Child Psychiatric Diagnoses Research Articles

Bir Üniversite Hastanesi Çocuk ve Ergen Ruh Sağlığı Adli Kuruluna Cinsel İstismar Nedeniyle Başvuran Olguların Değerlendirilmesi

Objective: The aim of this study was to examine the sociodemographic characteristics, psychiatric diagnoses and factors associated with psychiatric diagnoses of children and adolescents who are victims of sexual abuse. Method: The files of 92 children and adolescents aged between 0-18 who were referred to University Hospital Child and Adolescent Psychiatry Forensic Policlinic between January 2017 and December 2019 due to sexual abuse were evaluated retrospectively. Psychiatric diagnoses of the cases were made according to DSM 5 diagnostic criteria. Intellectual capacity of the cases was evaluated according to the latest verison of Wechsler Intelligence Scale for Children. Results: In our study, 78 (84.8%) cases were female and 14 (15.2%) were male. Mean age of the cases was 14.1±3.88 years. The most common type of sexual abuse was touching (52.2%, n=48). There was a psychiatric diagnose in 50 (54.3%) of them. The most common psychiatric diagnoses were posttraumatic stress disorder (n=29, 31.5%) and major depressive disorder (n=25, 27.2%). The rate of psychiatric diagnosis was significantly higher in cases exposed to coercion and violence (p=0.032). In 32 cases (34.8%), it was determined that the abuser was within the family. Conclusion: Sexual abuse has an effect on child’s development throughout life.In our study, the rate of psychiatric diagnosis was high. It is very important to provide the necessary psychiatric support to the victims of sexual abuse. With the studies to be done in this area, awareness can be increased and necessary precautions can be taken.

The Burden of Psychiatric Disorders Associated With Orofacial Cleft Pathology Among Children in Ontario, Canada

Background: Individuals with orofacial cleft (OFC) may be at higher risk of developing psychiatric disorders(PD). We determined the risk of psychiatric diagnoses in children with OFC in Canada. Methods: This population-based retrospective cohort study used health administrative data from the province of Ontario, Canada. Children with OFC who were born from April 1, 1994 to March 31, 2017 in Ontario were each matched to five non-OFC children based on sex, date of birth and mother’s age. We determined rate of events and time-to-event for first diagnosis of PD in children aged ≥3 years(y), and for intellectual developmental delay (IDD) from birth. Risk factors for PD and IDD were assessed using 1-way ANOVA for means, Kruskal-Wallis for medians, χ 2 test for categorical variables. Outcomes: There were 3,051 children with OFC (matched to 15,255 controls), of whom 2,515 OFC patients had complete follow-up to the third birthday (matched to 12,575 controls). The mean age to first PD diagnosis was 8.6±4.2y for OFC patients; the cleft palate group had a higher risk (HR 1.33, 95% CI 1.18-1.49). The OFC patients had a higher risk of IDD diagnosis (HR 8.08, 95% CI 7.28-8.97, p<001), especially those with other congenital malformations (HR 4.57, 95% CI 3.95-5.28 p<0.001). Geography (place of living) was a significant risk factor for PD and IDD. Interpretation: Children born with OFC in Ontario had a higher risk of psychiatric diagnosis and IDD compared to controls. Further research is required to better understand the cause of geographical variation and identify potential areas for intervention. Funding: Claudia Malic was supported by the ICES Faculty Scholars Program. Eric Benchimol was supported by a New Investigator Award from the Canadian Institutes of Health Research, Canadian Association of Gastroenterology, and Crohn’s and Colitis Canada. He was also supported by the Career Enhancement Program of the Canadian Child Health Clinician Scientist Program. Conflict of Interest: Simone Vigod reports royalties from UpToDate Inc for authorship of chapters related to depression and pregnancy. The remaining authors have no conflicts of interest to disclose. Ethical Approval: The Research Ethics Board of the Children’s Hospital of Eastern Ontario approved this study and informed consent was not required as per Ontario privacy law.

