Screen For Child Anxiety Related Emotional Disorders Research Articles

Association between vision-related quality of life and mental health status in myopia children using various optical correction aids

PurposeTo evaluate the relationship between vision-related quality of life and mental health in myopia children with various optical aids. MethodsThis cross-sectional study enrolled children aged 8–13 years, exhibiting myopia ranging from −4.50 to −0.75 D, and utilizing various optical aids for correction. Full ocular examinations and completion of two questionnaires were performed. Vision-related quality of life was evaluated using the Paediatric Refractive Error Profile (PREP), and mental health status was assessed utilising the Screen for Child Anxiety Related Emotional Disorders (SCARED). Univariate and multivariate analyses were conducted to evaluate the association between vision-related quality of life and mental health status. ResultsThe study sample comprised 209 children with corrected myopia using single vision spectacles (100 [47.8 %]), soft contact lenses (66 [31.6 %]), and orthokeratology lenses (43 [20.6 %]). The mean age was 10.31 ± 1.65 y, and males accounted for 50.7 % of the sample. The distribution of demographic characteristics showed no significant difference among all correction types, except that the myopia duration was longer for orthokeratology lens wearers than those using spectacles (P=0.03). Contact lens showed clear benefits in almost all dimensions of vision-related quality of life, especially in appearance, satisfaction, activity and peer perceptions dimensions. The prevalence of anxiety disorders among spectacle wearers was 25.0 %, the highest among all groups. For myopia children with optical corrections, not being in the top 30 percent of their class rank, reporting lower PREP scores on symptoms, handling and peer perceptions dimensions were related with a higher prevalence of anxiety disorders. ConclusionsLower vision-related quality of life was associated with worse mental health status of myopia children with optical corrections. Identifying this association is crucial for protecting the mental health of myopia children and enhancing corrective measures.

Factors associated with anxiety-related symptoms in children and adolescents during COVID-19 in Oman: a cross-sectional study.

Reports from different parts of the world suggest that the COVID-19 pandemic and the resultant lockdown and social distancing measures have heralded unprecedented mental health challenges among children and adolescents. To date, there is a dearth of studies emerging from the Arabian Gulf, where the majority of its population are children and adolescents. The study aims to examine the prevalence of anxiety-related symptoms and their covariates among children and adolescents in an Arabian Gulf country, Oman. This is a cross-sectional analytic study carried out over two weeks (1st to 15th of August 2020) during the COVID-19 pandemic across Oman. Parents were asked to complete the online survey, which consisted of the parent version of the Screen for Child Anxiety Related Emotional Disorders (SCARED) instrument and questions regarding basic socio-demographic information. Logistic regression was used to identify the contributing variables associated with anxiety-related symptoms. A total of 790 valid responses were received. Among the 790 children, 33.3% (n = 263) were diagnosed with anxiety-related symptoms by the SCARED instrument. Logistic regression analysis suggested that anxiety-related symptoms in children and adolescents were significantly associated with three demographic variables. The model shows that children with divorced or separated parents were 1.9 times more likely to have anxiety-related symptoms than children of married couples (OR = 1.93, p = 0.035). Children living in families with an income below USD 1000/month, were 1.8 times more likely to have anxiety-related symptoms than a family with an income of USD 4000/month (OR = 1.833, p = 0.018). Children in grades 3-6 were 1.8 times more likely to have anxiety-related symptoms than those in grades 1-2 (OR = 1.79, p = 0.024). Anxiety-related symptoms are common among Omani children and adolescents. They are more likely to be reported in middle scholastic grade levels and children from families with marital discord and low socioeconomic status. It is not clear whether the presently observed rates of anxiety exceed the prevalence that would have been observed prior to the COVID-19 pandemic. More studies are therefore warranted using children and adolescents' self-reported scales.

Effectiveness of cognitive-behavioral group play therapy on anxiety-based school refusal and behavioral problems in elementary school boys: a preliminary randomized controlled trial

This study aimed to examine the effectiveness of cognitive-behavioral group play therapy on anxiety-based school refusal and behavioral issues in elementary school boys. A randomized controlled trial design (pretest-posttest with a control group) was utilized. Thirty elementary school boys with school refusal issues were randomly assigned to intervention (n = 15) and control (n = 15) groups. The intervention group received ten sessions of cognitive-behavioral group play therapy. The Screen for Child Anxiety-Related Emotional Disorders (SCARED) questionnaire and Rutter's Children's Behavior Questionnaire were used as assessment tools. Mean scores for anxiety-based school refusal and behavioral problems in the intervention group showed a significant decrease (p < 0.001). Cognitive-behavioral group play therapy is a practical approach to reducing anxiety levels and behavior problems in children with anxiety-based school refusal in primary school grades.

