Internet Gaming Disorder and Mental Health of Children in China:A Latent Profile Analysis

In recent years,speculation of an increase in Internet Gaming Disorder(IGD)has surfaced with the growing popularity of internet gaming among Chinese children and adolescents.The detrimental impact of IGD on mental health cannot be denied,even though only a small portion of the screen-dependent population exhibits psychopathological and behavioral symptoms.The present study aimed to explore a latent profile analysis(LPA)of Internet Gaming Disorder on the mental health of Chinese school students.The data were collected from a sample of 1005 Chinese school students(49.8%male;age M=13.32,SD=1.34 years)using a paper-pencil survey through convenience sampling.LPA explored three latent profiles of internet gamers:regular gamers(62.4%),moderate gamers(28.1%),and probable disordered gamers(9.4%).Results showed that the probable disordered gamers had significantly higher levels of depression,anxiety,emotional and conduct problems,hyperactivity,and peer problem symptoms as well as lower life satisfaction,and pro-social symptoms compared to regular and moderate gamers(p<0.05).This study would be helpful to mental health professionals in designing interventions for gamers who present IGD symptoms.Future longitudinal studies should also be undertaken to assess whether mental health worsens for probable disordered gamers.

An Intervention Study of Language Cognition and Emotional Speech Community Method for Children’s Speech Disorders

Speech disorders are a common type of childhood disease.Through experimental intervention,this study aims to improve the vocabulary comprehension levels and language ability of children with speech disorders through the language cognition and emotional speech community method.We also conduct a statistical analysis of the inter-ventional effect.Among children with speech disorders in Dongguan City,224 were selected and grouped accord-ing to their receptive language ability and IQ.The 112 children in the experimental group(EG)received speech therapy with language cognitive and emotional speech community,while the 112 children in the control group(CG)only received conventional treatment.After six months of experimental intervention,the Peabody Picture Vocabulary Test-Revised(PPVT-R)was used to test the language ability of the two groups.Overall,we employed a quantitative approach to obtain numerical values,examine the variables identified,and test hypotheses.Further-more,we used descriptive statistics to explore the research questions related to the study and statistically describe the overall distribution of the demographic variables.The statistical t-test was used to analyze the data.The data shows that after intervention through language cognition and emotional speech community therapy,the PPVT-R score of the EG was significantly higher than that of the CG.Therefore,we conclude that there is a significant difference in language ability between the EG and CG after the therapy.Although both groups improved,the post-therapy language level of EG is significantly higher than that of CG.The total effective rate in EG is higher than CG,and the difference is statistically significant(p<0.05).Therefore,we conclude that the language cogni-tion and emotional speech community method is effective as an interventional treatment of children’s speech dis-orders and that it is more effective than traditional treatment methods.

Epidemiology of functional gastrointestinal disorders in children and adolescents: A systematic review

To assess the prevalence of functional gastrointestinal disorders (FGIDs) in children and adolescents.METHODSPubMed, EMBASE, and Scopus databases were searched for original articles from inception to September 2016. The literature search was made in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. For inclusion, each study had to report epidemiological data on FGIDs in children between 4 and 18 years old and contain standardized outcome based on Rome II, III or IV criteria. The overall quality of included epidemiological studies was evaluated in accordance with Loney’s proposal for prevalence studies of health literature. Two reviewers assessed each study for data inclusion and extraction. Discrepancies were reconciled through discussion with seniors.RESULTSA total of 659 articles were identified from the databases and 16 through manual search. A total of 43 articles fulfilled the eligibility criteria for full-text reading, with 26 remaining to be included in the final analysis. All studies were written in English and published between 2005 and 2016. Eight (30.8%) articles were performed in North America, five (19.2%) in Latin America, five (19.2%) in Europe, seven (27%) in Asia, and one (3.8%) in Africa. Sample size varied between 114 and 99416 subjects, totaling 132600 individuals. Fourteen (53.9%) studies recruited their target samples from schools, 11 (42.3%) from healthcare settings and the remaining one (3.8%) from online panel community. The overall FGID prevalence rates for student samples ranged from 9.9% to 29% to as high as 87% in clinical samples. Cyclic vomiting, irritable bowel syndrome and functional constipation were the most researched conditions, with a prevalence ranging from 0.2% to 6.2%, 0% to 45.1% and 0.5% to 86.9%, respectively. The qualitative appraisal revealed that most of the studies showed average or below average generalizability.CONCLUSIONThe heterogeneity of the studies on FGIDs must be improved in order to allow comparison. Improvements should include appropriate sampling of representative population, comparable study setting, and consistent data collection.