Cooperation between child and adolescent psychiatry and youth welfare concerning socio-educational residence for children and adolescents

Kinder- und Jugendpsychiatrie und Kinder- und Jugendhilfe betreuen viele gemeinsame Kinder und Jugendliche. Insbesondere bei den schwierigsten Kindern und Jugendlichen ist eine Kooperation am meisten gefordert. Viele dieser schwierigen Kinder und Jugendlichen kommen aus schwierigen Lebensverhältnissen, sind häufig traumatisiert und zeigen stark externalisierendes Verhalten. Die Unterbringung in einer extrafamilialen Wohnform stellt die Beteiligten aller Systeme häufig vor große Probleme.Die Kinder- und Jugendpsychiatrie kann auf allen Ebenen wertvolle Beiträge leisten. Einerseits im Rahmen der spezifischen Kinder- und Jugendpsychiatrischen Diagnostik und Behandlung, ganz besonders im Konsiliar- und Liäsondienst und/oder in kooperativen Einrichtungen oder Betreuungsformaten. Dieses Angebot wird anhand der von der Kinder- und Jugendhilfe angebotenen Wohnformen diskutiert und konkrete Vorschläge zur Umsetzung diese Kooperation dargestellt.

Measurement-Based Care in the Treatment of Attention-Deficit/Hyperactivity Disorder and Disruptive Behavior Disorders.

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common childhood psychiatric diagnoses. The core symptoms of ADHD include inattention, impulsivity, and hyperactivity. ADHD entails impairments that have extensive and profound detrimental effects on many critical developmental areas. As a valid neurobiologic condition that causes significant impairments in those affected, it is one of the best-researched disorders in medicine. Measurement-based care in treatment of ADHD is critical in establishing a diagnosis, determining a treatment target, and assessing treatment response. This article highlights the rationale for measurement-based care in ADHD, how to implement measurement-based care in clinical practice, and common challenges encountered.

Risk of psychiatric diagnoses in children and adolescents of parents with torture trauma and war trauma

Evidence point to intergenerational effects of trauma in refugee populations. This study estimates the risk of psychiatric diagnoses in children of severely traumatized refugees. The unique clinical sample consisted of refugee parents treated for torture trauma and war trauma, and outcomes were investigated using population-level data. A nationwide register study, following all children residing in Denmark. The exposure was parental torture trauma and war trauma, and outcomes were any psychiatric disorder, mood, neurotic, behavioural and emotional disorders and disorders of psychological development. Children's hazard of being diagnosed was estimated using Cox proportional hazards regression. Study participants were followed from the date of birth or immigration to their 18th birthday. The cohort included 3346993 children of which 19294 were identified as offspring to traumatized refugees. During the study period, 205610 children were diagnosed with a psychiatric disorder. Children with parents from the Middle East and Northern Africa had a hazard ratio of 0.78 (95% CI: 0.72, 0.84) for those treated for parental trauma and 0.79 (95% CI: 0.76, 0.81) for those not treated compared with children of non-traumatized Danish-born parents. For children of parents from former Yugoslavia, the corresponding estimates were 0.69 (95% CI: 0.58, 0.81) and 0.69 (95% CI: 0.65, 0.73). The results suggest that children of parents with and without registered torture trauma and war trauma have a lower risk of being diagnosed with a psychiatric disorder compared to children of Danish-born parents. These findings contradict research done on the transmission of trauma but supports evidence suggesting mental health services underutilization by refugee and ethnic minority populations.

Anxiety disorders in children with high intellectual potential.