Depression and Anxiety in Pediatric Patients with Beckwith-Wiedemann Syndrome: A Pilot Study.

The study's aim was to determine the prevalence of depression and anxiety in children with Beckwith-Wiedemann syndrome (BWS) and their effects on social relationships and family acceptance. The Pediatric Symptom Checklist-35 items (PSC-35), Screen for Child Anxiety Related Emotional Disorders (SCARED), and the Vineland Adaptive Behavior Scale Second Edition (VABS-II) were administered to the children. The parental Acceptance Rejection/Control Questionnaire (PARQ/Control) and Zarit Burden Inventory (ZBI) were administered to parents. In total, 6 patients and 10 parents were included. Patients showed a significant presence of internalizing behavior in PSC-35 (mean, 7.66 ± 3.67), anxiety symptoms (SCARED: mean, 46.33 ± 17.50) and socialization difficulties (mean, 90.83 ± 10.09). Parents reported a perceived good acceptance (mean, 56.33 ± 1.03) and a moderate control (mean, 24.17 ± 1.83), but the burden level was ranked moderate to severe (mean, 59.33 ± 16.78). It was found that the severity of the burden level reported by parents was related to internalizing behavior (OR = 2.000; 95% CI = 0.479-3.521; p = 0.022) and anxiety symptoms (SCARED total score: OR = 3.000; 95% CI = 1.479-4.521; p = 0.005) of children. During psychological counseling in the context of BWS treatment, it is important to identify specific resources that can support patients and families in dealing with stress and identify any critical areas that could hinder the adaptation process.

Secondary outcomes of enhanced cognitive behavioral therapy (eCBT) for children and adolescents with obsessive-compulsive disorder.

Obsessive-compulsive disorder (OCD) is a debilitating mental health condition usually presenting with a high degree of comorbid symptoms in the majority of cases. Although face-to-face cognitive-behavioral therapy (CBT) is considered the therapeutic golden standard for pediatric OCD, its accessibility, availability, and consistency in delivery are still limited. To address some of these challenges, an enhanced CBT (eCBT) package was created and introduced. This study explored eCBT's broad-based impact on OCD-related comorbid symptoms, functional impairment, quality of life and family accommodation among youth with OCD. This open trial involved 25 pediatric patients with OCD (7-17 years), assessed between January 2018 to February 2020. All patients received eCBT for 14 weeks. Secondary outcomes were assessed at baseline, post-treatment, and 3-, 6-, and 12-month follow-up co-occurring symptoms were evaluated using the Strengths and Difficulties Questionnaire (SDQ), Screen for Child Anxiety-Related Emotional Disorders (SCARED), and Mood and Feelings Questionnaire (MFQ). Quality of life was measured using the KINDL-R, functional impairment through the Child Obsessive-Compulsive Impact Scale Revised (COIS-R), and family accommodation by the Family Accommodation Scale (FAS). Linear mixed-effects models were applied to analyze treatment effects. Results indicated a significant decrease in OCD-related comorbid symptoms post-treatment, with SDQ mean reduce of 3.73 (SE = 1.10, child) and 4.14 (SE = 1.19, parent), SCARED mean reduce of 10.45 (SE = 2.52, child) and 8.40 (SE = 2.82, parent), MFQ mean reduce of 3.23 (SE = 1.11, child) and 2.69 (SE = 1.18, parent). Family accommodation declined with clinician scored FAS mean reduction of 13.25 (SE = 2.31). Quality-of-Life improved significantly post-treatment, with KINDL mean increase of 8.15 (SE = 2.87, children), and 10.54 (SE = 3.07, parents). These positive improvements were further amplified at the 3-month follow-up and remained consistent at the 12-month follow-up. A significant reduction was observed in all secondary outcomes employed and OCD-related functional impairments from baseline to post-treatment, which was maintained through 12-month follow-up. These results imply that after receiving eCBT, children and adolescents experienced substantial decrease in the negative impacts of OCD-related symptoms on their daily life, including home, school, and social interactions.