Central choroidal thickness in children and adolescents with anxiety disorders:enhanced depth imaging optical coherence tomography findings

AIM:To measure the central choroidal thickness(ChT)in children and adolescents with anxiety disorders.METHODS:Totally 41 anxiety patients(8-16 y)and 35 healthy controls(age-matched)were evaluated.Complete ophthalmic examination was performed.Inclusion criteria were best corrected visual acuity≥20/20,normal intraocular pressure(IOP;10-21 mm Hg),and no systemic or ocular diseases according to history.The diagnosis of psychiatric disorders was determined using Schedule for Affective Disorders and Schizophrenia for School Aged Children Present-Lifetime Version(K-SADS-PL).Enhanced depth imaging optical coherence tomography(EDI-OCT)was used to measure the central ChT.RESULTS:The mean age was 12.18±3.24 y in the patient group and 12.86±3.15 y in the control group.Age and gender distribution of the two groups was similar.Central ChT mean value was 353.26±31.9μm in anxiety patients while 318.75±60.9μm in the control group.Mean central ChT was statistically significantly higher in the children and adolescents with anxiety disorders than healthy controls(P=0.002).CONCLUSION:The children and adolescents with anxiety disorders have significantly thicker central ChT than controls.In the larger sample,longitudinal studies will contribute to the use of choroidal differences as a clinical marker for monitoring anxiety disorders.

Management of sleep disorders among children and adolescents with neurodevelopmental disorders: A practical guide for clinicians

There is a complex relationship between sleep disorders and childhood neurodevelopmental,emotional,behavioral and intellectual disorders(NDEBID).NDEBID include several conditions such as attention deficit/hyperactivity disorder,autism spectrum disorder,cerebral palsy,epilepsy and learning(intellectual)disorders.Up to 75%of children and young people(CYP)with NDEBID are known to experience different types of insomnia,compared to 3%to 36%in normally developing population.Sleep disorders affect 15%to 19%of adolescents with no disability,in comparison with 26%to 36%among CYP with moderate learning disability(LD)and 44%among those with severe LD.Chronic sleep deprivation is associated with significant risks of behavioural problems,impaired cognitive development and learning abilities,poor memory,mood disorders and school problems.It also increases the risk of other health outcomes,such as obesity and metabolic consequences,significantly impacting on the wellbeing of other family members.This narrative review of the extant literature provides a brief overview of sleep physiology,aetiology,classification and prevalence of sleep disorders among CYP with NDEBIDs.It outlines various strategies for the management,including parenting training/psychoeducation,use of cognitive-behavioral strategies and pharmacotherapy.Practical management including assessment,investigations,care plan formulation and follow-up are outlined in a flow chart.

Socio-Demographic,Biopsychosocial and Lifestyle Behaviors Related with Eating Disorders of Children and Adolescents of Costa Rica

The objective of the study was to evaluate the association of sociodemographic, biopsychosocial and lifestyle behaviors (diet, sedentarism and physical activity) with eating disorders (ED) in a national sample of Costa Rican children and adolescents. This was a cross-sectional and descriptive study. A total of 2667 students of elementary, middle and high school from sixty-four educative centers (40 schools and 24 high schools) of Costa Rica participated in the study. The predictive factors associated with ED are: body image dissatisfaction (β = 0.367;p β = 0.131;p β = 0.109;p 0.001), intentionally hurt or harm itself (β = 0.074;p β = 0.053;p β = 0.052;p β = 0.051;p β = -0.071;p β = -0.068;p = 0.010) and the age (β = -0.064;p = 0.001) are not related with the development of ED. Psychosocial factors (body image dissatisfaction and intentionally self-injure) had the greatest influence (near 27%) of the global variance of the regression model that explained the association with ED. Programs should be promoted to monitor children and adolescents with excess weight, as well as, the coexistence of erroneous weight and body image perceptions in these population. This could protect against the development of ED in children and adolescents. Evidence-Based Medicine: Level V of evidence (descriptive study).