Several studies have reported anxiety disorders in children with high intellectual potential (HIP). However, there are discrepant results possibly as a result of methodological biases (different/absent definitions of HIP, small sample sizes, non-validated/adapted/specific tools for assessing anxiety and a single observational source). To examine more thoroughly the relationships between HIP and anxiety in large samples of children using clear definitions of HIP, different observational sources and specific assessments of anxiety. Children with HIP (n = 211, total IQ ≥130) were compared with children without HIP (n = 397, total IQ <130) for anxiety using different observational sources (child psychiatric diagnosis, parental evaluation and child's self-evaluation). Intellectual functioning was assessed using the Wechsler Intelligence Scale. There were significantly more children with HIP who had anxiety disorders than children without HIP based on the child psychiatric diagnosis. Moreover, based on the child's self-evaluation, children with a high Verbal Comprehension Index (VCI ≥130) were significantly more anxious than children with a VCI <130, whereas children with a high Perceptual Reasoning Index (PRI ≥130) were significantly less anxious than children with a PRI <130. Finally, there was no significant relationship between levels of intellectual functioning and anxiety according to parental observation. The results highlight the importance of using multiple observational sources and conducting analyses on different dimensions of intellectual functioning (such as VCI and PRI), rather than only on the composite total IQ score. High verbal potential might be a factor of vulnerability for anxiety, whereas high perceptual reasoning might be a protective factor. Further studies are necessary to understand better the mechanisms underlying these results.

Effect of Predeployment Psychiatric Diagnoses on Postdeployment Long-Term Sickness Absence and Mental Health Problems Among Danish Military Personnel.

Military personnel may withhold information on mental health problems (MHPs) for fear of not being permitted to deploy. Past or current MHPs may, however, increase the risk of postdeployment MHPs. Using psychiatric diagnoses rather than self‐report assessments in predeployment screening may be a more effective screening strategy for determining deployment fitness. This retrospective follow‐up study investigated (a) the extent to which predeployment childhood and adult psychiatric diagnoses predicted postdeployment MHPs, measured as psychiatric diagnosis and the purchase of psychiatric drugs, and long‐term sickness absence among formerly deployed Danish military personnel and (b) whether perceived combat exposure moderated or mediated the effect of predeployment psychiatric diagnoses. Complete data were available for 7,514 Danish military personnel who answered questions on perceived combat exposure between 6–8 months after returning from their first deployment to the Balkans, Iraq, or Afghanistan. Data on all psychiatric diagnoses given at Danish hospitals, all medicine purchases, and all sickness absences were retrieved from nationwide research registers. Personnel with predeployment psychiatric diagnoses had a statistically significant higher risk for both postdeployment long‐term sickness absence, hazard ratio (HR) = 2.06, 95% CI [1.52, 2.80]; and postdeployment MHPs, HR = 2.38, 95% CI [1.73, 3.27], than personnel without a predeployment psychiatric diagnosis. Personnel with a predeployment psychiatric diagnosis demonstrated a higher risk of reporting high levels of perceived combat exposure. Perceived combat exposure was not found to moderate or mediate the effect of a predeployment psychiatric diagnosis on the two outcomes. Additional findings, limitations, and implications are discussed.

Psychiatric comorbidity in children with psychogenic and functional breathing disorders.

The present study aims to assess psychiatric diagnoses in children with psychogenic and functional breathing disorders (PFBD), which consist of children with psychogenic cough, throat-clearing tics, and sighing dyspnea, and compare them to a control group without any diagnosis of chronic medical problems. The participants consist of 52 children with PFBD and 42 children without any chronic medical problems. Psychiatric diagnoses were assessed via semistructured psychiatric interviews in both groups. The two groups did not differ on age (PFBD group 11.25 ± 2.61, control group 11.17 ± 2.58; t = 0.14, P = .88) or sex (48.1% of the PFBD group were female, 61.9% of the control group were female; χ2 = 1.79, P = .18). 55.8% of the PFBD group and 28.6% of the control group had at least one psychiatric diagnosis according to the semistructured interviews (χ2 = 6.99, P = .008). The most common psychiatric diagnoses in the PFBD group were attention deficit hyperactivity disorder (ADHD; 17.3%), tic disorders, (15.4%), and specific phobia (15.4%). 11.5% of the cases in the PFBD group were diagnosed with somatic symptom disorder and more than half of the patients (n = 27 (51.9%)) showed clinical characteristics of tic disorders. Psychiatric diagnoses are common in children with PFBD, and teamwork involving child psychiatrists may be essential for the management of children with PFBD.

