) word categories were used to construct machine learning classification models from language harvested from interviews. Data were analyzed for four individual MINI identified disorders and for three mutually exclusive groups: participants with no psychiatric disorders, participants with non-suicidal psychiatric disorders, and participants with any degree of suicidality. Performance was measured using areas under the receiver operating characteristic curve (AROCs). Classifiers were constructed from 227 interviews with 122 participants (7.5±3.1minutes and 454±299 words). AROCs for models differentiating the non-overlapping groups and individual disorders ranged 57%-78% (many with P<.02). Machine-learning classifiers of spoken language can reliably identify current or lifetime history of suicidality and depression in people with epilepsy. Data suggest identification of anxiety and bipolar disorders may be achieved with larger data sets. Machine-learning analysis of spoken language can be promising as a useful screening alternative when traditional approaches are unwieldy (eg, telephone calls, primary care offices, school health clinics).

Attention-deficit hyperactivity disorder and nonsuicidal self-injury in a clinical sample of adolescents: the role of comorbidities and gender

BackgroundThe aim of the present study was to investigate the possible association between attention-deficit hyperactivity disorder (ADHD) and non-suicidal self-injury (NSSI) with special focus on the role of comorbidities and gender in a clinical sample of adolescents with both a dimensional and a categorical approach to psychopathology.MethodsUsing a structured interview, the Mini International Neuropsychiatric Interview Kid and a self-rated questionnaire, the Deliberate Self-Harm Inventory, the authors examined 202 inpatient adolescents (aged: 13–18 years) in the Vadaskert Child and Adolescent Psychiatric Hospital and Outpatient Clinic, Budapest, Hungary. Descriptive statistics, Mann–Whitney U test, chi-square test and mediator model were used.ResultsFifty-two adolescents met full criteria for ADHD and a further 77 showed symptoms of ADHD at the subthreshold level. From the 52 adolescents diagnosed with ADHD, 35 (67.30%) had NSSI, of whom there were significantly more girls than boys, boys: n = 10 (28.60%), girls: n = 25 (71.40%) ((χ2(1) = 10.643 p < .001 ϕ = .452). Multiple mediation analyses resulted in a moderated mediation model in which the relationship between symptoms of ADHD and the prevalence of current NSSI was fully mediated by the symptoms of comorbid conditions in both sex. Significant mediators were the symptoms of affective and psychotic disorders and suicidality in both sexes and the symptoms of alcohol abuse/dependence disorders in girls.ConclusionsADHD symptoms are associated with an increased risk of NSSI in adolescents, especially in the case of girls. Our findings suggest that clinicians should routinely screen for the symptoms of ADHD and comorbidity, with a special focus on the symptoms of affective disorders and alcohol abuse/dependence psychotic symptoms to prevent NSSI.

Reading Disability Spectrum: Early and Late Recognition, Subthreshold, and Full Comorbidity

Several studies have reported high comorbidity for reading disability (RD) and psychiatric disorders. The aim of this study was to investigate the comorbidity of subthreshold and full psychiatric disorders with RD while comparing subgroups based on age of RD recognition (early vs. late). We analyzed data from 130 children with RD and 82 typically developing children aged 7 to 18 years. RD was assessed with the Dyslexia Differential Diagnosis Maastricht-Hungarian Standard Test. Psychiatric diagnoses were based on the Mini International Neuropsychiatric Interview Kid. Chi-square tests were used for group comparisons of the prevalence of subthreshold and full disorders. A higher proportion of children in the RD group were assessed as having internalizing or externalizing disorders. When subthreshold and full diagnoses were considered together, the prevalence of internalizing but not externalizing pathology was higher in the RD group than the control group. The prevalence of internalizing pathology was similar in the early and late RD subgroups, but externalizing pathology was more common in the late RD subgroup. When subthreshold and full diagnoses were considered together, mood disorder and externalizing pathology were more prevalent in the late RD subgroup than the early RD subgroup. This study demonstrated that early recognition of RD may play a role in determining comorbid psychopathology and should therefore be an educational and clinical priority. Clinicians should routinely screen children with RD for comorbid disorders, including subthreshold pathology.