Review of the genetic basis of emotion dysregulation in children and adolescents

Previous evidence suggests that emotion dysregulation may have different biological correlates between adults and children/adolescents. Although the role of genetic factors has been extensively studied in adult-onset emotion dysregulation, the genetic basis for pediatriconset emotion dysregulation remains elusive. The current review article presents a summary of previous studies that have suggested a few genetic variants associated with pediatric emotion dysregulation. Among these candidate loci, many prior studies have been focused on serotonin transporter promoter gene polymorphism 5-HTTLPR. Certain alleles of the 5-HTTLPR gene polymorphism have been found to be associated with traits associated with emotion dysregulation, such as aggression, affect reactivity, and insecure attachment. Additionally, genetic variants involving dopamine and neurophysiological biomarkers like the COMT Val158Met(rs460) and dopamine receptor D2/ ankyrin repeat and kinase domain containing one polymorphisms may play a role in emotion dysregulation. Inconsistent findings have been noted, possibly due to the heterogeneity in study designs and characteristics of different populations. Further research on the role of genetic predetermination of emotion dysregulation in children and adolescents is warranted.

Classification,prevalence and integrated care for neurodevelopmental and child mental health disorders:A brief overview for paediatricians

‘Neurodevelopmental disorders’comprise a group of congenital or acquired longterm conditions that are attributed to disturbance of the brain and or neuromuscular system and create functional limitations,including autism spectrum disorder,attention deficit/hyperactivity disorder,tic disorder/Tourette’s syndrome,developmental language disorders and intellectual disability.Cerebral palsy and epilepsy are often associated with these conditions within the broader framework of paediatric neurodisability.Co-occurrence with each other and with other mental health disorders including anxiety and mood disorders and behavioural disturbance is often the norm.Together these are referred to as neurodevelopmental,emotional,behavioural,and intellectual disorders(NDEBIDs)in this paper.Varying prevalence rates for NDEBID have been reported in developed countries,up to 15%,based on varying methodologies and definitions.NDEBIDs are commonly managed by either child health paediatricians or child/adolescent mental health(CAMH)professionals,working within multidisciplinary teams alongside social care,education,allied healthcare practitioners and voluntary sector.Fragmented services are common problems for children and young people with multi-morbidity,and often complicated by subthreshold diagnoses.Despite repeated reviews,limited consensus among clinicians about classification of the various NDEBIDs may hamper service improvement based upon research.The recently developed“Mental,Behavioural and Neurodevelopmental disorder”chapter of the International Classification of Diseases-11 offers a way forward.In this narrative review we search the extant literature and discussed a brief overview of the aetiology and prevalence of NDEBID,enumerate common problems associated with current classification systems and provide recommendations for a more integrated approach to the nosology and clinical care of these related conditions.

Motor abilities of children and adolescents with a psychiatric condition:A systematic literature review

AIM: To summarize research regarding the motor abilities of children and adolescents who suffer from a common psychiatric condition.METHODS: In order to outline the current knowledge regarding the motor abilities of children and adolescents with autism spectrum disorders(ASD), attention deficit hyperactivity disorder(ADHD), disruptive behavior disorders(DBD) and depression, a comprehensive systematic literature search was carried out using Pub Med, Medline and ERIC databases. The databases were searched for relevant English language articles published between January 1990 and April 2014. Only studies that conducted a quantitative evaluation of motor ability and concerned individuals aged 0-18 years were included. A separate search was conducted for each disorder(ASD, ADHD, DBD, depression) in conjunction with each of the following keywords:(psycho/perceptuo) motor/movement skill(s),(psycho/perceptuo) motor/movement abilities,(psycho/perceptuo) motor/movement impairment,(psycho/perceptuo) motor/movement problem(s), motor function, motor coordination, motor performance, motor deficit(s). To detect supplementary relevant literature, the reference lists of the retrieved articles were examined. RESULTS: The search strategy yielded 51 studies meeting the inclusion criteria. In total, 28 studies were included that examined the motor abilities of children and adolescents with ASD. All studies indicated that they performed below average on various standardized motor assessment instruments. The overall prevalence rate for impairment in motor abilities ranged from 33% to 100%. Twenty-seven studies examined the motor abilities of children and adolescents with ADHD. Depending on the type of motor assessment tool and the cut-off points used by different researchers, prevalence rates of impairment in motor abilities are highly variable and ranged from 8% to 73%. Remarkably, there is a paucity of research addressing the motor abilities of individuals with DBD or depression. Furthermore, methodological problems, such as measurement and comorbidity issues, complicate the generalization of the findings. CONCLUSION: Research suggests that motor impairment is highly prevalent in some psychiatric conditions, particularly ASD and ADHD. However, future work is necessary to draw sound conclusions.