Association of Parental Incarceration With Psychiatric and Functional Outcomes of Young Adults

In 2016, an estimated 8% of US children younger than 18 years had experienced the incarceration of a parent, and rates were substantially higher among children from racial and ethnic minority backgrounds and disadvantaged groups. Little is known about whether parental incarceration during childhood is associated with adult psychiatric problems and functional outcomes. To examine whether parental incarceration is associated with increased levels of psychiatric diagnosis and poor outcomes in health, legal, financial, and social domains in adulthood. This cohort study used data from the community-representative, prospective, longitudinal Great Smoky Mountains Study. Children and their parents were interviewed up to 8 times from January 1993 to December 2000 (ages 9-16 years; 6674 observations of 1420 participants) using the Child and Adolescent Psychiatric Assessment, which assessed parental incarceration, childhood psychiatric diagnoses, and other adversities. Young adults were followed up at ages 19, 21, 25, and 30 years from January 1999 to December 2015 (4556 observations of 1334 participants) to assess psychiatric diagnoses and functional outcomes indicative of a disrupted transition to adulthood. Data analysis was conducted from June 2018 to June 2019. By age 16 years, 475 participants (weighted percentage, 23.9%) had a parental figure who had been incarcerated, including 259 young men (22.2%) and 216 young women (25.5%). Parental incarceration was associated with higher prevalence of childhood psychiatric diagnoses (eg, any depressive diagnosis: adjusted odds ratio [aOR], 2.5; 95% CI, 1.3-4.6; P = .006; attention-deficit/hyperactivity disorder: aOR, 2.3; 95% CI, 1.0-5.5; P = .06; and conduct disorder: aOR, 2.5; 95% CI, 1.4-4.3; P = .001). After accounting for childhood psychiatric diagnoses and adversity exposure, parental incarceration remained associated with increased odds of having an adult anxiety disorder (aOR, 1.7; 95% CI, 1.0-3.0; P = .04), having an illicit drug use disorder (aOR, 6.6; 95% CI, 2.6-17.0; P < .001), having a felony charge (aOR, 3.4; 95% CI, 1.8-6.5; P < .001), incarceration (aOR, 2.8; 95% CI, 1.4-5.4; P = .003), not completing high school (aOR, 4.4; 95% CI, 2.2-8.8; P < .001), early parenthood (aOR, 1.7; 95% CI, 1.0-3.0; P = .04), and being socially isolated (aOR, 2.2; 95% CI, 1.2-4.0; P = .009). This study suggests that parental incarceration is associated with a broad range of psychiatric, legal, financial, and social outcomes during young adulthood. Parental incarceration is a common experience that may perpetuate disadvantage from generation to generation.

Effects of Parental Opioid Use

Opioid use is a significant national crisis impacting individuals struggling with addiction and their families. The majority of individuals who abuse opioids are of child-rearing age, and critical knowledge gaps remain regarding how this abuse impacts their offspring. Fortunately, treatment for opioid use disorders is available. The primary goal of this study was to evaluate both physical and psychiatric diagnoses of children who have at least 1 parent participating in a buprenorphine-assisted treatment program. This retrospective study is based on chart review (January 1, 2010, through June 30, 2018). Children with parents receiving care in a buprenorphine clinic were identified and matched on sex, race, and age in a ratio of 1:5 with controls from the general pediatric clinic population. Data related to health outcomes were extracted from the medical records. Compared to controls (n = 120), children of parents receiving buprenorphine-assisted treatment (n = 24) were more likely to have been born premature (odds ratio [OR] = 3.3, P = .035), had jaundice after birth (OR = 2.7, P = .034), had enuresis/encopresis (P < .001), and had been the victims of abuse or neglect (OR = 19.7, P = .0005). Children of parents with opioid use disorders were also more likely to utilize emergency services (ie, being seen in the emergency department for fussiness; OR = 4.0, P = .046) and were less likely to be covered by private insurance compared to state-funded insurance (OR = 0.2, P = .0013). Parental opioid use disorder impacts children. More research is needed to better describe long-term effects of treatment of parental opioid use on their offspring and to help design addiction treatment programs to support whole family units.