Sequenced treatment alternatives to relieve adolescent depression (STAR-AD): a multicentre open-label randomized controlled trial protocol

BackgroundAdolescent major depressive disorder (MDD) is a prevalent mental health problem with low treatment success rates. Whether fluoxetine or fluoxetine combined with cognitive-behavioural therapy (CBT) is the more effective initial treatment for adolescent MDD remains controversial, and few studies have investigated whether treatment switching or augmentation is preferred when the initial treatment is not working well.MethodsWe developed a multicentre open-label Sequential Multiple Assignment Randomized Trial (SMART) design, consisting of two phases lasting 8 weeks each. In phase 1 (at baseline), patients will be recruited and grouped in fluoxetine group or fluoxetine combined with CBT group by patient self-selection. In phase 2 (after 8 weeks of treatment), the nonresponders will be randomly assigned to six groups, in which participants will switch to sertraline, vortioxetine, or duloxetine or added aripiprazole, olanzapine, or lithium carbonate to fluoxetine. After the full 16 weeks of treatment, we will assess the long-term sustainability of the treatment effects by evaluating participants during their subsequent naturalistic treatment. The primary outcome will be the response rate, determined by the Children’s Depression Rating Scale-Revised (CDRS-R). Secondary outcomes include the change in scores on the Beck Depression Inventory (BDI), the Screen for Child Anxiety-Related Emotional Disorders (SCARED) and the Safe Assessment.DiscussionThe results from this study will aid clinicians in making informed treatment selection decisions for adolescents with MDD.Trial registrationThis protocol was registered at ClinicalTrials.gov with Identifier: NCT05814640.

Prevalence of anxiety disorders and its associated factors among adolescents in Arpookara Panchayat

Background: Adolescents (10 -19 years) constitute 1.3 billion in the world today. According to WHO mental health issues constitute 13% of the global burden of disease in adolescents of which anxiety disorders are the most common. Objective was to estimate the prevalence of anxiety disorders among adolescents using SCARED tool, to find the association of selected factors with anxiety disorders. Methods: A cross sectional study was conducted among 590 adolescents in Arpookara Panchayat. A semi-structured pretested questionnaire was used for collecting sociodemographic details. Anxiety disorder was assessed using Screen for Child Anxiety Related Emotional Disorder (SCARED) tool. Data was coded and entered in Microsoft excel and analysed using IBM SPSS software version 20 Results: The mean age of the study participants was 15.04 with SD ±3.013. Prevalence of anxiety disorders using SCARED tool was found to be 21.4%. Factors found to have statistically significant association with anxiety on univariate analysis were female gender (p=0.001), mother’s education more than high school level (p=0.036), time spent with father (p=0.001), time spent with mother(p=0.001), inadequate sleep (p=0.001) and family history of mental illness(p=0.043). On binary logistic regression following factors with p&lt;0.05 were found to be independent predictors of anxiety-female gender (OR=2.037), mother’s education more than high school level (OR=1.469) adequate time spent with father (OR=0.713), inadequate sleep (OR=14.726), family history of mental illness (OR=3.521) Conclusions: More than one fifth of adolescents are having anxiety disorders. There should be efforts for early diagnosis and prompt treatment of anxiety disorders among adolescents.

Are children with mitral valve prolapse more anxious?

Mitral valve prolapse (MVP) is a common valvular disease in children. Symptoms in children with MVP are not explained by the severity of mitral regurgitation alone. Hence, we sought to correlate symptom status with the incidence of anxiety disorder in this population. Groups were as follows: (a) MVP; n = 115; mean age: 13.5 ± 3.06 years and (b) control; n = 53; mean age: 15.1 ± 13.2. The Screen for Child Anxiety-Related Emotional Disorders (SCAREDs) scale was filled by all participants. The SCARED scores of 25 and above determined a warning for anxiety disorders. The mean SCARED scale values of MVP and control groups were 29.2 ± 13.08 and 24.9 ± 14.17, respectively (P = 0.065). Although the SCARED scale score was higher among the MVP patients, no significant difference was found between the groups in terms of the mean SCARED score, or the number of participants with a score of 25 or more. While girls with MVP had higher anxiety scores compared to boys with the disorder, there was no difference with respect to SCARED scores in children with MVP and the general population when analyzed separately by gender. Moreover, the SCARED scale score was significantly higher in symptomatic MVP patients than in asymptomatic cases. Children with MVP did not have higher anxiety scores compared to those without the syndrome. However, MVP patients with higher anxiety scores may benefit from a psychiatric assessment since higher scores correlate with symptoms.