Dyskinesia in Treatment-Naive and Stimulant-Treated Children With ADHD

Objective: Stimulants are safe and effective medications for the treatment of ADHD. There are a number of case studies that report stimulant-induced dyskinesia. The aim of this study was to compare dyskinesia in a treated and a treatment-naive group of children with ADHD, and a healthy control group. Method: Children aged 6 to 18 years were involved in the study (n = 158). Diagnosis of ADHD was measured with the Mini International Neuropsychiatric Interview Kid (MINI Kid). Dyskinesia was assessed with the Abnormal Involuntary Movement Scale (AIMS). Results: Before methylphenidate administration, the treated ADHD group showed significantly higher AIMS total score than the control group (p = .001) and the treatment-naive ADHD group (p < .001). We found the same pattern 1.5 hr after methylphenidate administration. Conclusion: These results call attention that clinicians should take special care for the possible development of dyskinesia during the treatment of their ADHD patients with methylphenidate.

Suttur study: An epidemiological study of psychiatric disorders in south Indian rural population.

Background:Based on review of literature World Health Organization (WHO) Global Burden of Disease Study has estimated that psychiatric disorders are among the most burdensome, around the globe and has suggested general population surveys for future research. This study aims to estimate the prevalence of psychiatric disorders and study their association with various socioeconomic variables.Materials and Methods:This was an exploratory study where a door-to-door survey of the entire population residing in a South Indian village was done (n = 3033). Mini international neuropsychiatric interview kid (MINI) or MINI plus were administered to all the subjects according to the age group.Results:It was found that 24.40% of the subjects were suffering from one or more diagnosable psychiatric disorder. Prevalence of depressive disorders was found to be 14.82% and of anxiety disorders was 4%. Alcohol dependence syndrome was diagnosed in 3.95% of the population. Prevalence of dementia in subjects above 60 years was found to be 10%.Conclusion:Our study is among the very few epidemiological studies with respect to methodological design which does not use screening questionnaires and evaluates each subject with detailed administration of MINI. It concluded that one among four were suffering from a psychiatric disorder. Improving the training of undergraduate medical and nursing students is likely to play a significant role in addressing the increasing psychiatric morbidities.

Association among depressive disorder, adjustment disorder, sleep disturbance, and suicidal ideation in Taiwanese adolescent

The aim of this study is to investigate the association among depressive disorder, adjustment disorder, sleep disturbance, and suicidal ideation in Taiwanese adolescent. We recruited 607 students (grades 5-9) to fill out the investigation of basic data and sleep disturbance. Psychiatrists then used the Mini International Neuropsychiatric Interview-Kid to interview these students to assess their suicidal ideation and psychiatric diagnosis. Multiple logistic regression with forward conditionals was used to find the risk factors for multivariate analysis. Female, age, depressive disorder, adjustment disorder, and poor sleep all contributed to adolescent suicidal ideation in univariate analysis. However, poor sleep became non-significant under the control of depressive disorder and adjustment disorder. We found that both depressive disorder and adjustment disorder play important roles in sleep and adolescent suicidal ideation. After controlling both depressive disorder and adjustment disorder, sleep disturbance was no longer a risk of adolescent suicidal ideation. We also confirm the indirect influence of sleep on suicidal ideation in adolescent.

Why are children and adolescents referred for psychiatric assessment without fulfiling diagnostic criteria for any psychiatric disorder?

Clinicians often experience that children are referred for psychiatric evaluation without fulfiling the diagnostic criteria of any psychiatric disorders. This study investigates factors that might lead children to psychiatric referral without any psychiatric disorder. Children/adolescents who were referred for psychiatric assessment (referred group) (n=418, mean age=10.82years, SD=3.81) and a control group (n=48, mean age=10.38years, SD=3.77) were evaluated by the Mini International Neuropsychiatric Interview Kid (MINI Kid) and the Erfassung der Lebensqualität Kindern und Jugendlichen (Measure of Quality of Life for Children and Adolescents). The referred group was further divided into two subgroups: referred subgroup without MINI Kid diagnosis (n=61) and referred subgroup with MINI Kid diagnosis (n=357). Subjects less than 18years old were included and there was no lower age limit. Attention-deficit/hyperactivity disorder (ADHD) symptoms significantly increased the odds for referral as social phobia symptoms significantly decreased the odds for psychiatric referral. Regarding quality of life (QoL), the control group showed significantly less impairment when compared with the referred group; the two referred subgroup with and without diagnosis did not differ significantly. ADHD symptoms, even in a subthreshold level and impaired QoL represent risk factors for psychiatric referral in children. Secondary prevention of children should target to screen subthreshold ADHD symptoms and QoL.