Toward an Empirically Based Developmental Trauma Disorder Diagnosis for Children: Factor Structure, Item Characteristics, Reliability, and Validity of the Developmental Trauma Disorder Semi-Structured Interview.

Developmental trauma disorder (DTD) is an integrative syndrome for assessing the biopsychosocial sequelae of early life traumatization and attachment disruption. The psychometrics of a DTD Semi-Structured Interview (DTD-SI) and the validity and structure of the DTD construct were tested. The DTD-SI was administered by research clinicians at 5 sites between September 2011 and August 2013 to a convenience sample of 236 children ages 7-17 years (50% female, 47% black or Latino/Hispanic, 91% with trauma histories) and/or a parent, recruited in pediatric or mental health services. Validity data were obtained from structured interviews for traumatic stressor and attachment disruption history (Traumatic Events Screening Instrument), DSM-IV disorders (Kiddie Schedule for Affective Disorders and Schizophrenia, Present/Lifetime Version), and potential alternative DSM-5 disorders; parent ratings on the Child Behavior Checklist; and child self-report on measures of emotion dysregulation and quality of life. Statistical analyses confirmed (a) the DTD-SI's item-level temporal and interrater reliability, informativeness, and absence (with 1 exception) of demographic bias and (b) DTD construct factor structure, unidimensionality, and convergent and discriminant validity. The DTD-SI yielded reliable, structurally meaningful, and valid item- and criterion-level data for the proposed DTD syndrome. Further clinical and scientific investigation of the clinical utility of DTD as a childhood psychiatric syndrome and diagnosis is warranted.

Pediatric patients with psoriasis and psychiatric disorders: premorbidity and comorbidity in a case-control study

Background: Psychiatric disorders are thought to play an important role in the onset, exacerbation and course of several chronic dermatological diseases. We aimed to investigate psychiatric diagnoses in children with psoriasis before and during the disease and to examine potentially related factors.Methods: A total of 108 children aged 8–16 years, 54 with a diagnosis of psoriasis and 54 healthy individuals, were included in the study. Participants were evaluated using The Kiddie Schedule for Affective Disorders and Schizophrenia, Present and Lifetime Version (K-SADS PL), Children’s Dermatology Life Quality Index (CDLQI), Screen for Child Anxiety Related Emotional Disorders (SCARED) and Children's Depression Inventory (CDI), and the results were compared using statistical techniques.Results: At least one psychiatric diagnosis was present in 70.3% of children with psoriasis and in 27.7% of the control group, the difference being significant (p = .0001). It was seen that 73.6% of children with a psychiatric diagnosis were psychiatric diagnoses in the premorbid period. Children with psoriasis were determined to have 9.21-fold greater risk of anxiety (p = .0001) and a 6.65-fold greater risk of depression (p = .0019) compared with the control group.Conclusions: A statistically significant increase in psychiatric disorders occurs in disease periods in cases of pediatric psoriasis. Moreover, a high prevalence of psychiatric disorders was detected in the premorbid process. We think that it is important for these to be considered in the management of the disease and in controlling exacerbation, and for the mechanisms involved to be elucidated.

