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

{"title":"Evidence-based guidelines for anxiety, depression, obsessive-compulsive disorder and Tourette syndrome in children and youth: A rapid review.","authors":"T Pringsheim, L A Gaudet, J Pillay, L Hartling, J Fletcher, G Wilcox, S Patten, D Martino","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>In response to the increasing need for mental health services in Canadian children and youth, the Canadian Institutes of Health Research launched funding towards developing pan-Canadian standards for children and youth mental health services.</p><p><strong>Objective: </strong>The objective of this rapid review is to synthesize current evidence-based recommendations on assessment and treatment for children and youth with anxiety, depression, obsessive-compulsive disorder (OCD) and Tourette syndrome (TS).</p><p><strong>Methods: </strong>This rapid review was developed and conducted using the STARR decision tool and the Cochrane organization's minimum standards. We included evidence-based guidelines providing recommendations for and comparative studies evaluating the effectiveness of implementation of evidence-based guideline recommendations on assessment and/or treatment of anxiety, depression, OCD, or TS in children and youth compared to usual care.</p><p><strong>Results: </strong>Twenty guidelines and one study of the effectiveness of treatment approximating guideline standards were included in this review. There was reasonable consistency in recommendations between guidelines, especially for the management of anxiety disorders and TS, where psychological therapies were recommended as first line. For depression, some minor differences were noted in recommendations for the management of moderate to severe depression, with psychological therapies or SSRIs recommended as first-line in the some guidelines, whereas other guidelines prioritized psychological therapies.</p><p><strong>Conclusion: </strong>Current evidence-based guidelines prioritize psychological therapies for children and adolescents with anxiety, depression, OCD, or TS. If adequate and equitable service provision is a priority for decision makers, it is essential for the healthcare system to fund appropriately trained mental health therapists to deliver these interventions.</p>","PeriodicalId":47053,"journal":{"name":"Journal of the Canadian Academy of Child and Adolescent Psychiatry","volume":"33 3","pages":"171-205"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630341","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":"Olanzapine use for the treatment of adolescents with anorexia nervosa - reflecting on research and clinical practice.","authors":"Wendy Spettigue, Mark L Norris","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Anorexia nervosa is a complex and potentially devastating mental health (MH) diagnosis that is recognized as having high rates of non-response to treatment, pronounced medical as well as MH morbidity, and elevated mortality rates. Olanzapine is a second-generation atypical antipsychotic that has demonstrated benefit with weight gain in adults with anorexia nervosa (AN), although controlled research involving children and youth remains limited. In this commentary, the authors provide a brief history and review of research relating to olanzapine for the adjunctive treatment of children and adolescents with AN. Although the medication has been used for more than two decades, its mechanism of action remains incompletely understood and is likely multifactorial. Despite a paucity of research to guide clinical decision making, olanzapine prescription among youth with moderate to severe AN appears to be prevalent among eating disorder specialists in Canada. In addition to commenting on gaps and challenges related to controlled randomized research in this area, the authors reflect on factors likely contributing to olanzapine's adoption into clinical practice. Moving forward, it is critical that further research involving olanzapine for the adjunctive treatment of AN in youth be undertaken to better understand efficacy, appropriate indications for use, and safety profile.</p>","PeriodicalId":47053,"journal":{"name":"Journal of the Canadian Academy of Child and Adolescent Psychiatry","volume":"33 3","pages":"164-170"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628631","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":"Investigating the association between generalized anxiety symptoms and social and communication impairments of autistic youth.","authors":"Lilly Zepp, Evdokia Anagnostou, Jessica Jones, Rob Nicolson, Stelios Georgiades, Sabrina Lutchmeah, Elizabeth Kelley","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Past research has found that overall anxiety and social anxiety symptoms are associated with the occurrence of social and communication challenges within autistic populations.</p><p><strong>Objective: </strong>The aim of this study was to determine whether generalized anxiety disorder symptoms were associated with social and communication symptoms in autistic youth.</p><p><strong>Method: </strong>The cross-sectional sample was comprised of 253 autistic youth aged 8-18 (196 Males, 57 Females). Participants were divided in a child (Grade 3-8) group and an adolescent (Grade 9-12) group. A hierarchical linear regression analysis was conducted to evaluate whether the generalized anxiety score predicted the social communication composite score, derived from the ADOS-2, after controlling for sex, grade level and expressive language ability.</p><p><strong>Results: </strong>Correlation analyses showed an association between social communication ability and general anxiety disorder symptoms in the child group such that those with greater anxiety had fewer social communication symptoms. However, after controlling for sex, grade, and language ability, general anxiety disorder symptoms did not predict social communication difficulties in either children or adolescents.</p><p><strong>Conclusions: </strong>Alongside past literature, these findings suggest that the different types of anxiety disorders may have differential impacts on autistic youth's social and communication symptoms. Further research should investigate whether other anxiety subtypes affect autistic youth's social and communication symptoms.</p>","PeriodicalId":47053,"journal":{"name":"Journal of the Canadian Academy of Child and Adolescent Psychiatry","volume":"33 3","pages":"206-214"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628507","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":"Practice guidelines in child and adolescent mental health.","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 3","pages":"160-161"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628847","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":"An environmental scan of mental health services for indigenous youth in Canada.","authors":"Sofia Hempelmann Perez, Isabella Kakish, Gregory Brass, Kathleen MacDonald, Chris Mushquash, Srividya N Iyer","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>There is an urgent need for culturally and contextually relevant mental health support for First Nations, Inuit and Métis youth.</p><p><strong>Objective: </strong>Our aim was to identify mental health and wellness services that are currently available to Indigenous youth across Canada.</p><p><strong>Methodology: </strong>As a first step, we conducted a web-based environmental scan of services tailored to Indigenous youth. Specific factors were examined for each program, including organization type and mission, types of services, and who provides services.</p><p><strong>Results: </strong>One hundred and seventeen programs were found, with 54% being non-profits and 34% being on-reserve. Four core features were identified. The first was a strengths-based focus, rather than a pathology/deficit-focus, in programs' vision and mission statements, reflected in words like wellness and resilience. The second (87% of included programs) was the integration of mental health services with a range of other services and supports (e.g., health, employment, housing). The third was the provision of land-based programming (in 34% of programs) such as camps or hunting. Such programs were framed as promoting wellness and healing and strengthening identity. The fourth was the role of community members without formal mental health professional training (in 42% of programs), for example, as youth workers or knowledge keepers. This stems not only from the dearth of specialists in many Indigenous settings, but also a valuing of Indigenous knowledge.</p><p><strong>Conclusion: </strong>These core features in mental health services for Indigenous youth may be promising avenues for communities seeking to strengthen the services they offer to First Nations, Inuit and Métis youth.</p>","PeriodicalId":47053,"journal":{"name":"Journal of the Canadian Academy of Child and Adolescent Psychiatry","volume":"33 2","pages":"93-130"},"PeriodicalIF":2.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11201723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141477662","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":"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}