Journal of the Canadian Academy of Child and Adolescent Psychiatry最新文献

{"title":"Clinical pathway development to standardize pharmacological medication management of agitation in pediatric inpatient settings.","authors":"Michael D Wood, Kavi Gandhi, Dean Elbe, Kelly Saran, Sarah Leung, Joanna McKay, Roxane Carr, Andrea Chapman","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>Acute agitation in pediatrics is commonly encountered in hospital settings, can contribute to significant physical and psychological distress, and management is highly varied in practice. As such, the development of a standardized pharmacologic guideline is paramount. We aimed to develop a novel clinical pathway (CP) for management of acute agitation for all hospitalized pediatric patients in Canada.</p><p><strong>Methods: </strong>Healthcare professionals in Canada with expertise in treating and managing pediatric agitation formed a working group and developed a CP through conducting a literature review, engaging key partners, and obtaining interdisciplinary consensus (iterative real-time discussions with content experts). Once developed, the preliminary CP was presented to additional internal and external partners via multiple grand rounds and a webinar; feedback from participants guided final CP revisions.</p><p><strong>Results: </strong>The working group created a pediatric inpatient CP to guide pharmacologic management of agitation and serve as an easy-to-use clinical and educational resource with three complementary sections including: 1) a treatment algorithm, 2) a quick reference medication chart, and 3) two supporting documents, which provide a general overview of non-pharmacologic strategies prior to CP implementation and an illustrative scenario to accompany the medication chart to ensure effective utilization.</p><p><strong>Conclusions: </strong>This is the first CP to standardize pharmacological treatment and management of acute agitation in children in inpatient settings in Canada. Although further research is warranted to assess implementation and support process improvement, the CP can be adapted by individual institutions to assist in prompt pharmacological management of pediatric agitation to potentially improve outcomes for patients, families, and healthcare professionals.</p>","PeriodicalId":47053,"journal":{"name":"Journal of the Canadian Academy of Child and Adolescent Psychiatry","volume":"33 2","pages":"131-144"},"PeriodicalIF":2.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11201725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141477663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating school environment strategies into adolescent substance use prevention: insights from Taiwan and implications for global research.","authors":"Lien-Chung Wei","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":47053,"journal":{"name":"Journal of the Canadian Academy of Child and Adolescent Psychiatry","volume":"33 2","pages":"76"},"PeriodicalIF":2.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11201731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141477665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The urgency in child welfare services is addressing poor mental health trajectories.","authors":"Nico Trocmé, Barbara Fallon","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":47053,"journal":{"name":"Journal of the Canadian Academy of Child and Adolescent Psychiatry","volume":"33 2","pages":"91-92"},"PeriodicalIF":2.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11201726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141478360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychodynamic psychotherapy for gender dysphoria is not conversion therapy.","authors":"Joanne Sinai, Peter Sim","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Over the last ten years, there has been a substantial increase in the number of children and adolescents referred to gender clinics for possible gender dysphoria. The gender affirming model of care, a dominant treatment approach in Canada, is based on low quality evidence. Other countries are realizing this and making psychosocial treatments and/or exploratory psychotherapy a first line of treatment for gender related distress in young patients. Psychodynamic (exploratory) psychotherapy has established efficacy for a range of conditions, and has been used in youth and adults with gender dysphoria. In Canada, the adoption of psychodynamic psychotherapy for gender dysphoria is impeded by some academics who argue that it may violate laws against conversion therapy. Psychodynamic psychotherapy is not conversion therapy and should be made available in Canada as a treatment modality for gender dysphoria.</p>","PeriodicalId":47053,"journal":{"name":"Journal of the Canadian Academy of Child and Adolescent Psychiatry","volume":"33 2","pages":"145-153"},"PeriodicalIF":2.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11201722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141478358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recommended Academic Reading.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":47053,"journal":{"name":"Journal of the Canadian Academy of Child and Adolescent Psychiatry","volume":"33 2","pages":"154-155"},"PeriodicalIF":2.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11201729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141478359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Highlights of the July issue.","authors":"John D McLennan","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":47053,"journal":{"name":"Journal of the Canadian Academy of Child and Adolescent Psychiatry","volume":"33 2","pages":"74"},"PeriodicalIF":2.