O12.5. GENETIC AND ENVIRONMENTAL PREDICTORS OF MAIN OUTCOMES IN THE DANISH HIGH RISK AND RESILIENCE STUDY - VIA 7. A STUDY OF 522 7-YEAR-OLD CHILDREN OF PARENTS WITH SCHIZOPHRENIA, BIPOLAR DISORDER OR NEITHER OF THESE DISORDERS

BackgroundStudies of children born to parents with schizophrenia and affective disorders can allow us to study the processes preceding the manifestation of the disease, and thereby provide a possibility for identifying early amendable risk factors such as poor parenting, deviances in cognitive functioning, and early, subtle signs of psychopathology at a point where preventive intervention can be applied.MethodsThe Danish High Risk and Resilience Study - VIA7 is a representative nationwide cohort study of 522 7-year-old children of parents with schizophrenia, bipolar disorder or neither of these disorders recruited during 2013–2015. The sample consists of: 202 children with a parent diagnosed with schizophrenia spectrum psychosis, 120 children with a parent diagnosed with bipolar disorder, and 200 children with neither of the parents treated in mental health services for the above diagnoses.We have collected blood and saliva samples from the children and their parents and polygenic risk scores were calculated. We have thoroughly assessed the home environment with the instrument HOME. We have assessed main outcomes such as psychopathology, PLIKS, neurocognition and social cognition.We will analyse the influence of genetic and environmental exposures and their interaction.ResultsGenerally, the children with a familial risk of schizophrenia had lower neurocognitive, social cognitive and neuromotor functioning, more child psychiatric diagnoses, and more severe symptoms compared to control children. In most comparisons, children of parents with bipolar disorder were not different from controls, but in some tests they performed poorer or had more symptoms compared to than control children.We will present data on genetic and environmental risk factors for these outcomesDiscussionThis is the largest high-risk study ever conducted. It is unique that we have access to detailed phenotyping and extensive information on environmental and genetic risk factors. Studies like this can inform about patogenesis and possibilities for future preventive interventions

O12.7. RISK OF PSYCHOSIS IN OFFSPRING OF PARENTS WITH A HISTORY OF HOMELESSNESS DURING CHILDHOOD AND ADOLESCENCE: A NATIONWIDE, REGISTER-BASED, COHORT STUDY

BackgroundChildren and adolescents with deprived backgrounds have high rates of psychiatric problems. Parental and social factors are regarded crucial for children’s healthy and positive development but whether children’s risk of psychosis in an early age is associated with parental social marginalisation is unknown. We aimed to analyse the association between mothers’ and fathers’ history of homelessness and the offspring’s risk of psychiatric disorders during childhood and adolescence with attention to the specific child and adolescent psychiatric diagnosis: psychosis, as well as to the combined effect of mother’s and father’s schizophrenia and bipolar disorder and homelessness experiences according to the child’s risk of any psychiatric disorder.MethodsWe conducted a nationwide, register-based cohort study of 1,072,882 children aged 0−16 years living or being born in Denmark between Jan 1, 1999 and Dec 31, 2015. Parental homelessness was the primary exposure and offspring’s risk of psychosis and other psychiatric disorders the outcome. We analysed the association by survival analysis using Poisson regression and incidence rate ratios (IRRs), adjusted for year and offspring characteristics, and additionally adjusted for parental factors (age at offspring’s birth and parental psychiatric disorders).ResultsIn total, 17,238 (2%) offspring had either one or two parents with a history of homelessness, and 56330 (5%) offspring were diagnosed with any psychiatric diagnosis during the study period. Of these, 850 (1.5%) had a diagnosis of psychosis before their 16th birthday. The incidence rate of any psychiatric disorder was 28.2 cases per 1000 person-years (20.7–38.4) in offspring with at least one parent with a history of homelessness and a mother with a schizophrenia or bipolar disorder, compared with 18.3 cases per 1000 person-years (16.8–20.0) in those whose parents had no history of homelessness.The IRR of psychosis in offspring born to a mother with a history of homelessness was 3.1 (95% CI 1.9–5.0) compared with those whose parents had no history of homelessness. A similar risk was found if both parents had a history of homelessness (IRR 5.4, 95% CI 2.7-1.9), whereas no association was found when only the father had experiences of homelessness. Also after full adjustment including parental psychiatric disorders, an increased risk of psychosis was found in offspring if the mother (IRR 1.8, 95% CI 1.1–3.0) or both parents (IRR 2.9, 95% CI 1.4–5.9) had a history of homelessness. Highest risk was found for attachment disorder when both parents had a history of homelessness (IRR 32.5, 95% CI 24.6−42.9) and substance use disorder when only the mother experienced homelessness (6.9, 95% CI 4.9−9.7). In offspring whose mother had a history of homelessness and a psychiatric disorder, 36% (95% CI 27%−45%) had received a psychiatric diagnosis themselves by the age of 15. If the mother or father had a schizophrenia or bipolar disorder, homelessness experiences did not add further to the increased risk of any psychiatric disorder in offspring.DiscussionParental homelessness was strongly associated with an increased risk of psychosis and several other severe psychiatric disorders in offspring during childhood and adolescence. These findings have important implications for public health and policy because they suggest a need for improvement in the support of socially marginalised families to help prevent psychiatric illness in offspring. However, our findings also suggested that the risk of any psychiatric disorder in offspring associated with parental homelessness depended on the parental psychiatric diagnoses.