Review of barriers and interventions to promote treatment engagement for pediatric attention deficit hyperactivity disorder care

Attention deficit hyperactivity disorder(ADHD)is a common and impairing behavioral health disorder,impacting over 5%of children worldwide.There are multiple evidence-based pharmacological and psychosocial treatments for ADHD,and greater service utilization is associated with improved acute and long-term outcomes.However,long-term outcomes are suboptimal as multimodal treatments are often not accessed and most care ends prematurely.This narrative review discusses barriers to engagement for children and adolescents with ADHD and their families as well as interventions to overcome these barriers.Families face a variety of structural and attitudinal barriers,ranging from cost and access to stigma and low self-efficacy to successfully implement change.There are multiple interventions that may enhance engagement with ADHD care including psychoeducation,integration of behavioral services in general medical settings,telehealth as well as specific adaptations to existing ADHD treatments,such as the use of motivational interviewing or shared decision making.Integration of behavioral health into general medical settings and telehealth have been found in controlled studies to increase access by reducing both structural and attitudinal barriers.Adding motivational interviewing,shared decision making and other engagement interventions to evidence-based ADHD treatments has been found to reduce attitudinal barriers that translates into improved participation and satisfaction while enhancing outcomes.However,little is known about how to promote extended engagement with ADHD services even though a chronic care model for ADHD is recommended.

Review of the effects of SARS-CoV2 infection and COVID-19 on common pediatric psychiatric illnesses

Severe acute respiratory syndrome coronavirus-2 is a novel coronavirus strain that causes pneumonia and acute respiratory distress syndrome along with other morbidities,collectively known as coronavirus disease 2019(COVID-19)disease.There has been widespread discussion about the psychological impact of COVID-19 particularly on children and adolescents.There have been overarching negative effects with regards to decreased physical activity,more screen time,increasingly unhealthy diets,and irregularities in sleep/wake schedules.This,coupled with disruptions in ongoing mental health treatment and associated support structures,has caused unprecedented declines in the emotional and psychosocial wellbeing of children and adolescents.This review aims to systematically review the literature to provide a general overview of the ways in which COVID-19 has affected common psychiatric illnesses in children and adolescents.The included articles in all subsections concluded that symptoms of these common childhood psychiatric disorders have generally been exacerbated by the COVID-19 pandemic.This review indicates that quarantine and the consequent isolation have had multiple significant and consistent negative implications on the mental health of children and adolescents.Our study indicates that there should be increased vigilance among providers and families to mitigate the negative psychological effects that the COVID-19 pandemic has on children with common childhood psychiatric disorders.

Threat perception predicts cognitive behavioral therapy outcomes in anxious children

Objective: Anxiety disorders of childhood are prevalent, debilitating conditions that do not always respond to existing treatments. Attentional biases towards threatening stimuli have been reported in anxious children and hypothesized to interfere with treatment response. Therefore, we examined such biases in children with anxiety disorders in relation to cognitive behavioral therapy (CBT) outcomes. Method: Thirty-eight children diagnosed with anxiety disorders in a specialized clinic (21 girls and 17 boys;age = 10.50 ± 1.11 years) and 36 unaffected community controls (19 girls and 17 boys;age = 10.20 ± 1.07 years) participated. Participants completed standardized questionnaire measures of anxiety and a probe position task (PPT) with facial cues. This task often reveals a response slowing effect related to threatening faces in vulnerable individuals. Children with anxiety disorders repeated these measures after completing CBT. Results: Groups did not differ in performance on the PPT, but angry/calm incongruent difference scores were significantly associated with self-reports of social anxiety and state anxiety. When controlling for pre-CBT anxiety levels, incongruent difference scores involving angry faces predicted post-CBT anxiety disorders index scores on the Multidimensional Anxiety Scale for Children. PPT scores did not change significantly with CBT. Conclusions: Attentional bias towards threat on the PPT task may predict response to CBT and appears linked to social anxiety. Interventions to ameliorate this bias merit further study, as they might improve treatment outcomes for anxious, especially socially anxious, children.