Attention-deficit hyperactivity disorder and suicidality in a treatment naïve sample of children and adolescents

BackgroundThe aim of the present study was to investigate the possible association between attention-deficit/hyperactivity disorder (ADHD) and suicidality. MethodsUsing a structured interview (Mini International Neuropsychiatric Interview Kid), the authors examined 418 treatment naïve children/adolescents (aged: 3–18 years). Suicidality was defined by the M.I.N.I. Kid as having any current suicidal ideations and/or suicide attempts. ResultsTwo hundred and eleven children/adolescents fulfilled the DSM-IV diagnosis of ADHD and a further 105 showed symptoms of ADHD in subthreshold level. Multiple mediation analyses resulted in a moderated meditational model in which the relationship between symptoms of ADHD and current suicidality was fully mediated by the symptoms of comorbid conditions, but this was moderated by age. In children under 12 years, significant mediators were the symptoms of specific anxiety disorders, while in the adolescent group symptoms of major depressive episode and dysthymia and symptoms of substance abuse/dependence approved as significant mediators. LimitationsAs the study was cross-sectional, it did not reveal any causal relationship among the investigated factors. Furthermore, as the study population included a treatment naïve clinical sample, we can assume that adolescents, who and/or whose family seek for help at the first time in this age belonged to the less sever end of the spectrum. ConclusionsADHD symptoms are associated with an increased risk of suicidality in treatment naïve children/adolescents. The mechanisms of this relationship can be understood only when developmental factors are considered. Our findings suggest that clinicians should screen suicidality and comorbid symptoms routinely in patients with ADHD.

DRD4 gene and obsessive compulsive disorder: Do symptom dimensions have specific genetic correlates?

The dopamine D4 receptor (DRD4) is a promising candidate gene in obsessive compulsive disorder (OCD). A 48-bp variable number of tandem repeats (VNTR) sequence in exon 3 has been studied previously, and alleles containing 2-11 repeats (2R-11R) have been identified. We investigated the association of DRD4 VNTR polymorphism with OCD and its relationship with various clinical parameters (age of onset, gender, family history, co-morbidity, factor-analyzed symptom dimensions and insight). One hundred and seventy three South Indian OCD patients (DSM-IV) recruited from a specialty OCD clinic were evaluated using the Yale-Brown obsessive compulsive scale (YBOCS), YBOCS item-11 for insight, Mini International Neuropsychiatric Interview (MINI) plus, tic disorder subsection of the MINI-KID and Clinical Global Impression scale. 201 healthy controls were evaluated using MINI plus. All subjects were genotyped for the DRD4 VNTR polymorphism. Genotype frequencies did not deviate significantly from the Hardy-Weinberg equilibrium. Case-control association analysis revealed that the 7R allele frequency was significantly greater in OCD patients than controls. This difference was restricted to the women subsample when performing the gender sub-analysis. Among other clinical variables examined, factor 3 (symmetry) was associated with presence of 2R allele. Linear regression analysis confirmed the association of symmetry dimension with the 2R allele (Beta=0.23, t=2.96, p=0.004, CI=0.19-0.95). Our data provides further evidence that DRD4 VNTR polymorphism is associated with OCD. Furthermore, the presence of the 2R allele was significantly associated with the symmetry dimension. This dimension may represent a more homogeneous subtype of OCD with a genetic etiology.

The development of a screening test for suicide risk in 10-to-15- year-old school children: a tool for people-centered public health

Objective: We aimed to develop a Screening Test for Suicide Risk (STSR) in 10-15-year-old school children as a tool for people-centered public health.Methods: 607 students filled out the Taiwanese Depression Questionnaire (TDQ) for assessing suicide risk and multiple logistic regression analysis was used to extract items in the STSR. Psychiatrists then used the Mini-International Neuropsychiatric Interview-Kid to verify the validity of the STSR.Results: Prevalence of positive risk for these students was 17.8%. Five items were extracted for the STSR: “I felt like crying”, “I felt blue and depressed”, “I had trouble sleeping”, “I felt upset” and “I felt miserable and even wanted to die”. Any three of the five yielded the best-balanced algorithm with sensitivity of 70.4%, specificity of 66.8%, positive predictive value of 31.5% and negative predictive value of 91.3%.Conclusion: We extracted five items from the TDQ to create the STSR, which is a rapid screening test for screening suicide risk by 10-to-15-year-old school children. It is a practical and reliable tool in a school-based practice for the preliminary screening of potentially suicidal adolescents.