Delineating the psychiatric and behavioral phenotype of recurrent 2q13 deletions and duplications.

Recurrent deletions and duplications at the 2q13 locus have been associated with developmental delay (DD) and dysmorphisms. We aimed to undertake detailed clinical characterization of individuals with 2q13 copy number variations (CNVs), with a focus on behavioral and psychiatric phenotypes. Participants were recruited via the Unique chromosomal disorder support group, U.K. National Health Service Regional Genetics Centres, and the DatabasE of genomiC varIation and Phenotype in Humans using Ensembl Resources (DECIPHER) database. A review of published 2q13 patient case reports was undertaken to enable combined phenotypic analysis. We present a new case series of 2q13 CNV carriers (21 deletion, 4 duplication) and the largest ever combined analysis with data from published studies, making a total of 54 deletion and 23 duplication carriers. DD/intellectual disabilities was identified in the majority of carriers (79% deletion, 70% duplication), although in the new cases 52% had an IQ in the borderline or normal range. Despite the median age of the new cases being only 9 years, 64% had a clinical psychiatric diagnosis. Combined analysis found attention deficit hyperactivity disorder (ADHD) to be the most frequent diagnosis (48% deletion, 60% duplication), followed by autism spectrum disorders (33% deletion, 17% duplication). Aggressive (33%) and self‐injurious behaviors (33%) were also identified in the new cases. CNVs at 2q13 are typically associated with DD with mildly impaired intelligence, and a high rate of childhood psychiatric diagnoses—particularly ADHD. We have further characterized the clinical phenotype related to imbalances of the 2q13 region and identified it as a region of interest for the neurobiological investigation of ADHD.

The prevalence of traumatic brain injury, comorbid anxiety and other psychiatric disorders in an outpatient child and adolescent mental health service

Background: A history of traumatic brain injury (TBI) is prevalent in children and adolescents within the health system, which may be accompanied with higher rates of poor mental health outcomes including anxiety and other psychiatric disorders.Aims: To explore rates of TBI and associated anxiety and other psychiatric diagnoses in children and adolescents aged 5–18 years within the mental health system.Methods: Participants were recruited from an outpatient mental health service in Canterbury, New Zealand. The Ohio State University TBI Identification method was utilised to ascertain TBI history. Anxiety and other diagnoses were identified by a mental health file review.Results: Over 28% of children in this study reported a history of TBI, the majority of which were mild. Review of mental health files revealed no significant differences between participants with and without TBI for anxiety and psychiatric diagnoses.Conclusions: A proportionately high number of children and adolescents within the mental health system reported a previous TBI. However, anxiety and other psychiatric problems were not over-represented in this group. Further research is essential for examining the characteristics of children and adolescents with TBI within the mental health system, particularly those with more severe injuries, who may present a subgroup.

Antidepressant use during pregnancy and psychiatric disorders in offspring: Danish nationwide register based cohort study

Objective To investigate the association between in utero exposure to antidepressants and risk of psychiatric disorders.Design Population based cohort study.Setting Danish national registers.Participants 905 383 liveborn singletons born during 1998-2012...