MDT模式在门诊情绪障碍患儿中的应用

目的 探讨多学科协作诊疗(multidisciplinary diagnosis and treatment, MDT)模式在儿童门诊情绪障碍患儿中的应用效果。方法 在MDT模式下,收集2021年6月至2022年12月门诊就诊的32例情绪障碍患儿作为观察组,遵从患者意愿将常规模式下2020年11月至2021年5月门诊就诊的68例患儿作为对照组。比较2组人均诊断、检查、缴费、门诊停留时间,并对痊愈率、满意度、重复事件发生率进行比较。结果 观察组患儿人均诊断、检查、缴费、门诊停留时间较对照组明显缩短,差异有统计学意义(P<0.001);重复事件发生率明显低于对照组,差异有统计学意义(χ^(2)=12.337,P=0.001);痊愈率明显高于对照组,效果不明显率低于对照组,差异有统计学意义(χ^(2)=7.449,P=0.014);就诊满意度明显高于对照组,差异有统计学意义(χ^(2)=11.313,P=0.01)。结论 MDT模式简化了儿童门诊情绪障碍患儿就诊流程,降低了就诊过程中重复就诊、门诊误诊、漏诊发生率,可明显提高就诊效率、患者满意度和就诊依从性,有利于情绪障碍患儿的早发现、早诊断、早治疗,能够避免此类患儿因漏诊延误治疗带来的伤害。

儿童青少年精神障碍患者家长自杀倾向及危险因素分析

目的探讨儿童青少年精神障碍患者家长自杀倾向及其危险因素,并构建自杀倾向的预测模型。方法采用横断面调查的方法,收集2022年8月至2023年7月就诊于安徽省内两所医院共299名儿童青少年精神障碍家长的社会人口学资料,并采用自杀相关的标准化问题、患者健康问卷-9(PHQ-9)以及多伦多述情障碍量表(TAS-20)分别评估调查对象自杀倾向、抑郁症状及述情障碍的程度。结果自杀倾向的总体检出率为15.4%,其中自杀意念、自杀计划和自杀未遂检出率分别为11.0%、3.3%和8.0%。Logistic回归分析结果显示,躯体疾病史、抑郁症状、述情障碍以及情感辨别不能因子与较高的自杀倾向风险有关(均P<0.05)。基于回归分析结果,构建预测患儿家长自杀倾向风险预测模型,并绘制受试者工作特征(ROC)曲线下面积(AUC)为0.80(95%CI:0.72~0.87,P<0.05)。结论儿童青少年精神障碍患者家长自杀倾向检出率较高,提示临床上在注重青少年精神障碍患者的同时,亦不能忽视患儿家长的心理健康,应加强对患儿和家长的护理,必要时应提供个体化的综合干预措施。

屏幕暴露与学龄前孤独症谱系障碍儿童情绪行为问题相关性研究

背景既往已有多项研究证实屏幕暴露现象在学龄前儿童中普遍存在,并且与儿童情绪行为问题相关,现有研究多集中在正常学龄前儿童,有关屏幕暴露与学龄前孤独症谱系障碍(ASD)儿童情绪行为问题相关的研究较为罕见。目的 调查学龄前ASD儿童屏幕暴露情况及情绪行为问题异常检出情况,探究屏幕暴露与学龄前ASD儿童情绪行为问题有无相关。方法 选择2022年2—8月在郑州大学第三附属医院儿童发育行为科就诊的符合《精神障碍诊断和统计手册》(DSM-V)孤独症诊断标准的ASD学龄前儿童为ASD组,同期选取郑州市某幼儿园正常发育儿童为对照组。由两组儿童主要照护人进行填写屏幕暴露问卷及长处与困难问卷(家长版)。结果 两组儿童屏幕接触时间、家长对屏幕管理、“屏幕剥夺”反应比较,差异无统计学意义(P<0.001);ASD组儿童亲社会行为、困难总分及各个分维度(情绪症状、品行问题、多动/注意缺陷问题、同伴交往问题)异常检出率均高于对照组(P<0.001);Logistic回归分析发现电子设备放置在睡觉或玩耍空间、观看时照护人是否互动讲解、照护人对孩子观看电子屏幕态度、接触电子屏幕是主动要求还是被动参与、强制关掉电子屏幕孩子反应是学龄前ASD儿童情绪行为问题的影响因素(P<0.05)。结论 屏幕暴露可能对ASD儿童情绪行为问题产生影响,家长应合理管理学龄前ASD儿童屏幕使用。