Navigating young minds: reliability and validity of the Greek version of kiddie – schedule for affective disorders and schizophrenia – present and lifetime DSM-5 version (K-SADS-PL-GR-5)

BackgroundThe Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL) is one of the most popular semi-structured psychiatric interviews for children and adolescents. Its latest DSM-5 version (K-SADS-PL DSM-5) has only recently been adapted and validated in various languages. In the present study, we aimed to investigate the reliability and validity of the Greek version of the K-SADS-PL DSM-5.MethodsA total of 137 patients consecutively referred for admission, aged 7–17, were included. The K-SADS-PL DSM-IV was translated and adapted to correspond to DSM-5 categories. Convergent and divergent validity were assessed against two self-report rating scales, Children’s Depression Inventory (CDI) and Screen for Child Anxiety Related Emotional Disorders (SCARED). Inter-rater reliability was calculated exclusively for instances where a diagnosis involved three or more patients.ResultsOur findings revealed good to excellent inter-rater reliability and good to excellent consensual validity across most psychiatric diagnoses, except for panic disorder. Diagnostic efficiency, measured by sensitivity, specificity, positive and negative predictive values, consistently showed high specificity and negative predictive validity across all diagnostic categories.ConclusionsThese findings support the applicability of the Greek version of the K-SADS-PL DSM-5 as a reliable and valid diagnostic tool in Greek-speaking populations.

Depression, Generalize Anxiety Disorder, and School Avoidance in Early School Years in Pupils with Poor Reading Ability

Background: Children with poor reading ability may be at risk of early mental health problems. Objective: To determine an association between poor reading ability and generalize anxiety, school avoidance and depression among pupils in early school years. Materials and Methods: The cross-sectional study was conducted in 1,038 pupils studying in Grade 2 in 8 primary schools in Thailand. All pupils were individually assessed in their reading abilities by the Thai Standard Reading Tests. Generalized anxiety disorder and significant school avoidance were screened by using the Thai version of the Screen for Child Anxiety Related Emotional Disorders (SCARED). Depression was screened by using the Thai version of the Short Mood and Feelings Questionnaire (SMFQ). Results: A total of 877 pupils completed the tests. The mean age was 7.0 years (SD 0.4 years). The prevalence of generalized anxiety disorder, significant school avoidance, and depression were 18.4% (95% CI 15.8 to 20.9), 32.2% (95% CI 29.1 to 35.3), and 36.0% (95% CI 32.9 to 39.2), respectively. Poor reading ability was significantly associated with school avoidance with the odds ratio of 2.2 (95% CI 1.5 to 3.3, p&lt;0.001) and depression with the odds ratio of 1.8 (95% CI 1.2 to 2.6, p=0.005), but was not significantly associated with generalized anxiety disorder. Conclusion: Poor reading ability was associated with school avoidance and depression in early school years. Emotional problems should be screened early in those with poor reading ability. Keywords: Poor reading ability; Anxiety; Depression; School avoidance; Mental health

Sleep, social media use and mental health in female adolescents aged 12 to 18 years old during the COVID-19 pandemic

BackgroundAdolescents with high social media (SM) use experienced poor sleep quality and high anxiety and depression levels. The study aimed to investigate the characteristics of sleep, use of SM, mental health in female aged 12 to 18 years old, and to assess the association between poor sleep, SM usage, and mental health.MethodsIn total, 219 Thai female adolescents were recruited between December 2019 and September 2020 and completed self-administrative questionnaires three periods of time (baseline, 3 months and 6 months later). The questionnaires included: the Pittsburgh Sleep Quality Index (PSQI), depression screening (PHQ-9), Screen for Child Anxiety Related Emotional Disorders (SCARED). Demographic and use of social media data were also included. Cochran’s Q test, correlation coefficient, and binary logistic regression were performed.ResultsParticipants’ mean age was 14.52 (range 12–17) years. Average Thai-PSQI global scores did not differ during 3 periods (p = 0.13) but average time of sleep latency, sleep duration, and SM usage were significant different (p = 0.002, p = 0.001, and p = < 0.001, respectively). There were positive correlations between PSQI scores and total SM usage at baseline (r = 0.14; P < 0.05) and 6 months (r = 0.20; P < 0.05). Anxiety, depression, and self-perception of poor sleep were significantly related to poor sleep quality during the 3 periods. After adjusting for confounding factors, depression and self-reported poor sleep were the only significant factors predicting poor sleep quality.ConclusionsPoor sleep was associated with SM usage, depression, and anxiety in this population. Time-limited SM usage should be implemented for Thai female adolescents to improve sleep-related outcomes.

