Adolescent Psychiatry最新文献

{"title":"Addressing Crises in Teenage Pregnancy","authors":"Osarumen Nicole Doghor, Faith O Nomamiukor, Efe Okotcha, Edore Onigu-Otite","doi":"10.2174/2210676609666190531102808","DOIUrl":"https://doi.org/10.2174/2210676609666190531102808","url":null,"abstract":"\u0000\u0000Adolescent pregnancy is a major public health concern with medical,\u0000psychiatric, and social implications. Within this population, there is an elevated rate of\u0000co-occurring psychiatric conditions including mood disorders, anxiety disorders, suicidality,\u0000and substance use. However, little is known about the assessment and treatment of adolescent\u0000pregnancy within the context of these co-occurring psychiatric conditions, particularly\u0000in an emergency situation.\u0000\u0000\u0000\u0000This article utilizes a case report to illustrate the challenges faced in consultative\u0000psychiatry in the assessment and treatment of a pregnant suicidal youth with a complex psychosocial\u0000history. Topics addressed include: 1) The role of childhood trauma and suicidality\u0000in adolescent pregnancy 2) A consideration of the risks and benefits of treating adolescents\u0000with psychotropics during pregnancy.\u0000\u0000\u0000\u0000A literature search was performed with the key words of adolescent, pregnancy,\u0000child sexual abuse and psychiatric illness. In addition, expert opinions of a reproductive psychiatrist\u0000and a psychiatrist who had specialized in addiction and adolescents were enlisted on\u0000key aspects of the case formulation and treatment.\u0000\u0000\u0000\u0000Several studies were found that focused on depression, substance abuse and trauma\u0000in adolescent pregnancy. There were more studies that looked at psychopharmacological\u0000treatment in adult pregnant women and a few that focused on adolescents.\u0000\u0000\u0000\u0000Addressing the crisis of psychiatric illness in adolescent pregnancy requires a\u0000thorough approach in understanding the severity of the illness and the contribution of child\u0000abuse and suicidality. Psychotherapeutic interventions are most certainly always necessary\u0000and beneficial when dealing with this population. Deciding when to start and maintain medication\u0000during pregnancy should be individualized, with considerations of the risks of untreated\u0000illness and of medication exposure.\u0000","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":"9 1","pages":"69-80"},"PeriodicalIF":0.4,"publicationDate":"2020-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68173733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“Medical Clearance” of Psychiatric Patients in the Emergency Department","authors":"G. Santillanes, Edore Onigu-Otite, V. Tucci, N. Moukaddam","doi":"10.2174/2210676609666191015123100","DOIUrl":"https://doi.org/10.2174/2210676609666191015123100","url":null,"abstract":"DOI: 10.2174/2210676609666191015123100 Abstract: Background & Aims: The past few years have seen an increase in the number of children and adolescents presenting to emergency departments with mental health complaints, including, but not limited to, depression, suicidality, and substance use-related conditions. This places many demands on the emergency physicians ranging from evaluating medical stability (also known as medical clearance) to arranging for psychiatric are, be it inpatient or outpatient. The goals of this article are to describe the current landscape of emergency care for the pediatric patient presenting with mental health issues and to highlight gaps in the current system.","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":"9 1","pages":"159-165"},"PeriodicalIF":0.4,"publicationDate":"2020-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/2210676609666191015123100","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68174025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Suicidal Adolescents Presenting to the Emergency Department","authors":"N. Valles, Dana Billups, Topaz Sampson, T. Harris","doi":"10.2174/2210676609666190730094236","DOIUrl":"https://doi.org/10.2174/2210676609666190730094236","url":null,"abstract":"\u0000\u0000Increasingly, adolescents are presented to hospital emergency departments\u0000with suicidal ideation (SI) and depression. Even among those who come in with\u0000other complaints, depression and SI are common. Emergency personnel are placed in the default\u0000position of providing care for these patients, but often lack sufficient knowledge and\u0000skills to do this effectively.\u0000\u0000\u0000\u0000The aim of this paper is to offer guidance to emergency personnel and describe\u0000goals and strategies for screening and brief interventions.\u0000\u0000\u0000\u0000We review risk factors, assessment tools and evidence-based interventions that can\u0000be utilized by mental health professionals working in EDs and by ED staff in the absence of\u0000mental health professionals.\u0000\u0000\u0000\u0000Emergency departments can serve a critical role in risk management and treatment\u0000of adolescent depression and suicidal ideation. All patients presenting to the ED should\u0000be screened for current and past depression and suicidal ideation or attempts. Brief interventions\u0000can be delivered in the ED that can increase the likelihood that patients will receive follow-\u0000up care.\u0000","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":"9 1","pages":"81-91"},"PeriodicalIF":0.4,"publicationDate":"2020-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49382391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency Management in Eating Disorders","authors":"Heather E. Needham, E. Ferguson, Darcie M. Takemoto, Sindhu Idicula","doi":"10.2174/2210676609666190730093039","DOIUrl":"https://doi.org/10.2174/2210676609666190730093039","url":null,"abstract":"\u0000\u0000Eating disorders commonly present during the adolescent and\u0000young adult years, and are complex in that they are a group of psychiatric diagnoses with\u0000medical complications.