Cognitive Function of Children and Adolescents with Attention Deficit Hyperactivity Disorder and Learning Difficulties： A Developmental Perspective

Background： The cognitive function of children with either attention deficit hyperactivity disorder （ADHD） or learning disabilities （LDs） is known to be impaired. However, little is known about the cognitive function of children with comorbid ADHD and LD. The present study aimed to explore the cognitive function of children and adolescents with ADH D and learning difficulties in comparison with children with ADHD and healthy controls in different age groups in a large Chinese sample. Methods： Totally, 1043 participants with ADHD and learning difficulties （the ADHD ＋ learning difficulties group）, 870 with pure ADHD （the pure ADHD group）, and 496 healthy controls were recruited. To investigate the difference in cognitive impairment using a developmental approach, all participants were divided into three age groups （6-8, 9-11, and 12-14 years old）. Measurements were the Chinese-Wechsler Intelligence Scale for Children, the Stroop Color-Word Test, the Trail-Making Test, and the Behavior Rating Inventory of Executive Function-Parents （BRIEF）. Multivariate analysis of variance was used. Results： The results showed that after controlling for the effect of ADHD symptoms, the A DHD ＋ learning difficulties group was still significantly worse than the pureADHD group, which was, in turn, worse than the control group on full intelligence quotient （98.66 ± 13.87 vs. 105.17 ± 14.36 vs. 112.93 ± 13.87, P 〈 0.001 ）. The same relationship was also evident for shift function （shifting time of the Trail-Making Test, 122.50 [62.00, 194.25] s vs. 122.00 [73.00, 201.50] s vs. 66.00 [45.00, 108.00] s, P 〈 0.001） and everyday life executive function （BRIEF total score, 145.71 ± 19.35 vs. 138.96± 18.00 vs. 122.71 ± 20.45, P 〈 0.001 ） after controlling for the effect of the severity of ADHD symptoms, intelligence quotient, age, and gender. As for the age groups, the differences among groups became nonsignificant in the 12-14 years old group for inhibition （meaning interference of the Stroop Color-Word Test, 18.00 [13.00, 25.00] s vs. 17.00 [15.00, 26.00] s vs. 17.00 [10.50, 20.00] s, P =0.704） and shift function （shifting time of the Trail-Making Test, 62.00 [43.00, 97.00] s vs. 53.00 [38.00, 81.00] s vs. 101.00 [88.00, 114.00] s, P = 0.778）. Conclusions： Children and adolescents with ADHD and learning difficulties have more severe cognitive impairment than pure ADHD patients even after controlling for the effect of ADHD symptoms. However, the differences in impairment in inhibition and shift function are no longer significant when these individuals were 12-14 years old.

孤独症谱系障碍和精神分裂症青少年的面部表情识别能力

目的:探讨孤独症谱系障碍、精神分裂症青少年的面部表情识别能力特点。方法:入组12~18岁孤独症谱系障碍患者77例、精神分裂症患者67例及年龄相匹配的正常发育青少年68例,完成面部表情识别任务测查。结果:孤独症谱系障碍组基础面部表情识别任务总分低于精神分裂症组及正常发育组(Ps<0.05),精神分裂症组和正常发育组间无统计学差异(P>0.05);孤独症谱系障碍组和精神分裂症组间复杂表情识别任务总分差异无统计学意义(P>0.05),但两组均低于正常对照组(均P<0.001)。结论:孤独症谱系障碍和精神分裂症青少年均存在面部表情识别缺陷,孤独症谱系障碍表现为基础和复杂面部表情识别缺陷,而精神分裂症表现为复杂面部表情识别缺陷。