A Comprehensive Assessment of Long-Term Complications in Patients with Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

Introduction: Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and SJS/TEN overlap syndrome are rare severe hypersensitivity reactions that lead to epithelial sloughing. Studies investigating the chronic multisystem effects of these syndromes and assessing patients in terms of quality of life (QOL), depression, and anxiety in the pediatric population are limited. In this study, we aimed to investigate the long-term effects of these diseases from a multisystem perspective. Method: Sixteen pediatric patients diagnosed with SJS, TEN, and SJS/TEN overlap syndrome were evaluated between September 2020 and March 2021. Physical and eye examinations were performed. To evaluate QOL and psychological status, Children’s Dermatology Life Quality Index (CDLQI), Screen for Child Anxiety-Related Emotional Disorders (SCARED), and Children’s Depression Inventory (CDI) were conducted. The patients’ general characteristics, symptoms, and examination findings at their first admission were retrospectively obtained from the hospital’s electronic records. Results: Nineteen percent of the patients were female (n = 3). There were 7 patients (44%) with the diagnosis of SJS, 5 patients (31%) with TEN, and 4 patients (25%) with SJS/TEN overlap. The median follow-up time of the subjects was 6.5 years. The most common sequelae in the chronic period were skin changes (n = 13, 81%). Hyperpigmentation was the most common skin change (n = 9, 56%). In the last evaluation, 9 cases had eye involvement. In two cases, eye examination was normal in the acute phase, while ocular involvement was present in the chronic period. In 4 (50%) patients, there was height and/or weight percentile loss. Three patients’ SCARED scores and 2 patients’ CDI scores were high. According to the CDLQI survey, SJS, TEN, or SJS/TEN overlap syndrome had a small to moderate effect on the QOL in the 43% (n = 6) of the patients. The ANA values of 3 patients (60%) were positive at the follow-up and negative at the first admission. Conclusion: SJS, TEN, and SJS/TEN overlap syndrome may cause sequelae even after a long time of the onset of the disease. Patients’ QOL and psychological status can be affected negatively. Ocular symptoms may develop in the follow-up, even without involvement in the acute period. Patients with SJS, TEN, and SJS/TEN overlap syndrome should be followed up in the chronic period and approached multidisciplinary.

The level of anxiety in healthcare workers and their children during the COVID-19 pandemic

During the early stages of the COVID-19 pandemic, healthcare workers (HcWs) reported having high levels of psychological stress caused by the risk of being infected and infecting their families, social isolation, and inadequate protective equipment. This study aimed to determine the level of anxiety and related factors in HcWs and their children during the first phase of the COVID-19 pandemic in Turkey. Online questionnaires were sent to HcWs with children aged 8–18 years via e-mail and WhatsApp messages. In total, 144 HcWs and 135 of their children participated in this study.HcWs completed the State-Trait Anxiety Inventory state subscale (STAI-S) and the COVID-19 Risk Perception Scale. Their children completed the Screen for Child Anxiety-Related Emotional Disorders (SCARED). STAI-S and COVID-19 Risk Perception Scale scores of the HcWs in direct contact with COVID-19 patients were significantly higher than of those not in direct contact. Moreover, the children of HcWs that were in direct contact with COVID-19 patients had significantly higher SCARED subscale scores than those whose parents were not in direct contact. There was a significant correlation between the SCARED somatic/panic subscale scores and HcW STAI-S scores. The presence of a mental illness and direct contact with COVID-19 patients were the 2 main predictors of COVID-19 risk perception and the level of anxiety in HcWs. During the COVID-19 pandemic the children of HcWs were observed to be a mentally sensitive group, and preventive mental health programs should be developed.

Early puberty paradox: an investigation of anxiety levels of mothers and children, children's quality of life, and psychiatric diagnoses.