\u0000\u0000\u0000\u0000The diagnosis of an eating disorder can often go undetected while a patient is being\u0000evaluated for organic causes of weight loss. Anorexia nervosa, in particular, has the\u0000highest mortality rate of any psychiatric diagnosis. In the Diagnostic and Statistical Manual\u0000of Mental Disorders 5th Edition (DSM-5), there are several diagnoses that are classified as\u0000eating or feeding disorders.\u0000\u0000\u0000\u0000This article will discuss anorexia nervosa and bulimia nervosa, with a focus on\u0000medical and psychiatric emergencies that are important for primary care providers to keep in\u0000mind when caring for adolescents and young adults.\u0000","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":"9 1","pages":"135-141"},"PeriodicalIF":0.4,"publicationDate":"2020-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/2210676609666190730093039","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43950174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conscience Relevance and Sensitivity in Psychiatric Evaluations in the Youth-span","authors":"M. Galvin, L. Hulvershorn, Margaret M. Gaffney","doi":"10.2174/2210676609666190415142734","DOIUrl":"https://doi.org/10.2174/2210676609666190415142734","url":null,"abstract":"\u0000\u0000While practice parameters recommend assessment of conscience\u0000and values, few resources are available to guide clinicians.\u0000\u0000\u0000\u0000To improve making moral inquiry in youth aged 15 to 24.\u0000\u0000\u0000\u0000After documenting available resources for behavioral health clinicians who are inquiring\u0000about their patient’s moral life, we consider our studies of conscience development\u0000and functioning in youth. We align descriptions of domains of conscience with neurobiology.\u0000We compare youth reared in relative advantage, who have fairly smooth functional progressions\u0000across domains, with youth reared in adverse circumstances. We offer the heuristic\u0000conscience developmental quotient to help mind the gap between conscience in adversity and\u0000conscience in advantage. Next, we consider severity of psychopathological interference as\u0000distinct from delay. A case illustration is provided to support the distinction be\u0000\u0000\u0000\u0000Our findings support the hypotheses that youth who experience adverse childhood\u0000experiences show evidence of fragmentation, unevenness and delay in their conscience\u0000stage-attainment. We demonstrate proof of concept for conscience sensitive psychiatric assessment\u0000in the youth-span. Conscience sensitive inquiries improve upon merely conscience\u0000relevant interpretations by affording better appreciation of moral wounding, in turn setting\u0000the stage for moral-imaginative efforts that elicit and make the latent values of the youth\u0000more explicit.\u0000\u0000\u0000\u0000A conscience sensitive approach should be part of both psychiatric and general\u0000medical education, supported explicitly by clinical guidelines recommending conscience\u0000sensitive interview techniques that aim to acquire information aligned with current neurobiological\u0000terminology.\u0000","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":"9 1","pages":"167-184"},"PeriodicalIF":0.4,"publicationDate":"2020-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/2210676609666190415142734","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45545072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender Differences in the Suicide Attempts of Adolescents in Emergency Departments: Focusing on Individuals with Autism Spectrum Disorder","authors":"K. Mikami, Seiji Inomata, Yuichi Onishi, Yasushi Orihashi, Kenji Yamamoto, H. Matsumoto","doi":"10.2174/2210676609666190617144453","DOIUrl":"https://doi.org/10.2174/2210676609666190617144453","url":null,"abstract":"Background: Few studies on gender-based diagnostic characteristics of adolescent suicide attempters in emergency departments (EDs) have included individuals with autism spectrum disorder (ASD). Objective: This study aimed to examine the clinical features of adolescent suicide attempts in EDs, focusing on gender differences and considering individuals with ASD. Methods: Ninety-four adolescent patients, aged less than 20 years, who had attempted suicide and had been hospitalized in an emergency department, participated in this study. Psychiatric diagnoses according to DSM-IV criteria and clinical features were compared between male and female patients. Results: The number (%) of males was 15 (16.0), and that of females was 79 (84.0). The mean age (SD) of males was 17.1 (1.5), and that of females was 16.9 (1.6). The attempt methods were more serious, length of stay in the emergency room longer, and rate of outpatient treatment lower in males. In addition, suicide attempters with ASD were significantly more frequent in male. Adjusting for age and gender, adjustment disorder was significantly associated with the presence of suicide attempters with ASD using a multivariable logistic regression. Conclusion: Males were less likely to visit psychiatric service previous to attempting suicides, and may be likely to complete suicides. In addition, suicide attempters with ASD are characteristic in male, and likely to have comorbid adjustment disorder. ED visits offer a window of opportunity to provide suicide prevention interventions for adolescents, and therefore, psychiatrists in EDs have a crucial role as gatekeepers of preventing suicide reattempts, especially in adolescent males including individuals with ASD having adjustment disorder.","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":"9 1","pages":"232-240"},"PeriodicalIF":0.4,"publicationDate":"2020-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/2210676609666190617144453","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42343626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing Sexual Acting Out Behaviors with Adolescents on the Autism Spectrum","authors":"Leah N. Clionsky, Amanda M. N’zi","doi":"10.2174/2210676609666190730091304","DOIUrl":"https://doi.org/10.2174/2210676609666190730091304","url":null,"abstract":"DOI: 