精神科医师对MECT应用于儿童与青少年精神障碍患者的认知情况调查

目的调查精神科医师对无抽搐电休克治疗(MECT)应用于儿童与青少年精神障碍患者的认知情况。方法采用一般资料调查表、MECT的基本知识和经验调查问卷、对儿童与青少年精神障碍患者应用MECT的经验和知识调查问卷、对儿童与青少年患者应用MECT疗效和不良反应认知情况调查问卷、对儿童与青少年精神障碍患者应用MECT态度调查问卷调查中原地区63家医院的138名精神科医师对MECT应用儿童与青少年精神障碍患者的认知情况。结果不同级别医院精神科医师在有MECT相关基本知识方面,未给所管理的患者做过MECT应用、如何评估自己对于患者应用MECT的知识方面,MECT对患者记忆力有无长期不良影响、MECT对患者注意力和专注力有无长期不良影响的认知方面,具有严重精神障碍的青少年(13~17岁)使用MECT方面的比较,差异均有统计学意义(P<0.05或0.01)。结论不同级别医院精神科医师对MECT应用于儿童与青少年精神障碍患者的认知和使用方面,均存在差异,有必要建立区域性或全国性MECT数据中心,制定MECT指南,为儿童与青少年精神障碍的治疗提供指导。

叙事暴露疗法在儿童和青少年创伤后应激障碍患者中应用效果的Meta分析

背景叙事暴露疗法(NET)结合叙事疗法和暴露疗法的优点,对缓解创伤后应激障碍(PTSD)症状有效,有助于患者对创伤进行深入的认识,也具有较好的安全性。儿童和青少年是PTSD的高发人群,但NET对该人群干预效果的研究结果存在差异。目的系统评价NET对儿童和青少年PTSD患者的干预效果,为NET的临床应用提供参考。方法于2022年8月1日,计算机检索Cochrane Library、PubMed、Web of Science、CINAHL、中国知网(CNKI)、中国生物医学文献数据库(SinoMed)、维普数据库和万方数据库,检索时限为建库至2022年6月。采用主题词与自由词相结合的方式进行检索,收集NET治疗儿童和青少年PTSD的文献。根据Cochrane协作网更新的偏倚风险评估手册中对随机对照试验的真实性评价标准(2011),评价文献质量。采用RevMan 5.4对纳入的随机对照试验进行Meta分析。结果纳入9篇文献,共包括394例儿童和青少年PTSD患者。Meta分析结果显示,在PTSD症状缓解程度方面,干预后1~3个月(SMD=0.22,95%CI:-0.84~1.28)以及干预后6个月(SMD=0.21,95%CI:-0.75~1.17),NET与放松疗法的效果比较,差异无统计学意义;干预后1~3个月(SMD=-0.66,95%CI:-1.04~-0.27)以及干预后6个月(SMD=-0.77,95%CI:-1.36~-0.19),NET的效果均优于常规治疗,差异均有统计学意义。在抑郁症状缓解程度方面,治疗后1~3个月,NET与常规治疗的效果比较,差异无统计学意义(SMD=-0.39,95%CI:-0.98~0.21);干预后6个月,NET与常规治疗的效果比较,差异无统计学意义(SMD=-0.74,95%CI:-2.23~0.75)。在心理困扰缓解程度方面,干预后1~3个月,NET与常规治疗的效果比较,差异无统计学意义(SMD=-0.54,95%CI:-2.14~1.07)。在食欲亢进缓解程度方面,NET与常规治疗的效果比较,差异无统计学意义(SMD=-0.17,95%CI:-0.54~0.19)。结论与常规治疗相比,NET对缓解儿童和青少年PTSD症状的效果更佳,且具有中长期效果,但在改善抑郁症状、心理困扰以及食欲亢进方面无明显优势。

儿童青少年精神障碍照料者负担现状及影响因素研究进展

对儿童青少年精神障碍照料者负担现状、影响因素进行综述,以期为我国儿童青少年精神障碍照料者负担的相关因素及干预措施研究提供方向。