Early puberty signs lead to an increase in anxiety levels of parents and children. The aim of this study was to investigate the quality of life and anxiety levels of girls and their mothers who were admitted to a pediatric endocrinology clinic with concerns about early puberty.Girls and their mothers who were admitted to endocrinology outpatient clinic with concerns about early puberty were compared to healthy control group. Screen for Child Anxiety Related Emotional Disorders (SCARED) parent form, Quality of Life for Children Scale (PedsQL) parent form, and Beck Anxiety Inventory (BAI) were administered to the mothers. Children were evaluated with the Schedule for Affective Disorders and Schizophrenia for School-Age Children (Kiddie-SADS Lifetime Version) (K-SADS-PL).The study sample consisted of 92 girls and 62 of them were administered to clinic with concerns about early puberty. There were 30 girls in early puberty group (group 1), 32 girls were in the normal development group (group 2), and 30 were in the healthy control group (group 3). The anxiety level of group 1 and group 2 was significantly higher, and their quality of life was significantly lower when compared to group 3 (p < 0.001). Mother's anxiety level was found significantly higher in group 2 (p < 0.001). It has shown that anxiety level and quality of life of children were associated with anxiety level of mothers and the current Tanner stage (r = 0.302, p < 0.005). Conclusion: Mothers and children who have concerns about early puberty are negatively affected when early puberty is a possibility. For this reason, educating parents will prevent negative impacts of this situation on children. At the same time, it will decrease health burden. What is Known? • Early adolescence is one of the most common reasons for admission to pediatric endocrinology outpatient clinics. It is known that increasing early adolescence anxiety in the society causes cost and time losses in the field of health. However, studies investigating the reasons for this result are limited in the literature. What's New? • The level of anxiety increased significantly in girls with suspected precocious puberty and their mothers, and their quality of life was affected. • For this reason, we would like to emphasize the importance of multidisciplinary approaches before psychiatric disorders occur in children with suspected precocious puberty and their parents.

Symptoms of depression and anxiety in Chinese adolescents: heterogeneity and associations with executive function

BackgroundDepression and anxiety are common symptoms associated with significant morbidity in adolescents. Few studies have explored the relationship between latent profiles of adolescent depression-anxiety symptoms and executive function (EF), which is also a major pediatric public health concern.MethodsThe sample included 1,306 participants who were recruited from two schools in Ningxia. The Depression Self-Rating Scale for Children (DSRSC) and the Screen for Child Anxiety Related Emotional Disorders (SCARED) were used to assess the level of depression-anxiety symptoms in adolescents, and their executive function state was assessed using the Behavior Rating Inventory of Executive Function-Self-Report version (BRIEF-SR). Latent profile analysis (LPA) was carried out using Mplus 7.0 to explore the most likely number of profiles based on the subscales of DSRSC and SCARED. The relationship between adolescents’ executive function and depression-anxiety symptoms were analyzed by multivariable logistic regression, and the odds ratio were used to test the impact of this relationship.ResultsThe LPA results show that the three-profile model was the best-fitting model for adolescent depression and anxiety symptoms. The proportions of Profile-1 (“Healthy Group”), Profile-2 (“Anxiety Disorder Group”), and Profile-3 (“Depression-Anxiety Disorder Group”) were 61.4%, 23.9%, and 14.7%, respectively. Additional analyses using multivariable logistic regression suggested that poor shifting capacity and emotional control were significantly more likely to be classified into the depression and/or anxiety groups, and worse working memory, task completion, and better inhibition were significantly more likely to be classified into the anxiety group.ConclusionsThe findings contribute to our understanding of the heterogeneity of adolescents’ depression-anxiety symptoms and highlight the important role of executive function in influencing mental health outcomes. These findings will guide the improvement and delivery of interventions for the treatment of anxiety and depression in adolescents, mitigating functional impairments in patients and reducing disease risk.