10.2174/2210676609666190730091304 Abstract: Adolescents with autism spectrum disorders (ASDs) have similar sexual desires and relationship needs to their neuro-typical peers. However, they may be more likely to demonstrate problematic sexual behaviors as they mature, due to lack of education about sexuality, vulnerability to sexual abuse, deficits in social communication and understanding, restricted and repetitive interests and behaviors, and sensory interests. Treatment for sexual acting out behaviors in adolescents with ASD has not been explored and current recommendations focus on prevention through sexual education, which provides little guidance to clinicians working with adolescents who are already displaying sexual acting out behaviors. Adapting treatments for problematic sexual behaviors in neuro-typical children and adolescents may be the first step, although adaptation is complicated by developmental abilities that may not match an adolescent’s chronological age. A thorough developmental and sexual assessment is the first step to designing an appropriate treatment plan. Further research should focus on adapting and applying current treatments for sexual acting out by the ASD population.","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":"9 1","pages":"129-134"},"PeriodicalIF":0.4,"publicationDate":"2020-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/2210676609666190730091304","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41480992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Knowledge Enough? The Relationship Between Mental Health Knowledge and Stigmatising Attitudes Among Australian Adolescents","authors":"Emmelin. Teng, Venning Anthony, Winefield Helen, Crabb Shona","doi":"10.2174/2210676609666181204145835","DOIUrl":"https://doi.org/10.2174/2210676609666181204145835","url":null,"abstract":"\u0000\u0000Young people carry mental health problems disproportionate to the\u0000size of their population, and rates of help-seeking are low. School mental health programs\u0000have been developed to address these issues, founded on an educational approach to target\u0000mental health literacy, and indirectly improve help-seeking. However, it has been suggested\u0000that knowledge does not necessarily predict health behaviour in young people.\u0000\u0000\u0000\u0000A cross-sectional study was conducted to explore whether knowledge\u0000about mental illness was related to attitudes towards mental illness and intentions to seek\u0000help in a sample of adolescent girls (N=327).\u0000\u0000\u0000\u0000Results indicated a weak negative relationship between knowledge about mental\u0000health and stigmatising attitudes about mental illness, but no relationship between\u0000knowledge about mental health and intentions to seek help for mental health problems.\u0000When mental health was categorised (e.g., optimal vs. poorer mental health), a negative\u0000relationship between knowledge about and stigmatising attitudes toward mental health was\u0000shown in those with poor mental health, but not for adolescents categorised as having\u0000moderate or optimal mental health.\u0000\u0000\u0000\u0000Findings suggest that while the traditional adage - more information on mental\u0000health equals better attitude to mental health - may be true for those with ‘poorer’ levels of\u0000mental health (e.g., high levels of psychological distress), it may not reduce stigma\u0000associated with mental illness or motivate positive health behaviour in adolescent girls with\u0000‘optimal’ mental health (e.g., low or no levels of psychological distress).\u0000","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":"9 1","pages":"206-219"},"PeriodicalIF":0.4,"publicationDate":"2020-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/2210676609666181204145835","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46822375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hashimoto’s Encephalopathy Presenting as Recurrent Brief Psychotic Episodes in a 13-Year-Old Girl: A Case Report","authors":"N. Uvais","doi":"10.2174/2210676609666190415125923","DOIUrl":"https://doi.org/10.2174/2210676609666190415125923","url":null,"abstract":"\u0000\u0000Hashimoto’s encephalopathy (HE) is a debilitating manifestation of\u0000an autoimmune reaction against the thyroid that rarely can present with prominent psychiatric\u0000symptoms. It is often under-diagnosed primarily due to its variety of symptoms as well as\u0000a lack of definitive diagnostic criteria.\u0000\u0000\u0000\u0000We report the case of a 13-year-old girl who has been diagnosed with HE after presenting with recurrent and severe psychosis with fever and a thyroidopathy. The patient had prominent visual hallucinations and paranoid delusions. Between episodes, the patient did not show evidence of psychiatric symptoms. This patient struggled with several incorrect diagnoses and treatments for two years before the correct diagnosis of HE was made and displayed extreme improvement upon corticosteroid administration. \u0000\u0000\u0000\u0000This case illustrates the importance of increasing awareness of HE as well as including\u0000HE in a differential diagnosis when paediatric patients present with psychosis and\u0000concurrent thyroidopathy.\u0000","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2020-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44302503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Critical Issues in Adolescent Mental Health in the Emergency Department: Looking Beyond Triage and Risk Assessment","authors":"N. Moukaddam, Edore Onigu-Otite, V. Tucci","doi":"10.2174/221067660902200110090955","DOIUrl":"https://doi.org/10.2174/221067660902200110090955","url":null,"abstract":"<jats:sec>\u0000<jats:title />\u0000<jats:p />\u0000</jats:sec>","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":"9 1","pages":"67-68"},"PeriodicalIF":0.4,"publicationDate":"2020-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47250828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}