Social selection in cohort studies and later representation of childhood psychiatric diagnoses: The Danish National Birth Cohort.

Aim: This study aimed to estimate the relative representation of childhood psychiatric diagnoses and use of psychotropic medication in the Danish National Birth Cohort (DNBC) compared to the general population. Methods: The general population was identified as all childbirths in Denmark during 1998-2002 (N=344,160). Linking the DNBC (N=91,442) and the general population to the Danish national health registries, all children were followed until they received an ICD-10 psychiatric diagnosis, had a prescription of psychotropic medication or to the end of follow-up in 2013. The prevalence ratios (PRs) with corresponding 95% confidence intervals (CI) were estimated for each psychiatric diagnosis and by sex. Age at first diagnosis presented as means were compared using the one-sample t-test. Results: In the DNBC, the selected childhood psychiatric diagnoses were underrepresented by 3% (PR=0.97, 95% CI 0.94-0.99), ranging from a 20% underrepresentation for schizophrenia (PR=0.80, 95% CI 0.59-1.09) to a 6% over-representation for anxiety disorder or obsessive-compulsive disorder (PR=1.06, 95% CI 0.97-1.17). The majority of the specific diagnoses were modestly underrepresented in the DNBC compared to the general population, while use of psychotropic medication had similar representation. Girls were generally more underrepresented than boys. Depression was on average diagnosed 0.4 years earlier in the DNBC than in the general population (p=0.023). Conclusions: These findings suggest that the social selection may influence the prevalence of diagnosed childhood psychiatric disorders in the DNBC.

Assessment of Physical Child Abuse Risk in Parents with Children Referred to Child and Adolescent Psychiatry

Given the vulnerability of the child psychiatric population, this study examined whether parenting a child referred to a child and adolescent psychiatry department leads to a higher risk of physical child abuse and if that risk is associated with a specific child psychopathology. The clinical sample consisted of caregivers with a six‐to‐11‐year‐old child who consulted child and adolescent psychiatry for a psychiatric assessment. The Dutch Child Abuse Potential Inventory (CAPI), socio‐demographic data and child psychiatric diagnosis were collected from 59 caregivers of 59 children. Ten per cent of the sample obtained an Abuse scale score indicative of a potential risk for physically maltreating their child. Compared to a non‐clinical sample, this study showed a two and a half times higher risk potential for physical child abuse in caregivers with children referred to child and adolescent psychiatry. The elevated risk was not associated with a specific child psychiatric diagnosis. The caregivers at risk were more unhappy and experienced more problems with their child, their family and with others. Results support the need for implementing a standard risk assessment for physical child abuse in a child psychiatric setting. Copyright © 2017 John Wiley &amp; Sons, Ltd.‘This study examined whether parenting a child referred to a child and adolescent psychiatry department leads to a higher risk of physical child abuse’Key Practitioner Messages Compared to a non‐clinical sample, there is a two and a half times higher risk potential for physical child abuse in caregivers with children with mental health problems examined with the self‐report screening questionnaire CAPI. Child psychopathology in general is associated with an elevated potential for physical child abuse; there is no correlation with a specific child psychiatric disorder. There is a need for implementing a standard risk assessment for child abuse in a clinical child psychiatric setting.

ADHD: a critical update for educational professionals

ABSTRACTA medical approach towards behavioural problems could make professionals without a medical background, like teachers and other educational professionals feel inapt. In this article, we raise six scientifically grounded considerations regarding ADHD, currently the most prevalent childhood psychiatric diagnosis. These “need to knows” show just how misguided and potentially stigmatizing current conceptualizations of unruly behaviour have become. Some examples are given of how teachers are misinformed, and alternative ways of reporting about neuropsychological research are suggested. A reinvigorated conceptual understanding of ADHD could help educational institutions to avoid the expensive outsourcing of behavioural problems that could also—and justifiably better—be framed as part of education’s primary mission of professionalized socialization.