Atomoxetine Versus Combination of Methylphenidate Plus Fluoxetine for Management of Anxiety Disorders in ADHD Children: A Randomized Clinical Trial

Background: Attention-deficit/hyperactivity disorder (ADHD) is the most common psychiatric disorder in childhood. Concurrent anxiety disorders have turned into a challenging issue for psychiatrists. Numerous medications have been applied with controversial responses. Objectives: The current study aimed to compare the efficacy of the combination of methylphenidate (MPH) and fluoxetine (FLX) versus atomoxetine (ATX) in the symptoms and function of ADHD children with concurrent anxiety disorders. Methods: The current randomized clinical was conducted on 76 outpatient children with concurrent ADHD and anxiety disorder within 2020 - 2021. The patients were divided into two equal groups. The first group was treated with MPH (5 mg twice daily) plus FLX (10 - 20 mg daily); nevertheless, the second group received ATX with a dose of 1.4 mg/kg. The Conner’s Parents Rating Scale (CPRS), Screen for Child Anxiety Related Emotional Disorders (SCARED), and Children’s Anxiety Impact Scale-Child (CAIS-C) were applied to assess anxiety at the baseline and 1 month and 4 months after the interventions. Results: The mean age of the studied population was 9.26 ± 1.92 years (range: 6 - 12 years), and 46 subjects (57.89%) were male. The significant trends of improvement in both groups, regardless of the interventions in the assessments of all the scales, were noted (P &lt; 0.001 for all the scales); however, the comparison of the groups revealed no differences in the CPRS (P = 0.397), SACRED (P = 0.663), and CAIS-C (P = 0.683). Conclusions: Based on the findings of this study, as ATX alone was as effective as MPH plus FLX for controlling anxiety disorders among ADHD children, ATX is preferred to apply fewer daily medications.

Epidemiologie seelischen Wohlbefindens von Kindern und Jugendlichen in Deutschland. Ergebnisse aus 3 Studien vor und während der COVID-19-Pandemie

ZusammenfassungHintergrundEin kontinuierliches bundesweites Gesundheitsmonitoring ist wichtig, um das Wohlbefinden von Kindern und Jugendlichen im Blick zu behalten und Entwicklungsverläufe abzubilden. Anhand der Ergebnisse von 3 ausgewählten epidemiologischen Studien werden Entwicklungen zum kindlichen Wohlbefinden der letzten 20 Jahre vorgestellt.MethodikDatengrundlage bilden (1.) die bevölkerungsbezogene BEfragung zum seeLischen WohLbefinden und VerhAlten (BELLA-Studie, 2003–2017, N = 1500–3000), die ein Modul der KiGGS-Studie ist, (2.) die COrona und PSYche Studie (COPSY, 2020–2022, N = 1600–1700), die auf der BELLA-Studie aufbaut, und (3.) die internationale Health-Behaviour in School-aged Children Studie (HBSC, 2002–2018, N = 4300–7300). Das Wohlbefinden wurde bei 7‑ bis 17-Jährigen mittels der Indikatoren gesundheitsbezogene Lebensqualität (KIDSCREEN-10), Lebenszufriedenheit (Cantril Ladder) und psychische Auffälligkeiten (Strenghts and Difficulties Questionnaire (SDQ), Screen for Child Anxiety Related Emotional Disorders (SCARED) und Center for Epidemiological Studies Depression Scale for Children (CES-DC)) erfasst.ErgebnisseInsgesamt zeigen Kinder und Jugendliche präpandemisch (2002–2018) eine konstant hohe gesundheitsbezogene Lebensqualität und eine hohe allgemeine Lebenszufriedenheit, die sich mit Beginn der COVID-19-Pandemie 2020 zunächst verschlechterte. 2 Jahre später zeigen sich Verbesserungen, die jedoch noch nicht das Ausgangsniveau erreichen. Psychische Auffälligkeiten, ängstliche und depressive Symptome nahmen mit Pandemiebeginn um bis zu 12 Prozentpunkte zu und zeigen auch 2 Jahre nach Pandemiebeginn noch höhere Werte als präpandemische Studien.DiskussionDie Epidemiologie kindlichen Wohlbefindens bietet eine notwendige Datengrundlage, um den Unterstützungsbedarf von Kindern und Jugendlichen zu erfassen und auf dieser Basis Maßnahmen der Gesundheitsförderung, Prävention und Intervention zu entwickeln.

The Role of Pediatric Sensory Over-responsivity and Anxiety Symptoms in the Development of Family Accommodations.

Sensory over-responsivity (SOR) is linked with elevated anxiety and reduced family wellbeing. Family accommodation of anxiety relates with greater symptom severity and reduced intervention outcome. This study examined the contribution of child SOR and co-occurring anxiety symptoms to family accommodation and its consequences. Ninety families of typically developing children (ages 4-13 years), completed an online survey including the Sensory Profile 2, Screen for Child Anxiety Related Emotional Disorders (SCARED), and Family Accommodation Sensory Scale (FASENS). FASENS scores include frequency of accommodation, child impact, and family impact.Children with elevated anxiety symptoms had significantly higher sensory and FASENS scores. Stepwise linear regression indicated that only SOR symptoms significantly predicted the frequency of sensory family accommodation, while both SOR and anxiety symptoms predicted the impact of family accommodation upon child and family well-being.Both SOR and anxiety symptoms in children predict the impact of sensory family accommodations on child and family well-being.