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11201730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141477664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental health service use of young people in child welfare services in Quebec, Canada.","authors":"Kathleen MacDonald, Lyne Desrosiers, Lise Laporte, Srividya N Iyer","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Youth involved in child welfare have high rates of mental health problems and are known to receive mental health services from multiple settings. Still, gaps remain in our understanding of service use patterns across settings over the course of youth's involvement with child welfare.</p><p><strong>Objective: </strong>To examine the settings, reasons for contact, persons involved in initiating care, and timing of each mental health service contact for individuals over their involvement with the child welfare system, and to identify factors that predict multi-setting use.</p><p><strong>Methods: </strong>Data on mental health service contacts were collected retrospectively from charts for youth aged 11-18 (n=226) during their involvement with child welfare services in Montreal, Quebec. Logistic regression analysis was conducted to determine predictors of multi-setting mental health services use (defined as ≥3 settings).</p><p><strong>Results: </strong>83% of youth had at least one mental health service contact over the course of their child welfare services follow-up, with 45% having multi-setting use. Emergency Departments were the top setting for mental health services. Youth with a higher number of placements and from neighborhoods with greater social and material deprivation were significantly likelier to use ≥3 mental health service settings over the course of their follow-up.</p><p><strong>Conclusion: </strong>These findings suggest a need for enhanced collaboration between youth-serving sectors to ensure that continuous and appropriate mental health care is being offered to youth followed by child welfare systems. The relationship between placement instability and multi-setting mental health service use calls for specific policies to ensure that young people do not experience multiple discontinuities of care.</p>","PeriodicalId":47053,"journal":{"name":"Journal of the Canadian Academy of Child and Adolescent Psychiatry","volume":"33 2","pages":"77-90"},"PeriodicalIF":2.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11201724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141477666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advocacy and an advocacy column: more questions than answers.","authors":"Peter Braunberger","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":47053,"journal":{"name":"Journal of the Canadian Academy of Child and Adolescent Psychiatry","volume":"33 2","pages":"156-158"},"PeriodicalIF":2.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11201728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141477704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparison of psychiatric inpatient admissions in youth before and during the COVID-19 pandemic.","authors":"Joanne L Park, Chris A Clark, Mercedes Bagshawe, Jennifer Kuntz, Andrea Perri, Avril Deegan, Brian Marriott, Abdul Rahman, Susan Graham, Carly A McMorris","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The current understanding of the effect of COVID-19 on child and youth admissions to psychiatric inpatient units over time is limited, with conflicting findings and many studies focusing on the initial wave of the pandemic.</p><p><strong>Objectives: </strong>This study identified changes in psychiatric inpatient admissions, and reasons for admission, including suicidality and self-harm, before and during the COVID-19 pandemic.</p><p><strong>Method: </strong>This time series study analyzed 3,723 admissions of youth (ages 0-18.88 years) admitted to four major psychiatry inpatient units in a large Canadian city between January 1^st, 2016 and December 31^st, 2021. Pre-pandemic (before March 11, 2020) and during-pandemic (after March 11, 2020) trends of admissions were explored using a Bayesian structural time series model (BSTS).</p><p><strong>Results: </strong>The model revealed that overall admissions during the pandemic period exceeded what would have been predicted in the absence of a pandemic, a relative increase of 29%. Additionally, a rise in the total number of admissions due to self-harm and suicidality (29% increase), externalizing/behavioral issues (69% increase), and internalizing/emotional issues (28% increase) provided strong evidence of increased admissions compared to what might have been expected from pre-pandemic numbers.</p><p><strong>Conclusions: </strong>There was strong evidence of increases in psychiatric inpatient admissions during the COVID-19 pandemic compared to expected trends based on pre-pandemic data. To ensure accessible and continuous mental health supports and services for youth and their families during future pandemics, these findings highlight the need for rapid expanse of inpatient mental health services, similar to what occurred in many intensive care units across Canada.</p>","PeriodicalId":47053,"journal":{"name":"Journal of the Canadian Academy of Child and Adolescent Psychiatry","volume":"33 1","pages":"3-17"},"PeriodicalIF":2.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10914150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140050608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community, Perspectives, and Recommendations (COPAR).","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":47053,"journal":{"name":"Journal of the Canadian Academy of Child and Adolescent Psychiatry","volume":"33 1","pages":"70-72"},"PeriodicalIF":2.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10914153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140050609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}