Influence of in-person and remote Satir family therapy on emotions and behavior of adolescents with major depressive disorder

BackgroundMajor depressive disorder in adolescents is characterized by high prevalence rate, high recurrence rate, high suicide rate and high disability rate. However, the recognition rate and cure rate are low, and the disease has a very bad influence on the family and society. The lack of psychiatrists and psychotherapists in villages and small towns makes it difficult to get timely and professional intervention and treatment for adolescent with major depressive disorder. MethodsA total of 84 adolescents with major depressive disorder who received treatment in the department of psychosomatic medicine of the Second Affiliated Hospital of Nanchang University participated in this survey, and they were divided into the control group and the intervention group by random number table. Adolescent Non-suicidal Self-injury Assessment Questionnaire (ANSSIAQ), Self-rating Questionnaire for Adolescent Problematic Mobile Phone Use (SQAPMPU), Screen for Child Anxiety Related Emotional Disorders (SCARED) and Depression Self-Rating Scale for Childhood (DSRS) were used to investigate the negative emotions and behavior of adolescents with major depressive disorder at baseline and intervention for 12 weeks. ResultsThere were no significant differences in the baseline information of adolescents (sex ratio, age, education level), including the total score of SCARED, DSRS and SQAPMPU, the total mean score of ANSSIAQ between the two groups (P > 0.05). After 12-week intervention, the score of SCARED, DSRS and SQAPMPU, the total mean score of ANSSIAQ in both groups were lower than that of the baseline, and the score of the intervention group showed a more obvious downward trend (P < 0.05). ConclusionsIn-person and remote Satir family therapy not only effectively reduced the anxiety and depression level among participants, but also validly reduced their non-suicidal self-injury behavior and mobile phone use behavior. The results verified that the model we adopted can be well applied for the out-patient management of adolescents with major depressive disorder, especially in villages and small towns.

Restricted and repetitive behaviors and their developmental and demographic correlates in 4-8-year-old children: A transdiagnostic approach.

Background: Restricted and repetitive behaviors (RRBs) are a broad class of behaviors characterized by frequent action repetition and intense preference for sameness. Research has predominantly focused on RRBs in diagnosed clinical groups, particularly in autism spectrum disorder and genetic disorders. Using a transdiagnostic approach, the current study examined RRBs in a diverse sample of children in relation to developmental and demographic correlates (age, language, non-verbal ability, child anxiety, sex, and socioeconomic status). Separate analyses examined two RRB subtypes; repetitive sensory and motor behaviors (RSMB) and insistence on sameness (IS). Method: Children (N = 260, age 4-8 years, 174 male, 86 female) in mainstream schools identified by teachers as having behavioral, emotional, and/or cognitive difficulties, were assessed using the Repetitive Behavior Questionnaire-2 (RBQ-2), the British Picture Vocabulary Scale (BPVS), Lucid Ability Scale, the Welsh Index of Multiple Deprivation (WIMD) and the Screen for Child Anxiety Related Emotional Disorders (SCARED). Recruitment excluded diagnosed clinical conditions. The Strengths and Difficulties Questionnaire (SDQ) was used to assess children's difficulties. Results: RRB scores were of high frequency and the scores for the IS were higher than for RSMB. The severity of anxiety symptoms and male sex were significantly associated with both RRB subtypes, and younger age and SES scores were associated with IS. Elevated RRB total and subtype scores were significantly related to SDQ scores for emotion, conduct, hyperactivity, and peer-relations. Discussion: The study provides the first evidence of RRBs in a diverse sample of young children with emerging difficulties in behavior, cognition, and/or emotion. The results contribute to proposals about psychological development in RRB and indicate that RRBs are best represented on a continuum of severity found across children in the early school years. The results support previous findings of a relation between RRB and anxiety reported in clinical samples and importantly, they indicate that it is time to move beyond the study of categorically defined groups and consider correlates of RRBs that include broad indices of mental health and well-being.